Deviations from the regulations at the Cardiovascular Center of Puerto Rico
The Office of the Comptroller of Puerto Rico issued a qualified opinion on the fiscal operations of the Corporation of the Cardiovascular Center of Puerto Rico and the Caribbean. A qualified opinion is issued when the instances of noncompliance, individually or in the aggregate, are significant but not pervasive.
The Report reveals that the executive director did not present to the Board of Directors the approval of an extraordinary request-for-proposals process to contract the services of a medication supplier and inventory administrator of the Pharmacy Warehouse. Nine days before publishing the request for proposals, on August 25, 2017, the executive director reported as new business to the Board that he was receiving proposals and expressed his preference for the company that was later selected. However, it was not found in the minutes or in the recordings that the Board evaluated the need to carry out an extraordinary process as established by the General Regulation and the regulation governing the acquisition and sale of equipment, materials, and non-professional services.
The two-finding audit notes that the executive director designated the members of the proposal evaluation committee, and not the Board of Directors. In fact, as a result of the intervention of the Comptroller's auditors, the Board issued the Certification delegating to the executive director the carrying out of the extraordinary processes and the appointment of the evaluation committee on November 21, 2018.
In addition, at the time of formalizing the contract, on December 1, 2018, the contractor had not obtained the performance bond, for which reason the Cardiovascular Center was without guarantees during the first 10 months of the contract. The contract established the amount to be billed at $121 per patient per day. As of September 6, 2019, $2,692,322 had been disbursed.
The auditors detected, from a sample of 17 invoices from a supplier for $135,455, that the Cardiovascular Center paid $56,145 for 115 units of consignment material for which it could not provide evidence of their use. The materials, such as wires, catheters, and stents or balloons, among others, are used in the Invasive Laboratory for the procedures of hospitalized patients. This situation is attributed in part to the absence of provisions in the Manual of Norms and Procedures of the Central Warehouse to maintain the perpetual inventory of the consigned material.
The audited financial statements, corresponding to fiscal years 2017 through 2021, reflected that the Cardiovascular Center generated revenue of $522,065,719, and recorded operational expenses of $399,039,182, for a balance of $123,026,537. For that period, the audited financial statements reflected accumulated deficits of $170,276,613, $185,016,556, $192,217,257, $68,310,005, and $63,901,775 respectively.
The Report recommends that the Board of Directors exercise effective supervision and ensure that the executive director complies with the provisions of the regulations on extraordinary processes for non-professional services, among others.
Audit Report OC-24-44 covers the period from July 1, 2016 to November 30, 2020, and is available at www.ocpr.gov.pr.
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