Audit 24427

2022 ? 001 Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID 19 Provider Relief Funding Assistance Listing Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Significant Deficiency in Internal Control over Compliance Compliance Requirement: Reporting Criteria or specific requirement: The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus and that the funds shall reimburse the recipient only for expenses or lost revenues that are attributable to coronavirus. Condition: During our testing, we identified the Hospital did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines. Questioned costs: None Context: As reflected in the prior year schedule of findings, item 2021-002 was identified related to the Hospital?s calculation of lost revenues not being measured consistently between budgeted and actual amounts when reporting Period 1 lost revenues. For Period 4 the calculation of lost revenues was not updated and included the same inconsistent measurement between budgeted and actual amounts. Cause: For Period 4 reporting management identified that they were not aware that they needed to update the previous reporting of lost revenues. Upon notification management attempted to correct the reporting after the original submission but were unable to access the inputs to correct. Effect: The calculation of lost revenues continues not to be measured inconsistently as previously identified. However, regarding the Period 4 payments management has reported sufficient expenses to support the amount of COVID-19 Provider Relief Fund and American Rescue Plan Rural Distributions received. Repeat Finding: Yes Recommendation: We recommend the Hospital design controls to ensure that reporting is completed in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.

2022 ? 001 Federal agency: U.S. Department of Health and Human Services Other Programs Federal program title: COVID 19 Provider Relief Funding Assistance Listing Number: 93.498 Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: Period 4 Type of Finding: Significant Deficiency in Internal Control over Compliance Compliance Requirement: Reporting Criteria or specific requirement: The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116-136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus and that the funds shall reimburse the recipient only for expenses or lost revenues that are attributable to coronavirus. Condition: During our testing, we identified the Hospital did not have internal controls in place to ensure reporting was completed in accordance with HHS guidelines. Questioned costs: None Context: As reflected in the prior year schedule of findings, item 2021-002 was identified related to the Hospital?s calculation of lost revenues not being measured consistently between budgeted and actual amounts when reporting Period 1 lost revenues. For Period 4 the calculation of lost revenues was not updated and included the same inconsistent measurement between budgeted and actual amounts. Cause: For Period 4 reporting management identified that they were not aware that they needed to update the previous reporting of lost revenues. Upon notification management attempted to correct the reporting after the original submission but were unable to access the inputs to correct. Effect: The calculation of lost revenues continues not to be measured inconsistently as previously identified. However, regarding the Period 4 payments management has reported sufficient expenses to support the amount of COVID-19 Provider Relief Fund and American Rescue Plan Rural Distributions received. Repeat Finding: Yes Recommendation: We recommend the Hospital design controls to ensure that reporting is completed in accordance with latest HHS guidelines. Views of responsible officials: There is no disagreement with the audit finding.