Finding 982478 (2020-003)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2020
Accepted
2024-07-02
Audit: 311581
Organization: Hospital Damas INC (PR)
Auditor: Galindez LLC

AI Summary

  • Core Issue: The Hospital failed to properly reconcile federal grant expenditures to source documents, leading to amended monthly reports and potential noncompliance.
  • Impacted Requirements: The grant agreement mandates accurate recordkeeping and timely submission of detailed Use of Funds reports by the 15th of each month.
  • Recommended Follow-Up: The Hospital should stay updated on federal award guidelines and consult with AAFAF for clarity on any interpretative issues or new awards.

Finding Text

Finding No. 2020-003 – Recordkeeping Federal Program Assistance Listing 21.019 – Coronavirus Relief Fund – COVID-19 Name of Federal Agency U.S. Department of Treasury Pass-through entity Puerto Rico Treasury Department Category Significant deficiency in internal controls over compliance / Non-compliance Compliance requirements Reporting Criteria The grant agreement with the pass-through entity establishes in section 2.3, Recordkeeping, the following: “Grantee will maintain its books and records in a manner that will provide Grantor with sufficient detail to review Grantee’s receipts and expenditures relating to the Grant.” Also, the grant agreement establishes in its Exhibit A, Grant Plan, Reporting, the following: “By the 15th day of each month, the Grantee will submit a Use of Funds Grant Report for the prior month’s expenses. The financial report will provide a detailed explanation of how the Grant funds were spent.” Condition The federal grant expenditures recorded in the financial statements and reported monthly to the pass-through entity were not duly reconciled to source and other supporting documents, which resulted in performing such reconciliation at the time when the single audit process was conducted. It also resulted in changes to the major program expenditures during the completion of the single audit, to properly provide such supporting documents duly reconciled to the pass-through entity as part of the closeout process. As a result, the monthly reports of Use of Funds required by the grant agreement were amended and re-submitted to the pass-through entity on March 2, 2022. Cause In response to the global pandemic of COVID – 19, the government of the United States enacted various laws to provide grants and support to hospitals and other healthcare entities responding to the coronavirus pandemic, among others, some of which have never been subject to a single audit process. Furthermore, the rules and regulations for the management, reporting and allowability of the federal grants were being developed and published at the same time, and even after, the entities were receiving the federal awards. Also, the publishing of the Office of Management and Budget’s Compliance Supplement addendum for single audits was delayed until late December 2020. This caused confusion among all the recipients of the federal awards. The Hospital interpreted the methods allowed for reporting expenses with the information available at the time of the receipt of the federal grants and applied a methodology to report expenditures in line with such interpretation. Effect The absence of source documents duly reconciled to expenses reported to the pass-through entity may be considered by the grantor and the pass-through entity as a noncompliance with the above-mentioned criteria and could lead to administrative sanctions. Also, the monthly reports submitted to the pass-through entity had to be amended and resubmitted by the Hospital. Questioned cost None Context There was an overstatement on the Coronavirus Relief Fund expenses initially reported to the pass-through entity amounting to $433,463 out of a total of allowable expenditures of $5,072,031, or 8.55% of total expenditures that were finally reported for the period from March 1, 2020 through December 31, 2020. Identification of a repeat finding This is not a repeat finding. Recommendation The Hospital should continue to monitor and review guidelines for federal awards under the CARES Act to ensure it is up to date on the applicable requirements and changes therein. In addition, the Hospital should consider consulting with AAFAF when available guidance may be subject to interpretation or when new awards, if any, are received. Views of responsible officials and planned corrective actions The Hospital’s management and responsible officers agree with this finding. Please refer to the corrective action plan section for the Hospital’s response on pages 57 to 59.

Categories

Subrecipient Monitoring Reporting Significant Deficiency Internal Control / Segregation of Duties

Other Findings in this Audit

  • 406034 2020-001
    Significant Deficiency
  • 406035 2020-002
    Significant Deficiency
  • 406036 2020-003
    Significant Deficiency
  • 406037 2020-004
    Significant Deficiency
  • 982476 2020-001
    Significant Deficiency
  • 982477 2020-002
    Significant Deficiency
  • 982479 2020-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
21.019 Coronavirus Relief Fund $5.07M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $283,017
93.889 National Bioterrorism Hospital Preparedness Program $7,196