FAC Explorer

Audit 40455

FY End
2022-05-31
Total Expended
$2.89M
Findings
4
Programs
8
Organization: North Olympic Healthcare Network (WA)
Year: 2022 Accepted: 2022-11-06
Auditor: Cliftonlarsonallen LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
45097 2022-001 Significant Deficiency - N
45098 2022-002 Significant Deficiency - L
621539 2022-001 Significant Deficiency - N
621540 2022-002 Significant Deficiency - L

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $863,552 Yes 0
93.224 Covid-19 American Rescue Plan Act Funding for Health Centers $731,121 Yes 0
93.498 Covid-19 Provider Relief Fund $675,242 Yes 1
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $248,282 - 0
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $200,006 Yes 1
93.788 Opioid Str $101,303 - 0
93.213 Research and Training in Complementary and Integrative Health $37,611 - 0
93.461 Covid-19 Testing for the Uninsured $8,778 - 0

Contacts

Name Title Type
M9K5UL3NLA46 Beau Brown Auditee
3604527891 Kyla Delgado 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 the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business amounts reported as expenditures in prior years. De Minimis Rate Used: Y Rate Explanation: North Olympic Healthcare Network has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of North Olympic Healthcare Network under programs of the federal government for the year ended May 31, 2022. The information in the Schedule is presented in accordance with the requirements of 2 CFR 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 International Community Health Services, it is not intended to and does not present the financial position, changes in net assets, or cash flows of North Olympic Healthcare Network.
Title: RECONCILIATION TO THE FINANCIAL STATEMENTS Accounting Policies: Expenditures reported on 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. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business amounts reported as expenditures in prior years. De Minimis Rate Used: Y Rate Explanation: North Olympic Healthcare Network has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The financial statements reflect revenue recognized from the Provider Relief Fund (PRF) of $652,546 and $22,696 for the years ended May 31, 2021 and 2020, respectively. The Schedule includes $675,242 of Period 1 expenditures of PRF in accordance with the requirements of the compliance supplement for assistance listing number 93.498.

Finding Details

Finding 2022-001
2022 ? 001 Federal agency: U.S. Department of Health and Human Services Federal program title: Health Center Program Cluster CFDA Number: 93.224 and 93.527 Award Period: June 1, 2021 through May 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR section 51c.303(g) and 42 CFR section 56.303(f)). Condition: North Olympic Healthcare Network?s (the Organization) sliding fee discount program provides discounts to uninsured patients based on the patient?s income and poverty levels. During our audit we noted one instance of an inaccurate sliding fee discount provided. Questioned costs: None. Context: A sample of 25 encounters were tested in relation to the sliding fee discount program. Of the 25 encounters tested one was found to not have received the proper sliding fee discount based upon the patient?s application. Cause: The Organization did not comply with their sliding fee policy. Effect: Improper sliding fee discount was applied to a patient?s account. Repeat finding: No. Recommendation: Management should review their policies and procedures with the personnel responsible for providing the sliding fee discount. We also recommend that management implement, monthly or quarterly, a self-audit process of newly approved sliding fee discount applicants and their associated patient record. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-002
2022 ? 002 Federal agency: U.S. Department of Health and Human Services (HHS) Federal program title: Provider Relief Fund CFDA Number: 93.498 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Performance and Financial Performance Monitoring 45 CFR ?75.342 Condition: North Olympic Healthcare Network?(the Organization) is required to prepare and submit period 1 provider relief fund reporting using accurate financial information and in a manner that is compliant with the guidelines set forth by HHS. A portion of the financial information included in the report calculations was not in compliance with the reporting guidelines. Questioned costs: None. Context: The Organization selected for reporting period 1 Option 2, a comparison of actual to budgeted results by quarter. Option 2 required for the time period, quarter 1 of calendar year 2020 through quarter 2 of calendar year 2021 the use of budgeted results from a budget approved prior to March 27, 2020. A portion of quarter 2 of calendar year 2020 through quarter 2 of calendar year 2021 were not from a budget approved prior to March 27, 2020. Cause: The Organization did have an approved budget prior to March 27, 2020 for quarter 1 2020, the time period that calculated lost revenue was used to meet the terms and conditions of the Organization?s PRF award. Effect: The use of calendar quarter budgets that were not approved prior to March 27, 2020 resulted in the a calculation of lost revenue available for a future time period that is not in compliance with the program. Repeat finding: No. Recommendation: Management should implement procedures to ensure the lost revenue is calculated and reported using an option that is appropriate for any future periods and revise the lost revenue amounts on any subsequent filings, if applicable. Views of responsible officials: The Organization understands the context and effect of the audit finding. However, the first quarter of calendar year 2020 was from an approved budget and resulted in a lost revenue calculation that more than covered the Organization?s award. We believe we are compliant and would have been better suited selecting option 3. There are no plans to use the lost revenue calculated in period 1 going forward as there have been no additional awards of PRF to the Organization.
Finding 2022-001
2022 ? 001 Federal agency: U.S. Department of Health and Human Services Federal program title: Health Center Program Cluster CFDA Number: 93.224 and 93.527 Award Period: June 1, 2021 through May 31, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR section 51c.303(g) and 42 CFR section 56.303(f)). Condition: North Olympic Healthcare Network?s (the Organization) sliding fee discount program provides discounts to uninsured patients based on the patient?s income and poverty levels. During our audit we noted one instance of an inaccurate sliding fee discount provided. Questioned costs: None. Context: A sample of 25 encounters were tested in relation to the sliding fee discount program. Of the 25 encounters tested one was found to not have received the proper sliding fee discount based upon the patient?s application. Cause: The Organization did not comply with their sliding fee policy. Effect: Improper sliding fee discount was applied to a patient?s account. Repeat finding: No. Recommendation: Management should review their policies and procedures with the personnel responsible for providing the sliding fee discount. We also recommend that management implement, monthly or quarterly, a self-audit process of newly approved sliding fee discount applicants and their associated patient record. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2022-002
2022 ? 002 Federal agency: U.S. Department of Health and Human Services (HHS) Federal program title: Provider Relief Fund CFDA Number: 93.498 Type of Finding: Significant Deficiency in Internal Control over Compliance and Compliance Criteria or specific requirement: Performance and Financial Performance Monitoring 45 CFR ?75.342 Condition: North Olympic Healthcare Network?(the Organization) is required to prepare and submit period 1 provider relief fund reporting using accurate financial information and in a manner that is compliant with the guidelines set forth by HHS. A portion of the financial information included in the report calculations was not in compliance with the reporting guidelines. Questioned costs: None. Context: The Organization selected for reporting period 1 Option 2, a comparison of actual to budgeted results by quarter. Option 2 required for the time period, quarter 1 of calendar year 2020 through quarter 2 of calendar year 2021 the use of budgeted results from a budget approved prior to March 27, 2020. A portion of quarter 2 of calendar year 2020 through quarter 2 of calendar year 2021 were not from a budget approved prior to March 27, 2020. Cause: The Organization did have an approved budget prior to March 27, 2020 for quarter 1 2020, the time period that calculated lost revenue was used to meet the terms and conditions of the Organization?s PRF award. Effect: The use of calendar quarter budgets that were not approved prior to March 27, 2020 resulted in the a calculation of lost revenue available for a future time period that is not in compliance with the program. Repeat finding: No. Recommendation: Management should implement procedures to ensure the lost revenue is calculated and reported using an option that is appropriate for any future periods and revise the lost revenue amounts on any subsequent filings, if applicable. Views of responsible officials: The Organization understands the context and effect of the audit finding. However, the first quarter of calendar year 2020 was from an approved budget and resulted in a lost revenue calculation that more than covered the Organization?s award. We believe we are compliant and would have been better suited selecting option 3. There are no plans to use the lost revenue calculated in period 1 going forward as there have been no additional awards of PRF to the Organization.