Finding 377305 (2023-006)

Significant Deficiency
Requirement
P
Questioned Costs
-
Year
2023
Accepted
2024-03-14
Audit: 295111
Organization: Floyd County Medical Center (IA)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Hospital lacks an effective internal control system for preparing the Schedule of Expenditures of Federal Awards.
  • Impacted Requirements: Proper financial reporting controls are necessary to ensure the Schedule is complete and accurate.
  • Recommended Follow-Up: Management should enhance awareness of financial reporting requirements and strengthen internal controls related to the Schedule preparation.

Finding Text

Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID‐19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN #420868216 Preparation of Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance – Other Criteria: Proper controls over financial reporting include the ability to prepare the Schedule of Expenditures of Federal Awards (Schedule) and accompanying notes to the Schedule. Condition: The Hospital does not have an internal control system designed to provide for a complete and accurate Schedule being audited. We were requested to draft the Schedule and notes to the Schedule. Cause: Auditor assistance with preparation of the Schedule is not unusual as the Schedule has unique and specialized requirements and preparation is only required when the Hospital meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the Hospital would not be able to draft the Schedule that is correct without the assistance of the auditors. Questioned Costs: None reported. Context: Sampling was not used. Repeat Finding from Prior Years: No Recommendation: While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital’s Schedule and the internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Federal Agency Name: Department of Health and Human Services Program Name: COVID‐19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN #420868216 Federal Financial Assistance Listing #93.498 Compliance Requirement: Preparation of Schedule of Expenditures of Federal Awards ‐ Other Finding Summary: The Hospital does not have an internal control system designed to provide for a complete and accurate Schedule being audited. Eide Bailly, LLP, the auditors, were requested to draft the Schedule and notes to the Schedule. Responsible Individuals: Craig Carstens, CFO Corrective Action Plan: Management agrees with this finding. Management will develop and implement an internal control system tailored to ensure completeness and accuracy in auditing the Schedule. Management will clearly define the objectives of the internal control system to address gaps in auditing procedures. Management will set clear standards and protocols for auditing processes, ensuring adherence to regulatory requirements. Management will provide comprehensive training to staff involved in auditing processes to ensure they understand their roles and responsibilities. Management will conduct regular assessments and reviews of the internal control system's effectiveness and make adjustments as needed to improve accuracy and completeness. Anticipated Completion Date: 2/26/2024.

Categories

Reporting Significant Deficiency

Other Findings in this Audit

  • 377303 2023-004
    Significant Deficiency
  • 377304 2023-005
    Significant Deficiency Repeat
  • 953745 2023-004
    Significant Deficiency
  • 953746 2023-005
    Significant Deficiency Repeat
  • 953747 2023-006
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $1.71M
93.301 Small Rural Hospital Improvement Grant Program $254,631
93.697 Covid-19 Testing for Rural Health Clinics $100,000