Finding 3842 (2020-002)

Material Weakness
Requirement
P
Questioned Costs
-
Year
2020
Accepted
2023-12-11
Audit: 6053
Organization: Frederick Health Inc. (NJ)

AI Summary

  • Core Issue: The System failed to establish a formal process for preparing and reviewing the Schedule of Expenditures of Federal Awards, leading to delays in timely completion.
  • Impacted Requirements: This finding violates Title 2 U.S. Code of Federal Regulations, Part 200.303, which mandates effective internal controls for managing Federal awards.
  • Recommended Follow-Up: Develop a formal process for preparing the Schedule and ensure staff with the necessary expertise are identified and trained for this task.

Finding Text

Federal Program Information Federal Agency: U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) Award: Assistance Listing Number 93.461 COVID-19 - HRSA COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund Award Period: February 4, 2020 - Ongoing Description: Timely Preparation of Schedule of Expenditures of Federal Awards Type of Finding: Material Weakness in Internal Control Over Compliance Criteria or specific requirement (including statutory, regulatory or other citation) In accordance with Title 2 U.S. Code of Federal Regulations, Part 200.303, Internal controls, “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.” These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition The System had not developed a formal process to prepare and review its Schedule of Expenditures of Federal Awards and was not able to complete the Schedule for the year ended June 30, 2020 in a timely manner. Cause During the year ended June 30, 2020, the System was required to prepare the Schedule for the first time since its expenditures exceeded $750,000. This was primarily due to a new grant that arose suddenly in response to treating Covid-19 patients. Consequently, the System had not identified individuals with the appropriate knowledge and training to prepare the Schedule for this fiscal period. This also occurred as a result of Covid-19 which impacted the availability of resources due to the challenges presented to the System which were unexpected and strained existing resources and the ability to hire new resources on a timely basis. Effect or potential effect The reporting and verification of the completeness and accuracy of the expenditures required more time than expected since this was the initial preparation of the Schedule and the unique requirements of the Covid-19 funds. Questioned costs None Identification of a repeat finding This is not a repeat finding. Context The audit was not completed and the reporting submitted within the earlier of 30 calendar days after receipt of the auditor’s report(s), or nine months after the end of the audit period as required by the Uniform Guidance. Recommendation The System’s should develop a formal process to prepare and review the Schedule and identify resources with appropriate knowledge to be involved in this process. View of responsible officials There is no disagreement with the audit finding.

Corrective Action Plan

Management analyzed the amounts submitted for reimbursement and compared to the applicable terms and conditions of this grant. As part of this review, management assessed whether any internal control gaps existed and confirmed the completeness and accuracy of reimbursement claims that were flagged within its patient accounting system. Refunds were issued in the amount of $144,355.56 for accounts that were identified to have insurance as the result of this review

Categories

Reporting Cash Management Material Weakness Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 3843 2020-001
    Material Weakness
  • 580284 2020-002
    Material Weakness
  • 580285 2020-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.461 Covid-19 Testing for the Uninsured $462,559
16.575 Crime Victim Assistance $289,217
93.817 Hospital Preparedness Program (hpp) Ebola Preparedness and Response Activities $87,248
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $25,000
16.588 Violence Against Women Formula Grants $21,717