Audit 323168

FY End
2023-12-31
Total Expended
$34.30M
Findings
4
Programs
22
Year: 2023 Accepted: 2024-09-30

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
500402 2023-001 Significant Deficiency - L
500403 2023-002 Material Weakness - AB
1076844 2023-001 Significant Deficiency - L
1076845 2023-002 Material Weakness - AB

Contacts

Name Title Type
DQ8MDZ5TPBZ1 Melissa McCoy Auditee
3045984784 Sabrina Preston Auditor
No contacts on file

Notes to SEFA

Title: 1. Basis of Presentation Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. The System did not pass through any funding to subrecipients. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance The accompanying consolidated schedule of expenditures of federal and state awards (the Schedule) includes the federal and state award activity of West Virginia University Health System and Controlled Entities (the System) under the programs of the federal and state governments for the year ended December 31, 2023. The information in this Schedule is presented in accordance with the requirements of Title 2 US Code of Federal Regulations Part 200, Uniform Administration Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). All federal and state awards received directly and indirectly from federal and state agencies are included in this Schedule. 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. The consolidated schedule of expenditures of federal and state awards includes all federal and state grants to the System that had activity during the year ended December 31, 2023, except those awarded to Wheeling Hospital, Inc. and Subsidiaries. A separate audit in accordance with OMB Uniform Guidance is completed for Wheeling Hospital, Inc. and Subsidiaries. As outlined in the May 2023 OMB Compliance Supplement, the amounts reported in the accompanying schedule related to the Provider Relief Fund and American Rescue Plan Rural Distribution (“PRF”), Assistance Listing No. 93.498, are reported based upon the PRF reporting portal submission guidelines established by the Health Resource and Service Administration (“HRSA”). Six separate reporting periods were established by HRSA based on the dates of receipt of PRF payments. Each reporting period has a specific period of availability which begins on January 1, 2020 and extends through specified deadlines, as indicated below:
Title: 2. Basis of Accounting Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. The System did not pass through any funding to subrecipients. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. The System did not pass through any funding to subrecipients.
Title: 3. Contingencies Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. The System did not pass through any funding to subrecipients. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance The grant programs are subject to financial and compliance audits by the grantors or their representatives. Such audits could lead to requests for reimbursement to the grantor agencies for expenditures disallowed under terms of the grants. Management believes disallowances, if any, will not be material.
Title: 4. Categorization of Expenditures and Other Matters Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. The System did not pass through any funding to subrecipients. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance The categorization of expenditures by program included in the consolidated schedule of expenditures of federal and state awards is based upon the grant documents. Changes in the categorization of expenditures occur based upon revisions to the Assistance Listing, which is issued in June and December of each year. The consolidated schedule of expenditures of federal and state awards for the year ended December 31, 2023 reflects Assistance Listing changes through May 2023.
Title: 5. Schedule of State Grant Receipts and Expenditures Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. The System did not pass through any funding to subrecipients. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance The System received and expended state grant awards for the year ended December 31, 2023 as summarized below: Grant Name Grant Number Entity Total Current Year State Award Revenues Total Current Year State Award Expenditures Under (Over) Expended End of Year Children's Mental Health G230279 United Summit Center $ - $ 179,701 $ - Children’s Mental Health G240116 United Summit Center 320,000 111,432 208,568 Adult Mental Health – Day Support G230198day United Summit Center - 103,814 - Adult Mental Health – Day Support G240005day United Summit Center 218,090 104,039 114,051 Adult Mental Health – Harrison House G230198HH United Summit Center - 499,082 - Adult Mental Health – Harrison House G240005HH United Summit Center 876,750 453,945 422,805 Community Engagement Specialists G230215 United Summit Center - 154,389 15,000 Community Engagement Specialists G240020 United Summit Center 259,000 102,836 156,164 Complex Support Services G230312 United Summit Center - 63,907 14,325 Complex Support Services G240070 United Summit Center 138,800 41,275 97,525 Continuum Enhancement Funds G230235 United Summit Center - 366,609 - Continuum Enhancement Funds G240047 United Summit Center 346,578 346,578 - Healing House G241000 United Summit Center - 216,807 (216,807) Jobs and Hope G230812 United Summit Center - 58,806 - Jobs and Hope G240716 United Summit Center - 19,047 (19,047) Juvenile Remediation and Restoration G230493 United Summit Center - 100,203 - Juvenile Remediation and Restoration G240480 United Summit Center - 20,302 (20,302) Statewide Therapist Loan Repayment Program G230569 United Summit Center 30,000 30,000 - Indigent Care G230294 United Summit Center - 407,166 497,520 Indigent Care G240086 United Summit Center 1,319,904 529,109 790,795 Behavioral Health – Children’s Mobile Crisis Response G200712 United Summit Center 80,717 80,717 - Crisis Stabilization Unit – Pilot G200924 United Summit Center 12,468 12,468 - Behavioral Health – Community Engagement Specialist G210263 United Summit Center 111,456 111,456 - ECMO – Center for Threat Preparedness G220775 West Virginia University Hospitals 294,316 294,316 - OCHS & HP STLR G230920 West Virginia University Hospitals 35,000 35,000 - OCHS & HP STLR G230568 Chestnut Ridge Center (of WVU Hospitals) 108,500 108,500 - Behavioral Health Providers Loan Repay G210813 City Hospital Inc (DBA Berkeley Medical Center) 20,000 20,000 - Recruitment and Retention Community Program G200531 City Hospital Inc (DBA Berkeley Medical Center) 5,000 5,000 - Recruitment and Retention Community Program G200835 Jefferson Medical Center 10,000 10,000 - Recruitment and Retention Community Program G220462 Princeton Community Hospital 10,000 10,000 - Telestroke G231055 Berkeley Medical Center 25,000 25,000 - Telestroke G231055 Jefferson Medical Center 25,000 25,000 - Telestroke G231055 St. Joseph’s Hospital 25,000 25,000 - Telestroke G231055 Braxton County Memorial Hospital 25,000 25,000 - Telestroke G231055 Summersville Regional Medical Center 25,000 25,000 - Telestroke G231055 Thomas Memorial Hospital /St. Francis 50,000 50,000 - Telestroke G231055 Potomac Valley Hospital 25,000 25,000 - Telestroke G231055 Grant Memorial Hospital 25,000 25,000 - Telestroke G231055 Camden Clark Medical Center 25,000 25,000 - Telestroke G231055 Reynolds Memorial Hospital 25,000 25,000 - Telestroke G231055 Jackson General Hospital 25,000 25,000 - Telestroke G231055 Wetzel County Hospital 25,000 25,000 - Telestroke G231055 Princeton Community Hospital 25,000 25,000 -

Finding Details

Assistance Listing #93.788 Opioid STR Significant Deficiency Criteria: The Uniform Guidance requires appropriate internal controls over compliance for each direct and material compliance requirement. Proper review controls over the monthly expected outcomes and performance measures reporting ensure that reports are completed timely. Reports should be submitted in the timeline as determined in the grant agreement. Condition: The System established a procedure over reporting that is not being adhered to in order to guarantee timely submissions. Cause: The System has limited staff available for these report types to allow for a timely submission. Effect: The reports were not submitted timely. Questioned Costs: None. Context: The monthly expected outcomes and performance measures reports were sampled and a population of 12 was selected for auditing. Of those sampled, 6 were found to not be submitted timely. The sample was not considered statistically valid. Identification as a Repeat Finding: N/A Recommendation: The System should implement a process to ensure the timely submission of the reports. Views of Responsible Officials: See corrective action plan.
Assistance Listing #93.498 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions Material Weakness and Material Noncompliance Criteria: The Department of Health and Human Services provided terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions. Those terms and conditions outlined the usages of the PRF distributions received, specifically related to expenses. PRF distributions should only be used to prevent, prepare for, and response to the coronavirus that have not been reimbursed from other sources or that other sources are not obligated to reimburse. Management should have effectively designed controls to prevent, or detect and correct, noncompliance related to the usage of PRF distributions. Condition: The System’s internal control over Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions resulted in ineligible costs reported on the Department of Health and Human Services PRF portal submission for Princeton Community Hospital. Cause: Lack of effectively designed and implemented controls, including oversight and detail review of expenditures submitted through the Department of Health and Human Services PRF portal. Effect: The System overstated supplies and payroll expenses submitted through the Department of Health and Human Services PRF portal for Princeton Community Hospital. Questioned Costs: Unknown. Context: Expenses included in the portal submission for Princeton Community Hospital were sampled and policies for these expenses were obtained. Of the population, supplies and payroll expenses entered into the PRF portal were found to not follow the terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions as they were not able to be directly tied to COVID-19. Identification as a Repeat Finding: N/A Recommendation: Effective controls over compliance should be implemented to ensure expenditures submitted through the Department of Health and Human Services PRF portal meet the criteria established in the terms and conditions. Views of Responsible Officials: See corrective action plan.
Assistance Listing #93.788 Opioid STR Significant Deficiency Criteria: The Uniform Guidance requires appropriate internal controls over compliance for each direct and material compliance requirement. Proper review controls over the monthly expected outcomes and performance measures reporting ensure that reports are completed timely. Reports should be submitted in the timeline as determined in the grant agreement. Condition: The System established a procedure over reporting that is not being adhered to in order to guarantee timely submissions. Cause: The System has limited staff available for these report types to allow for a timely submission. Effect: The reports were not submitted timely. Questioned Costs: None. Context: The monthly expected outcomes and performance measures reports were sampled and a population of 12 was selected for auditing. Of those sampled, 6 were found to not be submitted timely. The sample was not considered statistically valid. Identification as a Repeat Finding: N/A Recommendation: The System should implement a process to ensure the timely submission of the reports. Views of Responsible Officials: See corrective action plan.
Assistance Listing #93.498 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions Material Weakness and Material Noncompliance Criteria: The Department of Health and Human Services provided terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions. Those terms and conditions outlined the usages of the PRF distributions received, specifically related to expenses. PRF distributions should only be used to prevent, prepare for, and response to the coronavirus that have not been reimbursed from other sources or that other sources are not obligated to reimburse. Management should have effectively designed controls to prevent, or detect and correct, noncompliance related to the usage of PRF distributions. Condition: The System’s internal control over Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions resulted in ineligible costs reported on the Department of Health and Human Services PRF portal submission for Princeton Community Hospital. Cause: Lack of effectively designed and implemented controls, including oversight and detail review of expenditures submitted through the Department of Health and Human Services PRF portal. Effect: The System overstated supplies and payroll expenses submitted through the Department of Health and Human Services PRF portal for Princeton Community Hospital. Questioned Costs: Unknown. Context: Expenses included in the portal submission for Princeton Community Hospital were sampled and policies for these expenses were obtained. Of the population, supplies and payroll expenses entered into the PRF portal were found to not follow the terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions as they were not able to be directly tied to COVID-19. Identification as a Repeat Finding: N/A Recommendation: Effective controls over compliance should be implemented to ensure expenditures submitted through the Department of Health and Human Services PRF portal meet the criteria established in the terms and conditions. Views of Responsible Officials: See corrective action plan.