Finding 586668 (2023-004)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-01-26
Audit: 13879
Organization: Veterans Memorial Hospital (IA)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Hospital lacked an approved budget for the entire reporting period, leading to incorrect reporting of patient revenues.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) regarding effective internal controls over federal awards was not met.
  • Recommended Follow-Up: Implement procedures to ensure accurate lost revenue calculations align with federal program requirements.

Finding Text

Department of Health and Human Services Federal Assistance Listing #93.498 COVID‐19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN #421030129 Reporting Material Weakness in Internal Control Over Compliance and Material Noncompliance 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. Condition: The Hospital selected option II to calculate lost revenue, which consists of a comparison of actual results during the period of availability to the approved budget. The Hospital did not have a budget for the entire reporting period that was approved prior to March 27, 2020. For the periods that the client did not have an approved budget, $0 was entered for net patient revenues even though there were patient revenues for this period. Cause: The Hospital did have an approved budget prior to March 27, 2020 for fiscal year 2020, but the approved budget did not cover the entire period of availability. Effect: The reporting to HHS for Period 4 was considered incorrect. The Hospital did not have a budget approved prior to March 27, 2020 for the entire period of availability. The Medical Center reported $0 for quarter 3 and 4 of 2021 and quarters 1, 2, 3 and 4 of 2022. Questioned Costs: None. The Hospital claimed expenses for all Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution amounts in Period 4, so did not use lost revenue to support any of these. Context: Key line items were tested on the Period 4 HHS report. Repeat Finding from Prior Years: No Recommendation: We recommend the Hospital implement procedures to ensure the lost revenue calculation claimed meets the requirements of the federal program. Views of Responsible Officials: Management agrees with the finding.

Categories

Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 10226 2023-004
    Material Weakness
  • 10227 2023-005
    Significant Deficiency
  • 586669 2023-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $1.08M