FAC Explorer

Finding 417476 (2022-002)

Significant Deficiency Repeat Finding
Requirement
I
Questioned Costs
-
Year
2022
Accepted
2023-03-20
Audit: 312152
Organization: Big Springs Medical Association D/b/a Missouri Highlands Health Care (MO)
Auditor: Forvis LLP

AI Summary

  • Core Issue: Procurement records were not kept as required by federal guidelines, leading to potential compliance risks.
  • Impacted Requirements: The Organization failed to verify that vendors were not suspended or debarred, violating its own procurement policy and Uniform Guidance.
  • Recommended Follow-up: Establish a process to ensure proper documentation is maintained for vendor verification in future procurements.

Finding Text

Health Center Program Cluster ? Assistance Listing Nos. 93.224 and 93.527U.S. Department of Health and Human Services6 H80CS00703, June 1, 2021 ? May 31, 20226 C14CS39926, September 1, 2020 ? August 31, 20236 H8FCS40544, April 1, 2021 ? March 31, 2023Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement Program ? Assistance Listing No. 93.912U.S. Department of Health and Human Services6 GA1RH33488, September 1, 2019 ? August 31, 20226 D60RH36761, August 1, 2020 ? July 31, 20216 D60RH36761, August 1, 2021 ? July 31, 20226 UK9RH43497, September 1, 2021 ? August 31, 2022Criteria or specific requirement ? Procurement (45 CFR 75.329)Condition ? Procurement records were not maintained according to Uniform Guidance. The Organization did not follow its policy governing the verification that vendors of goods or services charged to federal awards are not suspended, debarred, or otherwise excluded.Questioned costs ? UnknownContext ? Procurements from each major program were tested.? Health Center Program Cluster ? A sample of three procurements totaling $749,531 were tested out of a population of ten procurements.? Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement Program ? A sample of two procurements totaling $85,031 were tested out of a population of eleven procurements.Samples were not, and were not intended to be, statistically valid. For the two vendors tested for the Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement Program, the Organization?s procurement records were insufficient in accordance with the Organization?s procurement policy and Uniform Guidance. In all cases, documentation was not maintained of the verification that vendors selected for testing were not suspended, debarred, or otherwise excluded before entering into transactions with these vendors.Effect ? Purchases of goods or services were made that may not have been obtained in the most effective manner or in compliance with Uniform Guidance.Cause ? The Organization did not comply with its procurement policy.Identification as a repeat finding, if applicable ? Yes, see Finding 2021-001.Recommendation ? The Organization should develop a process for maintaining documentation required by its procurement policy.Views of responsible officials and planned corrective actions ?

Categories

Procurement, Suspension & Debarment

Other Findings in this Audit

  • 417471 2022-002
    Significant Deficiency Repeat
  • 417472 2022-002
    Significant Deficiency Repeat
  • 417473 2022-002
    Significant Deficiency Repeat
  • 417474 2022-002
    Significant Deficiency Repeat
  • 417475 2022-002
    Significant Deficiency Repeat
  • 417477 2022-002
    Significant Deficiency Repeat
  • 417478 2022-004
    Significant Deficiency
  • 417479 2022-004
    Significant Deficiency
  • 417480 2022-004
    Significant Deficiency
  • 417481 2022-003
    Material Weakness
  • 993913 2022-002
    Significant Deficiency Repeat
  • 993914 2022-002
    Significant Deficiency Repeat
  • 993915 2022-002
    Significant Deficiency Repeat
  • 993916 2022-002
    Significant Deficiency Repeat
  • 993917 2022-002
    Significant Deficiency Repeat
  • 993918 2022-002
    Significant Deficiency Repeat
  • 993919 2022-002
    Significant Deficiency Repeat
  • 993920 2022-004
    Significant Deficiency
  • 993921 2022-004
    Significant Deficiency
  • 993922 2022-004
    Significant Deficiency
  • 993923 2022-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $3.14M
10.768 Business and Industry Loans $1.72M
93.498 Covid-19 - Provider Relief Fund $1.68M
93.224 Covid-19 - Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $843,652
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $215,404
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $34,779
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $21,064
93.940 Hiv Prevention Activities_health Department Based $13,561
93.778 Medical Assistance Program $6,267
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $3,038
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1,516