Audit 37762

FY End
2022-06-30
Total Expended
$10.46M
Findings
2
Programs
3
Organization: Mercy Hospital Iowa City, Ia (IA)
Year: 2022 Accepted: 2023-03-28

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
37163 2022-002 Significant Deficiency Yes Activities Allowed/Unallowed
613605 2022-002 Significant Deficiency Yes Activities Allowed/Unallowed

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $10.16M Yes 1
21.019 Coronavirus Relief Fund $291,127 - 0
93.461 Covid-19 Testing for the Uninsured $7,580 - 0

Contacts

Name Title Type
CB7ANBL9CFK5 Stuart Elkin Auditee
3193390300 Judith Dockendorf Auditor
No contacts on file

Notes to SEFA

Title: PROVIDER RELIEF FUND Accounting Policies: Basis of Presentation: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Mercy Iowa City and Subsidiaries (Mercy) 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 Mercy, it is not intended to and does not present the financial position, changes in net assets or cash flows of Mercy. Summary of Significant 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. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The Schedule includes payments from the Department of Health and Human Services for the Provider Relief Fund of the following entities: Mercy Hospital, Iowa City, Iowa - Tax Identification Number 42-0680391; Mercy Services Iowa City, Inc. - Tax Identification Number 42-1241044.

Finding Details

Finding No. 2022-002 Allowable Activities and Reporting Significant Deficiency in Internal Controls over Compliance Federal Program: Federal Financial Assistance Listing #93.498 US Department of Health and Human Services COVID-19 Provider Relief Fund Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) require funds received to be used to prevent, prepare for, and respond to coronavirus and that the payment shall reimburse the recipient only for health care related expenses and lost revenues that are attributable to the coronavirus. Condition: During the process of identifying expenses that were incurred to prevent, prepare for, or respond to the coronavirus pandemic, management included certain expense amounts that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic in the PRF submission. Cause: Management inadvertently included certain expenses as part of the Period 2 PRF Reporting Portal submission that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic as a result of an insufficient review of reported expenses. Effect: Management included expenses in the PRF Reporting Portal which were not allowable based on the terms and conditions of the PRF award. Questioned costs: Total questions costs amounted to $158,832 and were calculated based off expenses that were reported in the PRF Reporting Portal that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic. Context: During the audit, management identified costs related to two vendors in the amount of $41,805 and we identified one invoice out of 60 testing samples, of $117,027, that were reported in the PRF Reporting Portal submission and could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic. Repeat finding: Yes Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that allowable costs included in the amount expended as reported in the PRF Reporting Portal are sufficiently reviewed to determine those expenses relate to those incurred to prevent, prepare for, or respond to the coronavirus pandemic. View of Responsible Official and Planned Corrective Action: Management agrees with the finding noted. However, Mercy also incurred and reported sufficient lost revenues in the PRF Reporting Portal that if the noted expenses were not to be reported, Mercy would have satisfactorily incurred eligible expenses and lost revenues in excess of the PRF funds received, including interest earned on such funds. See Corrective Action Plan.
Finding No. 2022-002 Allowable Activities and Reporting Significant Deficiency in Internal Controls over Compliance Federal Program: Federal Financial Assistance Listing #93.498 US Department of Health and Human Services COVID-19 Provider Relief Fund Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) require funds received to be used to prevent, prepare for, and respond to coronavirus and that the payment shall reimburse the recipient only for health care related expenses and lost revenues that are attributable to the coronavirus. Condition: During the process of identifying expenses that were incurred to prevent, prepare for, or respond to the coronavirus pandemic, management included certain expense amounts that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic in the PRF submission. Cause: Management inadvertently included certain expenses as part of the Period 2 PRF Reporting Portal submission that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic as a result of an insufficient review of reported expenses. Effect: Management included expenses in the PRF Reporting Portal which were not allowable based on the terms and conditions of the PRF award. Questioned costs: Total questions costs amounted to $158,832 and were calculated based off expenses that were reported in the PRF Reporting Portal that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic. Context: During the audit, management identified costs related to two vendors in the amount of $41,805 and we identified one invoice out of 60 testing samples, of $117,027, that were reported in the PRF Reporting Portal submission and could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic. Repeat finding: Yes Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that allowable costs included in the amount expended as reported in the PRF Reporting Portal are sufficiently reviewed to determine those expenses relate to those incurred to prevent, prepare for, or respond to the coronavirus pandemic. View of Responsible Official and Planned Corrective Action: Management agrees with the finding noted. However, Mercy also incurred and reported sufficient lost revenues in the PRF Reporting Portal that if the noted expenses were not to be reported, Mercy would have satisfactorily incurred eligible expenses and lost revenues in excess of the PRF funds received, including interest earned on such funds. See Corrective Action Plan.