Audit 299747

Assistance Listing. Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services (HHS), COVID-19: Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Federal Award Identification Number and Year - N/A Pass-through Entity - N/A - Direct funded Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - Per the Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements dated April 7, 2023, recipients must meet compliance with reporting requirements as outlined in the Terms and Conditions of the funding received. The Terms and Conditions require that the funding recipient certify that it will not use the payments received to reimburse it for expenses or losses that have been reimbursed from other sources, or that other sources are obligated to reimburse. In addition, the Terms and Conditions state that net charges from patient care are to be used to calculate lost revenue amounts reported by quarter. Condition - The Corporation's controls in place for reporting submissions did not identify that the General and Targeted Distribution Post-Payment Notice of Reporting Requirements guidelines were not followed related to certain reported lost revenue amounts in the Corporation’s Period 4 portal submissions. In addition, the Corporation's controls in place did not identify that lost revenue amounts for one subsidiary were reported at gross charges from patient care (compared to recording these amounts at net charges from patient care). Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - The single audit for the Corporation included four portal submissions related to funding received in Period 4. As a result of the funding received, the Organization was required to attest to the applicable expenses and lost revenues incurred, which are defined by HHS, as noted in the criteria above. In two Period 4 portal submissions, available lost revenue amounts reported by the Corporation were duplicated, resulting in approximately $58.2 million of lost revenue for one subsidiary being reported on two separate Period 4 portal submissions. In addition, the lost revenue amounts for one subsidiary were incorrectly reported at gross patient service revenues. This resulted in the reporting of approximately S6.4 million of lost revenue during the period of availability. The correct amount of lost revenues to be reported by the organization should have been $1.6 million. Cause and Effect - Appropriate review of the reporting submissions was not completed to ensure the reports followed required guidelines. As a result, the Corporation reported incorrect totals for lost revenue for the period 4 portal submissions. Recommendation - We recommended that the Corporation implement controls, including levels of review, to ensure that reports are completed and submitted in accordance with the guidelines established by HHS. Views of Responsible Officials and Corrective Action Plan - The Corporation will review its processes surrounding the methodologies used to report lost revenue and will implement additional levels of review to ensure that the proper lost revenue amounts are used in future reporting periods.

Assistance Listing. Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services (HHS), COVID-19: Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Federal Award Identification Number and Year - N/A Pass-through Entity - N/A - Direct funded Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - Per the Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements dated April 7, 2023, recipients must meet compliance with reporting requirements as outlined in the Terms and Conditions of the funding received. The Terms and Conditions require that the funding recipient certify that it will not use the payments received to reimburse it for expenses or losses that have been reimbursed from other sources, or that other sources are obligated to reimburse. In addition, the Terms and Conditions state that net charges from patient care are to be used to calculate lost revenue amounts reported by quarter. Condition - The Corporation's controls in place for reporting submissions did not identify that the General and Targeted Distribution Post-Payment Notice of Reporting Requirements guidelines were not followed related to certain reported lost revenue amounts in the Corporation’s Period 4 portal submissions. In addition, the Corporation's controls in place did not identify that lost revenue amounts for one subsidiary were reported at gross charges from patient care (compared to recording these amounts at net charges from patient care). Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - The single audit for the Corporation included four portal submissions related to funding received in Period 4. As a result of the funding received, the Organization was required to attest to the applicable expenses and lost revenues incurred, which are defined by HHS, as noted in the criteria above. In two Period 4 portal submissions, available lost revenue amounts reported by the Corporation were duplicated, resulting in approximately $58.2 million of lost revenue for one subsidiary being reported on two separate Period 4 portal submissions. In addition, the lost revenue amounts for one subsidiary were incorrectly reported at gross patient service revenues. This resulted in the reporting of approximately S6.4 million of lost revenue during the period of availability. The correct amount of lost revenues to be reported by the organization should have been $1.6 million. Cause and Effect - Appropriate review of the reporting submissions was not completed to ensure the reports followed required guidelines. As a result, the Corporation reported incorrect totals for lost revenue for the period 4 portal submissions. Recommendation - We recommended that the Corporation implement controls, including levels of review, to ensure that reports are completed and submitted in accordance with the guidelines established by HHS. Views of Responsible Officials and Corrective Action Plan - The Corporation will review its processes surrounding the methodologies used to report lost revenue and will implement additional levels of review to ensure that the proper lost revenue amounts are used in future reporting periods.