Finding 380535 (2020-006)

Material Weakness Repeat Finding
Requirement
A
Questioned Costs
-
Year
2020
Accepted
2024-03-15
Audit: 295322
Auditor: Marcum LLP

AI Summary

  • Core Issue: QCHC lacks adequate documentation to prove that patient services meet grant guidelines.
  • Impacted Requirements: This finding indicates a material weakness in internal controls and noncompliance with federal documentation standards.
  • Recommended Follow-Up: Management should enhance documentation retention processes to ensure compliance and support for services provided.

Finding Text

FINDING 2020-006 Lack of Adequate Documentation to Support that Services Provided to Patients were an Allowable Activity FEDERAL PROGRAM Health Centers Program (Health Centers Cluster) CFDA NUMBER AND TITLE: 93.224 - Consolidated Health Centers (community health centers, migrant health centers, health care for the homeless, and public housing primary care centers) 93.527 - Affordable Care Act (ACA) grants for new and expanded services under the health center program. FINDING TYPE Noncompliance, material weakness in internal control over compliance. Criteria QCHC is required to maintain adequate patient service and billings records to document patients are receiving services that are allowable under grant guidelines. CONDITION AND CONTEXT During the audit of the financial statements for the fiscal year ended July 31, 2020, QCHC was unable to provide adequate documentation to support the nature of services provided to patients. CAUSE In February 2020, the Organization was victim of a database breach which corrupted the Organization’s servers and resulted in the loss of general ledger and patient service data dating through February 2020. QCHC was unable to recover adequate documentation to support patient services. 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. RECOMMENDATION We recommend management improve their documentation retention processes to support to services provided to individuals. Views of Responsible Officials and Planned Corrective Action See the attached response and corrective action plan.

Corrective Action Plan

QCHC was unable to provide adequate documentation to support the nature of the services provided to patients at Fiscal Year End July 31,2020. Subsequent to July 31, 2020, QCHC's Chief Financial Officer, Accounting Manager and Billing Supervisor have worked together on the operation process to improve document retention. As of March 14, 2023, QCHC has transitioned from paper medical Explanation of Benefits (EOB) to electronic. QCHC has also contracted with Athena Health to provide full cycle medical billing as of November 1, 2023. Currently, QCHC has about 95% of all claims, medical and dental EOB's in an electronic format via Dentrix and Athena Health. In addition to Dentrix the transition to Athena Health with full cycle billing, will allow QCHC to maintain adequate patient service billing records. Any paper records received are scanned upon arrival and are housed in billing and accounting file storage. All electronic documents are saved on the QCHC network and are backed up daily.

Categories

HUD Housing Programs Material Weakness Internal Control / Segregation of Duties

Other Findings in this Audit

  • 380533 2020-004
    Material Weakness
  • 380534 2020-005
    Material Weakness Repeat
  • 380536 2020-007
    Material Weakness Repeat
  • 380537 2020-004
    Material Weakness
  • 380538 2020-005
    Material Weakness Repeat
  • 380539 2020-006
    Material Weakness Repeat
  • 380540 2020-007
    Material Weakness Repeat
  • 380541 2020-004
    Material Weakness
  • 380542 2020-005
    Material Weakness Repeat
  • 380543 2020-006
    Material Weakness Repeat
  • 380544 2020-007
    Material Weakness Repeat
  • 956975 2020-004
    Material Weakness
  • 956976 2020-005
    Material Weakness Repeat
  • 956977 2020-006
    Material Weakness Repeat
  • 956978 2020-007
    Material Weakness Repeat
  • 956979 2020-004
    Material Weakness
  • 956980 2020-005
    Material Weakness Repeat
  • 956981 2020-006
    Material Weakness Repeat
  • 956982 2020-007
    Material Weakness Repeat
  • 956983 2020-004
    Material Weakness
  • 956984 2020-005
    Material Weakness Repeat
  • 956985 2020-006
    Material Weakness Repeat
  • 956986 2020-007
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.16M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.43M