EIN: 931250581
UEI: TRKAM8E6WVJ5
Data as of August 23, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on January 27, 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 July 27, 2021 (1854 days ago).
What is a management decision? →Item 2020-001, Sliding Fee Discounts and Special Tests and Provisions: U.S. Department of Health and Human Services, Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (93.224) and Grants for New and Expanded Services under the Health Center Program (93.527). Criteria or specific requirement: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Statement of condition: During our review of patient billing, 2 out of 25 samples selected for testing special tests and provisions compliance requirements had exceptions. The exceptions are as follows: (1) the Center did not properly determine the sliding fee discount category to 1 patient selected for testing based on the sliding fee scale approved by the board; and (2) the Center did not have either proof of income or self-attestation document on file for 1 patient selected for testing, thus, it could not be ascertained if the patient was properly slid in accordance with the Center's sliding fee scale. The sample size tested was a statistically valid sample size. Statement of cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2020. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Identification of repeat finding: No. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of responsible official: Management recognizes the need to ensure appropriate compliance with all sliding fee scale guidelines and will implement measures to ensure that all staff understand and are trained on collection of documentation from patients.
Show full finding ▾Hide full finding ▴Item 2020-001, Sliding Fee Discounts and Special Tests and Provisions: U.S. Department of Health and Human Services, Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) (93.224) and Grants for New and Expanded Services under the Health Center Program (93.527). Criteria or specific requirement: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Statement of condition: During our review of patient billing, 2 out of 25 samples selected for testing special tests and provisions compliance requirements had exceptions. The exceptions are as follows: (1) the Center did not properly determine the sliding fee discount category to 1 patient selected for testing based on the sliding fee scale approved by the board; and (2) the Center did not have either proof of income or self-attestation document on file for 1 patient selected for testing, thus, it could not be ascertained if the patient was properly slid in accordance with the Center's sliding fee scale. The sample size tested was a statistically valid sample size. Statement of cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2020. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Identification of repeat finding: No. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of responsible official: Management recognizes the need to ensure appropriate compliance with all sliding fee scale guidelines and will implement measures to ensure that all staff understand and are trained on collection of documentation from patients.
Health Resources and Services Administration Waterfall Clinic, Inc. respectfully submits the following corrective action plan for the year ended June 30, 2020. CohnReznick LLP 1301 Avenue of the Americas New York, NY 10019 Audit Period: June 30, 2020 The findings from the June 30, 2020 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the number assigned in the schedule. See Finding 2020-001 below for recommendation and corrective action taken. FINDINGS ? FEDERAL AWARDS PROGRAM AUDIT U.S. Department of Health and Human Services, Health Centers Cluster Programs (CFDA 93.224/93.527) Finding 2020-001 ? Federal Award Findings & Questioned Costs We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance and with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient?s proof of income or self-attestation regarding their income. Action Taken This finding was corrected on December 10, 2020. The corrective action taken was a refresher training for Front Desk Staff on the Sliding Discount Fee application process and recordkeeping requirements. The application process has been reviewed and includes individual review of each application accepted by the Front Desk staff by the Billing Specialist for accuracy prior to entry into the registration system. We have also updated our process to include a periodic spot check of application documentation quarterly by the Revenue Cycle Director, who oversees the Billing and Front Desk Staff. If the Health Resources and Services Administration has questions regarding this plan, please call Wendy R. Boone, CFO at 541-435-7001.
FAC accepted this audit on March 19, 2019 — management decision was due September 19, 2019.
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2017-008
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2018-006
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2017-007
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2017-009
FAC accepted this audit on March 27, 2018 — management decision was due September 27, 2018.
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2016-006
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2016-004
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FAC accepted this audit on December 5, 2017 — management decision was due June 5, 2018.
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2015-004
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2015-005
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2015-006
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Show full finding ▾Hide full finding ▴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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