Finding 1186615 (2025-002)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2026-03-25
Audit: 394322
Organization: Valley Healthcare System, Inc. (GA)

AI Summary

  • Core Issue: Inconsistent documentation for sliding fee discounts at Community Health Centers.
  • Impacted Requirements: Compliance with federal guidelines for offering discounts to patients below 200% of the federal poverty level.
  • Recommended Follow-Up: Strengthen procedures to ensure all necessary documentation is consistently collected and stored in patient files.

Finding Text

Federal Program Identification: U.S. Department of Health and Human Services Health Centers Cluster - Consolidated Health Center Program, AL 93.224, and Grant Number: H8000678 Condition/Criteria: Community Health Centers are required to offer sliding fee discounts to patients with annual incomes at or below 200% of the federal poverty guidelines. While the Organization has established policies to administer these discounts, opportunities exist to strengthen controls, particularly in documentation practices. Supporting documentation used to determine sliding fee discounts is not consistently maintained in every patient file. Cause: A system conversion has resulted in procedures related to the maintenance of required documentation for sliding fee determinations not being fully implemented or consistently followed in accordance with the Organization’s established policies. Effect: Without proper documentation, there is a risk that patients may receive incorrect sliding fee discounts, potentially resulting in overpayment or underpayment for services. Recommendation: We recommend the Organization enhance its procedures to ensure that all required documentation used in the determination of sliding fee discounts is consistently collected and retained in each patient's file. View of Responsible Officials and Planned Corrective Action: See corrective action plan.

Corrective Action Plan

Sliding Fee Discount Supporting Documentation - Significant Deficiency 2025-002 Valley Healthcare System, Inc. acknowledges that supporting documentation used to determine sliding fee discounts should be consistenly maintained. Valley Healthcare System, Inc. will implement procedures and controls to ensure that documentation is consistently maintained.

Categories

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Programs in Audit

ALN Program Name Expenditures
93.527 AFFORDABLE CARE ACT (ACA) GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $215,174
93.224 CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $58,122
10.766 COMMUNITY FACILITIES LOANS AND GRANTS $31,884
93.217 FAMILY PLANNING_SERVICES $31,425
93.526 AFFORDABLE CARE ACT (ACA) GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $17,941