Finding 49594 (2022-005)

Material Weakness
Requirement
B
Questioned Costs
$1
Year
2022
Accepted
2023-02-26
Audit: 42385
Organization: Taos Health Systems, Inc. (NM)

AI Summary

  • Core Issue: The Organization is not following federal requirements for reporting grants, specifically failing to adjust Provider Relief Fund (PRF) expenses by Medicare reimbursements, totaling $1,062,184.
  • Impacted Requirements: Non-compliance with 2 CFR Part 200 regarding financial management and internal controls, which could lead to delayed reimbursements or loss of federal funding.
  • Recommended Follow-Up: The Organization should assess and improve its financial reporting processes and controls to ensure compliance with PRF guidelines and consider seeking guidance from HRSA for necessary corrections.

Finding Text

Criteria or specific requirement: According to ?200.302 Financial management of 2 CFR Part 200, the non-Federal entity?s financial management systems, including records documenting compliance with Federal statutes, regulations, and the terms and conditions of the Federal award, must be sufficient to permit the preparation of reports required by general and program-specific terms and conditions. Further, the financial management system of each non-Federal entity must provide accurate, current, and complete disclosure of the financial results of each Federal award or program in accordance with the reporting requirements. According to ?200.303 Internal controls of 2 CFR Part 200, the non-Federal entity must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition: We noted the Organization is not in compliance with requirements related to the reporting of grants. Questioned costs: $1,062,184 Context: During our testing, we noted the following exception: ? The Organization did not reduce the PRF expenses claimed by the amounts reimbursed by Medicare through the cost report. Auditor calculated the average amount reimbursed by MCR and noted an average MCR reimbursement rate of 26.8% and 28.1% in fiscal years 2021 and 2020, respectively. The calculated total of costs reimbursed by Medicare through the cost report is $1,062,184. Cause: The Organization lacks established internal controls and procedures over financial grant management to ensure submitted reports are complete, agree to supporting spreadsheets, submitted timely, and properly maintained in the files of the Organization. Effect: The auditor noted instances of noncompliance. Noncompliance can result in delayed reimbursement of eligible Federal expenditures or potential loss of Federal funding. Repeat Finding: No. Recommendation: We recommend the Organization evaluate its financial reporting processes and controls to determine whether additional controls over the preparation of any Provider Relief Fund reports are needed to ensure the reports are prepared in line with the Provider Relief Fund guidelines. Views of responsible officials: The Organization missed reducing the costs claimed against PRF by the amounts reimbursed through the Medicare cost report. The Organization did have additional lost revenues though that would offset these costs claimed and wouldn?t result in a repayment of the funds. We would look to HRSA for guidance on how you would like us to update our Phase 1 PRF report or how you would like to see this corrected. Also, the CFO will listen to webinars to receive education for Phase IV funds that were received by the Organization to ensure compliance with the reporting requirements.

Corrective Action Plan

COVID-19 Provider Relief Fund ? AL No. 93.498 Recommendation: Our auditors recommended the Organization evaluate its financial reporting processes and controls to determine whether additional controls over the preparation of any Provider Relief Fund reports are needed to ensure the reports are prepared in line with the Provider Relief Fund guidelines. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Management?s response: The Organization missed reducing the costs claimed against PRF by the amounts reimbursed through the Medicare cost report. The Organization did have additional lost revenues though that would offset these costs claimed and wouldn?t result in a repayment of the funds. We would look to HRSA for guidance on how you would like us to update our Phase 1 PRF report or how you would like to see this corrected. Also, the CFO will listen to webinars to receive education for Phase IV funds that were received by the Organization to ensure compliance with the reporting requirements. COVID-19 Provider Relief Fund ? AL No. 93.498 (Continued) Name(s) of the contact person(s) responsible for corrective action: Connie Prewitt, Interim CFO Planned completion date for corrective action plan: Will implement in fiscal year 2023.

Categories

Questioned Costs Cash Management HUD Housing Programs Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 49590 2022-001
    Significant Deficiency Repeat
  • 49591 2022-002
    Significant Deficiency Repeat
  • 49592 2022-003
    Significant Deficiency Repeat
  • 49593 2022-004
    Significant Deficiency Repeat
  • 626032 2022-001
    Significant Deficiency Repeat
  • 626033 2022-002
    Significant Deficiency Repeat
  • 626034 2022-003
    Significant Deficiency Repeat
  • 626035 2022-004
    Significant Deficiency Repeat
  • 626036 2022-005
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19: Provider Relief Fund - Phase 1 $5.55M
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $762,292
93.461 Covid-19: Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and for the Covid-19 Coverage Assistance Funds $239,661
93.110 Maternal and Child Health Federal Consolidated Programs $202,375
95.001 High Intensity Drug Trafficking Areas Program $152,915
93.778 Medical Assistance Program $76,615
93.276 Drug-Free Communities Support Program Grants $6,989
93.799 Cara Act - Comprehensive Addiction and Recovery Act of 2016 $6,680