FAC Explorer

Audit 52958

FY End
2022-04-30
Total Expended
$4.95M
Findings
6
Programs
8
Organization: Heartland Medical Clinic, Inc., D/b/a Heartland Community Health Center (KS)
Year: 2022 Accepted: 2023-01-29
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
57884 2022-001 Significant Deficiency - N
57885 2022-001 Significant Deficiency - N
57886 2022-001 Significant Deficiency - N
634326 2022-001 Significant Deficiency - N
634327 2022-001 Significant Deficiency - N
634328 2022-001 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.60M Yes 1
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.45M Yes 1
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $1.00M Yes 0
93.268 Immunization Cooperative Agreements $162,653 - 0
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $162,451 - 0
93.917 Hiv Care Formula Grants $53,110 - 0
93.145 Aids Education and Training Centers $27,147 - 0
93.461 Covid-19 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $24,960 - 0

Contacts

Name Title Type
FCN3YXWSDC36 Scott Burcher Auditee
4058208567 James Lacroix Auditor
No contacts on file

Notes to SEFA

Title: COVID-19 - HRSA COVID-19 Claims Reimbursement for the Uninsured Program and Accounting Policies: The accompanying schedule of expenditures of federal awards (the "Schedule") includes thefederal award activity of Heartland Medical Clinic, Inc. d/b/a Heartland Community Health Center(the "Organization") under programs of the federal government for the year ended April 30, 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, andAudit Requirements for Federal Awards ("Uniform Guidance"). Because the Schedule presents onlya selected portion of the operations of the Organization, it is not intended to and does not presentthe financial position, changes in net assets, or cash flows of the Organization. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Suchexpenditures 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 HRSA COVID-19 Claims Reimbursement for the UninsuredProgram and the COVID-19 Coverage Assistance Fund program (the "Uninsured/CAF Program"),the amounts on the Schedule relate to the amount of revenue recognized in the financialstatements during the year ended April 30, 2022.
Title: COVID-19 - Provider Relief Fund and American Rescue Plan ("ARP") Rural Dist Accounting Policies: The accompanying schedule of expenditures of federal awards (the "Schedule") includes thefederal award activity of Heartland Medical Clinic, Inc. d/b/a Heartland Community Health Center(the "Organization") under programs of the federal government for the year ended April 30, 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, andAudit Requirements for Federal Awards ("Uniform Guidance"). Because the Schedule presents onlya selected portion of the operations of the Organization, it is not intended to and does not presentthe financial position, changes in net assets, or cash flows of the Organization. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Suchexpenditures 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 ("PRF") and American Rescue Plan("ARP") Rural Distribution program, DHHS has indicated that the amounts on the Schedule bereported corresponding to reporting requirements of the HRSA PRF Reporting Portal. Paymentsfrom DHHS for PRF are assigned to 'Payment Received Periods' (each, a Period) based upon thedate each payment from the PRF was received. Each Period has a specified Period of Availabilityand timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after eachPeriod's deadline to use the funds (i.e., after the end of the Period of Availability).The Schedule includes $141,865 received from DHHS between April 10, 2020 through June 30,2020. In accordance with guidance from DHHS, this amount relates to Period 1. Such amountswere recognized in the fiscal year ended April 30, 2022 as grant revenue based on lost revenues.The Schedule includes $20,586 received from DHHS between July 1, 2020 through December 31,2020. In accordance with guidance from DHHS, this amount relates to Period 2. Such amountswere recognized in the fiscal year ended April 30, 2022 as grant revenue based on lost revenues.

Finding Details

Finding 2022-001
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Organization must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Organization did not always have the proper documentation on file to support the patient's income and family size. Context A test of 25 sliding fee discount transactions was performed and resulted in 15 instances where the Organization was unable to provide approved documentation. Our sample was a statistically valid sample. Questioned Costs None. Cause The Organization did not have adequate internal controls in place to effectively ensure that the proper sliding fee discount information is on file and illustrates the appropriate discount based on the Organization's sliding fee discount policy. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No. Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-001
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Organization must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Organization did not always have the proper documentation on file to support the patient's income and family size. Context A test of 25 sliding fee discount transactions was performed and resulted in 15 instances where the Organization was unable to provide approved documentation. Our sample was a statistically valid sample. Questioned Costs None. Cause The Organization did not have adequate internal controls in place to effectively ensure that the proper sliding fee discount information is on file and illustrates the appropriate discount based on the Organization's sliding fee discount policy. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No. Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-001
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Organization must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Organization did not always have the proper documentation on file to support the patient's income and family size. Context A test of 25 sliding fee discount transactions was performed and resulted in 15 instances where the Organization was unable to provide approved documentation. Our sample was a statistically valid sample. Questioned Costs None. Cause The Organization did not have adequate internal controls in place to effectively ensure that the proper sliding fee discount information is on file and illustrates the appropriate discount based on the Organization's sliding fee discount policy. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No. Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-001
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Organization must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Organization did not always have the proper documentation on file to support the patient's income and family size. Context A test of 25 sliding fee discount transactions was performed and resulted in 15 instances where the Organization was unable to provide approved documentation. Our sample was a statistically valid sample. Questioned Costs None. Cause The Organization did not have adequate internal controls in place to effectively ensure that the proper sliding fee discount information is on file and illustrates the appropriate discount based on the Organization's sliding fee discount policy. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No. Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-001
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Organization must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Organization did not always have the proper documentation on file to support the patient's income and family size. Context A test of 25 sliding fee discount transactions was performed and resulted in 15 instances where the Organization was unable to provide approved documentation. Our sample was a statistically valid sample. Questioned Costs None. Cause The Organization did not have adequate internal controls in place to effectively ensure that the proper sliding fee discount information is on file and illustrates the appropriate discount based on the Organization's sliding fee discount policy. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No. Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-001
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Organization must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Organization did not always have the proper documentation on file to support the patient's income and family size. Context A test of 25 sliding fee discount transactions was performed and resulted in 15 instances where the Organization was unable to provide approved documentation. Our sample was a statistically valid sample. Questioned Costs None. Cause The Organization did not have adequate internal controls in place to effectively ensure that the proper sliding fee discount information is on file and illustrates the appropriate discount based on the Organization's sliding fee discount policy. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No. Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.