Catawba Valley Medical Center and AffiliateNon-Profit

Federal agency: U.S. Department of Health and Human Services Federal program title: Grants to Provide Outpatient Early Intervention Services with Respect to HIV Disease Federal Assistance Listing Number: 93.918 Type of Finding: Significant Deficiency in Internal Control over Compliance Condition: During our cash management testing, we noted that all five drawdown selections were missing physical sign of review or approval. Criteria: It is an ideal practice to have all the cash drawdowns reviewed and approved by a second individual. This review should be documented. Questioned costs: None Cause: All the draw down requests as well as the data compiled to make such requests were reviewed in person with the preparer, and no documentation of this review was maintained. Effect: Lack of proper review and approvals could lead to incorrect draw requests. Recommendation: We recommend management maintain documentation of review and approval of the draw downs. Views of responsible officials: There is no disagreement with the audit finding. Management will update the current review and approval process going forward.

Federal agency: U.S. Department of Health and Human Services Federal program title: Grants to Provide Outpatient Early Intervention Services with Respect to HIV Disease Federal Assistance Listing Number: 93.918 Type of Finding: Significant Deficiency in Internal Control over Compliance and Other Matter Condition: During our cash disbursements testing, we noted one expense out of 40 selections was not allowable. An expenditure related to a retirement party was erroneously charged to the grant. Criteria: All expenses incurred under the grant must be to provide outpatient, high-quality, early intervention services and primary care related to the Human Immunodeficiency Virus (HIV) and the Acquired Immune Deficiency Syndrome (AIDS). Questioned costs: $24.61 Cause: There was an oversight in the review and approval process. Effect: Unallowable costs were charged to the grant. Recommendation: We recommend management ensure that all expenses are properly reviewed and approved before payment to ensure only allowable expenditures are approved. Views of responsible officials: There is no disagreement with the audit finding. Management will ensure all expenses are properly reviewed.

Criteria: Expenditures reported to the U.S. Department of Health and Human Services must represent actual costs incurred. Condition: Inaccurate hours and pay rates were documented in the payroll expenditure details submitted to the U.S. Department of Health and Human Services. Cause: Thorough management review of the submissions was not performed. Effect: Expenditures submitted to the U.S. Department of Health and Human Services did not represent actual costs incurred. Questioned costs: $1,385 Recommendation: We recommend the Medical Center reach out to the U.S. Department of Health and Human Services to determine what process they would like the Medical Center to follow to correct the submissions. Identification of repeat findings: Not a repeat finding. Views of responsible officials: See Corrective Action Plan.

Criteria: Expenditures reported to NC Pandemic Recovery Office must represent actual allowable costs incurred. Condition: Inaccurate hours and pay rates were documented in the payroll expenditure details submitted to NC Pandemic Recovery Office. Additionally, four instances were identified in which sales tax was inappropriately included in expenditure amounts reported to NC Pandemic Recovery Office. Cause: Thorough management review of the submissions was not performed. Effect: Unallowable costs were submitted to NC Pandemic Recovery Office for reimbursement. Questioned costs: $5,834 Recommendation: We recommend the Medical Center reach out to NC Pandemic Recovery Office to determine what process they would like the Medical Center to follow to correct the submissions. Identification of repeat findings: Not a repeat finding. Views of responsible officials: See Corrective Action Plan.