Finding 46090 (2022-003)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2022
Accepted
2023-03-30
Audit: 40855
Organization: Total Health Care, Inc. (MD)
Auditor: Forvis LLP

AI Summary

  • Core Issue: Tuerk House, Inc. failed to provide proper documentation for Provider Relief Fund expenses, leading to questioned costs of $261,607.
  • Impacted Requirements: Compliance with federal guidelines on allowable costs and reporting for the COVID-19 Provider Relief Fund.
  • Recommended Follow-Up: Update policies and procedures to ensure accurate reporting and documentation of grant expenditures.

Finding Text

COVID-19 Provider Relief Fund and American Rescue (ARP) Rural Distribution CFDA No. 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116- 136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) and Reporting (45 CFR 75.342) Condition ? Tuerk House, Inc. (THI) was required to file a Period 2 and Period 3 Provider Relief Fund (PRF) reports during the year; however, did not maintain adequate documentation to support the other PRF expenses were attributable to coronavirus and/or had not been or were not eligible to be reimbursed by other sources. Questioned Costs ? $261,607 calculated as the PRF amounts received by the THI and included in Period 2 and Period 3 reporting. Context ? THI was unable to provide adequate documentation to support the other PRF expenses had not been or were not eligible to be reimbursed by other sources. Effect ? THI utilized PRF payments received on expenses that were not documented as attributable to coronavirus, were potentially reimbursed by other sources, and/or were not allowable in accordance with other guidance issued by HHS. Cause ? Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution is a new program with complex and evolving regulations and compliance requirements. Internal controls were not in place to ensure the THI correctly applied the guidance. Identification as a repeat finding ? Not a repeat finding Recommendation ? Policies and procedures over allowable activities and federal grant reporting should be modified to ensure expenditures charged to grants are for activities allowed and federal grant reports are prepared using complete and accurate information.

Corrective Action Plan

Views of Responsible Officials and Planned Corrective Actions - Management has updated its PRF documentation to include a lost revenue calculation in accordance with PRF guidance. The calculation fully supports the PRF funding received. Future reporting submissions will be prepared with oversight by the parent organization. Organization contact persons responsible for corrective action: Richard Greene, CFO Anticipated completion date: Correction action has been completed and is awaiting feedback from HRSA on how to submit updated lost revenue calculation.

Categories

Questioned Costs Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 46089 2022-002
    Material Weakness Repeat
  • 622531 2022-002
    Material Weakness Repeat
  • 622532 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 $5.66M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $3.98M
93.498 Provider Relief Fund $1.07M
93.914 Hiv Emergency Relief Project Grants $254,496
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $111,169
93.461 Covid-19 Testing for the Uninsured $111