EIN: 931230223
UEI: V1T8PBZKVCN9
Audited by: Aprio, LLP
Oversight agency: 93 [Department of Health and Human Services]
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Showing data from August 28, 2026 — the Federal Audit Clearinghouse is under high demand right now, so this couldn't be refreshed. This is the most recent data on record, not necessarily today's.
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on March 4, 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 September 4, 2026 (4 days from today).
What is a management decision? →FAC accepted this audit on October 22, 2025 — management decision was due April 22, 2026.
There were 4 instances in our sample of 62 where the proof of income documentation did not support the sliding fee discount adjustment. In 3 of those 4 instances, 100 percent of the fee was written off without any support for the adjustment. In addition, x-ray services are a flat $50 charge regardless of the patient’s ability to pay. The Organization’s sliding fee scale policy should be updated to reflect that policy for x-ray services. Cause: Policies and procedures were not established to ensure that the appropriate sliding fee discount adjustment was taken for all eligible transactions. Effect: Patients could have been improperly charged for services provided. Recommendation: Appropriate policies and procedures should be established to ensure that all sliding fee discounts taken follow the Organization’s sliding fee scale policy. The policy for x-ray service charges should be updated to reflect current practice.
Show full finding ▾Hide full finding ▴Criteria: The health center must prepare and apply a sliding fee discount schedule so that the amounts owed for heath center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay based on specific guidelines. Condition: There were 4 instances in our sample of 62 where the proof of income documentation did not support the sliding fee discount adjustment. In 3 of those 4 instances, 100 percent of the fee was written off without any support for the adjustment. In addition, x-ray services are a flat $50 charge regardless of the patient’s ability to pay. The Organization’s sliding fee scale policy should be updated to reflect that policy for x-ray services. Cause: Policies and procedures were not established to ensure that the appropriate sliding fee discount adjustment was taken for all eligible transactions. Effect: Patients could have been improperly charged for services provided. Recommendation: Appropriate policies and procedures should be established to ensure that all sliding fee discounts taken follow the Organization’s sliding fee scale policy. The policy for x-ray service charges should be updated to reflect current practice.
The leadership agrees that the sliding fee discount given to patients must be done correctly and proper documentation needs to be maintained in the patient’s file. Management will see why these patients never had documentation showing their income and do a root cause analysis to see what caused the breakdown. Management will train the staff who gather the information to do the sliding fee calculations and ensure that they know how to do it properly. We have new managers who will do spot checks on the sliding fee applications to ensure everything in the patients’ file is there which is required for the discount. The people responsible to ensure this happens will be Erich Koch, CEO, and Kacie Cunningham, Clinic Manager.
FAC accepted this audit on February 18, 2025 — management decision was due August 18, 2025.
There were 4 instances in our sample of 44 where there was no proof of income documentation to support the sliding fee discount adjustment. Cause: Policies and procedures were not established to ensure that proof of income documentation was retained. Effect: Patients could have been improperly charged for services provided. Recommendation: Appropriate policies and procedures should be established to ensure that all sliding fee scale eligible patients have the appropriate proof of income documentation in their file.
Show full finding ▾Hide full finding ▴Criteria: The health center must prepare and apply a sliding fee discount schedule so that the amounts owed for heath center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay based on specific guidelines. Condition: There were 4 instances in our sample of 44 where there was no proof of income documentation to support the sliding fee discount adjustment. Cause: Policies and procedures were not established to ensure that proof of income documentation was retained. Effect: Patients could have been improperly charged for services provided. Recommendation: Appropriate policies and procedures should be established to ensure that all sliding fee scale eligible patients have the appropriate proof of income documentation in their file.
The leadership agrees that the sliding fee discount given to patients must be done correctly and proper documentation needs to be maintained in the patient’s file. Management will see why these patients never had documentation showing their income and do a root cause analysis to see what caused the breakdown. Management will train the staff who gather the information to do the sliding fee calculations and ensure that they know how to do it properly. We have new managers who will do spot checks on the sliding fee applications to ensure everything in the patients’ file is there which is required for the discount. The people responsible to ensure this happens will be Erich Koch, CEO, and Kacie Cunningham, Clinic Manager.
FAC accepted this audit on April 4, 2024 — management decision was due October 4, 2024.
We noted the Family Practice lacked a financial management system and the internal control system to demonstrate compliance with requirements related to allowable and unallowable activities and allowable costs. Questioned costs: Unknown Context: The Family Practice incurred and allocated expenses for reimbursement by the grant but was unable to provide adequate detail for selection and testing of the source documentation required by the auditor to verify compliance. Cause: Management oversight. The Family Practiced lacked established internal controls and procedures over financial grant management to ensure submitted reports are complete, agree to supporting records and documentation, and are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding Recommendation: We recommend the Family Practice design controls and procedures to ensure submitted reports and the documentation used to prepare the reports are properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
Show full finding ▾Hide full finding ▴2021-003 Allowable and Unallowable Activities and Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Provider Relief Fund Assistance Listing Numbers: 93.498 Award Period: January 1, 2020 through June 30, 2021 Type of Finding: • Material Weakness in Internal Control over Compliance • Material Noncompliance (Modified Opinion) Criteria or specific requirement: According to § 75.302 Financial management and standards for financial management systems of 45 CFR Part 75, the non-federal entity’s financial management systems, including records documenting compliance with federal statutes, regulations, and the terms and conditions of the federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-federal entity must provide accurate, current, and complete disclosure of the financial results of each federal award or program in accordance with the reporting requirements. According to § 75.303 Internal controls of 45 CFR Part 75, the non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: We noted the Family Practice lacked a financial management system and the internal control system to demonstrate compliance with requirements related to allowable and unallowable activities and allowable costs. Questioned costs: Unknown Context: The Family Practice incurred and allocated expenses for reimbursement by the grant but was unable to provide adequate detail for selection and testing of the source documentation required by the auditor to verify compliance. Cause: Management oversight. The Family Practiced lacked established internal controls and procedures over financial grant management to ensure submitted reports are complete, agree to supporting records and documentation, and are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding Recommendation: We recommend the Family Practice design controls and procedures to ensure submitted reports and the documentation used to prepare the reports are properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
2021-003 Material Weakness - Allowable and Unallowable Activities and Allowable Costs Recommendation: We recommend the Family Practice design controls and procedures to ensure submitted reports and the documentation used to prepare the reports are properly maintained in the files of the Family Practice. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Family Practice designed controls and procedures to ensure submitted reports and the documentation used to prepare the reports are properly maintained in the files of the Family Practice. The CEO and CFO roles have been separated into two distinct positions. Separating the roles has significantly strengthened internal controls. Furthermore, a controller has been hired to prepare the reports and maintain appropriate and complete supporting documentation, which will then be reviewed by the CFO and CEO before submission. Name(s) of the contact person(s) responsible for corrective action: Amanda Blodgett, CEO Planned completion date for corrective action plan: December 31, 2024
We noted the Family Practice is not in compliance with cash management. Questioned costs: None Context: During our testing of cash management we noted drawdown requests were not supported by adequate records and documentation to ensure proper cash management practices. Cause: Management oversight. The Family Practiced lacked established internal controls and procedures over financial grant management to ensure submitted reports are complete, agree to supporting records and documentation, and are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records are properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
Show full finding ▾Hide full finding ▴2021–004 Cash Management Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00233 – 20 Award Period: January 1, 2021 through December 31, 2021 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Other Matters Criteria or specific requirement: According to § 75.302 Financial management and standards for financial management systems of 45 CFR Part 75, the non-federal entity’s financial management systems, including records documenting compliance with federal statutes, regulations, and the terms and conditions of the federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-federal entity must provide accurate, current, and complete disclosure of the financial results of each federal award or program in accordance with the reporting requirements. According to § 75.303 Internal controls of 45 CFR Part 75, the non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: We noted the Family Practice is not in compliance with cash management. Questioned costs: None Context: During our testing of cash management we noted drawdown requests were not supported by adequate records and documentation to ensure proper cash management practices. Cause: Management oversight. The Family Practiced lacked established internal controls and procedures over financial grant management to ensure submitted reports are complete, agree to supporting records and documentation, and are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records are properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
2021-004 Significant Deficiency - Cash Management Activities Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records are properly maintained in the files of the Family Practice. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Family Practice designed controls and procedures to ensure documentation and records are properly maintained in the files of the Family Practice. The CEO and CFO roles have been separated into two distinct positions. Separating the roles has significantly strengthened internal controls.. Furthermore, a controller has been hired to prepare the reports and oversee cash management activities. Name(s) of the contact person(s) responsible for corrective action: Amanda Blodgett, CEO Planned completion date for corrective action plan: March 11, 2024
CLA was unable to verify if the Family Practice is in compliance with period of performance. Questioned costs: Unknown Context: During our review expenditures for period of performance we noted expenditures were not supported by adequate records and documentation to facilitate testing. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records required to identify expenses and the date incurred are properly maintained in the files of the Family Practice. Cause: Management oversight. The Family Practice lacked established internal controls and procedures over financial grant management to ensure supporting records and documentation are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure documentation is properly maintained in the files of Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
Show full finding ▾Hide full finding ▴2021–005 Period of Performance Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H8ECS37958 Award Period: May 1, 2020 through May 31, 2021 Type of Finding: • Material Weakness in Internal Control over Compliance • Other Matters (Modified Opinion) Criteria or specific requirement: According to § 75.302 Financial management and standards for financial management systems of 45 CFR Part 75, the non-federal entity’s financial management systems, including records documenting compliance with federal statutes, regulations, and the terms and conditions of the federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-federal entity must provide accurate, current, and complete disclosure of the financial results of each federal award or program in accordance with the reporting requirements. According to § 75.303 Internal controls of 45 CFR Part 75, the non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: CLA was unable to verify if the Family Practice is in compliance with period of performance. Questioned costs: Unknown Context: During our review expenditures for period of performance we noted expenditures were not supported by adequate records and documentation to facilitate testing. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records required to identify expenses and the date incurred are properly maintained in the files of the Family Practice. Cause: Management oversight. The Family Practice lacked established internal controls and procedures over financial grant management to ensure supporting records and documentation are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure documentation is properly maintained in the files of Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
2021–005 Period of Performance Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H8ECS37958 Award Period: May 1, 2020 through May 31, 2021 Type of Finding: • Material Weakness in Internal Control over Compliance • Other Matters (Modified Opinion) Criteria or specific requirement: According to § 75.302 Financial management and standards for financial management systems of 45 CFR Part 75, the non-federal entity’s financial management systems, including records documenting compliance with federal statutes, regulations, and the terms and conditions of the federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-federal entity must provide accurate, current, and complete disclosure of the financial results of each federal award or program in accordance with the reporting requirements. According to § 75.303 Internal controls of 45 CFR Part 75, the non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: CLA was unable to verify if the Family Practice is in compliance with period of performance. Questioned costs: Unknown Context: During our review expenditures for period of performance we noted expenditures were not supported by adequate records and documentation to facilitate testing. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records required to identify expenses and the date incurred are properly maintained in the files of the Family Practice. Cause: Management oversight. The Family Practice lacked established internal controls and procedures over financial grant management to ensure supporting records and documentation are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure documentation is properly maintained in the files of Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
Documentation supporting allowable costs was not maintained by the Family Practice. Questioned costs: Unknown Context: During our testing of expenditures we noted two instances where payroll expenditures charged to the grant were not supported the by the employee’s approved wage rate. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records required to support wage calculations are properly maintained in the files of the Family Practice. Cause: Management oversight. The Family Practice lacked established internal controls and procedures over financial grant management to ensure supporting records and documentation are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure documentation is properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
Show full finding ▾Hide full finding ▴2021–006 Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00233 – 20 Award Period: January 1, 2021 through December 31, 2021 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Other Matters Criteria or specific requirement: According to § 75.302 Financial management and standards for financial management systems of 45 CFR Part 75, the non-federal entity’s financial management systems, including records documenting compliance with federal statutes, regulations, and the terms and conditions of the federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-federal entity must provide accurate, current, and complete disclosure of the financial results of each federal award or program in accordance with the reporting requirements. According to § 75.303 Internal controls of 45 CFR Part 75, the non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: Documentation supporting allowable costs was not maintained by the Family Practice. Questioned costs: Unknown Context: During our testing of expenditures we noted two instances where payroll expenditures charged to the grant were not supported the by the employee’s approved wage rate. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records required to support wage calculations are properly maintained in the files of the Family Practice. Cause: Management oversight. The Family Practice lacked established internal controls and procedures over financial grant management to ensure supporting records and documentation are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure documentation is properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
2021–006 Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00233 – 20 Award Period: January 1, 2021 through December 31, 2021 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Other Matters Criteria or specific requirement: According to § 75.302 Financial management and standards for financial management systems of 45 CFR Part 75, the non-federal entity’s financial management systems, including records documenting compliance with federal statutes, regulations, and the terms and conditions of the federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-federal entity must provide accurate, current, and complete disclosure of the financial results of each federal award or program in accordance with the reporting requirements. According to § 75.303 Internal controls of 45 CFR Part 75, the non-federal entity must establish and maintain effective internal control over the federal award that provides reasonable assurance that the non-federal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. Condition: Documentation supporting allowable costs was not maintained by the Family Practice. Questioned costs: Unknown Context: During our testing of expenditures we noted two instances where payroll expenditures charged to the grant were not supported the by the employee’s approved wage rate. Recommendation: We recommend the Family Practice design controls and procedures to ensure the documentation and records required to support wage calculations are properly maintained in the files of the Family Practice. Cause: Management oversight. The Family Practice lacked established internal controls and procedures over financial grant management to ensure supporting records and documentation are properly maintained in the files of the Family Practice. Effect: Inability to support compliance with the grant and a potential loss of federal funding. Recommendation: We recommend the Family Practice design controls and procedures to ensure documentation is properly maintained in the files of the Family Practice. Views of responsible officials: There is no disagreement with the audit finding.
FAC accepted this audit on August 8, 2022 — management decision was due February 8, 2023.
FAC accepted this audit on April 14, 2021 — management decision was due October 14, 2021.
During the course of our audit procedures it was identified that certain patient encounters were provided a sliding fee discount but the Family Practice did not have evidence of patient income to support the discount provided or did not have evidence of supervisor approval of the documentation from the patient to support their eligibility. Effect: Not documenting income eligibility or approval of the proper documentation to determine eligibility of a sliding fee encounter resulted in noncompliance with certain special tests and provisions of the major federal program. Cause: The Family Practice has properly designed controls that require personnel to document patient income and approve the documentation that supports patient eligibility for sliding fee adjustments, but the controls were not properly implemented during the fiscal year and the controls in practice were ineffective. Prevalence: This is an internal control implementation deficiency. Repeat finding: Yes. Context: In a sample of 25 sliding fee encounters reviewed, which the auditor considers to be statistically valid, seven instances were identified where the control was not properly implemented, as detailed below: Five instances in which income documentation was not recorded or maintained to support the sliding fee discount applied to the patient encounter. Four of these encounters appear to have been first time patient visits to the Family Practice.; Two instances in which the Family Practice did not have evidence of approval of documentation from the patient to support their eligibility for the sliding fee discount. Auditor?s recommendation: The Family Practice should implement effective controls to document patient income and approve documentation that supports patient income eligibility for sliding fee adjustments in accordance with the compliance requirements of the federal program. The Family Practice?s response: Management agrees with the above finding and recommendation. See attached corrective action plan prepared by management.
Show full finding ▾Hide full finding ▴Type: Significant deficiency in internal control over compliance and immaterial special tests and provision noncompliance. Federal programs: The Health Centers Cluster ? CFDA 93.224 Health Center Program and CFDA 93.527 Grants for New and Expanded Services under the Health Center Program. Criteria: Per PHS Act Section 330(k)(3)(G) and 42 CFR 51c.303(f) and (u), health centers must have a system in place to determine eligibility for patient discounts adjusted on the basis of the patient?s ability to pay. Questioned costs: None. Condition: During the course of our audit procedures it was identified that certain patient encounters were provided a sliding fee discount but the Family Practice did not have evidence of patient income to support the discount provided or did not have evidence of supervisor approval of the documentation from the patient to support their eligibility. Effect: Not documenting income eligibility or approval of the proper documentation to determine eligibility of a sliding fee encounter resulted in noncompliance with certain special tests and provisions of the major federal program. Cause: The Family Practice has properly designed controls that require personnel to document patient income and approve the documentation that supports patient eligibility for sliding fee adjustments, but the controls were not properly implemented during the fiscal year and the controls in practice were ineffective. Prevalence: This is an internal control implementation deficiency. Repeat finding: Yes. Context: In a sample of 25 sliding fee encounters reviewed, which the auditor considers to be statistically valid, seven instances were identified where the control was not properly implemented, as detailed below: Five instances in which income documentation was not recorded or maintained to support the sliding fee discount applied to the patient encounter. Four of these encounters appear to have been first time patient visits to the Family Practice.; Two instances in which the Family Practice did not have evidence of approval of documentation from the patient to support their eligibility for the sliding fee discount. Auditor?s recommendation: The Family Practice should implement effective controls to document patient income and approve documentation that supports patient income eligibility for sliding fee adjustments in accordance with the compliance requirements of the federal program. The Family Practice?s response: Management agrees with the above finding and recommendation. See attached corrective action plan prepared by management.
Responsible Person: Signe Porter, CEO-CFO Corrective Action Plan: KHP is implementing eClinicalWorks April, 2021. We will update our Sliding Fee training program for employees who provide patient assistance with Sliding Fee. Training for Front Desk, Patient Resources and Billing will be required for new employees and updated annually. Unlike PrimeSuite, eCW has specific functionality for Sliding Fee provides a much similar and clearer platform for entering and approving documentation. Progress: Auditing current SF accounts for accuracy. Waiting to update our existing training program with detailed instruction and screen shots of eCW entry so Sliding Fee is calculated correctly. Anticipated Completion Date: Two to three months after eCW implementation.
2018-005
FAC accepted this audit on September 29, 2019 — management decision was due March 29, 2020.
GSA_MIGRATION
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2017-002
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2017-003
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2017-004
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GSA_MIGRATION
FAC accepted this audit on September 26, 2018 — management decision was due March 26, 2019.
GSA_MIGRATION
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GSA_MIGRATION
FAC accepted this audit on September 18, 2017 — management decision was due March 18, 2018.
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