Views of Responsible Officials and Planned Corrective Actions – Description of Finding: Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Health Center’s policy. Statement of Concurrence: Shasta Community Health Center (SCHC) management acknowledges the finding and agrees that there were instances where the approved sliding fee policy of SCHC was misapplied. SCHC also recognizes that this is a repeat finding and recognize the need to strengthen controls to ensure full compliance with HRSA requirements. Root Cause: The identified errors were primarily due to: - Staff inattention in recognizing sliding fee discount expiration dates - Lack of clear guidance from management on sliding fee discounts related to nurse only or other generally unbillable patient visits - Lack of guidance in policies and procedures related to treatment of sliding fee discounts on nurse visits Corrective Action: - Management will reinforce through re-training of front office staff the importance of ensuring that sliding fee eligibility is carefully reviewed at each patient’s appointment. - Billing staff will be retrained in proper application of sliding fee discounts related to nurse-only visits. - Policy will be reviewed for any necessary changes and clarifications to nurse-only visits. - Electronic Health Record (EHR) system will be updated to correctly provide discounts based on patient’s sliding fee eligibility. Responsible Parties: - Front Office Retraining – Director of Informatics and Training - Billing Staff Retraining – Senior Director of Revenue Cycle Integrity and Billing Manager - Policy Revision – Chief Financial Officer and Senior Director of Revenue Cycle Integrity - EHR System Updates – Director of Informatics and Senior Director of Revenue Cycle Integrity Timeline: - Front Office Retraining – Next “All Staff Meeting”, currently scheduled for May 5, 2026. - Billing Staff Retraining – Billing meeting on April 29, 2026, to identify logistical issues and develop a plan to work through necessary EHR process revision. Full correction planned by June 30, 2026. - Policy Revision – Bring revised policy to board meeting in May 2026. - EHR System Updates – Full correction planned by June 30, 2026.