Mission Hospice & Home Care Inc

Finding Title: Lack of Documented Evidence of Review Process for Reports Submitted to HRSA Federal Agency: U.S. Department of Health and Human Services (HHS) - Health Resources and Services Administration (HRSA) Federal Program: COVID-19 Provider Relief Fund Assistance Listing Number: 93.498 Award Year: January 1, 2022 to June 30, 2022 Compliance Requirement: Reporting Questioned Costs: N/A Type of Finding: A Significant Deficiency in Internal Control Over Compliance Criteria: The Uniform Guidance Compliance Supplement (2 CFR § 200.303) requires agencies to establish and maintain effective internal controls over federal awards to ensure compliance with statutes, regulations, and the terms of federal awards. Documented evidence of controls, such as review and approval processes, is critical for demonstrating compliance with federal reporting requirements. Condition: During testing of compliance controls, we noted that the Agency failed to provide documented evidence supporting the review and approval process for reports submitted to the Health Resources and Services Administration (HRSA). Management could not produce traceable records or evidence demonstrating that reports were reviewed for accuracy and completeness prior to submission. Cause: The deficiency arose from a lack of formalized processes and procedures requiring the documentation of review and approval steps for federal grant reporting. Contributing factors included inadequate oversight and insufficient training on federal grant compliance requirements. Effect: The absence of documented evidence of a review process increases the risk of errors or omissions in reports submitted to HRSA. This deficiency could result in non-compliance with federal reporting requirements, potentially jeopardizing the Agency's ability to demonstrate appropriate use of Provider Relief Fund (PRF) grant funds. Context: The Provider Relief Fund (PRF), established under the CARES Act, supports healthcare providers affected by the COVID-19 pandemic. Recipients of PRF funds are required to submit detailed reports to HRSA, ensuring accountability and transparency in the allocation of federal resources. A documented review process is essential to ensure that submitted reports accurately reflect the use of grant funds in compliance with federal requirements. Recommendation: We recommend that the Agency: - Develop and implement formalized procedures for the review and approval of federal grant reports before submission to HRSA. - Maintain traceable audit evidence, such as documented review checklists, signed approvals, and timestamps, to demonstrate compliance with federal reporting requirements. - Provide training to staff involved in the preparation and review of federal grant reports to ensure understanding of compliance requirements and the importance of documentation.