Finding 404124 (2023-001)

Significant Deficiency Repeat Finding

Requirement

Questioned Costs

Year

2023

Accepted

2024-06-28

Audit: 310909

Organization: Wayne County Healthy Communities (MI)

Auditor: Glen Olivache CPA PC

AI Summary

Core Issue: Income data for 6 out of 25 patients was not entered, leading to incorrect charges based on the sliding fee discount policy.
Impacted Requirements: Health centers must accurately apply a sliding fee discount schedule based on family income and size.
Recommended Follow-Up: Management should enhance procedures and provide training to ensure accurate income data entry in the electronic health record system.

Finding Text

Finding Type - Significant Deficiency. CFDA Number, Federal Agency/Pass-Through Agency and Program Name - 93.224/93.527- Health Center Cluster. Repeat Finding - No. Questioned Costs - None. Criteria - Health centers must prepare and apply a sliding fee discount schedule so that amounts owed by patients for health care services are calculated. Discounts are adjusted based on family income and size. Criteria - Health centers must prepare and apply a sliding fee discount schedule so that amounts owed by patients for health care services are calculated. Discounts are adjusted based on family income and size. Context - Out of a sample of 25 patients selected for testing, income calcuation was not inputted for 6 of the patients. Cause and Effect - Income data was not inputted by the intate staff for 6 of the patients selected for testing. As a result, patients were not charged the correct amount for the services based on the sliding fee discount policy. Recommendation - We recommend that management implement procedures to ensure that income calculation is inputted into the electronic health record system. View of Responsible Officials and Corrective Action Planned - Management agrees with the finding and will conduct a review of the current process for data intake and application of sliding fee calculations into eClinicalWorks (our Electronic Health Record system) performed by front desk staff. Process improvement actions will be taken (including trainings) to ensure all front desk staff have full understanding of the process, address any concerns, and avoid future errors.

Corrective Action Plan

In response to the audit finding for fiscal year 2023, Wayne County Healthy Communities has implemented processes and procedures to address the finding. • Finding Number 2023-01 WCHC Management agrees with the finding and will conduct a review of the current process for data intake and application of sliding fee calculations into eClinicalWorks (our Electronic Health Record [EHR] system) performed by front desk staff. Process improvement actions will be taken (including trainings) to ensure all front desk staff have full understanding of the process, address any concerns, and avoid future errors. Anticipated Completion Date: December 15, 2024 Individuals Responsible: Amaal Haimout, Chief Operating Officer Jawan Simpson, Chief Financial Officer

Other Findings in this Audit

404125 2023-001

Significant Deficiency Repeat
404126 2023-001

Significant Deficiency Repeat
404127 2023-001

Significant Deficiency Repeat
980566 2023-001

Significant Deficiency Repeat
980567 2023-001

Significant Deficiency Repeat
980568 2023-001

Significant Deficiency Repeat
980569 2023-001

Significant Deficiency 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)	$1.42M
93.224	Covid-19 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care)	$374,516
93.940	Hiv Prevention Activities_health Department Based	$151,798
93.527	Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program	$49,496
93.247	Advanced Nursing Education Grant Program	$25,577