SUN RIVER HEALTH, INC.

Finding 2023-001: Special Tests and Provisions - Significant Deficiency – Incorrect Application of the Sliding Scale Federal Assistance Listing Number: 93.224/93.527- Health Center Program Cluster [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers: H80CS00313-13-12; H8FCS41390-01-00, H2ECS45521-01-00 Federal Award Year: January 1, 2023- December 31, 2023 Pass-Through Entity: Sun River Health Care Criteria: Under 42 CFR Sections 51c.303(e), (f) and (g), health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay. To verify this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. HHLI should maintain patient files t…

Corrective action: Views of Responsible Officials and Planned and Corrective Actions: As a result of prior audit finding, HHLI has instituted mandated training sessions with a required curriculum for a sliding fee scale. These training were conducted over a period which included competency testing and retraining if necessary. It is documented that we have had a high turnover of clerical staff during the past year. As a result, we had the task of training new clerical staff as we were onboarded. We understand this interrupted the continuity of learned processes for our clerical staff and thus the outlined process. As well, we have continued with our internal audit processes. We have identified an internal repor…

Finding 2022-001: Special Tests and Provisions - Significant Deficiency - Failure to Update and Apply the Sliding Scale Federal Assistance Listing Number: 93.224/93.527- Health Center Program [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers: H80CS00313-13-12; H8FCS41390-01-00, H2ECS45521-01-00 Federal Award Year: January 1, 2022- December 31, 2022 Pass-Through Entity: Hudson River Health Care Criteria: Under 42 CFR Sections 51c.303(e), (f) and (g), health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay. To verify this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. LIFQHC should maintain patient files to…

Corrective action: LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients' information, such as income, in order to ensure that all patients are charged appropriately. All the above findings were happened before the training was provided. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as th…

Federal Assistance Listing Number: 93.224 - Health Center Program Cluster [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers in Cluster: H80CS00313-13-12; H8CCS35118-01-00; H8DCS36593-01-00; H8ECS38680-01-00; H8FCS41390-01-00 Federal Award Year in Cluster: January 1, 2021 ? December 31, 2021 Pass-Through Entity: Hudson River Health CareCriteria: Under 42 CFR Sections 51c.303(e), (f) and (g), health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted based on the patient's ability to pay. To verify that this criteria, the compliance supplement has the suggested audit procedures which require the auditor to review a sample of patients treated. LIFQHC should maintain patient files to support the patient's eligibility and that the patient…

Corrective action: LIFQHC has implemented procedures to ensure that all patients are charged appropriately based on services, income and where they should be categorized on the LIFQHC sliding fee scale. Management is currently providing training to the registration staff across all sites. The objective of this training is to verify patients? information, such as income, to verify that all patients are charged appropriately. Management has also implemented a new process in which the sliding fee scale will be updated on a more timely basis. LIFQHC will update the sliding fee scale in the electronic medical record system as soon as the current years poverty guidelines are available.

Federal Assistance Listing Number: 93.224 - Health Center Program Cluster [including Covid-19 funds] Federal Agency: U.S. Department of Health and Human Services Federal Award Numbers in Cluster: H80CS00313-13-12; H8CCS35118-01-00; H8DCS36593-01-00; H8ECS38680-01-00; H8FCS41390-01-00Federal Award Year in Cluster: January 1, 2021 ? December 31, 2021 Pass-Through Entity: Hudson River Health Care Criteria: LIFQHC is required to submit quarterly expenditure reports within 30 days of the end of the quarter. Questioned Cost: None Condition: The first quarter of 2021 expenditure report was not filed within 30 days of the end of the quarter. Context: The first quarter of 2021 expenditure report was filed 32 days after the end of the quarter. This was not a statistically valid sample. Effect: One of the quarterly expenditure reports was filed 32 days after the end of the quarter. Cause: There was…

Corrective action: Effective April 1, 2022, the quarterly Federal Financial Report (FFR) is no longer required by the U.S Health Resources and Services Administration (HRSA). The first quarterly FFR report for 2021 was due on Friday, April 30, 2021, based on HRSA guidelines, and LIFQHC filed that report on Monday, May 3, 2021. LIFQHC?s account was never placed on hold for untimely filing. To our knowledge, LIFQHC was not out of compliance. The LIFQHC finance department had significant turnover in 2021 and access to HRSA system contributed to the late filing of the first quarterly 2021 FFR report.