Audit 302244

FY End
2021-06-30
Total Expended
$13.97M
Findings
4
Programs
1
Organization: Avita Health System (OH)
Year: 2021 Accepted: 2024-04-02

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
392099 2021-004 Material Weakness - L
392100 2021-005 Material Weakness - L
968541 2021-004 Material Weakness - L
968542 2021-005 Material Weakness - L

Programs

ALN Program Spent Major Findings
93.498 Covid-19 - Provider Relief Fund $13.97M Yes 2

Contacts

Name Title Type
M2Q4MZVZ8HY9 Eric Draime Auditee
6144684841 Jordan Pace 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 Avita Health System (the “System ”) under programs of the federal government for the year ended June 30, 2021. 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 System, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the System. Expenditures reported in the Schedule are reported on the accrual basis of accounting of accounting. Such expenditures do 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 apply the U.S. Department of Health and Human Services’ guidance and frequently asked questions, as outlined in the compliance supplement. For the PRF program, HHS has indicated that the amounts on the Schedule should be reported in correspondence with reporting requirements of the HHS PRF Reporting Portal. Payments from HHS for PRF are assigned to one of the payment received periods based upon the date each PRF payment was received. Each period has a specified period of availability and timing of reporting requirements. The System 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 System 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

Assistance Listing Number, Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services, COVID-19 - Provider Relief Fund Federal Award Identification Number and Year - N/A Pass-through Entity - N/A Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - The Post Payment Notice of Reporting Requirements for Provider Relief Fund General and Target Distributions (the "Notice"), dated June 11, 2021, requires that unreimbursed COVID-19 expenses reported within the HHS reporting portal should be properly supported and reviewed for accuracy, and the lost revenue methodology utilized by the System should be reported accurately within the HHS portal submission. Condition - The information entered into the period one HHS portal submission for Galion Community Hospital was not adequately supported or reviewed in accordance with the terms and conditions of the PRF funding and the Notice. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - Expenses and lost revenue entered into the period one portal submission for Galion Community Hospital were not adequately reviewed for accuracy and allowability prior to completion of the period one portal submission. After the report was submitted to HHS, the System decided to utilize lost revenues only to justify the expenditures reported on the schedule of expenditures of federal awards. Cause and Effect - The System did not review expenses and lost revenue compiled and reported within the period one portal submission for Galion Community Hospital, which resulted in expenses included in the report not being adequatly supported in accordance with the terms and conditions of the PRF funding and the Notice. Recommendation - The System should review all instructions and FAQs released by the awarding agency and should perform adequate review of the information reported to ensure reporting requirements are completed in accordance with the required regulations. Views of Responsible Officials and Corrective Action Plan - The System utilized lost revenue to support expenditures recognized on the Schedule. For future grant funds received, management will adequately review terms and conditions of the funding received and ensure allowable expense are properly supported and reviewed before completing the required reports.
Assistance Listing Number, Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services, COVID-19 - Provider Relief Fund Federal Award Identification Number and Year - N/A Pass-through Entity - N/A Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - In accordance with 2 CFR 200.303, the System must establish and maintain effective internal controls over federal awards that provide reasonable assurance that the nonfederal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. The reporting requirements for PRF targeted distributions required the recipient entity to report on the use of the funds. Condition - The System received targeted distributions for Bucyrus Community Hospital. A period one portal submission was completed, but no allowable expenses or lost revenues were reported within the Bucyrus Community Hospital report. All allowable expenses and lost revenues were reported on the first period portal submission for Galion Community Hospital, another hospital of the Avita Health System. Questioned Costs - None Identification of How Questioned Costs Were Computed - Lost revenues related to the targeted distributions of $3,878,983 received by Bucyrus Community Hospital were reported within the Galion Community Hospital period 1 portal submission. Context - Galion Community Hospital and Bucyrus Community Hospital received targeted distributions during period one. The allowable expenses and lost revenues related to the Galion Community Hospital targeted distributions were reported within the recipient entities portal submission, while there were no allowable expenses or lost revenues reported within the Bucyrus Community Hospital period one portal submission. The total lost revenue reported in the Galion Community Hospital period one portal submission was sufficient to cover all period one funding. Cause and Effect - The System failed to review all reporting requirements, which caused the System to fail to report allowable expenses and lost revenues within the portal submission for the specific entity that received targeted PRF. Recommendation - The System should adequately review all applicable reporting requirements for federal funding received. Views of Responsible Officials and Planned Corrective Actions - The portal submission could not be modified by the time we identified the reporting issue. As such, no corrective report was completed, however management will implement procedures to ensure reporting requirements are adequately reviewed for all federal funding.
Assistance Listing Number, Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services, COVID-19 - Provider Relief Fund Federal Award Identification Number and Year - N/A Pass-through Entity - N/A Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - The Post Payment Notice of Reporting Requirements for Provider Relief Fund General and Target Distributions (the "Notice"), dated June 11, 2021, requires that unreimbursed COVID-19 expenses reported within the HHS reporting portal should be properly supported and reviewed for accuracy, and the lost revenue methodology utilized by the System should be reported accurately within the HHS portal submission. Condition - The information entered into the period one HHS portal submission for Galion Community Hospital was not adequately supported or reviewed in accordance with the terms and conditions of the PRF funding and the Notice. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - Expenses and lost revenue entered into the period one portal submission for Galion Community Hospital were not adequately reviewed for accuracy and allowability prior to completion of the period one portal submission. After the report was submitted to HHS, the System decided to utilize lost revenues only to justify the expenditures reported on the schedule of expenditures of federal awards. Cause and Effect - The System did not review expenses and lost revenue compiled and reported within the period one portal submission for Galion Community Hospital, which resulted in expenses included in the report not being adequatly supported in accordance with the terms and conditions of the PRF funding and the Notice. Recommendation - The System should review all instructions and FAQs released by the awarding agency and should perform adequate review of the information reported to ensure reporting requirements are completed in accordance with the required regulations. Views of Responsible Officials and Corrective Action Plan - The System utilized lost revenue to support expenditures recognized on the Schedule. For future grant funds received, management will adequately review terms and conditions of the funding received and ensure allowable expense are properly supported and reviewed before completing the required reports.
Assistance Listing Number, Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services, COVID-19 - Provider Relief Fund Federal Award Identification Number and Year - N/A Pass-through Entity - N/A Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - In accordance with 2 CFR 200.303, the System must establish and maintain effective internal controls over federal awards that provide reasonable assurance that the nonfederal entity is managing the federal award in compliance with federal statutes, regulations, and the terms and conditions of the federal award. The reporting requirements for PRF targeted distributions required the recipient entity to report on the use of the funds. Condition - The System received targeted distributions for Bucyrus Community Hospital. A period one portal submission was completed, but no allowable expenses or lost revenues were reported within the Bucyrus Community Hospital report. All allowable expenses and lost revenues were reported on the first period portal submission for Galion Community Hospital, another hospital of the Avita Health System. Questioned Costs - None Identification of How Questioned Costs Were Computed - Lost revenues related to the targeted distributions of $3,878,983 received by Bucyrus Community Hospital were reported within the Galion Community Hospital period 1 portal submission. Context - Galion Community Hospital and Bucyrus Community Hospital received targeted distributions during period one. The allowable expenses and lost revenues related to the Galion Community Hospital targeted distributions were reported within the recipient entities portal submission, while there were no allowable expenses or lost revenues reported within the Bucyrus Community Hospital period one portal submission. The total lost revenue reported in the Galion Community Hospital period one portal submission was sufficient to cover all period one funding. Cause and Effect - The System failed to review all reporting requirements, which caused the System to fail to report allowable expenses and lost revenues within the portal submission for the specific entity that received targeted PRF. Recommendation - The System should adequately review all applicable reporting requirements for federal funding received. Views of Responsible Officials and Planned Corrective Actions - The portal submission could not be modified by the time we identified the reporting issue. As such, no corrective report was completed, however management will implement procedures to ensure reporting requirements are adequately reviewed for all federal funding.