Audit 299830

Activities Allowed or Unallowed, Allowable Cost/Cost Principles - Material Weakness in Internal Control Over Compliance Reporting - Material Weakness in Internal Control Over Compliance and Material Noncompliance Federal Program: Federal Financial Assistance Listing #93.498 US Department of Health and Human Services COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) distributions state that funds are not to be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition: During the process of identifying expenses that were incurred to prevent, prepare for or respond to the coronavirus pandemic, it was noted that payroll expenses were not reduced by amounts reimbursable from other sources, namely Medicare. Cause: Due to the amount of detailed information that was required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently included in eligible expenses certain costs that were not reduced by amounts reimbursable from Medicare. Effect: Management included amounts in the PRF reporting portal which were not eligible based on the terms and conditions of the PRF distributions. Questioned Costs: None. Context: Activities Allowed or Unallowed, Allowable Cost/Cost Principles – While agreeing the expenses reported in the HRSA reporting portal submission, we identified expenses not reduced for amounts reimbursed from other sources. Reporting – Key line items were tested on the Period 4 HHS report. Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that only eligible costs are included in amounts expended and that the same expenses are not reimbursed by other sources. Views of Responsible Officials and Planned Corrective Action: Management agrees with the noted finding. Management will continue to refine processes to more diligently review expenses to ensure that expenses are not being utilized for reimbursement from multiple sources.

Activities Allowed or Unallowed, Allowable Cost/Cost Principles - Material Weakness in Internal Control Over Compliance Reporting - Material Weakness in Internal Control Over Compliance and Material Noncompliance Federal Program: Federal Financial Assistance Listing #93.498 US Department of Health and Human Services COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Criteria: The terms and conditions of the CARES Act Provider Relief Fund (PRF) distributions state that funds are not to be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Condition: During the process of identifying expenses that were incurred to prevent, prepare for or respond to the coronavirus pandemic, it was noted that payroll expenses were not reduced by amounts reimbursable from other sources, namely Medicare. Cause: Due to the amount of detailed information that was required to be compiled by management in order to enter data into the PRF reporting portal, management inadvertently included in eligible expenses certain costs that were not reduced by amounts reimbursable from Medicare. Effect: Management included amounts in the PRF reporting portal which were not eligible based on the terms and conditions of the PRF distributions. Questioned Costs: None. Context: Activities Allowed or Unallowed, Allowable Cost/Cost Principles – While agreeing the expenses reported in the HRSA reporting portal submission, we identified expenses not reduced for amounts reimbursed from other sources. Reporting – Key line items were tested on the Period 4 HHS report. Recommendation: We recommend that management continue to monitor and enhance its internal controls over federal award compliance to ensure that only eligible costs are included in amounts expended and that the same expenses are not reimbursed by other sources. Views of Responsible Officials and Planned Corrective Action: Management agrees with the noted finding. Management will continue to refine processes to more diligently review expenses to ensure that expenses are not being utilized for reimbursement from multiple sources.