Finding 523596 (2022-002)

Significant Deficiency

Requirement

Questioned Costs

Year

2022

Accepted

2025-02-18

Audit: 342976

Organization: Klamath Health Partners, Inc. Dba: Klamath Open Door Family Practice (OR)

Auditor: Hoffman Stewart & Schmidt PC

AI Summary

Core Issue: The health center failed to maintain proof of income documentation for sliding fee discounts.
Impacted Requirements: This affects the requirement to adjust fees based on patients' ability to pay.
Recommended Follow-Up: Implement policies to ensure all eligible patients have necessary income documentation on file.

Finding Text

Criteria: The health center must prepare and apply a sliding fee discount schedule so that the amounts owed for heath center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay based on specific guidelines. Condition: There were 4 instances in our sample of 44 where there was no proof of income documentation to support the sliding fee discount adjustment. Cause: Policies and procedures were not established to ensure that proof of income documentation was retained. Effect: Patients could have been improperly charged for services provided. Recommendation: Appropriate policies and procedures should be established to ensure that all sliding fee scale eligible patients have the appropriate proof of income documentation in their file.

Corrective Action Plan

The leadership agrees that the sliding fee discount given to patients must be done correctly and proper documentation needs to be maintained in the patient’s file. Management will see why these patients never had documentation showing their income and do a root cause analysis to see what caused the breakdown. Management will train the staff who gather the information to do the sliding fee calculations and ensure that they know how to do it properly. We have new managers who will do spot checks on the sliding fee applications to ensure everything in the patients’ file is there which is required for the discount. The people responsible to ensure this happens will be Erich Koch, CEO, and Kacie Cunningham, Clinic Manager.

Other Findings in this Audit

523597 2022-002

Significant Deficiency
523598 2022-002

Significant Deficiency
1100038 2022-002

Significant Deficiency
1100039 2022-002

Significant Deficiency
1100040 2022-002

Significant Deficiency

Programs in Audit

ALN	Program Name	Expenditures
93.527	Grants for New and Expanded Services Under the Health Center Program	$2.25M
93.224	Health Center Program (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care)	$980,735
93.912	Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement	$112,978
93.994	Maternal and Child Health Services Block Grant to the States	$3,785