Finding 369475 (2022-002)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2024-02-15
Audit: 290693

AI Summary

  • Core Issue: The Hospital lacks effective internal controls for reporting under the Provider Relief Funding program.
  • Impacted Requirements: Compliance with HHS reporting guidelines was not ensured, leading to incorrect reporting under Option 1 instead of Option 3.
  • Recommended Follow-Up: Implement stronger internal controls to align reporting processes with the latest HHS guidelines.

Finding Text

Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: Provider Relief Funding CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 1 & 2 Type of Finding: Significant Deficiency in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Hospital’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Hospital did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines. Questioned costs: None Context: During our testing, it was identified that the Hospital input lost revenue information under Option 1, which compared actual net patient revenue for each quarter during the period of availability against actual for each quarter. In order to utilize this option, all net patient revenue must be included in the calculation and management identified a net percentage within the calculation and intended to report under Option 3. As such, the Hospital calculated lost revenues in accordance with the guidelines of Option 3, but erroneously reported under Option 1. Cause: The Hospital was amidst a pandemic and due to the reporting requirements constantly changing, the Hospital reported under their initial understanding of the lost revenue guidance. Effect: The auditor noted no instances of noncompliance with the provisions of lost revenues claimed, as the approved quarters lost revenues exceeded the amount claimed; however, the internal controls around compliance over reporting were not effective. Repeat Finding: N/A Recommendation: We recommend the Hospital design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.

Corrective Action Plan

Recommendation: We recommend the Hospital design controls to ensure documentation is completed timely and sufficiently on how costs are necessary to respond to COVID-19. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Hospital will ensure that controls are put into place to report lost revenues in accordance with HHS guidelines. Name of the contact person responsible for corrective action: Barry Mandell, VP Special Projects. Planned completion date for corrective action plan: April 1, 2022

Categories

Reporting Significant Deficiency Internal Control / Segregation of Duties Special Tests & Provisions

Other Findings in this Audit

  • 369474 2022-001
    Significant Deficiency
  • 945916 2022-001
    Significant Deficiency
  • 945917 2022-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $7.72M
93.461 Covid-19 Testing for the Uninsured $98,600
93.889 National Bioterrorism Hospital Preparedness Program $45,150