Finding 46046 (2022-001)

Significant Deficiency
Requirement
B
Questioned Costs
-
Year
2022
Accepted
2023-06-19
Audit: 51260
Organization: Valley Children's Healthcare (CA)
Auditor: Moss Adams

AI Summary

  • Core Issue: Valley Children's Healthcare reported duplicate expenses for the COVID-19 Provider Relief Fund in Period 2, which were already claimed in Period 1.
  • Impacted Requirements: The organization failed to comply with the complex reporting terms of the Provider Relief Fund and American Rescue Plan, leading to inaccuracies in financial submissions.
  • Recommended Follow-Up: Update reporting processes and enhance controls to ensure compliance with program requirements, as corrective measures have already begun for Period 3 reporting.

Finding Text

Finding 2022-001 ? Reporting ? Significant Deficiency in Internal Control Over Compliance Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution (Assistance Listing #93.498) Federal Agency: U.S. Department of Health and Human Services Award Year: 2020-2021 Criteria: Under the COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program, providers are required to submit reporting to the Health Resources Services Administration (HRSA) that describes the uses of the funds and how the provider complied with the terms and conditions of the program. Condition: During our testing of the reporting of expenses that were reimbursed by Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program funds, expenses previously reported for Period 1 reimbursement were also included in the Period 2 reporting. Cause: The specific terms and conditions of the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program are complex and have evolved over the duration of the program. Valley Children?s Healthcare?s processes over Period 2 reporting were not sufficient to interpret the complexities of the terms and conditions of the program, which was the primary cause of the condition noted above. Effect or potential effect: Due to the above noted cause, duplicate expenses that were previously reported for Period 1 were reported again in Period 2 reporting. Questioned costs: None to be reported. Context: During the fiscal year ended September 30, 2022, the specific terms and conditions of the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program evolved and included complexities. As a result, Valley Children's Healthcare?s processes did not identify the discrepancy in reporting. However, Valley Children?s Healthcare has sufficient unreimbursed lost revenues and additional, unreported expenses in the appropriate period of availability to cover the duplicate expenses reported in Period 2 reporting. Identification as a repeat finding, if applicable: This is not a repeat finding. Recommendation: We recommend that Valley Children's Healthcare update processes and review controls to comply with the terms and conditions of the COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program. . Views of responsible officials: Beginning with Period 3 reporting, Valley Children?s Healthcare has corrected their process and added an additional layer of review control over the completeness and accuracy of expenditures and calculations included in all submissions.

Corrective Action Plan

As required by the OMB Uniform Guidance, we have provided our response and corrective action plan addressing the finding in the Schedule of Findings and Questioned Costs for the year ended September 30, 2022. Management?s Views and Corrective Action Plan Finding No: 2022-001: Reporting ? Significant Deficiency in Internal Control Over Compliance Federal Program Information Federal Agency: U.S Department of Health and Human Services, Health Resources and Services Administration (HRSA) Assistance Listing No: 93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year 2020-2021 Corrective Action Planned Management has implemented a corrective action plan. Management has added an additional layer of review control over the completeness and accuracy of expenditures and calculations included in all submissions. Person Responsible for Corrective Action: Stephanie Vance, VP Finance Anticipated Completion Date: September 30, 2022

Categories

Cash Management Reporting Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 622488 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $32.41M
93.395 Cancer Treatment Research $147,750
32.006 Covid-19 Telehealth Program $138,626
93.697 Covid-19 Testing and Mitigation for Rural Health Clinics $100,000
93.837 Cardiovascular Diseases Research $78,842
16.575 Crime Victim Assistance $35,451
93.365 Sickle Cell Treatment Demonstration Program $30,657
93.399 Cancer Control $21,000
93.889 National Bioterrorism Hospital Preparedness Program $11,525
93.110 Maternal and Child Health Federal Consolidated Programs $11,523
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $7,000
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $1,580
93.394 Cancer Detection and Diagnosis Research $750