Finding 583093 (2023-002)

Significant Deficiency
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2023-12-27
Audit: 8606
Organization: Logan Health (MT)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Corporation lacks formal review and approval processes for expenditure calculations related to the COVID-19 Provider Relief Fund.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) regarding effective internal controls over federal awards is not being met.
  • Recommended Follow-Up: Enhance internal control policies to ensure all supporting documentation and reports have formal review and approval at all locations.

Finding Text

2023-002 U.S. Department of Health and Human Services Federal Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN #810515463 Activities Allowed or Unallowed, Allowable Costs/Costs 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 the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Corporation claimed expenses based on specifically identified COVID related expenses and COVID related incremental expenses. The Corporation selected Option i and Option iii to calculate lost revenue (this varied based on specific entity). Condition – During our testing, we noted reviews were performed over individual eligible expenditures; however, there was no formal review or approval of the expenditure spreadsheet used to calculate the expenditures claimed for the federal program outside of the preparer at the LH Chester location. In addition, there was no evidence retained that the Corporation’s HHS Special Report submitted to the Department of Health and Human Services for Period 4 was reviewed and approved by a separate individual outside of the preparer at the LH Chester location. Cause – The Corporation did not have an adequate internal control policy in place to ensure review and approval over tracking of other funding sources, lost revenue, or reporting was documented at all locations. Effect - The lack of adequate policies governing review 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/Sampling - Detail testing was performed over eligible expenditures for activities allowed and unallowable and allowable cost/cost principles. There were nine HHS Special Reports in the population and all were tested of which one did not have documented evidence of proper review. Repeat Findings from Prior Years – No Recommendation - We recommend that the Corporation enhance internal control policies to ensure that formal documentation of reviews is present at for all supporting documentation and reports all locations. Views of Responsible Officials - Management agrees with the finding.

Categories

Allowable Costs / Cost Principles

Other Findings in this Audit

  • 6651 2023-002
    Significant Deficiency
  • 6652 2023-003
    Material Weakness Repeat
  • 6653 2023-004
    Material Weakness Repeat
  • 583094 2023-003
    Material Weakness Repeat
  • 583095 2023-004
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 Provider Relief Fund $27.13M
93.931 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $682,431
93.697 Covid-19 Testing for Rural Health Clinics $279,735
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $49,529
93.435 Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke- $37,000
93.110 Maternal and Child Health Federal Consolidated Programs $20,510