Finding 613605 (2022-002)

Significant Deficiency Repeat Finding
Requirement
Activities Allowed/Unallowed
Questioned Costs
$1
Year
2022
Accepted
2023-03-28
Audit: 37762
Organization: Mercy Hospital Iowa City, Ia (IA)

AI Summary

  • Core Issue: Management included unsubstantiated expenses in the PRF submission, violating the CARES Act requirements.
  • Impacted Requirements: Expenses must be directly related to COVID-19 response; $158,832 in questioned costs were identified.
  • Recommended Follow-Up: Enhance internal controls to ensure thorough review of expenses before reporting in the PRF Portal.

Finding Text

Finding No. 2022-002 Allowable Activities and Reporting Significant Deficiency in Internal Controls over Compliance Federal Program: Federal Financial Assistance Listing #93.498 US Department of Health and Human Services COVID-19 Provider Relief Fund Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) require funds received to be used to prevent, prepare for, and respond to coronavirus and that the payment shall reimburse the recipient only for health care related expenses and lost revenues that are attributable to the coronavirus. Condition: During the process of identifying expenses that were incurred to prevent, prepare for, or respond to the coronavirus pandemic, management included certain expense amounts that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic in the PRF submission. Cause: Management inadvertently included certain expenses as part of the Period 2 PRF Reporting Portal submission that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic as a result of an insufficient review of reported expenses. Effect: Management included expenses in the PRF Reporting Portal which were not allowable based on the terms and conditions of the PRF award. Questioned costs: Total questions costs amounted to $158,832 and were calculated based off expenses that were reported in the PRF Reporting Portal that could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic. Context: During the audit, management identified costs related to two vendors in the amount of $41,805 and we identified one invoice out of 60 testing samples, of $117,027, that were reported in the PRF Reporting Portal submission and could not be substantiated as being incurred to prevent, prepare for, or respond to the coronavirus pandemic. Repeat finding: Yes Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that allowable costs included in the amount expended as reported in the PRF Reporting Portal are sufficiently reviewed to determine those expenses relate to those incurred to prevent, prepare for, or respond to the coronavirus pandemic. View of Responsible Official and Planned Corrective Action: Management agrees with the finding noted. However, Mercy also incurred and reported sufficient lost revenues in the PRF Reporting Portal that if the noted expenses were not to be reported, Mercy would have satisfactorily incurred eligible expenses and lost revenues in excess of the PRF funds received, including interest earned on such funds. See Corrective Action Plan.

Categories

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

Other Findings in this Audit

  • 37163 2022-002
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $10.16M
21.019 Coronavirus Relief Fund $291,127
93.461 Covid-19 Testing for the Uninsured $7,580