Audit 25012

FY End

2022-09-30

Total Expended

$31.67M

Findings

2

Programs

2

Organization: McLeod Health (SC)

Year: 2022 Accepted: 2023-06-27

Auditor: Plante & Moran PLLC

Organization Exclusion Status:

Checking exclusion status...

ID	Ref	Severity	Repeat	Requirement
25869	2022-001	Material Weakness	-	E
602311	2022-001	Material Weakness	-	E

ALN	Program	Spent	Major	Findings
93.498	Covid-19 Provider Relief Fund and American Rescue Plan Rural Distribution	$30.24M	Yes	0
93.461	Covid-19 Testing for the Uninsured	$1.43M	Yes	1

Contacts

Name	Title	Type
MFMHYXDP4244	David Anderson	Auditee
8437775315	Adam Stevenson	Auditor
No contacts on file

Notes to SEFA

Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of McLeod Health and its subsidiaries (the Organization) under programs of the federal government for the year ended September 30, 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 (the Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization. Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, wherein certain types of expenditures are not allowable or are limited as to reimbursement except for expenditures related to Assistance Listing Number (ALN) 93.498, Provider Relief Fund (PRF) and American Rescue Plan Rural Distribution. PRF does not apply the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, but rather applies the U.S. Department of Health and Human Services (HHS) guidance and frequently asked questions, as outlined in the Compliance Supplement. For the PRF program, HHS has indicated the amounts on the schedule be reported corresponding to reporting requirements of the HHS PRF Reporting Portal. Payments from HHS for PRF are assigned to payment received periods (each, a period) based upon the date each PRF payment was received. Each period has a specified period of availability and timing of reporting requirements. Entities report into the HHS PRF Reporting Portal after each periods deadline to use the funds (i.e., after the end of the period of availability). The pass-through entity identifying numbers are presented where available. The Organization has elected not to use the 10 percent de minimis indirect cost rate to recover indirect costs as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The Organization has elected not to use the 10 percent de minimis indirect cost rate to recover indirect costs as allowed under the Uniform Guidance.

Finding Details

Finding 2022-001

ALN Number, Federal Agency, and Program Name - 93.461, U.S. Department of Health and Human Services, COVID-19 - Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund Federal Award Identification Number and Year - N/A, 2022 Pass through Entity - N/A Finding Type: Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - The COVID-19 - HRSA Uninsured Program is to be used for "reimbursement of payment for COVID-19 testing and testing-related items for individuals who do not have coverage through an individual or employer-sponsored plan," per the 2022 Compliance Supplement Condition - The Organization charged costs to the grant which were associated with individuals who were subsequently discovered to have insurance. In addition, the Organization did not timely refund private pay patients for payments that were paid by HRSA funding. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - During testing of 60 patients, we identified three patients who were submitted to the Health Resources and Services Administration (HRSA) for reimbursement, and then a subsequent payment was received from insurance and HRSA or private pay which was not returned timely to the patient or HRSA. Management performed a deeper review of these issues and identified 63 additional patients that fell into one of these two categories. As a result of management's analysis approximately $4,600 was removed from the SEFA and returned to HRSA and approximately $3,900 was refunded directly to patients. Cause and Effect - While the Organization had a process in place to review individuals for eligibility prior to claims being submitted, there was no process in place for when subsequent payments were received from insurance or patients to timely refund the patient or HRSA. Recommendation - The Organization should have a process in place to review and identify subsequent payments on claims for insurance and private pay patient, in which refunds need to be issued to patients or HRSA. Views of Responsible Officials and Corrective Action Plan - Management agrees with the findings as reported. The Organization identified all patients and HRSA refunds.

Finding 2022-001

ALN Number, Federal Agency, and Program Name - 93.461, U.S. Department of Health and Human Services, COVID-19 - Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund Federal Award Identification Number and Year - N/A, 2022 Pass through Entity - N/A Finding Type: Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - The COVID-19 - HRSA Uninsured Program is to be used for "reimbursement of payment for COVID-19 testing and testing-related items for individuals who do not have coverage through an individual or employer-sponsored plan," per the 2022 Compliance Supplement Condition - The Organization charged costs to the grant which were associated with individuals who were subsequently discovered to have insurance. In addition, the Organization did not timely refund private pay patients for payments that were paid by HRSA funding. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - During testing of 60 patients, we identified three patients who were submitted to the Health Resources and Services Administration (HRSA) for reimbursement, and then a subsequent payment was received from insurance and HRSA or private pay which was not returned timely to the patient or HRSA. Management performed a deeper review of these issues and identified 63 additional patients that fell into one of these two categories. As a result of management's analysis approximately $4,600 was removed from the SEFA and returned to HRSA and approximately $3,900 was refunded directly to patients. Cause and Effect - While the Organization had a process in place to review individuals for eligibility prior to claims being submitted, there was no process in place for when subsequent payments were received from insurance or patients to timely refund the patient or HRSA. Recommendation - The Organization should have a process in place to review and identify subsequent payments on claims for insurance and private pay patient, in which refunds need to be issued to patients or HRSA. Views of Responsible Officials and Corrective Action Plan - Management agrees with the findings as reported. The Organization identified all patients and HRSA refunds.