Expenditures reported in the schedule of federal awards 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.
Criteria: The Organization should maintain documentation establishing and verifying patient income to justify the amount charged to the patient based on the Organization's sliding scale of fees. Condition: During our review of internal control and patient documentation, it was noted that proper documentation of income verification and determination was not maintained for all patients. Context: We examined 60 patient files and determined that 15 of the files did not include all of the necessary documentation establishing and verifying patient income. Questioned Costs: None. Effect: The lack of income verification could lead to the Organization charging an improper amount for services to its patients. Cause: The Organization experienced turnover in their staff and internal software that holds the files, which led to inconsistent documentation being maintained on its patients. Recommendation: Management should establish a consistent policy regarding the establishment and verification of patient income to ensure its fees are properly charged. Views of Responsible Officials and Planned Corrective Actions: The Organization agrees with the finding and is evaluating the best way to address the issue.