FAC Explorer

Audit 328059

FY End
2022-06-30
Total Expended
$2.77M
Findings
2
Programs
5
Organization: Teton County Hospital District (WY)
Year: 2022 Accepted: 2024-11-12
Auditor: Forvis Mazars LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
505379 2022-001 Material Weakness - A
1081821 2022-001 Material Weakness - A

Programs

ALN Program Spent Major Findings
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.03M Yes 0
32.006 Covid-19 Telehealth Program $707,171 - 0
93.461 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $560,154 - 0
93.301 Small Rural Hospital Improvement Grant Program $298,016 - 0
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $177,807 Yes 1

Contacts

Name Title Type
EL8YKMPUCPC8 John Kren Auditee
3034135736 Justine Sime 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 District has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Teton County Hospital District d/b/a St. John’s Health (the District) 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 District, it is not intended to and does not present the financial position, changes in net assets or cash flows of the District.
Title: Note 2: Summary of Significant Accounting Policies 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 District has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. 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.
Title: Note 3: Indirect Cost Rat 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 District has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The District has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance.

Finding Details

Finding 2022-001
2022-001 Finding: Activities Allowed or Unallowed Costs/Cost Principles Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement – Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub.. L. No. 116-139, 134 Stat. 622 and 623) Condition – The District is required to only use funds on costs associated with items and services outlined in the terms and conditions for “Infection Control Expenses” that are not reimbursed by other types of funding. Questioned Costs – $13,839 Context – The District had several staff working on administering COVID-19 tests to residents of the nursing home. As such, the expenditures related to these employee’s time used for testing were estimated using an average of wages for the employees focused on administering the tests and the estimated number of hours each day it took to perform the tests. Additionally, tests were included in allowable expenditures which were reimbursed by third-party payors. Cause – The district controls were not functioning for review of allowable costs. Effect – The auditor was unable to substantiate the estimated amount. Additionally, immaterial amounts of expenditures were reimbursed by multiple parties. Identification as a repeat finding – Not a repeat finding. Recommendation - Policies and procedures over federal grant spending should be modified to ensure support is reviewed and maintained for all expenditures. Views of responsible officials and planned corrective actions – The District agrees with the finding. See separate auditee document for planned correction action.
Finding 2022-001
2022-001 Finding: Activities Allowed or Unallowed Costs/Cost Principles Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement – Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub.. L. No. 116-139, 134 Stat. 622 and 623) Condition – The District is required to only use funds on costs associated with items and services outlined in the terms and conditions for “Infection Control Expenses” that are not reimbursed by other types of funding. Questioned Costs – $13,839 Context – The District had several staff working on administering COVID-19 tests to residents of the nursing home. As such, the expenditures related to these employee’s time used for testing were estimated using an average of wages for the employees focused on administering the tests and the estimated number of hours each day it took to perform the tests. Additionally, tests were included in allowable expenditures which were reimbursed by third-party payors. Cause – The district controls were not functioning for review of allowable costs. Effect – The auditor was unable to substantiate the estimated amount. Additionally, immaterial amounts of expenditures were reimbursed by multiple parties. Identification as a repeat finding – Not a repeat finding. Recommendation - Policies and procedures over federal grant spending should be modified to ensure support is reviewed and maintained for all expenditures. Views of responsible officials and planned corrective actions – The District agrees with the finding. See separate auditee document for planned correction action.