CUMBERLAND FAMILY MEDICAL CENTER, INC.

Sliding Fee Discounts Criteria ? Sliding fee discounts should be granted in accordance with organizational policy based on the application of a qualifying patient?s household income and family size to the sliding fee discount schedule in effect. Condition ? Based on the 40 patients selected for testing, we noted 5 errors. In three instances, the effective sliding fee discount schedule was improperly applied based on the household income and family size. In two instances, sliding fee discounts were granted to patients without obtaining the appropriate documentation of the patient?s household income and family size. Cause ? Due to the numerous operational disruptions caused by the COVID-19 pandemic, CFMC staff was unable to perform regular internal audits of sliding fee patient encounters or employee training sessions on sliding fee discounts. As a result, undetected errors in applying…

Corrective action: Condition: Sliding fee discounts: Based on the 40 patients selected for testing, we noted 5 errors. In three instances, the effective sliding fee discount schedule was improperly applied based on patient income and family size. In the other two instances, the documentation required to support eligibility for sliding fee discounts was not obtained. Action: As a result of the operational disruptions caused by the outbreak of the coronavirus pandemic, regular internal audits and employee trainings required by the Sliding Fee Discount Schedule Policy were not performed during 2020. In accordance with policy, CFMC will reinstitute the performance of regular internal audits and employee trainings…