Audit 27289

FY End

2022-03-31

Total Expended

$7.40M

Findings

2

Programs

2

Organization: Mercer County Joint Township Community Hospital (OH)

Year: 2022 Accepted: 2022-12-20

Auditor: Baker Tilly US LLP

Organization Exclusion Status:

Checking exclusion status...

ID	Ref	Severity	Repeat	Requirement
31032	2022-002	Significant Deficiency	-	L
607474	2022-002	Significant Deficiency	-	L

ALN	Program	Spent	Major	Findings
93.498	Provider Relief Fund	$7.16M	Yes	1
93.461	Covid-19 Testing for the Uninsured	$243,539	-	0

Contacts

Name	Title	Type
Y3CYBW27W642	Jon Dingledine	Auditee
4196785104	Justin Schumaker	Auditor
No contacts on file

Notes to SEFA

Title: 2. Summary of Significant Accounting Policies Accounting Policies: 1.Basis of PresentationThe accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Mercer County Joint Township Community Hospital (the Organization) under programs of the federal government for the year ended March 31, 2022. The information in this 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 Organization, it is not intended to and does not present the financial position, changes in net position or cash flows of the Organization. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. 2.Summary of Significant Accounting Policies Expenditures reported on the Schedule are reported on the accrual basis of accounting, with exception of expenditures associated with the U.S. Department of Health and Human Services (HHS) Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF). 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. PRF expenditures are reported based upon PRF reports required to be submitted to the Health Resources and Services Administration (HRSA) reporting portal.

Title: Note 3 Accounting Policies: 1.Basis of PresentationThe accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Mercer County Joint Township Community Hospital (the Organization) under programs of the federal government for the year ended March 31, 2022. The information in this 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 Organization, it is not intended to and does not present the financial position, changes in net position or cash flows of the Organization. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. 3.Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498For the U.S. Department of Health and Human Services Health Resources and Services Administration (HHS) award related to the PRF program, HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the Health Resources and Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to 'Payment Received Periods' (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability).The Schedule includes $7,155,107 of funding (including $24,800 of interest earned) from the HHS between April 21, 2020, through December 31, 2020. In accordance with guidance from the HHS, these amounts are presented on the Schedule as Period 1 and Period 2. Such amounts were recognized as a component of Federal and State Awards Revenue and Other Income (losses) in the Organizations consolidated financial statements in the amounts of $7,155,107 for the year ended March 31, 2021.The Schedule includes the following entities that received the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution program:Legal Entity NameTax Identification NumberMercer County Joint Township Community Hospital341101385Medical and Educational Development Foundation Physicians Corporation341957399

Finding Details

Finding 2022-002

Section III - Federal Award Findings and Questioned Costs Finding 2022-002: Significant Deficiency in Internal Control over Compliance ? Reporting Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Pass-through Agency: N/A Award Number: N/A Award Year: 2020 Compliance Requirement: Reporting Questioned Costs: Not determinable Criteria: Provider Relief Fund (PRF) payment amounts (excluding Skilled Nursing Facility (SNF) and Nursing Home Infection Control Distribution payments) not fully expended on health care-related expenses attributable to coronavirus may be applied to patient care lost revenues, if applicable. Recipients may choose to apply PRF payments toward lost revenues using one of three options: Option i: of the difference between actual patient care revenues; Option ii: of the difference between budgeted and actual patient care revenues. Option iii: calculated by any reasonable method of estimating revenues. Condition: In the Organization?s reporting submissions, the Organization incorrectly reported lost revenues under Option ii rather than their selected Option iii. The Organization?s methodology for option iii was to use budget-to-actual patient revenues utilizing the fiscal year 2020, 2021, and 2022 budgets that cover calendar years 2021 and 2022 as the base period. Cause: The Organization has insufficient controls in place to identify and correct errors before reporting is completed. Effect: The amounts reported to Health Resources & Services Administration (HRSA) were not in accordance with established U.S. Department of Health and Human Services reporting guidance. Recommendation: We recommend that management implement procedures to ensure that the most recent guidance is reviewed and understood, and that information used in preparation of the reports is reviewed, with errors addressed, prior to reporting. Views of Responsible Officials: Management of the Organization agrees with the finding.

Finding 2022-002

Section III - Federal Award Findings and Questioned Costs Finding 2022-002: Significant Deficiency in Internal Control over Compliance ? Reporting Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Pass-through Agency: N/A Award Number: N/A Award Year: 2020 Compliance Requirement: Reporting Questioned Costs: Not determinable Criteria: Provider Relief Fund (PRF) payment amounts (excluding Skilled Nursing Facility (SNF) and Nursing Home Infection Control Distribution payments) not fully expended on health care-related expenses attributable to coronavirus may be applied to patient care lost revenues, if applicable. Recipients may choose to apply PRF payments toward lost revenues using one of three options: Option i: of the difference between actual patient care revenues; Option ii: of the difference between budgeted and actual patient care revenues. Option iii: calculated by any reasonable method of estimating revenues. Condition: In the Organization?s reporting submissions, the Organization incorrectly reported lost revenues under Option ii rather than their selected Option iii. The Organization?s methodology for option iii was to use budget-to-actual patient revenues utilizing the fiscal year 2020, 2021, and 2022 budgets that cover calendar years 2021 and 2022 as the base period. Cause: The Organization has insufficient controls in place to identify and correct errors before reporting is completed. Effect: The amounts reported to Health Resources & Services Administration (HRSA) were not in accordance with established U.S. Department of Health and Human Services reporting guidance. Recommendation: We recommend that management implement procedures to ensure that the most recent guidance is reviewed and understood, and that information used in preparation of the reports is reviewed, with errors addressed, prior to reporting. Views of Responsible Officials: Management of the Organization agrees with the finding.