VNA HEALTH CARE, AN ILLINOIS NOT-FOR-PROFIT CORPORATION

Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: Significant deficiency in internal control over compliance Criteria: 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 (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to …

Corrective action: 2022-001 Health Centers Cluster ? Assistance Listing No. 93.224 and 93.527; Condition: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale assigned to three patient encounters. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: ? Registration management …

Major Program: Special Supplemental Nutrition Program for Women, Infants, and Children CDFA Number: 10.557 Federal Agency: U.S. Department of Health and Human Services Pass-Through: Illinois Department of Human Services Grantor Number: FCSYQ01106 Award Period: July 1, 2019 through June 30, 2020 Type of Finding: -Significant deficiency in Internal Control over Compliance. -Other Matters. Criteria: Uniform Guidance section 200.430(h)(8)(i) indicates that the standards for documentation of personnel expenses are such that (1) Charges to Federal awards for salaries and wages must be based on records that accurately reflect the work performed. These records must:(i) Be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated;(ii) Be incorporated into the official records of the non-Federal entity and (ii…

Corrective action: VNA management will review its policies and procedures in order to further define the process in an effort to eliminate any deficiencies going forward. The allocations employed to capture grant related activities by staff providing direct supportive services to WIC grant operations needs to more clearly demonstrate interim reviews assuring allocation assumptions are valid. The bases used to determine allocation estimates will be documented and maintained with the relevant grant documents. Enforcement of documenting the review of allocations on a semi-annual basis will eliminate the deficiency going forward. All staff chargeable to federal or state grants will receive training, direction, a…

Finding 2019-001 ? Application of Sliding Fee Discount Major Program: Health Center Program Cluster CFDA Number: 93.224 and 93.527 Federal Agency: U.S. Department of Health and Human Services Grantor Number: H80CS03983 Award Period: March 1, 2018 through February 28, 2019 and March 1, 2019 through February 29, 2020 Type of Finding: - Significant deficiency in Internal Control over Compliance. - Other Matters. Criteria: Per Title 42 Chapter 1 Subchapter D Section 51c303(f), ?Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient?s ability to pay. Condition: During our testing of sliding fee discounts, we identified…

Corrective action: U.S. Department of Health and Human Services, Health Resources and Services Administration VHA Health Care respectfully submits the following corrective action plan for the year ended June 30, 2019. Audit period: July 1, 2018 ? June 30, 2019 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS?FEDERAL AWARD PROGRAMS AUDITS SIGNIFICANT DEFICIENCIES 2019-001 Application of Sliding Fee Discount Recommendation: We recommend the Organization take measures to ensure that appropriate sliding fee rates/categories are used for each sliding fee encounter. Action taken in r…