FAC Explorer

Audit 7792

FY End
2023-09-30
Total Expended
$11.01M
Findings
2
Programs
3
Organization: Health First, Inc. (FL)
Year: 2023 Accepted: 2023-12-20
Auditor: Rsm US LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
5733 2023-001 Significant Deficiency - BL
582175 2023-001 Significant Deficiency - BL

Programs

ALN Program Spent Major Findings
93.498 Covid-19- Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $10.06M Yes 1
93.575 Child Care and Development Block Grant $699,608 - 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $248,565 - 0

Contacts

Name Title Type
MLRFM5DE1HN4 Ashley Pepper Auditee
3219781203 Carlos Hernandez 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. 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. Expenditures reported in the Schedule for Federal Assistance Listing Number 93.498, Department of Health and Human Services – Provider Relief Fund American Rescue Plan Rural Distribution, include $20,892 and $10,039,793 of expenditures incurred by the Corporation and awarded as of the years ended September 30, 2023 and 2022, respectively. The Corporation did not pass through any federal award amounts to subrecipients during the year ended September 30, 2023 De Minimis Rate Used: N Rate Explanation: The Corporation has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of Federal awards (the Schedule) includes the federal award activity of Health First, Inc. and Subsidiaries (the Corporation) under programs of the federal government for the year ended September 30, 2023. 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 the Corporation, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Corporation.
Title: Note 3. Indirect Cost Rate 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. Expenditures reported in the Schedule for Federal Assistance Listing Number 93.498, Department of Health and Human Services – Provider Relief Fund American Rescue Plan Rural Distribution, include $20,892 and $10,039,793 of expenditures incurred by the Corporation and awarded as of the years ended September 30, 2023 and 2022, respectively. The Corporation did not pass through any federal award amounts to subrecipients during the year ended September 30, 2023 De Minimis Rate Used: N Rate Explanation: The Corporation has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The Corporation has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance.
Title: Note 4. Provider Relief Fund - COVID 19 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. Expenditures reported in the Schedule for Federal Assistance Listing Number 93.498, Department of Health and Human Services – Provider Relief Fund American Rescue Plan Rural Distribution, include $20,892 and $10,039,793 of expenditures incurred by the Corporation and awarded as of the years ended September 30, 2023 and 2022, respectively. The Corporation did not pass through any federal award amounts to subrecipients during the year ended September 30, 2023 De Minimis Rate Used: N Rate Explanation: The Corporation has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The following entities within the Corporation received Provider Relief Funds: Entity Tax ID Health First Shared Services, Inc. 59-3336894 Holmes Regional Medical Center, Inc. 59-0624371 Cape Canaveral Hospital, Inc. 59-2477479 Viera Hospital, Inc. 26-4019868 Hospice of Health First, Inc. 59-1911574 Holmes Regional Enterprises, Inc. 59-2109953 Health First Physician Specialties, Inc. 26-3094596 Health First Medical Group, LLC 46-1243081 Doctor’s Surgical Partnership, LLC 59-3490279 Doctors GI Partnership, Ltd. 59-3758988
Title: Note 5. Fair Market Value of Donated Personal Protective Equipment (Unaudited) 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. Expenditures reported in the Schedule for Federal Assistance Listing Number 93.498, Department of Health and Human Services – Provider Relief Fund American Rescue Plan Rural Distribution, include $20,892 and $10,039,793 of expenditures incurred by the Corporation and awarded as of the years ended September 30, 2023 and 2022, respectively. The Corporation did not pass through any federal award amounts to subrecipients during the year ended September 30, 2023 De Minimis Rate Used: N Rate Explanation: The Corporation has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. During the year ended September 30, 2023, the Corporation did not receive significant donated personal protective equipment from federal sources.

Finding Details

Finding 2023-001
Total Unused Lost Revenues Reporting Federal program: U.S. Department of Health and Human Services – ALN 93.498, COVID-19—Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution. Criteria: 2 CFR Part 200.303(a) states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and terms and conditions of the federal award. Specific criteria are established by the U.S. Department of Health and Human Services (HHS) with respect to allowable cost and reporting requirements for this program, including: - Funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. - Entities may elect to calculate and report lost revenue using one of three options. For entities electing to report lost revenues using Option i, quarterly actual patient care revenues are to be reported. Condition: In preparing the Reporting Period 4 and 5 General Distribution submission report to Health Resources & Services Administration (HRSA), the Corporation did not reduce the Unused Lost Revenues included within the ARP Distribution submission report from the Unused Lost Revenues in the General Distribution report in the Current Reporting Period. This resulted in the Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports to be overstated by $723,754. Context: The Corporation reported Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports of $42,297,586 and $42,276,693. Had the correct amounts of Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports been reported, the Total Unused Lost Revenues would have been $723,754 less. The Total Unused Lost Revenues would still have exceeded PRF amounts received. Cause: In preparing the Reporting Period 4 and 5 General Distribution submission report to Health Resources & Services Administration (HRSA), the Corporation did not reduce the Unused Lost Revenues included within the ARP Distribution submission report from the Unused Lost Revenues in the General Distribution report in the Current Reporting Period. This resulted in the Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports to be overstated by $723,754. Review processes were performed before the reports were submitted, but these reviews were not effective in detecting and correcting the errors before report submission. Effect: The Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports were overstated by $723,754. Questioned costs: None Repeat finding: No Recommendation: We recommend that internal controls be strengthened related to review of the quarterly lost revenue calculations and reporting in the PRF reporting portal. We suggest these reviews include review of documentation supporting input included in the report. View of responsible officials of the auditee: Management agrees with the finding, has prepared an assessment of the root cause of this significant deficiency, and has developed a corrective action plan.
Finding 2023-001
Total Unused Lost Revenues Reporting Federal program: U.S. Department of Health and Human Services – ALN 93.498, COVID-19—Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution. Criteria: 2 CFR Part 200.303(a) states that the auditee must establish and maintain effective internal control over the federal award that provides reasonable assurance that the auditee is managing the federal award in compliance with federal statutes, regulations, and terms and conditions of the federal award. Specific criteria are established by the U.S. Department of Health and Human Services (HHS) with respect to allowable cost and reporting requirements for this program, including: - Funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. - Entities may elect to calculate and report lost revenue using one of three options. For entities electing to report lost revenues using Option i, quarterly actual patient care revenues are to be reported. Condition: In preparing the Reporting Period 4 and 5 General Distribution submission report to Health Resources & Services Administration (HRSA), the Corporation did not reduce the Unused Lost Revenues included within the ARP Distribution submission report from the Unused Lost Revenues in the General Distribution report in the Current Reporting Period. This resulted in the Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports to be overstated by $723,754. Context: The Corporation reported Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports of $42,297,586 and $42,276,693. Had the correct amounts of Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports been reported, the Total Unused Lost Revenues would have been $723,754 less. The Total Unused Lost Revenues would still have exceeded PRF amounts received. Cause: In preparing the Reporting Period 4 and 5 General Distribution submission report to Health Resources & Services Administration (HRSA), the Corporation did not reduce the Unused Lost Revenues included within the ARP Distribution submission report from the Unused Lost Revenues in the General Distribution report in the Current Reporting Period. This resulted in the Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports to be overstated by $723,754. Review processes were performed before the reports were submitted, but these reviews were not effective in detecting and correcting the errors before report submission. Effect: The Total Unused Lost Revenues in the Reporting Period 4 and 5 General Distribution submission reports were overstated by $723,754. Questioned costs: None Repeat finding: No Recommendation: We recommend that internal controls be strengthened related to review of the quarterly lost revenue calculations and reporting in the PRF reporting portal. We suggest these reviews include review of documentation supporting input included in the report. View of responsible officials of the auditee: Management agrees with the finding, has prepared an assessment of the root cause of this significant deficiency, and has developed a corrective action plan.