FAC Explorer

Finding 58418 (2022-001)

- Repeat Finding
Requirement
E
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 55048
Organization: Quartz Valley Indian Reservation (CA)
Auditor: Melissa B Petersen CPA LLC

AI Summary

  • Core Issue: Eligibility documentation for services is missing for several patients, including tribal membership and residency proof.
  • Impacted Requirements: Compliance with 42 CFR 136.12(a)(2) regarding eligibility criteria for Indian Health Services.
  • Recommended Follow-Up: Implement staff training and conduct thorough reviews of eligibility documentation to prevent future issues.

Finding Text

2022-001 93.441 Indian Health Services; Repeat Finding Criteria: 42 CFR 136.12(a)(2) Eligibility for service as evidenced by tribal membership; residency in tax-exempt land; Condition: Items selected for testing contained the following exceptions: 4 of 40 items Missing documentation of tribal membership 4 of 40 items Missing documentation of residency 2 of 40 items Missing documentation of current application / registration Effect: Patients may have received services that they were not eligible Questioned Costs: None identified Cause: Staff turnover and lack of oversight Recommendation: Staff training and review of files for eligibility documentation Management response: Management agrees with the finding.

Corrective Action Plan

2022-001 Sufficient documentation of eligibility not maintained for all items selected for testing. Contact Person Trisha Braswell Anticipated Completion Date 12/31/2023 Action Plan: Due to large turnover in staff at the front desk , we were not able to fully correct this finding this year. The Clinic Manager will ensure all new staff are trained and that it is part of the of the orientation.

Categories

Eligibility Internal Control / Segregation of Duties

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $833,355
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $714,053
15.021 Consolidated Tribal Government Program $604,575
93.441 Indian Self-Determination $598,468
66.605 Performance Partnership Grants $298,793
16.841 Voca Tribal Victim Services Set-Aside Program $238,300
21.023 Emergency Rental Assistance Program $167,065
16.587 Violence Against Women Discretionary Grants for Indian Tribal Governments $141,110
15.114 Indian Education_higher Education Grant Program $115,183
93.575 Child Care and Development Block Grant $111,490
15.144 Indian Child Welfare Act_title II Grants $73,286
93.237 Special Diabetes Program for Indians_diabetes Prevention and Treatment Projects $32,252
15.519 Indian Tribal Water Resources Development, Management, and Protection $31,169
21.026 Homeowner Assistance Fund $22,348
15.160 Bia Wildland Urban Interface Community Fire Assistance $22,080
15.035 Forestry on Indian Lands $18,346
15.141 Indian Housing Assistance $13,707
15.608 Fish and Wildlife Management Assistance $9,946
93.568 Low-Income Home Energy Assistance $9,380
10.699 Partnership Agreements $6,534
15.024 Indian Self-Determination Contract Support $4,129
15.036 Indian Rights Protection $3,965
93.499 Low Income Household Water Assistance Program $3,878
20.205 Highway Planning and Construction $2,293
15.113 Indian Social Services_welfare Assistance $2,179
15.037 Water Resources on Indian Lands $72