Ohio Northeast Health Systems, Inc.Non-Profit

Information on the federal program – Assistance Listing Number 93.224/93.527, Health Center Program Cluster from the U.S. Department of Health and Human Services, Federal Award No. 6 H80CS00196 for project period January 1, 2023 through December 31, 2025. Criteria or specific requirement – Health centers must comply with federal reporting requirements. Condition – The Organization incorrectly reported a certain line item on the Uniform Data System (UDS) report filed. Within Table 9E of the UDS report, the amount reported within line 1q column A was inaccurate. Recommendation – We recommend management implement an additional layer of review of reports by an individual with knowledge of the reporting requirements. Views of responsible officials and planned corrective actions – See separate auditee document for planned corrective action. Cause – There was a lack of detailed review of the amounts reported on the UDS. Effect or potential effect – Inaccurate filing of reports may result in the federal program not being properly monitored, thus resulting in potential noncompliance with program requirements. Questioned costs – None Context – 1 special report was required to be submitted during the year under audit (UDS), thus this was the only report selected for testing. On this report 10 line items were tested, and of those 10 items, 1 of the lines was inaccurately reported. Identification as a repeat finding – Not a repeat finding.

Information on the federal program – Assistance Listing Number 93.224/93.527, Health Center Program Cluster from the U.S. Department of Health and Human Services, Federal Award No. 6 H80CS00196 for project period January 1, 2023 through December 31, 2025. Criteria or specific requirement – Health centers must prepare and apply a sliding fee discount schedule that incorporates the provisions of 42 CFR 51c.303e through 56.303g to ensure that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition – The audit of the major federal program identified errors in the application of sliding fee adjustments. Cause – The sliding fee calculation was improperly set up within the Electronic Health Record System. Effect or potential effect – Inaccurate application of sliding fee adjustments may result in potential noncompliance with program requirements. Questioned costs – Not applicable Context – Out of a population of 1,478 sliding fee adjustments, a sample of 25 adjustments were tested. Out of the 25 tested, 6 adjustments were incorrectly calculated based on the Organization’s approved sliding fee scales and the patient’s sliding fee application. A non-statistical sampling methodology was used to select the sample. Identification as a repeat finding – Is a repeat finding (see 2023-001) Recommendation – We recommend that the Organization perform a review of the calculation of the sliding fee adjustments within the Electronic Health Record system to ensure it is properly set up. Additionally, we recommend that a member of management with an understanding of the Organization’s billing and sliding fee policies regularly review a sample of sliding fee adjustments in comparison to the Organization’s sliding fee policy. Views of responsible officials and planned corrective actions – See separate auditee document for planned corrective action.

Information on the federal program - Assistance Listing Number 93.224/93.527, Health Center Program Cluster from the U.S. Department of Health and Human Services, Federal Award No. 6 H80CS00196 for project period January 1, 2023 through December 31, 2025. Criteria or specific requirement - Health centers must prepare and apply a sliding fee discount schedule that incorporates the provisions of 42 CFR 51c.3032 through 56.303g to ensure that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition - The audit of the major federal program identified errors in the application of sliding fee adjustments. Questioned costs - Not applicable Context - Out of a population of 1,547 sliding fee adjustments, a sample of 25 adjustments were tested. Out of the 25 tested, 2 adjustments were incorrectly calculated based on the Organization’s approved sliding fee scales and the patient’s sliding fee application. A non-statistical sampling methodology was used to select the sample. Effect - The sliding fee adjustments were not appropriately applied. Cause - Manual inputs required to calculate the sliding fee discounts resulted in errors in application of the sliding fee scales. Identification as a repeat finding - Not a repeat finding. Recommendation - We recommend that the Organization implement a review process for sliding fee and other adjustments applied in the billing system, including review for the sliding fee application and relating supporting documents. Additionally, we recommend that a member of management with an understanding of the Organization’s billing and sliding fee policies regularly review a sample of sliding fee adjustments in comparison to the Organization’s sliding fee policy. Views of responsible officials and planned corrective actions - The Organization agrees with the finding. See separate auditee document for planned corrective action.

Finding Number: 2019-001 Significant Deficiency/Non-Compliance - Reporting Program Information: U.S. Department of Health and Human Services Consolidated Health Centers Cluster, CFDA 93.224 and 93.527 Award Number: H80CS00196 Criteria: As part of the reporting compliance requirement, the Office of Management and Budget (OMB) Compliance Supplement indicates that the Uniform Data Systems (UDS) Report is a critical report for testing during the compliance audit and also indicates that Table 8A contains critical data. Information included in this table of the report should be complete and accurate. Condition: The Organization is required to submit the UDS report to HRSA annually for the calendar year. The UDS Table 8A reports total accrued costs for the Organization. For the 2019 annual report, accrued costs were significantly overstated. Cause: Due to the timing of the report due date, the Organization used estimated costs in order to determine total accrued costs on the UDS report. The accrued costs error appears to be the result of significant adjustments subsequent to the submission of the UDS report to adjust estimated to actual accrued costs. Effect: The UDS report was submitted with inaccurate information. Recommendation: We recommend that the Organization attempt to close the fiscal year books prior to the required UDS submission date of February 15 in order to prevent significant adjustments subsequent to the submission of the UDS report. Management?s Response: See Corrective Action Plan.

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