Finding 496764 (2023-001)

Material Weakness
Requirement
AB
Questioned Costs
-
Year
2023
Accepted
2024-09-13
Audit: 319532
Organization: Fairview Health Services (MN)

AI Summary

  • Core Issue: Fairview Health Services lacked proper documentation for reviewing lab supplies expense calculations related to FEMA funding.
  • Impacted Requirements: This finding violates internal control standards under Section 200.303 of the Uniform Guidance, which mandates effective documentation and compliance with federal regulations.
  • Recommended Follow-Up: Implement formal documentation procedures for reviewing and approving lab supplies calculations to ensure compliance with federal requirements.

Finding Text

Finding 2023-001 Identification of the federal program: Federal Grantor: United States Department of Homeland Security Assistance Listing No.: 97.036, COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) Pass-Through Grantor: State of Minnesota Pass-Through Award Period: 01/20/2020 – 05/11/2023 Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) 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. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” The Uniform Guidance 2 CRF Subpart E Section 200.403 states the following: “Costs must meet the following general criteria in order to be allowable under Federal awards: (c) be consistent with policies and procedures that apply uniformly to both federally financed and other activities of the non-Federal entity; and (g) be adequately documented.” Condition: Fairview Health Services (the Company) did not retain sufficient documentation of its review of the allowability lab percentage calculation (which represents the total unreimbursed lab revenue as a percentage of total lab revenue to address duplication of benefits) used in determining lab supplies expense to be charged to FEMA. Cause: The Company did not have internal controls in place to formally document its review of the allowability percentage calculation applied to the lab supplies. Effect or potential effect: Lab supplies expenses may be charged to the federal award that are not consistent with the methodology adopted by the Company. Questioned costs: None. Context: We selected a sample of five of eight allowability percentage calculations for lab supplies and noted that for four of the calculations, there was no supporting documentation of the review and approval performed of the allowability percentage calculation. For Assistance Listing No. 97.036, total lab supplies to which the allowability percentage was applied were $8,432,353, representing 17% of total federal expenditures of $49,821,059 for the year ended December 31, 2023. Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: The Company should retain formal documentation of review and approval controls related to the lab supplies calculation. Views of responsible officials: “Management agrees with the finding. In May 2023, the COVID-19 emergency ended and, therefore, remediation of internal controls specific to allowability of costs for the FEMA program is no longer applicable. However, remediation steps were taken to improve documentation of review of internal controls over all federal expenditures, not limited to the FEMA program.” Fairview revised its internal control processes to improve the retention and documentation of the review and approval of inputs to the calculation of federal expenditures.

Corrective Action Plan

Finding 2023-001 Federal Grantor: United States Department of the Homeland Security Planned Corrective Actions: Responsible Official – Dawn Ksepka, VP of Finance and System Controller Anticipated completion date – August 31, 2024 Management agrees with the finding. In May 2023, the COVID-19 emergency was ended and therefore remediation of internal controls specific to allowability of costs for the FEMA program are no longer applicable. However, remediation steps were taken to improve documentation of review of internal controls over all federal expenditures, not limited to the FEMA program. Remediation: Fairview revised its internal control processes to improve the retention and documentation of the review and approval of inputs to the calculation of federal expenditures.

Categories

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 496765 2023-002
    Material Weakness
  • 1073206 2023-001
    Material Weakness
  • 1073207 2023-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $49.82M
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $47.64M
93.817 Hospital Preparedness Program (hpp) Ebola Preparedness and Response Activities $527,962
93.493 Congressional Directives $85,416
16.838 Comprehensive Opioid, Stimulant, and Other Substances Use Program $84,248
93.155 Rural Health Research Centers $44,198
93.110 Maternal and Child Health Federal Consolidated Programs $35,183
93.184 Disabilities Prevention $25,937
93.173 Research Related to Deafness and Communication Disorders $16,796
93.837 Cardiovascular Diseases Research $10,923
93.435 The Innovative Cardiovascular Health Program $9,086
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $4,536
10.331 Gus Schumacher Nutrition Incentive Program $3,659