EIN: 481193556
UEI: EAVWMLV5NMF5
Data as of August 19, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on August 5, 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 February 5, 2025, which was (561 days ago).
What is a management decision? →Finding 2023.001: Special Tests and Provisions - Sliding Fee Discounts Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program, COVID-19 - Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 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), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Organization did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance in 2023. Questioned Costs None Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Identification of Repeat Finding Repeat finding of 2022-01 Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023.001 - Sliding Fee Scale Documentation Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Action Taken CareArc was notified of the 2023 annual audit finding related to Sliding Fee Discounts being applied incorrectly according to the Health Center Program Compliance Manual and out of compliance with our sliding fee policy. CareArc's CFO was aware of the incorrect slide adjustments during the sampling process of the audit. The two patients on Slide B that should have received 50% discount, only received 49% ($3.00 miscalculation) as our electronic medical records did not identify an internal lab as being all inclusive of the same-day office visit. The corrective action plan was to have the Electronic Medical Records system recognize internal labs as being all inclusive of the same-day office visit. This issue was identified by CareArc through an internal audit in September 2023 and we began working with Health Choice Network (HCN). HCN is our vendor that helps program our electronic medical records system. HCN has helped CareArc correct the system going forward. CareArc is working with HCN on creating a report on historical slide applications to correct accounts earlier in 2023. CareArc was able to manually correct the two identified patient accounts. The corrective action plan is still in process of being implemented by CareArc with the assistance of HCN/EPIC with an estimated completion in September 2024. If there are any question regarding this plan, please e-mail Seresa Howe at showe@carearc.org.
2022-001
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on July 10, 2023. 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 January 10, 2024, which was (953 days ago).
What is a management decision? →Health Center Program Cluster ? CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS28423-07-02 Program Year 2022 Criteria or Specific Requirement ? Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR Sections 51c.303(g); and 42 CFR Sections 56.303(f)) Condition ? Patients with insurance received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization?s policy. Questioned costs ? None Context ? A sample of 25 patients were tested out of the total population of 30,172 encounters. The sampling methodology used is not and is not intended to be statistically valid. Three patients with third-party insurance received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect ? Sliding fee discounts were given to patients with third-party insurance that were inconsistent with the Organization?s sliding fee discount policy. Cause ? The Organization did not comply with their sliding fee policy. Identification as a repeat finding ? Not a repeat finding. Recommendation ? We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual when combined with insurance plan contractual adjustments and payments. Views of Responsible Officials and Planned Corrective Actions ? It is the responsibility of the CFO, Seresa Howe, to oversee the Sliding Fee Discount implementation and policy. It is also the responsibility of Seresa Howe, CFO to keep Renee Hively, CEO informed of all possible non-compliance findings of the slide fee discounts being assessed to patient?s accounts. The planned corrective action is still in process of being implemented into our electronic medical records as the sliding fee discounts are automated. CEO will be notified when ticket has been completed by HCN and all testing of new sliding fee rules have been completed.
CareArc was notified of the 2022 annual audit finding related to Sliding Fee Discounts being applied incorrectly according to the Health Center Program Compliance Manual and out of compliance with our sliding fee policy. CareArc?s CFO and CEO was notified it was a finding at our 5/11/23 meeting with Forvis. The finding was identified that a patient on a Slide higher than Slide A was given a sliding fee discount after third-party insurance payments were completed putting their final charge below the nominal fee assessed to Slide A patients. The incorrect adjustment was in the identified patient?s financial favor and did not result in the patient paying more to the Health Center. The corrective action plan is to prevent future automated sliding fee discounts being assessed to insured patients when those charges after payment and contractual adjustments are below the nominal fees charged to Slide A patients. CareArc is working with Health Choice Network (HCN). HCN is our vendor that helps program and implement EPIC (our new electronic medical records system). CareArc changed to EPIC on 11/5/22. Seresa Howe, CFO and Michelle Cole, Billing Manager has had two conversations with HCN team to get assistance on how to identify those patients and how to set up a qualifying rule in EPIC to prevent the automatic sliding fee discount from being processed when total fees fall below the applicable nominal charge for medical, dental, and behavioral health services. CareArc has a ticket open with HCN to complete the process. HCN is using their resources as they work with other Federally Qualified Health Center?s to mimic the rules set up for sliding fee discounts to stay in compliance with Health Center Program Compliance Manual. The corrective action plan is still in process of being implemented by CareArc with the assistance of HCN/EPIC with an estimated completion in July 2023.
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on July 12, 2022. 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 January 12, 2023, which was (1316 days ago).
What is a management decision? →Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) Condition ? The Organization is required to prepare and submit period one provider relief fund (PRF) reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned costs - Unknown Context ? In the period one report, the Organization obligated the provider relief funds received utilizing option II for calculating lost revenues. However, the Organization did not meet the requirement to utilize option II as clarified in later reporting guidelines issued by the Department of Health and Human Services. The report was resubmitted utilizing option III. Effect ? Errors were made in reporting lost revenues. Cause ? The Organization did not properly apply the revised guidance regarding the requirement for option II. Identification as a repeat finding ? Not a repeat finding Recommendation ? Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of Responsible Officials and Planned Corrective Actions ? It is the responsibility of the CFO, Seresa Howe, to report on the utilization of the Provider Relief Funds using HRSA?s Provider Relief Reporting Portal. It is also the responsibility of Seresa Howe, CFO to keep Renee Hively, CEO informed of the reporting progress. The planned corrective action that has already been completed included resubmitting CareArc?s PRF Report using option iii ? Alternative Reasonable Methodology. Reopening the portal was approved by HRSA?s provider Support Center in June 2022. Report was resubmitted by Seresa Howe, CFO on 6/9/22.
CareArc was notified of the 2021 annual audit finding related to the Provider Relief Funding reporting for Period 1. When submitting the Provider Relief Funding Report in September 2021, CareArc chose reporting option ii (actuals to budget patient revenue loss) based on the portal information. However, there was a FAQ that was updated on 8/30/21 revising that for option ii, the 2020 and 2021 budget had to be approved prior to March 27, 2020. CareArc?s 2021 budget was not approved by our Board of Directors until December 2020. The correction action plan was to contact HRSA to request reporting portal to be opened back up and resubmit the report using option iii. As part of the correct action plan, Seresa Howe, CFO called the Provider Support Center with HRSA Provider Relief Reporting to request the PRF Reporting Portal be reopened so that CareArc could correct the report. The request to reopen was made on 5/26/22 and approved on 6/2/22 giving CareArc one week to resubmit. On the HRSA PRF Reporting Portal, Seresa Howe, CFO was able to update the report with option iii ? Alternative Reasonable Methodology with an explanation of when our 2020 and 2021 budgets were approved. For fiscal year 2020, CareArc had lost revenues of ($1,040,044) budget vs. actual and an additional lost revenues of ($372,891) budget vs. actual for 1/1/21-6/30/21 period. The updated PRF Report for Period 1 was resubmitted on 6/9/22; therefore, completing the corrective action plan for the finding. The BKD auditing team met with both Seresa Howe, CFO and Renee Hively, CEO about the finding. Seresa Howe kept Renee Hively informed of the corrective action plan and when the PRF Report was resubmitting on 6/9/22.
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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