Finding 3405 (2023-003)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2023
Accepted
2023-12-05

AI Summary

  • Core Issue: The Hospital inaccurately calculated lost revenue for COVID-19 reimbursements, leading to inflated claims due to inconsistent revenue reporting.
  • Impacted Requirements: The Hospital failed to comply with 2 CFR 200.303(a), which mandates effective internal controls over federal awards to ensure compliance with regulations.
  • Recommended Follow-Up: Management should establish procedures to ensure consistent calculations for lost revenue claims in line with federal program requirements.

Finding Text

Material Weakness: Identification of the Federal Program: Federal Assistance Listing Number 10.766 US Department of Agriculture Community Facilities Loans and Grants Cluster Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Material Weakness in Internal Control Over Compliance and Material Noncompliance. Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Hospital claimed reimbursement for health-related lost revenue during the COVID-19 pandemic. The Hospital claimed reimbursement for health-related lost revenue based on a comparison of actual monthly revenue for the months of March, April, and May 2020 to the same corresponding months of 2019. Within the calculation, the Hospital excluded certain other operating revenue from the 2020 monthly totals which were included in the 2019 monthly totals. As a result, the compilation of revenue used between the periods was not consistently applied resulting in a higher lost revenue calculation than prescribed by the applicable guidance. Cause: The Hospital did not have an adequate internal control policy in place to ensure that the lost revenue calculation followed applicable guidance. Effect: The Hospital used a methodology of calculating lost revenue that was not consistent between monthly periods. Questioned Costs: Calculating lost revenue on a consistent basis between monthly periods results in question costs of $56,766. The Hospital reported eligible lost revenue of $2,063,648 which was eligible for reimbursement under the grant at 55%, up to a maximum grant award of $1,000,000. Calculating lost revenue utilizing consistent revenue between monthly periods would result in a lost revenue calculation of $1,714,971. Context: There was one lost revenue calculation required under the grant and it was selected for testing. Recommendation: We recommend that management implement procedures to ensure the lost revenue calculation claimed meets the requirement of the federal program. Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Material Weakness: Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Hospital claimed reimbursement for health-related lost revenue during the COVID-19 pandemic. Condition: The Hospital claimed reimbursement for health-related lost revenue based on a comparison of actual monthly revenue for the months of March, April, and May 2020 to the same corresponding months of 2019. Within the calculation, the Hospital excluded certain other operating revenue from the 2020 monthly totals which were included in the 2019 monthly totals. As a result, the compilation of revenue used between the periods was not consistently applied resulting in a higher lost revenue calculation than prescribed by the applicable guidance. Views of Responsible Officials: Management agrees with the finding. Planned Completion Date: April 30, 2024. Person Responsible: Cyrstal Wyatt, CFO.

Categories

Questioned Costs Allowable Costs / Cost Principles Cash Management Material Weakness Reporting Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 579847 2023-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $1.00M
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $250,000
93.697 Covid-19 Testing for Rural Health Clinics $160,691
93.155 Rural Health Research Centers $150,561
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $108,323
93.301 Small Rural Hospital Improvement Grant Program $12,836