Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: The District’s internal control structure should ensure that patients whom have filled out a sliding scale fee application were charged the appropriate rate.
Condition: During the audit, it was identified one patient out of twenty-five tested was charged an inappropriate amount when compared to the sliding fee scale application filled out. The patient was accurately determined to be a full discount eligible, self-pay patient. While reviewing the invoice billed to the patient, it was determined that all charge codes except the coronavirus lab test fee were fully discounted appropriately. After noting that one incident, an additional seven patients who were billed with the coronavirus charge code were reviewed. All of the seven patients reviewed, of varying discount eligibility, were noted to have been fully charged for the coronavirus lab fee.
Cause: The coronavirus lab test code was manually overwritten to exempt the sliding fee scale eligibility determination due to a previous grant covering the fee. The grant that covered this expense for self pay patients had lapsed and the manual override was not removed.
Effect: Self pay patients of varying discount eligibility were fully charged for the coronavirus lab test.
Recommendation: We recommend that the District review invoices for self-pay patients to ensure they are being accurately billed. We also recommend that manual overrides are reviewed periodically.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s leadership is committed to developing processes to ensure all compliance requirements are met.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate.
Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied.
Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items.
Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled.
Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.
Criteria: Monthly, the District is required to request funds in the form of a draw down from Health Resources & Services Administration online. The District’s internal control structure should ensure that draw down support is complete, accurate, and made available in a timely and orderly manner.
Condition: During the audit, it was identified that two of four draw downs were not supported completely and consistently. The February 2023 draw down support was completely unsubstantiated for the $366,785 requested and received. The November 2022 draw down was substantiated in support; however, approval for the draw down was not noted as being received.
Cause: Previous leadership processes maintained a majority of their draw down support in paper files that were disorganized which created a difficulty in re-producing for substantiation.
Effect: The draw down support for November 2022 and February 2023 was not complete.
Recommendation: We recommend that the District retain all support in regards to draw downs and create a better filing system.
Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District’s new leadership is already in the process of improving the document support, retention, and filing system in order to alleviate missing documents.