FAC Explorer

Audit 361694

FY End
2024-12-31
Total Expended
$4.25M
Findings
10
Programs
6
Organization: Maple City Health Care Center, Inc. (IN)
Year: 2024 Accepted: 2025-07-08
Auditor: Kruggel Lawton and Company LLC

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
570673 2024-001 Significant Deficiency - N
570674 2024-001 Significant Deficiency - N
570675 2024-001 Significant Deficiency - N
570676 2024-002 Material Weakness - I
570677 2024-003 - - I
1147115 2024-001 Significant Deficiency - N
1147116 2024-001 Significant Deficiency - N
1147117 2024-001 Significant Deficiency - N
1147118 2024-002 Material Weakness - I
1147119 2024-003 - - I

Programs

ALN Program Spent Major Findings
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $243,025 Yes 1
93.526 Grants for Capital Development in Health Centers $229,684 Yes 2
21.027 Coronavirus State and Local Fiscal Recovery Funds $41,319 - 0
93.527 Grants for New and Expanded Services Under the Health Center Program $30,783 Yes 1
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $19,281 - 0
14.218 Community Development Block Grants/entitlement Grants $5,325 - 0

Contacts

Name Title Type
LL2XTE6MNGN9 Karen Miller Rush Auditee
5745343300 Allison James Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, wherein certain types of expenditures are not allocable or are limited as to reimbursement. The Organization has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The Organization has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance The accompanying Schedule of Expenditures of Federal Awards ("Schedule") includes the federal award activity of Maple City Health Care Center, Inc. d/b/a Vista Community Health Center, Northside Community Health Center, and Maple City Dental  the "Organization") under programs of the federal government for the year ended December 31, 2024. The information in this Schedule 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 the Organization, it is not intended to and does not present the  financial position, changes in net assets, functional expenses, or cash flows of the Organization.
Title: Summary of Significant Accounting Policies Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, wherein certain types of expenditures are not allocable or are limited as to reimbursement. The Organization has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The Organization has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, wherein certain types of expenditures are not allocable or are limited as to reimbursement. The Organization has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance.

Finding Details

Finding 2024-001
SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.
Finding 2024-001
SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.
Finding 2024-001
SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.
Finding 2024-002
PROCUREMENT, SUSPENSION & DEBARMENT Federal Agency: Department of Health and Human Services Federal Program or Cluster: Grants for Capital Development in Health Centers Assistance Listing Number: 93.526 Federal Award Numbers and Years Award Period: 9/15/21-8/31/25 - 4 C8ECS44755-01-07 Questioned Costs $0 Condition: The Organization did not follow its internal procurement policy or the guidelines for procurement in the Uniform Guidance. The Organization did not solicit the correct number of bids to align with its internal policy, nor did it document the adequacy of the number it did procure to align with federal guidelines for a small threshold project. The Organization selected a vendor it had worked with previously and did not document criteria for selecting this vendor rather than requesting multiple bids. Criteria: 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls, policies and procedures in place designed to ensure compliance with these provisions. Cause: The Organization has not updated its internal processes and procedures related to procurement, suspension and debarment for several years. The dollar amounts included in the policy are out of date. However if this policy would have been followed, the Organization would have been in compliance with current laws and regulations regarding purchases and procurement requirements as the thresholds were less than those allowed under the Uniform Guidance. Effect: The Organization could pay more than necessary for comparative services and goods. Recommendation: We recommend the Organization review, update, and follow its procurement policy to ensure compliance with the Uniform Guidance. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding. Management will review its existing procurement policy and update as necessary. Staff involved in projects and procurements will receive training regarding the policy and federal guidelines for federally funded projects. Management will ensure staff adhere to the policy prospectively.
Finding 2024-003
PROCUREMENT, SUSPENSION & DEBARMENT Federal Agency: Department of Health and Human Services Federal Program or Cluster: Grants for Capital Development in Health Centers Assistance Listing Number: 93.526 Federal Award Numbers and Years Award Period: 9/15/21-8/31/25 - 4 C8ECS44755-01-07 Questioned Costs $0 Condition: The Organization did not comply with the Davis-Bacon prevailing wage requirement. Criteria: CFR 45 requires all prime construction contracts in excess of $2,000 awarded by non-Federal entities to include a provision for compliance with the Davis- Bacon Act as supplemented by Department of Labor regulations. In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. Contractors must also submit certified payroll records to demonstrate compliance. Cause: The Organization did not follow its internal policy for procurement and suspension and debarment. Effect: The Organization could have paid wages at rates other than those required by law. Recommendation: We recommend that grant staff and management review award contracts and related grant guidance and follow documented internal procedures to ensure applicable compliance requirements are identified and implemented. Identification of repeat findings: This is not a repeat finding.View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding. The Director of Finance will prepare a summary document regarding the federal guidelines on procurement, including the requirement that future contractors include contract language complying with the Davis-Bacon Act.
Finding 2024-001
SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.
Finding 2024-001
SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.
Finding 2024-001
SPECIAL TESTS AND PROVISIONS Federal Agency: Department of Health and Human Services Federal Program or Cluster: Health Center Program Cluster Assistance Listing Number: 93.224 Federal Award Numbers and Years Award Period 6/1/23-5/31/24: 5 H80CS24133-12-00 Award Period 6/1/24-5/31/25: 6 H80CS24133-13-02 Questioned Costs $0 Condition: During our testing of applied sliding fee discounts, twenty-five patient encounters were tested. Of those encounters, we identified two encounters that were charged less than the approved nominal fee due to the nominal fee amount not being updated in the electronic medical record ("EMR") system. Criteria: The Organization failed to update the board approved sliding fee schedule in its EMR system, resulting in an incorrect nominal fee being applied to certain income level behavior health encounters. Cause: Employees missed updating and raising this fee when the new sliding scale was approved. Effect: The Organization received a lower fee for services than it could have based on the approved schedule. Recommendation: We recommend the Organization review internal controls over updates to its sliding fee scale each year to ensure it is properly updated. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding, has updated fees in the electronic medical record ("EMR"), made sure that they match approved nominal fees, and will make sure they are in alignment prospectively.
Finding 2024-002
PROCUREMENT, SUSPENSION & DEBARMENT Federal Agency: Department of Health and Human Services Federal Program or Cluster: Grants for Capital Development in Health Centers Assistance Listing Number: 93.526 Federal Award Numbers and Years Award Period: 9/15/21-8/31/25 - 4 C8ECS44755-01-07 Questioned Costs $0 Condition: The Organization did not follow its internal procurement policy or the guidelines for procurement in the Uniform Guidance. The Organization did not solicit the correct number of bids to align with its internal policy, nor did it document the adequacy of the number it did procure to align with federal guidelines for a small threshold project. The Organization selected a vendor it had worked with previously and did not document criteria for selecting this vendor rather than requesting multiple bids. Criteria: 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls, policies and procedures in place designed to ensure compliance with these provisions. Cause: The Organization has not updated its internal processes and procedures related to procurement, suspension and debarment for several years. The dollar amounts included in the policy are out of date. However if this policy would have been followed, the Organization would have been in compliance with current laws and regulations regarding purchases and procurement requirements as the thresholds were less than those allowed under the Uniform Guidance. Effect: The Organization could pay more than necessary for comparative services and goods. Recommendation: We recommend the Organization review, update, and follow its procurement policy to ensure compliance with the Uniform Guidance. Identification of repeat findings: This is not a repeat finding. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding. Management will review its existing procurement policy and update as necessary. Staff involved in projects and procurements will receive training regarding the policy and federal guidelines for federally funded projects. Management will ensure staff adhere to the policy prospectively.
Finding 2024-003
PROCUREMENT, SUSPENSION & DEBARMENT Federal Agency: Department of Health and Human Services Federal Program or Cluster: Grants for Capital Development in Health Centers Assistance Listing Number: 93.526 Federal Award Numbers and Years Award Period: 9/15/21-8/31/25 - 4 C8ECS44755-01-07 Questioned Costs $0 Condition: The Organization did not comply with the Davis-Bacon prevailing wage requirement. Criteria: CFR 45 requires all prime construction contracts in excess of $2,000 awarded by non-Federal entities to include a provision for compliance with the Davis- Bacon Act as supplemented by Department of Labor regulations. In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. Contractors must also submit certified payroll records to demonstrate compliance. Cause: The Organization did not follow its internal policy for procurement and suspension and debarment. Effect: The Organization could have paid wages at rates other than those required by law. Recommendation: We recommend that grant staff and management review award contracts and related grant guidance and follow documented internal procedures to ensure applicable compliance requirements are identified and implemented. Identification of repeat findings: This is not a repeat finding.View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding. The Director of Finance will prepare a summary document regarding the federal guidelines on procurement, including the requirement that future contractors include contract language complying with the Davis-Bacon Act.