Finding 1064 (2023-002)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2023-11-01
Audit: 2032
Organization: Cgh Medical Center (IL)

AI Summary

  • Core Issue: The Medical Center lacked effective internal controls for reporting COVID-19 expenses, leading to an overstatement of approximately $4.5 million.
  • Impacted Requirements: Compliance with HHS reporting guidelines was not met due to unclear portal design and inadequate controls.
  • Recommended Follow-Up: Implement stronger controls to ensure accurate reporting in line with HHS guidelines.

Finding Text

Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Material Weakness in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Medical Center’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Medical Center did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines as the Medical Center reported the same COVID-19 expenses in Period 2, and Period 4 reports, thus overstating the amount of reported covid expenses by approx. $4.5 million. Questioned costs: None Context: Based on the portal configuration the Medical Center believed accumulated costs, since the beginning of the pandemic, should be entered into Period 4 vs. just the incremental amounts exclusive to Period 1 and 2. Cause: The design of the portal was unclear as the reporting for expenses and lost revenues are handled differently. Effect: The Medical Center’s internal controls around compliance were not effective in identifying allowable expenses associated with COVID-19. Repeat Finding: N/A Recommendation: We recommend the Medical Center design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.

Corrective Action Plan

COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution Recommendation: We recommend the Medical Center design controls to ensure that expenses are reported in accordance with latest HHS guidelines. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Management has identified that the Medical Center has more than a sufficient amount of lost revenues related to COVID-19 to offset this difference. Action taken in response to finding: The Medical Center will ensure that controls are put into place to capture Covid specific costs in accordance with HHS guidelines. Name of the contact person responsible for corrective action: Megan Shank, COF. Planned completion date for corrective action plan: February 1, 2024

Categories

Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1063 2023-001
    Significant Deficiency Repeat
  • 577505 2023-001
    Significant Deficiency Repeat
  • 577506 2023-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $6.93M
93.575 Child Care and Development Block Grant $42,300
93.461 Covid-19 Testing for the Uninsured $11,732