FAC Explorer

Audit 332013

FY End
2022-06-30
Total Expended
$4.07M
Findings
2
Programs
6
Organization: Pennsylvania Mountains Care Network (PA)
Year: 2022 Accepted: 2024-12-11
Auditor: Baker Tilly

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
513881 2022-002 Material Weakness Yes L
1090323 2022-002 Material Weakness Yes L

Programs

ALN Program Spent Major Findings
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $1.48M Yes 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.08M Yes 0
93.498 Provider Relief Fund $841,058 Yes 1
93.155 Rural Health Research Centers $480,184 - 0
93.461 Covid-19 Testing for the Uninsured $184,461 - 0
93.889 National Bioterrorism Hospital Preparedness Program $12,966 - 0

Contacts

Name Title Type
J6JTLQLKVSV9 Michael Ickowski, Mba, CPA Auditee
7243577013 Debra Bowes, CPA Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception of expenditures associated with the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) and the expenditures associated with Disaster Grants - Public Assistance (Presidentially Declared Disasters). 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 the timing of reporting periods in accordance with guidance provided by the Health Resources and Services Administration (HRSA). Expenditures related to disaster grants are reported when the System has expended the necessary funds and the Federal Emergency Management Agency (FEMA) has approved the associated project. Expenditures on the Schedule that occurred prior to the reporting period were $1,475,354. De Minimis Rate Used: N Rate Explanation: The System did not elect to use the 10% de minimis indirect cost rate allowed under Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Pennsylvania Mountains Care Network (the System) for the year ended June 30, 2022. As disclosed in Note 1 to the consolidated financial statements, the System is comprised of Indiana Regional Medical Center and its controlled entities (collectively, IRMC) and Punxsutawney Area Hospital and its controlled entity (collectively, PAH). 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). Therefore, some amounts may differ from amounts presented in, or used in the preparation of the consolidated financial statements. Because the Schedule presents only a selected portion of the operations of the System, it is not intended to and does not present the financial position, changes in net assets or cash flows of the System.
Title: Provider Relief Fund and American Rescue Planj (ARP) Rural Distribution Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception of expenditures associated with the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) and the expenditures associated with Disaster Grants - Public Assistance (Presidentially Declared Disasters). 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 the timing of reporting periods in accordance with guidance provided by the Health Resources and Services Administration (HRSA). Expenditures related to disaster grants are reported when the System has expended the necessary funds and the Federal Emergency Management Agency (FEMA) has approved the associated project. Expenditures on the Schedule that occurred prior to the reporting period were $1,475,354. De Minimis Rate Used: N Rate Explanation: The System did not elect to use the 10% de minimis indirect cost rate allowed under Uniform Guidance. For the U.S. Department of Health and Human Services (HHS) awards related to the PRF program, HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the 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 $841,058 received from HHS between July 1, 2020 through June 30, 2021. In accordance with guidance from HHS, these amounts are presented as Period 2 and Period 3, as follows: (See Notes to the SEFA for chart/table) Such amounts were recognized as a component of COVID-19 grant income in the System's consolidated statements of operations during the years ended June 30, 20222 and 2021. Due to the PRF Reporting requirements, these amounts are not the total PRF received and/or recognized as COVID-19 grant income in the year presented in the Schedule. The Schedule includes the following entities that received PRF funds: (See the Notes to the SEFA for chart/table)

Finding Details

Finding 2022-002
Repeat finding of 2021-002 Federal Program: COVID-19: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Number: N/A Award Year: 2021 Compliance Requirement: Reporting Questioned Costs: Not applicable Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which requires an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Recipients of Provider Relief Funds (PRF) payments must also comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition and Context: The System did not complete the PRF Periods 2 and 3 reporting in accordance with the U.S. Department of Health and Human Services guidance. The System did not enter the correct amounts from its data supporting lost revenues for all quarters. We note that many of these amounts carried forward in the PRF reports from errors made in the PRF Period 1 reporting. The adjustments needed within the PRF reports to correct the errors noted for PRF Periods 2 and 3 are as follows: (1) lost revenues for the period of availability should decrease from $13,866,058 to $2,405,463 and (2) unused lost revenues should decrease from $12,493,140 to $1,032,545. Furthermore, errors in reporting total revenues by quarter led to errors in the allocation among payers by quarter. 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. Cause: Errors in the lost revenues presented in the Periods 2 and 3 report submissions were not detected by the Sytem's internal control process. 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. Planned Corrective Actions and View of Responsible Officials: System management agrees with the finding and has updated its lost revenue calculation, with cumulative amounts through Period 6 reporting. While management did attempt to update its lost revenue amounts with filing of its Period 4 reports, additional data entry errors were made.
Finding 2022-002
Repeat finding of 2021-002 Federal Program: COVID-19: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program Assistance Listing Number: 93.498 Federal Agency: U.S. Department of Health and Human Services Award Number: N/A Award Year: 2021 Compliance Requirement: Reporting Questioned Costs: Not applicable Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which requires an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Recipients of Provider Relief Funds (PRF) payments must also comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition and Context: The System did not complete the PRF Periods 2 and 3 reporting in accordance with the U.S. Department of Health and Human Services guidance. The System did not enter the correct amounts from its data supporting lost revenues for all quarters. We note that many of these amounts carried forward in the PRF reports from errors made in the PRF Period 1 reporting. The adjustments needed within the PRF reports to correct the errors noted for PRF Periods 2 and 3 are as follows: (1) lost revenues for the period of availability should decrease from $13,866,058 to $2,405,463 and (2) unused lost revenues should decrease from $12,493,140 to $1,032,545. Furthermore, errors in reporting total revenues by quarter led to errors in the allocation among payers by quarter. 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. Cause: Errors in the lost revenues presented in the Periods 2 and 3 report submissions were not detected by the Sytem's internal control process. 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. Planned Corrective Actions and View of Responsible Officials: System management agrees with the finding and has updated its lost revenue calculation, with cumulative amounts through Period 6 reporting. While management did attempt to update its lost revenue amounts with filing of its Period 4 reports, additional data entry errors were made.