FAC Explorer

Audit 317404

FY End
2022-06-30
Total Expended
$43.50M
Findings
4
Programs
4
Organization: Monongalia Health System, Inc. and Subsidiaries (WV)
Year: 2022 Accepted: 2024-08-19
Auditor: Baker Tilly US LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
481368 2022-001 Material Weakness Yes L
481369 2022-001 Material Weakness Yes L
1057810 2022-001 Material Weakness Yes L
1057811 2022-001 Material Weakness Yes L

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $23.50M Yes 0
93.498 Provider Relief Fund $16.27M Yes 1
93.461 Covid-19 Testing for the Uninsured $131,244 - 0
93.899 Covid-19 Preparedness and Response Activities $76,344 - 0

Contacts

Name Title Type
VWTSZPKAUDK1 Kevin Gessler Auditee
3043294700 James Raley Auditor
No contacts on file

Notes to SEFA

Title: 49 1. Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception of expenditures associated with the U.S. Department of Health and Human Services (HHS) Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF). Such expenditures are recognized following the cost principles contained in the Uniform Guidance wherein certain types of expenditures are not allowable or limited as to reimbursement. For the awards related to the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program, the HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the Health Resources and Services Administration (HRSA) PRF Reporting Portal. Payments from the HHS for PRF are assigned to "Payment Received Periods" (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). De Minimis Rate Used: N Rate Explanation: Monongalia Health System, Inc. and Subsidiaries has not elected to use the 10% de minimis indirect cost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Monongalia Health System, Inc. and Subsidiaries (the Health System) under programs of the federal government for the year ended June 30, 2022. The information in this 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 (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 financial position, changes in net position or cash flows of the Health System.
Title: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution - Assistance Listing Number 93.498 Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception of expenditures associated with the U.S. Department of Health and Human Services (HHS) Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF). Such expenditures are recognized following the cost principles contained in the Uniform Guidance wherein certain types of expenditures are not allowable or limited as to reimbursement. For the awards related to the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program, the HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the Health Resources and Services Administration (HRSA) PRF Reporting Portal. Payments from the HHS for PRF are assigned to "Payment Received Periods" (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). De Minimis Rate Used: N Rate Explanation: Monongalia Health System, Inc. and Subsidiaries has not elected to use the 10% de minimis indirect cost rate. The Schedule includes $3,528,060 received from HHS between July 1, 2020 through December 31, 2020. In accordance with guidance from HHS, these amounts are presented as Period 2. The Schedule includes $16,265,982 received from HHS between January 1, 2021 through June 30, 2021. In accordance with guidance from HHS, these amounts are presented as Period 3. Such amounts were recognized as other revenue in the Health System's consolidated financial statements the years ended June 30, 2022 and June 30, 2021, respectively. Due to the PRF Reporting requirements, the amounts recognized in the consolidated financial statements do not correspond with the amount reported in the Schedule. The Schedule includes the following entities that received the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program: Legal Entity Name Tax Identification Number Monongalia County General Hospital Company dba Mon Health Medical Center 23-7441353 Mon Elder Services, Inc. 31-1520863
Title: 5. Loan and Loan Guarantee Programs Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception of expenditures associated with the U.S. Department of Health and Human Services (HHS) Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF). Such expenditures are recognized following the cost principles contained in the Uniform Guidance wherein certain types of expenditures are not allowable or limited as to reimbursement. For the awards related to the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program, the HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the Health Resources and Services Administration (HRSA) PRF Reporting Portal. Payments from the HHS for PRF are assigned to "Payment Received Periods" (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). De Minimis Rate Used: N Rate Explanation: Monongalia Health System, Inc. and Subsidiaries has not elected to use the 10% de minimis indirect cost rate. The Schedule includes $23,496,737 received from the USDA. In accordance with guidance from the USDA, these amounts represent the balance of the loans as of the beginning of the reporting period (i.e., the June 30, 2021, balance). There were no interest subsidies, cash, administrative costs allowances or new loans made or received during the year ended June 30, 2022. The balance of the loan as of June 30, 2022, amounted to $23,019,875.

Finding Details

Finding 2022-001
Federal Program: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Number: N/A Award Year: 2021 Compliance Requirements: Reporting Questioned Costs: Not determinable Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations and the terms and conditions of the Federal award. Provider Relief Funds (PRF) payments must be used for allowable expenses and lost revenue described in the PRF terms and conditions and specified in guidance issued by the U.S. Department of Health and Human Services. Activities allowed have been defined as expense used to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Additionally, all recipients of PRF payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition and context: Monongalia County General Hospital Company dba Mon Health Medical Center did not complete the PRF reporting in accordance with the U.S. Department of Health and Human Services guidance. We noted that the facility had multiple errors in its underlying calculation of lost revenues which resulted in lost revenues being overstated $92,483. The entity reported total lost revenues of $66,955,875 on total PRF distributions that amounted to $21,763,852, as such, there were no questioned costs. Effect: The amounts reported to HRSA were not in accordance with established U.S. Department of Health and Human Services guidance. Cause: Monongalia Health System, Inc. and Subsidiaries had an insufficient control in place to identify and correct errors prior to reporting on the use of their Provider Relief Funds. Repeat Finding: 2021-005 Recommendation: We recommend that management review policies and procedures in place and update for most recent interpretation of the U.S. Department of Health and Human Services guidance. Procedures should be implemented and monitored. Unallowable cost recognized should be corrected in future reporting periods. Management's Response: Monongalia Health System, Inc. and Subsidiaries agrees with the finding.
Finding 2022-001
Federal Program: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Number: N/A Award Year: 2021 Compliance Requirements: Reporting Questioned Costs: Not determinable Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations and the terms and conditions of the Federal award. Provider Relief Funds (PRF) payments must be used for allowable expenses and lost revenue described in the PRF terms and conditions and specified in guidance issued by the U.S. Department of Health and Human Services. Activities allowed have been defined as expense used to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Additionally, all recipients of PRF payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition and context: Monongalia County General Hospital Company dba Mon Health Medical Center did not complete the PRF reporting in accordance with the U.S. Department of Health and Human Services guidance. We noted that the facility had multiple errors in its underlying calculation of lost revenues which resulted in lost revenues being overstated $92,483. The entity reported total lost revenues of $66,955,875 on total PRF distributions that amounted to $21,763,852, as such, there were no questioned costs. Effect: The amounts reported to HRSA were not in accordance with established U.S. Department of Health and Human Services guidance. Cause: Monongalia Health System, Inc. and Subsidiaries had an insufficient control in place to identify and correct errors prior to reporting on the use of their Provider Relief Funds. Repeat Finding: 2021-005 Recommendation: We recommend that management review policies and procedures in place and update for most recent interpretation of the U.S. Department of Health and Human Services guidance. Procedures should be implemented and monitored. Unallowable cost recognized should be corrected in future reporting periods. Management's Response: Monongalia Health System, Inc. and Subsidiaries agrees with the finding.
Finding 2022-001
Federal Program: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Number: N/A Award Year: 2021 Compliance Requirements: Reporting Questioned Costs: Not determinable Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations and the terms and conditions of the Federal award. Provider Relief Funds (PRF) payments must be used for allowable expenses and lost revenue described in the PRF terms and conditions and specified in guidance issued by the U.S. Department of Health and Human Services. Activities allowed have been defined as expense used to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Additionally, all recipients of PRF payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition and context: Monongalia County General Hospital Company dba Mon Health Medical Center did not complete the PRF reporting in accordance with the U.S. Department of Health and Human Services guidance. We noted that the facility had multiple errors in its underlying calculation of lost revenues which resulted in lost revenues being overstated $92,483. The entity reported total lost revenues of $66,955,875 on total PRF distributions that amounted to $21,763,852, as such, there were no questioned costs. Effect: The amounts reported to HRSA were not in accordance with established U.S. Department of Health and Human Services guidance. Cause: Monongalia Health System, Inc. and Subsidiaries had an insufficient control in place to identify and correct errors prior to reporting on the use of their Provider Relief Funds. Repeat Finding: 2021-005 Recommendation: We recommend that management review policies and procedures in place and update for most recent interpretation of the U.S. Department of Health and Human Services guidance. Procedures should be implemented and monitored. Unallowable cost recognized should be corrected in future reporting periods. Management's Response: Monongalia Health System, Inc. and Subsidiaries agrees with the finding.
Finding 2022-001
Federal Program: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Number: N/A Award Year: 2021 Compliance Requirements: Reporting Questioned Costs: Not determinable Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations and the terms and conditions of the Federal award. Provider Relief Funds (PRF) payments must be used for allowable expenses and lost revenue described in the PRF terms and conditions and specified in guidance issued by the U.S. Department of Health and Human Services. Activities allowed have been defined as expense used to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Additionally, all recipients of PRF payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition and context: Monongalia County General Hospital Company dba Mon Health Medical Center did not complete the PRF reporting in accordance with the U.S. Department of Health and Human Services guidance. We noted that the facility had multiple errors in its underlying calculation of lost revenues which resulted in lost revenues being overstated $92,483. The entity reported total lost revenues of $66,955,875 on total PRF distributions that amounted to $21,763,852, as such, there were no questioned costs. Effect: The amounts reported to HRSA were not in accordance with established U.S. Department of Health and Human Services guidance. Cause: Monongalia Health System, Inc. and Subsidiaries had an insufficient control in place to identify and correct errors prior to reporting on the use of their Provider Relief Funds. Repeat Finding: 2021-005 Recommendation: We recommend that management review policies and procedures in place and update for most recent interpretation of the U.S. Department of Health and Human Services guidance. Procedures should be implemented and monitored. Unallowable cost recognized should be corrected in future reporting periods. Management's Response: Monongalia Health System, Inc. and Subsidiaries agrees with the finding.