FAC Explorer

Audit 357447

FY End
2023-06-30
Total Expended
$26.52M
Findings
22
Programs
9
Organization: El Dorado County Community Health Center (CA)
Year: 2023 Accepted: 2025-05-29
Auditor: Wipfli LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
561791 2023-002 Significant Deficiency - L
561792 2023-002 Significant Deficiency - L
561793 2023-002 Significant Deficiency - L
561794 2023-002 Significant Deficiency - L
561795 2023-002 Significant Deficiency - L
561796 2023-002 Significant Deficiency - L
561797 2023-003 Significant Deficiency - N
561798 2023-003 Significant Deficiency - N
561799 2023-003 Significant Deficiency - N
561800 2023-003 Significant Deficiency - N
561801 2023-003 Significant Deficiency - N
1138233 2023-002 Significant Deficiency - L
1138234 2023-002 Significant Deficiency - L
1138235 2023-002 Significant Deficiency - L
1138236 2023-002 Significant Deficiency - L
1138237 2023-002 Significant Deficiency - L
1138238 2023-002 Significant Deficiency - L
1138239 2023-003 Significant Deficiency - N
1138240 2023-003 Significant Deficiency - N
1138241 2023-003 Significant Deficiency - N
1138242 2023-003 Significant Deficiency - N
1138243 2023-003 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $18.50M Yes 1
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $650,063 Yes 2
93.788 Opioid Str $603,333 - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $577,746 - 0
93.268 Immunization Cooperative Agreements $423,650 - 0
93.498 Provider Relief Fund $332,387 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $231,220 - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $171,234 Yes 2
93.387 National and State Tobacco Control Program (b) $45,000 - 0

Contacts

Name Title Type
YLLEVAMRNUH5 Judy Stein Auditee
5306217700 Julie Toups Auditor
No contacts on file

Notes to SEFA

Title: Note 1: Basis of Presentation Accounting Policies: Note 2: Summary of Significant Accounting Policies With the exception of expenditures related to the Provider Relief Fund (PRF), expenditures reported on the Schedule are reported on the accruals 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. The PRF is not subject to cost principle requirements contained in the Uniform Guidance. Expenditures reported on the Schedule for PRF are based on the PRF period of availability, terms and conditions of the PRF program, and amounts reported in the PRF portal for the reporting period 4. De Minimis Rate Used: N Rate Explanation: Note 3: Indirect Cost The Organization has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. Note 1: Basis of Presentation The accompanying schedule of expenditures of federal awards (the “Schedule”) includes the federal grant activity of El Dorado County Community Health Center (the “Organization”) under programs of the federal government for the year ended June 30, 2023. The information in the Schedule is presented in accordance with requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the “Uniform Guidance”). Because the Schedule presents only a selected portion of the operations of the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization.
Title: Note 3: Subrecipients Accounting Policies: Note 2: Summary of Significant Accounting Policies With the exception of expenditures related to the Provider Relief Fund (PRF), expenditures reported on the Schedule are reported on the accruals 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. The PRF is not subject to cost principle requirements contained in the Uniform Guidance. Expenditures reported on the Schedule for PRF are based on the PRF period of availability, terms and conditions of the PRF program, and amounts reported in the PRF portal for the reporting period 4. De Minimis Rate Used: N Rate Explanation: Note 3: Indirect Cost The Organization has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. Note 4: Subrecipients The Organization passed no federal awards through to subrecipients.
Title: Note 4: Balance of Outstanding Loans Accounting Policies: Note 2: Summary of Significant Accounting Policies With the exception of expenditures related to the Provider Relief Fund (PRF), expenditures reported on the Schedule are reported on the accruals 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. The PRF is not subject to cost principle requirements contained in the Uniform Guidance. Expenditures reported on the Schedule for PRF are based on the PRF period of availability, terms and conditions of the PRF program, and amounts reported in the PRF portal for the reporting period 4. De Minimis Rate Used: N Rate Explanation: Note 3: Indirect Cost The Organization has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. Note 5: USDA Community Facilities Loan Program The Organization had an outstanding loan with Western Alliance of $18,500,000 and $12,649,577 as of June 30, 2023 and 2022, respectively. The federal expenditures reported on the schedule of expenditures of federal awards includes the beginning balance of $12,649,577 and the draws made during the year which include construction loan funds of $5,850,423. Subsequent to year-end, the construction loan was refinanced with a USDA loan in September 2024.

Finding Details

Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-002
Condition: El Dorado County Community Health Center did not meet its financial reporting obligations under the grant during the year. During the audit, it was determined El Dorado County Community Health Center did not file the annual Federal Financial Report within 90 days of the required reporting end date as well as did not file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria: El Dorado County Community Health Center is required to file the annual Federal Financial Report within 90 days of the required reporting end date and is required to file the SF-SAC within 30 days after receipt of audit or 9 months after year end, whichever is first. Cause: Staffing challenges. Effect: El Dorado County Community Health Center was not in compliance with federal regulations and the Health Center Program grant. Recommendation: We recommend Federal Financial Reports are submitted on a timely basis and recommend audit preparations are completed on a timely basis to ensure that the reporting deadlines are met. View of Responsible Officials Management acknowledges there were significant capacity issues which contributed to the late filing of the Federal Financial Report and the annual audit report. Management has been in contact with HRSA and the Office of Federal Assistance Management Division of Financial Integrity to keep them abreast of our progress.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.
Finding 2023-003
Condition: El Dorado County Community Health Center lacked adequate controls over its sliding fee discount program to ensure applications were properly processed, recorded, and received the correct discount. For one of 40 patient files reviewed who received a sliding fee discount, the patient was not eligible for a sliding fee discount. For one of the 40 patient files reviewed who received a sliding fee discount, the patient’s income was not documented in accordance with the policy before moving forward with determination of sliding fee discount and no supporting documentation regarding the hardship was included on the application. Criteria: El Dorado County Community Health Center must have a policy and processes in place to ensure that eligible patient charges are adjusted based on the patient’s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Cause: El Dorado County Community Health Center did not properly follow the review process in place to verify that eligible patients received the applicable sliding fee discount according to the Organization’s policy. Effect: El Dorado County Community Health Center's sliding fee program was not operating in accordance with the Organization's policies and federal regulations. Recommendation: We recommend El Dorado County Community Health Center review their sliding fee process and provide additional training to individuals regarding the process. In addition, we recommend El Dorado County Community Health Center implement a review process to identify errors that may occur. View of Responsible Officials Management acknowledges this condition related to lack of adequate controls over the sliding fee discount program and is creating controls that will assure compliance with requirements.