Finding 404816 (2023-007)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2023
Accepted
2024-07-01
Audit: 311195
Organization: Mobridge Regional Hospital (SD)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Hospital lacked a proper internal control process for reviewing and approving final expenditure listings, leading to potential claims of ineligible costs.
  • Impacted Requirements: Noncompliance with 2 CFR 200.303(a), which mandates effective internal controls over federal awards.
  • Recommended Follow-Up: Implement a secondary review and approval process for final expenditure listings to ensure compliance and accuracy in claims.

Finding Text

2023-007 Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN #460255944 Activities Allowed or Unallowed and Allowable Costs/Cost Principles Material Weakness in Internal Control over Compliance and Material Noncompliance 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 Hospital’s final expenditure listing identified as eligible and claimed under the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program (the program) was not reviewed and approved by a separate individual outside of the preparer. Additionally, the Hospital claimed mortgage reimbursements as expenditures under the program. Cause: The Hospital did not have an internal control process in place to ensure a secondary review and approval of the final expenditure listing and to ensure the expenditures claimed on the report were for expenditures incurred. Some amounts claimed under the program were mortgage reimbursements. Effect: Without a secondary review and approval, there is a possibility that ineligible expenditures are claimed under the program and included within the special report. Expenses included within the special report submitted to the Department of Health and Human Services for Period 4 TIN#460255944 relating to the mortgage reimbursements were overstated by $66,094. Questioned Costs: $66,094. Context/Sampling: Summary level testing was performed over mortgage and insurance expenses. In addition, a nonstatistical sample of 8 ($185,866) out of a population of 31 transactions ($302,202) relating to general and administrative and healthcare related expenses, including personnel, lease payments, supplies, equipment and other healthcare expenses were tested. Repeat Finding from Prior Years: No Recommendation: We recommend the Hospital implement a control process which includes a secondary review and approval of the final expenditure listing used to claim the allowable costs under the program. Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Federal Agency Name: Department of Health and Human Services Program Name: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Federal Financial Assistance Listing #93.498 Finding Summary: The Hospital’s final expenditure listing identified as eligible and claimed under the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program (the program) was not reviewed and approved by a separate individual outside of the preparer. Additionally, the Hospital claimed mortgage reimbursements as expenditures under the program. Responsible Individuals: Renae Karst, Chief Financial Officer Corrective Action Plan: A Grant Award Policy and Procedure Manual was established which includes, but not limited to, outlined internal controls around the review, approval, and tracking of grants/awards allowable expenses and reporting. Anticipated Completion Date: June 30, 2024

Categories

Questioned Costs Allowable Costs / Cost Principles Cash Management Eligibility Material Weakness Reporting Equipment & Real Property Management

Other Findings in this Audit

  • 404807 2023-003
    Material Weakness Repeat
  • 404808 2023-003
    Material Weakness Repeat
  • 404809 2023-003
    Material Weakness Repeat
  • 404810 2023-003
    Material Weakness Repeat
  • 404811 2023-004
    Material Weakness Repeat
  • 404812 2023-004
    Material Weakness Repeat
  • 404813 2023-004
    Material Weakness Repeat
  • 404814 2023-005
    Significant Deficiency
  • 404815 2023-006
    Material Weakness
  • 981249 2023-003
    Material Weakness Repeat
  • 981250 2023-003
    Material Weakness Repeat
  • 981251 2023-003
    Material Weakness Repeat
  • 981252 2023-003
    Material Weakness Repeat
  • 981253 2023-004
    Material Weakness Repeat
  • 981254 2023-004
    Material Weakness Repeat
  • 981255 2023-004
    Material Weakness Repeat
  • 981256 2023-005
    Significant Deficiency
  • 981257 2023-006
    Material Weakness
  • 981258 2023-007
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $784,570
10.766 Community Facilities Loans and Grants $221,626
93.155 Rural Health Research Centers $59,890
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $26,617
93.301 Small Rural Hospital Improvement Grant Program $13,011