Finding 50944 (2022-004)

Significant Deficiency
Requirement
ABL
Questioned Costs
-
Year
2022
Accepted
2023-10-01
Audit: 51724
Organization: Meeker Memorial Hospital (MN)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Hospital did not have a proper review process for lost revenue calculations and reports submitted to the Department of Health and Human Services.
  • Impacted Requirements: This violates 2 CFR 200.303(a), which mandates effective internal controls over federal awards.
  • Recommended Follow-Up: Implement a secondary review and approval process for all required reports and supporting documents.

Finding Text

Department of Health and Human Services Federal Financial Assistance Listing/CFDA #93.498 COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution (ARP) Applicable Federal Award Number and Year ? Period 4 TIN #618044389 Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Significant Deficiency in Internal Control over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over federal awards that provides reasonable assurance that the Hospital is managing the federal awards in compliance with federal statutes, regulations, and terms and conditions of the federal award. Condition: The Hospital?s lost revenue calculation and special reports submitted to the Department of Health and Human Services for Period 4 were not reviewed and approved by a separate individual outside of the preparer. Cause: The Hospital did not have an adequate internal control policy in place to ensure review and approval of the lost revenue calculation and report submitted to the Department of Health and Human Services for Period 4. Effect: The lack of adequate policies governing review and approval increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: Key line items were tested on the Period 4 Department of Health and Human Services special report and supporting lost revenue documents. Repeat Finding from Prior Years: No Recommendation: We recommend the Hospital implement a control process which includes a secondary review and approval of required reports and internal supporting documents such as the expense tracking and lost revenue calculation. Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Finding 2021-004 Federal Agency Name: Department of Health and Human Services Program Name: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Federal Financial Assistance Listing #93.498 Significant Deficiency Compliance Requirement: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over federal awards that provides reasonable assurance that the Hospital is managing the federal awards in compliance with federal statutes, regulations and terms and conditions of the federal award. Finding Summary: The Hospital did not have an adequate internal control policy in place to ensure review and approval of the lost revenue calculation and report submitted to the Department of Health and Human Services for Period 4. Responsible Individuals: Nicole Siegner, CFO Status: Management will enhanced internal controls to ensure lost revenue calculations and reporting submissions to HRSA were reviewed by an individual other than the preparer and documentation of approval was maintained.

Categories

Allowable Costs / Cost Principles Reporting Significant Deficiency

Other Findings in this Audit

  • 627386 2022-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $1.16M
93.155 Rural Health Research Centers $57,908
93.461 Covid-19 Testing for the Uninsured $15,207
93.301 Small Rural Hospital Improvement Grant Program $11,206