FAC Explorer

Audit 25771

FY End
2022-12-31
Total Expended
$5.34M
Findings
2
Programs
2
Organization: Great Plains Health (NE)
Year: 2022 Accepted: 2023-09-28
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
31455 2022-002 Significant Deficiency - AB
607897 2022-002 Significant Deficiency - AB

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $4.84M Yes 1
93.461 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $495,933 - 0

Contacts

Name Title Type
CWCENNTCA9C9 Monica Lynch Auditee
3086968000 Jess Paisley Auditor
No contacts on file

Notes to SEFA

Title: Note 4: Provider Relief Funds Accounting Policies: Note 1: Basis of Presentation - The accompanying schedule of expenditures of federal awards (schedule) includes the federal award activity of the Organization under programs of the federal government for the year ended December 31, 2022. The information in this schedule is presented in accordance with the requirements for 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 Organization, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Organization. Note 2: Summary of Significant Accounting Policies - Expenditures reported on the schedule are reported on the accrual basis of accounting, with the exception for the COVID-19 Testing for the Uninsured Program, which are recorded based on when the claim is deemed eligible as evidenced by receipt of monies from the federal agency. 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. Pass-through entity identifying numbers are presented where available. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Organization has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The Organization received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund (PRF) program (Federal Financial Assistance Listing/CFDA #93.498) during the years ended December 31, 2022 and 2021. The Organization incurred eligible expenditures and, therefore, recognized revenue totaling $575,088 and $4,841,931 for the years ended December 31, 2022 and 2021, respectively, in the financial statements. In accordance with the compliance supplement, the PRF expenditures recognized on the schedule are based on the reporting to HHS for the period ending December 31, 2022, as required under the PRF program. The amount of PRF expenditures included on the schedule requires management to make estimates and assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant estimate. Estimates and assumptions may include reducing actual expenses by amount that have been reimbursed or are obligated to be reimbursed by other sources and estimating marginal increases in expenses related to coronavirus. Actual results could differ from those estimates.

Finding Details

Finding 2022-002
Federal Program: Federal Assistance Listing Number #93.498; US Department of Health and Human Services; Provider Relief Fund and American Rescue Plan (ARP) Distribution Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) distributions state that funds are to only be used to prevent, prepare for and respond to coronavirus, and that funds may only be used for healthcare related expenses or lost revenue that is attributable to the coronavirus and represent actual costs. Condition: During the process of identifying expenses that were incurred to prevent, prepare for or respond to the coronavirus pandemic, management utilized projected expenses claimed for reimbursement. Cause: Due to the amount of detailed information that was required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently claimed projected expenses for future periods. Effect: Management included amounts in the PRF reporting portal which were not actual costs based on the terms and conditions of the PRF distributions and subsequent HRSA guidance. Questioned Costs: None reported. Context: We performed testing on a sample of six expenditures out of a population of 36 transactions. Four of the six sample selections contained expenses related to reporting projected expenses for reimbursement instead of using actual costs. Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that only eligible costs are included in amounts expended. Views of Responsible Officials: Management agrees with the noted finding and will continue to refine processes to more diligently review allowable costs to ensure only actual costs are included in future reporting. However, the Organization also incurred and reported unreimbursed expenses attributable to the coronavirus in the PRF reporting portal that if the noted questioned costs were not reported, the Organization would have satisfactorily incurred eligible expenses in excess of the PRF funds received.
Finding 2022-002
Federal Program: Federal Assistance Listing Number #93.498; US Department of Health and Human Services; Provider Relief Fund and American Rescue Plan (ARP) Distribution Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) distributions state that funds are to only be used to prevent, prepare for and respond to coronavirus, and that funds may only be used for healthcare related expenses or lost revenue that is attributable to the coronavirus and represent actual costs. Condition: During the process of identifying expenses that were incurred to prevent, prepare for or respond to the coronavirus pandemic, management utilized projected expenses claimed for reimbursement. Cause: Due to the amount of detailed information that was required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently claimed projected expenses for future periods. Effect: Management included amounts in the PRF reporting portal which were not actual costs based on the terms and conditions of the PRF distributions and subsequent HRSA guidance. Questioned Costs: None reported. Context: We performed testing on a sample of six expenditures out of a population of 36 transactions. Four of the six sample selections contained expenses related to reporting projected expenses for reimbursement instead of using actual costs. Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that only eligible costs are included in amounts expended. Views of Responsible Officials: Management agrees with the noted finding and will continue to refine processes to more diligently review allowable costs to ensure only actual costs are included in future reporting. However, the Organization also incurred and reported unreimbursed expenses attributable to the coronavirus in the PRF reporting portal that if the noted questioned costs were not reported, the Organization would have satisfactorily incurred eligible expenses in excess of the PRF funds received.