Finding 1211141 (2022-002)

Material Weakness Repeat Finding
Requirement
B
Questioned Costs
-
Year
2022
Accepted
2026-04-30
Audit: 400353
Organization: Carestl Health (MO)

AI Summary

  • Core Issue: Lack of supporting documentation for allowable activities under federal programs 93.224, 93.225, 93.493, and 93.527 hindered compliance verification.
  • Impacted Requirements: Failure to meet 2 CFR 200.303 and 200.302 standards for internal controls and financial management, leading to uncertainty about the legitimacy of expenditures.
  • Recommended Follow-Up: Implement improved recordkeeping practices and oversight to ensure all program documentation is maintained and accessible for audits.

Finding Text

Finding 2022-02 – Inability to Support Allowable Activities Program Number: 93.224, 93.225, 93.493, 93.527 Type of Finding: Internal Control, Compliance and Material Weakness Condition During our audit of compliance with federal requirements, we were unable to perform sufficient testing of allowable activities due to a significant lack of supporting documentation. Management was unable to provide adequate evidence demonstrating that expenditures and program activities were conducted in accordance with the terms and conditions of the federal award. Specifically: ▪ Documentation supporting program activities was not maintained or not provided upon request ▪ Only general ledger entries and limited journal supports were made available ▪ Supporting evidence of programmatic execution (e.g., participant records, activity reports, eligibility documentation, or service delivery evidence) was largely absent ▪ As a result, we could not determine whether expenditures were incurred for authorized program purposes This lack of documentation prevented us from verifying that funds were used for allowable activities under the federal program. Criteria Under 2 CFR 200.303 (Internal Controls) and 2 CFR 200.302 (Financial Management), nonfederal entities must maintain effective internal control over federal awards and provide accurate, current, and complete disclosure of financial results, supported by records that adequately demonstrate compliance. Additionally, program-specific requirements require that expenditures be incurred only for activities that are allowable and aligned with the objectives of the federal award. Cause These deficiencies appear to result from inadequate recordkeeping practices, lack of formal documentation requirements, and insufficient oversight of program-level activities. Management did not implement procedures to ensure that programmatic and financial documentation was retained and accessible for audit purposes. Effect Due to the absence of adequate documentation: ▪ We were unable to determine whether expenditures were used for allowable program activities

Corrective Action Plan

Recommendation We recommend that management: ▪ Implement formal procedures to ensure complete documentation of all program activities ▪ Maintain records demonstrating that activities are authorized and aligned with program objectives ▪ Establish centralized recordkeeping and retention policies ▪ Perform ongoing monitoring and review of program activities ▪ Train staff on federal compliance requirements and documentation expectations

Categories

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Eligibility Material Weakness Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 1211105 2022-001
    Material Weakness Repeat
  • 1211106 2022-002
    Material Weakness Repeat
  • 1211107 2022-003
    Material Weakness Repeat
  • 1211108 2022-004
    Material Weakness Repeat
  • 1211109 2022-005
    Material Weakness Repeat
  • 1211110 2022-001
    Material Weakness Repeat
  • 1211111 2022-002
    Material Weakness Repeat
  • 1211112 2022-003
    Material Weakness Repeat
  • 1211113 2022-004
    Material Weakness Repeat
  • 1211114 2022-005
    Material Weakness Repeat
  • 1211115 2022-001
    Material Weakness Repeat
  • 1211116 2022-002
    Material Weakness Repeat
  • 1211117 2022-003
    Material Weakness Repeat
  • 1211118 2022-004
    Material Weakness Repeat
  • 1211119 2022-005
    Material Weakness Repeat
  • 1211120 2022-001
    Material Weakness Repeat
  • 1211121 2022-002
    Material Weakness Repeat
  • 1211122 2022-003
    Material Weakness Repeat
  • 1211123 2022-004
    Material Weakness Repeat
  • 1211124 2022-005
    Material Weakness Repeat
  • 1211125 2022-001
    Material Weakness Repeat
  • 1211126 2022-002
    Material Weakness Repeat
  • 1211127 2022-003
    Material Weakness Repeat
  • 1211128 2022-004
    Material Weakness Repeat
  • 1211129 2022-005
    Material Weakness Repeat
  • 1211130 2022-001
    Material Weakness Repeat
  • 1211131 2022-002
    Material Weakness Repeat
  • 1211132 2022-003
    Material Weakness Repeat
  • 1211133 2022-004
    Material Weakness Repeat
  • 1211134 2022-005
    Material Weakness Repeat
  • 1211135 2022-001
    Material Weakness Repeat
  • 1211136 2022-002
    Material Weakness Repeat
  • 1211137 2022-003
    Material Weakness Repeat
  • 1211138 2022-004
    Material Weakness Repeat
  • 1211139 2022-005
    Material Weakness Repeat
  • 1211140 2022-001
    Material Weakness Repeat
  • 1211142 2022-003
    Material Weakness Repeat
  • 1211143 2022-004
    Material Weakness Repeat
  • 1211144 2022-005
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $5.67M
93.224 HEALTH CENTER PROGRAM $4.13M
93.526 GRANTS FOR CAPITAL DEVELOPMENT IN HEALTH CENTERS $0
93.778 GRANTS TO STATES FOR MEDICAID $0