Livingston HealthCare

2021-004? Department of Health and Human Services CFDA #93.498 COVID-19 Provider Relief Fund Applicable Federal Award Number and Year ? Period 1 TIN #810378200 Activities Allowed or Unallowed and Allowable Costs/Cost Principles and 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?s final expenditures identified as eligible and claimed under the Provider Relief Fund program were reviewed and approved by separate individuals outside of the preparer. However, the Hospital?s special reports submitted to the Department of Health and Human Services for Period 1 TIN #810378200 had no evidence of review and approval by a separate individual outside of the preparer. Cause ? The Hospital had multiple individuals identifying and compiling eligible costs, however, the Hospital did not have an internal control process in place to ensure evidence of a secondary review and approval, of eligible expenditures that were summarized from the underlying supporting spreadsheets to the final expenditure listing, was documented. The final expenditure listing was used to claim allowable costs under the federal program. The review and approval of the final expenditure listing submitted to the Department of Health and Human Services for Period 1 was not performed by someone other than the preparer of the report. Effect ? Without a secondary review and approval, there is a possibility that ineligible expenditures may be claimed under the program and the report may not be accurately completed. Questioned Costs ? None reported. Context/Sampling ? Testing was performed over payroll, supplies, and equipment for activities allowed and unallowed and allowable costs/cost principles. Key line items were tested on the Period 1 Department of Health and Human Services special reports. Repeat Finding from Prior Year(s) ? No. Recommendation ? We recommend the Hospital implement a control process which includes a secondary review and approval of the summarized final expenditure listing used to claim the allowable costs under the federal program and a secondary review and approval of required reports submitted to the federal agency. Views of Responsible Officials ? Management agrees with the finding.

Finding 2021-004 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/CFDA #93.498 Applicable Federal Award Number and Year - Period 1 TIN#264230898 Finding Summary: The facility did not have an internal control process in place to ensure a secondary review and approval of eligible expenditures, that were summarized from the underlying supporting spreadsheets to the final expenditure listing, was documents. The final expenditure listing was used to claim allowable costs under the federal program. The reivew and approval of the final expenditure listing submitted to the Department of Health and Human Services for Period 1 was not preformed by someone other than the preparer of the report. Responsible Individual: Kris Kester, Vice President of Finance. Corrective Action Plan: The final expenditure listing will be reviewed and approved by an individual other than the preparer and the review process will be documented. Before reports are submitted to the federal agency, documented review and approval of the submission will be performed by a second person before final submission to the Department of Health and Human Services. Anticipated Completion Date: October 2022.