Audit 296919

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 4 TIN#460360899 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting 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: Our testing identified four months of other general and administrative expenses claimed under the federal program did not consider the credit to be received back from a third-party vendor for service time not performed by the third party vendor. Cause: Monument Health prepaid a third-party vendor for services to be performed and at the end of the service period, Monument Health did not consider the refunds to be received back from a third-party vendor when claiming expenses under the federal program. Effect: The secondary review and approval over final expenditures claimed under the federal program did not identify this matter and therefore, expenses were overclaimed under the federal program and included within the special report submitted to the federal agency. Questioned Costs: The Period 4 report incorrectly included $64,404 of other general and administrative expenses. However, the Period 4 report also included approximately $6,077,500 of unused lost revenue. As a result, there are no questioned costs for activities allowed or unallowed and allowable costs/cost principles. Context: A non-statistical sample of 19 ($228,440) out of a population of 92 transactions relating to general and administrative and healthcare related expenses ($263,750), including mortgage/rent, supplies, purchased services, information technology, and facilities were tested. Summary level testing was also performed as it relates to incremental increased personnel costs relating to nursing contract labor and special incentives provided to employees. Repeat Finding from Prior Year: No Recommendation: We recommend management review the third party vendor invoices and reduce unused lost revenue in any future federal reports. Views of Responsible Officials: Management agrees with the finding.

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 4 TIN#460360899 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting 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: Our testing identified four months of other general and administrative expenses claimed under the federal program did not consider the credit to be received back from a third-party vendor for service time not performed by the third party vendor. Cause: Monument Health prepaid a third-party vendor for services to be performed and at the end of the service period, Monument Health did not consider the refunds to be received back from a third-party vendor when claiming expenses under the federal program. Effect: The secondary review and approval over final expenditures claimed under the federal program did not identify this matter and therefore, expenses were overclaimed under the federal program and included within the special report submitted to the federal agency. Questioned Costs: The Period 4 report incorrectly included $64,404 of other general and administrative expenses. However, the Period 4 report also included approximately $6,077,500 of unused lost revenue. As a result, there are no questioned costs for activities allowed or unallowed and allowable costs/cost principles. Context: A non-statistical sample of 19 ($228,440) out of a population of 92 transactions relating to general and administrative and healthcare related expenses ($263,750), including mortgage/rent, supplies, purchased services, information technology, and facilities were tested. Summary level testing was also performed as it relates to incremental increased personnel costs relating to nursing contract labor and special incentives provided to employees. Repeat Finding from Prior Year: No Recommendation: We recommend management review the third party vendor invoices and reduce unused lost revenue in any future federal reports. Views of Responsible Officials: Management agrees with the finding.