Finding 579846 (2023-001)

Significant Deficiency
Requirement
A
Questioned Costs
-
Year
2023
Accepted
2023-12-05
Audit: 5303
Organization: Alabama Hospital Association (AL)

AI Summary

  • Core Issue: Four out of nine hospitals did not provide adequate documentation to support their reported staffing costs related to COVID funding.
  • Impacted Requirements: Compliance with 2 CFR 200.302 and 2 CFR 200.303 was not met due to insufficient internal controls and lack of source documentation.
  • Recommended Follow-Up: Strengthen policies and procedures for disbursements to ensure accurate reporting and retention of necessary documentation.

Finding Text

Finding 2023-001- Allowable Activities (Significant Deficiency) Information on the federal program: U.S. Department of Treasury, Assistance Listing No. 21.027 Coronavirus Fiscal Recovery Funds Criteria: 2 CFR 200.302 and 2 CFR 200.303 require entities to establish and maintain internal controls and financial management procedures to provide reasonable assurance the award is managed in compliance with statutes, regulations, and terms and conditions of the award and to ensure federal award expenditures adequately supported by source documentation. Condition: We tested controls over disbursements to 9 hospitals during the year. For each hospital to receive funding they were to submit a staffing spreadsheet reporting their increased staffing costs due to COVID. Of the 9 tested, 4 hospitals supporting documentation was not readily available. Additional information, therefore, had to be obtained from the hospital to support the information reported by the hospital in the staffing spreadsheet. In addition, one of the 4 tested could not provide documentation that agreed to the amounts reported on the staffing spreadsheet. Cause: Salary information obtained in support of the staffing spreadsheet included Form 941, Employees Quarterly Federal Tax Return (941). However, some 941s are combined with other hospitals or filed by agency and did not agree to amounts submitted for reimbursement. Additional general ledger information had to be requested from the hospitals during the audit to reconcile to the amounts reported in the staffing spreadsheet. Effect: Internal Controls were not properly implemented to obtain source documentation to adequately support the amounts reported by the hospitals as additional staffing costs. Recommendation: We recommend the Organization strengthen its policies and procedures surrounding disbursements to hospitals to ensure the amounts reported were determined accurate and source documentation is retained to ensure compliance requirements. Views of Responsible Officials and Planned Corrective Action: See Management’s View and Corrective Action Plan included at the end of the report.

Categories

Cash Management Reporting Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 3404 2023-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $95.83M
93.155 Rural Health Research Centers $6.45M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $1.56M
93.301 Small Rural Hospital Improvement Grant Program $529,303
93.241 State Rural Hospital Flexibility Program $249,592
93.136 Injury Prevention and Control Research and State and Community Based Programs $128,885
93.889 National Bioterrorism Hospital Preparedness Program $44,233
93.913 Grants to States for Operation of Offices of Rural Health $16,500