EIN: 223158253
UEI: RP5CMH69RWV7
Data as of August 22, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on November 22, 2024. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by May 22, 2025 (457 days ago).
What is a management decision? →Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Show full finding ▾Hide full finding ▴Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
To Health Resources and Services Administration Generations Family Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2024. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: June 30, 2024 The findings from the June 30, 2024 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the number assigned in the schedule. Financial Statement Findings: Finding 2024.001 - Sliding Fee Scale Documentation Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Action Taken A discrepancy was found in the sliding fee information of a selection in the audit process. The information collected by the patient intake system was not properly entered into the practice management system for a selection. Action: A periodic sliding fee scale audit across all sites will be conducted to compare the information in the patient intake system with the data in the practice management system. If there are any question regarding this plan, please e-mail Debra Daviau Savoie at DSavoie@genhealth.org.
2023-001
FAC accepted this audit on November 20, 2023 — management decision was due May 20, 2024.
Finding 2023.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Compliance Requirement: Special Tests and Provisions Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes - 2022.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Show full finding ▾Hide full finding ▴Finding 2023.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Compliance Requirement: Special Tests and Provisions Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes - 2022.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
October 5, 2023 To: United States Department of Health and Human Services Generations Family Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2023. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: June 30, 2023 The findings from the June 30, 2023 schedule of findings and questioned costs are discussed below. The finding is numbered consistently with the numbers assigned in the schedule. FINANCIAL STATEMENT FINDINGS: Finding 2023.001- Sliding Fee Scale Documentation Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Action Taken: Upon review of the finding, it was determined that the system calculated the slide correctly, but the procedure code was assigned to the incorrect procedure class, creating the error. Beginning July 1, 2023, Management has: • Reviewed the entire fee schedule, schedule of discounts and procedure groupings in the practice management system compared to the board approved fee schedule. Only one procedure group required correction of one procedure code. • In addition, the Director of Patient Revenue will work with the Electronic Health Record vendor to organize the system procedure classes for all procedure codes and financial classes to decrease any crosswalk issues or redundancies. In addition, the Director of Patient Revenue will work with the EHR vendor to upload fee schedules and sliding fee discount groups electronically. Previous internal controls adopted include: • Upon creating adding a new charge to the system, the Director of Patient Revenue posts the charge into a test patient account to confirm that the standard and slide rates match those entered on the fee schedule • At the annual review and/or revision of the Agency’s fee schedule, the Billing Manager assists the Director of Patient Revenue in reviewing every charge on the updated/approved year’s fee schedule to confirm the rates and slide assignment match the Fee Schedule. • A quarterly audit of insured and self-pay patients occur to review that adjustments are correct per agency policy. This action decreases chances of system issues that cause erroneous adjustments going unnoticed. If the Cognizant or Oversight Agency for Audit has questions regarding this plan, please call: Debra Savoie, CFO at (860) 456-6271.
2022-001
FAC accepted this audit on December 15, 2022 — management decision was due June 15, 2023.
Finding 2022-001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Context A test of 40 discount transactions was performed and resulted in two instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Show full finding ▾Hide full finding ▴Finding 2022-001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Context A test of 40 discount transactions was performed and resulted in two instances of sliding fee discounts not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
CORRECTIVE ACTION PLAN November 30, 2022 United States Department of Health and Human Services Generations Family Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2022. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: June 30, 2022 The findings from the June 30, 2022 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FEDERAL AWARDS FINDINGS AND QUESTIONED COSTS SIGNIFICANT DEFICIENCY 2022.001 - Sliding Fee Scale Discount Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Action Taken: Three new internal controls will be implemented immediately: 1. Upon adding a new charge to the system, the Director of Patient Revenue will post the charge into a test patient account to confirm that the standard fee and slide rates match those entered on the fee schedule. Set up will be verified by the Billing Manager. 2. At the annual review and/or revision of the Agency's fee schedule, the Billing Manager will assist the Director of Patient Revenue in reviewing every charge on the updated/approved year's fee schedule to confirm the rates and slide assignment match the Fee Schedule. 3. A quarterly audit of underinsured and self-pay patients will occur to review that adjustments are correct per agency policy for slide documentation. If the Cognizant or Oversight Agency for Audit has questions regarding this plan, please contact me at dsavie@genhealth.org or 860-456-6271. Sincerely, Debra Daviau Savoie, MBA Chief Financial Officer
2021-001
FAC accepted this audit on November 29, 2021 — management decision was due May 29, 2022.
Finding 2021-001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster, Health Center Program, COVID-19 Health Center Program, Grants for New and Expanded Services under the Health Center Program. Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Context A test of 25 discount transactions was performed and resulted in one instance where the documentation for sliding fee discount was not able to be provided. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based off approved documentation. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Show full finding ▾Hide full finding ▴Finding 2021-001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster, Health Center Program, COVID-19 Health Center Program, Grants for New and Expanded Services under the Health Center Program. Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's family size and income. Condition The Center did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Context A test of 25 discount transactions was performed and resulted in one instance where the documentation for sliding fee discount was not able to be provided. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based off approved documentation. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding No Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly supported. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
November 17, 2021 United States Department of Health and Human Services Generations Family Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2021. CohnReznick LLP 350 Church Street Hartford, CT 06103 Audit Period: June 30, 2021 The findings from the June 30, 2021 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FEDERAL AWARDS FINDINGS AND QUESTIONED COSTS SIGNIFICANT DEFICIENCY - Sliding Fee Scale Discount Recommendation The Center should ensure that internal controls are in place to ensure that all sliding fee discounts are properly supported. Action Taken: 1. Sliding Fee Scale Determination workflow will be reviewed to determine areas of improvement needed. 2. Additional Internal Controls will be developed to decrease discounts rendered without supporting documentation. 3. Billing Manager and Lead Patient Account Representatives will be assigned monthly audits for completion. If the Cognizant or Oversight Agency for Audit has questions regarding this plan, please call: Debra Savoie, CFO at (860-456-6271 ). Sincerely yours, Debra Daviau Savoie, MBA Chief Financial Officer
FAC accepted this audit on December 4, 2018 — management decision was due June 4, 2019.
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