Finding 393278 (2023-002)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-04-16
Audit: 303568
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Medical Center reported expenses incorrectly in Period 5 due to a carryover error from a previous report.
  • Impacted Requirements: The lack of effective internal controls violated 2 CFR 200.303(a), which mandates proper management of federal awards.
  • Recommended Follow-Up: Enhance internal control policies to ensure thorough review and approval of expense reports for compliance with federal program requirements.

Finding Text

Department of Health and Human Services Federal Assistance Listing #93.498 COVID‐19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 and Period 5 TIN #450231181 Reporting Significant Deficiency in Internal Control Over Compliance and Noncompliance 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 The Medical Center improperly reported expenses in the Period 5 report submission due to an amount improperly carried forward from a previous report. Cause The Medical Center did not have an adequate internal control policy in place to ensure that expenses were properly reported in future submissions in accordance with the terms and conditions of the grant. Effect While the error provided a difference between reported expenses and supportable expenses, the Medical Center had excess lost revenues available to be applied to future periods. This error also indicated there is a lack of policies governing the review and approval of the expense reporting to the HHS special report. Questioned Costs None reported. Reported expenses were overstated by $66,659 on the Period 5 report, however, the Medical Center had $94,302 of excess lost revenue to offset this error. Context/Sampling: All key line items from the Period 4 and Period 5 reports were tested. Repeat Finding from Prior Years: No Recommendation We recommend that the Medical Center enhance internal control policies to ensure all reports are reviewed and approved to ensure the proper reporting and meet the requirements of the federal program. Views of Responsible Officials Management agrees with the finding.

Corrective Action Plan

Federal Agency Name: Department of Health and Human Services Federal Assistance Listing: #93.498 Program Name: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Finding Summary: Expense carryforward was improperly submitted as unused lost revenue in Period 1, which caused the amount to be improperly carried forward to Period 5 from the previous report. Corrective Action Plan: All tracking and reports will be reviewed by someone other than the preparer. The reviewer will sign off by email or by physical signature that they have reviewed and agree with the support. Responsible Individuals: Beverly Fiferlick, CFO Anticipated Completion Date: June 30, 2024

Categories

Reporting Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 969720 2023-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $11.04M
93.498 Provider Relief Fund $1.60M
93.301 Small Rural Hospital Improvement Grant Program $241,816