Finding 1148659 (2023-003)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2025-07-30
Audit: 363352
Auditor: McConnell Jones

AI Summary

  • Core Issue: Four out of seven key line items in the 2023 Uniform Data System report lacked proper support, leading to discrepancies in reported patient numbers and financial data.
  • Impacted Requirements: The District must ensure that all data reported to the Health Resources & Services Administration is complete and accurate, as required annually.
  • Recommended Follow-Up: The District should develop reconciled reports that align with the final Uniform Data System submission to prevent future discrepancies.

Finding Text

Criteria: Annually, the District is required to report patient characteristics along with financial data within the Uniform Data Systems report and submit it to the Health Resources & Services Administration online. The District’s internal control structure should ensure that their Uniform Data System annual report is complete and accurate. Condition: During the audit, it was identified that four of seven key line items reviewed within the Uniform Data System report for 2023 were unable to be substantiated. The first key line item reviewed revolved around patient numbers and data received supported 11,584 patients while 11,575 patients were reported. For second the key line item reviewed, regarding total physician clinic and virtual visits, data reports provided supported 8,330 physician visits while 10,893 physician visits were noted as being reported within the Uniform Data System report. The third key line item reviewed was total accrued costs before donations and after allocation of overhead. Data supplied showed $14,466,183 which was $39,967 less than what was reported on the Uniform Data System report. The final key line reviewed with exception was regarding total accrued medical staff and other medical cost after allocation of overhead excluding lab and x-ray cost with a total cost within the Uniform Data System reported as $7,393,886, for this key item, no support was supplied. Cause: While the financial system has the data to back up most of the initial figures reported, comments left by Health Resources & Services Administration reviewers required adjustment to some of the key line items. Effect: The final Uniform Data System report has non-financial and financial data that cannot be substantiated at the amount reported as the adjustments and reasoning for those adjustments were not reconciled. Recommendation: We recommend that the District create reports that capture the data and is reconciled to the final Uniform Data System report filed. Managements Response: The District has reviewed the Independent Auditor’s recommendation. The District was already in the midst of creating Uniform Data System reports within their financial reporting software in order to be able to reconcile to final reports uploaded.

Categories

Allowable Costs / Cost Principles Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 572213 2023-002
    Material Weakness
  • 572214 2023-002
    Material Weakness
  • 572215 2023-002
    Material Weakness
  • 572216 2023-002
    Material Weakness
  • 572217 2023-003
    Significant Deficiency
  • 572218 2023-003
    Significant Deficiency
  • 572219 2023-003
    Significant Deficiency
  • 572220 2023-003
    Significant Deficiency
  • 572221 2023-004
    Significant Deficiency
  • 572222 2023-004
    Significant Deficiency
  • 572223 2023-004
    Significant Deficiency
  • 572224 2023-004
    Significant Deficiency
  • 1148655 2023-002
    Material Weakness
  • 1148656 2023-002
    Material Weakness
  • 1148657 2023-002
    Material Weakness
  • 1148658 2023-002
    Material Weakness
  • 1148660 2023-003
    Significant Deficiency
  • 1148661 2023-003
    Significant Deficiency
  • 1148662 2023-003
    Significant Deficiency
  • 1148663 2023-004
    Significant Deficiency
  • 1148664 2023-004
    Significant Deficiency
  • 1148665 2023-004
    Significant Deficiency
  • 1148666 2023-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $2.42M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.08M
93.268 Immunization Cooperative Agreements $802,973
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $675,715
21.027 Coronavirus State and Local Fiscal Recovery Funds $376,864
93.977 Preventive Health Services_sexually Transmitted Diseases Control Grants $254,582
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $242,087
66.472 Beach Monitoring and Notification Program Implementation Grants $132,301
93.991 Preventive Health and Health Services Block Grant $117,042
93.940 Hiv Prevention Activities_health Department Based $108,178
97.091 Homeland Security Biowatch Program $107,586
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $102,260
93.994 Maternal and Child Health Services Block Grant to the States $73,478
93.008 Medical Reserve Corps Small Grant Program $48,679
66.605 Performance Partnership Grants $47,692
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $43,902
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $25,257
93.069 Public Health Emergency Preparedness $17,050
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $5,118
93.967 Cdc's Collaboration with Academia to Strengthen Public Health $3,775