FAC Explorer

Audit 40855

FY End
2022-06-30
Total Expended
$13.02M
Findings
4
Programs
6
Organization: Total Health Care, Inc. (MD)
Year: 2022 Accepted: 2023-03-30
Auditor: Forvis LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
46089 2022-002 Material Weakness Yes L
46090 2022-003 Material Weakness - ABL
622531 2022-002 Material Weakness Yes L
622532 2022-003 Material Weakness - ABL

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $5.66M Yes 0
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $3.98M Yes 0
93.498 Provider Relief Fund $1.07M Yes 2
93.914 Hiv Emergency Relief Project Grants $254,496 - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $111,169 - 0
93.461 Covid-19 Testing for the Uninsured $111 - 0

Contacts

Name Title Type
SMHWA39LDFV9 Richard Greene Auditee
4143833104 Justin Kensinger Auditor
No contacts on file

Notes to SEFA

Title: Federal Loan Programs 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. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Total Health Care, Inc. did not have any federal loan programs during the year ended June 30, 2022.
Title: Donated 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. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Total Health Care, Inc. did not receive any donated Personal Protective Equipment (PPE) from a federal source during the year ended June 30, 2022.
Title: 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. Negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Total Health Care, Inc. 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 Total Health Care, Inc., it is not intended to and does not present the financial position, results of operations, changes in net assets, or cash flows of Total Health Care, Inc.

Finding Details

Finding 2022-002
COVID-19 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 ? Reporting (45 CFR 75.342) Condition ? The Health Center was required to prepare and submit period two provider relief fund (PRF) reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned costs ? None Context ?The period 2 provider relief fund report was tested. The Health Center selected option 1 to report lost revenues based on quarterly actuals. Amounts reported for each quarter were not based on a final audited trial balance. Effect ? Errors were made in reporting quarterly Total Revenue/Net Charges from Patient Care. Lost revenues were not accurately reported. Cause ? Final trial balances amounts were not available timely. Identification as a repeat finding ? Repeat finding- see 2021-002. Recommendation ? The Organization?s policies and procedures in effect at June 30, 2022, did not identify certain necessary adjustments required to present the financial statements in accordance with GAAP. Policies and procedures over federal grant reporting should be modified to ensure reports are prepared and report complete and accurate information timely.
Finding 2022-003
COVID-19 Provider Relief Fund and American Rescue (ARP) Rural Distribution CFDA No. 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116- 136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) and Reporting (45 CFR 75.342) Condition ? Tuerk House, Inc. (THI) was required to file a Period 2 and Period 3 Provider Relief Fund (PRF) reports during the year; however, did not maintain adequate documentation to support the other PRF expenses were attributable to coronavirus and/or had not been or were not eligible to be reimbursed by other sources. Questioned Costs ? $261,607 calculated as the PRF amounts received by the THI and included in Period 2 and Period 3 reporting. Context ? THI was unable to provide adequate documentation to support the other PRF expenses had not been or were not eligible to be reimbursed by other sources. Effect ? THI utilized PRF payments received on expenses that were not documented as attributable to coronavirus, were potentially reimbursed by other sources, and/or were not allowable in accordance with other guidance issued by HHS. Cause ? Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution is a new program with complex and evolving regulations and compliance requirements. Internal controls were not in place to ensure the THI correctly applied the guidance. Identification as a repeat finding ? Not a repeat finding Recommendation ? Policies and procedures over allowable activities and federal grant reporting should be modified to ensure expenditures charged to grants are for activities allowed and federal grant reports are prepared using complete and accurate information.
Finding 2022-002
COVID-19 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 ? Reporting (45 CFR 75.342) Condition ? The Health Center was required to prepare and submit period two provider relief fund (PRF) reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned costs ? None Context ?The period 2 provider relief fund report was tested. The Health Center selected option 1 to report lost revenues based on quarterly actuals. Amounts reported for each quarter were not based on a final audited trial balance. Effect ? Errors were made in reporting quarterly Total Revenue/Net Charges from Patient Care. Lost revenues were not accurately reported. Cause ? Final trial balances amounts were not available timely. Identification as a repeat finding ? Repeat finding- see 2021-002. Recommendation ? The Organization?s policies and procedures in effect at June 30, 2022, did not identify certain necessary adjustments required to present the financial statements in accordance with GAAP. Policies and procedures over federal grant reporting should be modified to ensure reports are prepared and report complete and accurate information timely.
Finding 2022-003
COVID-19 Provider Relief Fund and American Rescue (ARP) Rural Distribution CFDA No. 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116- 136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) and Reporting (45 CFR 75.342) Condition ? Tuerk House, Inc. (THI) was required to file a Period 2 and Period 3 Provider Relief Fund (PRF) reports during the year; however, did not maintain adequate documentation to support the other PRF expenses were attributable to coronavirus and/or had not been or were not eligible to be reimbursed by other sources. Questioned Costs ? $261,607 calculated as the PRF amounts received by the THI and included in Period 2 and Period 3 reporting. Context ? THI was unable to provide adequate documentation to support the other PRF expenses had not been or were not eligible to be reimbursed by other sources. Effect ? THI utilized PRF payments received on expenses that were not documented as attributable to coronavirus, were potentially reimbursed by other sources, and/or were not allowable in accordance with other guidance issued by HHS. Cause ? Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution is a new program with complex and evolving regulations and compliance requirements. Internal controls were not in place to ensure the THI correctly applied the guidance. Identification as a repeat finding ? Not a repeat finding Recommendation ? Policies and procedures over allowable activities and federal grant reporting should be modified to ensure expenditures charged to grants are for activities allowed and federal grant reports are prepared using complete and accurate information.