FAC Explorer

Audit 49742

FY End
2022-12-31
Total Expended
$14.94M
Findings
2
Programs
1
Organization: Sansum Clinic (CA)
Year: 2022 Accepted: 2023-09-05
Auditor: Moss Adams

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
47396 2022-001 Material Weakness - L
623838 2022-001 Material Weakness - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $14.94M Yes 1

Contacts

Name Title Type
QACYRP27TZH3 Alexander Bauer Auditee
8056817718 Kimberly Sokoloff Auditor
No contacts on file

Notes to SEFA

Title: NOTE 1 BASIS OF PRESENTATION Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Under the accrual basis of accounting, expenditures are recognized when incurred. 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: Sansum Clinic has not elected to use the 10 percent de minimis indirect cost rate as allowed under theUniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Sansum Clinic under programs of the federal government for the year ended December 31, 2022. The information in the Schedule is presented in accordance with the requirements of the Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selectedportion of the operations of Sansum Clinic, it is not intended to, and does not, present the financial position, changes in net assets, or cash flows of Sansum Clinic.Sansum Clinics reporting entity is defined in Note 1 of the financial statements. All federal awards from federal agencies are included in the Schedule. The Schedule includes the grant revenues of Sansum Clinic with the Tax Identification Number of 95-6419205.
Title: NOTE 3 PROVIDER RELIEF FUND Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Under the accrual basis of accounting, expenditures are recognized when incurred. 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: Sansum Clinic has not elected to use the 10 percent de minimis indirect cost rate as allowed under theUniform Guidance. In accordance with guidance from the U.S. Department of Health and Human Services (HHS), Sansum Clinic included the Reporting Period 3 and Period 4 expenditures for Provider Relief Fund Assistance Listing No. 93.498 of $14,940,161 in the Schedule for the year ended December 31, 2022, to align with HHS reporting guidelines. In accordance with U.S. GAAP, the total amount of Provider Relief Fund assistancereceived by Sansum Clinic for Periods 3 and 4 was recognized as revenue during the year ended December 31, 2021, and is included in beginning net assets as of and for the year ended December 31, 2022.
Title: NOTE 4 SUBRECIPIENT AWARDS Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Under the accrual basis of accounting, expenditures are recognized when incurred. 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: Sansum Clinic has not elected to use the 10 percent de minimis indirect cost rate as allowed under theUniform Guidance. Sansum Clinic did not provide any federal awards to subrecipients during the year ended December 31, 2022.

Finding Details

Finding 2022-001
Finding 2022-001 ? Reporting ? Material Weakness in Internal Control Over Compliance Federal Program: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (Assistance Listing #93.498) Federal Agency: U.S. Department of Health and Human Services Award Year: 2021 Criteria: Under the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program, providers are required to submit reporting to the Health Resources Services Administration (HRSA) in a timely manner as well as submit reporting that is accurate and can be substantiated. Condition: During our testing of the required report for Period 4, it was identified the reporting submission was submitted subsequent to the deadline. During our testing of the reporting of lost revenues that were reimbursed by Provider Relief Fund distributions for Periods 3 and 4, it was identified the reporting submission contained calculation errors that resulted in a total overstatement of lost revenues reported for a total of $7.2 million. Cause: Sansum Clinic has experienced business and staffing disruptions in recent fiscal years. This resulted in a lack of sufficient review over submissions and led to untimely submission of Period 4 reporting and the lost revenues reporting errors. This situation, coupled with the evolving nature of the specific terms and conditions of the Provider Relief Fund program, is the primary causes of the condition noted above. Effect or potential effect: Due to the above noted business and staffing disruptions, budgeted adjustments were not reflected in the Period 3 and Period 4 reporting. However, the lost revenue amounts carried over from the Periods 1 and 2 Provider Relief Fund reporting demonstrate a significant amount of cumulative unused lost revenue that would exceed the overstatement noted as a result of the Period 3 and 4 reporting errors. Questioned costs: None to be reported. Context: During the fiscal year ended December 31, 2022, health care providers were subject to staffing shortages as well as increased operational challenges as a result of the COVID-19 pandemic. As a result, Sansum Clinic did not have sufficient staffing levels to perform precise reviews to validate the lost revenue calculation subject to Provider Relief Fund reporting. Identification as a repeat finding, if applicable: This is not a repeat finding.
Finding 2022-001
Finding 2022-001 ? Reporting ? Material Weakness in Internal Control Over Compliance Federal Program: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (Assistance Listing #93.498) Federal Agency: U.S. Department of Health and Human Services Award Year: 2021 Criteria: Under the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program, providers are required to submit reporting to the Health Resources Services Administration (HRSA) in a timely manner as well as submit reporting that is accurate and can be substantiated. Condition: During our testing of the required report for Period 4, it was identified the reporting submission was submitted subsequent to the deadline. During our testing of the reporting of lost revenues that were reimbursed by Provider Relief Fund distributions for Periods 3 and 4, it was identified the reporting submission contained calculation errors that resulted in a total overstatement of lost revenues reported for a total of $7.2 million. Cause: Sansum Clinic has experienced business and staffing disruptions in recent fiscal years. This resulted in a lack of sufficient review over submissions and led to untimely submission of Period 4 reporting and the lost revenues reporting errors. This situation, coupled with the evolving nature of the specific terms and conditions of the Provider Relief Fund program, is the primary causes of the condition noted above. Effect or potential effect: Due to the above noted business and staffing disruptions, budgeted adjustments were not reflected in the Period 3 and Period 4 reporting. However, the lost revenue amounts carried over from the Periods 1 and 2 Provider Relief Fund reporting demonstrate a significant amount of cumulative unused lost revenue that would exceed the overstatement noted as a result of the Period 3 and 4 reporting errors. Questioned costs: None to be reported. Context: During the fiscal year ended December 31, 2022, health care providers were subject to staffing shortages as well as increased operational challenges as a result of the COVID-19 pandemic. As a result, Sansum Clinic did not have sufficient staffing levels to perform precise reviews to validate the lost revenue calculation subject to Provider Relief Fund reporting. Identification as a repeat finding, if applicable: This is not a repeat finding.