FAC Explorer

Audit 298633

FY End
2023-06-30
Total Expended
$2.17M
Findings
2
Programs
6
Organization: Valley County Hospital D/b/a Valley County Health System (NE)
Year: 2023 Accepted: 2024-03-27
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
386209 2023-003 Material Weakness - ABL
962651 2023-003 Material Weakness - ABL

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $1.00M Yes 0
93.498 Provider Relief Fund $843,799 Yes 1
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $250,000 - 0
20.509 Formula Grants for Rural Areas and Tribal Transit Program $53,784 - 0
93.301 Small Rural Hospital Improvement Grant Program $12,836 - 0
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $5,250 - 0

Contacts

Name Title Type
SPX9NJDW5LR4 Ashley Woodward Auditee
3087284351 Marty Dubas Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Health System does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate. The accompanying schedule of expenditures of federal awards (the schedule) includes the federal award activity of Valley County Health System (Health System), a component unit of Valley County, Nebraska, under programs of the federal government for the year ended June 30, 2023. The information 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 (Uniform Guidance). Because the schedule presents only a selected portion of the operations of the Health System, it is not intended to and does not present the statement of net position, statement of revenue, expenses and changes in net position, and statement of cash flows of the Health System.
Title: Summary of Significant Accounting Policies Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Health System does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate. Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has been provided to a subrecipient.
Title: Indirect Cost Rate Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Health System does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate. The Health System does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate.
Title: Provider Relief Funds and American Rescue Plan Rural Distribution Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Health System does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate. The Health System received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan Rural Distribution (PRF) program (Federal Financial Assistance Listing #93.498) in the amount of $5,141,990 as of June 30, 2023. The Health System reported interest earned on PRF payments of $7,024 ($7,024 in Period 1 and $-0- in Period 4). The PRF expenditures are not recognized on the schedule until the expenditures are included in the reporting to HHS as required under the PRF program. The following summarizes the Provider Relief Funds and the timing of when the amounts were recognized in the financial statements. Amounts Amounts Amounts Amounts Recognized in Recognized in Recognized in Recognized in Federal Accordance Accordance Accordance Accordance Financial with GAAP for with GAAP for with GAAP for with GAAP for Assistance the Year Ended the Year Ended the Year Ended the Year Ended Federal Department/Program Title/Grant Name Listing June 30, 2020 June 30, 2021 June 30, 2022 June 30, 2023 Department of Health and Human Services Health Resources and Services Administration COVID-19 Provider Relief Fund and American Rescue Plan General and Targeted Distribution - Period 1 (not included in 2023 Schedule) 93.498 $1,683,763 $2,614,428 $- $- COVID-19 Provider Relief Fund and American Rescue Plan General and Targeted Distribution - Period 4 (included in 2023 Schedule) 93.498 - - 843,799 - Total Department of Health and Human Services $1,683,763 $2,614,428 $843,799 $-

Finding Details

Finding 2023-003
2023-003 Department of Health and Human Services FAL #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Activities Allowed or Unallowed, Allowable Costs/Cost Principles and Reporting Material Weakness in Internal Control over Compliance Criteria: 2CFR 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: The Health System’s final expenditure listing identified as eligible and claimed under the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program were not reviewed and approved by a separate individual outside of the preparer. In addition, the Health System’s special report submitted to the Department of Health and Human Services for Period 4 was not reviewed and approved by a separate individual outside of the preparer. Cause: The Health System did not have an internal control process in place and documented to ensure a secondary review and approval of eligible expenditures that were summarized from the underlying supporting spreadsheets to the final expenditure listing. The summary spreadsheet was used to claim allowable costs under the federal program. In addition, the review and approval of the report submitted to the Department of Health and Human Services for Period 4 was not performed by someone other than the prepared of the report. Effect: Without a secondary review and approval, there is a possibility that ineligible expenditures may be claimed under the program and the report may not be accurately completed. Questioned Costs: None reported. Context/Sampling: A nonstatistical sample of 60 items were tested for activities allowed or unallowed and allowable costs/cost principles. Key line items were tested on the Period 4 Department of Health and Human Services special report. Repeat Finding from Prior Year(s): No. Recommendation: We recommend the Health System implement a control process which includes a secondary review and approval of the summarized final expenditure listing used to claim the allowable costs under the federal program and a secondary review and approval of required reports to be submitted to the federal agency. Views of Responsible Individuals: Management agrees with the finding.
Finding 2023-003
2023-003 Department of Health and Human Services FAL #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Activities Allowed or Unallowed, Allowable Costs/Cost Principles and Reporting Material Weakness in Internal Control over Compliance Criteria: 2CFR 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: The Health System’s final expenditure listing identified as eligible and claimed under the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program were not reviewed and approved by a separate individual outside of the preparer. In addition, the Health System’s special report submitted to the Department of Health and Human Services for Period 4 was not reviewed and approved by a separate individual outside of the preparer. Cause: The Health System did not have an internal control process in place and documented to ensure a secondary review and approval of eligible expenditures that were summarized from the underlying supporting spreadsheets to the final expenditure listing. The summary spreadsheet was used to claim allowable costs under the federal program. In addition, the review and approval of the report submitted to the Department of Health and Human Services for Period 4 was not performed by someone other than the prepared of the report. Effect: Without a secondary review and approval, there is a possibility that ineligible expenditures may be claimed under the program and the report may not be accurately completed. Questioned Costs: None reported. Context/Sampling: A nonstatistical sample of 60 items were tested for activities allowed or unallowed and allowable costs/cost principles. Key line items were tested on the Period 4 Department of Health and Human Services special report. Repeat Finding from Prior Year(s): No. Recommendation: We recommend the Health System implement a control process which includes a secondary review and approval of the summarized final expenditure listing used to claim the allowable costs under the federal program and a secondary review and approval of required reports to be submitted to the federal agency. Views of Responsible Individuals: Management agrees with the finding.