EIN: 382406558
UEI: HJW2CKPXD6L8
Data as of August 26, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on August 8, 2021. 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 February 8, 2022 (1660 days ago).
What is a management decision? →2021-001 CFDA # 93.224 and 93.527 Health Center Cluster - Cash Management. Material Weakness in Internal Control over Compliance and Material Noncompliance. (Repeat Finding) Criteria - Health centers are required to maintain written procedures that minimize the time elapsing between the transfer of funds from the U.S. Treasury and disbursement of funds by the non-Federal entity (2 CFR section 200.305). Condition - During audit procedures, we tested advanced payments received by the Center to verify procedures were followed minimizing time elapsed between receipt and disbursement of funds. We noted one advance reciept that do not appear the follow the Center's written procedures nor do they appear to minimize the time elapsed to disbursement. Questioned Costs - None. Context - Hamiton Community Health Network received additional funding under the Health Center Cluster program to assist with costs incurred for addressing COVID-19. Although, the expenditures allocated to the funding appeared allowable under the grant terms and conditions, funds were drawn down before all expeditures allocated to the funding were incurred and paid. Potential Effect - Noncompliance with cash management could result in a loss of funding. Cause - Due to turnover of key finance personnel and COVID-19 pandemic complications during the year, there was inadequate oversight of the financial and grant accounting. Additionally, there was general confusion on the purpose and compliance requirements of COVID-19 funding received. Although the Center has since hired qualified finance personnel to oversee the financial and grant accounting, during the year, Uniform Guidance compliance requirements were not followed regarding grant draw downs. Recommendation - We recommend the Center's management to continue to monitor and evaluate the performace of their accounting staff, and to make improvements to prevent and/or detect noncompliance when necessary. Additionally, the Center should provide training to all personnel involved in accounting for federal awards. Views of Responsible Officials and Planned Corrective Actions - Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of cash management.
Show full finding ▾Hide full finding ▴2021-001 CFDA # 93.224 and 93.527 Health Center Cluster - Cash Management. Material Weakness in Internal Control over Compliance and Material Noncompliance. (Repeat Finding) Criteria - Health centers are required to maintain written procedures that minimize the time elapsing between the transfer of funds from the U.S. Treasury and disbursement of funds by the non-Federal entity (2 CFR section 200.305). Condition - During audit procedures, we tested advanced payments received by the Center to verify procedures were followed minimizing time elapsed between receipt and disbursement of funds. We noted one advance reciept that do not appear the follow the Center's written procedures nor do they appear to minimize the time elapsed to disbursement. Questioned Costs - None. Context - Hamiton Community Health Network received additional funding under the Health Center Cluster program to assist with costs incurred for addressing COVID-19. Although, the expenditures allocated to the funding appeared allowable under the grant terms and conditions, funds were drawn down before all expeditures allocated to the funding were incurred and paid. Potential Effect - Noncompliance with cash management could result in a loss of funding. Cause - Due to turnover of key finance personnel and COVID-19 pandemic complications during the year, there was inadequate oversight of the financial and grant accounting. Additionally, there was general confusion on the purpose and compliance requirements of COVID-19 funding received. Although the Center has since hired qualified finance personnel to oversee the financial and grant accounting, during the year, Uniform Guidance compliance requirements were not followed regarding grant draw downs. Recommendation - We recommend the Center's management to continue to monitor and evaluate the performace of their accounting staff, and to make improvements to prevent and/or detect noncompliance when necessary. Additionally, the Center should provide training to all personnel involved in accounting for federal awards. Views of Responsible Officials and Planned Corrective Actions - Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of cash management.
Hamilton Community Health Network respectfully submits the following corrective action plan for the year ended March 31, 2021. Name and address of independent public accounting firm: Quast, Janke & Company, P.C. 1010 N. Johnson Street Bay City, MI 48708 Audit Period: March 31, 2021 Contact Person Responsible for Corrective Action: Clarence Pierce, Chief Executive Officer The findings from the March 31, 2020 schedule of findings and questions costs are detailed in the schedule above. The findings are numbered consistently with the numbers assigned in the schedule. 2021-001 CFDA #'s 93.224 and 93.527 Health Center Cluster of Programs Material Weakness - Lack of internal control and noncompliance with cash management. Response - Hamilton Community Health Network will ensure proper Accounting staff are hired and trained to comply with Uniform Guidance. The Center will review it's written cash management procedures and make enhancements to controls where needed. The CFO will be responsible for all federal awards compliance and will ensure all federal awards are analyzed for compliance and adhered to.
2020-003
FAC accepted this audit on December 23, 2020 — management decision was due June 23, 2021.
2020-002 CFDA # 93.224 and 93.527 Health Center Cluster - Special Tests and Provisions - Sliding Fee Program. Material Weakness in Internal Control and Material Noncompliance (Repeat Finding)Criteria -Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate, and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale.Condition -During audit procedures of sliding fee adjustments there were multiple instances where the slide was inappropriately applied based on the sliding fee discount schedule in place at the time of service and multiple applications were missing.Questioned Costs -None.Context-A nonstatistical sample of 25 sliding fee adjustment transactions were selected for testing. Of this sample 8 errors were identified as wrong sliding fee was given to the patient and 7 sliding fee applications were not saved in the software application. This is a repeat finding, the Center did implement recommendations from prior year's finding, however, most transactions selected were before implementation of the new controls.Potential Effect -The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended March 31, 2020. In addition, the Center did not comply with its policies and procedures and may have not properly calculated the sliding fee or discount given to the patients and the discount given, in any, may not have been based on the patient's ability to pay.Cause -The condition is attributable to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being collected and applied.Recommendation -We recommend the Center provide proper training to employees to ensure that the sliding fee discounts are being properly applied and documented. In addition to implementing policies and procedures to ensure the sliding fee discounts are being properly monitored and supervised on a periodic basis to ensure compliance.Views of Responsible Officials and Planned Corrective Actions -Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of the sliding fee discounts.
Show full finding ▾Hide full finding ▴2020-002 CFDA # 93.224 and 93.527 Health Center Cluster - Special Tests and Provisions - Sliding Fee Program. Material Weakness in Internal Control and Material Noncompliance (Repeat Finding)Criteria -Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate, and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale.Condition -During audit procedures of sliding fee adjustments there were multiple instances where the slide was inappropriately applied based on the sliding fee discount schedule in place at the time of service and multiple applications were missing.Questioned Costs -None.Context-A nonstatistical sample of 25 sliding fee adjustment transactions were selected for testing. Of this sample 8 errors were identified as wrong sliding fee was given to the patient and 7 sliding fee applications were not saved in the software application. This is a repeat finding, the Center did implement recommendations from prior year's finding, however, most transactions selected were before implementation of the new controls.Potential Effect -The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended March 31, 2020. In addition, the Center did not comply with its policies and procedures and may have not properly calculated the sliding fee or discount given to the patients and the discount given, in any, may not have been based on the patient's ability to pay.Cause -The condition is attributable to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being collected and applied.Recommendation -We recommend the Center provide proper training to employees to ensure that the sliding fee discounts are being properly applied and documented. In addition to implementing policies and procedures to ensure the sliding fee discounts are being properly monitored and supervised on a periodic basis to ensure compliance.Views of Responsible Officials and Planned Corrective Actions -Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of the sliding fee discounts.
2020-002 CFDA #'s 93.224 and 93.527 Health Center Cluster of ProgramsMaterial Weakness - Lack of internal control and noncompliance with sliding fee discount.Response -Hamilton Community Health Network has implemented a monthly internal audit function to monitor and review patient visit documents as it relates to the sliding fee discount program. Mandatory sliding fee training for all front desk staff has been initiated by Hamilton Community Health Network and ongoing quarterly trainings will be conducted to ensure sliding fee patients are properly documented, assessed, and discount properly given.
2019-001
2020-003 CFDA # 93.224 and 93.527 Health Center Cluster - Cash Management. Material Weakness in Internal Control over Compliance and Material Noncompliance.Criteria -Health centers are required to maintain written procedures that minimize the time elapsing between the transfer of funds from the U.S. Treasury and disbursement of funds by the non-Federal entity (2 CFR section 200.305).Condition -During audit procedures, we tested advanced payments received by the Center to verify procedures were followed minimizing time elapsed between receipt and disbursement of funds. We noted seven advance reciepts that do not appear the follow the Center's written procedures nor do they appear to minimize the time elapsed to disbursement.Questioned Costs -None.Context -Hamiton Community Health Network requests federal funds to help cover payroll costs. The Center's written procedures state the request for federal funds is to be made monthly for the prior months payroll. Seven federal fund draws appear to be drawn before payroll costs were incurred for the month.Potential Effect -Noncompliance with cash management could result in a loss of funding.Cause -Due to turnover of key finance personnel during the year, there was inadequate oversight of the financial accounting and grant compliane functions by personnel with sufficient knowledge and expertise to prevent or detect errors and ensure compliance with Uniform Guidance. Although the Center has since hired qualified finance personnel to oversee the finance department, during the year, procedures were not followed regarding grant draw downs, noncompliance with cash management was not detected or corrected.Recommendation -We recommend the Center revisit it's written cash management procedures to make improvements to prevent and/or detect noncompliance. Additionally, the Center should provide training to all personnel involved in accounting for federal awards.Views of Responsible Officials and Planned Corrective Actions -Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of cash management.
Show full finding ▾Hide full finding ▴2020-003 CFDA # 93.224 and 93.527 Health Center Cluster - Cash Management. Material Weakness in Internal Control over Compliance and Material Noncompliance.Criteria -Health centers are required to maintain written procedures that minimize the time elapsing between the transfer of funds from the U.S. Treasury and disbursement of funds by the non-Federal entity (2 CFR section 200.305).Condition -During audit procedures, we tested advanced payments received by the Center to verify procedures were followed minimizing time elapsed between receipt and disbursement of funds. We noted seven advance reciepts that do not appear the follow the Center's written procedures nor do they appear to minimize the time elapsed to disbursement.Questioned Costs -None.Context -Hamiton Community Health Network requests federal funds to help cover payroll costs. The Center's written procedures state the request for federal funds is to be made monthly for the prior months payroll. Seven federal fund draws appear to be drawn before payroll costs were incurred for the month.Potential Effect -Noncompliance with cash management could result in a loss of funding.Cause -Due to turnover of key finance personnel during the year, there was inadequate oversight of the financial accounting and grant compliane functions by personnel with sufficient knowledge and expertise to prevent or detect errors and ensure compliance with Uniform Guidance. Although the Center has since hired qualified finance personnel to oversee the finance department, during the year, procedures were not followed regarding grant draw downs, noncompliance with cash management was not detected or corrected.Recommendation -We recommend the Center revisit it's written cash management procedures to make improvements to prevent and/or detect noncompliance. Additionally, the Center should provide training to all personnel involved in accounting for federal awards.Views of Responsible Officials and Planned Corrective Actions -Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of cash management.
2020-003 CFDA #'s 93.224 and 93.527 Health Center Cluster of ProgramsMaterial Weakness - Lack of internal control and noncompliance with cash management.Response -Hamilton Community Health Network will ensure proper Accounting staff are hired and trained to comply with Uniform Guidance. The Center will review it's written cash management procedures and make enhancements to controls where needed. The CFO will be responsible for all federal awards compliance and will ensure all federal awards are analyzed for compliance and adhered to.
FAC accepted this audit on November 19, 2019 — management decision was due May 19, 2020.
2019-001 CFDA # 93.224 and 93.527 Health Center Cluster - Significant Deficiency in Internal Control over Compliance and Compliance Criteria - Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate, and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition - During audit procedures, we tested the application of the sliding scale fee discount for 25 patient visits during the year. Out of the 25 tested, the sliding fee discount was not properly applied for three individuals and four individuals did not have a current application on file. Cause - The condition is attributable to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being collected and applied. Potential Effect - The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended March 31, 2019. In addition, the Center did not comply with its policies and procedures and may have not properly calculated the sliding fee or discount given to the patients and the discount given, in any, may not have been based on the patient's ability to pay. Recommendation - We recommend the Center provide proper training to employees to ensure that the sliding fee discounts are being properly applied and documented. In addition to implementing policies and procedures to ensure the sliding fee discounts are being properly monitored and supervised on a periodic basis to ensure compliance. Views of Responsible Officials and Planned Corrective Actions - Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of the sliding fee discounts.
Show full finding ▾Hide full finding ▴2019-001 CFDA # 93.224 and 93.527 Health Center Cluster - Significant Deficiency in Internal Control over Compliance and Compliance Criteria - Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate, and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition - During audit procedures, we tested the application of the sliding scale fee discount for 25 patient visits during the year. Out of the 25 tested, the sliding fee discount was not properly applied for three individuals and four individuals did not have a current application on file. Cause - The condition is attributable to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being collected and applied. Potential Effect - The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended March 31, 2019. In addition, the Center did not comply with its policies and procedures and may have not properly calculated the sliding fee or discount given to the patients and the discount given, in any, may not have been based on the patient's ability to pay. Recommendation - We recommend the Center provide proper training to employees to ensure that the sliding fee discounts are being properly applied and documented. In addition to implementing policies and procedures to ensure the sliding fee discounts are being properly monitored and supervised on a periodic basis to ensure compliance. Views of Responsible Officials and Planned Corrective Actions - Management concurs with this finding and will ensure that controls are established to ensure proper training and monitoring of the sliding fee discounts.
Hamilton Community Health Network respectfully submits the following corrective action plan for the year ended March 31, 2019. Name and address of independent public accounting firm: Quast, Janke & Company, P.C. 1010 N. Johnson Street Bay City, MI 48708 Audit Period: March 31, 2019 Contact Person Responsible for Corrective Action: Clarence Pierce, Chief Executive Officer Anticipated date for completion of action - March 31, 2019 Single audit report due date 1-1-20 to be completed timely. The findings from the March 31, 2019 schedule of findings and questions costs are detailed in the schedule above. The findings are numbered consistently with the numbers assigned in the schedule. FINANCIAL STATEMENT AUDIT FINDINGS There were no findings in the current year that require a corrective action plan. MAJOR FEDERAL AWARD FINDINGS 2019-001 CFDA #'s 93.224 and 93.527 Health Center Cluster of Programs Significant Deficiency - Lack of internal control and noncompliance with sliding fee discount. Response - Hamilton Community Health Network has implemented a monthly internal audit function to monitor and review patient visit documents as it relates to the sliding fee discount program. Mandatory sliding fee training for all front desk staff has been initiated by Hamilton Community Health Network and ongoing quarterly trainings will be conducted to ensure sliding fee patients are properly documented, assessed, and discount properly given.
FAC accepted this audit on October 27, 2019 — management decision was due April 27, 2020.
GSA_MIGRATION
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