Finding 383910 (2023-001)

Significant Deficiency
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2024-03-22
Audit: 296919
Organization: Monument Health, Inc. (SD)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: There was a significant internal control deficiency in managing federal funds, leading to overclaimed expenses of $64,404 due to unaccounted refunds from a third-party vendor.
  • Impacted Requirements: Compliance with 2 CFR 200.303 (a) was not met, as effective internal controls were lacking in the review of claimed expenses.
  • Recommended Follow-Up: Management should review third-party vendor invoices and adjust future federal reports to accurately reflect unused lost revenue.

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#460360899 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting Significant Deficiency in Internal Control over Compliance 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: Our testing identified four months of other general and administrative expenses claimed under the federal program did not consider the credit to be received back from a third-party vendor for service time not performed by the third party vendor. Cause: Monument Health prepaid a third-party vendor for services to be performed and at the end of the service period, Monument Health did not consider the refunds to be received back from a third-party vendor when claiming expenses under the federal program. Effect: The secondary review and approval over final expenditures claimed under the federal program did not identify this matter and therefore, expenses were overclaimed under the federal program and included within the special report submitted to the federal agency. Questioned Costs: The Period 4 report incorrectly included $64,404 of other general and administrative expenses. However, the Period 4 report also included approximately $6,077,500 of unused lost revenue. As a result, there are no questioned costs for activities allowed or unallowed and allowable costs/cost principles. Context: A non-statistical sample of 19 ($228,440) out of a population of 92 transactions relating to general and administrative and healthcare related expenses ($263,750), including mortgage/rent, supplies, purchased services, information technology, and facilities were tested. Summary level testing was also performed as it relates to incremental increased personnel costs relating to nursing contract labor and special incentives provided to employees. Repeat Finding from Prior Year: No Recommendation: We recommend management review the third party vendor invoices and reduce unused lost revenue in any future federal reports. 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 Federal Financial Assistance Listing: #93.498 Finding Summary: Audit testing identified four months of other general and administrative expenses claimed under the federal program did not consider the credit to be received back from a third‐party vendor for service time not performed by the third‐party vendor. The Period 4 report incorrectly included $64,404 of other general and administrative expenses. However, the Period 4 report also included approximately $6,077,500 of unused lost revenue. As a result, there are no questioned costs for activities allowed or unallowed and allowable costs/cost principles. Responsible Individuals: Austin Willuweit, Chief Financial Officer; Jen Schmaltz, Vice President of Finance Corrective Action Plan: Monument Health will review the third‐party vendor invoices and reduce unused lost revenue in any future federal reports. Anticipated Completion Date: June 30, 2024

Categories

Allowable Costs / Cost Principles Procurement, Suspension & Debarment Reporting Significant Deficiency

Other Findings in this Audit

  • 960352 2023-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $16.60M
93.461 Covid-19 Testing for the Uninsured $810,780
93.697 Covid-19 Testing for Rural Health Clinics $183,467
93.217 Family Planning_services $69,124
93.301 Small Rural Hospital Improvement Grant Program $52,044
93.103 Food and Drug Administration_research $8,364
93.268 Immunization Cooperative Agreements $600