Finding 20377 (2022-001)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-02-05
Audit: 19419
Organization: Peacehealth Networks (WA)
Auditor: Kpmg

AI Summary

  • Core Issue: Duplicate reporting of lost revenues totaling $11,318,467 occurred between the parent entity and its subsidiary, leading to overstatement in the Provider Relief Fund Portal.
  • Impacted Requirements: Internal controls were ineffective in ensuring compliance with federal reporting standards, specifically regarding the prohibition of reporting the same lost revenues in multiple periods.
  • Recommended Follow-Up: Enhance internal controls by implementing an independent review process for portal reporting to prevent future duplicate entries.

Finding Text

Program Information Federal Program: Provider Relief Fund (PRF) Assistance Listing Number: 93.498 Federal Agency: Department of Health & Human Services Award Year: PRF Periods 2 and 3: Funds received July 1, 2020 through June 30, 2021 Criteria or requirement Per Title 2, U.S. Code of Federal Regulations Part 200 (2 CRF 200), Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award, (Subpart D, Section 200.303), the nonfederal entity must 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. Reporting (L) ? Special Reporting Under the terms and conditions of the award, Provider Relief Funds (PRF) is subject to 45 CFR section 75.302 (Financial management and standards for financial management systems). The PRF program requires special reporting through the Provider Relief Fund Reporting Portal that contains key line items containing critical information based on the period reported on, which includes the Calculation of Lost Revenues Attributable to Coronavirus. The Provider Relief Programs: Provider Relief Fund and ARP Rural Payments Frequently Asked Questions states that PRF payments may not be applied to the same expenses and lost revenues that were reported on in prior reporting periods. Finding Criteria Discussion Condition found, including facts that support the deficiency identified in the finding and information to provide proper perspective for judging the prevalence and consequences of the finding: During our testing over reporting, we observed management did not have effective internal controls in place to ensure lost revenues reported in the Portal were not duplicated between a subsidiary entity and the parent entity, resulting in an overstatement of lost revenues reported in the Portal. Lost revenues attributable to Coronavirus in the amount of $11,318,467 were reported in both the parent entity?s PRF reports for the general distribution report for Period 1 and for PeaceHealth St. John Medical Center?s, a subsidiary, targeted distribution report for Period 2 (i.e., lost revenues were duplicated). Cause and possible asserted effect: Controls were not operating effectively to detect and correct duplicate lost revenues shown on the portal reporting between the parent entity and the stand-alone subsidiary reports for targeted funds. Identification of questioned costs and how they were computed: None. Despite the duplicated lost revenues, there was still sufficient lost revenues in excess of PRF payments received for Period 1, 2, and 3 and therefore the Corporation has demonstrated it did earn all of the PRF payments received. This matter was isolated to the error in reporting requirements under the Federal grant program. Sample Statistically Valid The sample was not intended to be, and was not, a statistically valid sample. Repeat finding from prior year This matter is not a repeat of a finding in the immediately prior audit. Recommendation We recommend PeaceHealth management enhance their internal control process to ensure the data underlying the portal reporting is appropriately reviewed by an individual other than the preparer to ensure that duplicate lost revenue information is not reported. Views of Responsible Officials: As noted within the portal filing summary for the general reporting Period 1, the Corporation?s consolidated lost revenue totaled $141,363,926. Payments from the PRF for Period 1 totaled $53,982,121 for the consolidated parent and $14,810,675 for St. John?s Medical Center Period 2 targeted report. As a result, there were sufficient qualifying lost revenues to receive and earn all PRF funds received, regardless of the reporting error identified and described in the ?condition found? section above. Therefore, management believes no repayment of PRF funds received would be required. Management is implementing a process to add additional review steps prior to finalizing future reporting submissions.

Corrective Action Plan

As noted within the portal filing summary for the general reporting Period 1, the Corporation?s consolidated lost revenue totaled $141,363,926. Payments from the PRF for Period 1 totaled $53,982,121 for the consolidated parent and $14,810,675 for St. John?s Medical Center Period 2 targeted report. As a result, there were sufficient qualifying lost revenues to receive and earn all PRF funds received, regardless of the reporting error identified and described in the ?condition found? section above. Therefore, management believes no repayment of PRF funds received would be required. Management is implementing a process to add additional review steps prior to finalizing future reporting submissions.

Categories

Matching / Level of Effort / Earmarking Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 596819 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $19.39M
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $440,492
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $294,415
93.788 Opioid Str $189,184
93.461 Covid-19 Testing for the Uninsured $50,720
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $34,572
93.242 Mental Health Research Grants $22,261
93.268 Immunization Cooperative Agreements $13,779
93.855 Allergy, Immunology and Transplantation Research $5,396