FAC Explorer

Audit 10165

FY End
2023-03-31
Total Expended
$1.57M
Findings
2
Programs
8
Organization: Cherry County Hospital (NE)
Year: 2023 Accepted: 2024-01-08
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
7831 2023-004 Significant Deficiency - ABL
584273 2023-004 Significant Deficiency - ABL

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund (prf) and American Rescue Plan (arp) Rural Distribution $1.09M Yes 1
93.155 Rural Health Research Centers $202,787 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $111,472 - 0
93.697 Testing and Mitigation for Rural Health Clinics $100,000 - 0
93.461 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $51,886 - 0
93.301 Small Rural Hospital Improvement Grant Program $12,836 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $307 - 0
93.436 Well-Integrated Screenind and Evaluation for Women Across the Nation (wisewoman) $142 - 0

Contacts

Name Title Type
TGU4TG32P9L9 Nancy Hicks-Arsenault Auditee
4023762525 Brian Green Auditor
No contacts on file

Notes to SEFA

Title: Note 4 ‐ Provider Relief Funds Accounting Policies: Note 1: Basis of Presentation - The accompanying schedule of expenditures of federal awards (the “Schedule”) includes the federal award activity of the Hospital under programs of the federal government for the year ended March 31, 2023. The information in the Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net position or cash flows of the Hospital. Note 2: Summary of Significant Accounting Policies - Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Hospital has elected not to use the 10-percent de minimus indirect cost rate allowed under the Uniform Guidance and does not draw for indirect costs. The Hospital received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund (PRF) program (Federal Financial Assistance Listing 93.498) during the year ended March 31, 2022. The Hospital incurred eligible expenditures and, therefore, recognized revenue totaling $1,086,304 for the year ended March 31, 2022 in the financial statements. In accordance with the compliance supplement, the PRF expenditures recognized on the schedule are based on the reporting to HHS for the period ending December 31, 2022, as required under the PRF program. The amount of PRF expenditures included on the schedule requires management to make estimates and assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant estimate. Estimates and assumptions may include reducing actual expenses by amounts than have been reimbursed or are obligated to be reimbursed by other sources. Actual results could differ from those estimates.

Finding Details

Finding 2023-004
Federal Program: Federal Financial Assistance Listing 93.498; US Department of Health and Human Services; Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Activities Allowed/Unallowed and Allowable Costs/Cost Principles Reporting Significant Deficiency in Internal Control over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Hospital reported amounts in the reporting portal for information technology expenditures for Quarter 3 2022 in excess of amounts that are supported by audit evidence. Cause: The Hospital did not have an effective internal control process in place to ensure review and approval of the expenses claimed under the federal program and to ensure the report submitted for Period 4 was accurate and in accordance with the terms and conditions of the federal award. Effect: The reporting to HHS for Period 4 was considered incorrect. Amounts reported for information technology expenditures for Quarter 3 2022 did not agree to audit evidence provided by management. Questioned Costs: None. Context: Key line items were tested on the Period 4 HHS report. Recommendation: We recommend that the Hospital enhance its existing internal control processes to ensure expenses reported to HHS are supportable by underlying audit evidence. Views of Responsible Officials and Planned Corrective Actions: Management agrees with the noted finding. Management will continue to refine processes to more diligently review the reporting portal submission and underlying audit evidence to ensure the accuracy of calculations and amounts reported to HHS.
Finding 2023-004
Federal Program: Federal Financial Assistance Listing 93.498; US Department of Health and Human Services; Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Activities Allowed/Unallowed and Allowable Costs/Cost Principles Reporting Significant Deficiency in Internal Control over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Hospital reported amounts in the reporting portal for information technology expenditures for Quarter 3 2022 in excess of amounts that are supported by audit evidence. Cause: The Hospital did not have an effective internal control process in place to ensure review and approval of the expenses claimed under the federal program and to ensure the report submitted for Period 4 was accurate and in accordance with the terms and conditions of the federal award. Effect: The reporting to HHS for Period 4 was considered incorrect. Amounts reported for information technology expenditures for Quarter 3 2022 did not agree to audit evidence provided by management. Questioned Costs: None. Context: Key line items were tested on the Period 4 HHS report. Recommendation: We recommend that the Hospital enhance its existing internal control processes to ensure expenses reported to HHS are supportable by underlying audit evidence. Views of Responsible Officials and Planned Corrective Actions: Management agrees with the noted finding. Management will continue to refine processes to more diligently review the reporting portal submission and underlying audit evidence to ensure the accuracy of calculations and amounts reported to HHS.