Finding 394818 (2023-008)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2023
Accepted
2024-04-26

AI Summary

  • Core Issue: The Hospital misused Provider Relief Fund and American Rescue Plan funds by reimbursing expenses already covered by other sources.
  • Impacted Requirements: Funds must only cover un-reimbursed expenses related to COVID-19 response, as per federal guidelines.
  • Recommended Follow-Up: Strengthen policies for tracking federal awards and ensure proper training on allowable fund uses to prevent future noncompliance.

Finding Text

Identification: 93.498 United States Department of Health and Human Services, Provider Relief Fund and American Rescue Plan Rural Distribution (PRF); Noncompliance Finding/Material Weakness; Activities Allowed or Unallowed, Allowable Costs/Cost Principles and Reporting Compliance Requirements Criteria: The Provider Relief Fund and the American Rescue Plan Rural Distribution was established under the Coronavirus, Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and the Coronavirus Relief and Response Supplemental Appropriations Act (Pub. L. No. 116-260) and the American Rescue Plan Act of 2021 (Pub. L. No. 117-2) . The PRF and ARPA funds are to be used to prevent, prepare for, and respond to coronavirus. The PRF and ARPA funds are to reimburse recipients for health care related expenses or lost revenues that are attributable to coronavirus. The PRF and ARPA funds may not be used to reimburse expenses or losses that have been reimbursed by other sources or that other sources are obligated to reimburse. Condition: The Hospital did not meet the requirement that the PRF and ARPA funds be used to reimburse expenses that have not been reimbursed by other sources or that other sources are obligated to reimburse and that the funds be used to prevent, prepare for, and respond to coronavirus. Cause: The Hospital does not have procedures in place to track and monitor federal awards. Effect: The Hospital included expenditures that had been reimbursed by other federal awards and an expenditure that was not related to preventing, preparing, and responding to coronavirus. Questioned costs: $101,325 Perspective Information: Only three expenditures were listed on the recreated spreadsheet for expenditures reported for Period 4. Two were included on the listing of federal awards for the COVID-19 Small Rural Hospital Improvement Program. The other expenditure was tested and determined to not be related to preventing, preparing, or responding to coronavirus. Repeating Finding: N/A Recommendations: We recommend policies and procedures over federal grant reporting be strengthened to ensure expenditures are for their intended purpose and that the expenditures have not been reimbursed by another source or obligated to be reimbursed by other sources. Views of Responsible Officials: The Hospital has identified additional expenditures that occurred during Period 4 to prevent, prepare for, and respond to coronavirus that were not reimbursed by other sources or that other sources were obligated to reimburse that were omitted from the original submission. The Hospital will work with the Department of Health and Human Services to correct the reporting. In the future, the Hospital will maintain adequate financial records and supporting documentation for the federal awards. The tracking mechanism will include denoting if the expenditures have been reimbursed by another source or are obligated to be reimbursed by other sources. In addition, the Hospital will be proactive in getting necessary training and education regarding the allowable uses of federal funding received in future years.

Corrective Action Plan

The  Hospital  has  identified  additional  expenditures  that  occurred  during  Period  4  to  prevent, prepare for, and respond to coronavirus that were not reimbursed by other sources or that other sources were  obligated  to  reimburse  that  were  omitted  from  the  original  submission.   In  the  future,  the  Hospital  will  maintain adequate financial records and supporting documentation for the federal awards. The tracking mechanism will include denoting if the expenditures have been reimbursed by another source or are obligated to be  reimbursed  by  other  sources.  In  addition,  the  Hospital  will  be  proactive  in  getting  necessary  training  and  education regarding the allowable uses of federal funding received in future years. Responsible Individuals: Stephani Tipton, Accountant and Ken Fisher, CFO Anticipated Completion Date: Ongoing

Categories

Questioned Costs Allowable Costs / Cost Principles Material Weakness Reporting

Other Findings in this Audit

  • 394814 2023-004
    Material Weakness
  • 394815 2023-005
    Material Weakness
  • 394816 2023-006
    Material Weakness
  • 394817 2023-007
    Material Weakness
  • 971256 2023-004
    Material Weakness
  • 971257 2023-005
    Material Weakness
  • 971258 2023-006
    Material Weakness
  • 971259 2023-007
    Material Weakness
  • 971260 2023-008
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $968,885
93.301 Small Rural Hospital Improvement Grant Program $11,388