Finding 7831 (2023-004)

Significant Deficiency
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2024-01-08
Audit: 10165
Organization: Cherry County Hospital (NE)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: The Hospital reported inflated IT expenditures for Quarter 3 2022, lacking proper internal controls for expense verification.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) was not met, as effective internal controls over federal award management were absent.
  • Recommended Follow-Up: Enhance internal control processes to ensure all reported expenses are backed by adequate audit evidence.

Finding Text

Federal Program: Federal Financial Assistance Listing 93.498; US Department of Health and Human Services; Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Activities Allowed/Unallowed and Allowable Costs/Cost Principles Reporting Significant Deficiency in Internal Control over Compliance 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. Condition: The Hospital reported amounts in the reporting portal for information technology expenditures for Quarter 3 2022 in excess of amounts that are supported by audit evidence. Cause: The Hospital did not have an effective internal control process in place to ensure review and approval of the expenses claimed under the federal program and to ensure the report submitted for Period 4 was accurate and in accordance with the terms and conditions of the federal award. Effect: The reporting to HHS for Period 4 was considered incorrect. Amounts reported for information technology expenditures for Quarter 3 2022 did not agree to audit evidence provided by management. Questioned Costs: None. Context: Key line items were tested on the Period 4 HHS report. Recommendation: We recommend that the Hospital enhance its existing internal control processes to ensure expenses reported to HHS are supportable by underlying audit evidence. Views of Responsible Officials and Planned Corrective Actions: Management agrees with the noted finding. Management will continue to refine processes to more diligently review the reporting portal submission and underlying audit evidence to ensure the accuracy of calculations and amounts reported to HHS.

Corrective Action Plan

Condition: The Hospital reported amounts in the reporting portal for information technology expenditures for Quarter 3 2022 in excess of amounts that are supported by audit evidence. Planned Corrective Action: Management will continue to refine processes to more diligently review the calculation of allowable expenses and amounts entered into the provider relief fund reporting portal. Contact Person: Stephanie Jacobsen, Interim Chief Financial Officer Anticipated Completion Date: March 31, 2024

Categories

Allowable Costs / Cost Principles Reporting Significant Deficiency

Other Findings in this Audit

  • 584273 2023-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund (prf) and American Rescue Plan (arp) Rural Distribution $1.09M
93.155 Rural Health Research Centers $202,787
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $111,472
93.697 Testing and Mitigation for Rural Health Clinics $100,000
93.461 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $51,886
93.301 Small Rural Hospital Improvement Grant Program $12,836
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $307
93.436 Well-Integrated Screenind and Evaluation for Women Across the Nation (wisewoman) $142