Finding 6156 (2023-003)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2023-12-21
Audit: 8022
Organization: Cedar County Memorial Hospital (MO)

AI Summary

  • Core Issue: The Hospital lacks effective internal controls for reporting under HHS guidelines.
  • Impacted Requirements: Compliance with reporting activities related to COVID-19 Provider Relief Funding.
  • Recommended Follow-Up: Implement controls to ensure accurate reporting in line with HHS guidelines.

Finding Text

2023–003 Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution CFDA Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Significant Deficiency in Internal Control in and over Compliance Compliance Requirement: Reporting Criteria or specific requirement: Surrounding reporting activities, the Hospital’s internal controls should be designed to assure all reporting completed under program guidelines. Condition: During our testing, we identified the Hospital did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines. Questioned costs: None Context: It was identified the calculation of lost revenue amounts were incorrectly input based on the Hospital’s fiscal year end quarters vs. calendar quarters as required under the reporting guidance. Cause: The Hospital misunderstood the input of the information to be on fiscal vs. calendar year end. Effect: The auditor noted no instances of noncompliance with the provisions of lost revenues claimed, as the quarters lost revenues exceeded the amount claimed; however, the internal controls around compliance over reporting were not effective. Repeat Finding: N/A Recommendation: We recommend the Hospital design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.

Corrective Action Plan

U.S. Department of Health and Human Services Cedar County Memorial Hospital (“Organization”) respectfully submits the following corrective action plan for the year ended January 31, 2023. Audit period: February 1, 2022 – January 31, 2023 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS— FINDINGS AND QUESTIONED COSTS – MAJOR FEDERAL PROGRAMS DEPARTMENT OF HEALTH AND HUMAN SERVICES 2023 – 003 COVID-19 Provider Relief Funding and American Rescue Plan Rural Distribution Recommendation: We recommend the Hospital design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Management misunderstood the input of the information to be on fiscal vs. calendar year end. Name of the contact person responsible for corrective action: Carla Gilbert, CFO. Planned completion date for corrective action plan: November 1, 2023 If the Department of Health and Human Services has questions regarding this plan, please call Carla Gilbert, CFO at (417) 876-3097.

Categories

Reporting Significant Deficiency Internal Control / Segregation of Duties Special Tests & Provisions

Other Findings in this Audit

  • 582598 2023-003
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 Provider Relief Funding and American Rescue Plan Rural Distribution $782,171
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $29,719
93.301 Small Rural Hospital Improvement Grant Program $16,860