Finding 607213 (2022-003)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-09-28

AI Summary

  • Core Issue: ProMedica Health System failed to report infection control expenses accurately, entering all expenses in the wrong quarters.
  • Impacted Requirements: Reporting guidelines from HHS were not followed, leading to material weaknesses and noncompliance.
  • Recommended Follow-Up: Implement stronger review controls to ensure compliance with reporting guidelines and accurate expense tracking.

Finding Text

Assistance Listing, Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services, COVID-19: Provider Relief Fund and American Rescue Plan Rural Distribution (PRF) Federal Award Identification Number and Year - N/A - 2022 Pass through Entity - N/A - Direct funded Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - Per the Provider Relief Fund Distributions and American Rescue Plan Rural Distribution Post Payment Notice of Reporting Requirements dated October 27, 2022, infection control expenses paid with Nursing Home Infection Control distributions, allowable expenses may be reported as a use of targeted funds. Allowable expenses must be those that are unreimbursed by other sources and determined using the recipient's basis of accounting. Condition - ProMedica Health System's controls in place for reporting submissions did not identify that guidelines were not followed related to the reporting of infection control expenses in the correct period. Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A - Refer to context below for additional information. Context - The reporting submissions for certain HCR entities did not follow the guidelines published by the U.S. Department of Health and Human Services (HHS). These entities did not break out infection control expenses in the correct quarter in which they were expended. All infection control expenses were entered in quarter 1 and quarter 2 2022, regardless of if they were incurred in 2020 or 2021. Cause and Effect - Appropriate review of the expenses was not completed to ensure that eligible expenses were entered into correct period. As a result, the reports submitted were inaccurate, but the schedule of expenditure was not impacted. Recommendation - We recommend ProMedica Health System implement controls, including levels of review, to ensure reports are completed and submitted in accordance with the guidelines established by HHS. Views of Responsible Officials and Corrective Action Plan - Management fully understands and acknowledges the importance of identifying and complying with the reporting guidelines of federal awards, including the reporting of infection control expenses in the correct period. The receipt of Provider Relief Funds has broadened the scope of individuals that are responsible for reporting of Federal awards to those outside of the Grants and Research departments. Expenses for the Provider Relief Funds were correctly captured by period incurred and appropriately tracked for allowability. ProMedica has implemented a review procedure of the Provider Relief Funds consistent with other grant reporting so that the HRSA reports will be reviewed by a Grants Advisor or Grants Analyst prior to submission to ensure that eligible expenses are entered into the correct period in accordance with the guidelines established by HHS.

Categories

Material Weakness Reporting

Other Findings in this Audit

  • 30771 2022-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 - Provider Relief Fund and American Rescue Plan Rural Distribution $53.65M
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $3.95M
21.027 Coronavirus State and Local Fiscal Recovery Funds $950,000
93.155 Rural Health Research Centers $257,853
10.569 Emergency Food Assistance Program (food Commodities) $242,000
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $230,788
10.551 Supplemental Nutrition Assistance Program $223,671
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $175,000
93.884 Grants for Primary Care Training and Enhancement $169,391
93.461 Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $144,231
93.926 Healthy Start Initiative $108,121
16.560 National Institute of Justice Research, Evaluation, and Development Project Grants $85,751
93.889 National Bioterrorism Hospital Preparedness Program $76,994
93.394 Cancer Detection and Diagnosis Research $69,690
20.616 National Priority Safety Programs $69,000
93.136 Injury Prevention and Control Research and State and Community Based Programs $63,931
93.395 Cancer Treatment Research $57,906
93.558 Temporary Assistance for Needy Families $56,000
93.788 Opioid Str $52,882
93.301 Small Rural Hospital Improvement Grant Program $47,244
93.991 Preventive Health and Health Services Block Grant $11,919
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $10,659
16.575 Crime Victim Assistance $5,336
93.110 Maternal and Child Health Federal Consolidated Programs $3,464
93.839 Blood Diseases and Resources Research $1,771
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $852