Finding 1162247 (2021-003)

Material Weakness Repeat Finding
Requirement
ABL
Questioned Costs
$1
Year
2021
Accepted
2025-11-12
Audit: 372059
Organization: Stephens Memorial Hospital (TX)
Auditor: FORIVS MAZARS

AI Summary

  • Core Issue: The District failed to accurately report lost revenues for the COVID-19 Provider Relief Fund, leading to errors in financial reporting.
  • Impacted Requirements: Reporting requirements under 45 CFR 75.342 were not met, including lack of board approval for budgets and no documented review of reports.
  • Recommended Follow-Up: Update policies and procedures for federal grant reporting to ensure accuracy and completeness of financial information before submission.

Finding Text

COVID-19 Provider Relief Fund Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement: Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) Condition: The District is required to prepare and submit period one provider relief fund report to the U.S. Department of Health and Human Services. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned costs: Unknown Context: The period one provider relief fund report was tested. The District selected option 2 to report lost revenues based on quarterly gross patient service revenue by department in comparison to budgeted gross patient service revenue. A material error in the calculation of the patient service revenue for the quarters reported was identified. Additionally, budgets were not reviewed and approved by the board within the required timeline. Finally, there was no documented review and approval of the reporting prior to submission. Effect: Errors were made in reporting quarterly total revenue/net charges from patient care. Lost revenue was not accurately reported. Cause: Internal controls over compliance were not in place to ensure the District properly calculated lost revenue including a lack of documented approval by management of the reporting prior to submission. Identification as a repeat finding: Not a repeat finding. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District’s response to finding.

Corrective Action Plan

Corrective Action Plan for Finding 2021-003, Reporting and Activities Allowed/Unallowed and Allowable Costs/Cost Principles We are in receipt of the findings required to be reported by the single audit for Period 1 reporting for payments received from the Provider Relief Fund (PRF), specifically, regarding discrepancies in the reporting requirements and auditing for the above period for the PRF. Management does not dispute the finding. The District will work to develop policies over financial reporting for future periods for PRF reporting and auditing. The District will perform detailed analysis of the reporting requirements in accordance with the guidelines set forth by HRSA. The District CEO, Gena Speer, will oversee this to ensure that this is accomplished. The Corrective Action Plan will be implemented by September 30, 2025.

Categories

Questioned Costs Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 1162248 2021-004
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 PROVIDER RELIEF FUND $5.93M
93.697 COVID-19 TESTING FOR RURAL HEALTH CLINICS $100,000
93.301 SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM $8,068