EIN: 866053462
UEI: GKMAKN7EGGW9
Audited by: CliftonLarsonAllen
Oversight agency: 10 [Department of Agriculture]
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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 February 27, 2026. 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 August 27, 2026 (9 days ago).
What is a management decision? →We randomly selected forty sliding fee discounts to test for compliance. Five of the forty sliding fee selections had instances in which the sliding fee discount was improperly adjusted in the Practice Management System (“PMS”), resulting in a net undercharge of $104.
Show full finding ▾Hide full finding ▴We randomly selected forty sliding fee discounts to test for compliance. Five of the forty sliding fee selections had instances in which the sliding fee discount was improperly adjusted in the Practice Management System (“PMS”), resulting in a net undercharge of $104.
The sliding fee determination will be reviewed by the front desk staff thoughtfully to ensure the proper charge to the patient. o Once the patient is screened and determined to be eligible for the Sliding Fee program by the front office, the patient will complete the Sliding Fee application and self-declaration of income and family size. The front office will verify the application, determine the scale for which the patient qualifies, and verify with the Center’s practice management system. The lead biller will review all uploaded documents and approve the sliding fee in real time. o Additional training will take place with front desk personnel. The corrective action outlined above will be monitored on an ongoing basis. The CFO and the Controller will oversee the implementation and report progress to the CEO and Board . Regular internal reviews and reconciliations will be conducted to ensure continued compliance with internal controls and federal requirements.
2024-001
FAC accepted this audit on March 31, 2025 — management decision was due October 1, 2025.
During single audit planning, we performed a reconciliation of the drawdown report per the PMS for the major program to the balance reported on the SEFA and discovered that there was a drawdown that was not included in the balance on the SEFA specifically for award number H80CS00231. We inquired of management regarding the additional drawdown and discovered that this drawdown was initiated by the CEO and was not supported by way of expenditures incurred or any intent to expend the funds for a specific purchase within 30 days of receipt from the granting agency.
Show full finding ▾Hide full finding ▴During single audit planning, we performed a reconciliation of the drawdown report per the PMS for the major program to the balance reported on the SEFA and discovered that there was a drawdown that was not included in the balance on the SEFA specifically for award number H80CS00231. We inquired of management regarding the additional drawdown and discovered that this drawdown was initiated by the CEO and was not supported by way of expenditures incurred or any intent to expend the funds for a specific purchase within 30 days of receipt from the granting agency.
The Controller will review the detailed information related ot the drawdown to ensure the amount charged to the specific grant is allowable, reasonable and properly supported prior to when the drawdown is requested.
We randomly selected forty sliding fee discounts to test for compliance. One of the forty sliding fee selections did not have a sliding fee scale application on file at the date of service. Also, there were four instances in which the sliding fee discount was improperly adjusted in the Practice Management System (“PMS”), resulting in a net undercharge of $45.
Show full finding ▾Hide full finding ▴We randomly selected forty sliding fee discounts to test for compliance. One of the forty sliding fee selections did not have a sliding fee scale application on file at the date of service. Also, there were four instances in which the sliding fee discount was improperly adjusted in the Practice Management System (“PMS”), resulting in a net undercharge of $45.
The sliding fee determination will be reviewed by the front desk staff thoughtfully to ensure the proper charge to the patient. Once the patient is screened and determined to be eligible for the Sliding Fee program by the front office, the patient will complete the Sliding Fee application and self declaration of income and family size. The front office will verify the application, determine the scale for which the patient qualifies, and verify with the Center's practice management system. The lead biller will review all uploaded documents and approve the sliding fee in real time. Additional traning will take place with front desk personnel.
FAC accepted this audit on February 18, 2024 — management decision was due August 18, 2024.
FAC accepted this audit on December 6, 2022 — management decision was due June 6, 2023.
During our testing of sliding fee discounts for health center, there were two instances in which the sliding fee was calculated incorrectly. Context: We randomly selected twenty-five sliding fee discounts to test for compliance. Two of the twenty-five sliding fee selections was incorrectly calculated. Questioned Costs: None Cause: The clinic entered the patient?s salary amount incorrectly in the billing system. There is not a system in place to properly detect and identify slides that may be incorrectly entered or applied. Effect: The patient may not receive the discount they are eligible for and noncompliance with Federal requirements and terms of the grant which may result in withdrawal or revocation of the grant given by the Federal agency. Recommendation: Management?s close supervision and review is the best means to ensure all requirements are met. We recommend implementation of a second level independent review over the demographic data and income verification information entered into the patient billing system in order to ensure the financial classification is correct.
Show full finding ▾Hide full finding ▴2022-001: Significant Deficiency in Internal Control Over Compliance and Compliance Over Application of Sliding Fee Discounts Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Centers Cluster CFDA Number: 93.224 and 93.527 Criteria: The Health Centers Program, 42 U.S.C. ? 245b(k)(3)(G)(i) states that ?the center has prepared a schedule of fees or payments for the provision of its services consistent with locally prevailing rates or charges and designed to cover its reasonable costs of operation and has prepared a corresponding schedule of discounts to be applied to the payment of such fees or payments, which discounts are adjusted on the basis of the patient?s ability to pay.? Condition: During our testing of sliding fee discounts for health center, there were two instances in which the sliding fee was calculated incorrectly. Context: We randomly selected twenty-five sliding fee discounts to test for compliance. Two of the twenty-five sliding fee selections was incorrectly calculated. Questioned Costs: None Cause: The clinic entered the patient?s salary amount incorrectly in the billing system. There is not a system in place to properly detect and identify slides that may be incorrectly entered or applied. Effect: The patient may not receive the discount they are eligible for and noncompliance with Federal requirements and terms of the grant which may result in withdrawal or revocation of the grant given by the Federal agency. Recommendation: Management?s close supervision and review is the best means to ensure all requirements are met. We recommend implementation of a second level independent review over the demographic data and income verification information entered into the patient billing system in order to ensure the financial classification is correct.
Marana Health Center, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2022. Audit Period: July 1, 2021 - June 30, 2022 Category: GENERAL MARANA HEALTH CENTER, INC. AD-2-010 Procedure: Sliding Fee Schedule Patient Demographic Changes Page 1 of 2 I. PURPOSE: The Sliding Fee Schedule (SFS) Patient Demographic Changes process was created to ensure any patient who is certified on MHC Healthcare's (MHC) SFS and has changes on their Patient Profile (Profile) to their Family Size and/or Income are referred to the Outreach Department (OR) and that these changes are only made by an OR employee or the OR Manager. II. PROCESSES: A. Front Office (FO) staff print Profiles from the Electronic Health Record (EHR) for all patient appointments, which allows patients to make required changes to their demographics on file. This includes Family Size and/or Income. When a patient on MHC's SFS notifies FO of changes to the aforementioned demographics, the patient must be referred to the MHC OR Department for further review. Only OR staff may make these demographic changes in the EHR for SFS Patients. Ill. PROCEDURES: A. FO staff will print a Profile for all patient appointments. 1. FO will ensure all patients review the Profile for required changes to their demographics in the EHR system. a. If the patient is on the SFS and notates any changes required on the Profile to be made to their Family Size and/or Income, the FO will: 1) Immediately notify the health center's assigned OR employee that a patient in the office for an appointment has required changes to these demographics. a) Notification can be made via telephone or a Teams message. b) If the site does not have an assigned OR employee, notification will be made to the OR Manager. 2) The OR employee will respond to FO: a) The patient is placed on the OR schedule for an immediate appointment while the patient is in the health center and available, either prior to or after the clinical visit, depending on allowable time. b) An appointment will be scheduled while the patient is in the health center for a later date to review changes and the possible affect these changes may have on the patient's SFS certification and/or SFS tier. c) The patient is contacted via telephone by the OR employee to schedule an appointment to review the possible changes to the patient's SFS certification and/or SFS tier. d) When scheduling the appointment, the patient may schedule it at the Health Center or choose to have this appointment via telehealth. 3) Only OR employees may change the Family Size and/or Income demographics in the EHR for SFS patients. a) FO will make all necessary demographic changes in the EHR, excluding Family Size and/or Income. b. FO will scan the Profile into the EHR and forward a copy to the appropriate OR employee. 2. The OR Manager will ensure that FO staff have a current list of OR employees, along with appropriate contact information and location. Category: GENERAL MARANA HEALTH CENTER, INC. AD-2-010 Procedure: Sliding Fee Schedule Patient Demographic Changes Page 2 of 2 3. The OR Manager will immediately communicate any deviations to this policy and procedure to the assigned Associate Director of Integrated Operations (ADIO) when noted. IV. REFERENCES: Sliding Fee Schedule V. ATTACHMENTS: None Approved: Original Approval: 09/2022 9/28/2022 Date 9/28/2022 Date Reviewed/Revised: Responsible Party: Director, Integrated Operations If the Department of Health and Human Services has questions regarding this plan, please call Tamie Olson, CFO at (520) 784-8655.
FAC accepted this audit on December 1, 2021 — management decision was due June 1, 2022.
FAC accepted this audit on December 14, 2020 — management decision was due June 14, 2021.
FAC accepted this audit on November 12, 2019 — management decision was due May 12, 2020.
FAC accepted this audit on November 6, 2018 — management decision was due May 6, 2019.
FAC accepted this audit on October 26, 2017 — management decision was due April 26, 2018.
FAC accepted this audit on October 26, 2016 — management decision was due April 26, 2017.
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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