FAC Explorer

Audit 6359

FY End
2022-09-30
Total Expended
$835,394
Findings
8
Programs
3
Organization: Granville Health System (NC)
Year: 2022 Accepted: 2023-12-13
Auditor: Cliftonlarsonallen LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
4037 2022-001 Significant Deficiency - E
4038 2022-002 Significant Deficiency - E
4039 2022-001 Significant Deficiency - N
4040 2022-002 Significant Deficiency - N
580479 2022-001 Significant Deficiency - E
580480 2022-002 Significant Deficiency - E
580481 2022-001 Significant Deficiency - N
580482 2022-002 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
21.019 Coronavirus Relief Fund $101,569 - 0
93.461 Covid-19 Testing for the Uninsured $81,600 Yes 2
93.498 Provider Relief Fund $52,412 - 0

Contacts

Name Title Type
CUKLSPJ656U1 Adam McConnell Auditee
9196911441 Kevin Leder Auditor
No contacts on file

Notes to SEFA

Accounting Policies: BASIS OF PRESENTATION The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Granville Health System, under programs of the federal government for the year ended September 30, 2022. The information in this Schedule is presented in accordance with the requirements of 2 CFR 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 Granville Health System, it is not intended to and does not present the net position, changes in net position, and cash flows of Granville Health System. SUMMARY OF SIGNIFICANT 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 for all awards with the exception of Federal Assistance Listing Number 21.019, which follows criteria determined by the Department of Treasury for allowability of costs. Under these principles, certain types of expenditures are not allowable or are limited as to reimbursement. Any negative amounts shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. The combined financial statements reflect revenue recognized from COVID-19 Provider Relief Funds of approximately $3,121,000 for the year ended September 30, 2022. The amount of funding from Period 1 was approximately $10,956,000. The amount of revenue recognized from Period 1 for the year ended September 30, 2022 was approximately $328,000. The SEFA includes COVID-19 Provider Relief Funds of approximately $239,000 that were received in Period 2 and Period 3 in accordance with the requirements of the compliance supplement for assistance listing number 93.498. Of this amount, approximately $215,000 was recognized in the combined financial statements for the year ended September 30, 2022. De Minimis Rate Used: Y Rate Explanation: Granville Health System has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance.

Finding Details

Finding 2022-001
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System received reimbursement for testing of uninsured patients however it was later determined that those patients were insured. Criteria: Funds for reimbursement are for the cost associated with COVID-19 testing and testing-related items for individuals who did not have any health care coverage at the time of service. Questioned Costs: $439 Cause: The System’s controls around the determination of a patient’s insurance status were not operating effectively. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System review the submissions to HRSA to ensure that the patients they requested reimbursement for were in fact uninsured. Views of responsible officials: We understand the finding. In future submissions, the System will review all patients to ensure that are uninsured.
Finding 2022-002
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System mistakenly submitted one of the patient’s non-covered charges from HRSA for North Carolina Debt payment to be offset with state tax refund. Criteria: The remaining statement balance should not be balance billed to the patient. Questioned Costs: $370 Cause: The System did not have the control in place to ensure the patient balance was not transferred. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System ensure that remaining statement balance for uninsured testing is not balance billed to the patient. Views of responsible officials: We understand the finding. All balances remaining after HRSA payments will be reviewed and adjusted to zero.
Finding 2022-001
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System received reimbursement for testing of uninsured patients however it was later determined that those patients were insured. Criteria: Funds for reimbursement are for the cost associated with COVID-19 testing and testing-related items for individuals who did not have any health care coverage at the time of service. Questioned Costs: $439 Cause: The System’s controls around the determination of a patient’s insurance status were not operating effectively. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System review the submissions to HRSA to ensure that the patients they requested reimbursement for were in fact uninsured. Views of responsible officials: We understand the finding. In future submissions, the System will review all patients to ensure that are uninsured.
Finding 2022-002
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System mistakenly submitted one of the patient’s non-covered charges from HRSA for North Carolina Debt payment to be offset with state tax refund. Criteria: The remaining statement balance should not be balance billed to the patient. Questioned Costs: $370 Cause: The System did not have the control in place to ensure the patient balance was not transferred. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System ensure that remaining statement balance for uninsured testing is not balance billed to the patient. Views of responsible officials: We understand the finding. All balances remaining after HRSA payments will be reviewed and adjusted to zero.
Finding 2022-001
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System received reimbursement for testing of uninsured patients however it was later determined that those patients were insured. Criteria: Funds for reimbursement are for the cost associated with COVID-19 testing and testing-related items for individuals who did not have any health care coverage at the time of service. Questioned Costs: $439 Cause: The System’s controls around the determination of a patient’s insurance status were not operating effectively. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System review the submissions to HRSA to ensure that the patients they requested reimbursement for were in fact uninsured. Views of responsible officials: We understand the finding. In future submissions, the System will review all patients to ensure that are uninsured.
Finding 2022-002
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System mistakenly submitted one of the patient’s non-covered charges from HRSA for North Carolina Debt payment to be offset with state tax refund. Criteria: The remaining statement balance should not be balance billed to the patient. Questioned Costs: $370 Cause: The System did not have the control in place to ensure the patient balance was not transferred. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System ensure that remaining statement balance for uninsured testing is not balance billed to the patient. Views of responsible officials: We understand the finding. All balances remaining after HRSA payments will be reviewed and adjusted to zero.
Finding 2022-001
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System received reimbursement for testing of uninsured patients however it was later determined that those patients were insured. Criteria: Funds for reimbursement are for the cost associated with COVID-19 testing and testing-related items for individuals who did not have any health care coverage at the time of service. Questioned Costs: $439 Cause: The System’s controls around the determination of a patient’s insurance status were not operating effectively. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System review the submissions to HRSA to ensure that the patients they requested reimbursement for were in fact uninsured. Views of responsible officials: We understand the finding. In future submissions, the System will review all patients to ensure that are uninsured.
Finding 2022-002
Federal Agency: Department of Health and Human Services Federal Program Title: COVID-19 HRSA Uninsured Program Federal Assistance Listing Number: 93.461 Type of Finding: Significant Deficiency over Compliance and Internal Control over Compliance Condition: The System mistakenly submitted one of the patient’s non-covered charges from HRSA for North Carolina Debt payment to be offset with state tax refund. Criteria: The remaining statement balance should not be balance billed to the patient. Questioned Costs: $370 Cause: The System did not have the control in place to ensure the patient balance was not transferred. Effect: Noncompliance with the federal requirements around the determination of uninsured patients. Recommendation: We recommend that the System ensure that remaining statement balance for uninsured testing is not balance billed to the patient. Views of responsible officials: We understand the finding. All balances remaining after HRSA payments will be reviewed and adjusted to zero.