EIN: 270216316
UEI: HM8AGGB4CM37
Data as of August 22, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on June 4, 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 December 4, 2024 (626 days ago).
What is a management decision? →2 out of 43 selected patients receiving healthcare under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. Context: We recalculated the annual income thresholds utilizing the patient files to validate the sliding fee scale in which the patients were categorized. 2 out of 43 selected patients receiving healthcare services under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. This was not a statistically valid sample. Effect: 2 out of 43 patients were not charged the appropriate fees based on their income levels. Incorrect payment amount was received per the sliding fee scale. This is a significant deficiency in internal controls. Cause: A review was not performed properly to verify that annual patient income was input correctly. Recommendation: We recommend that HHLI continue to implement procedures to ensure that the sliding fee scale is appropriately charged to every patient and that an annual verification is performed. Procedures should also be implemented to validate the accuracy of the annual patient income for sliding scale categorization purposes.
Show full finding ▾Hide full finding ▴Finding 2023-001: Special Tests and Provisions - Significant Deficiency – Incorrect Application of the Sliding Scale Federal Assistance Listing Number: 93.224/93.527- Health Center Program Cluster [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers: H80CS00313-13-12; H8FCS41390-01-00, H2ECS45521-01-00 Federal Award Year: January 1, 2023- December 31, 2023 Pass-Through Entity: Sun River Health Care Criteria: Under 42 CFR Sections 51c.303(e), (f) and (g), health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay. To verify this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. HHLI should maintain patient files to support the patient's eligibility and that the patient charges were appropriately adjusted based on income and family size by appropriately applying HHLI's sliding fee discount schedule. Questioned Cost: None Condition: 2 out of 43 selected patients receiving healthcare under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. Context: We recalculated the annual income thresholds utilizing the patient files to validate the sliding fee scale in which the patients were categorized. 2 out of 43 selected patients receiving healthcare services under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. This was not a statistically valid sample. Effect: 2 out of 43 patients were not charged the appropriate fees based on their income levels. Incorrect payment amount was received per the sliding fee scale. This is a significant deficiency in internal controls. Cause: A review was not performed properly to verify that annual patient income was input correctly. Recommendation: We recommend that HHLI continue to implement procedures to ensure that the sliding fee scale is appropriately charged to every patient and that an annual verification is performed. Procedures should also be implemented to validate the accuracy of the annual patient income for sliding scale categorization purposes.
Views of Responsible Officials and Planned and Corrective Actions: As a result of prior audit finding, HHLI has instituted mandated training sessions with a required curriculum for a sliding fee scale. These training were conducted over a period which included competency testing and retraining if necessary. It is documented that we have had a high turnover of clerical staff during the past year. As a result, we had the task of training new clerical staff as we were onboarded. We understand this interrupted the continuity of learned processes for our clerical staff and thus the outlined process. As well, we have continued with our internal audit processes. We have identified an internal report through our data system that weekly provides information on variances of sliding fee scale processes. We have met internally and reviewed the current policy and training curriculum. We look to simplify the process for our clerical staff. We anticipate partnering with our EMR platform and standardizing the language for the sliding fee scale process. We want to leverage technology to support the procedural process for the sliding fee scale. We also will inform staff to document variances of findings. Please note that our patients were not negatively impacted or financially affected. Responsible Party: Stacey Harley, Chief Operating Officer, EMR administrator, and Site Leadership Estimated Time of Completion: September 30, 2024
2022-001
FAC accepted this audit on May 24, 2023 — management decision was due November 24, 2023.
3 out of 40 selected patients receiving healthcare under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. Context: We recalculated the annual income thresholds utilizing the patient files to validate the sliding fee scale in which the patients were categorized. 3 out of 40 selected patients receiving healthcare services under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. This was not a statistically valid sample. Effect: 3 out of 40 patients were not charged the appropriate fees based on their income levels. Incorrect payment amount was received per the sliding fee scale. This is a significant deficiency in internal controls. Cause: A review was not performed to verify that annual patient income was input correctly. The updated sliding fee scale was not uploaded and utilized timely. Recommendation: We recommend that LIFQHC continue to implement procedures to ensure that the sliding fee scale is appropriately charged to every patient and that an annual verification is performed. Procedures should also be implemented to validate the accuracy of the annual patient income for sliding scale categorization purposes. The updated sliding fee scale should be approved by the board and updated timely. Views of Responsible Officials and Planned and Corrective Actions: LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients' information, such as income, in order to ensure that all patients are charged appropriately. All the above findings were happened before the training was provided. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current year's poverty guidelines are available. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
Show full finding ▾Hide full finding ▴Finding 2022-001: Special Tests and Provisions - Significant Deficiency - Failure to Update and Apply the Sliding Scale Federal Assistance Listing Number: 93.224/93.527- Health Center Program [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers: H80CS00313-13-12; H8FCS41390-01-00, H2ECS45521-01-00 Federal Award Year: January 1, 2022- December 31, 2022 Pass-Through Entity: Hudson River Health Care Criteria: Under 42 CFR Sections 51c.303(e), (f) and (g), health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay. To verify this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. LIFQHC should maintain patient files to support the patient's eligibility and that the patient charges were appropriately adjusted based on income and family size by appropriately applying LIFQHC's sliding fee discount schedule. Questioned Cost: None Condition: 3 out of 40 selected patients receiving healthcare under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. Context: We recalculated the annual income thresholds utilizing the patient files to validate the sliding fee scale in which the patients were categorized. 3 out of 40 selected patients receiving healthcare services under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. This was not a statistically valid sample. Effect: 3 out of 40 patients were not charged the appropriate fees based on their income levels. Incorrect payment amount was received per the sliding fee scale. This is a significant deficiency in internal controls. Cause: A review was not performed to verify that annual patient income was input correctly. The updated sliding fee scale was not uploaded and utilized timely. Recommendation: We recommend that LIFQHC continue to implement procedures to ensure that the sliding fee scale is appropriately charged to every patient and that an annual verification is performed. Procedures should also be implemented to validate the accuracy of the annual patient income for sliding scale categorization purposes. The updated sliding fee scale should be approved by the board and updated timely. Views of Responsible Officials and Planned and Corrective Actions: LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients' information, such as income, in order to ensure that all patients are charged appropriately. All the above findings were happened before the training was provided. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current year's poverty guidelines are available. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients' information, such as income, in order to ensure that all patients are charged appropriately. All the above findings were happened before the training was provided. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current year's poverty guidelines are available. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
2021-002
FAC accepted this audit on July 16, 2022 — management decision was due January 16, 2023.
3 out of 40 selected patients receiving healthcare under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. Context: We recalculated the annual income thresholds utilizing the patient files to validate the sliding fee scale in which the patients were categorized. 3 out of 40 selected patients receiving healthcare services under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. This was not a statistically valid sample. Effect: 3 out of 40 patients were not charged the appropriate fees based on their income levels. Payment received, if any, was below the correct amount per the sliding fee scale. This is a significant deficiency in internal controls. Cause: A review was not performed to verify that the sliding fee scale was applied to the correct or the most recently approved sliding fee scale was utilized. Recommendation: We recommend that LIFQHC implement procedures to ensure that the sliding fee scale is appropriately charged to every patient, and that an annual verification is performed. Procedures should also be implemented to validate the accuracy of the annual patient income for sliding scale categorization purposes. Views of Responsible Officials and Planned and Corrective Actions: LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients? information, such as income, to verify that all patients are charged appropriately. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current years poverty guidelines are available. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
Show full finding ▾Hide full finding ▴Federal Assistance Listing Number: 93.224 - Health Center Program Cluster [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers in Cluster: H80CS00313-13-12; H8CCS35118-01-00; H8DCS36593-01-00; H8ECS38680-01-00; H8FCS41390-01-00 Federal Award Year in Cluster: January 1, 2021 ? December 31, 2021 Pass-Through Entity: Hudson River Health CareCriteria: Under 42 CFR Sections 51c.303(e), (f) and (g), health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay. To verify that this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. LIFQHC should maintain patient files to support the patient's eligibility and that the patient charges were appropriately adjusted based on income and family size by appropriately applying LIFQHC?s sliding fee discount schedule. Questioned Cost: None Condition: 3 out of 40 selected patients receiving healthcare under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. Context: We recalculated the annual income thresholds utilizing the patient files to validate the sliding fee scale in which the patients were categorized. 3 out of 40 selected patients receiving healthcare services under the sliding fee arrangement had income which did not align with the sliding scale category, and therefore, were not charged appropriately based on the appropriate sliding scale category. This was not a statistically valid sample. Effect: 3 out of 40 patients were not charged the appropriate fees based on their income levels. Payment received, if any, was below the correct amount per the sliding fee scale. This is a significant deficiency in internal controls. Cause: A review was not performed to verify that the sliding fee scale was applied to the correct or the most recently approved sliding fee scale was utilized. Recommendation: We recommend that LIFQHC implement procedures to ensure that the sliding fee scale is appropriately charged to every patient, and that an annual verification is performed. Procedures should also be implemented to validate the accuracy of the annual patient income for sliding scale categorization purposes. Views of Responsible Officials and Planned and Corrective Actions: LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients? information, such as income, to verify that all patients are charged appropriately. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current years poverty guidelines are available. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients? information, such as income, to verify that all patients are charged appropriately. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current years poverty guidelines are available.
The first quarter of 2021 expenditure report was not filed within 30 days of the end of the quarter. Context: The first quarter of 2021 expenditure report was filed 32 days after the end of the quarter. This was not a statistically valid sample. Effect: One of the quarterly expenditure reports was filed 32 days after the end of the quarter. Cause: There was turnover at the Chief Financial Officer position and additional time was needed for the new Chief Financial Officer to have access to the filing. Recommendation: LIFQHC should have procedures in place to ensure that quarterly reports are filed on a timely basis in accordance with requirements and that more than one individual has access to the filing. Views of Responsible Officials and Planned and Corrective Actions: Effective April 1, 2022, the quarterly Federal Financial Report (FFR) is no longer required by the U.S Health Resources and Services Administration (HRSA). The first quarterly FFR report for 2021 was due on Friday, April 30, 2021, based on HRSA guidelines, and LIFQHC filed that report on Monday, May 3, 2021. LIFQHC?s account was never placed on hold for untimely filing. To our knowledge, LIFQHC was not out of compliance. The LIFQHC finance department had significant turnover in 2021 and access to HRSA system contributed to the late filing of the first quarterly 2021 FFR report. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
Show full finding ▾Hide full finding ▴Federal Assistance Listing Number: 93.224 - Health Center Program Cluster [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers in Cluster: H80CS00313-13-12; H8CCS35118-01-00; H8DCS36593-01-00; H8ECS38680-01-00; H8FCS41390-01-00Federal Award Year in Cluster: January 1, 2021 ? December 31, 2021 Pass-Through Entity: Hudson River Health Care Criteria: LIFQHC is required to submit quarterly expenditure reports within 30 days of the end of the quarter. Questioned Cost: None Condition: The first quarter of 2021 expenditure report was not filed within 30 days of the end of the quarter. Context: The first quarter of 2021 expenditure report was filed 32 days after the end of the quarter. This was not a statistically valid sample. Effect: One of the quarterly expenditure reports was filed 32 days after the end of the quarter. Cause: There was turnover at the Chief Financial Officer position and additional time was needed for the new Chief Financial Officer to have access to the filing. Recommendation: LIFQHC should have procedures in place to ensure that quarterly reports are filed on a timely basis in accordance with requirements and that more than one individual has access to the filing. Views of Responsible Officials and Planned and Corrective Actions: Effective April 1, 2022, the quarterly Federal Financial Report (FFR) is no longer required by the U.S Health Resources and Services Administration (HRSA). The first quarterly FFR report for 2021 was due on Friday, April 30, 2021, based on HRSA guidelines, and LIFQHC filed that report on Monday, May 3, 2021. LIFQHC?s account was never placed on hold for untimely filing. To our knowledge, LIFQHC was not out of compliance. The LIFQHC finance department had significant turnover in 2021 and access to HRSA system contributed to the late filing of the first quarterly 2021 FFR report. Responsible Party: Savitree Pestano, Chief Financial Officer Estimated Time of Completion: December 31, 2022
Effective April 1, 2022, the quarterly Federal Financial Report (FFR) is no longer required by the U.S Health Resources and Services Administration (HRSA). The first quarterly FFR report for 2021 was due on Friday, April 30, 2021, based on HRSA guidelines, and LIFQHC filed that report on Monday, May 3, 2021. LIFQHC?s account was never placed on hold for untimely filing. To our knowledge, LIFQHC was not out of compliance. The LIFQHC finance department had significant turnover in 2021 and access to HRSA system contributed to the late filing of the first quarterly 2021 FFR report.
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