EIN: 920126047
UEI: FLLRL6MHN2V4
Data as of August 21, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on March 1, 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 September 1, 2021 (1816 days ago).
What is a management decision? →Client was unable to provide a full detail of the medical billings or those patients who received a sliding fee discount for which a sample could be selected from. Cause: See Finding 2020-001 Effect or Potential Effect: Auditor was unable to obtain a reliable population and therefore unable to opine on the relevant compliance requirements of sliding fee scale being appropriately charged. Questioned Costs: Not determinable. Context: Due to implementation of a new billing system a full population for medical billing was unable to be reliably obtained. CRHM lost access to the previous billing systems data and obtaining any further assistance from prior provider was cost prohibitive. Due to the inability to gain assurance over the completeness of the population auditor is unable to verify compliance with grant requirement. Recommendation: We suggest management maintain appropriate billing records and reconcile detail to the trial balance periodically to ensure completeness and accuracy of the accounting records. Those receiving sliding fee discounts should have a unique identifier for ease of tracking purposes. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan.
Show full finding ▾Hide full finding ▴Finding 2020-004 Special Test and Provisions ? Material Weakness in Internal Control over Compliance Programs: Agency: Department of Health and Human Services Program: Health Center Program Cluster CFDA: 93.224/93.527 Award No: H80CS01444-17 Year: 2017-2020 Criteria or specific requirement: Uniform Guidance require health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover their reasonable costs of operation. Condition: Client was unable to provide a full detail of the medical billings or those patients who received a sliding fee discount for which a sample could be selected from. Cause: See Finding 2020-001 Effect or Potential Effect: Auditor was unable to obtain a reliable population and therefore unable to opine on the relevant compliance requirements of sliding fee scale being appropriately charged. Questioned Costs: Not determinable. Context: Due to implementation of a new billing system a full population for medical billing was unable to be reliably obtained. CRHM lost access to the previous billing systems data and obtaining any further assistance from prior provider was cost prohibitive. Due to the inability to gain assurance over the completeness of the population auditor is unable to verify compliance with grant requirement. Recommendation: We suggest management maintain appropriate billing records and reconcile detail to the trial balance periodically to ensure completeness and accuracy of the accounting records. Those receiving sliding fee discounts should have a unique identifier for ease of tracking purposes. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan.
Finding Number: 2020-004 Special Test and Provisions ? Material Weakness in Internal Control over Compliance Planned Corrective Action: New procedures are being implemented to monitor and review the services provided by the thirdparty billing company?s fee structure in place. The billing department will conduct periodic audits of the sliding fee scale application process similar to the external audit process. This provides for corrective actions throughout the year to minimize the overall impact to program requirements. The new medical billing system reporting will help ensure balances are reconciled. Reports will be saved monthly as revenue is entered. Quarterly reconciliations will also be conducted to ensure completeness. Anticipated Date of Completion: March 31, 2021
Finding 2020-005 Allowable Costs ? Payroll ? Compliance and Significant Deficiency in Internal Control over Compliance Programs: Agency: Department of Health and Human Services Program: Health Center Program Cluster CFDA: 93.224/93.527 Award No: H80CS01444-17 Year: 2017-2020 See Finding 2020-002 Questioned Costs: None identified. Context: 1 of the 40 transactions selected for testing had errors. Cause: Overtime hours were erroneously entered into accounting software as regular hours. Effect or Potential Effect: Proper review of data entry is not being performed. Payroll transactions may be misstated due to data entry errors. Recommendation: We recommend that payroll personnel review timesheets and compare subtotals to those being entered to accounting software.
Show full finding ▾Hide full finding ▴Finding 2020-005 Allowable Costs ? Payroll ? Compliance and Significant Deficiency in Internal Control over Compliance Programs: Agency: Department of Health and Human Services Program: Health Center Program Cluster CFDA: 93.224/93.527 Award No: H80CS01444-17 Year: 2017-2020 See Finding 2020-002 Questioned Costs: None identified. Context: 1 of the 40 transactions selected for testing had errors. Cause: Overtime hours were erroneously entered into accounting software as regular hours. Effect or Potential Effect: Proper review of data entry is not being performed. Payroll transactions may be misstated due to data entry errors. Recommendation: We recommend that payroll personnel review timesheets and compare subtotals to those being entered to accounting software.
Finding Number: 2020-005 Allowable Costs ? Payroll ? Compliance and Significant Deficiency in Internal Control over Compliance Planned Corrective Action: New procedures are being implemented to update personnel and payroll files. Standard forms and checklists will be implemented to ensure the completeness and accuracy of personnel records. For payroll costs charged to the federal and state programs, additional procedures will be implemented to ensure reviews of proper documentation are conducted by the accounting manager for each payroll cycle. Anticipated Date of Completion: December 31, 2020
Insufficient controls were in place to ensure the timing of Federal cash draws was such that time elapsing between the drawdown and the disbursement of funds was minimized. Cause: Insufficient controls were established in this area Effect or Potential Effect: Drawdowns may occur before needed for disbursement purposes Questioned costs: None identified. Context: During our walkthrough procedures related to controls over cash management, we noted there were no controls in place to ensure proper monitoring of cash drawdowns and reimbursements against actual expenses during the first half of the year. Controls were subsequently implemented as new Finance Manager took over duties from previous Controller. There were no exceptions identified related to compliance over cash management. Recommendations: We recommend the established controls to ensure cash management requirements are followed. Management should track the status of the federally funded cash disbursements against the need to draw funds on related grant, and procedure be established to document that a review of the need for a drawdown or payment request has been performed. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan for further information.
Show full finding ▾Hide full finding ▴Finding 2020-006 Cash Management ? Compliance and Significant Deficiency in Internal Control Over Compliance Programs: Agency: Department of Health and Human Services Program: Health Center Program Cluster CFDA: 93.224/93.527 Award No: H80CS01444-17 Year: 2017-2020 Criteria or specific requirement: 2 CFR 200.302(b) of the Compliance Supplement requires organizations receiving federal funds to establish controls and procedures that would minimize the amount of time between drawdowns and the disbursement of grant monies. Condition: Insufficient controls were in place to ensure the timing of Federal cash draws was such that time elapsing between the drawdown and the disbursement of funds was minimized. Cause: Insufficient controls were established in this area Effect or Potential Effect: Drawdowns may occur before needed for disbursement purposes Questioned costs: None identified. Context: During our walkthrough procedures related to controls over cash management, we noted there were no controls in place to ensure proper monitoring of cash drawdowns and reimbursements against actual expenses during the first half of the year. Controls were subsequently implemented as new Finance Manager took over duties from previous Controller. There were no exceptions identified related to compliance over cash management. Recommendations: We recommend the established controls to ensure cash management requirements are followed. Management should track the status of the federally funded cash disbursements against the need to draw funds on related grant, and procedure be established to document that a review of the need for a drawdown or payment request has been performed. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan for further information.
Finding Number: 2020-006 Cash Management ? Compliance and Significant Deficiency in Internal Control Over Compliance Planned Corrective Action: A fund tracking spreadsheet has been created to track all draw downs and expenses tied to each draw. Anticipated Date of Completion: May 1, 2020
FAC accepted this audit on November 19, 2019 — management decision was due May 19, 2020.
Finding 2019-002 Allowable Costs ? Payroll - Significant Deficiency in Internal Control over Compliance Programs: Department of Health and Human Services Health Center Program Cluster: 93.224/93.527 See Finding 2019-001 Questioned Costs: None reported Context: 1 of the 40 transactions selected for testing had errors. Identification as a Repeat Finding Reported as finding 2018-02 in the prior year.
Show full finding ▾Hide full finding ▴Finding 2019-002 Allowable Costs ? Payroll - Significant Deficiency in Internal Control over Compliance Programs: Department of Health and Human Services Health Center Program Cluster: 93.224/93.527 See Finding 2019-001 Questioned Costs: None reported Context: 1 of the 40 transactions selected for testing had errors. Identification as a Repeat Finding Reported as finding 2018-02 in the prior year.
Finding Number: 2019-002 Allowable Costs ? Payroll - Significant Deficiency in Internal Control over Compliance Planned Corrective Action: New procedures are being implemented to update personnel and payroll files. Standard forms and checklists will be implemented to ensure the completeness and accuracy of personnel records. For payroll costs charged to the federal and state programs, additional procedures will be implemented to ensure reviews of proper documentation are conducted by the accounting manager for each payroll cycle. Anticipated Date of Completion: March 31, 2020
2018-002
Certain services were charged differently from the fee schedule Cause: CRHM has moved billing in house to process their bills. There was a lack of review of fees charged by the billing staff as sliding fee is done manually. Effect or Potential Effect: The program income at the end of the year was misstated. Questioned Costs: None reported Context: 4 out of 40 samples tested had certain services charged that did not match the fee schedule. Identification as a Repeat Finding: Reported as finding 2018-03 in the prior year. Recommendation: We recommend that a process is put into place to review that sliding fee charges agree to the fee schedule. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan.
Show full finding ▾Hide full finding ▴Finding 2019-003 Program Income ? Significant Deficiency in Internal Control over Compliance Programs: Department of Health and Human Services Health Center Program Cluster: 93.224/93.527 Criteria or specific requirement: Uniform Guidance require health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges and designed to cover their reasonable costs of operation. Condition: Certain services were charged differently from the fee schedule Cause: CRHM has moved billing in house to process their bills. There was a lack of review of fees charged by the billing staff as sliding fee is done manually. Effect or Potential Effect: The program income at the end of the year was misstated. Questioned Costs: None reported Context: 4 out of 40 samples tested had certain services charged that did not match the fee schedule. Identification as a Repeat Finding: Reported as finding 2018-03 in the prior year. Recommendation: We recommend that a process is put into place to review that sliding fee charges agree to the fee schedule. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan.
Finding Number: 2019-003 Program Income - Significant Deficiency in Internal Control over Compliance Planned Corrective Action: New procedures are being implemented to monitor and review the services provided by the third-party billing company?s fee structure in place. The accounting department will conduct periodic audits of the sliding fee scale application process similar to the external audit process. This provides for corrective actions throughout the year to minimize the overall impact to program requirements. Anticipated Date of Completion: March 31, 2020
2018-003
Insufficient controls were in place to ensure the timing of Federal cash draws was such that time elapsing between the drawdown and the disbursement of funds was minimized. Cause: Insufficient controls were established in this area Effect or Potential Effect: Drawdowns may occur before needed for disbursement purposes Questioned costs: None identified. Context: During our walkthrough procedures related to controls over cash management, we noted there were no controls in place to ensure proper monitoring of cash drawdowns and reimbursements against actual expenses. There were no exceptions identified related to compliance over cash management. Recommendations: We recommend controls be established to ensure cash management requirements are followed. Management should track the status of the federally funded cash disbursements against the need to draw funds on related grant, and procedure be established to document that a review of the need for a drawdown or payment request has been performed. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan for further information.
Show full finding ▾Hide full finding ▴Finding 2019-004 Cash Management ? Material Weakness in Internal Control Over Compliance Programs: Department of Health and Human Services Health Center Program Cluster: 93.224/93.527 Criteria or specific requirement: 2 CFR 200.302(b) of the Compliance Supplement requires organizations receiving federal funds to establish controls and procedures that would minimize the amount of time between drawdowns and the disbursement of grant monies. Condition: Insufficient controls were in place to ensure the timing of Federal cash draws was such that time elapsing between the drawdown and the disbursement of funds was minimized. Cause: Insufficient controls were established in this area Effect or Potential Effect: Drawdowns may occur before needed for disbursement purposes Questioned costs: None identified. Context: During our walkthrough procedures related to controls over cash management, we noted there were no controls in place to ensure proper monitoring of cash drawdowns and reimbursements against actual expenses. There were no exceptions identified related to compliance over cash management. Recommendations: We recommend controls be established to ensure cash management requirements are followed. Management should track the status of the federally funded cash disbursements against the need to draw funds on related grant, and procedure be established to document that a review of the need for a drawdown or payment request has been performed. Views of responsible officials and planned corrective actions: Management concurs with the finding. See corrective action plan for further information.
Finding Number: 2019-004 Cash Management ? Material Weakness in Internal Control Over Compliance Planned Corrective Action: The drawdown procedure will be edited to implement a review of the drawdown need before processing payment requests. Anticipated Date of Completion: March 31, 2020
FAC accepted this audit on December 27, 2018 — management decision was due June 27, 2019.
GSA_MIGRATION
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2017-003
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2017-004
FAC accepted this audit on December 4, 2017 — management decision was due June 4, 2018.
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