Audit 13228

FY End
2023-06-30
Total Expended
$995,647
Findings
2
Programs
4
Year: 2023 Accepted: 2024-01-23

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
9574 2023-001 Material Weakness - L
586016 2023-001 Material Weakness - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $795,916 Yes 1
93.155 Rural Health Research Centers $104,798 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $82,097 - 0
93.301 Small Rural Hospital Improvement Grant Program $12,836 - 0

Contacts

Name Title Type
MNNXPLLFUFH3 Darcy Robertson Auditee
3075485215 Shaun Johnson Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The District has not elected to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The District has not elected to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of North Big Horn Hospital District (the District) under programs of the federal government for the year ended June 30, 2023. Amounts reported on the Schedule for Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution are based upon the June 30, 2023, Provider Relief Fund report. The information in the Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the District, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the District.

Finding Details

2023-001 Provider Relief Fund Reporting of Lost Revenue Federal Agency Department of Health and Human Services Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan Rural Distribution Award Numbers Not applicable Criteria [ X ] Compliance Finding [ ] Significant Deficiency [ X ] Material Weakness Under the terms and conditions of the award, the recipient certifies it will report actual net patient service revenues for the periods reported on in its reporting of actual net patient service revenues for its calculation of lost revenues due to coronavirus. Condition Patient service revenues for were not reported net of contractual adjustments and bad debt. Context This finding appears to be an isolated problem. Cause The District prepared its lost revenue calculations using gross patient service revenues without including contractual adjustments and bad debt. Effect The actual patient service revenues for 2023 did not reflect the correct amounts to be used in its lost revenue calculations. If net patient service revenues had been reported, the District would still have sufficient healthcare-related expenses attributable to coronavirus and lost revenues to use all of the Provider Relief Fund amounts received. Therefore, there is no effect on the District’s retention of the Provider Relief Funds. Recommendation We recommend the District’s management correct its lost revenue calculation for any future reporting for the Provider Relief Fund. Views of responsible officials and planned corrective actions Net Patient Revenues by Financial Class are not available in the CPSI system and can only be estimated. In the event there is another PHE that results in more than $750,000 received by facility, Net Patient Revenue will be easily obtainable in the CERNER system for future reporting.
2023-001 Provider Relief Fund Reporting of Lost Revenue Federal Agency Department of Health and Human Services Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan Rural Distribution Award Numbers Not applicable Criteria [ X ] Compliance Finding [ ] Significant Deficiency [ X ] Material Weakness Under the terms and conditions of the award, the recipient certifies it will report actual net patient service revenues for the periods reported on in its reporting of actual net patient service revenues for its calculation of lost revenues due to coronavirus. Condition Patient service revenues for were not reported net of contractual adjustments and bad debt. Context This finding appears to be an isolated problem. Cause The District prepared its lost revenue calculations using gross patient service revenues without including contractual adjustments and bad debt. Effect The actual patient service revenues for 2023 did not reflect the correct amounts to be used in its lost revenue calculations. If net patient service revenues had been reported, the District would still have sufficient healthcare-related expenses attributable to coronavirus and lost revenues to use all of the Provider Relief Fund amounts received. Therefore, there is no effect on the District’s retention of the Provider Relief Funds. Recommendation We recommend the District’s management correct its lost revenue calculation for any future reporting for the Provider Relief Fund. Views of responsible officials and planned corrective actions Net Patient Revenues by Financial Class are not available in the CPSI system and can only be estimated. In the event there is another PHE that results in more than $750,000 received by facility, Net Patient Revenue will be easily obtainable in the CERNER system for future reporting.