Finding 601452 (2022-006)

Significant Deficiency
Requirement
ABL
Questioned Costs
-
Year
2022
Accepted
2023-01-30
Audit: 23714
Organization: Tri Valley Health System (NE)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Health System claimed expenses incurred before the COVID-19 response period, leading to incorrect reporting to HHS.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) regarding effective internal controls over federal awards was not maintained.
  • Recommended Follow-Up: Enhance internal control policies and ensure future reports to HHS accurately reflect allowable expenses.

Finding Text

2022-006Department of Health and Human Services Federal Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 1 TIN #476028103 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and Reporting Significant Deficiency in Internal Control Over Compliance and 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 Health System claimed expenses that were incurred prior to when the Health System began to prepare for, prevent and respond to the coronavirus. This resulted in the incorrect treatment of expenses on the special report submitted to the Department of Health and Human Services (HHS) for Period 1. Cause: The terms and conditions were not properly assessed to ensure claimed expenses were allowable under the federal program and claimed on the special report submitted to HHS for Period 1. Effect: There were $144,685 of expenses claimed and reported in the special report submitted to HHS for Period 1 relating to January 2020, which is prior to when the Health System began to prepare for, prevent and respond to the coronavirus. Questioned Costs: None reported for activities allowed or unallowed and allowable costs/cost principles as there was additional lost revenue claimed in excess of $600,000 on the special report submitted to HHS for Period 1 TIN #476028103 that was tested to cover the amount of unallowed expenses. Context: A nonstatistical sample of 60 expenditures were selected for testing, which accounted for $84,077 of $3,048,891 direct program expenditures. One expenditure from the sample contained a January 2020 expenditure. All January 2020 expenditures were identified from the population to arrive at the known error. Repeat Finding from Prior Years: No Recommendation: We recommend the Health System enhance internal control policies to ensure expenditures claimed under the federal program meet the terms and conditions of the award and are properly included in the reports required to be submitted to the federal agency. We recommend management update any future special reports submitted to HHS as deemed appropriate. Views of Responsible Individuals: Management agrees with the finding.

Categories

Allowable Costs / Cost Principles Reporting Significant Deficiency

Other Findings in this Audit

  • 25008 2022-004
    Material Weakness
  • 25009 2022-005
    Significant Deficiency
  • 25010 2022-006
    Significant Deficiency
  • 601450 2022-004
    Material Weakness
  • 601451 2022-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
14.128 Mortgage Insurance_hospitals $14.26M
93.498 Provider Relief Fund $4.16M
20.509 Formula Grants for Rural Areas and Tribal Transit Program $163,452
93.461 Covid-19 Testing for the Uninsured $34,258
93.697 Covid-19 Testing for Rural Health Clinics $26,410
93.301 Small Rural Hospital Improvement Grant Program $11,855