Finding 397059 (2021-006)

Material Weakness Repeat Finding
Requirement
N
Questioned Costs
-
Year
2021
Accepted
2024-05-16

AI Summary

  • Core Issue: Missing documentation for patient eligibility affects the accuracy of sliding fee discounts.
  • Impacted Requirements: Compliance with special tests and provisions related to sliding fee discounts is not met.
  • Recommended Follow-Up: Implement procedures to ensure all necessary documents for patient eligibility are maintained and easily accessible.

Finding Text

Assistance Listing Numbers 93.224 Consolidated Health Centers Grant Number H80CS00112 US Department of Health and Human Services Finding 2021-006 Compliance Requirement: Special Tests and Provisions-Sliding Fee Discounts Type of Finding: Material Weakness Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay and their eligibility. A patient’s eligibility to pay is determined on the basis of the official poverty guidelines. Condition and Context: Supporting documents could not be located for four of the thirty patients selected for testing. As such, we were unable to determine eligibility. Cause: The condition can be attributed to changeover in patient management software, personnel, and passage of time. Various files were moved off-stie and stored without adequate communication to incoming personnel. Effect: Sliding fee discounts given could potentially be incorrect, or the patient could be ineligible. Questioned Costs: None Repeat Finding: Yes Recommendation: The Organization should be implementing and monitoring procedures to ensure that all supporting documents are kept for determining patient eligibility. Management’s Response: Management agrees with the finding.

Corrective Action Plan

Finding 2021-006 Compliance Requirement: Special Tests and Provisions – Sliding Fee Discounts Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 U.S. Department of Human Services Condition: Supporting documents could not be located for four of the thirty patients selected for testing. As such, we were unable to determine eligibility. Action Planned in Response to the Finding: Effective immediately, the revenue cycle team will implement and monitor procedures to ensure that all supporting documents are kept for determining sliding fee discounts and patient eligibility. Official Responsible for Ensuring the CAP: Becky Howard Planned Completion Date: June 30th, 2024

Categories

Eligibility Special Tests & Provisions Subrecipient Monitoring Material Weakness

Other Findings in this Audit

  • 397056 2021-005
    Material Weakness Repeat
  • 397057 2021-005
    Material Weakness Repeat
  • 397058 2021-005
    Material Weakness Repeat
  • 397060 2021-006
    Material Weakness Repeat
  • 397061 2021-006
    Material Weakness Repeat
  • 973498 2021-005
    Material Weakness Repeat
  • 973499 2021-005
    Material Weakness Repeat
  • 973500 2021-005
    Material Weakness Repeat
  • 973501 2021-006
    Material Weakness Repeat
  • 973502 2021-006
    Material Weakness Repeat
  • 973503 2021-006
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.09M