Criteria Under the terms of the federal award, QCHC is required to develop a sliding fee discount schedule and apply the appropriate calculated discount to eligible patients for services rendered. The sliding fee discount is based on the eligible patient's ability to pay. Condition and Context QCHC was unable to provide documentation to support the approved sliding fee discount was applied to eligible patients during the year. Recommendation We recommend management improve their documentation retention process to support patient charges and any related sliding fee discounts applied. Views of Responsible Officials and Planned Corrective Actions QCHC acknowledges the finding and has implemented the following corrective actions: 1. QCHC has implemented the Sliding Fee Discount Program Policy (POLICY #0001 SLIDING FEE DISCOUNT PROGRAM) which requires evaluation of forms used for the Sliding Fee Discount Program to ensure they are current and applicable, collection of utilization data, and patient satisfaction surveys. 2. QCHC has established procedures requiring patient satisfaction surveys to be provided at the end of each health center visit, with monthly compilation prepared for each health center site by Office Managers, and summarized data provided to the Financial Director and key management staff. 3. QCHC has implemented Policy 317 - Record Retention, which requires a minimum seven-year retention of financial and grant records. 4. QCHC has established a system to document the application of sliding fee discounts to eligible patients, including verification of patient eligibility and calculation of the appropriate discount. 5. QCHC has implemented the Systems Monitoring Policy requiring regular performance evaluations and documentation of all monitoring activities.