PRESBYTERIAN MEDICAL SERVICES

2025-001 – Special Tests and Provisions – Sliding Scale – Noncompliance and Significant Deficiency in Internal Control Over Compliance Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Health Center Program Cluster Assistance listing numbers: 93.224 and 93.527 Award year and number: 2025; 6 H80CS00205‐24‐08; 4 H8NCS53926-01-02; 6 H2ECS45598-02-03; 5 H8KCS49758-02-00; 1 Q8JCS54522-01-00 Criteria: According to 42 USC 254(k)(3)(E), (F), and (G) and Health Resources and Services Administration (HRSA) regulations, health centers are required to develop and implement a sliding fee discount schedule that adjusts service charges for eligible patients in accordance with their ability to pay. Condition: Documentation supporting income verification for eligible patients was obtained and maintained in patient files; however, income frequency ente…

Corrective action: Corrective Action Plan: The organization has implemented targeted training, revised patient intake forms to include standardized income calculations, and established monthly audits for 2026 to ensure compliance with Sliding Fee Discount Program requirements. Clinics identified with a 10% or greater error rate are receiving focused retraining and ongoing monitoring, with audit results shared with leadership to promote accountability. Two mandatory training sessions for CARs, AR staff, and administrators are being conducted to reinforce consistent and compliant program implementation. Persons Responsible: Steven Hansen, President & CEO; Pearl Lujan, Central Billing Office Director Estimated Co…

2024-001 – Special Tests and Provisions – Sliding Scale – Noncompliance and Significant Deficiency in Internal Control over Compliance Federal program information: Funding Agency: U.S. Department of Health and Human Services Title: Health Center Program Cluster Assistance listing numbers: 93.224 and 93.527 Award Year and number: 2024; 5 H80CS00205‐22‐05; H8FC540998-01-00; H8GCS47875-01-00 Criteria: According to 42 USC 254(k)(3)(E), (F), and (G) and Health Resources and Services Administration (HRSA) regulations, health centers are required to develop and implement a sliding fee discount schedule that adjust…

Corrective action: Corrective Action Plan: Targeted training will be implemented to ensure full compliance with the sliding scale requirements. A new income calculation section has been added to patient intake forms, and monthly audits will be conducted to ensure accuracy and continuous improvement throughout 2025. Audits by location will be carried out by CBO staff and financial analysts, with results shared with administrators and CARs for accountability. Clinics showing minimal improvement will receive additional training. Two mandatory sliding fee scale training sessions will be schedules for all CARs, accounts receivable staff, and administrators. Persons Responsible: Steven Hansen, President & CEO; Peral…

2024-002 – Single Audit Report Submission – Noncompliance and Significant Deficiency in Internal Control over Compliance Federal program information: Funding Agency: All Major Programs Title: All Major Programs Assistance listing numbers: All Major Programs Award Year and number: All Major Programs Criteria: In According to Section 200.512(a) of the Uniform Guidance, the Single Audit reporting package must be submitted within the earlier of 30 calendar days after receipt of the auditor’s report, or nine months after the end of the audit period. Condition: PMS’ Single Audit reporting package for the year ended December 31, 2023 was prepared, however, was not officially submitted to the Federal Audit Clearinghouse …

Corrective action: Corrective Action Plan: PMS will coordinate with the Audit Team to schedule a walkthrough of the Federal Clearinghouse submission process within the first week after Board approval of the Audit, to ensure timely filing. Persons Responsible: Kent Mosbrucker, Vice President of Finance; Denise Cantu, Director of Finance. Estimated Completion Date: May 15, 2025

Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Health Center Program Cluster Assistance listing numbers: 93.224 and 93.527 Award year and number: 2022; H80CS00205-21-00; H80CS00205-21-01 Criteria: According to 42 USC 254(k)(3)(E), (F), and (G), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. Condition: Documentation supporting income verification for eligible patients did not agree to the income amounts applied to the sliding fee discount schedule. The amount of income applied to the sliding fee discount schedule was either estimated or rounded down. Questioned Costs: None. Context: Of a sample of 25 patients who received sliding fee discounts, five patients did not hav…

Corrective action: Additional training for staff involved in the patient intake process will be implemented and a calculation of patient income will be added to the income determination sheets going forward. On a monthly basis, PMS will sample the documentation to ensure accuracy and continuous improvement during 2023.

Federal program information: Funding agency: U.S. Department of Health and Human Services Title: Provider Relief Fund Assistance listing number: 93.498 Criteria: Recipients of amounts from the Provider Relief Fund (PRF) must complete the required information in the Health Resources and Services Administration (HRSA) Provider Relief Fund Reporting Portal. The amounts reported as ?Other Provider Relief Fund Expenses for Payments Received During Payment Period? must be to prevent, prepare for, or respond to coronavirus. Recipients must maintain adequate documentation to substantiate that the reported expenses were for this purpose. Condition: Based on a sample of 25 expenses from the HRSA submission, one ineligible cost was identified. However, PMS had other eligible expenses far in excess of the PRF amou…

Corrective action: Audit Finding: 2021-001 Reporting Corrective Action Plan: Training for all Accounts Payable personnel will be provided. This training will review the proper coding of expenses in the General Ledger. Awareness will also be provided of the issue that has resulted in the Audit Finding for 2021 related to a miscoded expense. Persons Responsible: Kent Mosbrucker, Vice President of Finance in conjunction with Kimberly Andreone, Director of Finance, and Denise Cantu Accounting Manager will conduct this training. Estimated Completion Date: June 30, 2022