Audit 51835

Federal Agency: US Department of Homeland Security Federal Program Name: FEMA Public Assistance Grant Program Assistance Listing Number: 97.036 Award Period: Year ended December 31, 2022 Type of Finding: ? Significant Deficiency in Internal Controls over Compliance ? Other Matters Criteria: The Foundation?s internal controls related to the FEMA Public Assistance Grant Program state that authorization form are required to be obtained by the appropriate level of management for all capital purchases. Condition: The compliance requirements state that FEMA evaluates the eligibility of all costs claimed by the applicant. Not all costs incurred as a result of the incident are eligible. Costs must be authorized and not prohibited under federal, state, territorial, tribal, or local government laws or regulations as well as consistent with applicant?s internal policies, regulations, and procedures that apply uniformly to both federal awards and other activities of the applicant. Questioned Costs: $-0- Context: It was noted that as a part of Aultman Health Foundation's internal controls related to FEMA funding, as well as other capital projects, that one signed authorization form was required to be obtained by the appropriate level of management to approve capital purchases. Per discussions with client, they were unable to locate the signed authorization form for a set of disbursements totaling $44,631 associated with one of the FEMA projects. Per further discussion with client, the signed authorization form was obtained and retained by an employee who is no longer employed with the Foundation and therefore, access to this signed copy was no longer available. Effect: There is potential that capital purchases could be made without authorization from the proper level of management. Recommendation: We recommend that for all capital purchases, especially for projects that utilize federal funding, formal authorization is obtained from the appropriate level of management. Additionally, it is recommended that the signed authorization forms be retained in a location that is easily accessible when requested.Views of Responsible Officials and Planned Corrective Actions: Aultman Health Foundation created a central shared location for all signed capital authorization forms to be kept electronically for reference.

Federal Agency: US Department of Treasury Federal Program Name: Provider Relief Fund Assistance Listing Number: 93.498 Award Period: Year ended December 31, 2022 Type of Finding: ? Significant Deficiency in Internal Controls over Compliance ? Other Matters Criteria: The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus and that the funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. These funds may not be used to reimburse expenses of losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition: The Organization's internal controls over reporting were not effective. Questioned Costs: $-0- Context: During the audit, it was determined that one out of five reports selected for testing included quarterly revenue amounts that did not agree to the underlying revenue information. This resulted in one report understating lost revenue by approximately $550,000. Cause: The revenue information used to populate the reports was not reviewed prior to submission. Effect: Reported lost revenue was calculated incorrectly. After using the underlying revenue information to calculate lost revenue, there was sufficient lost revenue to utilize all the Provider Relief Funds reported. Recommendation: We recommend management implement additional procedures to review reported revenue before submitting reports. Views of Responsible Officials and Planned Corrective Actions: Aultman Health Foundation was able to correct the Period 5 Reporting for Aultman Specialty Hospital. Going forward, Aultman Corporate Finance Leadership will review data submissions, comparing to both internal reporting as well as Trial Balance to account for potential differences.

Federal Agency: US Department of Homeland Security Federal Program Name: FEMA Public Assistance Grant Program Assistance Listing Number: 97.036 Award Period: Year ended December 31, 2022 Type of Finding: ? Significant Deficiency in Internal Controls over Compliance ? Other Matters Criteria: The Foundation?s internal controls related to the FEMA Public Assistance Grant Program state that authorization form are required to be obtained by the appropriate level of management for all capital purchases. Condition: The compliance requirements state that FEMA evaluates the eligibility of all costs claimed by the applicant. Not all costs incurred as a result of the incident are eligible. Costs must be authorized and not prohibited under federal, state, territorial, tribal, or local government laws or regulations as well as consistent with applicant?s internal policies, regulations, and procedures that apply uniformly to both federal awards and other activities of the applicant. Questioned Costs: $-0- Context: It was noted that as a part of Aultman Health Foundation's internal controls related to FEMA funding, as well as other capital projects, that one signed authorization form was required to be obtained by the appropriate level of management to approve capital purchases. Per discussions with client, they were unable to locate the signed authorization form for a set of disbursements totaling $44,631 associated with one of the FEMA projects. Per further discussion with client, the signed authorization form was obtained and retained by an employee who is no longer employed with the Foundation and therefore, access to this signed copy was no longer available. Effect: There is potential that capital purchases could be made without authorization from the proper level of management. Recommendation: We recommend that for all capital purchases, especially for projects that utilize federal funding, formal authorization is obtained from the appropriate level of management. Additionally, it is recommended that the signed authorization forms be retained in a location that is easily accessible when requested.Views of Responsible Officials and Planned Corrective Actions: Aultman Health Foundation created a central shared location for all signed capital authorization forms to be kept electronically for reference.

Federal Agency: US Department of Treasury Federal Program Name: Provider Relief Fund Assistance Listing Number: 93.498 Award Period: Year ended December 31, 2022 Type of Finding: ? Significant Deficiency in Internal Controls over Compliance ? Other Matters Criteria: The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus and that the funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. These funds may not be used to reimburse expenses of losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition: The Organization's internal controls over reporting were not effective. Questioned Costs: $-0- Context: During the audit, it was determined that one out of five reports selected for testing included quarterly revenue amounts that did not agree to the underlying revenue information. This resulted in one report understating lost revenue by approximately $550,000. Cause: The revenue information used to populate the reports was not reviewed prior to submission. Effect: Reported lost revenue was calculated incorrectly. After using the underlying revenue information to calculate lost revenue, there was sufficient lost revenue to utilize all the Provider Relief Funds reported. Recommendation: We recommend management implement additional procedures to review reported revenue before submitting reports. Views of Responsible Officials and Planned Corrective Actions: Aultman Health Foundation was able to correct the Period 5 Reporting for Aultman Specialty Hospital. Going forward, Aultman Corporate Finance Leadership will review data submissions, comparing to both internal reporting as well as Trial Balance to account for potential differences.