Finding 394686 (2023-001)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2023
Accepted
2024-04-25
Audit: 304570
Organization: Harney District Hospital (OH)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The District failed to reduce expenses by amounts reimbursed from other sources, leading to overreported costs.
  • Impacted Requirements: This violates 2 CFR 200.303(a), which mandates effective internal controls for compliance with federal award regulations.
  • Recommended Follow-Up: Enhance internal control policies to ensure proper review of reimbursements and compliance with federal program requirements.

Finding Text

2023-001 Department of Health and Human Services Federal Financial Assistance Listing #93.498 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN # Activities Allowed or Unallowed, Allowable Costs/Cost Principles and Reporting Material Weakness in Internal Control Over Compliance and Material 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 District did not reduce expenses by amounts reimbursed by other sources related to cost-based reimbursement, as some costs incurred in providing services to the Medicare population are reimbursed. Cause: The District did not have an adequate internal control policy in place to ensure review of amounts reimbursed by other sources. Effect: The District submitted expenses over their actual allowable expenses. Questioned Costs: $369,475 Context: A nonstatistical sample of 9 expenditures were selected for testing, which accounted for $1,155,652 of $1,314,047 direct program expenditures. None of the expenditures were reduced by reimbursements from other sources, which resulted in unallowable costs of $369,475 when considered for the entire population. Repeat Finding from Prior Years: No Recommendation: We recommend that the District enhance internal control policies to ensure that expenses are reviewed for reimbursement from other sources and meet the requirements of the federal program. Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Federal Award Findings and Questioned Costs Finding 2023-001 Federal Agency Name: Department of Health and Human Services Assistance Listing Number: 93.498 Program Name: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Initial Fiscal Year Finding Occurred: 2023 Finding Summary: The District did not reduce expenses by amounts reimbursed by other sources related to cost-based reimbursement, as some costs incurred in providing services to the Medicare population are reimbursed. The amount of questionable costs not reduced for Medicare reimbursement total $369,475. However, the District had unreimbursed expenses identified on the HRSA Period 4 report as well as additional payroll in excess of what was reported: Additional ARP RURAL Personnel Expenses reduced for amounts reimbursed by other sources Q4 (2022) $45,337 Additional ARP RURAL Fringe Benefit Expenses reduced for amounts reimbursed by other sources Q4 (2022) $10,820 Unreimbursed Expenditures attributed to COVID-19 (reported on Period 4 Report) reduced for amounts reimbursed by other sources $9,122 TOTAL UNREIMBURSED EXPENDITURES $65,279 The District would appreciate consideration of the $65,279 unreimbursed expenses in determining the amount owed back for unspent funding so as to reduce the amount to be paid back to HRSA to $304,196. Corrective Action Plan: The District will enhance internal control practices to ensure expenses are reviewed for reimbursement from other sources and meet the requirements of the federal program. To ensure that expenses are reduced for amounts reimbursed by other sources, the District will incorporate a cost ratio calculation in their process of computing allowable expenses for federal funding programs. Responsible Individuals: Catherine White, Chief Financial Officer and Pennie Peasley, Accounting Manager Anticipated Completion Date: April 1, 2024

Categories

Questioned Costs Allowable Costs / Cost Principles

Other Findings in this Audit

  • 971128 2023-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $7.47M
93.498 Provider Relief Fund $1.31M
21.019 Coronavirus Relief Fund $98,258
93.155 Rural Health Research Centers $90,000