FAC Explorer

Finding 1169252 (2024-001)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
-
Year
2024
Accepted
2026-01-16
Audit: 382207
Organization: Goshen Medical Center, Inc. (NC)
Auditor: NUNN BRASHEAR & UZZELL P A

AI Summary

  • Core Issue: Six errors were found in billing calculations across 75 applications, impacting income due to incorrect fee assessments.
  • Impacted Requirements: GMC must ensure accurate billing for federally supplemented patient services; current procedures and standards are not consistently followed.
  • Recommended Follow-Up: Implement a review process for sliding fee scale applications, including recalculations by site leaders, and provide ongoing training for front desk staff.

Finding Text

75 applications at 3 locations were tested. Six errors were found, 1 incorrect calculation of income, fees would not change and 5 incorrect calculations where fees would change. GMC has responsibility of ensuring proper billing of patient services that are supplemented by the federal government. Findings had various effects depending on the issues noted above. In most instances where fees would change, more income would be due to Goshen from patients. Applicagtion calculations were not checked by another employee. Procedures and standards inconsistently followed. Review process of the sliding fee scale application should include a recalculation by the site leader. Front desk employees should receive continuing education classes. Management concurs.

Corrective Action Plan

To help make sure we have accurate sliding fee applications with the correct calculations we have promoted a proven site leader to a front desk trainer that is responsible for working with each new front desk worker for an entire day once they are on board with Goshen Medical Center. The trainer will focus on electronic medical records, practice management systems, and the sliding fee process/application. Goshen also recognized last year that additional training was needed on reading and recognizing gross income on tax forms, so we discuss this at our monthly site leader meetings and have seen progress since the 2023 Audit with less findings on the 2024 audit. In addition to our regular monthly site leader meetings , we have started holding a 3-day meeting each year that has an entire section dedicated to the sliding fee process. The sliding fee scale policy that was updated in 2021 and was updated again in 2024. Goshen has an Internal Auditor that visits sites each week and continues to meet with the site leaders to discuss any findings, including income calculation.

Categories

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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) $11.98M
93.912 RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT $488,742
93.847 DIABETES, DIGESTIVE, AND KIDNEY DISEASES EXTRAMURAL RESEARCH $53,813