FAC Explorer

Finding 1135418 (2024-001)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-05-01
Audit: 355210
Organization: Community Health Center Dba Alluvion Health, Inc. (MT)
Auditor: Withumsmith+brown PC

AI Summary

  • Core Issue: There is a significant deficiency in internal controls regarding the sliding fee scale, leading to incorrect discounts for patients.
  • Impacted Requirements: The organization failed to comply with the Health Center Program Compliance Manual, which mandates proper assessment of patient income and family size.
  • Recommended Follow-Up: Review and update policies, and provide ongoing training for staff involved in sliding fee scale assessments to ensure compliance.

Finding Text

#2024-001 – Misapplication of the Sliding Fee Scale – Special Tests and Provisions – Assistance Listing Numbers: 93.224 and 93.527 Consolidated Health Center Cluster (Repeat Finding) Type of Finding: Significant Deficiency in Internal Control over Compliance Condition: Inadequate oversight in ensuring compliance with its sliding fee scale policies and federal sliding fee guidelines. Criteria: The Health Center Program Compliance Manual requires a health center to have operating procedures assessing and re-assessing all patients for income and family size consistent with approved sliding fee discount program policies. Effect: The Organization did not properly follow its sliding fee scale policy and procedures for patients that applied for a sliding fee discount. Context: 7 out of 60 patients selected for testing received an incorrect discount based on the approved sliding fee scale and patient income levels. Questioned Costs: None Cause: Inconsistent application of the policies and procedures approved by the Organization. View of Responsible Officials: Management agrees with the finding. Recommendation: We recommend the Organization review its current policies and procedures and continue to provide training to all staff members handling the sliding fee scale assessments to ensure assessments are performed in accordance with policy.

Categories

Internal Control / Segregation of Duties Special Tests & Provisions Significant Deficiency

Other Findings in this Audit

  • 558976 2024-001
    Significant Deficiency Repeat
  • 558977 2024-001
    Significant Deficiency Repeat
  • 558978 2024-001
    Significant Deficiency Repeat
  • 558979 2024-001
    Significant Deficiency Repeat
  • 1135419 2024-001
    Significant Deficiency Repeat
  • 1135420 2024-001
    Significant Deficiency Repeat
  • 1135421 2024-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.85M
17.268 H-1b Job Training Grants $395,088
93.526 Grants for Capital Development in Health Centers $278,311
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $277,486
93.530 Teaching Health Center Graduate Medical Education Payment $186,798
93.150 Projects for Assistance in Transition From Homelessness (path) $163,588
93.958 Block Grants for Community Mental Health Services $158,246
93.788 Opioid Str $155,796
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $126,400
93.575 Child Care and Development Block Grant $64,882
93.940 Hiv Prevention Activities Health Department Based $56,833
93.527 Grants for New and Expanded Services Under the Health Center Program $1,680