Finding Text
U.S. Department of Health and Human Services Congressional Directives - 93.493 Award# CE152271 Criteria or Specific Requirement – Cash Management and Significant Deficiency Non-federal entities must minimize the time elapsing between the transfer of funds from the U.S. Treasury or pass-through entity and disbursement by the non-federal entity for direct program or project costs and the proportionate share of allowable indirect costs, whether the payment is made by electronic funds transfer, or issuance or redemption of checks, warrants, or payment by other means (2 CFR Section 200.305(b)). Condition – During our test work over the Congressional Directive grant, we noted the Hospital received the grant funds in October 2023. The funds were placed in a restricted cash account and were not expended until January 2025, when the MRI equipment was invoiced and subsequently paid for. As such, grant funds were drawn in advance of the incurrence of allowable costs. Cause – Management indicated that, at the time the grant funds were drawn, a former Chief Financial Officer was responsible for grant administration. Management believes the funds were drawn early to demonstrate receipt of grant funding in order for construction on the MRI suite to proceed. However, management was unable to locate written authorization, correspondence, or other documentation from HRSA approving an advance drawdown. Effect or Potential Effect – The Hospital did not comply with federal cash management requirements, as grant funds were drawn in advance of the incurrence of allowable costs and without documented federal approval. Questioned Costs – None noted. Context – The MRI equipment could not be purchased until remodeling of the imaging suite was completed, patient safety concerns were addressed, and inspection was completed. The Hospital did maintain the grant proceeds in restricted cash and did not use the funds for other purposes. No documentation was provided evidencing HRSA approval to draw funds prior to expenditure. Identification as a Repeat Finding, if applicable – Not applicable. Recommendation – Management should strengthen controls to ensure federal grant funds are drawn only as allowable costs are incurred and in accordance with grant agreement terms. Controls should require documented evidence of incurred costs prior to drawdown and retention of any federal approvals authorizing advance funding. Views of Responsible Official and Planned Corrective Actions – Management agrees with finding. See corrective action plan.