Audit 296677

2021-003 Federal Program Name: COVID – 19 Provider Relief Fund (PRF) Federal Agency: U.S. Department of Health and Human Services Federal Assistance Listing Title and Number: COVID-19 Provider Relief Fund, 93.498 Criteria or Specific Requirement: Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Condition: Lost revenues attributable to COVID-19 were not properly calculated and reported for Provider Relief Fund Portal reporting Period 2. Questioned Costs: None Context: The Hospital reported lost revenues using the actual revenues for 2021 and 2022 compared to actual revenues for 2019. During specific quarters in Period 2 reporting, the Hospital did not include patient revenues from the nursing home supplemental payment program in its calculation of lost revenues. This presentation did not conform with guidance published by the Health Resources and Services Administration (HRSA). Errors were identified by reconciling figures to underlying financial information. Effect: The Hospital did not properly calculate, and report lost revenues. Cause: Internal controls surrounding the review and submission of required reports were not adequately applied to ensure accuracy of required elements. Repeat Findings: No Recommendation: We recommend the Hospital evaluate lost revenues in future reporting submissions to HRSA under published guidance Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Under a revised calculation, utilizing detailed listings of expenses and updated lost revenue calculations, we have adequate expenses and lost revenues to support funding reported for Periods 1 and 2.

Federal Assistance Listing Title and Number: COVID-19 Provider Relief Fund, 93.498 Criteria or Specific Requirement: Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Condition: Expenses attributable to COVID-19 were not properly reported for Provider Relief Fund Portal reportion Periods 1 and 2 when compared to detailed listings of expenses attributable to COVID-19. Questioned Costs: None Context: The Hospital reported incorrect expense amounts when compared to detailed expense listings provided by third party nursing home managers and aggregated with Hospital information to report on a combined basis. Errors were identified by reconciling the entirety of the expense population to underlying summary expense information previously accumulated and reported for Periods 1 and 2. Effect: The Hospital did not properly report expenses attributable to COVID-19. Cause: Internal controls surrounding the review and submission of required reports were not adequately applied to ensure accuracy of required elements. Repeat Findings: No Recommendation: We recommend the Hospital reconcile summary information to detailed records prior to future reporting submissions to ensure that all information is complete and does not duplicate amounts reported in previous periods or omit amounts within detailed listings. Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Under a revised calculation, utilizing detailed listings of expenses and updated lost revenue calculations, we have adequate expenses and lost revenues to support funding reported for Periods 1 and 2.

2021-003 Federal Program Name: COVID – 19 Provider Relief Fund (PRF) Federal Agency: U.S. Department of Health and Human Services Federal Assistance Listing Title and Number: COVID-19 Provider Relief Fund, 93.498 Criteria or Specific Requirement: Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Condition: Lost revenues attributable to COVID-19 were not properly calculated and reported for Provider Relief Fund Portal reporting Period 2. Questioned Costs: None Context: The Hospital reported lost revenues using the actual revenues for 2021 and 2022 compared to actual revenues for 2019. During specific quarters in Period 2 reporting, the Hospital did not include patient revenues from the nursing home supplemental payment program in its calculation of lost revenues. This presentation did not conform with guidance published by the Health Resources and Services Administration (HRSA). Errors were identified by reconciling figures to underlying financial information. Effect: The Hospital did not properly calculate, and report lost revenues. Cause: Internal controls surrounding the review and submission of required reports were not adequately applied to ensure accuracy of required elements. Repeat Findings: No Recommendation: We recommend the Hospital evaluate lost revenues in future reporting submissions to HRSA under published guidance Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Under a revised calculation, utilizing detailed listings of expenses and updated lost revenue calculations, we have adequate expenses and lost revenues to support funding reported for Periods 1 and 2.

Federal Assistance Listing Title and Number: COVID-19 Provider Relief Fund, 93.498 Criteria or Specific Requirement: Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Condition: Expenses attributable to COVID-19 were not properly reported for Provider Relief Fund Portal reportion Periods 1 and 2 when compared to detailed listings of expenses attributable to COVID-19. Questioned Costs: None Context: The Hospital reported incorrect expense amounts when compared to detailed expense listings provided by third party nursing home managers and aggregated with Hospital information to report on a combined basis. Errors were identified by reconciling the entirety of the expense population to underlying summary expense information previously accumulated and reported for Periods 1 and 2. Effect: The Hospital did not properly report expenses attributable to COVID-19. Cause: Internal controls surrounding the review and submission of required reports were not adequately applied to ensure accuracy of required elements. Repeat Findings: No Recommendation: We recommend the Hospital reconcile summary information to detailed records prior to future reporting submissions to ensure that all information is complete and does not duplicate amounts reported in previous periods or omit amounts within detailed listings. Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Under a revised calculation, utilizing detailed listings of expenses and updated lost revenue calculations, we have adequate expenses and lost revenues to support funding reported for Periods 1 and 2.