Audit 20122

FY End
2022-03-31
Total Expended
$42.77M
Findings
2
Programs
20
Year: 2022 Accepted: 2022-12-22
Auditor: Rsm US LLP

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
21721 2022-001 Significant Deficiency - L
598163 2022-001 Significant Deficiency - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $39.52M Yes 1
93.461 Covid-19 Testing for the Uninsured $831,339 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $389,227 - 0
93.889 National Bioterrorism Hospital Preparedness Program $303,794 - 0
93.697 Covid-19 Testing for Rural Health Clinics $281,280 - 0
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $232,216 - 0
93.664 Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment (support) for Patients and Communities Act (b) $212,811 - 0
93.155 Rural Health Research Centers $163,035 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $150,287 - 0
93.393 Cancer Cause and Prevention Research $62,589 - 0
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $53,972 - 0
93.788 Opioid Str $50,496 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $42,362 - 0
93.395 Cancer Treatment Research $39,703 - 0
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $18,355 - 0
93.301 Small Rural Hospital Improvement Grant Program $11,722 - 0
93.387 National and State Tobacco Control Program (b) $7,038 - 0
10.874 Delta Health Care Services Grant Program $3,998 - 0
93.324 State Health Insurance Assistance Program $3,290 - 0
93.071 Medicare Enrollment Assistance Program $1,438 - 0

Contacts

Name Title Type
Y6PCD11XRNZ5 Warren Ladner Auditee
6184575200 Jay Adkisson Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation 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. De Minimis Rate Used: Y Rate Explanation: The Corporation has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Southern Illinois Healthcare Enterprises, Inc. and its subsidiaries (Corporation) under programs of the federal government for the year ended March 31, 2022. 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 Corporation, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Corporation.
Title: Non-Cash Assistance, Insurance, Loans and Loan Guarantees Outstanding 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. De Minimis Rate Used: Y Rate Explanation: The Corporation has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The Corporation did not receive any non-cash assistance during the year ended March 31, 2022. The Corporation did not have any federal insurance in effect during the year ended March 31, 2022, nor were there any loans or loan guarantees outstanding at year-end.
Title: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution 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. De Minimis Rate Used: Y Rate Explanation: The Corporation has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. For the federal awards related to the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) (ALN 93.498) program, the U.S. Department of Health and Human Services (HHS) has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the HRSA PRF Reporting Portal. Payments from HHS for PRF are assigned to "Payment Received Periods" (each, a Period) based upon the date each payment from the PFR was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). The accompanying Schedule includes $24,855,488 of Period 1 distributions received between April 10, 2020 through June 30, 2020 and $14.663,919 of Period 2 distributions received between July 1, 2020 through December 31, 2020. The Period 1 and Period 2 distributions have been reported by the Corporation in the HRSA PFR Reporting Portal as used during the corresponding Period of Availability in accordance with guidance from HHS. These amounts were recognized are other operating revenue in the Corporation's financial statements for the year ended March 31, 2021. Due to the PRF reporting requirements, these amounts are not the total PRF received and recognized as other operating revenue in the Corporation's financial statements were approximately $10,495,000 and $44,658,000 during the years ended March 31, 2022 and 2021, respectively.

Finding Details

Criteria: Provider Relief Fund (PFR) payments may be applied to lost revenues attributable to coronavirus according to the Period of Availability of funding. However, lost revenues may not be duplicated. Condition: In the report submitted to the Health Resources & Services Administration (HRSA) PRF Reporting Portal for reporting Period 1 for Southern Illinois Hospital Services (SIHS), the Corporation indicated that SIHS is the parent of Southern Illinois Medical Services (SIMS), and that SIHS is reporting on SIM's general distribution payments. The SIHS PRF report for Period 1 included the revenue from SIMS in the lost revenue calculations. SIMS also submitted a report to HRSA in the PRF portal for Period 1 targeted distributions under SIM's TIN. The SIMS lost revenue calculation included the same SIMS revenue that was reported by SIHS. Cause: The Corporation did not have adequate internal controls in place over monitoring of compliance with the HHS reporting requirements for the HRSA PFR Reporting Portal. Effect: SIMS revenue was included in the PRF Reporting Portal submission for both SIHS and SIMS for Period 1. SIMS revenue used in the SIMS period 1 portal submission lost revenue calculation should have been excluded from the SIHS Period 1 portal submission lost revenue calculation. Questioned Costs: None. Context: One of the two reports submitted to HRSA for Period 1 included duplicate SIMS revenue in the lost revenue calculation. Repeat finding?: No. Recommendation: We recommend management establish internal controls over the accuracy of the reports submitted to federal awarding agencies. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Criteria: Provider Relief Fund (PFR) payments may be applied to lost revenues attributable to coronavirus according to the Period of Availability of funding. However, lost revenues may not be duplicated. Condition: In the report submitted to the Health Resources & Services Administration (HRSA) PRF Reporting Portal for reporting Period 1 for Southern Illinois Hospital Services (SIHS), the Corporation indicated that SIHS is the parent of Southern Illinois Medical Services (SIMS), and that SIHS is reporting on SIM's general distribution payments. The SIHS PRF report for Period 1 included the revenue from SIMS in the lost revenue calculations. SIMS also submitted a report to HRSA in the PRF portal for Period 1 targeted distributions under SIM's TIN. The SIMS lost revenue calculation included the same SIMS revenue that was reported by SIHS. Cause: The Corporation did not have adequate internal controls in place over monitoring of compliance with the HHS reporting requirements for the HRSA PFR Reporting Portal. Effect: SIMS revenue was included in the PRF Reporting Portal submission for both SIHS and SIMS for Period 1. SIMS revenue used in the SIMS period 1 portal submission lost revenue calculation should have been excluded from the SIHS Period 1 portal submission lost revenue calculation. Questioned Costs: None. Context: One of the two reports submitted to HRSA for Period 1 included duplicate SIMS revenue in the lost revenue calculation. Repeat finding?: No. Recommendation: We recommend management establish internal controls over the accuracy of the reports submitted to federal awarding agencies. View of responsible officials of the auditee: Management agrees with the finding and recommendation.