Audit 42622

FY End
2022-06-30
Total Expended
$18.22M
Findings
8
Programs
20
Organization: North Country Healthcare, Inc. (AZ)
Year: 2022 Accepted: 2023-02-06

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
49913 2022-101 Significant Deficiency - N
49914 2022-101 Significant Deficiency - N
51110 2022-101 Significant Deficiency - N
51111 2022-102 Significant Deficiency - L
626355 2022-101 Significant Deficiency - N
626356 2022-101 Significant Deficiency - N
627552 2022-101 Significant Deficiency - N
627553 2022-102 Significant Deficiency - L

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $5.96M Yes 1
93.498 Provider Relief Fund $1.59M Yes 1
93.530 Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program $1.31M Yes 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $748,288 - 0
93.917 Hiv Care Formula Grants $335,435 - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $205,060 - 0
93.257 Grants for Education, Prevention, and Early Detection of Radiogenic Cancers and Diseases $192,115 - 0
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $188,290 - 0
93.914 Hiv Emergency Relief Project Grants $183,682 - 0
93.107 Area Health Education Centers Point of Service Maintenance and Enhancement Awards $123,082 - 0
16.588 Violence Against Women Formula Grants $116,985 - 0
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $78,418 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $69,325 - 0
93.247 Advanced Nursing Education Grant Program $68,977 - 0
93.788 Opioid Str $43,178 - 0
93.822 Health Careers Opportunity Program $29,930 - 0
16.575 Crime Victim Assistance $11,950 - 0
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $9,470 - 0
93.757 State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health Financed in Part by Prevention and Public Health Funding (pphf) $345 - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $89 Yes 1

Contacts

Name Title Type
HB6JK7NBTA16 James Gross Auditee
9285229568 Olivia Howerton Auditor
No contacts on file

Notes to SEFA

Title: FEDERAL ASSISTANCE LISTINGS NUMBER Accounting Policies: North Country HealthCare, Inc. for the year ended June 30, 2022. 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).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. Therefore, some amounts presented in this schedule may differ from amounts presented in, or used in preparation of, the financial statements. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The program titles and Federal Assistance Listings numbers were obtained from the federal or passthrough grantor or the 2022 Federal Assistance Listings. When no Federal Assistance Listings number has been assigned to a program, the two digit federal agency identifier and the federal contract number were used. When there was no federal contract number, the 2-digit federal agency identifier and the word "unknown" were used.

Finding Details

2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.
2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.
2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.
2022-102 Reporting for Provider Relief Funds Federal program: FAL 93.498 COVID-19: Provider Relief Fund U.S. Department of Health and Human Services (DHHS) Criteria: The Center was required to provide reports to DHHS for Provider Relief Funds (PRF) received during July 1, 2020 through December 31, 2020 (Period 2), and January 1, 2021 through June 30, 2021 (Period 3), no later than March 31, 2022 and September 30, 2022, respectively. Condition: The Center did not complete the required reports. Cause: Staffing turnover Effect: The Center was not in compliance with PRF reporting requirements. Recommendation: We recommend that the Center's management prepares, and periodically updates, a written document to include financial reporting compliance requirements for each grant that the Center receives. Copies of the document should be maintained by the Chief Financial Officer and Chief Executive Officer.
2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.
2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.
2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.
2022-102 Reporting for Provider Relief Funds Federal program: FAL 93.498 COVID-19: Provider Relief Fund U.S. Department of Health and Human Services (DHHS) Criteria: The Center was required to provide reports to DHHS for Provider Relief Funds (PRF) received during July 1, 2020 through December 31, 2020 (Period 2), and January 1, 2021 through June 30, 2021 (Period 3), no later than March 31, 2022 and September 30, 2022, respectively. Condition: The Center did not complete the required reports. Cause: Staffing turnover Effect: The Center was not in compliance with PRF reporting requirements. Recommendation: We recommend that the Center's management prepares, and periodically updates, a written document to include financial reporting compliance requirements for each grant that the Center receives. Copies of the document should be maintained by the Chief Financial Officer and Chief Executive Officer.