Audit 365931

Agency: U.S. Department of Health and Human Services Assistance Listing Number: Health Center Program Cluster: 93.527 and 93.224 Program: Health Center Program Cluster; Grants for New and Expanded Services under the Health Center Program and Health Centers Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care), Federal Award Identification Number H8000593, 2024-2025 Condition: We found one (1) instance where adequate documentation was not maintained to ensure the appropriate amount was charged to a patient based on the sliding fee policy in place. Upon further analysis, there were a total of four (4) instances where appropriate documentation was not maintained relating to fiscal year 2025. Criteria: Uniform Guidance requires the Organization to be in compliance with special tests and provisions. This includes maintaining appropriate documentation of the application and fee determination for every patient utilizing the sliding fee discount. This is a repeat of finding 2024-003 from the prior year. Questioned costs: One error was identified during our testing. Expanded procedures identified that the population impacted were four (4) individuals. The amount of questioned costs cannot be determined. Context: A sample of 40 individuals were selected and tested for compliance with the Organization's sliding fee policy. One (1) known compliance error was found during testing of the 40 individuals. Upon analyzing the entire population, it was determined that a total of four (4) files were not in compliance. Effect: The Organization was not in compliance with the requirements of the federal program due to a scanner malfunction where the application and supporting documentation were not adequately scanned, resulting in a corrupt file. Cause: Management has indicated that the scanner malfunction lead to the noncompliance. Upon the realization of the scanner issue, it was replaced and an analysis was performed for any other patient files that may have been corrupted. Management review of the entire population identified a total of (4) four files that were corrupt relating to fiscal year 2025. Recommendation: We recommend management continue to monitor their processes relating to the Organization's compliance with the sliding fee discount to ensure all appropriate documentation is maintained to support the sliding fee amounts charged to patients. Management's response: Management is in agreement with the above analysis by the auditors. The issue was discovered and corrected with an update to the server and an update to the process to ensure that all scans are reviewed prior to the destruction of the original documents. This was fully resolved prior to the fiscal year end.

Agency: U.S. Department of Health and Human Services Assistance Listing Number: Health Center Program Cluster: 93.527 and 93.224 Program: Health Center Program Cluster; Grants for New and Expanded Services under the Health Center Program and Health Centers Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care), Federal Award Identification Number H8000593, 2024-2025 Condition: We found one (1) instance where adequate documentation was not maintained to ensure the appropriate amount was charged to a patient based on the sliding fee policy in place. Upon further analysis, there were a total of four (4) instances where appropriate documentation was not maintained relating to fiscal year 2025. Criteria: Uniform Guidance requires the Organization to be in compliance with special tests and provisions. This includes maintaining appropriate documentation of the application and fee determination for every patient utilizing the sliding fee discount. This is a repeat of finding 2024-003 from the prior year. Questioned costs: One error was identified during our testing. Expanded procedures identified that the population impacted were four (4) individuals. The amount of questioned costs cannot be determined. Context: A sample of 40 individuals were selected and tested for compliance with the Organization's sliding fee policy. One (1) known compliance error was found during testing of the 40 individuals. Upon analyzing the entire population, it was determined that a total of four (4) files were not in compliance. Effect: The Organization was not in compliance with the requirements of the federal program due to a scanner malfunction where the application and supporting documentation were not adequately scanned, resulting in a corrupt file. Cause: Management has indicated that the scanner malfunction lead to the noncompliance. Upon the realization of the scanner issue, it was replaced and an analysis was performed for any other patient files that may have been corrupted. Management review of the entire population identified a total of (4) four files that were corrupt relating to fiscal year 2025. Recommendation: We recommend management continue to monitor their processes relating to the Organization's compliance with the sliding fee discount to ensure all appropriate documentation is maintained to support the sliding fee amounts charged to patients. Management's response: Management is in agreement with the above analysis by the auditors. The issue was discovered and corrected with an update to the server and an update to the process to ensure that all scans are reviewed prior to the destruction of the original documents. This was fully resolved prior to the fiscal year end.

Agency: U.S. Department of Health and Human Services Assistance Listing Number: Health Center Program Cluster: 93.527 and 93.224 Program: Health Center Program Cluster; Grants for New and Expanded Services under the Health Center Program and Health Centers Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care), Federal Award Identification Number H8000593, 2024-2025 Condition: We found one (1) instance where adequate documentation was not maintained to ensure the appropriate amount was charged to a patient based on the sliding fee policy in place. Upon further analysis, there were a total of four (4) instances where appropriate documentation was not maintained relating to fiscal year 2025. Criteria: Uniform Guidance requires the Organization to be in compliance with special tests and provisions. This includes maintaining appropriate documentation of the application and fee determination for every patient utilizing the sliding fee discount. This is a repeat of finding 2024-003 from the prior year. Questioned costs: One error was identified during our testing. Expanded procedures identified that the population impacted were four (4) individuals. The amount of questioned costs cannot be determined. Context: A sample of 40 individuals were selected and tested for compliance with the Organization's sliding fee policy. One (1) known compliance error was found during testing of the 40 individuals. Upon analyzing the entire population, it was determined that a total of four (4) files were not in compliance. Effect: The Organization was not in compliance with the requirements of the federal program due to a scanner malfunction where the application and supporting documentation were not adequately scanned, resulting in a corrupt file. Cause: Management has indicated that the scanner malfunction lead to the noncompliance. Upon the realization of the scanner issue, it was replaced and an analysis was performed for any other patient files that may have been corrupted. Management review of the entire population identified a total of (4) four files that were corrupt relating to fiscal year 2025. Recommendation: We recommend management continue to monitor their processes relating to the Organization's compliance with the sliding fee discount to ensure all appropriate documentation is maintained to support the sliding fee amounts charged to patients. Management's response: Management is in agreement with the above analysis by the auditors. The issue was discovered and corrected with an update to the server and an update to the process to ensure that all scans are reviewed prior to the destruction of the original documents. This was fully resolved prior to the fiscal year end.

Agency: U.S. Department of Health and Human Services Assistance Listing Number: Health Center Program Cluster: 93.527 and 93.224 Program: Health Center Program Cluster; Grants for New and Expanded Services under the Health Center Program and Health Centers Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless and Public Housing Primary Care), Federal Award Identification Number H8000593, 2024-2025 Condition: We found one (1) instance where adequate documentation was not maintained to ensure the appropriate amount was charged to a patient based on the sliding fee policy in place. Upon further analysis, there were a total of four (4) instances where appropriate documentation was not maintained relating to fiscal year 2025. Criteria: Uniform Guidance requires the Organization to be in compliance with special tests and provisions. This includes maintaining appropriate documentation of the application and fee determination for every patient utilizing the sliding fee discount. This is a repeat of finding 2024-003 from the prior year. Questioned costs: One error was identified during our testing. Expanded procedures identified that the population impacted were four (4) individuals. The amount of questioned costs cannot be determined. Context: A sample of 40 individuals were selected and tested for compliance with the Organization's sliding fee policy. One (1) known compliance error was found during testing of the 40 individuals. Upon analyzing the entire population, it was determined that a total of four (4) files were not in compliance. Effect: The Organization was not in compliance with the requirements of the federal program due to a scanner malfunction where the application and supporting documentation were not adequately scanned, resulting in a corrupt file. Cause: Management has indicated that the scanner malfunction lead to the noncompliance. Upon the realization of the scanner issue, it was replaced and an analysis was performed for any other patient files that may have been corrupted. Management review of the entire population identified a total of (4) four files that were corrupt relating to fiscal year 2025. Recommendation: We recommend management continue to monitor their processes relating to the Organization's compliance with the sliding fee discount to ensure all appropriate documentation is maintained to support the sliding fee amounts charged to patients. Management's response: Management is in agreement with the above analysis by the auditors. The issue was discovered and corrected with an update to the server and an update to the process to ensure that all scans are reviewed prior to the destruction of the original documents. This was fully resolved prior to the fiscal year end.