FAC Explorer

Audit 16670

FY End
2022-12-31
Total Expended
$56.43M
Findings
2
Programs
33
Organization: Ahs Hospital Corp. (NJ)
Year: 2022 Accepted: 2023-09-27
Auditor: Pricewaterhousecoopers LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
12305 2022-001 - - L
588747 2022-001 - - L

Programs

ALN Program Spent Major Findings
97.036 Covid-19 Federal Emergency Management Disaster Relief Public Assistance $42.21M Yes 0
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $6.28M Yes 1
21.027 Covid-19 Emergency Department Modernization and Renovation $3.00M Yes 0
93.323 Covid-19 Sars Cov2 Hospital Testing $1.58M - 0
93.461 Covid-19 Hrsa Claims Reimbursement for the Uninsured Program $701,555 - 0
93.399 Cancer Control $670,664 - 0
21.027 Covid-19 Western Region Plant Modernization $543,631 Yes 0
93.914 Ryan White Part A Hiv Emergency Relief Grant Program 2023 $462,806 - 0
93.116 Tuberculosis Ambulatory Care 2022 $144,840 - 0
93.940 Dhsts Federal Hiv Prevention Program 2022 $139,907 - 0
84.191 Early Intervention Program $135,611 - 0
93.914 Ryan White Part A Hiv Emergency Relief Grant Program 2022 $83,719 - 0
97.067 Ffy19 Urban Areas Security Initiative (uasi-Local Share) $81,763 - 0
20.600 Hts Federal Highway Safety Grant 2022 Morris County Safe Communities $79,499 - 0
93.898 New Jersey Cancer Education and Early Detection 2022 $57,584 - 0
16.575 Sexual Assault Response Team (sart)/forensic Nurse Examiner (fne) $53,143 - 0
93.994 Special Child Health Child Evaluation Centers 2022 $26,235 - 0
93.994 Special Child Health Child Evaluation Centers 2023 $25,230 - 0
20.600 Hts Federal Highway Safety Grant 2023 Morris County Safe Communities $21,718 - 0
93.394 Cancer Detection and Diagnosis Research for Glioblastoma $21,380 - 0
93.994 Special Child Health Case Management 2022 $17,949 - 0
93.855 Effect of Il-4rar576 Variant on Response to Dupilumab in Children with Asthma (idea) $17,946 - 0
93.994 Special Child Health Case Management 2023 $17,675 - 0
93.394 M.d. Anderson Edrn-Cvc for Early Detection of Ovarian Cancer (00004221) $16,538 - 0
93.898 New Jersey Cancer Education and Early Detection 2023 $11,700 - 0
93.991 Preventive Health & Health Services $7,987 - 0
93.855 Lyme Meningitis $5,563 - 0
16.017 Sexual Assault Services Program $4,483 - 0
93.395 Supplemental Per Case Reimbursement: Cog Phi Laurie (ar07544) $2,500 - 0
93.865 Sex Differences in Statural Growth Impairment in Pediatric Crohn's Disease $2,325 - 0
93.991 Morris Sex Offense Set Aside $2,060 - 0
93.837 Clinical, Electrocardiographic & Cardiac Magnetic Resonance Imaging Risk Factors Associated with Ventricular Tachyarrhythmias in Nonischemic Cardiomyopathy Urf (awd00002150) $1,410 - 0
93.847 Type 1 Diabetes Trialnet $720 - 0

Contacts

Name Title Type
CBEMLJBKLZB4 Katharine Driebe Auditee
9734512027 Kate Corgel Auditor
No contacts on file

Notes to SEFA

Title: COVID-19Department of Homeland Security Federal Emergency Management Agency Accounting Policies: The information on the Schedule of Expenditures of Federal Awards (the "Federal Schedule") is reported onthe accrual basis of accounting and is presented in accordance with the requirements of the Title 2U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and AuditRequirements for Federal Awards (Uniform Guidance). Therefore, some amounts presented in this FederalSchedule may differ from amounts presented in or used in preparation of the basic consolidated financialstatements. The purpose of the Federal Schedule is to present a summary of those activities of the Hospitalfor the year ended December 31, 2022 which have been financed by the federal government. For purposesof the Federal Schedule, federal awards include any assistance provided by a federal agency directly orindirectly in the form of grants, contracts and loan and loan guarantees.Direct and indirect costs are charged to awards in accordance with cost principles contained in theDepartment of Health and Human Services (DHHS), U.S. Office of the Assistant Secretary Comptroller(OASC), OASC-3, A Guide for Hospitals. Under these cost principles, certain types of expenditures are notallowable or are limited as to reimbursement.Because the Federal Schedule presents only a selected portion of the activities of the Hospital, it is notintended to, and does not present the consolidated financial position, results of operations, changes in netassets or cash flows of the Hospital. Full Assistance Listing Numbers (ALN) and pass-through entitynumbers are included when available.While certain awards on the Federal Schedule have program names identified as award year 2023, onlyexpenses incurred during the year ended December 31, 2022 are reported on the Federal Schedule. These awards have grant periods that do not align with the Hospitals calendar year end. De Minimis Rate Used: N Rate Explanation: Indirect costs are recovered at the lower of the rate specified under the grant agreement or the Hospitalsapproved indirect cost rate of 55%, rather than the allowed de minimus rate of 10%. For the year ended December 31, 2022, the Hospital recorded $42,213,059 of claims to FEMA under ALN 97.036. The claims submitted represented incurred eligible capital and operating expenses attributed to the Hospital's response to COVID-19, which were not only expended, but also approved by the federal and state agencies. The Hospital has additional claims outstanding and under review with FEMA as of December 31, 2022 which will be recognized in the year the related funds are approved by FEMA at the federal and state agencies.
Title: COVID-19ProviderRelief Fund and American Rescue Plan(ARP)Rural Distribution Accounting Policies: The information on the Schedule of Expenditures of Federal Awards (the "Federal Schedule") is reported onthe accrual basis of accounting and is presented in accordance with the requirements of the Title 2U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and AuditRequirements for Federal Awards (Uniform Guidance). Therefore, some amounts presented in this FederalSchedule may differ from amounts presented in or used in preparation of the basic consolidated financialstatements. The purpose of the Federal Schedule is to present a summary of those activities of the Hospitalfor the year ended December 31, 2022 which have been financed by the federal government. For purposesof the Federal Schedule, federal awards include any assistance provided by a federal agency directly orindirectly in the form of grants, contracts and loan and loan guarantees.Direct and indirect costs are charged to awards in accordance with cost principles contained in theDepartment of Health and Human Services (DHHS), U.S. Office of the Assistant Secretary Comptroller(OASC), OASC-3, A Guide for Hospitals. Under these cost principles, certain types of expenditures are notallowable or are limited as to reimbursement.Because the Federal Schedule presents only a selected portion of the activities of the Hospital, it is notintended to, and does not present the consolidated financial position, results of operations, changes in netassets or cash flows of the Hospital. Full Assistance Listing Numbers (ALN) and pass-through entitynumbers are included when available.While certain awards on the Federal Schedule have program names identified as award year 2023, onlyexpenses incurred during the year ended December 31, 2022 are reported on the Federal Schedule. These awards have grant periods that do not align with the Hospitals calendar year end. De Minimis Rate Used: N Rate Explanation: Indirect costs are recovered at the lower of the rate specified under the grant agreement or the Hospitalsapproved indirect cost rate of 55%, rather than the allowed de minimus rate of 10%. During the years ended December 31, 2022, 2021 and 2020, the Hospital received Provider Relief Funds (PRF) from DHHS ALN 93.498, as further described in Note 5 to the consolidated financial statements. Pursuant to the guidance provided by DHHS, the Federal Schedule includes all Period 3 and 4 funds received between January 1, 2021 and December 31, 2021 and expended by December 31, 2022 as reported to Health Resources and Services Administration (HRSA) via the PRF Reporting Portal. Pursuant to the guidance provided by DHHS, the Hospital will include all PRF funds received between January 1, 2022 and December 31, 2022 (Periods 5 and 6) on its Schedule of Expenditures of Federal Awards for the year ending December 31 2023.
Title: COVID-19 HRSA Claims Reimbursement for the Uninsured Program Accounting Policies: The information on the Schedule of Expenditures of Federal Awards (the "Federal Schedule") is reported onthe accrual basis of accounting and is presented in accordance with the requirements of the Title 2U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and AuditRequirements for Federal Awards (Uniform Guidance). Therefore, some amounts presented in this FederalSchedule may differ from amounts presented in or used in preparation of the basic consolidated financialstatements. The purpose of the Federal Schedule is to present a summary of those activities of the Hospitalfor the year ended December 31, 2022 which have been financed by the federal government. For purposesof the Federal Schedule, federal awards include any assistance provided by a federal agency directly orindirectly in the form of grants, contracts and loan and loan guarantees.Direct and indirect costs are charged to awards in accordance with cost principles contained in theDepartment of Health and Human Services (DHHS), U.S. Office of the Assistant Secretary Comptroller(OASC), OASC-3, A Guide for Hospitals. Under these cost principles, certain types of expenditures are notallowable or are limited as to reimbursement.Because the Federal Schedule presents only a selected portion of the activities of the Hospital, it is notintended to, and does not present the consolidated financial position, results of operations, changes in netassets or cash flows of the Hospital. Full Assistance Listing Numbers (ALN) and pass-through entitynumbers are included when available.While certain awards on the Federal Schedule have program names identified as award year 2023, onlyexpenses incurred during the year ended December 31, 2022 are reported on the Federal Schedule. These awards have grant periods that do not align with the Hospitals calendar year end. De Minimis Rate Used: N Rate Explanation: Indirect costs are recovered at the lower of the rate specified under the grant agreement or the Hospitalsapproved indirect cost rate of 55%, rather than the allowed de minimus rate of 10%. The Hospital recorded $701,555 on the Federal Schedule under DHHS ALN 93.461 for reimbursement of patient care services including COVID-19 testing and/or treatment of uninsured individuals with a COVID-19 primary diagnosis. The reimbursement recorded on the Federal Schedule represents eligible claims with services dates during the award period in 2022 (claims for testing and treatment were accepted through March 22, 2022 and claims for vaccine administration were accepted through April 5, 2022).

Finding Details

Finding 2022-001
2022-001: Provider Relief Fund Reporting Cluster: Not applicable Federal Granting Agency: DHHS Health Resources and Services Administration (?HRSA?) Award Name: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Assistance Listing Title: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year: January 1, 2020 ? December 31, 2022 Criteria Step 13 ? Lost Revenues of the HRSA User Guide for Provider Relief Fund (PRF) Reporting Portal ? Reporting dated June 30, 2022 requires Reporting entities (recipients) that apply PRF payments toward lost revenues to use one of the following three options for calculating lost revenues: ? Option (i): difference between 2019 actual patient care revenues and actuals for each quarter during the period of availability; ? Option (ii): difference between budgeted and actual patient care revenues for each quarter during the period of availability; or ? Option (iii): any reasonable method of estimating revenues. Per the HRSA User Guide, recipients that select Option (ii) must submit documentation of budgets approved prior to March 27, 2020 that covers the entire period of availability. Condition The Hospital completed its Period 3 PRF Reporting Portal submissions and attested to calculating lost revenues using Option (ii). However, in order to use this option, budgets covering the entire period of availability (January 1, 2020 to December 31, 2022) were required to be approved prior to March 27, 2020. While the budget of the Hospital for the year ended December 31, 2020 was approved prior to this date, budgets for the remaining period of availability (calendar years 2021 and 2022) were not approved prior to March 27, 2020. Cause The Hospital?s budgets for the years ended December 31, 2021 and 2022 were not approved prior to March 27, 2020. Effect The Hospital?s selection of Option (ii) to calculate lost revenue in accordance with the June 11, 2021 PRF General and Targeted Distribution Post-Payment Notice of Reporting Requirements was not appropriate for its Period 3 PRF Reporting Portal Submission. The amount of lost revenues reported as the difference between budgeted and actual patient care revenues for the year ended December 31, 2020 were far in excess of the funds received (both in Period 3 and cumulatively to date through Period 3). Questioned Costs None noted. Recommendation: We recommend management design and implement an internal control around review of HRSA guidance and the subsequent submissions in order to ensure proper review of all elements of the relevant guidance prior to submission to the portal. Additionally, we recommend the Hospital contact HRSA to determine any required corrective actions related to the incorrect reporting and correct the error on all future submissions Management?s Views and Corrective Action Plan Management?s response is included in ?Management?s Views and Corrective Action Plan? included at the end of this report.
Finding 2022-001
2022-001: Provider Relief Fund Reporting Cluster: Not applicable Federal Granting Agency: DHHS Health Resources and Services Administration (?HRSA?) Award Name: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Assistance Listing Title: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year: January 1, 2020 ? December 31, 2022 Criteria Step 13 ? Lost Revenues of the HRSA User Guide for Provider Relief Fund (PRF) Reporting Portal ? Reporting dated June 30, 2022 requires Reporting entities (recipients) that apply PRF payments toward lost revenues to use one of the following three options for calculating lost revenues: ? Option (i): difference between 2019 actual patient care revenues and actuals for each quarter during the period of availability; ? Option (ii): difference between budgeted and actual patient care revenues for each quarter during the period of availability; or ? Option (iii): any reasonable method of estimating revenues. Per the HRSA User Guide, recipients that select Option (ii) must submit documentation of budgets approved prior to March 27, 2020 that covers the entire period of availability. Condition The Hospital completed its Period 3 PRF Reporting Portal submissions and attested to calculating lost revenues using Option (ii). However, in order to use this option, budgets covering the entire period of availability (January 1, 2020 to December 31, 2022) were required to be approved prior to March 27, 2020. While the budget of the Hospital for the year ended December 31, 2020 was approved prior to this date, budgets for the remaining period of availability (calendar years 2021 and 2022) were not approved prior to March 27, 2020. Cause The Hospital?s budgets for the years ended December 31, 2021 and 2022 were not approved prior to March 27, 2020. Effect The Hospital?s selection of Option (ii) to calculate lost revenue in accordance with the June 11, 2021 PRF General and Targeted Distribution Post-Payment Notice of Reporting Requirements was not appropriate for its Period 3 PRF Reporting Portal Submission. The amount of lost revenues reported as the difference between budgeted and actual patient care revenues for the year ended December 31, 2020 were far in excess of the funds received (both in Period 3 and cumulatively to date through Period 3). Questioned Costs None noted. Recommendation: We recommend management design and implement an internal control around review of HRSA guidance and the subsequent submissions in order to ensure proper review of all elements of the relevant guidance prior to submission to the portal. Additionally, we recommend the Hospital contact HRSA to determine any required corrective actions related to the incorrect reporting and correct the error on all future submissions Management?s Views and Corrective Action Plan Management?s response is included in ?Management?s Views and Corrective Action Plan? included at the end of this report.