EIN: 330056551
UEI: MNNULJ6LJJF1
Audited by: Wipfli LLP
Oversight agency: 93 [Department of Health and Human Services]
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Data as of August 28, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on May 4, 2026. 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 November 4, 2026 (65 days from today).
What is a management decision? →FAC accepted this audit on May 8, 2025 — management decision was due November 8, 2025.
FAC accepted this audit on May 9, 2024 — management decision was due November 9, 2024.
FAC accepted this audit on May 23, 2023 — management decision was due November 23, 2023.
SECTION III ? FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001: PROGRAM INCOME ? CFDA #93.224 (Significant Deficiency in Internal Control over Compliance) Criteria: Per Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards at 2 CFR 200 (Uniform Guidance) for the Consolidated Health Centers grants, and per the grant agreement, centers are ?required to collect, or make every reasonable effort to collect appropriate reimbursement for their costs in providing health services to persons eligible for medical assistance.? Additionally, Health Centers are ?required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition/Effect: A patient was given an inappropriate sliding fee adjustment under the Organization's policy. Out of the total number of patients (11,268) who received a sliding fee adjustment, a sample of 30 patients was tested. One patient received an inappropriate adjustment based on their eligibility. As a result, improper sliding fee adjustments were given. Questioned Cost: N/A Cause: Organization personnel were not appropriately following the sliding fee policy. Repeat finding: This is a repeat finding. Recommendation: Management should ensure all personnel are informed of the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Because the policy affects the program income, procedures should be implemented to ensure that all patients are billed the appropriate amount based on the sliding fee scale and only individuals who qualify under the policy guidelines receive sliding fee scale adjustments. Patient files should include documentation of eligibility for such adjustments. Views of responsible officials and planned corrective actions: The Operations Department continues to utilize its audit tool to conduct monthly internal audits of the Sliding Fee Discount (SFD) program. The Organization has continued seeing an upward trend in the monthly internal audits. The current year SFD finding is due to the system incorrectly applying the correct SFD slide. The Organization has reached out for technical assistance with its Practice Management System (PMS) in identifying why the slide was applied inaccurately. Billing Department was trained to set up the SFD schedule in the PMS?s library if there is any upgrades to the PMS system.
Show full finding ▾Hide full finding ▴SECTION III ? FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001: PROGRAM INCOME ? CFDA #93.224 (Significant Deficiency in Internal Control over Compliance) Criteria: Per Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards at 2 CFR 200 (Uniform Guidance) for the Consolidated Health Centers grants, and per the grant agreement, centers are ?required to collect, or make every reasonable effort to collect appropriate reimbursement for their costs in providing health services to persons eligible for medical assistance.? Additionally, Health Centers are ?required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition/Effect: A patient was given an inappropriate sliding fee adjustment under the Organization's policy. Out of the total number of patients (11,268) who received a sliding fee adjustment, a sample of 30 patients was tested. One patient received an inappropriate adjustment based on their eligibility. As a result, improper sliding fee adjustments were given. Questioned Cost: N/A Cause: Organization personnel were not appropriately following the sliding fee policy. Repeat finding: This is a repeat finding. Recommendation: Management should ensure all personnel are informed of the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Because the policy affects the program income, procedures should be implemented to ensure that all patients are billed the appropriate amount based on the sliding fee scale and only individuals who qualify under the policy guidelines receive sliding fee scale adjustments. Patient files should include documentation of eligibility for such adjustments. Views of responsible officials and planned corrective actions: The Operations Department continues to utilize its audit tool to conduct monthly internal audits of the Sliding Fee Discount (SFD) program. The Organization has continued seeing an upward trend in the monthly internal audits. The current year SFD finding is due to the system incorrectly applying the correct SFD slide. The Organization has reached out for technical assistance with its Practice Management System (PMS) in identifying why the slide was applied inaccurately. Billing Department was trained to set up the SFD schedule in the PMS?s library if there is any upgrades to the PMS system.
Finding 2022-001 PROGRAM INCOME ? CFD #93.224 (Significant Deficiency in Internal Control over Compliance) Response: Corrective Action Plan The Operation Department will conduct a verification of the sliding fee scale. In their internal monthly Sliding Fee Discount audit process, the Site Manager is to review and verify each patient application, to the current Federal Poverty Level, to ensure patient is receiving the correct discount. Attached is a copy of policy and procedure for this corrective action plan.
2021-001
FAC accepted this audit on May 23, 2022 — management decision was due November 23, 2022.
Finding 2021-001: PROGRAM INCOME ? CFDA #93.224 (Significant Deficiency in Internal Control over Compliance) Criteria: Per Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards at 2 CFR 200 (Uniform Guidance) for the Consolidated Health Centers grants, and per the grant agreement, centers are ?required to collect, or make every reasonable effort to collect appropriate reimbursement for their costs in providing health services to persons eligible for medical assistance.? Additionally, Health Centers are ?required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition/Effect: A patient was given an inappropriate sliding fee adjustment under the Organization's policy. Out of the total number of patients (11,739) who received a sliding fee adjustment, a sample of 30 patients was tested. One patient received an inappropriate adjustment based on their eligibility. As a result, improper sliding fee adjustments were given. Questioned Cost: N/A Cause: Organization personnel were not appropriately following the sliding fee policy. Recommendation: Management should ensure all personnel are informed of the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Because the policy affects the program income, procedures should be implemented to ensure that all patients are billed the appropriate amount based on the sliding fee scale and only individuals who qualify under the policy guidelines receive sliding fee scale adjustments. Patient files should include documentation of eligibility for such adjustments. Management?s Response: The Operations Department continues to utilize its audit tool to conduct monthly internal audits of the Sliding Fee Discount (SFD) program. The Organization has continued seeing an upward trend in the monthly internal audits. The current year SFD finding is due to the system incorrectly applying the correct SFD slide. The Organization has reached out for technical assistance with its Practice Management System (PMS) in identifying why the slide was applied inaccurately. Billing Department was trained to set up the SFD schedule in the PMS?s library if there is any upgrades to the PMS system.
Show full finding ▾Hide full finding ▴Finding 2021-001: PROGRAM INCOME ? CFDA #93.224 (Significant Deficiency in Internal Control over Compliance) Criteria: Per Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards at 2 CFR 200 (Uniform Guidance) for the Consolidated Health Centers grants, and per the grant agreement, centers are ?required to collect, or make every reasonable effort to collect appropriate reimbursement for their costs in providing health services to persons eligible for medical assistance.? Additionally, Health Centers are ?required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay.? Condition/Effect: A patient was given an inappropriate sliding fee adjustment under the Organization's policy. Out of the total number of patients (11,739) who received a sliding fee adjustment, a sample of 30 patients was tested. One patient received an inappropriate adjustment based on their eligibility. As a result, improper sliding fee adjustments were given. Questioned Cost: N/A Cause: Organization personnel were not appropriately following the sliding fee policy. Recommendation: Management should ensure all personnel are informed of the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Because the policy affects the program income, procedures should be implemented to ensure that all patients are billed the appropriate amount based on the sliding fee scale and only individuals who qualify under the policy guidelines receive sliding fee scale adjustments. Patient files should include documentation of eligibility for such adjustments. Management?s Response: The Operations Department continues to utilize its audit tool to conduct monthly internal audits of the Sliding Fee Discount (SFD) program. The Organization has continued seeing an upward trend in the monthly internal audits. The current year SFD finding is due to the system incorrectly applying the correct SFD slide. The Organization has reached out for technical assistance with its Practice Management System (PMS) in identifying why the slide was applied inaccurately. Billing Department was trained to set up the SFD schedule in the PMS?s library if there is any upgrades to the PMS system.
Finding 2021-001 PROGRAM INCOME ? CFD #93.224 (Significant Deficiency in Internal Control over Compliance) Response: Corrective Action Plan 1. The Clinic Operations Department will continue to utilize its audit tools to conduct monthly random internal audits of the Sliding Fee Discount (SFD) program to validate the correct sliding fee. 2. The Billing Department?s Revenue Cycle Manager and Revenue Cycle Supervisor will conduct a monthly verification of the SFD program, by verifying the correct sliding fee schedule in the Practice Management System library. 3. In the event an inconsistency is identified with the current year SFD, Community Health Systems, Inc. (CHSI) will notify all pertinent parties and reach out for technical assistance from Practice Management System (PMS). 4. All corrective measures will take place by the proper department to restore the SFD and confirm the correct sliding fee is in place.
Finding 2021-002: PROGRAM INCOME ? CFDA #93.224 (Instance of Non-Compliance) Criteria: Per OMB Compliance Supplement for the Consolidated Health Centers grants, ?the health center must have a governing board that (1) consist of at least 9 and no more than 25 members; (2) is composed of individuals, a majority of whom are being served by the center and who, as a group, represent the individuals being served by the center; (3) non-patient health center board members must be representative of the community served by the health center and must be selected for their expertise in relevant subject areas and no more than one-half may derive more than 10% of their annual income from the health care industry; (4) may not be an employee of the center, or spouse or child, parent, brother or sister by blood or marriage of such an employee; and (5) is selected and removed based on the bylaws of the Organization or other internal governing rules.? Condition/Effect: The Organization did not maintain a governing board that met the requirements set forth in the grant. As of December 31, 2021, only five of ten active board members had been served by the center. Questioned Cost: N/A Cause: The Organization?s governing board did not adhere to the requirements of the grant. Recommendation: The Board of Directors should ensure every effort is made to adhere to the governing board requirements of the grant in order to maintain compliance. Management?s Response: The board will more closely monitor the requirements of the grant in order to avoid future instances of noncompliance by reviewing quarterly status reports indicating the number of visits required and remaining for the year.
Show full finding ▾Hide full finding ▴Finding 2021-002: PROGRAM INCOME ? CFDA #93.224 (Instance of Non-Compliance) Criteria: Per OMB Compliance Supplement for the Consolidated Health Centers grants, ?the health center must have a governing board that (1) consist of at least 9 and no more than 25 members; (2) is composed of individuals, a majority of whom are being served by the center and who, as a group, represent the individuals being served by the center; (3) non-patient health center board members must be representative of the community served by the health center and must be selected for their expertise in relevant subject areas and no more than one-half may derive more than 10% of their annual income from the health care industry; (4) may not be an employee of the center, or spouse or child, parent, brother or sister by blood or marriage of such an employee; and (5) is selected and removed based on the bylaws of the Organization or other internal governing rules.? Condition/Effect: The Organization did not maintain a governing board that met the requirements set forth in the grant. As of December 31, 2021, only five of ten active board members had been served by the center. Questioned Cost: N/A Cause: The Organization?s governing board did not adhere to the requirements of the grant. Recommendation: The Board of Directors should ensure every effort is made to adhere to the governing board requirements of the grant in order to maintain compliance. Management?s Response: The board will more closely monitor the requirements of the grant in order to avoid future instances of noncompliance by reviewing quarterly status reports indicating the number of visits required and remaining for the year.
Finding 2021-002 PROGRAM INCOME ? CFD #93.224 (Instance of Non-Compliance) Response: Corrective Action Plan CHSI will present quarterly reports to the Board of the patient requirements set by HRSA to ensure compliance in this category. In addition, CHSI will request staff to participate in recruitment of new patient Board Members. CHSI will be attentive in identifying current patients that have the potential to make dedicated board members.
FAC accepted this audit on June 1, 2021 — management decision was due December 1, 2021.
FAC accepted this audit on May 12, 2020 — management decision was due November 12, 2020.
FAC accepted this audit on May 22, 2019 — management decision was due November 22, 2019.
FAC accepted this audit on May 23, 2018 — management decision was due November 23, 2018.
FAC accepted this audit on June 7, 2017 — management decision was due December 7, 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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