Finding 602260 (2022-005)

Significant Deficiency
Requirement
B
Questioned Costs
$1
Year
2022
Accepted
2023-02-07
Audit: 27397
Organization: Cherry County Hospital (NE)
Auditor: Seim Johnson LLP

AI Summary

  • Core Issue: Management included unsupported capital items in the PRF reporting, leading to questioned costs of $678,214.
  • Impacted Requirements: Funds must only cover eligible healthcare expenses related to COVID-19, as per the CARES Act and HRSA guidance.
  • Recommended Follow-Up: Enhance internal controls to ensure only eligible costs are reported for federal awards.

Finding Text

Item 2022-005 Significant Deficiency Identification of the Federal Program: Federal Assistance Listing Number 93.498 US Department of Health and Human Services Provider Relief Fund Criteria or Specific Requirement: The terms and conditions of the CARES Act Provider Relief Fund (PRF) state that funds are only to be used to prevent, prepare for and respond to coronavirus, and that funds may only be used for healthcare related expenses or lost revenue that is attributable to the coronavirus. Subsequent guidance issued by the Health Resources and Services Administration (HRSA) states that recipients may use payments for eligible expenses incurred prior to the receipt of the PRF distributions dating back to January 1, 2020, so long as they are to prevent, prepare for, and respond to coronavirus. Condition: During the process of identifying expenses and capital costs that were incurred to prevent, prepare for or respond to the coronavirus pandemic, management included capital items for which there was a lack of supporting documentation. Cause: Due to the amount of detailed information that was required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently included capital items which could not be supported by auditable evidence. Effect or Potential Effect: Management included amounts in the PRF reporting portal which were not eligible based on the terms and conditions of the PRF distributions and subsequent HRSA guidance. Questioned Costs: Total questioned costs related to Federal Assistance Listing Number 93.498 amounted to $678,214 and were calculated based off the underlying capital asset listing management used to populate the PRF reporting portal and comparing such amounts to the Hospital?s depreciation schedule. Context: Certain costs were included on the PRF submission which could not be supported by audit evidence. Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that only eligible costs are included in amounts expended. Views of Responsible Officials and Planned Corrective Actions: Management agrees with the noted finding. However, the Hospital had also incurred sufficient unreimbursed expenses that if the noted questioned costs had not been reported, the Hospital would have satisfactorily incurred eligible expenses in excess of the PRF funds received, including interest earned on such funds.

Categories

Questioned Costs Cash Management Reporting Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $4.05M
93.461 Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $57,452
93.697 Covid-19 Testing and Mitigation for Rural Health Clinics $49,461
93.301 Small Rural Hospital Improvement Grant Program $11,855