Finding 1191584 (2025-001)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2025
Accepted
2026-03-27
Audit: 395451
Organization: Clinica Msr. Oscar A. Romero (CA)

AI Summary

  • Issue: Clinica incorrectly granted a sliding fee discount to a patient who was deemed non-compliant with income verification procedures.
  • Impacted Requirement: The sliding fee discount policy was not followed as per internal guidelines, leading to potential financial discrepancies.
  • Recommended Follow-Up: Review and reinforce training on income verification procedures to ensure compliance with discount policies.

Finding Text

During our compliance testing of sliding fee discounts, we identified one instance in which Clinica did not apply its sliding fee discount policy in accordance with established internal requirements. Specifically, a sliding fee discount was granted to a patient after the patient had been determined to be non‑compliant per Clinica’s income verification procedures and therefore ineligible for the discount.

Corrective Action Plan

Management is reviewing and strengthening the Sliding Fee Discount Program (SFDP) to ensure compliance with regulatory and internal requirements. Corrective actions focus on clarifying income verification and documentation standards, enhancing staff training, and implementing periodic monitoring to ensure consistent application of the sliding fee scale. As part of these efforts, Clinica Romero conducted a robust and targeted staff training through the CMOAR Clinical & Administrative Operations Training on February 21 and February 28, 2026. The training included 74 staff members and covered SFDP eligibility, income verification, documentation requirements, and proper application of discounts in alignment with HRSA Program Requirement. Expected outcomes include improved consistency in SFDP application across departments, increased staff understanding of compliance requirements, fewer incomplete or unsupported applications, and stronger documentation and audit readiness. Clinica will monitor closely and supervise the perfect execution of the sliding fee scale application, and it will set accountability standards for the application of the sliding fee scale.

Categories

Eligibility

Other Findings in this Audit

  • 1191585 2025-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.493 CONGRESSIONAL DIRECTIVES $854,094
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $500,476
93.224 HEALTH CENTER PROGRAM (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $370,297
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $321,149