Finding 51333 (2022-001)

Material Weakness
Requirement
P
Questioned Costs
-
Year
2022
Accepted
2023-09-27
Audit: 53146
Auditor: Kpmg LLP

AI Summary

  • Core Issue: The Schedule of Expenditures of Federal Awards (SEFA) inaccurately reported expenditures, missing $900,000 related to the COVID-19 Rural Health Research Centers program.
  • Impacted Requirements: Compliance with 2 CFR 200.510(b) and 2 CFR 200.303 was not met due to inadequate internal controls over federal grant reporting.
  • Recommended Follow-Up: Strengthen controls to ensure all federal grants and expenditures are accurately captured on the SEFA throughout the fiscal year.

Finding Text

Finding No: 2022-001 Federal Agency: U.S. Department of Health and Human Services Assistance Listing Number: 93.155 Program: COVID- 19 Rural Health Research Centers Compliance Requirement: Other ? Inaccurate reporting of the Schedule of Expenditures of Federal Awards Award Year: July 1, 2021 through December 21, 2022 (a) Criteria or Requirement According to 2 CFR 200.510(b), a recipient of federal awards is required to prepare a schedule of expenditures of federal awards (SEFA) for the period covered by the entity?s financial statements which must include the total federal awards expended as determined in accordance with 2 CFR 200.502. Additionally, 2 CFR 200.303 requires non-federal entities receiving federal awards to establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Effective internal control should include procedures to ensure federal expenditures are accurately and completely reported on the SEFA. (b) Condition Found The System did not have adequate controls relating to reporting expenditures for the COVD-19 Rural Health Research Centers program on the SEFA. Specifically, the SEFA did not include $900,000 of expenditures incurred in the current fiscal year related to this program. The System corrected the SEFA and the program was subsequently determined to be a major program. (c) Cause The System has a review process in place to identify all federal grants and related expenditures. However, the review control in place was not designed to detect grants for which reimbursement had not been initially requested as of September 30, 2022 for expenditures incurred during the year ended September 30, 2022. (d) Effect Failure to establish effective internal controls over the preparation of the SEFA may prevent the System from reporting accurate program information and completing an audit in accordance with the Uniform Guidance. (e) Questioned Cost None (f) Statistical Sample Not applicable (g) Repeat Finding in the Prior Year Not a repeat finding (h) Recommendation We recommend that the System strengthen controls over the identification of all federal grants and related expenditures to ensure that all relevant amounts are appropriately captured on the SEFA during the year. (i) View of Responsible Officials Identification of all federal grants that were not awarded in the Fiscal Year of the SEFA was not a part of the analysis of completeness for the SEFA. In December 2021, Tishomingo Health Services, Clay County Medical Corporation, Pontotoc Health Services, Webster Health Services, and Marion Regional Medical Center entered into a sub-grant agreement with the COVID-19 Ship Program (CFDA No. 93.155) and incurred expenses believed to be applicable to the program in fiscal year 2022. Since no requests of grant funding was made in FY2022, the COVID-19 Ship Program (CFDA No. 93.155) was not included.

Corrective Action Plan

See Corrective Action Plan for chart/table

Categories

Reporting

Other Findings in this Audit

  • 48475 2022-003
    Significant Deficiency
  • 51334 2022-002
    Significant Deficiency
  • 624917 2022-003
    Significant Deficiency
  • 627775 2022-001
    Material Weakness
  • 627776 2022-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $10.83M
93.461 Covid-19 Testing for the Uninsured $1.22M
93.155 Rural Health Research Centers $898,116
93.247 Advanced Nursing Education Grant Program $894,354
93.697 Covid-19 Testing for Rural Health Clinics $794,625
93.917 Hiv Care Formula Grants $790,654
21.027 Coronavirus State and Local Fiscal Recovery Funds $662,852
32.006 Covid-19 Telehealth Program $259,900
93.301 Small Rural Hospital Improvement Grant Program $26,139
93.889 National Bioterrorism Hospital Preparedness Program $8,583