Finding 12369 (2022-004)

Significant Deficiency Repeat Finding
Requirement
ABHN
Questioned Costs
-
Year
2022
Accepted
2023-09-26
Audit: 16759
Organization: Bjc Healthcare (MO)

AI Summary

  • Core Issue: Internal controls over FEMA expense reviews were inadequately designed, risking unallowable expenses being charged.
  • Impacted Requirements: Compliance with Section 200.303(a) of the Uniform Guidance regarding effective internal control over federal awards.
  • Recommended Follow-Up: Management should enhance controls and documentation to ensure proper review, reconciliation, and allocation of FEMA expenses.

Finding Text

Finding 2022-004 ? A. Activities Allowed or Unallowed, B. Allowable Costs/Cost Principles, H. Period of Performance and N. Special Tests and Provisions Identification of the federal program: Federal Agency: U.S. Department of Homeland Security, Federal Emergency Management Agency (FEMA) Pass-Through Entities: Missouri State Emergency Management Agency and Illinois Emergency Management Agency Federal Program: COVID-19 Disaster Grants ? Public Assistance (Presidentially Declared Disasters) (Assistance Listing No. 97.036) BJC HealthCare Location: Various Pass-Through Award Numbers: Pass-Through Award Periods: PA-07-MO-4490-PW-00281(0) 08/01/2020?09/30/2021 PA-07-MO-4490-PW-00492(664) 01/01/2020?05/11/2023 PA-07-MO-4490-PW-00508(688) 01/21/2020?03/31/2021 PA-05-IL-4489-PW-00787(0), PA-05-IL-4489-PW-00787(1) 07/01/2020?12/31/2021 PA-05-IL-4489-PW-00788(0), PA-05-IL-4489-PW-00788(1) 07/01/2020?12/31/2021 PA-05-IL-4489-PW-00789(0), PA-05-IL-4489-PW-00789(1) 07/01/2020?12/31/2021 PA-05-IL-4489-PW-01324(1704) 01/01/2020?05/11/2023 PA-05-IL-4489-PW-01329(1701) 01/01/2020?05/11/2023 PA-05-IL-4489-PW-01330(1702) 01/01/2020?05/11/2023 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: Management implemented an internal control over the review and approval of a sample of FEMA expenses during the fiscal year for compliance with allowability, period of performance, and special tests and provisions requirements. However, the internal control did not include the following: ? A reconciliation to ensure the population subject to the internal control reconciled to the expenses claimed or to be claimed under the FEMA program. ? A review to ensure that invoices allocated between multiple project worksheets did not exceed claim in total. In addition, documentation over when the internal control was performed and by whom was not consistently maintained. Cause: Management?s internal control over the review and approval FEMA expenses for compliance with allowability, period of performance, and special tests and provisions requirements was not properly designed. Effect or potential effect: Unallowable expenses could be charged to the FEMA program. Questioned costs: None. Context: Total FEMA expenditures reported on the schedule of expenditures of federal awards are $42,087,643 for the year ended December 31, 2022. Identification as a repeat finding: This finding is a partial repeat of finding 2021-004 from the prior year. Recommendation: Management should reassess its internal controls over the review and approval of FEMA expenses for compliance with allowability, period of performance, and special tests and provisions requirements. Views of responsible officials: Management agrees with the finding and will implement controls and documentation 1) to demonstrate when the control was performed and by whom, 2) to ensure that invoices allocated between multiple project worksheets do not exceed the claim in total, and 3) to include a reconciliation to ensure the population ties to the expenses claimed and expenses to be claimed.

Categories

Allowable Costs / Cost Principles Special Tests & Provisions

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
  • 12365 2022-005
    Material Weakness
  • 12366 2022-003
    Material Weakness
  • 12367 2022-004
    Significant Deficiency Repeat
  • 12368 2022-003
    Material Weakness
  • 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