ONE COMMUNITY HEALTHNon-Profit

Finding 2022-002: Program Name/ALN Title: Provider Relief Fund Federal Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Period: 4/1/2020 ? 6/30/2021 Federal Award Number: N/A Type of Finding: Significant Deficiency Criteria: Management is responsible for designing and maintaining a system of internal controls to achieve compliance with provisions of federal awards. Condition: CLA identified three instances in which the incentive amount paid to the employee was different than the amount that should have been paid according to the board approved incentive structure. Context: CLA identified three instances in which the incentive amount paid to the employee did not equal the amount that should have been paid according to the board approved incentive structure. OCH Board of Directors approved an incentive be paid to employees twice during the timeframe being audited. One incentive was approved to be calculated and paid based on longevity and the other was approved based on attendance of COVID-19 related events held by OCH. Cause: There was a lack of understanding regarding the incentive structure in the Human Resources Department. Effect: Three instances were noted in which the incentive amount paid to employees was different than the board approved incentive structure and no further approval was documented to support the increase or decrease in the incentive. Recommendation: We recommend management follow its existing internal control process for board approved incentive pay and ensure that any exceptions to the approved incentive pay structure are approved and documented. Views of responsible officials: There is no disagreement with the audit finding.

Criteria: Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amount owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: During our testing, we identified two instances in which a sliding fee application was not provided, indicating that the sliding fee application review and approval process did not occur. Context: Sliding fee applications are reviewed and approved by the billing department prior to the patient receiving a sliding fee discount. In the two instances noted, the sliding fee application could not be located. Cause: In one instance the sliding fee application was likely misplaced when transferring documents from billing to internal records to be scanned. In the other instance, the sliding fee application was likely never completed. This was caused by front desk employees having access to inadvertently click a verified box in the practice management system for sliding fee applications. Effect: Without proper review and approval over the sliding fee applications prior to applying the sliding fee to a patient accounts, a sliding fee discount can be applied to patient accounts that do not met the FPL scales and result in a loss of revenues. Recommendation: CLA recommends that all sliding fee applications are reviewed and approved by the billing department prior to verification in the practice management system. Further, CLA recommends that all sliding fee applications are retained electronically in the practice management system. Views of responsible officials: There is no disagreement with the audit finding.