EIN: 232555950
UEI: YYU3PQUJBCP1
Data as of August 21, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on December 19, 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 June 19, 2025 (428 days ago).
What is a management decision? →Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Context: A sample of 40 patients were tested out of the total population of 999 encounters. The sampling methodology used is not and is not intended to be statistically valid. 19 patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation and the organization did not have income documentation for 4 patients that received a sliding fee adjustment. Effect: Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause: The Organization did not comply with their sliding fee policy. Based on audit procedures performed, the income verification process was applied properly or there was lack of documentation to verify it was applied properly and therefore, patients were not charged the correct amount for the services provided. Questioned costs: None Repeat Finding: Is not a repeat finding. Recommendations: We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Organization’s Policy Compliance Manual.
Show full finding ▾Hide full finding ▴Finding 2024-001 – Special Tests and Provisions: Sliding Fee Determination and Related Patient Billing U.S. Department of Health and Human Services Assistance Listing Number 93.224 / 93.527, Health Center Program Cluster Criteria: Special Tests and Provisions: Sliding Fee Discounts. All section 330-funded health centers must prepare and apply a sliding fee discount schedule (SFDS), which adjust amount owed for health center services by eligible patients based on the patient’s ability to pay. Management is responsible to ensure controls are in place for patients to be charged in accordance with the SFDS and that income verifications are performed at least annually. Condition: Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Context: A sample of 40 patients were tested out of the total population of 999 encounters. The sampling methodology used is not and is not intended to be statistically valid. 19 patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation and the organization did not have income documentation for 4 patients that received a sliding fee adjustment. Effect: Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause: The Organization did not comply with their sliding fee policy. Based on audit procedures performed, the income verification process was applied properly or there was lack of documentation to verify it was applied properly and therefore, patients were not charged the correct amount for the services provided. Questioned costs: None Repeat Finding: Is not a repeat finding. Recommendations: We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Organization’s Policy Compliance Manual.
Views of Responsible Officials and Corrective Action Plan: Proper implementation of the sliding fee policy is a critical component of operating a successful FQHC. Project HOME’s sliding fee policy complies with all local, state, and federal funding or regulatory requirements, including those defined by HRSA as part of the Health Center Program pursuant to Section 330 of the Public Health Service Act. The policy and related procedures were reviewed and found to comply at the most recent HRSA site visit in March 2024. To address the identified deficiencies in oversight and effectiveness of controls related to the sliding fee discount income verification process, will implement the following actions: 1. Re-Training: Conduct comprehensive re-training sessions for all front desk team members on the sliding fee policies and procedures to ensure full understanding and compliance within 10 days for approved corrective action plan. Conduct an annual refresher training in the month of June. 2. Adherence to Controls: Reinforce adherence to all established controls outlined in the procedures, including the thorough review of all sliding fee discount program applications and income documentation. a. ACCT Sliding Fee Discount, Fee Waiver, and Payment Plan Policy b. ACCT Sliding Fee Discount, Fee Waiver, and Payment Plan Procedure 3. Monthly Audits: The Director of Operations will conduct monthly audits of the sliding fee discount program. This will involve random selection of applications to verify the accuracy of program documentation. Any identified errors will be promptly communicated to the VP of Health Services. All samples will be submitted to VP of Health Services for review. 4. Ongoing Audits: A designated member of the Project HOME accounting team will audit newly implemented sliding fee arrangements with patients. Any identified errors will be promptly communicated to the VP of Health Services and the Director of Operations. 5. Timely Re-Training: Upon identification of errors, necessary re-training for affected front desk team members will be addressed within one week of communication to ensure continuous compliance and improvement. 6. Corrective Action: Employees that are woefully non-compliant are subject to disciplinary action in accordance with Project HOME’s employee handbook. These actions aim to enhance oversight and ensure adherence to sliding fee policies and procedures, ultimately improving the effectiveness of the income verification process.
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