EIN: 461317334
UEI: H7S4J8RKKLC6
Audited by: Bonadio & CO., LLP
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 March 28, 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 September 28, 2024 (705 days ago).
What is a management decision? →FAC accepted this audit on January 19, 2024 — management decision was due July 19, 2024.
Criteria - Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. The health center must demonstrate adjustments to charges are consistent with the health center’s SFDS. Condition - We attempted to recalculate the applied discount using Metro Community Health Centers, Inc.’s policy and the patient documentation provided, noting instances where the adjustments to charges were inconsistent with Metro Community Health Centers, Inc.’s SFDS. Cause – SFDS discounts were inconsistently applied to services provided to individuals who attested to their eligibility. Effect - Out of our sample of 25 selections, we identified eight exceptions based on the SFDS. Recommendation - We recommend evaluating the current process and either changing it to match what is being done or provide education those involved in the process to adhere to Metro Community Health Centers, Inc.’s existing written policies and procedures in this area. We also encourage Metro Community Health Centers, Inc.’ to consider assigning a dedicated individual to regularly review the sliding fee visits to ensure compliance. This should be someone who is knowledgeable of the sliding fee requirements and Metro Community Health Centers, Inc.’s billing processes and procedures. View of Responsible Official – Metro Community Health Centers agrees that the sliding fee process needs to be revised and will implement procedures to match workflow. Additionally, Metro Community Health Centers will retrain all staff and assign a dedicated individual to perform monthly reviews.
Show full finding ▾Hide full finding ▴Criteria - Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. The health center must demonstrate adjustments to charges are consistent with the health center’s SFDS. Condition - We attempted to recalculate the applied discount using Metro Community Health Centers, Inc.’s policy and the patient documentation provided, noting instances where the adjustments to charges were inconsistent with Metro Community Health Centers, Inc.’s SFDS. Cause – SFDS discounts were inconsistently applied to services provided to individuals who attested to their eligibility. Effect - Out of our sample of 25 selections, we identified eight exceptions based on the SFDS. Recommendation - We recommend evaluating the current process and either changing it to match what is being done or provide education those involved in the process to adhere to Metro Community Health Centers, Inc.’s existing written policies and procedures in this area. We also encourage Metro Community Health Centers, Inc.’ to consider assigning a dedicated individual to regularly review the sliding fee visits to ensure compliance. This should be someone who is knowledgeable of the sliding fee requirements and Metro Community Health Centers, Inc.’s billing processes and procedures. View of Responsible Official – Metro Community Health Centers agrees that the sliding fee process needs to be revised and will implement procedures to match workflow. Additionally, Metro Community Health Centers will retrain all staff and assign a dedicated individual to perform monthly reviews.
The desired outcome of this corrective action plan is to retrain all staff working with the MCHC sliding fee discount scale and to have consistent and reliable application of the MCHC sliding fee discount scale to all eligible patients. Corrective Actions MCHC will implement a sliding fee discount schedule retraining program and engage all front desk staff, health center directors, and billing staff. Training will encompass all aspects of the sliding fee discount scale including but not limited to how individuals register, attest and apply the MCHC sliding fee discount scale. Retraining will be provided on a semiannual basis and include mock tests. This training program will be under the direct supervision of the Chief Operating Officer. All MCHC staff will be refamiliarized with the MCHC policy and procedures that relate to the Sliding Fee Discount Scale as part of the retraining process and will continue to review the Sliding fee discount program policy and procedure on an annual basis. The MCHC Sliding Fee Discount Scale and associated policy and procedure will be updated annually in accordance with policy, and we will ensure that the slide is provided to staff annually. A dedicated staff will be identified and assigned to do spot check reviews of the application of the sliding fee discount scale monthly and this will be implemented immediately. MCHC will provide an annual presentation on the Sliding Fee Discount Scale program to the MCHC Board of Directors that included annual updates to the program. The MCHC policies and procedures related to the Sliding Fee Discount Scale program will be revised to ensure inclusion of the above changes. Goal - Metro Community Health Center is committed to ensuring that we are compliant with all regulations as they relate to the Sliding Fee Discount Program. MCHC’s commitment moving forward is to perform more regular trainings as it relates to the sliding fee discount program as well as more regular review and testing of the program to ensure that the policies that are written are being appropriately applied and administered.
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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