MCR HEALTH INC

Assistance Listing Number: 93.224 Name of Federal Agency: Department of Health and Human Services, HRSA Program Title: Health Center Program Compliance Requirement: Special Tests and Provisions – Sliding Fee Discounts Pass-through Entity: N/A Federal Grant/Contract Number and Grant Year: 5 H80CS00097-24-00, 6 H80CS00097-24-01, 6 H80CS00097-24-03, 6 H80CS00097-24-04, 6 H80CS00097-24-05, 6 H80CS00097-24-06, 6 H80CS00097-24-07, 6 H80CS00097-24-08 Finding Type: Noncompliance and Significant Deficiency in Internal Control Known Questioned Costs: $1,300 Condition: The Organization did not follow the correct processes of review and approval of the application of the sliding fee scale. - Applications for patients were approved for one slide but their charges were applied to a different slide Criteria: 2 CFR section 200.303 requires that nonfederal entities receiving federal awards establish an…

Corrective action: MCR has established a procedure to require a completed application with signature and supporting documentation in order to qualify for a sliding fee scale. Any incomplete applications or those with incomes greater than 200% of the poverty level will only result in consideration for courtesy discount. Financial counselors have 7 business days from the return of a patient application to determine completeness and eligibity for sliding fee scale. The Chief Financial Officer, Kara Onorato, will be responsible for ensuring that this process is followed. The new policy was approved by the board of Directors in December 2025. The new process is being implemented in 2026. Internal audit began mon…

Assistance Listing Number: 93.224 and 93.527 Name of Federal Agency: Department of Health and Human Services, HRSA Program Title: Health Center Program Compliance Requirement: Special Tests and Provisions – Sliding Fee Discounts Pass-through Entity: N/A Federal Grant/Contract Number and Grant Year: 5 H80C00097-23-00 (2024), 6 H80CS00097-23-14 (2024), 1 H8GCS47591-01-00 (2022 and 2023), 1 H8LCS50961-01-00 (2023 and 2024) Finding Type: Noncompliance and Significant Deficiency in Internal Control Known Questioned Costs: $279 Condition: The Organization did not follow the correct processes of review and approval of the application of the sliding fee scale. - Failure to provide approval of one of the sliding fee scale applications. - One patient listed in the sliding fee scale population did not have an application. - One sliding fee scale claim was incorrectly applied to the slide as the pat…

Corrective action: MCR has established a procedure to require a completed application with signature and supporting documentation in order to qualify for a sliding fee scale. Any incomplete applications or those with incomes greater than 200% of the poverty level will only result in consideration for courtesy discount. Financial counselors have 7 business days from the return of a patient application to determine completeness and eligibity for sliding fee scale. The Chief Financial Officer, Kara Onorato, will be responsible for ensuring that this process is followed. This revised process will be put in place on October 1, 2025.

Part III ? Schedule of Findings and Questioned Costs ? Federal Programs Item 2022-001 Special Tests and Provisions ? Wage Rate Requirements Health Infrastructure Investment Program ? Assistance Listing # 93.526 U.S. Department of Health and Human Services Federal Award Year 2022 Criteria ? 2 CFR 200.303 requires non-federal entities to establish and maintain effective internal controls 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. Nonfederal entities shall include in their construction contracts subject to the Wage Rate Requirements a provision that the contractor or subcontractor comply with those requirements and the DOL regulations (29 CFR Part 5, Labor Standards Provisions Applicable to Contracts Governing Federally…

Corrective action: The following are management responses to the internal control findings: 2022-001 Single Audit major Program - Material Weakness MCR Health has established a policy and procedures to review the contract and 0MB Compliance Supplement requirements for all Federal or state awards to gain an understanding of the compliance requirements and will have in place internal controls to ensure compliance. The review will be completed by the Finance and Budget Manager, (Tracy Brown), during the application process for each grant. This was put into place March 1, 2023. If anything needs to be addressed, please do not hesitate to give me a call at 941-776- 4008 x306.