FAC Explorer

Finding 500403 (2023-002)

Material Weakness
Requirement
AB
Questioned Costs
-
Year
2023
Accepted
2024-09-30
Audit: 323168
Organization: West Virginia University Health System and Controlled Entities (WV)
Auditor: Forvis Mazars LLP

AI Summary

  • Core Issue: Ineligible costs were reported for the Provider Relief Fund (PRF) due to ineffective internal controls at Princeton Community Hospital.
  • Impacted Requirements: PRF distributions must only cover expenses directly related to COVID-19 that aren't reimbursed by other sources.
  • Recommended Follow-Up: Implement stronger compliance controls to ensure all submitted expenses meet the established criteria.

Finding Text

Assistance Listing #93.498 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions Material Weakness and Material Noncompliance Criteria: The Department of Health and Human Services provided terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions. Those terms and conditions outlined the usages of the PRF distributions received, specifically related to expenses. PRF distributions should only be used to prevent, prepare for, and response to the coronavirus that have not been reimbursed from other sources or that other sources are not obligated to reimburse. Management should have effectively designed controls to prevent, or detect and correct, noncompliance related to the usage of PRF distributions. Condition: The System’s internal control over Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions resulted in ineligible costs reported on the Department of Health and Human Services PRF portal submission for Princeton Community Hospital. Cause: Lack of effectively designed and implemented controls, including oversight and detail review of expenditures submitted through the Department of Health and Human Services PRF portal. Effect: The System overstated supplies and payroll expenses submitted through the Department of Health and Human Services PRF portal for Princeton Community Hospital. Questioned Costs: Unknown. Context: Expenses included in the portal submission for Princeton Community Hospital were sampled and policies for these expenses were obtained. Of the population, supplies and payroll expenses entered into the PRF portal were found to not follow the terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions as they were not able to be directly tied to COVID-19. Identification as a Repeat Finding: N/A Recommendation: Effective controls over compliance should be implemented to ensure expenditures submitted through the Department of Health and Human Services PRF portal meet the criteria established in the terms and conditions. Views of Responsible Officials: See corrective action plan.

Corrective Action Plan

Contact Person: Melissa McCoy Management’s Response: As part of the submission of expenses into the Provider Relief Portal, Princeton Community Hospital inadvertently submitted expenses for payroll and supplies expense that were ineligible. As a result, the following corrective actions will be taken to prevent ineligible expenses from being submitted in the future: • Exclude all ineligible expenses from any future Provider Relief Fund Portal submissions. • Offset the ineligible costs with lost revenues and unreimbursed expenses attributable to Corona virus. Princeton Community Hospital was a new acquisition into West Virginia University Health System as of January 1, 2023 and had not fully integrated into our processes at the time that this portal submission was completed. Upon further review, Princeton Community Hospital had lost revenues that support a significant portion of the funding received for this reporting period. Those lost revenues, along with eligible expenses, fully support the funding received. Completion Date: 09/27/2024

Categories

Internal Control / Segregation of Duties Eligibility Material Weakness

Other Findings in this Audit

  • 500402 2023-001
    Significant Deficiency
  • 1076844 2023-001
    Significant Deficiency
  • 1076845 2023-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $19.44M
93.493 Congressional Directives $6.30M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $4.61M
93.788 Opioid Str $1.52M
93.958 Block Grants for Community Mental Health Services $529,234
93.959 Block Grants for Prevention and Treatment of Substance Abuse $424,695
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $376,378
93.155 Rural Health Research Centers $282,086
10.766 Community Facilities Loans and Grants $162,472
93.859 Biomedical Research and Research Training $96,717
84.268 Federal Direct Student Loans $86,105
93.165 Grants to States for Loan Repayment $80,000
93.104 Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (sed) $78,763
32.006 Covid-19 Telehealth Program $70,669
93.279 Drug Abuse and Addiction Research Programs $50,917
93.003 Public Health and Social Services Emergency Fund $36,611
93.301 Small Rural Hospital Improvement Grant Program $36,123
93.889 National Bioterrorism Hospital Preparedness Program $35,814
84.063 Federal Pell Grant Program $33,620
93.211 Rural Telemedicine Grants $27,412
93.426 The National Cardiovascular Health Program $20,000
23.002 Appalachian Area Development $7,717