Audit 16503

FY End
2022-09-30
Total Expended
$171.96M
Findings
2
Programs
40
Organization: Hartford Healthcare Corporation (CT)
Year: 2022 Accepted: 2023-06-29
Auditor: Ernst & Young

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
12251 2022-001 - - ABL
588693 2022-001 - - ABL

Programs

ALN Program Spent Major Findings
93.498 Covid-19 - Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $154.12M Yes 1
93.558 Temporary Assistance for Needy Families $1.86M - 0
97.036 Covid-19 - Disaster Grants - Public Assistance (presidentially Declared Disasters) $1.77M - 0
93.958 Block Grants for Community Mental Health Sevices $1.26M - 0
93.461 Covid 19 Claims Reimbursement for the Uninsured Program $696,213 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $607,334 - 0
20.616 National Priority Safety Programs $570,909 - 0
16.575 Crime Victim Assistance $538,538 - 0
93.242 Mental Health Research Grants $538,140 Yes 0
93.914 Hiv Emergency Relief Project Grants $498,369 - 0
93.732 Mental and Behavioral Health Education and Training Grants $420,839 - 0
93.870 Maternal, Infant and Early Childhood Home Visiting Grant Program $243,354 - 0
93.800 Organized Approaches to Increase Colorectal Cancer Screening $187,101 - 0
93.283 Centers for Disease Control and Prevention_investigations and Technical Assistance $183,707 - 0
93.273 Alcohol Research Programs $163,535 Yes 0
93.994 Maternal and Child Health Services Block Grant to the States $125,287 - 0
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $78,839 Yes 0
93.268 Immunization Cooperative Agreements $75,543 - 0
21.027 Covid-19 - Coronavirus State and Local Fiscal Recovery Funds $73,211 - 0
93.155 Rural Health Research Centers $67,987 - 0
93.276 Drug-Free Communities Support Program Grants $58,370 - 0
93.279 Drug Abuse and Addiction Research Programs $49,743 Yes 0
93.855 Allergy and Infectious Diseases Research $38,385 Yes 0
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $36,202 - 0
93.361 Nursing Research $35,774 Yes 0
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $35,194 Yes 0
14.267 Continuum of Care Program $33,119 Yes 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $30,000 - 0
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $28,909 Yes 0
93.393 Cancer Cause and Prevention Research $25,866 Yes 0
93.650 Accountable Health Communities $20,933 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $18,000 - 0
93.669 Child Abuse and Neglect State Grants $17,014 - 0
93.924 Ryan White Hiv/aids Dental Reimbursement and Community Based Dental Partnership Grants $15,881 - 0
16.758 Improving the Investigation and Prosecution of Child Abuse and the Regional and Local Children's Advocacy Centers $12,350 - 0
21.019 Covid-19 - Coronavirus Relief Fund $9,660 - 0
93.323 Covid-19 - Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $4,885 - 0
12.420 Improving Outcomes in Lethal Prostate Cancer $2,019 Yes 0
93.837 Cardiovascular Diseases Research $1,907 Yes 0
93.914 Covid-19 - Hiv Emergency Relief Project Grants $1,523 - 0

Contacts

Name Title Type
SSEEF5MGC9H9 Carol Wardell Auditee
8606966283 Meaghan Schachtel Auditor
No contacts on file

Notes to SEFA

Title: 3. Noncash Assistance Accounting Policies: The consolidated financial statements contained in Hartford HealthCare Corporation and Subsidiaries (the Corporation) annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.The accompanying Schedule of Expenditures of Federal Awards (the Schedule) for the year ended September 30, 2022 includes the federal grant activity of the Corporation and is presented on the accrual basis of accounting. 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 (the Uniform Guidance) and other program-specific guidance (see Notes 5 and 6). In accordance with certain requirements, certain grants are not dependent on expenditure activity, and accordingly, such grants are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures column of the Schedule. Other programs may be presented in a certain fiscal year based on the program-specific guidance (see Notes 5 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Corporations consolidated financial statements.Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The Corporation uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program. During the year ended September 30, 2022, the U.S. Department of Health and Human Services issued $75,543 in Federal vaccines to the Corporation through the Immunization Cooperative Agreements program (Assistance Listing No. 93.268). These federal funds, which were passed through the State of Connecticut Department of Public Health, are included in the accompanying Schedule.
Title: 4. Consolidated Reporting Accounting Policies: The consolidated financial statements contained in Hartford HealthCare Corporation and Subsidiaries (the Corporation) annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.The accompanying Schedule of Expenditures of Federal Awards (the Schedule) for the year ended September 30, 2022 includes the federal grant activity of the Corporation and is presented on the accrual basis of accounting. 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 (the Uniform Guidance) and other program-specific guidance (see Notes 5 and 6). In accordance with certain requirements, certain grants are not dependent on expenditure activity, and accordingly, such grants are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures column of the Schedule. Other programs may be presented in a certain fiscal year based on the program-specific guidance (see Notes 5 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Corporations consolidated financial statements.Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The Corporation uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program. The federal award activity of the entities noted below is included in the accompanying Schedule for the year ended September 30, 2022: See notes to the SEFA for chart/table.
Title: 5. COVID-19 Disaster Grants Public Assistance (Presidentially Declared Accounting Policies: The consolidated financial statements contained in Hartford HealthCare Corporation and Subsidiaries (the Corporation) annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.The accompanying Schedule of Expenditures of Federal Awards (the Schedule) for the year ended September 30, 2022 includes the federal grant activity of the Corporation and is presented on the accrual basis of accounting. 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 (the Uniform Guidance) and other program-specific guidance (see Notes 5 and 6). In accordance with certain requirements, certain grants are not dependent on expenditure activity, and accordingly, such grants are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures column of the Schedule. Other programs may be presented in a certain fiscal year based on the program-specific guidance (see Notes 5 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Corporations consolidated financial statements.Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The Corporation uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program. The Corporation incurred eligible disaster expenditures related to the COVID-19 pandemic. After a presidentially declared disaster, the Federal Emergency Management Agency (FEMA) provides Disaster Grants Public Assistance (Presidentially Declared Disasters) (Assistance Listing No. 97.036) to reimburse eligible costs. In fiscal year 2022, FEMA approved $1,767,349 of eligible expenditures that were incurred in prior fiscal years. This amount has been included in the accompanying Schedule for the year ended September 30, 2022 in accordance with the guidance specific to Assistance Listing No. 97.036.
Title: 6. COVID-19 Provider Relief Fund Accounting Policies: The consolidated financial statements contained in Hartford HealthCare Corporation and Subsidiaries (the Corporation) annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.The accompanying Schedule of Expenditures of Federal Awards (the Schedule) for the year ended September 30, 2022 includes the federal grant activity of the Corporation and is presented on the accrual basis of accounting. 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 (the Uniform Guidance) and other program-specific guidance (see Notes 5 and 6). In accordance with certain requirements, certain grants are not dependent on expenditure activity, and accordingly, such grants are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures column of the Schedule. Other programs may be presented in a certain fiscal year based on the program-specific guidance (see Notes 5 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Corporations consolidated financial statements.Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The Corporation uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program. In accordance with the requirements specific to Assistance Listing No. 93.498, COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution, the amount presented on the accompanying Schedule for the year ended September 30, 2022 relates to (i) activity from the period January 1, 2020 through June 30, 2022 for (ii) Provider Relief Fund (PRF) payments received from July 1, 2020 through June 30, 2021. This activity period and payment receipt period and the resulting amount presented reconciles to the PRF information previously reported to the Health Resources and Services Administration (HRSA) for PRF Reporting Periods 2 and 3 as follows: See the Notes to the SEFA for the chart/table. The expenses attributable to Coronavirus Disease 2019 (COVID-19) and lost revenues incurred by the Corporation during the period of availability for PRF Reporting Period 2 (January 1, 2020 through December 31, 2021) and PRF Reporting Period 3 (January 1, 2020 through June 30, 2022) are in excess of the general and targeted distributions received in PRF Reporting Period 1 (which addressed payments received during April 10, 2020 to June 30, 2020, and previously reported on the Schedule of Expenditures of Federal Awards for the year ended September 30, 2021) and distributions received from July 1, 2020 through June 30, 2021 and, therefore, the amounts presented in the table above and on the accompanying Schedule are limited to the amount of such distributions. The Corporation received additional PRF payments subsequent to June 30, 2021 which are required to be reported in subsequent HRSA PRF Reporting Periods and, accordingly, pursuant to the requirements specific to Assistance Listing No. 93.498, such amounts are excluded from the accompanying Schedule.

Finding Details

Identification of the Federal Program: Grantor: U.S. Department of Health and Human Services Program Name: COVID-19 ? Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing No. / FAIN / Pass-Through Entity / Pass-Through Entity Identifying Number: 93.498 / Not Applicable / Not Applicable / Not Applicable Section III?Federal Award Findings and Questioned Costs (continued) Criteria or Specific Requirement (Including Statutory, Regulatory or Other Citation): The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus. The funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. 2 CFR 200.303 requires that a non-federal entity must ?(a) establish and maintain effective internal control 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. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States and the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? Condition: During our testing we observed management did not have effective internal controls in place to ensure expenses reported in the Health Resources and Services Administration PRF Reporting Portal (the Portal) were not duplicated. This resulted in an overstatement of expenses reported in the Portal. Cause: Management did not have effective internal controls in place to ensure the reported expenses attributable to Coronavirus reported in the Portal were not duplicated. Effect or Potential Effect: The result of the condition caused overreporting of eligible expenses reported within the Corporation?s PRF ? Reporting Period 2 submission. Section III?Federal Award Findings and Questioned Costs (continued) Questioned Costs: $592,928 Context: During our internal control and compliance testing, we obtained listings of payroll expenses management had identified as eligible expenditures. In order to aggregate and report total eligible expenses, the Corporation used system reports which detailed payroll, supplies and related expenditures. Certain system reports contained expenses that were duplicated. While duplication of these expenses resulted in an overstatement of eligible expenses in the Portal submission, the amount of lost revenues reported was far in excess of the Provider Relief Funding received. As such, there is no impact on meeting the requirements to retain the funding received as expenses and lost revenues attributable to COVID-19 significantly exceeded the Provider Relief Funds received. Recommendation: We recommend that management develop and implement effective internal controls to ensure accurate reporting in the Portal. This will ensure the expenses reported in the Portal are not duplicated.
Identification of the Federal Program: Grantor: U.S. Department of Health and Human Services Program Name: COVID-19 ? Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing No. / FAIN / Pass-Through Entity / Pass-Through Entity Identifying Number: 93.498 / Not Applicable / Not Applicable / Not Applicable Section III?Federal Award Findings and Questioned Costs (continued) Criteria or Specific Requirement (Including Statutory, Regulatory or Other Citation): The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus. The funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. 2 CFR 200.303 requires that a non-federal entity must ?(a) establish and maintain effective internal control 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. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States and the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? Condition: During our testing we observed management did not have effective internal controls in place to ensure expenses reported in the Health Resources and Services Administration PRF Reporting Portal (the Portal) were not duplicated. This resulted in an overstatement of expenses reported in the Portal. Cause: Management did not have effective internal controls in place to ensure the reported expenses attributable to Coronavirus reported in the Portal were not duplicated. Effect or Potential Effect: The result of the condition caused overreporting of eligible expenses reported within the Corporation?s PRF ? Reporting Period 2 submission. Section III?Federal Award Findings and Questioned Costs (continued) Questioned Costs: $592,928 Context: During our internal control and compliance testing, we obtained listings of payroll expenses management had identified as eligible expenditures. In order to aggregate and report total eligible expenses, the Corporation used system reports which detailed payroll, supplies and related expenditures. Certain system reports contained expenses that were duplicated. While duplication of these expenses resulted in an overstatement of eligible expenses in the Portal submission, the amount of lost revenues reported was far in excess of the Provider Relief Funding received. As such, there is no impact on meeting the requirements to retain the funding received as expenses and lost revenues attributable to COVID-19 significantly exceeded the Provider Relief Funds received. Recommendation: We recommend that management develop and implement effective internal controls to ensure accurate reporting in the Portal. This will ensure the expenses reported in the Portal are not duplicated.