Audit 43216

FY End
2022-09-30
Total Expended
$82.81M
Findings
2
Programs
70
Organization: Care New England Health System (MA)
Year: 2022 Accepted: 2023-03-06

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
51035 2022-001 - - L
627477 2022-001 - - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $37.87M Yes 1
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.40M - 0
21.019 Coronavirus Relief Fund $1.05M - 0
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $711,906 - 0
93.RD Niaid - Contract 75n91010d000024 $554,317 - 0
93.884 Grants for Primary Care Training and Enhancement $524,109 - 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $520,755 - 0
84.371 Striving Readers $516,987 - 0
93.RD Nichd - Contract Hhsn2752018011 $482,362 - 0
84.181 Special Education-Grants for Infants and Families $466,855 - 0
93.650 Accountable Health Communities $449,542 - 0
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $393,486 - 0
93.461 Covid-19 Testing for the Uninsured $308,415 - 0
93.667 Social Services Block Grant $246,501 - 0
14.195 Section 8 Housing Assistance Payments Program $221,490 - 0
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $220,095 - 0
64.024 Va Homeless Providers Grant and Per Diem Program $191,033 - 0
93.889 National Bioterrorism Hospital Preparedness Program $190,000 - 0
12.420 Military Medical Research and Development $176,857 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $170,483 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $163,199 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $160,368 - 0
93.788 Opioid Str $155,062 - 0
93.958 Block Grants for Community Mental Health Services $152,094 - 0
93.866 Aging Research $145,950 - 0
93.859 Biomedical Research and Research Training $130,874 - 0
93.732 Mental and Behavioral Health Education and Training Grants $102,898 - 0
93.969 Pphf Geriatric Education Centers $99,969 - 0
93.393 Cancer Cause and Prevention Research $96,996 - 0
93.865 Child Health and Human Development Extramural Research $92,531 - 0
93.855 Allergy, Immunology and Transplantation Research $89,899 - 0
93.394 Cancer Detection and Diagnosis Research $84,722 - 0
14.157 Supportive Housing for the Elderly $79,803 - 0
14.181 Supportive Housing for Persons with Disabilities $78,176 Yes 0
16.593 Residential Substance Abuse Treatment for State Prisoners $78,057 - 0
93.110 Maternal and Child Health Federal Consolidated Programs $75,067 - 0
93.839 Blood Diseases and Resources Research $66,600 - 0
93.079 Cooperative Agreements to Promote Adolescent Health Through School-Based Hiv/std Prevention and School-Based Surveillance $60,555 - 0
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $45,289 - 0
93.947 Tuberculosis Demonstration, Research, Public and Professional Education $45,169 - 0
64.RD Va Connecticut Healthcare System $39,750 - 0
93.053 Nutrition Services Incentive Program $38,925 - 0
93.213 Research and Training in Complementary and Integrative Health $35,260 - 0
93.044 Special Programs for the Aging_title Iii, Part B_grants for Supportive Services and Senior Centers $30,545 - 0
93.837 Cardiovascular Diseases Research $26,672 - 0
93.279 Drug Abuse and Addiction Research Programs $26,279 - 0
93.334 The Healthy Brain Initiative: Technical Assistance to Implement Public Health Actions Related to Cognitive Health, Cognitive Impairment, and Caregiving at the State and Local Levels $25,418 - 0
10.558 Child and Adult Care Food Program $25,126 - 0
93.310 Trans-Nih Research Support $23,811 - 0
93.361 Nursing Research $23,311 - 0
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $22,792 - 0
93.838 Lung Diseases Research $19,576 - 0
93.242 Mental Health Research Grants $17,567 - 0
14.871 Section 8 Housing Choice Vouchers $15,433 - 0
93.113 Environmental Health $14,272 - 0
10.555 National School Lunch Program $13,246 - 0
93.989 International Research and Research Training $12,942 - 0
14.267 Continuum of Care Program $12,244 - 0
93.586 State Court Improvement Program $10,527 - 0
93.233 National Center on Sleep Disorders Research $9,998 - 0
16.738 Edward Byrne Memorial Justice Assistance Grant Program $9,955 - 0
93.395 Cancer Treatment Research $6,777 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $5,823 - 0
93.994 Maternal and Child Health Services Block Grant to the States $4,829 - 0
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $3,494 - 0
93.RD Niaid - Contract 75n93021c00052 $2,688 - 0
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $2,499 - 0
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $2,154 - 0
93.273 Alcohol Research Programs $491 - 0
17.268 H-1b Job Training Grants $464 - 0

Contacts

Name Title Type
GAPPWM4B92A8 Megan C. Buie Auditee
4014308130 Karen Pfeil Auditor
No contacts on file

Notes to SEFA

Title: Note 3:Funding from the U.S. Department of Housing and Urban Development Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the total consolidated expenditures of Care New England Health System and its affiliates (Care New England) under programs of the federal government for the year ended September 30, 2022. The information presented in the Schedule is presented on the accrual basis of accounting, which is in accordance with the Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Such expenditures are recognized following the cost principles contained in OASC-3, Department of Health and Human Services Principles for Determining Costs Applicable to Research and Development under Grants and Contracts with Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. For purposes of the Schedule, federal awards include all grants, contracts and similar agreements entered directly by Care New England with agencies and departments of the federal government and all subawards to Care New England by nonfederal organizations pursuant to federal grants, contracts and similar agreements. Negative amounts on the Schedule represent adjustments to expenditures reported in the prior year. Because the Schedule presents only the federal award activity of Care New England, it is not intended to and does not present the financial position, changes in net assets and cash flows of Care New England. Assistance listing numbers and pass through numbers are provided when available. De Minimis Rate Used: N Rate Explanation: Indirect costs are charged to certain federal grants and contracts at federally approved predetermined indirect rates. Care New England has thus not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The Providence Center, Inc., whose sole corporate member is Care New England received funding from the U.S. Department of Housing and Urban Development (HUD) in both the current and prior years. The funding has been included in the accompanying schedule of expenditures of federal awards in consideration of the fact that the federal programs from which the funding originates imposes continuing compliance requirements on the use of the properties acquired and rehabilitated for specified periods ranging from 10 to 40 years. Those programs, include the following:Entity Assistance Listing # Capital AdvancesGrandview Second Corporation 14.181 $1,173,200Wilson Street Apartments, Inc. 14.181 1,152,335Wilson Street Apartments, Inc. 14.181 18,465Nashua Street Corporation 14.181 834,200Wilson Street Apartments, Inc. 14.181 78,176Additionally, The Providence Center, Inc. has a mortgage note with HUD on the property thatfollows:Entity Assistance Listing # Amount OutstandingGrandview Realty Corporation 14.157 $43,408
Title: Note 4:CARES Act Provider Relief Funds Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the total consolidated expenditures of Care New England Health System and its affiliates (Care New England) under programs of the federal government for the year ended September 30, 2022. The information presented in the Schedule is presented on the accrual basis of accounting, which is in accordance with the Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Such expenditures are recognized following the cost principles contained in OASC-3, Department of Health and Human Services Principles for Determining Costs Applicable to Research and Development under Grants and Contracts with Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. For purposes of the Schedule, federal awards include all grants, contracts and similar agreements entered directly by Care New England with agencies and departments of the federal government and all subawards to Care New England by nonfederal organizations pursuant to federal grants, contracts and similar agreements. Negative amounts on the Schedule represent adjustments to expenditures reported in the prior year. Because the Schedule presents only the federal award activity of Care New England, it is not intended to and does not present the financial position, changes in net assets and cash flows of Care New England. Assistance listing numbers and pass through numbers are provided when available. De Minimis Rate Used: N Rate Explanation: Indirect costs are charged to certain federal grants and contracts at federally approved predetermined indirect rates. Care New England has thus not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The Schedule includes grant activity related to the Department of Health and Human Services ("HHS") Provider Relief Fund and American Rescue Plan (ARP) Distribution Assistance Listing Number 93.498. As required based on guidance in the 2022 OMB Compliance Supplement, the Schedule includes all funds received between July 1, 2020 and June 30, 2021 and expended by September 30, 2022 as reported to HRSA via the Provider Relief Funding Reporting Portal. During Reporting Period 2 and 3, Care New England received $12,197,349 and $25,734,544, respectively, of reportable Provider Relief Payments, all of which were recognized as revenue in prior Care New England financial statements. Thus, these payments are reconciling items between the federal expenses in the Care New England's financial statements and the amount included on the Schedule.
Title: Note 5: Division of Family Health (WIC) (Assistance Listing #10.557) Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the total consolidated expenditures of Care New England Health System and its affiliates (Care New England) under programs of the federal government for the year ended September 30, 2022. The information presented in the Schedule is presented on the accrual basis of accounting, which is in accordance with the Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Such expenditures are recognized following the cost principles contained in OASC-3, Department of Health and Human Services Principles for Determining Costs Applicable to Research and Development under Grants and Contracts with Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. For purposes of the Schedule, federal awards include all grants, contracts and similar agreements entered directly by Care New England with agencies and departments of the federal government and all subawards to Care New England by nonfederal organizations pursuant to federal grants, contracts and similar agreements. Negative amounts on the Schedule represent adjustments to expenditures reported in the prior year. Because the Schedule presents only the federal award activity of Care New England, it is not intended to and does not present the financial position, changes in net assets and cash flows of Care New England. Assistance listing numbers and pass through numbers are provided when available. De Minimis Rate Used: N Rate Explanation: Indirect costs are charged to certain federal grants and contracts at federally approved predetermined indirect rates. Care New England has thus not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Care New England determines participant eligibility for receipt of food vouchers as part of the Special Supplemental Nutrition Program for the Women, Infants and Children program (Assistance Listing # 10.557). Of the $1,403,209 in expenditures presented in the Schedule, $379,435 represents direct costs incurred by Care New England for this program. The food vouchers for which Care New England determined eligibility for amounted to $1,023,773 for the year ended September 30, 2022.
Title: Note 6: State of Rhode Island Pass-Through Funds for 10.553/10.555 Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the total consolidated expenditures of Care New England Health System and its affiliates (Care New England) under programs of the federal government for the year ended September 30, 2022. The information presented in the Schedule is presented on the accrual basis of accounting, which is in accordance with the Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Such expenditures are recognized following the cost principles contained in OASC-3, Department of Health and Human Services Principles for Determining Costs Applicable to Research and Development under Grants and Contracts with Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. For purposes of the Schedule, federal awards include all grants, contracts and similar agreements entered directly by Care New England with agencies and departments of the federal government and all subawards to Care New England by nonfederal organizations pursuant to federal grants, contracts and similar agreements. Negative amounts on the Schedule represent adjustments to expenditures reported in the prior year. Because the Schedule presents only the federal award activity of Care New England, it is not intended to and does not present the financial position, changes in net assets and cash flows of Care New England. Assistance listing numbers and pass through numbers are provided when available. De Minimis Rate Used: N Rate Explanation: Indirect costs are charged to certain federal grants and contracts at federally approved predetermined indirect rates. Care New England has thus not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Care New England expended $13,246 from the State of Rhode Island for the School Breakfast Program Assistance Listing #10.553/National School Lunch Program Assistance Listing #10.555. The State of Rhode Island did not provide Care New England with any information regarding how the spending should be allocated between the two Assistance Listing numbers. As such, expenditures under this program are commingled on the Schedule.

Finding Details

2022-001: Duplicated expenses reported within the Health Resources & Services Administration (?HRSA?) Provider Relief Fund Portal Program: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Agency: Department of Health and Human Services (?HHS?) Health Resources and Services Administration (?HRSA?) Award Year: 1/1/2020-9/30/2022 Award Number: Not available Criteria Step Four of the Steps on Reporting on Use of Funds section of the June 11, 2021 Provider Relief Fund (?PRF?) General and Targeted Distribution Post-Payment Notice of Reporting Requirements requires recipients to report on expenses paid for with payments received through the General and Targeted Distribution payments. Reporting Entities that received $500,000 or more in aggregated PRF payments during each Payment Received Period are required to report on the use of the General and Other Targeted PRF payments in detailed categories of General and Administrative Expenses and Health Care- Related Expenses, by indicating the quarterly expenses reimbursed with the PRF payments. Condition The System reported total Health Care-Related Expenses of $7,403,539 (by calendar quarters Q1 2020 through Q2 2021) in the PRF Reporting Portal Submission for Period 1. The Care New England Health System (the ?System?) duplicated the reporting of these expenses (by calendar quarters Q1 2020 through Q2 2021) in the PRF Reporting Portal Submission for Period 2 and Period 3. In addition, incremental expenses from PRF Reporting Period 2 were duplicated in Period 3. Cause The System did not interpret the HRSA PRF Reporting instructions correctly, believing each portal filing should include all cumulative expenses claimed. This error was not identified through their review procedures prior to submission.. Effect The duplicate reporting of expenses in the PRF Portal Submission for Period 2 and Period 3 resulted in an incorrect calculation of the Total Reportable Other PRF remaining to be applied to Lost Revenues amount in the PRF Financial Summary section of the PRF Portal Submission for Period 2 and Period 3. The calculated amount of PRF Remaining to be applied to Lost Revenues in the PRF Portal Submission for Period 2 was calculated as $3,665,229 whereas the amount would have been $11,068,758 if the expenses had not been duplicated in the Period 2 PRF Portal Submission Reporting. In Reporting Period 3, the calculated amount of PRF Remaining to be applied to Lost Revenues in the PRF Portal Submission for Period 3 was $15,802,011 where-as the amount would have been $24,334,141 if the expense had not been duplicated in the Period 3 PRF Portal Submission Reporting. Recommendation We recommend the System contact the Health Resources and Services Administrator to determine any required corrective actions related to the incorrect reporting. We also recommend the System enhance their understanding of the reporting requirements and strengthen their review process in place to check for this issue prior to submission of future reports. Management?s Views and Corrective Action Plan Management?s response is included in ?Management?s Views and Corrective Action Plan? included after the Summary Schedule of Prior Audit Findings and Status.
2022-001: Duplicated expenses reported within the Health Resources & Services Administration (?HRSA?) Provider Relief Fund Portal Program: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Agency: Department of Health and Human Services (?HHS?) Health Resources and Services Administration (?HRSA?) Award Year: 1/1/2020-9/30/2022 Award Number: Not available Criteria Step Four of the Steps on Reporting on Use of Funds section of the June 11, 2021 Provider Relief Fund (?PRF?) General and Targeted Distribution Post-Payment Notice of Reporting Requirements requires recipients to report on expenses paid for with payments received through the General and Targeted Distribution payments. Reporting Entities that received $500,000 or more in aggregated PRF payments during each Payment Received Period are required to report on the use of the General and Other Targeted PRF payments in detailed categories of General and Administrative Expenses and Health Care- Related Expenses, by indicating the quarterly expenses reimbursed with the PRF payments. Condition The System reported total Health Care-Related Expenses of $7,403,539 (by calendar quarters Q1 2020 through Q2 2021) in the PRF Reporting Portal Submission for Period 1. The Care New England Health System (the ?System?) duplicated the reporting of these expenses (by calendar quarters Q1 2020 through Q2 2021) in the PRF Reporting Portal Submission for Period 2 and Period 3. In addition, incremental expenses from PRF Reporting Period 2 were duplicated in Period 3. Cause The System did not interpret the HRSA PRF Reporting instructions correctly, believing each portal filing should include all cumulative expenses claimed. This error was not identified through their review procedures prior to submission.. Effect The duplicate reporting of expenses in the PRF Portal Submission for Period 2 and Period 3 resulted in an incorrect calculation of the Total Reportable Other PRF remaining to be applied to Lost Revenues amount in the PRF Financial Summary section of the PRF Portal Submission for Period 2 and Period 3. The calculated amount of PRF Remaining to be applied to Lost Revenues in the PRF Portal Submission for Period 2 was calculated as $3,665,229 whereas the amount would have been $11,068,758 if the expenses had not been duplicated in the Period 2 PRF Portal Submission Reporting. In Reporting Period 3, the calculated amount of PRF Remaining to be applied to Lost Revenues in the PRF Portal Submission for Period 3 was $15,802,011 where-as the amount would have been $24,334,141 if the expense had not been duplicated in the Period 3 PRF Portal Submission Reporting. Recommendation We recommend the System contact the Health Resources and Services Administrator to determine any required corrective actions related to the incorrect reporting. We also recommend the System enhance their understanding of the reporting requirements and strengthen their review process in place to check for this issue prior to submission of future reports. Management?s Views and Corrective Action Plan Management?s response is included in ?Management?s Views and Corrective Action Plan? included after the Summary Schedule of Prior Audit Findings and Status.