Audit 357279

FY End
2024-12-31
Total Expended
$11.71M
Findings
10
Programs
8
Organization: Horizon Health Care, Inc. (SD)
Year: 2024 Accepted: 2025-05-28

Organization Exclusion Status:

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Contacts

Name Title Type
WQNTL7JUEWY7 Wade Erickson Auditee
6057724525 Jeremy Ulmer Auditor
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Notes to SEFA

Title: BASIS OF PRESENTATION Accounting Policies: Expenditures reported in the schedule of expenditures of federal awards (the schedule) are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Organization does not draw for indirect administrative costs and has not elected to use the 10% de minimis cost rate. The schedule includes the federal award activity of Horizon Health Care, Inc. under programs of the federal government for the year ended December 31, 2024. The information is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the schedule presents only a selected portion of the operations of Horizon Health Care, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of Horizon Health Care, Inc.

Finding Details

2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.
2024-001 Noncompliance – Application of SFS Discount Federal Programs – 93.224 & 93.527 Health Center Cluster Criteria – Horizon is required to have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover the reasonable costs of operation. The corresponding schedule of discounts applied and adjusted should be based on a patient’s ability to pay. The patient’s ability to pay is determined based on the official poverty guidelines, as revised by the U.S. Department of Health and Human services. Condition – During our testing of the Sliding Fee Schedule (SFS), we noted Horizon properly had a SFS schedule whereby the basis of the patient’s ability to pay is based upon the patient’s income, using the federal poverty guidelines as a basis for the percentage of the SFS discount. We tested a total of forty patient visits that received SFS adjustment and noted one of those visits tested was not handled in accordance with Horizon’s SFS policies and procedures. Cause – Horizon did not follow policies and procedures set in place to ensure SFS discount is correctly determined and applied to patient accounts. Context – In one of the forty patient files tested, the sliding fee adjustment was improperly calculated and was not later corrected. Effect or Potential Effect – The SFS discount applied is incorrect. Questioned costs – None noted. Repeat Finding – This is not a repeat finding. Recommendation – Management should review policies and procedures regarding the SFS program with staff that is responsible for determining the SFS discount. View of Responsible Officials – Management recognized the deficiency and plans to implement the auditor’s recommendation.