Finding 608811 (2022-001)

Significant Deficiency Repeat Finding
Requirement
ABL
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 27876
Organization: Inova Health System (VA)

AI Summary

  • Core Issue: Internal controls over the COVID-19 Provider Relief Fund submissions were inadequate, leading to potential inaccuracies in reported expenditures.
  • Impacted Requirements: Compliance with Title 2 U.S. Code of Federal Regulations, Part 200.303, which mandates effective internal controls for managing Federal awards.
  • Recommended Follow-Up: Management should establish proper internal controls and retain documentation for review and approval of expenditures to prevent repeat findings.

Finding Text

Criteria In accordance with Title 2 U.S. Code of Federal Regulations, Part 200.303, Internal controls, ?Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award.? The terms and conditions of the award require the recipient to submit reports as the secretary of HHS determines are needed to ensure compliance with conditions that are imposed on the payment, and such reports shall be in such form, with such content, as specified by the secretary of HHS in future program instructions directed to all recipients. Condition The System did not have appropriately designed internal controls in place over the COVID 19 Provider Relief Fund (?PRF?) grant awards related to the review and approval of the expenditures included in the U.S. Health Resources and Services Administration (?HRSA?) portal submission. Cause Management did not design internal controls or retain evidence of review and approval of the allowability of expenditures submitted within the HRSA portal. Effect or potential effect The expenditures included in the HRSA portal submission could be inaccurate or information reported to HRSA portal may be incomplete or inaccurate. Questioned costs None. Identification of a repeat finding This is a repeat finding and relates to prior year finding 2021-002. Context The System submitted a total of 9 reports within the HRSA portal during Period 3 and Period 4. The total PRF payments received by the System was $12,424,630. We tested 5 HRSA portal submissions that had total payments from HRSA amount to $11,977,661. Management did not retain documentation to support review and approval of the allowability of the expenditures entered in the HRSA portal. Audit procedures identified no questioned costs as it related to expenditures included within the HRSA portal submission. F) grant awards related to the review and approval of the expenditures included in the HRSA portal submission. Cause: Management did not design internal controls or retain evidence of review and approval of the expenditures. Effect or potential effect The expenditures included in the HRSA portal submission could be inaccurate or information reported to HRSA portal may be incomplete or inaccurate. Questioned costs: None. Identification of a repeat finding: This is a repeat finding and relates to prior year finding 2021-002. Context: The System submitted a total of 9 reports within the HRSA portal during Period 3 and Period 4. The total PRF payments received by the System was $12,424,630. We tested 5 HRSA portal submissions that had total payments from HRSA amount to $11,977,661. Management did not retain documentation to support review and approval of the expenditures entered in the HRSA portal. Audit procedures identified no questioned costs as it related to expenditures included within the HRSA portal submission.

Categories

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 32369 2022-001
    Significant Deficiency Repeat
  • 32370 2022-003
    Significant Deficiency Repeat
  • 32371 2022-002
    Material Weakness
  • 608812 2022-003
    Significant Deficiency Repeat
  • 608813 2022-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 - Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $12.42M
93.917 Hiv Care Formula Grants $3.05M
12.750 Uniformed Services University Medical Research Projects $2.36M
93.837 Cardiovascular Diseases Research $728,686
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $630,893
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $551,228
93.461 Covid-19 - Hrsa Covid-19 Claims Reimbursement for the Uninsured Program $537,317
93.939 Hiv Prevention Activities Non-Governmental Organization Based $428,237
20.RD Nhtsa Discretionary Safety Grants and Cooperative Agreements $358,219
93.350 National Center for Advancing Translational Sciences $278,879
93.145 Hiv-Related Training and Technical Assistance $249,634
93.RD Population Health Research Support $203,128
93.914 Hiv Emergency Relief Project Grants $168,245
93.767 Children's Health Insurance Program $166,981
93.353 21st Century Cures Act - Beau Biden Cancer Moonshot $144,695
93.103 Food and Drug Administration Research $134,239
16.575 Crime Victim Assistance $126,935
93.393 Cancer Cause and Prevention Research $102,253
93.RD Nhlbi Graft Sample and Data Collection Project $80,705
93.394 Cancer Detection and Diagnosis Research $73,677
12.420 Military Medical Research and Development $40,278
93.226 Research on Healthcare Costs, Quality and Outcomes $35,161
93.323 Covid-19 - Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $32,135
93.RD Nhlbi/inova Pulmonary Vascular Program $27,759
93.397 Cancer Centers Support Grants $21,633
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $17,834
21.027 Covid-19 - Coronoavirus State and Local Fiscal Recovery Funds $13,427
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $13,326
93.RD Nhlbi Pulmonary Vascular Program $7,240
93.855 Allergy and Infectious Desease Research $5,536
93.RD Support Services for the Lampoon Protocol Ide Enrollment Sites $4,248
93.940 Hiv Prevention Activities Health Department Based $2,126