Finding 619791 (2022-002)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 45183
Organization: Samaritan Medical Center (NY)
Auditor: Fustcharles LLP

AI Summary

  • Core Issue: There was a significant deficiency in internal controls related to the timely review of financial estimates, specifically affecting the New York State ICP and UPL distributions.
  • Impacted Requirements: The lack of timely reconciliation led to a $2.5 million adjustment in third-party payor settlements, risking the accuracy of financial statements.
  • Recommended Follow-Up: Implement monthly reconciliations of ICP and UPL activity, and conduct annual reconciliations with state reports to ensure accurate financial reporting.

Finding Text

2022-001 - New York State Indigent Care Pool (ICP) and Upper Payment Limit (UPL) Distributions - Significant Deficiency in Internal Control Criteria: Timely review of significant estimates is an essential internal control to ensure the financial statements presented are complete and accurate. Condition: The Medical Center is responsible for the internal control over the review of significant estimates including third party estimates. Context: During the audit, in conjunction with management, a significant adjustment was reported to the estimated third-party payor settlement balance to appropriately reflect the $2.5 million of cash receipts from the New York State ICP and UPL during 2022. Cause: The significant adjustment was due to lack of timely reconciliation of New York State ICP and UPL activity. Effect: Incomplete review of key estimates can result in significantly misstated internal financial statements. Recommendation: We recommend that all New York State ICP and UPL activity be reconciled on a monthly basis and SMC also reconcile all activity on an annual basis to the New York State Department of Health?s Division of Finance and Rate Setting reports to ensure that all activity is properly reflected on the financial statements. Views of Responsible Official: See management?s Corrective Action Plan on page 50.

Categories

Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 43349 2022-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $4.49M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $799,682
93.889 National Bioterrorism Hospital Preparedness Program $40,000
93.958 Block Grants for Community Mental Health Services $40,000