FAC Explorer

Audit 324409

FY End
2023-12-31
Total Expended
$10.56M
Findings
8
Programs
2
Organization: Eger Health Care and Rehabilitation Center Fha 012-10056 (NY)
Year: 2023 Accepted: 2024-10-10
Auditor: Pkf O'Connor Davies LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
502368 2023-001 Significant Deficiency - A
502369 2023-002 Significant Deficiency - L
502370 2023-003 Significant Deficiency - L
502371 2023-002 Significant Deficiency - L
1078810 2023-001 Significant Deficiency - A
1078811 2023-002 Significant Deficiency - L
1078812 2023-003 Significant Deficiency - L
1078813 2023-002 Significant Deficiency - L

Programs

ALN Program Spent Major Findings
14.129 Mortgage Insurance Nursing Homes, Intermediate Care Facilities, Board and Care Homes and Assisted Living Facilities $10.15M Yes 1
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $416,964 Yes 3

Contacts

Name Title Type
R1UJKSNN8PS7 Annmarie Covone Auditee
6466334702 Yossi Messafi Auditor
No contacts on file

Notes to SEFA

Title: NOTE 1 - Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10-percent de-minimus indirect cost rate allowable under the Uniform Guidance. The Schedule of Expenditures of Federal Awards (the “Schedule”) includes the federal award activity of Eger Health Care and Rehabilitation Center (the “Center”) under programs of the federal government for the year ended December 31, 2023. 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 Center, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Center.
Title: NOTE 3 - Non-Cash Awards Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10-percent de-minimus indirect cost rate allowable under the Uniform Guidance. The Center’s Schedule of Expenditures of Federal Awards consists of a HUD-insured loan which is classified as a Non-Cash Award (“Non-Cash Award”). The basis used to determine the value of the Non-Cash Award is equal to the value of the beginning balance (January 1, 2023) of the HUD loan. The balance of the HUD loan at December 31, 2023 is $9,680,767.
Title: NOTE 4 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10-percent de-minimus indirect cost rate allowable under the Uniform Guidance. For the awards from the Department of Health and Human Services (“HHS”) related to the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (“PRF”) program, HHS has indicated that the amounts on the Schedule should be reported in accordance with the reporting requirements of the Health Resources and Service Administration (“HRSA”) PRF Reporting Portal. Payments from 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 receiving PRF are required to report in the HRSA PRF Reporting Portal after each Period's deadline (i.e., after the end of the Period of Availability). The Schedule includes all Period 5 PRF payments received between January 1, 2022 and June 30, 2022 reported by the Center to HRSA in the PRF Reporting Portal totaling $416,964. The Center recognized PRF revenue for the year ended December 31, 2022 of $416,964 in the financial statement line item provider relief funds, net in the 2022 statements of operations and changes in net deficit.
Title: NOTE 5 - Personal Protective Equipment (“PPE”) (Unaudited) Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10-percent de-minimus indirect cost rate allowable under the Uniform Guidance. The Center did not receive donated PPE from a federal source during the year ended December 31, 2023.

Finding Details

Finding 2023-001
Finding 2023-001: Allowable Cost/Cost Principles – Unsupported PRF expenses Federal Agencies U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement Guidance provided by the Health Resources & Services Administration (“HRSA”) for the PRF program requires Providers to maintain supporting documentation which demonstrates that costs which incurred during the Period of Availability and to ensure that adequate documentation is maintained. Condition The Center reported healthcare related expenses of $219,968 in the PRF Period 5 report. Of these costs, management could not locate supporting documentation for $73,127 of expenses. Therefore, total reported costs reported exceeded supported expenses by $73,127 which are considered to be unallowable costs. Cause Due to changes in management personnel, invoices supporting $73,127 in healthcare related expenses submitted for PRF could not be located by the new management team. Effect Although the Center reported expenses that are deemed to be unallowable costs, management also reported lost revenues that exceeded amounts provided by HRSA during PRF reporting period 5 and prior that can be used to replace the unallowable costs. Questioned Costs None Context We requested a listing of healthcare related expenses which were used to prepare the Period 5 submission. Management disclosed that they could not locate support for $73,127 of costs on the submission. We have tested remaining expenses without exceptions. Identification of a repeat finding No Recommendation Management should contact HRSA and amend their PRF reporting to replace $73,127 of healthcare related costs with excess lost revenue. Views of responsible officials See corrective action plan
Finding 2023-002
Finding 2023-002: Late filing Federal Agencies U.S. Department of Housing and Urban Development U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) Mortgage Insurance Nursing Homes, Intermediate Care Facilities, Board and Care Homes and Assisted Living Facilities (14.129) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement The Uniform Guidance and HUD requires the single audit to be filed at the earliest of 9 months or prior of year end or 30 days after issuance of the Uniform Guidance audit report. Condition Uniform Grant Guidance Financial statements were issued after the Uniform Guidance and HUD’s reporting requirement. Cause Due to changes in management and limited staffing, management was unable to locate all supporting documentation for the single audit testing timely. Accordingly the financial statement audit was completed after the 9-month reporting requirement. Effect Financial statement issuance was not in compliance with the Uniform Guidance and HUD’s reporting requirements. Questioned Costs None Context We requested certain documents to support our account analyses and testing. Due to a change in management of the Center, certain documents requested were either missing or could not be located timely by current management that led to a delay in issuing the financial statements within the required time frame. Identification of a repeat finding No   Recommendation We recommend that all required audit schedules be completed in sufficient time to allow for completion of the single audit in sufficient time. Views of responsible officials See corrective action plan
Finding 2023-003
Finding 2023-003: Incorrect Reporting of Lost Revenue Federal Agencies U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement Lost revenue is required to be reported in the PRF reporting portal in accordance with one of the three methodologies included in the compliance supplement. Condition Management elected to report actual lost revenue in their PRF Period 5 submission, however lost revenue does not agree to management’s underlying general ledger or audited financial statements and could not be reconciled to reported amounts for all reporting periods from 2019 through June 30, 2023. Cause Due to changes in management and limited staffing, current management was unable to locate the reconciliations used to report lost revenue in the PRF Period 5 submission. Effect Although the Center reported lost revenue of $22,678,671, actual lost revenue per the Center’s general ledger and audited financial statements should have been $26,521,238. Accordingly, management understated lost revenue by $3,842,567. Questioned Costs None Context The Center’s changes in management personnel led to current management's inability to locate any reconciling items that may have been used by the predecessor management team in reporting period 5 lost revenues. Identification of a repeat finding No   Recommendation Management should contact HRSA for permission to amend their PRF Period 5 submission. Views of responsible officials See corrective action plan
Finding 2023-002
Finding 2023-002: Late filing Federal Agencies U.S. Department of Housing and Urban Development U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) Mortgage Insurance Nursing Homes, Intermediate Care Facilities, Board and Care Homes and Assisted Living Facilities (14.129) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement The Uniform Guidance and HUD requires the single audit to be filed at the earliest of 9 months or prior of year end or 30 days after issuance of the Uniform Guidance audit report. Condition Uniform Grant Guidance Financial statements were issued after the Uniform Guidance and HUD’s reporting requirement. Cause Due to changes in management and limited staffing, management was unable to locate all supporting documentation for the single audit testing timely. Accordingly the financial statement audit was completed after the 9-month reporting requirement. Effect Financial statement issuance was not in compliance with the Uniform Guidance and HUD’s reporting requirements. Questioned Costs None Context We requested certain documents to support our account analyses and testing. Due to a change in management of the Center, certain documents requested were either missing or could not be located timely by current management that led to a delay in issuing the financial statements within the required time frame. Identification of a repeat finding No   Recommendation We recommend that all required audit schedules be completed in sufficient time to allow for completion of the single audit in sufficient time. Views of responsible officials See corrective action plan
Finding 2023-001
Finding 2023-001: Allowable Cost/Cost Principles – Unsupported PRF expenses Federal Agencies U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement Guidance provided by the Health Resources & Services Administration (“HRSA”) for the PRF program requires Providers to maintain supporting documentation which demonstrates that costs which incurred during the Period of Availability and to ensure that adequate documentation is maintained. Condition The Center reported healthcare related expenses of $219,968 in the PRF Period 5 report. Of these costs, management could not locate supporting documentation for $73,127 of expenses. Therefore, total reported costs reported exceeded supported expenses by $73,127 which are considered to be unallowable costs. Cause Due to changes in management personnel, invoices supporting $73,127 in healthcare related expenses submitted for PRF could not be located by the new management team. Effect Although the Center reported expenses that are deemed to be unallowable costs, management also reported lost revenues that exceeded amounts provided by HRSA during PRF reporting period 5 and prior that can be used to replace the unallowable costs. Questioned Costs None Context We requested a listing of healthcare related expenses which were used to prepare the Period 5 submission. Management disclosed that they could not locate support for $73,127 of costs on the submission. We have tested remaining expenses without exceptions. Identification of a repeat finding No Recommendation Management should contact HRSA and amend their PRF reporting to replace $73,127 of healthcare related costs with excess lost revenue. Views of responsible officials See corrective action plan
Finding 2023-002
Finding 2023-002: Late filing Federal Agencies U.S. Department of Housing and Urban Development U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) Mortgage Insurance Nursing Homes, Intermediate Care Facilities, Board and Care Homes and Assisted Living Facilities (14.129) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement The Uniform Guidance and HUD requires the single audit to be filed at the earliest of 9 months or prior of year end or 30 days after issuance of the Uniform Guidance audit report. Condition Uniform Grant Guidance Financial statements were issued after the Uniform Guidance and HUD’s reporting requirement. Cause Due to changes in management and limited staffing, management was unable to locate all supporting documentation for the single audit testing timely. Accordingly the financial statement audit was completed after the 9-month reporting requirement. Effect Financial statement issuance was not in compliance with the Uniform Guidance and HUD’s reporting requirements. Questioned Costs None Context We requested certain documents to support our account analyses and testing. Due to a change in management of the Center, certain documents requested were either missing or could not be located timely by current management that led to a delay in issuing the financial statements within the required time frame. Identification of a repeat finding No   Recommendation We recommend that all required audit schedules be completed in sufficient time to allow for completion of the single audit in sufficient time. Views of responsible officials See corrective action plan
Finding 2023-003
Finding 2023-003: Incorrect Reporting of Lost Revenue Federal Agencies U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement Lost revenue is required to be reported in the PRF reporting portal in accordance with one of the three methodologies included in the compliance supplement. Condition Management elected to report actual lost revenue in their PRF Period 5 submission, however lost revenue does not agree to management’s underlying general ledger or audited financial statements and could not be reconciled to reported amounts for all reporting periods from 2019 through June 30, 2023. Cause Due to changes in management and limited staffing, current management was unable to locate the reconciliations used to report lost revenue in the PRF Period 5 submission. Effect Although the Center reported lost revenue of $22,678,671, actual lost revenue per the Center’s general ledger and audited financial statements should have been $26,521,238. Accordingly, management understated lost revenue by $3,842,567. Questioned Costs None Context The Center’s changes in management personnel led to current management's inability to locate any reconciling items that may have been used by the predecessor management team in reporting period 5 lost revenues. Identification of a repeat finding No   Recommendation Management should contact HRSA for permission to amend their PRF Period 5 submission. Views of responsible officials See corrective action plan
Finding 2023-002
Finding 2023-002: Late filing Federal Agencies U.S. Department of Housing and Urban Development U.S. Department of Health and Human Services Program Name (Federal Assistance Listing Number) Mortgage Insurance Nursing Homes, Intermediate Care Facilities, Board and Care Homes and Assisted Living Facilities (14.129) COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (93.498) Criteria or specific requirement The Uniform Guidance and HUD requires the single audit to be filed at the earliest of 9 months or prior of year end or 30 days after issuance of the Uniform Guidance audit report. Condition Uniform Grant Guidance Financial statements were issued after the Uniform Guidance and HUD’s reporting requirement. Cause Due to changes in management and limited staffing, management was unable to locate all supporting documentation for the single audit testing timely. Accordingly the financial statement audit was completed after the 9-month reporting requirement. Effect Financial statement issuance was not in compliance with the Uniform Guidance and HUD’s reporting requirements. Questioned Costs None Context We requested certain documents to support our account analyses and testing. Due to a change in management of the Center, certain documents requested were either missing or could not be located timely by current management that led to a delay in issuing the financial statements within the required time frame. Identification of a repeat finding No   Recommendation We recommend that all required audit schedules be completed in sufficient time to allow for completion of the single audit in sufficient time. Views of responsible officials See corrective action plan