FAC Explorer

Audit 20512

FY End
2022-06-30
Total Expended
$1.02M
Findings
4
Programs
2
Organization: Southern Mono Healthcare District Dba Mammoth Hospital (CA)
Year: 2022 Accepted: 2023-09-10
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
20658 2022-002 Significant Deficiency Yes AB
20659 2022-003 Material Weakness Yes L
597100 2022-002 Significant Deficiency Yes AB
597101 2022-003 Material Weakness Yes L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $916,407 Yes 2
93.697 Covid-19 Testing for Rural Health Clinics $100,000 - 0

Contacts

Name Title Type
LJ24CFL2PTT9 Melanie Van Winkle Auditee
7609244012 Renee Gravalin 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. When applicable, 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 financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The District does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Southern Mono Healthcare District d/b/a Mammoth Hospital (the District) under programs of the federal government for the year ended June 30, 2022. The information 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 District, it is not intended to and does not present the financial position, changes in net position, or cash flows of the District.
Title: Provider Relief Funds and American Rescue Plan (ARP) Rural Distribution Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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 financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The District does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. The District received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program (Federal Financial Assistance Listing #93.498) during the years ended June 30, 2020 and June 30, 2021, totaling $6,193,718 and $916,407. The District incurred eligible expenditures, including lost revenue, and therefore, recognized revenues totaling $7,110,125 for the year ended June 30, 2021, on the financial statements, which included $916,407 of Period 2 payments, included on the Schedule. In accordance with the 2022 Compliance Supplement, the PRF expenditures recognized on the Schedule are based on the reporting to HHS for Period 2, defined as payments received during July 1, 2020, to December 31, 2020, of $916,407.

Finding Details

Finding 2022-002
2022-002 Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 2 TIN #953154530 Activities Allowed or Unallowed and Allowable Costs/Cost Principles 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 District?s lost revenue calculation claimed under the Provider Relief Fund program and the HHS reported submitted to the Department of Health and Human Services were not reviewed and approved by a separate individual outside of the preparer. Cause: The District did not have an internal control process in place to ensure review and approval of the lost revenue calculation claimed under the federal program and the report submitted to the Department of Health and Human Services for Period 2 was documented. Effect: The lack of adequate policies governing review and approval increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context/Sampling: All key line items related to lost revenue were tested on the Period 2 Department of Health and Human Services special report. Repeat Finding from Prior Year: Yes, finding 2021-002 Recommendation: We recommend the District implement a control process which includes a secondary review and documented approval of the lost revenue calculation under the federal program. Views of Responsible Officials: Management agrees with the finding.
Finding 2022-003
2022-003 Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 2 TIN #953154530 Reporting Material Weakness in Internal Control over Compliance and Material Noncompliance 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. The District selected Option i to report lost revenue which consists of a comparison of actual results during the period of availability to the prior fiscal year. Condition: The District incorrectly selected Option i as the reporting method when they submitted their report as the client had calculated the amount reported based on Option iii. Cause: The District did not have an internal control process in place to ensure the reporting portal input fields for the lost revenue option was incorrectly chosen as Option i rather than Option iii. Effect: Option i was incorrectly selected as the reporting method. Questioned Costs: None reported. The District had sufficient lost revenue had they correctly indicated the method they intended to use in reporting. Had the District reported the amounts under the Option i method, the lost revenue on the HHS reporting would have decreased by approximately $188,000. In addition, total unused lost revenues remaining would be approximately $11,500,000. Context/Sampling: Key line items were tested on the Period 2 Department of Health and Human Services special report. Repeat Finding from Prior Year: Yes, finding 2021-003 Recommendation: We recommend the District update future reporting to Option iii. Views of Responsible Officials: Management agrees with the finding.
Finding 2022-002
2022-002 Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 2 TIN #953154530 Activities Allowed or Unallowed and Allowable Costs/Cost Principles 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 District?s lost revenue calculation claimed under the Provider Relief Fund program and the HHS reported submitted to the Department of Health and Human Services were not reviewed and approved by a separate individual outside of the preparer. Cause: The District did not have an internal control process in place to ensure review and approval of the lost revenue calculation claimed under the federal program and the report submitted to the Department of Health and Human Services for Period 2 was documented. Effect: The lack of adequate policies governing review and approval increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context/Sampling: All key line items related to lost revenue were tested on the Period 2 Department of Health and Human Services special report. Repeat Finding from Prior Year: Yes, finding 2021-002 Recommendation: We recommend the District implement a control process which includes a secondary review and documented approval of the lost revenue calculation under the federal program. Views of Responsible Officials: Management agrees with the finding.
Finding 2022-003
2022-003 Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 2 TIN #953154530 Reporting Material Weakness in Internal Control over Compliance and Material Noncompliance 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. The District selected Option i to report lost revenue which consists of a comparison of actual results during the period of availability to the prior fiscal year. Condition: The District incorrectly selected Option i as the reporting method when they submitted their report as the client had calculated the amount reported based on Option iii. Cause: The District did not have an internal control process in place to ensure the reporting portal input fields for the lost revenue option was incorrectly chosen as Option i rather than Option iii. Effect: Option i was incorrectly selected as the reporting method. Questioned Costs: None reported. The District had sufficient lost revenue had they correctly indicated the method they intended to use in reporting. Had the District reported the amounts under the Option i method, the lost revenue on the HHS reporting would have decreased by approximately $188,000. In addition, total unused lost revenues remaining would be approximately $11,500,000. Context/Sampling: Key line items were tested on the Period 2 Department of Health and Human Services special report. Repeat Finding from Prior Year: Yes, finding 2021-003 Recommendation: We recommend the District update future reporting to Option iii. Views of Responsible Officials: Management agrees with the finding.