EIN: 262735317
UEI: JTL8WJ3Y11L5
Audited by: Terry Horne, CPA
Oversight agency: 93 [Department of Health and Human Services]
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Data as of September 2, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on September 22, 2025. 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 March 22, 2026 (165 days ago).
What is a management decision? →Health centers that receive funding under the Health Center Program Cluster are required to document sliding fee discounts in accordance with the Organization’s policies. During compliance testing, it was determined that the Organization did not maintain proper documentation of all necessary elements of sliding fee discounts as required by the policy. This was a result of sliding fee applications being incomplete, expired, or missing. One patient did not receive a discount when the patient qualified for a discount based on the Organization’s policies. In addition, the Organization’s sliding fee policy does not address one-day self-certification for patients who have no income support documentation. Cause: There were deficiencies in internal controls over the Organization’s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained from the patients, and that the resulting sliding fee discounts were correctly calculated and applied in accordance with the Organization’s sliding fee policy. Effect: Documentation to substantiate discounts applied to certain patient accounts was not available for certain sliding fee patient visits during the year. One patient who qualified to receive a discount did not receive a discount. Questioned Costs: None Context/Sampling: For 12 of 48 patients selected for testing, sliding fee applications were incomplete, missing, or expired. For 1 of 48 patients selected for testing, the patient did not receive a discount when the patient qualified for a discount based on the Organization’s sliding fee policies. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees be trained to maintain the required documentation, for sliding fee discounts provided. It is also recommended that patient records are reviewed by a supervisor, on a periodic basis, to ensure that the required documentation is properly maintained and that patients who qualify for a discount receive the appropriate discount. It is also recommended that the Organization update its sliding fee policy to address self-certification for patients who have no income support documentation. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2025
Show full finding ▾Hide full finding ▴Material Weakness Finding: 2025-001 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. - 93.224 and 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster are required to document sliding fee discounts in accordance with the Organization’s policies. During compliance testing, it was determined that the Organization did not maintain proper documentation of all necessary elements of sliding fee discounts as required by the policy. This was a result of sliding fee applications being incomplete, expired, or missing. One patient did not receive a discount when the patient qualified for a discount based on the Organization’s policies. In addition, the Organization’s sliding fee policy does not address one-day self-certification for patients who have no income support documentation. Cause: There were deficiencies in internal controls over the Organization’s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained from the patients, and that the resulting sliding fee discounts were correctly calculated and applied in accordance with the Organization’s sliding fee policy. Effect: Documentation to substantiate discounts applied to certain patient accounts was not available for certain sliding fee patient visits during the year. One patient who qualified to receive a discount did not receive a discount. Questioned Costs: None Context/Sampling: For 12 of 48 patients selected for testing, sliding fee applications were incomplete, missing, or expired. For 1 of 48 patients selected for testing, the patient did not receive a discount when the patient qualified for a discount based on the Organization’s sliding fee policies. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: Yes Recommendation: It is recommended that employees be trained to maintain the required documentation, for sliding fee discounts provided. It is also recommended that patient records are reviewed by a supervisor, on a periodic basis, to ensure that the required documentation is properly maintained and that patients who qualify for a discount receive the appropriate discount. It is also recommended that the Organization update its sliding fee policy to address self-certification for patients who have no income support documentation. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2025
In Finding 2025-001, it was reported that the Organization did not maintain proper documentation of all necessary elements of sliding fee discounts as required by the Organization’s policy. This was a result of sliding fee applications being incomplete, expired, or missing. In addition, one patient who qualified for a discount did not receive a discount. Management recognizes the importance of complying with federal sliding fee guidelines and the Organization’s sliding fee policy. In response to Finding 2025-001, procedures will be established to ensure employees are trained to maintain the required documentation, including sliding fee applications, for sliding fee discounts provided. The Organization will establish procedures to ensure that selected patient records are reviewed by a supervisor on a periodic basis to ensure that the required documentation is properly maintained and that the patients receive the proper discount in accordance with the Organization’s policies.
2024-003
FAC accepted this audit on September 23, 2024 — management decision was due March 23, 2025.
The Organization did not verify that employees and certain vendors were not suspended, debarred, or otherwise excluded from participating in federal programs before entering into transactions with them. Cause: The Organization did not have proper procedures in place to ensure debarment searches were obtained as required. Effect: The Organization did not verify that employees and certain vendors were not suspended, debarred, or otherwise excluded from participating in federal programs before entering into transactions with them. Questioned Costs: None reported. Context/Sampling: The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: It is recommended that the Organization establish policies and procedures to ensure that the procurement policy is followed and that debarment searches are performed and documented as required. Views of Responsible Officials: Management concurs. Management will establish policies and procedures to ensure that employees and vendors are not suspended, debarred or otherwise excluded from participating in federal programs. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2024
Show full finding ▾Hide full finding ▴Finding: 2024-002 Procurement, Suspension, and Debarment Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. - 93.527 Criteria: Procurement 45 CFR 75.329 and 45 CFR 75.213 Condition: The Organization did not verify that employees and certain vendors were not suspended, debarred, or otherwise excluded from participating in federal programs before entering into transactions with them. Cause: The Organization did not have proper procedures in place to ensure debarment searches were obtained as required. Effect: The Organization did not verify that employees and certain vendors were not suspended, debarred, or otherwise excluded from participating in federal programs before entering into transactions with them. Questioned Costs: None reported. Context/Sampling: The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: It is recommended that the Organization establish policies and procedures to ensure that the procurement policy is followed and that debarment searches are performed and documented as required. Views of Responsible Officials: Management concurs. Management will establish policies and procedures to ensure that employees and vendors are not suspended, debarred or otherwise excluded from participating in federal programs. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2024
In Finding 2024-002, a condition was noted in which the Organization did not verify that employees and certain vendors were not suspended, debarred, or otherwise excluded from participating in federal programs before entering into transactions with them. Management recognizes the importance of complying with procurement, debarment, and suspension guidelines. In response to Finding 2024-002, procedures will be implemented to ensure debarment searches are completed and properly documented.
Health centers that receive funding under the Health Center Program Cluster are required to document sliding fee discounts in accordance with the Organization’s policies. During compliance testing, it was determined that the Organization did not maintain proper documentation of all necessary elements of sliding fee discounts as required by the Organization’s policy. This was a result of sliding fee applications being incomplete, expired, or missing. Cause: There were deficiencies in internal controls over the Organization’s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained from the patients, and that the resulting sliding fee discounts were correctly calculated in accordance with the Organization’s sliding fee policy. Effect: Documentation to substantiate discounts applied to certain patient accounts was not available for certain sliding fee patient visits during the year. Questioned Costs: None Context/Sampling: For 18 of 48 patients selected for testing, sliding fee applications were incomplete, missing, or expired. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: It is recommended that employees be trained to maintain the required documentation, including sliding fee applications, for sliding fee discounts provided. It is also recommended that patient records are reviewed by a supervisor on a periodic basis to ensure that the required documentation is properly maintained. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2024
Show full finding ▾Hide full finding ▴Finding: 2024-003 Sliding Fee Discounts Federal Programs: Department of Health and Human Services Health Center Program Cluster Assistance Listing No. - 93.527 Criteria: Uniform Guidance, Special Tests & Provisions, Sliding Fee Discounts, 42 CFR, 56.303 Condition: Health centers that receive funding under the Health Center Program Cluster are required to document sliding fee discounts in accordance with the Organization’s policies. During compliance testing, it was determined that the Organization did not maintain proper documentation of all necessary elements of sliding fee discounts as required by the Organization’s policy. This was a result of sliding fee applications being incomplete, expired, or missing. Cause: There were deficiencies in internal controls over the Organization’s sliding fee program. For certain patient accounts that were tested as part of the audit, the Organization was unable to substantiate that proper documentation was obtained from the patients, and that the resulting sliding fee discounts were correctly calculated in accordance with the Organization’s sliding fee policy. Effect: Documentation to substantiate discounts applied to certain patient accounts was not available for certain sliding fee patient visits during the year. Questioned Costs: None Context/Sampling: For 18 of 48 patients selected for testing, sliding fee applications were incomplete, missing, or expired. This sample was not, and was not intended to be, a statistically valid sample. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: It is recommended that employees be trained to maintain the required documentation, including sliding fee applications, for sliding fee discounts provided. It is also recommended that patient records are reviewed by a supervisor on a periodic basis to ensure that the required documentation is properly maintained. Views of Responsible Officials: Management concurs. Efforts will be made to implement corrective actions as recommended above. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2024
In Finding 2024-003, it was reported that the Organization was unable to substantiate that proper documentation was obtained and that proper sliding fee discounts were correctly applied to patient accounts in accordance with the Organization’s sliding fee policy. Management recognizes the importance of complying with sliding fee guidelines and the Organization’s sliding fee policy. In response to Finding 2024-003, procedures will be established to ensure that proper documentation is maintained for sliding fee discounts provided.
Time/activity reports (time sheets) are not maintained for salaried employees as required by federal cost principles. Cause: The Organization’s policy does not require that salaried employees maintain time and effort reports that coincide with the Organization’s payroll cycle (at least on a monthly basis). Effect: Failure to comply with federal requirements regarding personnel cost and time and effort could result in a reduction of grant funds. Questioned Costs: None Context/Sampling: A test of payroll disbursements revealed that time and effort certifications for salaried employees were not maintained. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: The Organization should evaluate and revise its policies to ensure that the policies require personnel to document time and efforts in accordance with federal cost principles. Procedures should subsequently be established to ensure that all salaried employees maintain time and effort reports in accordance with the revised policy. It is recommended that time and effort certifications be prepared no less than monthly and coincide with the Organization’s payroll cycle. Views of Responsible Officials: Policies and procedures will be established to ensure that salaried employees maintain time and effort reports that coincide with the Organization’s payroll cycle. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2024
Show full finding ▾Hide full finding ▴Finding: 2024-004 Monthly Time/Activity Reports not Maintained for Salaried Employees Federal Program Identification: U.S. Department of Health and Human Services Health Center Cluster Assistance Listing No. 93.527 Criteria: Uniform Guidance Compliance Supplement, Grant Policy Statements, 45 CFR, 75.430 Condition: Time/activity reports (time sheets) are not maintained for salaried employees as required by federal cost principles. Cause: The Organization’s policy does not require that salaried employees maintain time and effort reports that coincide with the Organization’s payroll cycle (at least on a monthly basis). Effect: Failure to comply with federal requirements regarding personnel cost and time and effort could result in a reduction of grant funds. Questioned Costs: None Context/Sampling: A test of payroll disbursements revealed that time and effort certifications for salaried employees were not maintained. The finding appears to be a systemic issue. Repeat Finding from Prior Year: No Recommendation: The Organization should evaluate and revise its policies to ensure that the policies require personnel to document time and efforts in accordance with federal cost principles. Procedures should subsequently be established to ensure that all salaried employees maintain time and effort reports in accordance with the revised policy. It is recommended that time and effort certifications be prepared no less than monthly and coincide with the Organization’s payroll cycle. Views of Responsible Officials: Policies and procedures will be established to ensure that salaried employees maintain time and effort reports that coincide with the Organization’s payroll cycle. Contact Person: Mark Rajkowski, CEO Anticipated Date of Completion: October 31, 2024
In Finding 2024-004, it was reported that time and activity report are not maintained for salaried employees. The Organization’s operating processes in place do not require salaried employees to certify time and efforts on a monthly basis. Procedures will be established to maintain time and effort certifications by all salaried employees. Procedures will be established to ensure that salaried employees certify time and effort that coincide with the Organization’s payroll cycle (at least on a monthly basis).
FAC accepted this audit on December 19, 2023 — management decision was due June 19, 2024.
FAC accepted this audit on December 30, 2022 — management decision was due June 30, 2023.
FAC accepted this audit on September 6, 2022 — management decision was due March 6, 2023.
FAC accepted this audit on January 26, 2021 — management decision was due July 26, 2021.
FAC accepted this audit on November 19, 2019 — management decision was due May 19, 2020.
FAC accepted this audit on September 26, 2018 — management decision was due March 26, 2019.
FAC accepted this audit on February 13, 2018 — management decision was due August 13, 2018.
FAC accepted this audit on May 1, 2017 — management decision was due November 1, 2017.
GSA_MIGRATION
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GSA_MIGRATION
2015-001
GSA_MIGRATION
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GSA_MIGRATION
2015-002
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