Finding 558341 (2024-003)

Material Weakness Repeat Finding
Requirement
L
Questioned Costs
-
Year
2024
Accepted
2025-04-30
Audit: 355131
Organization: Box Butte General Hospital (NE)

AI Summary

  • Core Issue: The Hospital missed the nine-month deadline for filing its financial statement and compliance audits due to delays from a new accounting system and a cyberattack.
  • Impacted Requirements: Timely filing of audits is mandated for compliance with federal regulations, specifically for federal assistance programs.
  • Recommended Follow-Up: Hospital management should address ongoing issues with their accounting and EHR vendors and consider increasing cyber liability coverage.

Finding Text

FINDING 2024-003 COMPLETION AND TIMELY FILING OF SINGLE AUDIT REPORTS Federal programs Federal Assistance Listing Number 10.766 U.S. Department of Agriculture (USDA) Direct Award, Community Facilities Loans and Grants Criteria The Hospital is required to have its financial statement and compliance audits completed and filed with the Federal Audit Clearinghouse nine months after the end of the audit period. Condition The Hospital’s financial statement and compliance audits for the June 30, 2024 reporting period were not filed within the required timeline. Cause The Hospital implemented a new accounting and electronic health record (EHR) system in May of 2023 and experienced significant delays in being able to bill and process claims. In addition, there was a cyberattack on the Hospital’s claims processing clearinghouse in February 2024 that took the Hospital offline from processing claims. These two events resulted in the financial statement audit requiring significantly more time to complete. Effect The Hospital was unable to meet the required nine month filing deadline. Questioned costs None. Perspective/Context The majority of the EHR implementation issues and subsequent cyberattack were outside of Hospital management’s control and directly related to issues associated with the accounting and EHR system vendor and Clearinghouse vendor. Hospital management also notified the USDA that the financial statement and compliance audits would be delayed due to these issues. Recommendation We suggest Hospital management continue working with its accounting and EHR system vendor to resolve issues affecting its operating results and suggest Hospital management increase their cyber liability coverage limits. Views of responsible officials and planned corrective actions The financial statement and compliance audit will be filed with the Federal Audit Clearinghouse shortly after issuance.

Corrective Action Plan

Effect and recommendation The Hospital implemented a new accounting and electronic health record (EHR) system in May of 2023 and experienced significant delays in being able to bill and process claims. In addition, there was a cyberattack on the Hospital’s claims processing clearinghouse in February 2024 that took the hospital offline from processing claims. These two events resulted in the financial statement audit requiring significantly more time to complete resulting in the Hospital’s financial statements and compliance audits for June 30, 2024 reporting period not being filed within the required timeline. Views of responsible officials and planned corrective actions The financial statement and compliance audit will be filed with the Federal Audit Clearinghouse shortly after issuance. Anticipated completion date Ongoing

Categories

Reporting Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 558340 2024-002
    Material Weakness Repeat
  • 1134782 2024-002
    Material Weakness Repeat
  • 1134783 2024-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $25.72M
93.301 Small Rural Hospital Improvement Grant Program $13,011