El Rio Santa Cruz Neighborhood Health Center Inc.

Criteria: The Provider Relief Fund grant requires the submission of the PRF Report. One of the critical line items on the PRF Report is the calculation of Lost Revenue. The Center opted to utilize actual revenue/net patient charges (the Actuals) from patient care services for the computation of Lost Revenue. The Lost Revenue calculation serves as a pivotal component of the PRF Report, enabling the Center to demonstrate its eligibility for receiving grant funds and ensure compliance with the program's requirements. Condition: The Center intended to utilize the Provider Relief Fund (PRF) grant under the provision of Lost Revenue, and it met the eligibility criteria based on the 2020 budgeted method. However, the Center failed to accurately report its use of the Lost Revenue on the required PRF Report for the period ended March 31, 2023. Instead, the Center mistakenly reported that actual expenditures incurred would be charged to the grant. Cause: The Center lacked proper internal control over preparing and reviewing the required PRF Reports. Effect: The Center did not report the required Lost Revenue calculation on the PRF Report. Recommendation: We recommend that the PRF Reports are reviewed and approved by a management team member who is not involved in the preparation and has sufficient knowledge of the program's requirements.

Section III - Federal Award Findings and Questioned Costs 2022-101 Special Tests and Provisions (Noncompliance, Material Weakness) Assistance Listing Number and Name: 93.224 Health Center Program Federal Agency: Department of Health and Human Services Compliance Requirement: Special Tests and Provisions Questioned Costs: Unknown Criteria: Patients applying for Sliding Fee Discount Schedule (SFDS) should have their income levels adequately documented and accurately calculated, and patients should be given the proper discount based upon their income level in accordance with 42 CFR Section 51c.303(f). Condition: Incorrect copay were applied to 2 of 40 sliding fee discount schedule (SFDS) patient encounters that were selected for testing. Cause: Unknown Effect: The Center was not in compliance with the requirement to provide SFS patients with the proper discount based upon the patients' income levels in accordance with 42 CFR Section 51c.303(f). Recommendation: To help ensure that SFS discounts are properly calculated and applied, the Center should strictly adhere to its formal written policies and procedures, and perform random reviews of its SFDS applications in order to detect and correct errors on a timely basis.