Audit 49694

FY End
2022-12-31
Total Expended
$17.12M
Findings
8
Programs
14
Year: 2022 Accepted: 2023-09-28
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
50937 2022-001 Significant Deficiency - N
50938 2022-001 Significant Deficiency - N
50939 2022-001 Significant Deficiency - N
50940 2022-001 Significant Deficiency - N
627379 2022-001 Significant Deficiency - N
627380 2022-001 Significant Deficiency - N
627381 2022-001 Significant Deficiency - N
627382 2022-001 Significant Deficiency - N

Contacts

Name Title Type
J1RNG2ESWV98 Lawrence Wojcik Auditee
7189457150 Gil Bernhard 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 De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of The Joseph P. Addabbo Family Health Center, Inc. (the "Center") under programs of the federal government for the year ended December 31, 2022. The information in the 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 (the "Uniform Guidance"). Because the Schedule presents only a selected portion of the operations of the Center, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Center.
Title: Indirect cost rate 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 De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The Center has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance.
Title: Nonmonetary assistance 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 De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Nonmonetary assistance is reported in the Schedule at the fair value of the Special Supplemental Nutrition Program for Women, Infants, and Children ("WIC") checks received. The total federal share of the food instruments distributed by the Center amounted to $4,374,500 and is included in the Schedule.
Title: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distri 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 De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. For the DHHS awards related to the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program, DHHS has indicated the amounts on the schedule be reported corresponding to reporting requirements of the HRSA PRF Reporting Portal. Payments from DHHS for PRF are assigned to 'Payment Received Periods' (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). The Schedule includes $180,943 received from DHHS between July 1, 2021 and December 31, 2021. In accordance with guidance from DHHS, this amount relates to Period 4. The amount is recognized as DHHS grant revenue in the consolidated financial statements in the year ended December 31, 2022.
Title: COVID-19 - HRSA COVID-19 Claims Reimbursement for the Uninsured Program and 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 De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. For the DHHS award related to the HRSA COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund program (the Uninsured/CAF Program), the amount on the Schedule relates to the amount of revenue recognized in the consolidated financial statements during the year ended December 31, 2022.

Finding Details

Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.
Section III - Federal Award Findings and Questioned Costs U.S. Department of Health and Human Services: Health Centers Program Cluster (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (Assistance Listing Number 93.224) and Grants for New and Expanded Services Under the Health Center Program (Assistance Listing Number 93.527). Finding 2022-001 - Special Tests and Provisions: Sliding Fee Discounts Criteria In accordance with 42 CFR sections 51c.303(f) and (g), health centers must prepare and apply a sliding fee discount schedule ("SFDS") so that the amounts paid for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay. Statement of Condition During our audit, we noted that the SFDS was not properly applied to a patient due to an error made by the patient services representative. Questioned costs None Cause The patient services representative did not record within the billing system, the patient's household income and number of dependents. Effect The amounts owed for the services provided were not based on the Center's SFDS. Context One exception from a statistically valid sample of 25. Identification of Repeat Finding No Recommendation We recommend that proper training be given to the patient services representatives, and the sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance. Management Response All supervisors were mandated to conduct training sessions for all staff members involved in patient registration and billing processes. The Center has improved communication between the registration and billing personnel, to ensure that patient information and financial details are accurately shared to minimize the risk of errors. The Center is in the process of updating its documentation processes to include clear guidelines on handling sliding fee scale patients, along with mandatory checklists to ensure all steps are followed correctly.