Finding 1224502 (2021-011)

Material Weakness Repeat Finding
Requirement
A
Questioned Costs
-
Year
2021
Accepted
2026-07-23
Audit: 407750
Auditor: CBIZ CPAS PC

AI Summary

  • Core Issue: Inadequate documentation for patient services raises concerns about compliance with federal funding requirements.
  • Impacted Requirements: Failure to maintain sufficient records violates the criteria for allowable activities under federal program ALN 93.224.
  • Recommended Follow-Up: Management should enhance documentation retention processes to ensure compliance and support for services provided.

Finding Text

Finding 2021-011: Allowable Activities – Lack of Adequate Documentation to Support That Services Provided to Patients Were an Allowable Activity – Material Weakness in Internal Control Over Compliance FEDERAL PROGRAM ALN 93.224 – Consolidated Health Centers; Grant Numbers H8GCS48610 and H8OCS00687; Grant Period: August 1, 2020 – July 31, 2021 CRITERIA QCHC is required to maintain sufficient patient records to support that federal funds were spent only on qualifying services. CONDITION AND CONTEXT During the audit of the financial statements for the fiscal year ended July 31, 2021, QCHC was unable to provide adequate documentation to support the nature of services provided to patients. CAUSE There was significant turnover in the Finance department and the adequate documentation to support patient services was not maintained. EFFECT OR POTENTIAL EFFECT By not retaining patient records and charges documentation, patients may have received services that are unallowed or may have not been charged the proper amount for the services received. This finding is a material weakness in internal control over compliance and noncompliance with the Uniform Guidance. QUESTIONED COST Amount, if any, could not be determined due to lack of supporting documentation. REPEAT FINDING Yes (2020-006) RECOMMENDATION We recommend management improve their documentation retention processes to support the services provided to individuals. VIEWS OF RESPONSIBLE OFFICIALS AND PLANNED CORRECTIVE ACTION See the attached response and corrective action plan.

Corrective Action Plan

Criteria QCHC is required to maintain sufficient patient records to support that federal funds were spent only on qualifying services. Condition and Context During the audit of the financial statements for the fiscal year ended July 31, 2021, QCHC was unable to provide adequate documentation to support the nature of services provided to patients. Recommendation We recommend management improve their documentation retention processes to support the services provided to individuals. Views of Responsible Officials and Planned Corrective Actions QCHC acknowledges the finding and has implemented the following corrective actions: 1. QCHC has implemented Policy 317 - Record Retention, which requires a minimum seven-year retention of medical records and lab results. 2. QCHC has established the Systems Monitoring Policy requiring regular performance evaluations, feedback, and documentation of all monitoring activities including chart reviews to assess 3. QCHC has implemented the Sliding Fee Discount Program Policy which requires evaluation of forms used to ensure they are current and applicable, collection of utilization data, and patient satisfaction surveys. 4. QCHC has established a system to maintain sufficient patient records to support that federal funds were spent only on qualifying services. 5. QCHC has implemented the Inventory Control Policy requiring all incoming medical, dental, and facility supplies inventory orders to be checked against invoices.

Categories

Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1224497 2021-009
    Material Weakness Repeat
  • 1224498 2021-009
    Material Weakness Repeat
  • 1224499 2021-010
    Material Weakness Repeat
  • 1224500 2021-010
    Material Weakness Repeat
  • 1224501 2021-011
    Material Weakness Repeat
  • 1224503 2021-012
    Material Weakness Repeat
  • 1224504 2021-012
    Material Weakness Repeat
  • 1224505 2021-013
    Material Weakness Repeat
  • 1224506 2021-013
    Material Weakness Repeat
  • 1224507 2021-014
    Material Weakness Repeat
  • 1224508 2021-014
    Material Weakness Repeat
  • 1224509 2021-015
    Material Weakness Repeat
  • 1224510 2021-015
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 HEALTH CENTER PROGRAM $3.13M