Finding 62131 (2022-001)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-02-27
Audit: 56996
Organization: Owensboro Health, Inc. (KY)
Auditor: Kpmg LLP

AI Summary

  • Core Issue: Lack of documented management review of grant reports before submission to the U.S. Department of Health and Human Services.
  • Impacted Requirements: Non-compliance with 45 CFR section 75.303 regarding effective internal controls and documentation for federal awards.
  • Recommended Follow-Up: Implement formal controls to ensure grant reports are reviewed and maintain evidence of these reviews.

Finding Text

Finding 2022-001 ? Reporting Federal Program: COVID-19 Provider Relief Fund ALN: 93.498 Federal Agency: U.S. Department of Health and Human Services Federal Award Years: January 1, 2020 through December 31, 2021 Criteria: 45 CFR section 75.303 (a) states non-federal entities must: 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. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government,? issued by the Comptroller General of the United States or the ?Internal Control Integrated Framework,? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). 45 CFR section 75.303 (b) states non-federal entities must: Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards. Recipients of provider relief funds must support all expenses with adequate documentation and maintain proper control documentation to substantiate that these funds were used for health care-related expenses or lost revenues attributable to coronavirus. Condition Found, Including Perspective: There is no evidence of management?s review of grant reports prior to their submission to the U.S. Department of Health and Human Services.Possible Cause and Effect: While Owensboro Health, Inc. maintains that some manual review did take place prior to submission, controls were not designed or implemented effectively to maintain evidence of management's manual review. Such reviews took place verbally over phone calls, online meeting platforms, and emails, which were not recorded or retained. Questioned Costs: None. Statistical Validity: The sample was not intended to be, and was not, a statistically valid sample. Repeat Finding in the Prior Year: This is not a repeat finding. Recommendation We recommend that management implement appropriate controls and processes to review the grant reports prior to submission and to provide evidence of the related review. Views of Responsible Officials: Owensboro Health, Inc. will implement controls and processes to ensure grant reports are reviewed prior to submission and that evidence of review is maintained.

Corrective Action Plan

Finding Name: 2022-001-Reporting Federal Program: COVID-19 Provider Relief Fund ALN: 93.498 Owensboro Health, Inc. (OHI)?s System CFO and VP of Accounting has reviewed the COVID-19 Provider Relief Fund findings from KPMG relating to the Uniform Guidance. We understand the recommendation set forth by KPMG and will revamp our controls and processes to include additional review of the quarterly grant reports entered in the US Department of Health Human Services portal before and after submission. OHI?s corrective action plan: 1. Going forward, OHI will have a formal agenda to discuss and approve the grant reports prior to the submission to the US Department of Health and Human Services portal. 2. The quarterly Cares Act (PRF) reporting will be reviewed, approved and attested by the System CFO, VP of Accounting, Manager of Revenue and Regulatory Analysis and Manager of Decision Support. Contact person/s responsible for the correction action: Ruby Jacildo and Jeremy Stewart Anticipated Date: March 31, 2023

Categories

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

Other Findings in this Audit

  • 638573 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $23.39M
93.965 Coal Miners Respiratory Impairment Treatment Clinics and Services $1.05M
93.461 Covid-19 Testing for the Uninsured $125,316