FAC Explorer

Audit 27255

FY End
2022-03-31
Total Expended
$4.24M
Findings
6
Programs
1
Organization: Spooner Health System (WI)
Year: 2022 Accepted: 2022-12-29
Auditor: Cliftonlarsonallen LLP (cla)

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
32351 2022-004 Significant Deficiency - B
32352 2022-003 Material Weakness - L
32353 2022-002 Material Weakness - B
608793 2022-004 Significant Deficiency - B
608794 2022-003 Material Weakness - L
608795 2022-002 Material Weakness - B

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $4.24M Yes 3

Contacts

Name Title Type
GK3UQ56WAJZ5 Rebecca Busch Auditee
7159391732 Ryan Strusz, CPA Auditor
No contacts on file

Notes to SEFA

Title: BASIS OF PRESENTATION Accounting Policies: No funds were identified as having been provided to subrecipients by the System 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. The System has elected to use the 10% de minimis indirect cost rate allowable under the Uniform Guidance. De Minimis Rate Used: Y Rate Explanation: The auditee used the de minimis cost rate. The accompanying schedule of expenditures of federal awards includes the federal grant activity of Spooner Health System (the System) 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 System, it is not intended to and does not present the financial position, changes in net position, or cash flows of the System.
Title: RECONCILIATION OF SEFA AND FINANCIAL STATEMENTS Accounting Policies: No funds were identified as having been provided to subrecipients by the System 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. The System has elected to use the 10% de minimis indirect cost rate allowable under the Uniform Guidance. De Minimis Rate Used: Y Rate Explanation: The auditee used the de minimis cost rate. The financial statements reflect revenue recognized from the Provider Relief Fund (PRF) of for the years ended March 31, 2022 and 2021 of approximately $893,000 and $3,791,000, respectively. The SEFA includes Provider Relief Funds of $4,240,733 that were received in Period 1 in accordance with the requirements of the compliance supplement for assistance listing number 93.498. Of the approximately $893,000 included in the financial statements for the year ended March 31, 2022, approximately $443,000 is not included in the SEFA as the funds received related to Period 4 and are not subject in this period.

Finding Details

Finding 2022-004
2022-004 Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund AL Number: 93.498 Award Period: April 1, 2020 ? June 30, 2020 (Period 1) and July 1, 2020 ? December 31, 2020 (Period 2) Type of Finding: Significant deficiency in Internal Control over Compliance and Other Matters Criteria or specific requirement: Provider Relief Fund cannot be used to cover unsupported or inaccurate expenditures. Condition and Context: During our testing we noted 13 instances out of a sample of 40 where there were differences in the reported payroll expenditures compared to the support received. Cause: There were changes in employee wage rates that didn?t get updated in the COVID-19 screening logs. Effect: Potential to receive excess reimbursement from the Provider Relief Fund. Questioned Costs: $257 Repeat finding: No Recommendation: We recommend that management review the Provider Relief Fund guidelines to make sure amounts requested for reimbursement are in line with the guidelines and tie back to support. Management?s Response: Management will review reporting requirements and policies to ensure proper reporting in future periods. However, it is noted there was sufficient lost revenue to support the PRF distributions received.
Finding 2022-003
2022-003 Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund AL Number: 93.498 Award Period: April 1, 2020 ? June 30, 2020 (Period 1) and July 1, 2020 ? December 31, 2020 (Period 2) Type of Finding: Material Weakness in Internal Control over Compliance and Other Matters Criteria or specific requirement: Lost revenues can be claimed against the Provider Relief Fund during the reporting period. Condition and Context: During our testing we noted the Provider Relief Fund report was incorrectly completed and an additional $1,709,045 of lost revenues was reported. Cause: Clerical error in completion of the lost revenue reporting table in the Provider Relief Fund Period 1 report. Effect: Potential to overclaim lost revenue against the Provider Relief Fund. Questioned Costs: None identified. Repeat finding: No Recommendation: We recommend the System review the Provider Relief Fund reporting guidelines to make sure the amounts claimed are in line with the guidelines. We also recommend a review take place to make sure all amounts claimed are correctly calculated. Management?s Response: The System plans to correct the clerical error in the reporting of lost revenue of $1,709,045 in its Period reporting submission.
Finding 2022-002
2022-002 Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund AL Number: 93.498 Award Period: April 1, 2020 ? June 30, 2020 (Period 1) and July 1, 2020 ? December 31, 2020 (Period 2) Type of Finding: Material Weakness in Internal Control over Compliance and Other Matters Criteria or specific requirement: Provider Relief Fund cannot be used to cover expenditures for which reimbursement is received. Condition and Context: During our testing we noted amounts reimbursed through the Provider Relief Fund were not reduced by the cost-based portion reimbursed by Medicare through the Medicare cost report. Cause: Management oversight in submitting costs for reimbursement without reducing for the amount that would be reimbursed through the Medicare cost report. Effect: Potential to receive excess reimbursement from the Provider Relief Fund. Questioned Costs: $245,075 Repeat finding: No Recommendation: We recommend that management review the Provider Relief Fund guidelines to make sure amounts requested for reimbursement are in line with the guidelines. Management?s Response: Management will review reporting requirements to ensure proper reporting in future periods. However, it is noted there was sufficient lost revenue to support the PRF distributions received.
Finding 2022-004
2022-004 Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund AL Number: 93.498 Award Period: April 1, 2020 ? June 30, 2020 (Period 1) and July 1, 2020 ? December 31, 2020 (Period 2) Type of Finding: Significant deficiency in Internal Control over Compliance and Other Matters Criteria or specific requirement: Provider Relief Fund cannot be used to cover unsupported or inaccurate expenditures. Condition and Context: During our testing we noted 13 instances out of a sample of 40 where there were differences in the reported payroll expenditures compared to the support received. Cause: There were changes in employee wage rates that didn?t get updated in the COVID-19 screening logs. Effect: Potential to receive excess reimbursement from the Provider Relief Fund. Questioned Costs: $257 Repeat finding: No Recommendation: We recommend that management review the Provider Relief Fund guidelines to make sure amounts requested for reimbursement are in line with the guidelines and tie back to support. Management?s Response: Management will review reporting requirements and policies to ensure proper reporting in future periods. However, it is noted there was sufficient lost revenue to support the PRF distributions received.
Finding 2022-003
2022-003 Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund AL Number: 93.498 Award Period: April 1, 2020 ? June 30, 2020 (Period 1) and July 1, 2020 ? December 31, 2020 (Period 2) Type of Finding: Material Weakness in Internal Control over Compliance and Other Matters Criteria or specific requirement: Lost revenues can be claimed against the Provider Relief Fund during the reporting period. Condition and Context: During our testing we noted the Provider Relief Fund report was incorrectly completed and an additional $1,709,045 of lost revenues was reported. Cause: Clerical error in completion of the lost revenue reporting table in the Provider Relief Fund Period 1 report. Effect: Potential to overclaim lost revenue against the Provider Relief Fund. Questioned Costs: None identified. Repeat finding: No Recommendation: We recommend the System review the Provider Relief Fund reporting guidelines to make sure the amounts claimed are in line with the guidelines. We also recommend a review take place to make sure all amounts claimed are correctly calculated. Management?s Response: The System plans to correct the clerical error in the reporting of lost revenue of $1,709,045 in its Period reporting submission.
Finding 2022-002
2022-002 Allowable Costs Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Provider Relief Fund AL Number: 93.498 Award Period: April 1, 2020 ? June 30, 2020 (Period 1) and July 1, 2020 ? December 31, 2020 (Period 2) Type of Finding: Material Weakness in Internal Control over Compliance and Other Matters Criteria or specific requirement: Provider Relief Fund cannot be used to cover expenditures for which reimbursement is received. Condition and Context: During our testing we noted amounts reimbursed through the Provider Relief Fund were not reduced by the cost-based portion reimbursed by Medicare through the Medicare cost report. Cause: Management oversight in submitting costs for reimbursement without reducing for the amount that would be reimbursed through the Medicare cost report. Effect: Potential to receive excess reimbursement from the Provider Relief Fund. Questioned Costs: $245,075 Repeat finding: No Recommendation: We recommend that management review the Provider Relief Fund guidelines to make sure amounts requested for reimbursement are in line with the guidelines. Management?s Response: Management will review reporting requirements to ensure proper reporting in future periods. However, it is noted there was sufficient lost revenue to support the PRF distributions received.