Audit 20631

FY End
2022-06-30
Total Expended
$21.38M
Findings
2
Programs
5
Year: 2022 Accepted: 2023-03-27

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
22152 2022-001 Material Weakness Yes L
598594 2022-001 Material Weakness Yes L

Contacts

Name Title Type
XZ9KP9XDNCS4 Gregg Ferlin Auditee
2199348249 Kari O'Connor Auditor
No contacts on file

Notes to SEFA

Title: Consolidated Reporting Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) for the year ended June 30, 2022 includes the federal grant activity of CFNI 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 therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, CFNIs consolidated financial statements. De Minimis Rate Used: N Rate Explanation: CFNI did not use the de minimis cost rate. The federal award activity of the entities below is included in the accompanying Schedule for the year ended June 30, 2022: Munster Medical Research Foundation, Inc.d/b/a The Community Hospital $21,610,263, St. Catherine Hospital, Inc. $18,731,199, St. Mary Medical Center, Inc.$5,979,861, Community Stroke and Rehabilitation Center, Inc. $112,518, Community Care Network, Inc. $2,120,820, Community Village, Inc. $1,085,140, Total $49,639,801
Title: Provider Relief Fund Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) for the year ended June 30, 2022 includes the federal grant activity of CFNI 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 therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, CFNIs consolidated financial statements. De Minimis Rate Used: N Rate Explanation: CFNI did not use the de minimis cost rate. In accordance with the requirements specific to Assistance Listing No. 93.498, COVID-19 - Provider Relief Fund, the amount presented on the accompanying Schedule for the year ended June 30, 2022 for Assistance Listing No. 93.498 relates to (i) activity from the period July 1, 2021 through June 30, 2022 for (ii) Provider Relief Fund (PRF) payment received from April 10, 2020 through June 30, 2020. 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 the PRF Reporting Period 1 as follows: See the Notes to the SEFA for chart/table. The expenses attributable to Coronavirus Disease 2019 (COVID-19) and lost revenues incurred by CFNI during the period of availability for PRF Reporting Period 2 and 3 (January 1, 2020 through June 30, 2021) are in excess of the general and targeted distributions received from April 10, 2020 through June 30, 2020 and, therefore, the amounts presented in the tables above and on the accompanying Schedule are limited to the amount of such distributions. CFNI received additional PRF payments subsequent to June 30, 2020 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

Finding 2022-001 ? Reporting Identification of the federal program: Federal Grantor: United States Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) Assistance Listing No.: Assistance Listing 93.498, Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) Federal Award Numbers: N/A Federal Award Period of Performance: April 10, 2020 ? December 31, 2021 Criteria or specific requirement (including statutory, regulatory or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: ?The 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 or the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? The terms and conditions of the award require the recipient to submit reports to the secretary of HHS for each reporting period to ensure compliance with conditions that are imposed on the payment, and such report shall be in such form, with such content that is complete and accurate, as specified by the secretary of HHS in program instructions directed to all recipients. Condition: Management did not have sufficiently designed internal controls to identify material misstatements and evidence review of the supporting documentation used in the lost revenue calculation and the data submitted into the HHS portal for Period 2. Section III ? Federal Award Findings and Questioned Costs (continued) Finding 2022-001 ? Reporting (continued) Cause: Management represented they performed a review and approved the lost revenue calculation and HHS portal submission; however, supporting documentation to evidence that the internal controls were appropriately designed and operating effectively was not maintained. Effect or potential effect: A lack of sufficiently designed internal controls over the review of the lost revenue calculations could lead to errors in the calculations and/or improper conclusions regarding the retention of Provider Relief Funds or errors in the data submitted to HRSA in the HHS portal. Questioned costs: None. Context: There was a total of six PRF lost revenue calculations and HHS portal submissions for the year ended June 30, 2022, all of which were submitted during Period 2. CFNI had no funding during Period 3 and, therefore, had no reporting submissions. We tested 5 PRF lost revenue calculations and HHS portal submissions for the year ended June 30, 2022, making up 94.68% of the FY22 PRF total per the SEFA. One entity, Community Village, Inc. (CVI), understated the Q3 2021 lost revenue within the Period 2 report submission, as there was $354,213 of calculated lost revenue for the quarter per the lost revenue calculation, but the amount that was reported was $0. Total PRF lost revenue on the SEFA is $20,240,401 for the year ended June 30, 2022. Identification as a repeat finding, if applicable: Yes, repeat of finding 2021-001
Finding 2022-001 ? Reporting Identification of the federal program: Federal Grantor: United States Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) Assistance Listing No.: Assistance Listing 93.498, Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) Federal Award Numbers: N/A Federal Award Period of Performance: April 10, 2020 ? December 31, 2021 Criteria or specific requirement (including statutory, regulatory or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: ?The 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 or the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? The terms and conditions of the award require the recipient to submit reports to the secretary of HHS for each reporting period to ensure compliance with conditions that are imposed on the payment, and such report shall be in such form, with such content that is complete and accurate, as specified by the secretary of HHS in program instructions directed to all recipients. Condition: Management did not have sufficiently designed internal controls to identify material misstatements and evidence review of the supporting documentation used in the lost revenue calculation and the data submitted into the HHS portal for Period 2. Section III ? Federal Award Findings and Questioned Costs (continued) Finding 2022-001 ? Reporting (continued) Cause: Management represented they performed a review and approved the lost revenue calculation and HHS portal submission; however, supporting documentation to evidence that the internal controls were appropriately designed and operating effectively was not maintained. Effect or potential effect: A lack of sufficiently designed internal controls over the review of the lost revenue calculations could lead to errors in the calculations and/or improper conclusions regarding the retention of Provider Relief Funds or errors in the data submitted to HRSA in the HHS portal. Questioned costs: None. Context: There was a total of six PRF lost revenue calculations and HHS portal submissions for the year ended June 30, 2022, all of which were submitted during Period 2. CFNI had no funding during Period 3 and, therefore, had no reporting submissions. We tested 5 PRF lost revenue calculations and HHS portal submissions for the year ended June 30, 2022, making up 94.68% of the FY22 PRF total per the SEFA. One entity, Community Village, Inc. (CVI), understated the Q3 2021 lost revenue within the Period 2 report submission, as there was $354,213 of calculated lost revenue for the quarter per the lost revenue calculation, but the amount that was reported was $0. Total PRF lost revenue on the SEFA is $20,240,401 for the year ended June 30, 2022. Identification as a repeat finding, if applicable: Yes, repeat of finding 2021-001