EIN: 232160896
UEI: GSA_MIGRATION
Audited by: MCKONLY & ASBURY
Oversight agency: 93 [Department of Health and Human Services]
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Data as of August 31, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on December 14, 2021. 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 June 14, 2022 (1540 days ago).
What is a management decision? →SECTION II ? FINANCIAL STATEMENT FINDINGS None. SECTION III ? FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Material Weakness Finding No. 2021-001 ? Sliding Fee Determination and Related Patient Billing CFDA No. 93.224 Consolidated Health Centers Program Cluster U.S. Department of Health and Human Services Compliance Requirement: Special Test Type of Finding: Material noncompliance Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjusts amounts owed for health center services by eligible patients based on the patient?s ability to pay. The National Health Services Corps (NHSC) statute mandates that NHSC-approved sites ?not deny requested health care services, and shall not discriminate in the provision of services to an individual because the individual is unable to pay for the services.? It stipulates, ?the entity shall prepare a schedule of discounts (including, in appropriate cases, waivers) to be applied to the payment of such fees or payments. In preparing the schedule, the entity shall adjust the discounts on the basis of a patient?s ability to pay.? (42 U.S.C. ? 254g) Condition and Context: As part of our compliance testing procedures for the Health Resources and Services Administration (HRSA) 330 grant program, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, four (7%) were found to have exceptions in the amount charged to the patient. Cause: In four instances, the patient was assigned the incorrect sliding discount level and therefore billed the improper amount. Effect: Four patients, out of a sample of sixty patients, were inaccurately billed for the services provided by the Center. One patient was overcharged $15 and three patients were under charged for a total of $272. Recommendation: Lancaster Health Center has established policies and controls which did not operate effectively in these instances. We recommend that management strengthen and expand the procedures for review of manual data inputs and enhance their training programs on sliding fee scale processes and procedures. Responsible Official?s Response: During the year there was no billing staff at each location to train and support front desk personnel with sliding fee applications at the time of service. This led to errors and inconsistencies with income verification and sliding fee determination. On November 1, 2021, Lancaster Health Center placed billing staff at each site location to support, train and review sliding fee applications with front desk personnel at time of service. This will improve internal controls and enhance staff training. On-site billing staff will also be available to review and discuss applications with patients. We will also conduct internal audits of sliding fee applications and selection of correct slide amounts credited to patients. Planned Implementation Date of Corrective Action: November 1, 2021 Person Responsible for Corrective Action: Chief Financial Officer
Show full finding ▾Hide full finding ▴SECTION II ? FINANCIAL STATEMENT FINDINGS None. SECTION III ? FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Material Weakness Finding No. 2021-001 ? Sliding Fee Determination and Related Patient Billing CFDA No. 93.224 Consolidated Health Centers Program Cluster U.S. Department of Health and Human Services Compliance Requirement: Special Test Type of Finding: Material noncompliance Criteria: All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjusts amounts owed for health center services by eligible patients based on the patient?s ability to pay. The National Health Services Corps (NHSC) statute mandates that NHSC-approved sites ?not deny requested health care services, and shall not discriminate in the provision of services to an individual because the individual is unable to pay for the services.? It stipulates, ?the entity shall prepare a schedule of discounts (including, in appropriate cases, waivers) to be applied to the payment of such fees or payments. In preparing the schedule, the entity shall adjust the discounts on the basis of a patient?s ability to pay.? (42 U.S.C. ? 254g) Condition and Context: As part of our compliance testing procedures for the Health Resources and Services Administration (HRSA) 330 grant program, we tested sixty patients billed under a sliding fee discount schedule. Of the patients tested, four (7%) were found to have exceptions in the amount charged to the patient. Cause: In four instances, the patient was assigned the incorrect sliding discount level and therefore billed the improper amount. Effect: Four patients, out of a sample of sixty patients, were inaccurately billed for the services provided by the Center. One patient was overcharged $15 and three patients were under charged for a total of $272. Recommendation: Lancaster Health Center has established policies and controls which did not operate effectively in these instances. We recommend that management strengthen and expand the procedures for review of manual data inputs and enhance their training programs on sliding fee scale processes and procedures. Responsible Official?s Response: During the year there was no billing staff at each location to train and support front desk personnel with sliding fee applications at the time of service. This led to errors and inconsistencies with income verification and sliding fee determination. On November 1, 2021, Lancaster Health Center placed billing staff at each site location to support, train and review sliding fee applications with front desk personnel at time of service. This will improve internal controls and enhance staff training. On-site billing staff will also be available to review and discuss applications with patients. We will also conduct internal audits of sliding fee applications and selection of correct slide amounts credited to patients. Planned Implementation Date of Corrective Action: November 1, 2021 Person Responsible for Corrective Action: Chief Financial Officer
During the year there was no billing staff at each location to train and support front desk personnel with sliding fee applications at the time of service. This led to errors and inconsistencies with income verification and sliding fee determination. On November 1, 2021, Lancaster Health Center placed billing staff at each site location to support, train and review sliding fee applications with front desk personnel at time of service. This will improve internal controls and enhance staff training. On-site billing staff will also be available to review and discuss applications with patients. We will also conduct internal audits of sliding fee applications and selection of correct slide amounts credited to patients.
FAC accepted this audit on November 5, 2020 — management decision was due May 5, 2021.
FAC accepted this audit on August 21, 2019 — management decision was due February 21, 2020.
FAC accepted this audit on August 14, 2018 — management decision was due February 14, 2019.
FAC accepted this audit on August 6, 2017 — management decision was due February 6, 2018.
FAC accepted this audit on August 21, 2016 — management decision was due February 21, 2017.
Data source: This information comes from the Federal Audit Clearinghouse, the official repository of Single Audit data. All data is public domain. Verify this organization's audit history at fac.gov.
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