FAC Explorer

Audit 8310

FY End
2023-03-31
Total Expended
$5.88M
Findings
16
Programs
2
Organization: Family Medical Center of Michigan, Inc. (MI)
Year: 2023 Accepted: 2023-12-22
Auditor: Yeo & Yeo PC

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
6388 2023-003 Material Weakness Yes N
6389 2023-003 Material Weakness Yes N
6390 2023-003 Material Weakness Yes N
6391 2023-003 Material Weakness Yes N
6392 2023-004 Material Weakness - B
6393 2023-004 Material Weakness - B
6394 2023-004 Material Weakness - B
6395 2023-004 Material Weakness - B
582830 2023-003 Material Weakness Yes N
582831 2023-003 Material Weakness Yes N
582832 2023-003 Material Weakness Yes N
582833 2023-003 Material Weakness Yes N
582834 2023-004 Material Weakness - B
582835 2023-004 Material Weakness - B
582836 2023-004 Material Weakness - B
582837 2023-004 Material Weakness - B

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) $2.78M Yes 2
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $216,319 Yes 2

Contacts

Name Title Type
DTGSAZLNB9Y4 Ed Larkins Auditee
7346542169 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 expenditures are recognized following the cost principles contained in the Uniform Guidance where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. 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, 2023. 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 expenditures are recognized following the cost principles contained in the Uniform Guidance where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Federal financial assistance revenue reconciles to the Statement of Operations as follows: Revenues per Statement of Operations: $5,993,174; Health Center Program Funds recognized as revenue in the current year general ledger related to the prior year, and should have been reported on prior year SEFA (Note 5): ($115,977); Total expenditures of federal awards: $5,877,197.
Title: Subrecipients 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 where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. No amounts were provided to subrecipients.
Title: Health Center Program Funds 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 where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The Center identified $115,979 of expenses related to the Health Center Program Cluster that should have been reported on the fiscal year 2022 schedule of expenditures of federal awards. The Center elected not to restate the 2022 SEFA. This amount is not material and would not have affected the major program determination for fiscal year 2022.

Finding Details

Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-003
2023-003, 2022-003 – Material Weakness and Material 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 encounters we noted 15 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, out of the 60 sliding fee adjustments tested, we noted 5 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. Also, there were 3 instances 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 3 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 patients 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 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.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2023-004
2023-004 – Material Weakness and Material Noncompliance – Allowable Costs: Missing Timesheets Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Pay’s should be supported by approved timesheets. Condition: We noted that 10 out of 40 payroll transactions tested for the Health Center Program Cluster could not be supported by approved timesheets. Questioned Costs: N/A Cause and Effect: There has been significant turnover in the finance department. Timesheets were not retained for a period of the fiscal year under audit. Recommendation: We recommend that management retain approved timesheets for each pay period for all employees. Timesheets should be retained in the Center’s payroll system and records. This will ensure that employees are being paid accurately for the time they have worked for each pay period. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.