Audit 50312

FY End
2022-03-31
Total Expended
$3.42M
Findings
8
Programs
3
Year: 2022 Accepted: 2023-01-30
Auditor: Yeo & Yeo Cpa's

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
52018 2022-003 Material Weakness - N
52019 2022-003 Material Weakness - N
52020 2022-003 Material Weakness - N
52021 2022-003 Material Weakness - N
628460 2022-003 Material Weakness - N
628461 2022-003 Material Weakness - N
628462 2022-003 Material Weakness - N
628463 2022-003 Material Weakness - N

Contacts

Name Title Type
DTGSAZLNB9Y4 Chris Croley Auditee
7348473802 Brian Dixon Auditor
No contacts on file

Notes to SEFA

Title: General Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expendituresare recognized following, as applicable, the cost principles contained in the Uniform Guidance where certaintypes 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 Family Medical Center of Michigan, Inc. under programs of the federal government for the year ended March 31, 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). Because the Schedule presents only a selected portion of the operations of Family Medical Center of Michigan, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of Family Medical Center of Michigan, Inc.
Title: Reconciliation to the Financial Statements Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expendituresare recognized following, as applicable, the cost principles contained in the Uniform Guidance where certaintypes 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. Federal financial assistance revenue reconciles to the Statement of Operations as follows: Revenues per Statement of Operations: $3,211,670, Provider Relief Funds recognized as revenue in the prior year on the Statement of Operations included on the current year SEFA: $212,393, & Total expenditures of federal awards: $3,424,063.
Title: Subrecipients Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expendituresare recognized following, as applicable, the cost principles contained in the Uniform Guidance where certaintypes 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. No amounts were provided to subrecipients.

Finding Details

2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
2022-003 ? Material Weakness and Noncompliance ? Special Tests. Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services. Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing of sliding fee?s we noted 7 instances out of 40 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 40 sliding fee adjustments tested, we noted 10 instances where the center was not able to locate the sliding fee application for the applicable patient, however a sliding fee adjustment was still applied, as well as one instance where the sliding fee application that was on file for the patient tested was 2 years old and has not been updated. Questioned Costs: N/A. Cause and Effect: There has been significant turnover in the billing department over the past 2 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients slide scale. Recommendation: We recommend that management reviews all current sliding fee patient?s and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that current patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.