Finding 12365 (2022-005)

Material Weakness
Requirement
AB
Questioned Costs
-
Year
2022
Accepted
2023-09-26
Audit: 16759
Organization: Bjc Healthcare (MO)

AI Summary

  • Core Issue: BJC HealthCare lacks consistent evidence for the review and approval of employee incentive pay expenses, risking non-compliance with federal program requirements.
  • Impacted Requirements: Internal controls must align with Section 200.303(a) of the Uniform Guidance, ensuring compliance with federal statutes and regulations.
  • Recommended Follow-Up: Management should improve internal controls over time card approvals and ensure retention of evidence for all control activities.

Finding Text

Finding 2022-005 ? A. Activities Allowed or Unallowed and B. Allowable Costs/Cost Principles Identification of the federal program: Federal Agency: U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (Assistance Listing No. 93.498) (PRF) BJC HealthCare Location: Various Tax Identification Numbers: Various Payment Received Period: 07/01/2021?06/30/2021 (Period 3) and 07/01/2021?12/31/2021 (Period 4) Deadline to Use Funds: December 31, 2022 Criteria or specific requirement (including statutory, regulatory or other citation): Section 200.303(a) of the Uniform Guidance states the following regarding the auditee and internal control: ?The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States or the ?Internal Control Integrated Framework,? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? Condition: Evidence was not consistently retained to show review and approval of employee incentive pay expenses. In addition, we were unable to validate the control activities performed by the reviewer/approver for employee incentive pay expenses that were based on unit vacancy rates. Cause: Time cards can be processed without manager approval. Evidence of control activities performed by the reviewer/approver for employee incentive pay expenses that were based on unit vacancy rates was not retained. Effect or potential effect: BJC HealthCare may incur unallowable expenses or not be in compliance with the terms and conditions of the federal program, including relevant cost principles. Questioned costs: None. Context: Payroll-related expenses are $3,627,526, representing 10.9% of total PRF expenditures reported on the schedule of expenditures of federal awards of $33,214,104 for the year ended December 31, 2022. Identification as a repeat finding: This finding is not a repeat finding from the prior year. Recommendation: Management should reassess the design of internal controls over the review and approval of time cards. Evidence of control activities performed should be retained. Views of responsible officials: Management agrees with the finding as reported. Expenses will not be utilized in future PRF reporting periods. If, at some future date, additional funds are received and expenses are utilized for the PRF funds, BJC HealthCare will implement appropriate internal controls around review and approval of allowable activities and allowable costs.

Corrective Action Plan

Finding 2022-005 ? A. Activities Allowed or Unallowed and B. Allowable Costs/Cost Principles Identification of the federal program: Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (Assistance Listing No. 93.498)(PRF) Federal Agency: U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) BJC HealthCare Location: Various Tax Identification Numbers: Various Payment Received Periods: July 1, 2021 through June 30, 2021 (Period 3) and July 1, 2021 through December 31, 2021 (Period 4) Views of responsible officials and planned corrective actions: BJC HealthCare agrees with the finding as reported. BJC HealthCare is committed to complying with program requirements and meeting program objectives as defined in Section 200.303(a) of the Uniform Guidance, regarding auditee internal controls. BJC HealthCare does not expect to report expenses in any future reporting period. If, at some future date, additional funds are received and expenses are utilized for the PRF funds, BJC HealthCare will implement appropriate internal controls around review and approval of allowable activities and allowable costs. Responsible Parties: Lori Schreiner, Vice President, Finance, BJC HealthCare Completion Date: Expenses will not be utilized in future PRF reporting periods.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 12361 2022-001
    Significant Deficiency Repeat
  • 12362 2022-002
    Material Weakness
  • 12363 2022-001
    Significant Deficiency Repeat
  • 12364 2022-002
    Material Weakness
  • 12366 2022-003
    Material Weakness
  • 12367 2022-004
    Significant Deficiency Repeat
  • 12368 2022-003
    Material Weakness
  • 12369 2022-004
    Significant Deficiency Repeat
  • 588803 2022-001
    Significant Deficiency Repeat
  • 588804 2022-002
    Material Weakness
  • 588805 2022-001
    Significant Deficiency Repeat
  • 588806 2022-002
    Material Weakness
  • 588807 2022-005
    Material Weakness
  • 588808 2022-003
    Material Weakness
  • 588809 2022-004
    Significant Deficiency Repeat
  • 588810 2022-003
    Material Weakness
  • 588811 2022-004
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
97.036 Covid-19 Disaster Grants - Public Assistance (presidentially Declared Disasters) $41.26M
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $33.21M
84.268 Federal Direct Student Loans $6.87M
32.006 Covid-19 Telehealth Program $996,722
93.399 Cancer Control $935,498
84.063 Federal Pell Grant Program $845,056
84.425 Covid-19 Education Stabilization Fund $772,347
93.889 National Bioterrorism Hospital Preparedness Program $573,948
93.788 Opioid Str $434,497
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $166,782
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $117,608
84.007 Federal Supplemental Educational Opportunity Grants $115,990
93.461 Covid-19 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Funding $109,704
93.155 Covid-19 Rural Health Research Centers $60,080
93.493 Congressional Directives $37,816
93.395 Cancer Treatment Research $21,783
93.124 Nurse Anesthetist Traineeships $15,896
21.027 Covid-19 Coronavirus State and Local Fiscal Recovery Funds $15,866
16.582 Crime Victim Assistance/discretionary Grants $15,706
93.173 Research Related to Deafness and Communication Disorders $13,366
93.732 Mental and Behavioral Health Education and Training Grants $11,136
93.301 Small Rural Hospital Improvement Grant Program $9,687
93.558 Temporary Assistance for Needy Families $9,423
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $6,864
93.671 Covid-19 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $3,196