Finding 570655 (2022-006)

Material Weakness
Requirement
ABL
Questioned Costs
-
Year
2022
Accepted
2025-07-08
Audit: 361677
Organization: Tuerk House, Inc. (MD)

AI Summary

  • Core Issue: The Organization failed to document PRF expenses as required, leading to questioned costs of $261,607.
  • Impacted Requirements: Compliance with federal guidelines for allowable costs and accurate reporting under the Provider Relief Fund.
  • Recommended Follow-Up: Update policies and procedures to ensure proper documentation and reporting for federal grants.

Finding Text

COVID-19 Provider Relief Fund and American Rescue (ARP) Rural Distribution ALN No. 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement – Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116- 136, 134 Stat. 563 and Pub. L. No. 116- 139, 134 Stat. 622 and 623) and Reporting (45 CFR 75.342) Condition – The Organization was required to file a Period 2 and Period 3 Provider Relief Fund (PRF) reports during the year; however, did not maintain adequate documentation to support the other PRF expenses were attributable to coronavirus and/or had not been or were not eligible to be reimbursed by other sources. Questioned Costs – $261,607 calculated as the PRF amounts received by the Organization and included in Period 2 and Period 3 reporting. Context – The Organization was unable to provide adequate documentation to support the other PRF expenses had not been or were not eligible to be reimbursed by other sources. Effect – The Organization utilized PRF payments received on expenses that were not documented as attributable to coronavirus, were potentially reimbursed by other sources, and/or were not allowable in accordance with other guidance issued by HHS. Cause – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution is a new program with complex and evolving regulations and compliance requirements. Internal controls were not in place to ensure the Organization correctly applied the guidance. Identification as a repeat finding – Not a repeat finding Recommendation – Policies and procedures over allowable activities and federal grant reporting should be modified to ensure expenditures charged to grants are for activities allowed and federal grant reports are prepared using complete and accurate information.

Corrective Action Plan

Management has updated its PRF documentation to include a lost revenue calculation in accordance with PRF guidance. The calculation fully supports the PRF funding received. Future reporting submissions will be prepared with oversight by the Organizations parent company (Total Health Care, Inc.). Organization contact persons responsible for corrective action: Richard Greene, CFO Anticipated completion date: Correction action has been completed and is awaiting feedback from HRSA on how to submit updated lost revenue calculation.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 570651 2022-003
    Material Weakness
  • 570652 2022-003
    Material Weakness
  • 570653 2022-004
    Material Weakness
  • 570654 2022-005
    Material Weakness
  • 1147093 2022-003
    Material Weakness
  • 1147094 2022-003
    Material Weakness
  • 1147095 2022-004
    Material Weakness
  • 1147096 2022-005
    Material Weakness
  • 1147097 2022-006
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.788 Opioid Str $2.29M
93.959 Block Grants for Prevention and Treatment of Substance Abuse $1.24M
95.007 Research and Data Analysis $278,945
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $261,607