Finding 410383 (2022-005)

Material Weakness
Requirement
AB
Questioned Costs
-
Year
2022
Accepted
2023-01-29
Audit: 311964
Organization: Washington County Hospital (IL)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Hospital incorrectly claimed $1,048,162 in expenses for COVID-19 relief, including costs incurred before eligible activities began and expenses funded by other sources.
  • Impacted Requirements: The Hospital failed to comply with 2 CFR 200.303(a), which requires effective internal controls to ensure compliance with federal award terms.
  • Recommended Follow-Up: Enhance internal control policies to verify that claimed expenditures meet federal program requirements and update future reports to HHS as necessary.

Finding Text

2022-005 Department of Health and Human ServicesFederal Financial Assistance Listing #93.498COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural DistributionApplicable Federal Award Number and Year ? Period 1 TIN #376020408Activities Allowed or Unallowed and Allowable Costs/Cost Principles and ReportingMaterial Weakness in Internal Control Over Compliance and Material Noncompliance for ReportingCriteria: 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 claimed expenses that were incurred prior to when the Hospital began to prepare for, prevent and respond to the coronavirus. The Hospital also claimed expenses within ?Other PRF Expenses? that were funded by other sources. The Hospital offset these other funding sources in later periods out of the ?Other Unreimbursed Expenses?. This resulted in the incorrect categorization of expenses on the special report submitted to the Department of Health and Human Services (HHS) for Period 1 which caused the report to be inaccurate.Cause: The terms and conditions were not properly reviewed to ensure claimed expenses were allowable under the federal program and claimed with the special report submitted to HHS for Period 1.Effect: There were $1,048,162 of expenses claimed and reported incorrectly in the special reported submitted to HHS for Period 1.Questioned Costs: None reported for activities allowed or unallowed and allowable costs/cost principles as expenses that were originally reported in the Unreimbursed Expenses Attributable to Coronavirus section of the special report submitted to HHS for Period 1 TIN #376020408 were tested to cover the amount of unallowed expenses.Context: A nonstatistical sample of 60 items ($302,483) from a total population exceeding 250 items ($3,824,947) were tested for activities allowed or unallowed and allowable costs/cost principles. Key line items were tested on the special report submitted to HHS for Period 1.Repeat Finding from Prior Years: NoRecommendation: We recommend the Hospital enhance internal control policies to ensure expenditures claimed under the federal program meet the terms and conditions and are properly included in the reports required to be submitted to the federal agency. We recommend management to update any future special reports submitted to HHS as deemed appropriate.Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Finding 2022-005Federal Agency Name: Department of Health and Human ServicesProgram Name: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural DistributionFederal Financial Assistance Listing #93.498Compliance Requirement: Activities Allowed or Unallowed and Allowable Costs/Cost Principles and ReportingFinding Summary: The Hospital claimed expenses that were incurred prior to when the Hospital began to prepare for, prevent and respond to the coronavirus. The Hospital also claimed expenses within "Other PRF Expenses" that were funded by other sources. The Hospital offset these other funding sources in later periods out of the "Other Unreimbursed Expenses". This resulted in the incorrect categorization of expenses on the special report submitted to the Department of Health and Human Services (HHS) for Period 1 which caused the report to be inaccurate.Responsible Individuals: Jennifer Venable, CFOCorrective Action Plan: Management agrees with the finding. In subsequent reporting expenses will be categorized appropriately and consideration given to align the receipt of other funding sources with the reporting of expenses within the same quarter.Anticipated Completion Date: January 25, 2023

Categories

Allowable Costs / Cost Principles Material Weakness Reporting

Other Findings in this Audit

  • 410382 2022-004
    Material Weakness
  • 410384 2022-005
    Material Weakness
  • 410385 2022-006
    Material Weakness
  • 410386 2022-004
    Material Weakness
  • 410387 2022-007
    Significant Deficiency
  • 986824 2022-004
    Material Weakness
  • 986825 2022-005
    Material Weakness
  • 986826 2022-005
    Material Weakness
  • 986827 2022-006
    Material Weakness
  • 986828 2022-004
    Material Weakness
  • 986829 2022-007
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $3.82M
93.155 Rural Health Research Centers $256,978
93.301 Small Rural Hospital Improvement Grant Program $10,833
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $7,500