Finding Text
DEPARTMENT OF HEALTH AND HUMAN SERVICES 2025-001 Other Matter: Special Tests and Provisions: Sliding Fee Scale Applications Condition: During our audit, we selected a sample of 25 records for patients treated during the audit period to determine whether patient charges were appropriately adjusted based on income and family size by applying the health center’s sliding fee discount schedule. During our procedures, five sliding fee scale applications were not documented for patients receiving the sliding fee discount. Criteria: The Clinic is required to establish systems for determining and documenting sliding fee eligibility determination. Sliding fee scale applications serve as the key source documentation for documenting patients’ income and family size for eligibility determination. Sliding fee scale applications should be completed and maintained for all patients receiving the sliding fee scale discount. Cause: The five undocumented sliding fee scale applications were related to one staff member. The staff member did not follow up with the patients in a timely manner to document the sliding fee scale applications. Effect: Sliding fee discounts for the referenced five patients with undocumented sliding fee scale applications were not supported by adequate documentation to determine if the patients were eligible to receive the sliding fee scale discount. Recommendations: The staff member responsible for the undocumented sliding fee scale applications should be informed and trained on the Clinic’s documentation requirements for the sliding fee program. The Clinic should monitor the staff member to ensure the condition has been resolved. View of Responsible Officials and Planned Corrective Actions: Management agrees with the other matter. Corrective action has been taken. On October 23, 2025, Management informed the applicable staff member regarding the undocumented sliding fee scale applications identified during the audit. The staff member acknowledged the undocumented sliding fee scale applications. The staff member has been retrained on the sliding fee scale documentation requirements. Management will supervise and monitor the staff member to ensure the other matter has been resolved.