FAC Explorer

Audit 41715

FY End
2022-12-31
Total Expended
$39.37M
Findings
6
Programs
7
Organization: Centra Health, Inc. (VA)
Year: 2022 Accepted: 2023-10-01
Auditor: Bdo USA PC

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
50692 2022-001 Significant Deficiency - N
50693 2022-001 Significant Deficiency - N
50694 2022-002 Significant Deficiency - A
627134 2022-001 Significant Deficiency - N
627135 2022-001 Significant Deficiency - N
627136 2022-002 Significant Deficiency - A

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $36.13M Yes 1
84.268 Federal Direct Student Loans $1.82M Yes 1
84.063 Federal Pell Grant Program $538,897 Yes 1
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $128,046 - 0
93.461 Covid-19 Testing for the Uninsured $89,942 - 0
84.425 Education Stabilization Fund $12,084 - 0
93.398 Cancer Research Manpower $3,250 - 0

Contacts

Name Title Type
HNR1MNZJGYJ1 Doug Davenport Auditee
4342004708 Karen Fitzsimmons Auditor
No contacts on file

Notes to SEFA

Title: Subrecipients Accounting Policies: Note 1. Basis of Presentation: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Centra Health, Inc. and Subsidiaries (Centra), under programs of the federal government for the year ended December 31, 2022.The Schedule of Centra includes the following legal entities: Entity Tax Identification Number (TIN): Centra Medical Group 20-3639329; Centra Specialty Hospital 20-4712023; Centra Outpatient Rehabilitations services 47-1052716; Southside Community Hospital 54-0555201; Bedford Memorial Hospital 54-0566100; Centra Health, Inc. 54-0715569. 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 Centra, it is not intended to and does not present the financial position, changes in net assets, or cash flows of Centra. Note 2. 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. HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured (Uninsured Program) The expenditures reported for the Uninsured Program on the Schedule represent reimbursements of claims for allowable patient services and are included in Net patient service revenue in the Combined Statement of Revenues, Expenses, and Changes in Net Position. Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution (PRF Program) The Provider Relief Fund program amount on the Schedule includes $25,180,057 of lost revenue and $10,947,898 of expenditures, out of which $437,004 are out-of-period expenditures which are reported in accordance with the terms and conditions included in the U.S. Department of Health and Human Services (HHS) Post-Payment Notice of Reporting Requirements specific to the Provider Relief Fund program. De Minimis Rate Used: N Rate Explanation: Centra has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Centra did not provide federal awards to subrecipients for the year ended December 31, 2022.
Title: Federal Student Loan Programs Accounting Policies: Note 1. Basis of Presentation: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Centra Health, Inc. and Subsidiaries (Centra), under programs of the federal government for the year ended December 31, 2022.The Schedule of Centra includes the following legal entities: Entity Tax Identification Number (TIN): Centra Medical Group 20-3639329; Centra Specialty Hospital 20-4712023; Centra Outpatient Rehabilitations services 47-1052716; Southside Community Hospital 54-0555201; Bedford Memorial Hospital 54-0566100; Centra Health, Inc. 54-0715569. 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 Centra, it is not intended to and does not present the financial position, changes in net assets, or cash flows of Centra. Note 2. 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. HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured (Uninsured Program) The expenditures reported for the Uninsured Program on the Schedule represent reimbursements of claims for allowable patient services and are included in Net patient service revenue in the Combined Statement of Revenues, Expenses, and Changes in Net Position. Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution (PRF Program) The Provider Relief Fund program amount on the Schedule includes $25,180,057 of lost revenue and $10,947,898 of expenditures, out of which $437,004 are out-of-period expenditures which are reported in accordance with the terms and conditions included in the U.S. Department of Health and Human Services (HHS) Post-Payment Notice of Reporting Requirements specific to the Provider Relief Fund program. De Minimis Rate Used: N Rate Explanation: Centra has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Centra participates in the Federal Direct Loan Program (ALN: 84.268) (the Program), which includes the Federal Direct Subsidized Loan Program, the Federal Direct Unsubsidized Loan Program, and the Federal Direct PLUS Program. The Program requires Centra to request cash from the Department of Education and disburse such funds. Centra is responsible only for the performance of certain administrative functions with respect to the Program, and accordingly, these loans are not included in Centras consolidated financial statements. It is not practicable to determine the balance of loans outstanding to students and former students of the Centra College of Nursing under the Program at December 31, 2022. Loan advances under the Program during the year ended December 31, 2022 have been reflected in the Schedule.
Title: Donated Personal Protective Equipment (Unaudited) Accounting Policies: Note 1. Basis of Presentation: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Centra Health, Inc. and Subsidiaries (Centra), under programs of the federal government for the year ended December 31, 2022.The Schedule of Centra includes the following legal entities: Entity Tax Identification Number (TIN): Centra Medical Group 20-3639329; Centra Specialty Hospital 20-4712023; Centra Outpatient Rehabilitations services 47-1052716; Southside Community Hospital 54-0555201; Bedford Memorial Hospital 54-0566100; Centra Health, Inc. 54-0715569. 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 Centra, it is not intended to and does not present the financial position, changes in net assets, or cash flows of Centra. Note 2. 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. HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured (Uninsured Program) The expenditures reported for the Uninsured Program on the Schedule represent reimbursements of claims for allowable patient services and are included in Net patient service revenue in the Combined Statement of Revenues, Expenses, and Changes in Net Position. Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution (PRF Program) The Provider Relief Fund program amount on the Schedule includes $25,180,057 of lost revenue and $10,947,898 of expenditures, out of which $437,004 are out-of-period expenditures which are reported in accordance with the terms and conditions included in the U.S. Department of Health and Human Services (HHS) Post-Payment Notice of Reporting Requirements specific to the Provider Relief Fund program. De Minimis Rate Used: N Rate Explanation: Centra has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. During the year ended December 31, 2022, Centra did not receive any personal protective equipment.

Finding Details

Finding 2022-001
2022-001 ? Special tests and provisions Information on Federal Program(s) - Federal Pell Grant (ALN: 84.063); Federal Direct Loans (ALN: 84.268) Criteria or Specific Requirement ? The Gramm-Leach-Bliley Act requires financial institutions to explain their information-sharing practices to their customers and to safeguard sensitive data (16 CFR 314). The Federal Trade Commission considers Title IV-eligible institutions that participate in Title IV Educational Assistance Programs as ?financial institutions? and subject to the Gramm-Leach-Bliley Act because they appear to be significantly engaged in wiring funds to consumers. Under an institution?s Program Participation Agreement with the ED and the Gramm-Leach-Bliley Act, institutions must protect student financial aid information, with particular attention to information provided to institutions by ED or otherwise obtained in support of the administration of the federal student financial aid programs. Accordingly, the Gramm-Leach-Bliley Act of the Special tests and provisions (N) compliance requirement states that the institution must designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Condition ? During our review of the special tests and provisions (N) compliance requirement, we noted that Centra did not perform the Gramm-Leach-Bliley Act risk assessment during the year under audit and therefore was not in compliance with the requirement. Cause ? Insufficient internal controls and administrative oversight with respect to the Special tests and provisions (N) compliance requirement. Effect or Potential Effect ? Centra is not in compliance with the Gramm-Leach-Bliley Act requirement for the year ended December 31, 2022. Questioned Costs ? None. Context ? Centra did not perform the Gramm-Leach-Bliley Act risk assessment for the year under audit. Recommendation - We recommend that Centra maintain appropriate internal controls and administrative oversight in order to comply with the special tests and provisions (N) compliance requirement and to designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Views of Responsible Officials ? Centra management agrees with this finding. While Centra had information security measures in place during the 2022 audit year, Centra was not aware of the specific GLBA requirements and did not complete the required risk assessment or have a designated individual responsible for coordinating the assessment. Centra has taken measures to ensure compliance going forward.
Finding 2022-001
2022-001 ? Special tests and provisions Information on Federal Program(s) - Federal Pell Grant (ALN: 84.063); Federal Direct Loans (ALN: 84.268) Criteria or Specific Requirement ? The Gramm-Leach-Bliley Act requires financial institutions to explain their information-sharing practices to their customers and to safeguard sensitive data (16 CFR 314). The Federal Trade Commission considers Title IV-eligible institutions that participate in Title IV Educational Assistance Programs as ?financial institutions? and subject to the Gramm-Leach-Bliley Act because they appear to be significantly engaged in wiring funds to consumers. Under an institution?s Program Participation Agreement with the ED and the Gramm-Leach-Bliley Act, institutions must protect student financial aid information, with particular attention to information provided to institutions by ED or otherwise obtained in support of the administration of the federal student financial aid programs. Accordingly, the Gramm-Leach-Bliley Act of the Special tests and provisions (N) compliance requirement states that the institution must designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Condition ? During our review of the special tests and provisions (N) compliance requirement, we noted that Centra did not perform the Gramm-Leach-Bliley Act risk assessment during the year under audit and therefore was not in compliance with the requirement. Cause ? Insufficient internal controls and administrative oversight with respect to the Special tests and provisions (N) compliance requirement. Effect or Potential Effect ? Centra is not in compliance with the Gramm-Leach-Bliley Act requirement for the year ended December 31, 2022. Questioned Costs ? None. Context ? Centra did not perform the Gramm-Leach-Bliley Act risk assessment for the year under audit. Recommendation - We recommend that Centra maintain appropriate internal controls and administrative oversight in order to comply with the special tests and provisions (N) compliance requirement and to designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Views of Responsible Officials ? Centra management agrees with this finding. While Centra had information security measures in place during the 2022 audit year, Centra was not aware of the specific GLBA requirements and did not complete the required risk assessment or have a designated individual responsible for coordinating the assessment. Centra has taken measures to ensure compliance going forward.
Finding 2022-002
2022-002 ? Activities Allowed or Unallowed Information on Federal Program(s) - Provider Relief Fund and American Rescue Plan Rural Distribution (ALN: 93.498) Criteria or Specific Requirement ? The activities allowed or unallowed (A) compliance requirements of the program states that funds shall be available for building or construction of temporary structures, leasing of properties, medical supplies and equipment, including personal protective equipment and testing. Condition ? During our testing of the controls over and compliance with activities allowed or unallowed (A) by the program, we noted three instances of documentation that did not support the allowablility of the activity expensed to the program. Cause ? Controls as designed failed due to inadequate education of the respective control owner over proper execution of the control activity. Effect or Potential Effect ? Inappropriate execution of controls can result in expenses charged to the program that are for unallowable activities. Questioned Costs ? None. Context ? For three of 60 expenses selected for tests of controls and compliance, two items were found to be miscoded and for expenses that represent unallowable activities, and one item lacked complete supporting documentation of the allowable activity. Recommendation - We recommend that Centra continue to provide additional and ongoing education related to the specific requirements of the federal award programs and proper execution of related control activities. Views of Responsible Officials ? Centra management agrees with this recommendation. While Centra provides education on proper coding of expenses, human error can occur. Current internal controls are focused around compliance to Centra?s spend policy and authority limits. While human error is difficult to detect, management can work to prevent future errors by enhancing training materials and providing ongoing education to staff.
Finding 2022-001
2022-001 ? Special tests and provisions Information on Federal Program(s) - Federal Pell Grant (ALN: 84.063); Federal Direct Loans (ALN: 84.268) Criteria or Specific Requirement ? The Gramm-Leach-Bliley Act requires financial institutions to explain their information-sharing practices to their customers and to safeguard sensitive data (16 CFR 314). The Federal Trade Commission considers Title IV-eligible institutions that participate in Title IV Educational Assistance Programs as ?financial institutions? and subject to the Gramm-Leach-Bliley Act because they appear to be significantly engaged in wiring funds to consumers. Under an institution?s Program Participation Agreement with the ED and the Gramm-Leach-Bliley Act, institutions must protect student financial aid information, with particular attention to information provided to institutions by ED or otherwise obtained in support of the administration of the federal student financial aid programs. Accordingly, the Gramm-Leach-Bliley Act of the Special tests and provisions (N) compliance requirement states that the institution must designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Condition ? During our review of the special tests and provisions (N) compliance requirement, we noted that Centra did not perform the Gramm-Leach-Bliley Act risk assessment during the year under audit and therefore was not in compliance with the requirement. Cause ? Insufficient internal controls and administrative oversight with respect to the Special tests and provisions (N) compliance requirement. Effect or Potential Effect ? Centra is not in compliance with the Gramm-Leach-Bliley Act requirement for the year ended December 31, 2022. Questioned Costs ? None. Context ? Centra did not perform the Gramm-Leach-Bliley Act risk assessment for the year under audit. Recommendation - We recommend that Centra maintain appropriate internal controls and administrative oversight in order to comply with the special tests and provisions (N) compliance requirement and to designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Views of Responsible Officials ? Centra management agrees with this finding. While Centra had information security measures in place during the 2022 audit year, Centra was not aware of the specific GLBA requirements and did not complete the required risk assessment or have a designated individual responsible for coordinating the assessment. Centra has taken measures to ensure compliance going forward.
Finding 2022-001
2022-001 ? Special tests and provisions Information on Federal Program(s) - Federal Pell Grant (ALN: 84.063); Federal Direct Loans (ALN: 84.268) Criteria or Specific Requirement ? The Gramm-Leach-Bliley Act requires financial institutions to explain their information-sharing practices to their customers and to safeguard sensitive data (16 CFR 314). The Federal Trade Commission considers Title IV-eligible institutions that participate in Title IV Educational Assistance Programs as ?financial institutions? and subject to the Gramm-Leach-Bliley Act because they appear to be significantly engaged in wiring funds to consumers. Under an institution?s Program Participation Agreement with the ED and the Gramm-Leach-Bliley Act, institutions must protect student financial aid information, with particular attention to information provided to institutions by ED or otherwise obtained in support of the administration of the federal student financial aid programs. Accordingly, the Gramm-Leach-Bliley Act of the Special tests and provisions (N) compliance requirement states that the institution must designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Condition ? During our review of the special tests and provisions (N) compliance requirement, we noted that Centra did not perform the Gramm-Leach-Bliley Act risk assessment during the year under audit and therefore was not in compliance with the requirement. Cause ? Insufficient internal controls and administrative oversight with respect to the Special tests and provisions (N) compliance requirement. Effect or Potential Effect ? Centra is not in compliance with the Gramm-Leach-Bliley Act requirement for the year ended December 31, 2022. Questioned Costs ? None. Context ? Centra did not perform the Gramm-Leach-Bliley Act risk assessment for the year under audit. Recommendation - We recommend that Centra maintain appropriate internal controls and administrative oversight in order to comply with the special tests and provisions (N) compliance requirement and to designate an employee or employees to coordinate the information security program, perform a risk assessment that addresses the three required areas noted in 16 CFR 314.4 (b), and document safeguards for identified risks. Views of Responsible Officials ? Centra management agrees with this finding. While Centra had information security measures in place during the 2022 audit year, Centra was not aware of the specific GLBA requirements and did not complete the required risk assessment or have a designated individual responsible for coordinating the assessment. Centra has taken measures to ensure compliance going forward.
Finding 2022-002
2022-002 ? Activities Allowed or Unallowed Information on Federal Program(s) - Provider Relief Fund and American Rescue Plan Rural Distribution (ALN: 93.498) Criteria or Specific Requirement ? The activities allowed or unallowed (A) compliance requirements of the program states that funds shall be available for building or construction of temporary structures, leasing of properties, medical supplies and equipment, including personal protective equipment and testing. Condition ? During our testing of the controls over and compliance with activities allowed or unallowed (A) by the program, we noted three instances of documentation that did not support the allowablility of the activity expensed to the program. Cause ? Controls as designed failed due to inadequate education of the respective control owner over proper execution of the control activity. Effect or Potential Effect ? Inappropriate execution of controls can result in expenses charged to the program that are for unallowable activities. Questioned Costs ? None. Context ? For three of 60 expenses selected for tests of controls and compliance, two items were found to be miscoded and for expenses that represent unallowable activities, and one item lacked complete supporting documentation of the allowable activity. Recommendation - We recommend that Centra continue to provide additional and ongoing education related to the specific requirements of the federal award programs and proper execution of related control activities. Views of Responsible Officials ? Centra management agrees with this recommendation. While Centra provides education on proper coding of expenses, human error can occur. Current internal controls are focused around compliance to Centra?s spend policy and authority limits. While human error is difficult to detect, management can work to prevent future errors by enhancing training materials and providing ongoing education to staff.