Finding 1162248 (2021-004)

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 provide adequate documentation for approximately $1,217,000 in claimed expenses under the COVID-19 Provider Relief Fund.
  • Impacted Requirements: Reporting requirements (45 CFR 75.342) and allowable costs principles were not met, leading to unsupported expenditures.
  • Recommended Follow-Up: Implement stronger internal controls and ensure management reviews and approves reports before submission to comply with program terms.

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. The funds cannot be used for expenses reimbursed or obligated to be reimbursed by other sources. Questioned costs: Approximately $1,217,000. Questioned costs were estimated by applying the error percentages separately for construction related expenditures and non-construction related expenditures to the related populations. Construction related claimed expenditures totaled $1,214,061 with one error noted of $1,124,595. Other claimed expenditures not related to construction totaled $467,154 with six errors noted amounting to $36,444. Context: The period one provider relief fund report was tested. The District was unable to provide supporting documentation to support all of the $467,154 expenditures not related to construction claimed on the period one reporting. Additionally, the District claimed expenditures for construction in the amount of $1,214,061 which included amounts that were not completed as of the end of the covered period. Finally, there was no documented review and approval of the reporting prior to submission. Effect: The District submitted expenses under the PRF program for which adequate support could not be provided. Cause: The guidance provided by HHS to providers across the country as to how to report their COVID-19-related expenses and lost revenues is, at times, difficult to comprehend and apply. Internal controls were not in place to ensure the District correctly applied the guidance including a lack of documented approval by management of the reporting prior to submission. Identification as a repeat finding: Not a repeat finding. Recommendation: Management should ensure proper internal controls are put into place to ensure that allowable expenses reported are properly supported and in accordance with program terms. 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 2021-004, 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 District had enough expenditures for Period 1 and 4 funding received to cover any disqualified lost revenues that were utilized as a basis for the funds received. The Corrective Action Plan will be implemented by September 30, 2025.

Categories

Questioned Costs Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 1162247 2021-003
    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