Audit 45183

FY End
2022-12-31
Total Expended
$5.37M
Findings
2
Programs
4
Organization: Samaritan Medical Center (NY)
Year: 2022 Accepted: 2023-09-28
Auditor: Fustcharles LLP

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
43349 2022-002 Significant Deficiency - L
619791 2022-002 Significant Deficiency - L

Contacts

Name Title Type
W9HFBYXJ2LM5 Raeanne Lafave Auditee
3157827148 Will Wildridge Auditor
No contacts on file

Notes to SEFA

Title: Basis for 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. 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 Samaritan Medical Center (parent company only) (Samaritan) under programs of the federal government for the year ended December 31, 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 Samaritan, it is not intended to and does not present the financial position, results of operations, changes in net assets or cash flows of Samaritan.
Title: Subrecipients 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. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Samaritan provided no federal awards to subrecipients for the year ended December 31, 2022.
Title: Provider Relief Fund 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. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Samaritan received amounts from U.S. Department of Health and Human Services through the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program (Federal Financial Assistance Listing No. 93.498) during the year ended December 31, 2021 totalling $4,493,666. Samaritan incurred eligible expenses (including lost revenue) and, therefore, recognized revenue consisting of $4,493,666 for the year ended December 31, 2021 on the parent company only financial statements. In accordance with the 2022 compliance supplement, the programs expenditures recognized on the schedule are based on the reporting to DHHS for Period 3 and Period 4, defined as payments received during January 1, 2021 to December 31, 2021 of $4,493,666, as required under the program.
Title: Disaster Grants - Public Assistance (Presidentially Declared Disasters) 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. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Samaritan received amounts from the U.S. Department of Homeland Security through the Disaster Grants - Public Assistance (Presidentially Declared Disasters) (Federal Financial Assistance Listing No. 97.036) during the year ended December 31, 2022 totalling $799,682. Samaritan incurred eligible expenses and, therefore, recognized revenue consisting of $799,682 for the year ended December 31, 2022 on the parent company only financial statements. In accordance with the 2022 compliance supplement, the programs expenditures recognized on the schedule are based on (1) Federal Emergency Management Agencys approval of Samaritans Project Worksheet in 2022, and (2) Samaritan incurring the eligible expenditures as of December 31, 2022.

Finding Details

2022-001 - New York State Indigent Care Pool (ICP) and Upper Payment Limit (UPL) Distributions - Significant Deficiency in Internal Control Criteria: Timely review of significant estimates is an essential internal control to ensure the financial statements presented are complete and accurate. Condition: The Medical Center is responsible for the internal control over the review of significant estimates including third party estimates. Context: During the audit, in conjunction with management, a significant adjustment was reported to the estimated third-party payor settlement balance to appropriately reflect the $2.5 million of cash receipts from the New York State ICP and UPL during 2022. Cause: The significant adjustment was due to lack of timely reconciliation of New York State ICP and UPL activity. Effect: Incomplete review of key estimates can result in significantly misstated internal financial statements. Recommendation: We recommend that all New York State ICP and UPL activity be reconciled on a monthly basis and SMC also reconcile all activity on an annual basis to the New York State Department of Health?s Division of Finance and Rate Setting reports to ensure that all activity is properly reflected on the financial statements. Views of Responsible Official: See management?s Corrective Action Plan on page 50.
2022-001 - New York State Indigent Care Pool (ICP) and Upper Payment Limit (UPL) Distributions - Significant Deficiency in Internal Control Criteria: Timely review of significant estimates is an essential internal control to ensure the financial statements presented are complete and accurate. Condition: The Medical Center is responsible for the internal control over the review of significant estimates including third party estimates. Context: During the audit, in conjunction with management, a significant adjustment was reported to the estimated third-party payor settlement balance to appropriately reflect the $2.5 million of cash receipts from the New York State ICP and UPL during 2022. Cause: The significant adjustment was due to lack of timely reconciliation of New York State ICP and UPL activity. Effect: Incomplete review of key estimates can result in significantly misstated internal financial statements. Recommendation: We recommend that all New York State ICP and UPL activity be reconciled on a monthly basis and SMC also reconcile all activity on an annual basis to the New York State Department of Health?s Division of Finance and Rate Setting reports to ensure that all activity is properly reflected on the financial statements. Views of Responsible Official: See management?s Corrective Action Plan on page 50.