Audit 53069

FY End
2022-12-31
Total Expended
$3.21M
Findings
6
Programs
6
Year: 2022 Accepted: 2023-05-30
Auditor: Terry Horne CPA

Organization Exclusion Status:

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Contacts

Name Title Type
K6NDCGB9AL56 Jennifer Dittes Auditee
6156442000 Terry Horne Auditor
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Notes to SEFA

Accounting Policies: Note A- Basis of PresentationThe accompanying schedule of expenditures of federal awards includes the federal award (the Schedule) of HOPE Family Health Services, Inc. under programs of the federal government for the year ended December 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 HOPE Family Health Services, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of HOPE Family Health Services, Inc.Note B-Summary of Significant Accounting PoliciesExpenditures 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 to amounts reported as expenditures in prior years. HOPE Family Health Services, Inc. has elected not to use the 10 percent de minimus indirect cost rate allowed under Uniform Guidance.Note C - Loans OutstandingHOPE Family Health Services, Inc. had the following loan balances outstanding at December 31, 2022:Program TitleFederal CFDA NumberAmount OutstandingCommunity Facilities Loan10.766$278,920Community Facilities Loan10.766$990,875 De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate.

Finding Details

Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023
Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023
Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023
Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023
Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023
Finding: 2022-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster CFDA 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster must prepare and apply a sliding fee discount so that the amounts owed for health center services by eligible patients are discounted based on the patient?s ability to pay. During compliance testing, it was determined that the Organization did not obtain and properly document all necessary elements required by the Organization?s policy. Cause: There were deficiencies in internal controls over the Organization?s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were applied to patient accounts in accordance with the Organization?s sliding fee scale. Effect: Proper documentation was unavailable to substantiate that discounts were properly applied to patient accounts. Questioned Costs: None. Context/Sampling: For 3 of 48 patients selected for testing, incorrect discounts were provided. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees are properly trained to document and apply the sliding fee discounts in accordance with the Organization?s sliding fee policy. It is also recommended that sliding fee discounts are reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. Views of Responsible Officials: Management concurs. These errors are a result of significant turnover within the Organization during the pandemic. Efforts will be made to implement corrective actions as recommended above. Contact Person: Jennifer Dittes, CEO Anticipated Date of Completion: July 31, 2023