FAC Explorer

Audit 8893

FY End
2023-03-31
Total Expended
$55.32M
Findings
8
Programs
18
Organization: Clinica Sierra Vista (CA)
Year: 2023 Accepted: 2023-12-29
Auditor: Dingus Zarecor & Associates PLLC

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
6907 2023-002 - - N
6908 2023-002 - - N
6909 2023-002 - - N
6910 2023-002 - - N
583349 2023-002 - - N
583350 2023-002 - - N
583351 2023-002 - - N
583352 2023-002 - - N

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) $11.71M Yes 1
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $3.72M - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $1.24M - 0
93.778 Medical Assistance Program $657,678 Yes 0
93.556 Promoting Safe and Stable Families $611,512 - 0
93.994 Maternal and Child Health Services Block Grant to the States $504,674 - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $357,333 Yes 1
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $319,036 - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $287,654 - 0
14.267 Continuum of Care Program $261,805 - 0
93.917 Hiv Care Formula Grants $232,082 - 0
14.241 Housing Opportunities for Persons with Aids $208,008 - 0
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $203,477 - 0
93.590 Community-Based Child Abuse Prevention Grants $175,818 - 0
84.181 Special Education-Grants for Infants and Families $159,175 - 0
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $138,048 - 0
93.247 Advanced Nursing Education Grant Program $108,316 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $33,086 - 0

Contacts

Name Title Type
WMC4EN344RB6 John Church Auditee
5593495652 Luke Zarecor 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 accordance with the Uniform Guidance wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: During the year ended March 31, 2023, the Organization did not elect to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Clinica Sierra Vista (the Organization 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 the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization.
Title: CFDA 93.530 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 accordance with the Uniform Guidance wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: During the year ended March 31, 2023, the Organization did not elect to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. Clinica Sierra Vista received and expended funds from the Affordable Care Act – Teaching Health Center Graduate Medical Education (THCGME) Payments Program. The amount of funds received during the period under audit, $2,637,139, are not included on the Schedule of Expenditures of Federal Awards above as the program, CFDA 93.530, is exempt from the audit requirements under the Uniform Guidance per the program description.

Finding Details

Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.
Finding 2023-002
2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for reduced-charge visits, we identified two incidents where the slide fee was applied to a patient’s account without a completed application on file. Context This finding appears to be an isolated incident. A sample size of 25 patients included two who did not have an application on file. Cause The Organization did not follow its policies and procedures set in place to ensure the sliding fee schedule discount is correctly determined and applied to patient accounts. Effect Patients may have been granted the incorrect sliding fee discount. Questioned Costs None identified Recommendation We recommend continued effort in training personnel to be properly trained on applying appropriate sliding fee discounts based on the Organization’s approved policy and in compliance with the OMB Compliance Supplement requirements. An appropriate level of review should be conducted on patient accounts to ensure proper document retention, application of sliding fee discounts, and third-party insurance billing. Views of responsible officials and planned corrective action Management is in agreement with the audit finding.