Finding 626356 (2022-101)

Significant Deficiency
Requirement
N
Questioned Costs
-
Year
2022
Accepted
2023-02-06
Audit: 42622
Organization: North Country Healthcare, Inc. (AZ)

AI Summary

  • Core Issue: The Center failed to maintain proper documentation for sliding fee scale discounts, affecting compliance with federal requirements.
  • Impacted Requirements: Inadequate documentation and incorrect calculations for SFS discounts violate 42CFR Section 51c.303(f).
  • Recommended Follow-Up: Implement regular reviews of SFS applications and ensure adherence to written policies to prevent future errors.

Finding Text

2022-101 Special Tests and Provisions - Sliding Fee Scale Discounts Federal program: FAL 93.224/93.527 Health Centers Program Cluster U.S. Department of Health and Human Services Criteria: Patients applying for sliding fee scale (SFS) discounts should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42CFR Section 51c.303(f). Condition: The Center did not maintain proper documentation to substantiate SFS copays assigned to patients for three encounters out of forty tested. Cause: Staffing turnover Effect: For two of forty sliding fee patient encounters tested, the Center did not have patients' financial applications on file to support the SFS discount assigned. In addition, one SFS discount was not properly calculated. Recommendation: To help ensure that sliding fee discounts are properly calculated and documented, the Center should adhere to its formal written policies and procedures, and conduct random reviews of sliding fee scale applications in order to detect and correct errors or incomplete applications on a timely manner.

Categories

Special Tests & Provisions

Other Findings in this Audit

  • 49913 2022-101
    Significant Deficiency
  • 49914 2022-101
    Significant Deficiency
  • 51110 2022-101
    Significant Deficiency
  • 51111 2022-102
    Significant Deficiency
  • 626355 2022-101
    Significant Deficiency
  • 627552 2022-101
    Significant Deficiency
  • 627553 2022-102
    Significant Deficiency

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) $5.96M
93.498 Provider Relief Fund $1.59M
93.530 Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program $1.31M
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $748,288
93.917 Hiv Care Formula Grants $335,435
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $205,060
93.257 Grants for Education, Prevention, and Early Detection of Radiogenic Cancers and Diseases $192,115
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $188,290
93.914 Hiv Emergency Relief Project Grants $183,682
93.107 Area Health Education Centers Point of Service Maintenance and Enhancement Awards $123,082
16.588 Violence Against Women Formula Grants $116,985
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $78,418
93.959 Block Grants for Prevention and Treatment of Substance Abuse $69,325
93.247 Advanced Nursing Education Grant Program $68,977
93.788 Opioid Str $43,178
93.822 Health Careers Opportunity Program $29,930
16.575 Crime Victim Assistance $11,950
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $9,470
93.757 State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health Financed in Part by Prevention and Public Health Funding (pphf) $345
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $89