FAC Explorer

Audit 2032

FY End
2023-04-30
Total Expended
$6.99M
Findings
4
Programs
3
Organization: Cgh Medical Center (IL)
Year: 2023 Accepted: 2023-11-01
Auditor: Cliftonlarsonallen

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
1063 2023-001 Significant Deficiency Yes L
1064 2023-002 Material Weakness - L
577505 2023-001 Significant Deficiency Yes L
577506 2023-002 Material Weakness - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $6.93M Yes 2
93.575 Child Care and Development Block Grant $42,300 - 0
93.461 Covid-19 Testing for the Uninsured $11,732 - 0

Contacts

Name Title Type
TDRCQMWQ1C97 Ben Schaab Auditee
8155644860 Josh Wilks Auditor
No contacts on file

Notes to SEFA

Title: NOTE 1 BASIS OF PRESENTATION Accounting Policies: No funds were identified as having been provided to subrecipients by the Medical Center and accordingly, no funds identified in the Schedule of Expenditures of Federal Awards are attributable to subrecipient entities. There were no federal awards expended for noncash assistance or insurance. De Minimis Rate Used: Y Rate Explanation: The Medical Center has elected to use the 10% de minimis indirect cost rate allowable under the Uniform Guidance. The accompanying schedule of expenditures of federal awards includes the federal grant activity of CGH Medical Center’s (the Medical Center) and is presented on the accrual basis of accounting. The information in this schedule is presented in accordance with the applicable 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 of expenditures of federal awards presents only a selected portion of the operations of the Medical Center, it is not intended to and does not present the financial position, changes in net position, or cash flows of the Medical Center.
Title: NOTE 3 RECONCILATION OF SEFA AND FINANCIAL STATEMENTS Accounting Policies: No funds were identified as having been provided to subrecipients by the Medical Center and accordingly, no funds identified in the Schedule of Expenditures of Federal Awards are attributable to subrecipient entities. There were no federal awards expended for noncash assistance or insurance. De Minimis Rate Used: Y Rate Explanation: The Medical Center has elected to use the 10% de minimis indirect cost rate allowable under the Uniform Guidance. The financial statements reflect revenue recognized from the COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution of approximately $3,816,000 and $6,814,000 for the years ended April 30, 2023 and 2022, respectively. The SEFA includes COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution of $6,931,216 that were received in Period 4 in accordance with the requirements of the compliance supplement for assistance listing number 93.498.

Finding Details

Finding 2023-001
Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Significant Deficiency in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Medical Center’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Medical Center did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines. Questioned costs: None Context: During our testing, it was identified that differences in the Medical Center’s accumulation of lost revenues by quarter occurred compared to actual results. Overall, the accumulated calculation of lost revenues was not impacted but the presentation by quarter was. Cause: The Medical Center’s spreadsheets used to accumulate the lost revenue information had formula problems. Effect: The auditor noted no instances of noncompliance with the provisions of lost revenues claimed, as the overall amount claimed was accurate; however, the internal controls around compliance over quarterly reporting were not effective. Repeat Finding: Yes Recommendation: We recommend the Medical Center design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2023-002
Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Material Weakness in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Medical Center’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Medical Center did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines as the Medical Center reported the same COVID-19 expenses in Period 2, and Period 4 reports, thus overstating the amount of reported covid expenses by approx. $4.5 million. Questioned costs: None Context: Based on the portal configuration the Medical Center believed accumulated costs, since the beginning of the pandemic, should be entered into Period 4 vs. just the incremental amounts exclusive to Period 1 and 2. Cause: The design of the portal was unclear as the reporting for expenses and lost revenues are handled differently. Effect: The Medical Center’s internal controls around compliance were not effective in identifying allowable expenses associated with COVID-19. Repeat Finding: N/A Recommendation: We recommend the Medical Center design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2023-001
Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Significant Deficiency in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Medical Center’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Medical Center did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines. Questioned costs: None Context: During our testing, it was identified that differences in the Medical Center’s accumulation of lost revenues by quarter occurred compared to actual results. Overall, the accumulated calculation of lost revenues was not impacted but the presentation by quarter was. Cause: The Medical Center’s spreadsheets used to accumulate the lost revenue information had formula problems. Effect: The auditor noted no instances of noncompliance with the provisions of lost revenues claimed, as the overall amount claimed was accurate; however, the internal controls around compliance over quarterly reporting were not effective. Repeat Finding: Yes Recommendation: We recommend the Medical Center design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.
Finding 2023-002
Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Material Weakness in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Medical Center’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Medical Center did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines as the Medical Center reported the same COVID-19 expenses in Period 2, and Period 4 reports, thus overstating the amount of reported covid expenses by approx. $4.5 million. Questioned costs: None Context: Based on the portal configuration the Medical Center believed accumulated costs, since the beginning of the pandemic, should be entered into Period 4 vs. just the incremental amounts exclusive to Period 1 and 2. Cause: The design of the portal was unclear as the reporting for expenses and lost revenues are handled differently. Effect: The Medical Center’s internal controls around compliance were not effective in identifying allowable expenses associated with COVID-19. Repeat Finding: N/A Recommendation: We recommend the Medical Center design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.