Finding 6653 (2023-004)

Material Weakness Repeat Finding
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2023-12-27
Audit: 8606
Organization: Logan Health (MT)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: LHMC reported inflated lost revenue due to including HC's revenue for 2020, leading to a discrepancy of $8,940,592.
  • Impacted Requirements: Failure to maintain effective internal controls as per 2 CFR 200.303(a) resulted in material noncompliance in reporting.
  • Recommended Follow-Up: Enhance internal controls to ensure accurate lost revenue calculations align with grant terms and conditions.

Finding Text

2023-004 U.S. Department of Health and Human Services Federal Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Applicable Federal Award Number and Year – Period 3 TIN #237293874, #810413632; #371518772; #810420653; and #810540517 Material Weakness in Internal Control over Compliance – Activities Allowed or Unallowed, Allowable Costs/Costs Principles, and Reporting; Material Noncompliance - Reporting Criteria – 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The Corporation selected Option i to calculate lost revenue for LHMC which consists of comparing actual quarterly revenues in calendar years 2020, 2021, and 2022 to actual quarterly revenues in calendar year 2019. Condition – The operations of HC were consolidated into LHMC as of December 31, 2020. When LHMC calculated their lost revenues, they included HC’s revenue for 2020, 2021, and 2022 instead of only the 2021 and 2022 information. This resulted in LHMC reporting higher lost revenues than the detailed reports supported in Period 3. LHMC selected Option iii for Period 4 and amounts were properly updated. Cause – The Corporation did not have adequate internal controls to ensure the lost revenue calculation was done in accordance with the terms and conditions of the grant. Effect – The impact of the above condition was as follows: Entity Lost Revenue Amount Reported in HHS Special Report Amounts that Should Have Been Reported in HHS Special Report Excess Lost Revenue Reported LHMC $ 26,318,146 $ 17,377,554 $ 8,940,592 Period 3 Questioned Costs – None reported. After recalculating the lost revenue, the amount still exceeded the amount of provider relief funds retained. Context/Sampling – Key line items were tested on the Period 3 HHS special report. Repeat Findings from Prior Years – Yes, Finding #2022-004 Recommendation - We recommend that the Corporation enhance internal controls to ensure the lost revenue calculation is completed according to the terms and conditions. Views of Responsible Officials - Management agrees with the finding. (See Table in Report)

Corrective Action Plan

Finding 2023-004 Federal Agency Name: Department of Health and Human Services Program Name: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Federal Assistance Listing #93.498 Finding Summary: The operations of HealthCenter Northwest, LLC (HC) were consolidated into Kalispell Regional Medical Center d/b/a Logan Health Medical Center (LHMC) as of December 31, 2020. When LHMC calculated their lost revenues, they included HC’s revenue for both 2020 and 2021 instead of only the 2021 information. This resulted in LHMC reporting higher lost revenues than the detailed reports supported in Period 3. This was corrected in Period 4 reporting. Responsible Individuals: Craig Lambrecht, CEO and Cole Turner, CFO Corrective Action Plan: The lost revenue calculation will be re-evaluated and the amount of lost revenue reported on the HHS reporting portal has been updated in Period 4. Completion Date: 12/31/23

Categories

Allowable Costs / Cost Principles Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 6651 2023-002
    Significant Deficiency
  • 6652 2023-003
    Material Weakness Repeat
  • 583093 2023-002
    Significant Deficiency
  • 583094 2023-003
    Material Weakness Repeat
  • 583095 2023-004
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 Provider Relief Fund $27.13M
93.931 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $682,431
93.697 Covid-19 Testing for Rural Health Clinics $279,735
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $49,529
93.435 Innovative State and Local Public Health Strategies to Prevent and Manage Diabetes and Heart Disease and Stroke- $37,000
93.110 Maternal and Child Health Federal Consolidated Programs $20,510