FAC Explorer

Audit 317748

FY End
2023-12-31
Total Expended
$15.66M
Findings
8
Programs
8
Organization: The Jamaica Hospital (NY)
Year: 2023 Accepted: 2024-08-22
Auditor: Pricewaterhousecoopers LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
484831 2023-001 - - L
484832 2023-001 - - L
484833 2023-001 - - L
484834 2023-002 - - L
1061273 2023-001 - - L
1061274 2023-001 - - L
1061275 2023-001 - - L
1061276 2023-002 - - L

Programs

ALN Program Spent Major Findings
10.557 Special Supplemental Food Program for Women, Infants, and Children - Food Vouchers $9.47M Yes 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children - Administrative Expenses $1.63M Yes 0
93.493 Congressional Directives $995,000 Yes 1
32.006 Covid-19 Telehealth Program Round 2 $925,912 Yes 0
93.889 National Bioterrorism Hospital Preparedness Program $190,000 Yes 0
93.926 Healthy Start Eliminating Disparities in Perinatal Health $106,805 - 0
93.268 Immunization Cooperative Agreements $67,502 - 0
93.994 Maternal and Child Health Services Block Grant to the States $24,511 - 0

Contacts

Name Title Type
S8FXAX834429 Manzar Sassani Auditee
7182066291 Kate Corgel Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation and Significant Accounting Principles Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the federal grant activity of Jamaica Hospital Medical Center and its subsidiary (“Jamaica”). 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”). The purpose of the Schedule is to present a summary of those activities of Jamaica for the year ended December 31, 2023 which have been financed by the federal government. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of loans or grants, contracts, cooperative agreements, loans and loan guarantees, and other noncash assistance. Where available, pass–through entity identifying numbers are included in the Schedule. Because the Schedule presents only a selected portion of the activities of Jamaica, it is not intended to and does not present either the financial position or the revenues, expenditures and other changes in net (deficit) assets of Jamaica. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in, the preparation of Jamaica’s consolidated financial statements. Expenditures for direct costs within the Schedule are recognized using the accrual method of accounting and in accordance with The Department of Health and Human Services, U.S. Office of the Assistant Secretary Comptroller (“OASC”) OASC–3, A Guide for Hospitals. Under those cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: Jamaica applies the indirect cost rate approved by the granting agency at the time of the award. In cases where the granting agency does not disclose a specific rate, Jamaica utilizes the 10% de minimis indirect cost rate as described in Section 200.414 of the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the federal grant activity of Jamaica Hospital Medical Center and its subsidiary (“Jamaica”). 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”). The purpose of the Schedule is to present a summary of those activities of Jamaica for the year ended December 31, 2023 which have been financed by the federal government. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of loans or grants, contracts, cooperative agreements, loans and loan guarantees, and other noncash assistance. Where available, pass–through entity identifying numbers are included in the Schedule. Because the Schedule presents only a selected portion of the activities of Jamaica, it is not intended to and does not present either the financial position or the revenues, expenditures and other changes in net (deficit) assets of Jamaica. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in, the preparation of Jamaica’s consolidated financial statements. Expenditures for direct costs within the Schedule are recognized using the accrual method of accounting and in accordance with The Department of Health and Human Services, U.S. Office of the Assistant Secretary Comptroller (“OASC”) OASC–3, A Guide for Hospitals. Under those cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. Jamaica applies the indirect cost rate approved by the granting agency at the time of the award. In cases where the granting agency does not disclose a specific rate, Jamaica utilizes the 10% de minimis indirect cost rate as described in Section 200.414 of the Uniform Guidance.
Title: Special Supplemental Food Program for Women, Infants and Children Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the federal grant activity of Jamaica Hospital Medical Center and its subsidiary (“Jamaica”). 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”). The purpose of the Schedule is to present a summary of those activities of Jamaica for the year ended December 31, 2023 which have been financed by the federal government. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of loans or grants, contracts, cooperative agreements, loans and loan guarantees, and other noncash assistance. Where available, pass–through entity identifying numbers are included in the Schedule. Because the Schedule presents only a selected portion of the activities of Jamaica, it is not intended to and does not present either the financial position or the revenues, expenditures and other changes in net (deficit) assets of Jamaica. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in, the preparation of Jamaica’s consolidated financial statements. Expenditures for direct costs within the Schedule are recognized using the accrual method of accounting and in accordance with The Department of Health and Human Services, U.S. Office of the Assistant Secretary Comptroller (“OASC”) OASC–3, A Guide for Hospitals. Under those cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: Jamaica applies the indirect cost rate approved by the granting agency at the time of the award. In cases where the granting agency does not disclose a specific rate, Jamaica utilizes the 10% de minimis indirect cost rate as described in Section 200.414 of the Uniform Guidance. During the year ended December 31, 2023, Jamaica participated in the Special Supplemental Food Program for Women, Infants and Children (“WIC”) (Assistance Listing Number 10.557) through the receipt and distribution of food instruments. The United States Department of Agriculture has determined that such WIC food instruments are considered property “in lieu of money” and, therefore, should be considered part of the subgrant award received by Jamaica. The WIC program funding has both a federal and state component (from the New York State Department of Health). For the year ended December 31, 2023, Jamaica’s total administrative costs were $1,949,638, of which 83.80% (or $1,633,796) was federally funded. The total value of Jamaica’s food checks redeemed ($9,465,917) was federally funded. These percentages were supplied by the New York State Department of Health for the year ended December 31, 2023. Only the federally funded component of the WIC program is included on the Schedule.

Finding Details

Finding 2023-001
2023-001: Congressional Directives SEFA Reporting Federal Agency: Department of Health and Human Services (“HHS”), Health Resources and Services Administration (“HRSA”) Assistance Listing Program Title: Congressional Directives Federal Award Project Title: Community Project Funding/ Congressionally Directed Spending ‐ Construction Assistance Listing Number: 93.493 Federal Award Identification Numbers: CE146569, CE152406, CE152466 Criteria OMB Uniform Guidance 2 CFR 200.510(b)(3) requires that the auditee provide the Federal awards expended for each individual Federal program on the Schedule of Expenditures of Federal Awards (“SEFA”). In accordance with 2 CFR 200.502, the determination of when a Federal award is expended, and thereby reported on the SEFA, is generally based on when the activity related to the Federal award occurs. Condition The Congressional Directives grant is a cost reimbursement based grant that reimburses award recipients for expenditures incurred on projects that relate to the construction and renovation (including equipment) of health care facilities. Jamaica tracked expenditures for SEFA reporting purposes on the basis of reimbursement from the sponsor, rather than expenditures incurred by Jamaica. Request for reimbursement for this award has not been made as of the date of this report. As a result, the expenditures reported by Jamaica on its draft 2023 SEFA were understated by the entire amount of the Congressional Directive grant’s expenditures incurred in 2023. This has been corrected by management in the final SEFA included in this report. There was no impact to our audit scoping given this award was included on the final SEFA and included as a major program. Questioned Costs None Cause Jamaica did not apply the accrual basis of accounting for the Congressional Directives grant to ensure proper reporting on the SEFA. Effect The draft 2023 SEFA omitted all 2023 expenditures incurred for the Congressional Directives grant, resulting in the draft SEFA expenditures being underreported by $2,904,920. This was corrected in the final SEFA included in this report, such that major program determination and audit scoping for the 2023 audit was not impacted, however, it would have been impacted if the final SEFA was not corrected (and reported on the accrual basis of accounting for the Congressional Directives grant). Recommendation We recommend Jamaica enhance their controls around grant terms and expenditures of allowable funds under federal award agreements to determine the appropriate amounts to be accrued and reported on the annual SEFA (regardless of when cash reimbursement is requested from the granting agency). Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-001
2023-001: Congressional Directives SEFA Reporting Federal Agency: Department of Health and Human Services (“HHS”), Health Resources and Services Administration (“HRSA”) Assistance Listing Program Title: Congressional Directives Federal Award Project Title: Community Project Funding/ Congressionally Directed Spending ‐ Construction Assistance Listing Number: 93.493 Federal Award Identification Numbers: CE146569, CE152406, CE152466 Criteria OMB Uniform Guidance 2 CFR 200.510(b)(3) requires that the auditee provide the Federal awards expended for each individual Federal program on the Schedule of Expenditures of Federal Awards (“SEFA”). In accordance with 2 CFR 200.502, the determination of when a Federal award is expended, and thereby reported on the SEFA, is generally based on when the activity related to the Federal award occurs. Condition The Congressional Directives grant is a cost reimbursement based grant that reimburses award recipients for expenditures incurred on projects that relate to the construction and renovation (including equipment) of health care facilities. Jamaica tracked expenditures for SEFA reporting purposes on the basis of reimbursement from the sponsor, rather than expenditures incurred by Jamaica. Request for reimbursement for this award has not been made as of the date of this report. As a result, the expenditures reported by Jamaica on its draft 2023 SEFA were understated by the entire amount of the Congressional Directive grant’s expenditures incurred in 2023. This has been corrected by management in the final SEFA included in this report. There was no impact to our audit scoping given this award was included on the final SEFA and included as a major program. Questioned Costs None Cause Jamaica did not apply the accrual basis of accounting for the Congressional Directives grant to ensure proper reporting on the SEFA. Effect The draft 2023 SEFA omitted all 2023 expenditures incurred for the Congressional Directives grant, resulting in the draft SEFA expenditures being underreported by $2,904,920. This was corrected in the final SEFA included in this report, such that major program determination and audit scoping for the 2023 audit was not impacted, however, it would have been impacted if the final SEFA was not corrected (and reported on the accrual basis of accounting for the Congressional Directives grant). Recommendation We recommend Jamaica enhance their controls around grant terms and expenditures of allowable funds under federal award agreements to determine the appropriate amounts to be accrued and reported on the annual SEFA (regardless of when cash reimbursement is requested from the granting agency). Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-001
2023-001: Congressional Directives SEFA Reporting Federal Agency: Department of Health and Human Services (“HHS”), Health Resources and Services Administration (“HRSA”) Assistance Listing Program Title: Congressional Directives Federal Award Project Title: Community Project Funding/ Congressionally Directed Spending ‐ Construction Assistance Listing Number: 93.493 Federal Award Identification Numbers: CE146569, CE152406, CE152466 Criteria OMB Uniform Guidance 2 CFR 200.510(b)(3) requires that the auditee provide the Federal awards expended for each individual Federal program on the Schedule of Expenditures of Federal Awards (“SEFA”). In accordance with 2 CFR 200.502, the determination of when a Federal award is expended, and thereby reported on the SEFA, is generally based on when the activity related to the Federal award occurs. Condition The Congressional Directives grant is a cost reimbursement based grant that reimburses award recipients for expenditures incurred on projects that relate to the construction and renovation (including equipment) of health care facilities. Jamaica tracked expenditures for SEFA reporting purposes on the basis of reimbursement from the sponsor, rather than expenditures incurred by Jamaica. Request for reimbursement for this award has not been made as of the date of this report. As a result, the expenditures reported by Jamaica on its draft 2023 SEFA were understated by the entire amount of the Congressional Directive grant’s expenditures incurred in 2023. This has been corrected by management in the final SEFA included in this report. There was no impact to our audit scoping given this award was included on the final SEFA and included as a major program. Questioned Costs None Cause Jamaica did not apply the accrual basis of accounting for the Congressional Directives grant to ensure proper reporting on the SEFA. Effect The draft 2023 SEFA omitted all 2023 expenditures incurred for the Congressional Directives grant, resulting in the draft SEFA expenditures being underreported by $2,904,920. This was corrected in the final SEFA included in this report, such that major program determination and audit scoping for the 2023 audit was not impacted, however, it would have been impacted if the final SEFA was not corrected (and reported on the accrual basis of accounting for the Congressional Directives grant). Recommendation We recommend Jamaica enhance their controls around grant terms and expenditures of allowable funds under federal award agreements to determine the appropriate amounts to be accrued and reported on the annual SEFA (regardless of when cash reimbursement is requested from the granting agency). Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-002
2023-002: Compliance with Reporting Requirements Federal Agency: Department of Health and Human Services (“HHS”) Program: Health Resources and Services Administration (“HRSA”) Community Project Funding/ Congressionally Directed Spending - Construction Assistance Listing Number: 93.493 Assistance Listing Title: Congressional Directives Federal Award Identification Number: CE146569 Criteria In accordance with the notice of award (“NoA”), a semi-annual progress report is required to be submitted to HHS twice a year until the project is completed. The 2023 deadlines for the semi-annual reports were May 22, 2023 and December 14, 2023. Condition The semi-annual report for Federal Award Identification Number CE146569 was submitted December 21, 2023, which was past the stated deadline of December 14, 2023. Questioned Costs None Cause Management did not have an adequate understanding of the reporting requirements of the award and the control was not designed to ensure that reports were completed and submitted to the agency in a timely manner. Effect The late submission of the December 2023 semi-annual report causes Jamaica to be out of compliance with specific grant reporting requirements. Recommendation We recommend Jamaica enhance its control around the monitoring of grant reporting requirements, including evaluating report due dates and performing reviews in advance of submission deadlines to ensure all reports are being completed accurately and submitted in a timely manner. Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-001
2023-001: Congressional Directives SEFA Reporting Federal Agency: Department of Health and Human Services (“HHS”), Health Resources and Services Administration (“HRSA”) Assistance Listing Program Title: Congressional Directives Federal Award Project Title: Community Project Funding/ Congressionally Directed Spending ‐ Construction Assistance Listing Number: 93.493 Federal Award Identification Numbers: CE146569, CE152406, CE152466 Criteria OMB Uniform Guidance 2 CFR 200.510(b)(3) requires that the auditee provide the Federal awards expended for each individual Federal program on the Schedule of Expenditures of Federal Awards (“SEFA”). In accordance with 2 CFR 200.502, the determination of when a Federal award is expended, and thereby reported on the SEFA, is generally based on when the activity related to the Federal award occurs. Condition The Congressional Directives grant is a cost reimbursement based grant that reimburses award recipients for expenditures incurred on projects that relate to the construction and renovation (including equipment) of health care facilities. Jamaica tracked expenditures for SEFA reporting purposes on the basis of reimbursement from the sponsor, rather than expenditures incurred by Jamaica. Request for reimbursement for this award has not been made as of the date of this report. As a result, the expenditures reported by Jamaica on its draft 2023 SEFA were understated by the entire amount of the Congressional Directive grant’s expenditures incurred in 2023. This has been corrected by management in the final SEFA included in this report. There was no impact to our audit scoping given this award was included on the final SEFA and included as a major program. Questioned Costs None Cause Jamaica did not apply the accrual basis of accounting for the Congressional Directives grant to ensure proper reporting on the SEFA. Effect The draft 2023 SEFA omitted all 2023 expenditures incurred for the Congressional Directives grant, resulting in the draft SEFA expenditures being underreported by $2,904,920. This was corrected in the final SEFA included in this report, such that major program determination and audit scoping for the 2023 audit was not impacted, however, it would have been impacted if the final SEFA was not corrected (and reported on the accrual basis of accounting for the Congressional Directives grant). Recommendation We recommend Jamaica enhance their controls around grant terms and expenditures of allowable funds under federal award agreements to determine the appropriate amounts to be accrued and reported on the annual SEFA (regardless of when cash reimbursement is requested from the granting agency). Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-001
2023-001: Congressional Directives SEFA Reporting Federal Agency: Department of Health and Human Services (“HHS”), Health Resources and Services Administration (“HRSA”) Assistance Listing Program Title: Congressional Directives Federal Award Project Title: Community Project Funding/ Congressionally Directed Spending ‐ Construction Assistance Listing Number: 93.493 Federal Award Identification Numbers: CE146569, CE152406, CE152466 Criteria OMB Uniform Guidance 2 CFR 200.510(b)(3) requires that the auditee provide the Federal awards expended for each individual Federal program on the Schedule of Expenditures of Federal Awards (“SEFA”). In accordance with 2 CFR 200.502, the determination of when a Federal award is expended, and thereby reported on the SEFA, is generally based on when the activity related to the Federal award occurs. Condition The Congressional Directives grant is a cost reimbursement based grant that reimburses award recipients for expenditures incurred on projects that relate to the construction and renovation (including equipment) of health care facilities. Jamaica tracked expenditures for SEFA reporting purposes on the basis of reimbursement from the sponsor, rather than expenditures incurred by Jamaica. Request for reimbursement for this award has not been made as of the date of this report. As a result, the expenditures reported by Jamaica on its draft 2023 SEFA were understated by the entire amount of the Congressional Directive grant’s expenditures incurred in 2023. This has been corrected by management in the final SEFA included in this report. There was no impact to our audit scoping given this award was included on the final SEFA and included as a major program. Questioned Costs None Cause Jamaica did not apply the accrual basis of accounting for the Congressional Directives grant to ensure proper reporting on the SEFA. Effect The draft 2023 SEFA omitted all 2023 expenditures incurred for the Congressional Directives grant, resulting in the draft SEFA expenditures being underreported by $2,904,920. This was corrected in the final SEFA included in this report, such that major program determination and audit scoping for the 2023 audit was not impacted, however, it would have been impacted if the final SEFA was not corrected (and reported on the accrual basis of accounting for the Congressional Directives grant). Recommendation We recommend Jamaica enhance their controls around grant terms and expenditures of allowable funds under federal award agreements to determine the appropriate amounts to be accrued and reported on the annual SEFA (regardless of when cash reimbursement is requested from the granting agency). Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-001
2023-001: Congressional Directives SEFA Reporting Federal Agency: Department of Health and Human Services (“HHS”), Health Resources and Services Administration (“HRSA”) Assistance Listing Program Title: Congressional Directives Federal Award Project Title: Community Project Funding/ Congressionally Directed Spending ‐ Construction Assistance Listing Number: 93.493 Federal Award Identification Numbers: CE146569, CE152406, CE152466 Criteria OMB Uniform Guidance 2 CFR 200.510(b)(3) requires that the auditee provide the Federal awards expended for each individual Federal program on the Schedule of Expenditures of Federal Awards (“SEFA”). In accordance with 2 CFR 200.502, the determination of when a Federal award is expended, and thereby reported on the SEFA, is generally based on when the activity related to the Federal award occurs. Condition The Congressional Directives grant is a cost reimbursement based grant that reimburses award recipients for expenditures incurred on projects that relate to the construction and renovation (including equipment) of health care facilities. Jamaica tracked expenditures for SEFA reporting purposes on the basis of reimbursement from the sponsor, rather than expenditures incurred by Jamaica. Request for reimbursement for this award has not been made as of the date of this report. As a result, the expenditures reported by Jamaica on its draft 2023 SEFA were understated by the entire amount of the Congressional Directive grant’s expenditures incurred in 2023. This has been corrected by management in the final SEFA included in this report. There was no impact to our audit scoping given this award was included on the final SEFA and included as a major program. Questioned Costs None Cause Jamaica did not apply the accrual basis of accounting for the Congressional Directives grant to ensure proper reporting on the SEFA. Effect The draft 2023 SEFA omitted all 2023 expenditures incurred for the Congressional Directives grant, resulting in the draft SEFA expenditures being underreported by $2,904,920. This was corrected in the final SEFA included in this report, such that major program determination and audit scoping for the 2023 audit was not impacted, however, it would have been impacted if the final SEFA was not corrected (and reported on the accrual basis of accounting for the Congressional Directives grant). Recommendation We recommend Jamaica enhance their controls around grant terms and expenditures of allowable funds under federal award agreements to determine the appropriate amounts to be accrued and reported on the annual SEFA (regardless of when cash reimbursement is requested from the granting agency). Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.
Finding 2023-002
2023-002: Compliance with Reporting Requirements Federal Agency: Department of Health and Human Services (“HHS”) Program: Health Resources and Services Administration (“HRSA”) Community Project Funding/ Congressionally Directed Spending - Construction Assistance Listing Number: 93.493 Assistance Listing Title: Congressional Directives Federal Award Identification Number: CE146569 Criteria In accordance with the notice of award (“NoA”), a semi-annual progress report is required to be submitted to HHS twice a year until the project is completed. The 2023 deadlines for the semi-annual reports were May 22, 2023 and December 14, 2023. Condition The semi-annual report for Federal Award Identification Number CE146569 was submitted December 21, 2023, which was past the stated deadline of December 14, 2023. Questioned Costs None Cause Management did not have an adequate understanding of the reporting requirements of the award and the control was not designed to ensure that reports were completed and submitted to the agency in a timely manner. Effect The late submission of the December 2023 semi-annual report causes Jamaica to be out of compliance with specific grant reporting requirements. Recommendation We recommend Jamaica enhance its control around the monitoring of grant reporting requirements, including evaluating report due dates and performing reviews in advance of submission deadlines to ensure all reports are being completed accurately and submitted in a timely manner. Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan is included at the end of this report.