Finding 387765 (2023-001)

Material Weakness
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2024-03-28
Audit: 299830
Organization: Davis County Hospital (IA)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: Management included ineligible payroll expenses in the PRF reporting portal that were also reimbursable from Medicare.
  • Impacted Requirements: Compliance with the CARES Act terms, which prohibit using funds for expenses already reimbursed by other sources.
  • Recommended Follow-Up: Enhance internal controls to ensure only eligible costs are reported and prevent double reimbursement from multiple sources.

Finding Text

Activities Allowed or Unallowed, Allowable Cost/Cost Principles - Material Weakness in Internal Control Over Compliance Reporting - Material Weakness in Internal Control Over Compliance and Material Noncompliance Federal Program: Federal Financial Assistance Listing #93.498 US Department of Health and Human Services COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) distributions state that funds are not to be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition: During the process of identifying expenses that were incurred to prevent, prepare for or respond to the coronavirus pandemic, it was noted that payroll expenses were not reduced by amounts reimbursable from other sources, namely Medicare. Cause: Due to the amount of detailed information that was required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently included in eligible expenses certain costs that were not reduced by amounts reimbursable from Medicare. Effect: Management included amounts in the PRF reporting portal which were not eligible based on the terms and conditions of the PRF distributions. Questioned Costs: None. Context: Activities Allowed or Unallowed, Allowable Cost/Cost Principles – While agreeing the expenses reported in the HRSA reporting portal submission, we identified expenses not reduced for amounts reimbursed from other sources. Reporting – Key line items were tested on the Period 4 HHS report. Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that only eligible costs are included in amounts expended and that the same expenses are not reimbursed by other sources. Views of Responsible Officials and Planned Corrective Action: Management agrees with the noted finding. Management will continue to refine processes to more diligently review expenses to ensure that expenses are not being utilized for reimbursement from multiple sources.

Corrective Action Plan

Criteria: The terms and conditions of the CARES Act Provider Relief fund (PRF) distributions state that funds are not to be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition: During the process of identifying expenses that were incurred to prevent, prepare for or respond to the coronavirus pandemic, it was noted that bonus expenses were not reduced by amounts reimbursable form other sources, namely Medicare. Corrective Action Plan: Management will continue to refine processes to more diligently review expenses to ensure that expenses are not being utilized for reimbursement from multiple sources. Anticipated Completion Date: Ongoing Responsible Individuals: Lisa Warren, CFO

Categories

Allowable Costs / Cost Principles Cash Management Material Weakness Reporting

Other Findings in this Audit

  • 964207 2023-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $761,491
93.301 Small Rural Hosital Improvement Grant Program $125,517
93.697 Testing and Mitigation for Rural Health Clinics $100,000
93.889 National Bioterrorism Hospital Preparedness $8,996