Finding 1148350 (2024-001)

Significant Deficiency Repeat Finding
Requirement
N
Questioned Costs
-
Year
2024
Accepted
2025-07-24

AI Summary

  • Core Issue: The health center did not consistently document patient assessments for the sliding fee discount, affecting compliance with grant requirements.
  • Impacted Requirements: Non-compliance with the Special Tests compliance requirement due to missing documentation for 36% of patients tested.
  • Recommended Follow-Up: Improve internal controls to ensure proper documentation and assessment of patients' ability to pay for sliding fee discounts.

Finding Text

Grantee 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 patient's ability to pay. The Organization adopted a Sliding Fee Discount Schedule based on current Federal poverty guidelines; however, they failed to consistently document the patient's assessment for the discount and retain thepatient's application. 9 out of 25 patients tested (36%) did not have documentation of the sliding fee discount assessment. We were unable to determine whether the sliding fee discount was properly applied to these patients. The effect is reportable non-compliance with the Special Tests compliance requirement for this grant. Further, the Organization has a significant deficiency in internal controls over compliance. The Organization's internal control over compliance was properly designed to ensure patients were assessed for ability to pay; however, it was not operating effectively during the period under audit.

Categories

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

Other Findings in this Audit

  • 571908 2024-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $2.08M
93.917 Hiv Care Formula Grants $1.03M
93.224 Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $437,456
93.940 Hiv Prevention Activities Health Department Based $390,870
93.939 Hiv Prevention Activities Non-Governmental Organization Based $372,702
93.217 Family Planning Services $223,472
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $214,996
93.526 Grants for Capital Development in Health Centers $46,351
93.527 Grants for New and Expanded Services Under the Health Center Program $20,022