Audit 44142

FY End
2022-09-30
Total Expended
$9.57M
Findings
2
Programs
5
Organization: Stamford Health, Inc. (CT)
Year: 2022 Accepted: 2023-09-13

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
38783 2022-001 Significant Deficiency Yes L
615225 2022-001 Significant Deficiency Yes L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $9.06M Yes 1
93.461 Claims Reimbursement for the Uninsured Program $283,732 - 0
93.994 Maternal and Child Health Services Block Grant to the States $144,975 - 0
93.914 Hiv Emergency Relief Project Grants $61,793 - 0
93.268 Immunization Cooperative Agreements $19,689 - 0

Contacts

Name Title Type
JK6DM38U8L97 Nick Jamieson Auditee
2032767002 Jeanna Doherty Auditor
No contacts on file

Notes to SEFA

Title: Noncash Assistance Accounting Policies: The consolidated financial statements contained in Stamford Health, Inc. and subsidiaries (Stamford Health) annual audit report are prepared on the accrual basis of accounting. Refer to the notes of the consolidated financial statements for a summary of the significant accounting policies.The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the Federal grant activity of Stamford Health and is reported on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of Stamford Health.For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance.Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 75 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, Stamford Health, Inc. did not make this election and uses a negotiated indirect cost rate. During the year ended September 30, 2022, the U.S. Department of Health and Human Services issued $19,689 in federally funded vaccines to Stamford Health through the Immunization Cooperative Agreements program (Assistance Listing No. 93.268). This non-cash assistance, which was passed through the State of Connecticut Department Health, is included in the accompanying Schedule.
Title: COVID-19 - Provider Relief Fund Accounting Policies: The consolidated financial statements contained in Stamford Health, Inc. and subsidiaries (Stamford Health) annual audit report are prepared on the accrual basis of accounting. Refer to the notes of the consolidated financial statements for a summary of the significant accounting policies.The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the Federal grant activity of Stamford Health and is reported on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of Stamford Health.For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance.Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 75 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, Stamford Health, Inc. did not make this election and uses a negotiated indirect cost rate. In accordance with the U.S. Department of Health and Human Services requirements specific to Federal Assistance Listing No. 93.498, COVID-19 Provider Relief Fund, the amount presented on the accompanying Schedule for the year ended September 30, 2022 for Federal Assistance Listing No. 93.498 relates to (i) Provider Relief Fund (PRF) payments received from July 1, 2020 through June 30, 2021 (ii) used for PRF-eligible activity from the period January 1, 2020 through June 30, 2022. This payment receipt period and activity period and the resulting amount presented on the accompanying Schedule for the year ended September 30, 2022 reconciles to the PRF information previously reported to the Health Resources and Services Administration (HRSA) for PRF Reporting Periods 2 as follows (see the Notes to the SEFA for the chart). The expenses attributable to Coronavirus Disease 2019 (COVID-19) and lost revenues incurred by Stamford Health during the period of availability for PRF Reporting Period 2 (January 1, 2020 through December 31, 2021) are in excess of the distributions received from July 1, 2020 through December 31, 2020 and, therefore, the amounts presented in the chart included in the Notes to the SEFA and on the accompanying Schedule are limited to the amount of such distributions. Stamford Health did not receive PRF payments in PRF Reporting Period 3 (January 1, 2021 to June 30, 2021).

Finding Details

Finding 2022 ? 001 Reporting Identification of the Federal Program: Grantor: Department of Health and Human Services Program Name: COVID-19 ? Provider Relief Fund Assistance Listing No.: 93.498 Criteria or Specific Requirement Title 2, Subtitle A Chapter II Part 200 Subpart D Section 200.303 of the Uniform Guidance states the following regarding internal control: ?The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States or the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? The terms and conditions for the award requires the recipient to submit reports as the Secretary of HHS determines are needed to ensure compliance with conditions that are imposed on the payment and such reports shall be in such form, with such content, as specified by the Secretary of HHS in future program instructions directed to all recipients. Condition: Stamford Health used Option II (2020 Budgeted Revenue Lost Revenues Reporting Model) in the PRF portal submission which requires the calculation of lost revenue as the difference between budgeted and actual patient care revenues using a budget approved before March 27, 2020. Stamford Health inappropriately used the 2021 and 2022 budget, approved in September of 2020 and 2021, to calculate lost revenue during PRF Reporting Period 2. Cause: The control performed to verify that the lost revenue reporting method selected in the PRF portal submission was consistent with the methodology used in calculating lost revenue was not sufficient. Effect or Potential Effect: Stamford Health selected a lost revenue reporting method that was inconsistent with the methodology utilized to calculate its lost revenue. Questioned Costs: There are no questioned costs related to this finding and no impact to amounts received or retained by Stamford Health. Context: In review of the lost revenue calculation, it was determined that a budget approved subsequent to March 27, 2020 was used in the lost revenue calculation. The method utilized to calculate lost revenue is allowable, however the incorrect method was selected in the PRF portal submission. Recommendation: Stamford Health should refine its controls to ensure that lost revenue reporting method selected within the PRF portal submission is consistent with the methodology utilized to calculate lost revenue. Views of Responsible Officials: Management concurs with the audit finding. Management has refined its controls to ensure the lost revenue reporting method selected in the PRF portal submission is consistent with the methodology utilized to calculate lost revenue.
Finding 2022 ? 001 Reporting Identification of the Federal Program: Grantor: Department of Health and Human Services Program Name: COVID-19 ? Provider Relief Fund Assistance Listing No.: 93.498 Criteria or Specific Requirement Title 2, Subtitle A Chapter II Part 200 Subpart D Section 200.303 of the Uniform Guidance states the following regarding internal control: ?The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States or the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? The terms and conditions for the award requires the recipient to submit reports as the Secretary of HHS determines are needed to ensure compliance with conditions that are imposed on the payment and such reports shall be in such form, with such content, as specified by the Secretary of HHS in future program instructions directed to all recipients. Condition: Stamford Health used Option II (2020 Budgeted Revenue Lost Revenues Reporting Model) in the PRF portal submission which requires the calculation of lost revenue as the difference between budgeted and actual patient care revenues using a budget approved before March 27, 2020. Stamford Health inappropriately used the 2021 and 2022 budget, approved in September of 2020 and 2021, to calculate lost revenue during PRF Reporting Period 2. Cause: The control performed to verify that the lost revenue reporting method selected in the PRF portal submission was consistent with the methodology used in calculating lost revenue was not sufficient. Effect or Potential Effect: Stamford Health selected a lost revenue reporting method that was inconsistent with the methodology utilized to calculate its lost revenue. Questioned Costs: There are no questioned costs related to this finding and no impact to amounts received or retained by Stamford Health. Context: In review of the lost revenue calculation, it was determined that a budget approved subsequent to March 27, 2020 was used in the lost revenue calculation. The method utilized to calculate lost revenue is allowable, however the incorrect method was selected in the PRF portal submission. Recommendation: Stamford Health should refine its controls to ensure that lost revenue reporting method selected within the PRF portal submission is consistent with the methodology utilized to calculate lost revenue. Views of Responsible Officials: Management concurs with the audit finding. Management has refined its controls to ensure the lost revenue reporting method selected in the PRF portal submission is consistent with the methodology utilized to calculate lost revenue.