Audit 33903

Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 U.S. Department of Health and Human Services Program Year 2020-2021 Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) Condition ? The Hospital is required to prepare and submit period one Provider Relief Fund reporting. This report is to be prepared using accurate financial information and submitted by the deadline established, including individually identifiable expenses to support all reported expenses. Questioned Costs ? No questioned costs were identified in our sampling procedures, however, the Hospital claimed $605,987 of other PRF expenses, while only providing $568,518 of actual expenditures, resulting in questioned costs of $37,469. Context ? The Hospital provided a listing of expenses by Provider Relief Fund category that does not agree to the amount claimed on HRSA submission by $37,469 due to not identifying the actual expenses. Effect ? A recipient?s failure to determine the expenditure is eligible for reimbursement can lead to repayment of the grant award. Prior Year Auditing Finding ? N/A Cause ? The Hospital did not specifically identify expenses to provide support for difference in their expenditure detail and amount claimed. Recommendation ? The Hospital should implement a process to ensure adequate detail review of allowable expenses in comparison to terms and conditions and that all reported expenses are supported by individually identified items. Views of Responsible Officials and Planned Corrective Actions ? Management concurs with the finding and will implement additional internal controls over the identification of eligible expenditures for the Provider Relief Fund program and the completion of the required reports. The identified expenditures included gross payroll without consideration of allowable fringes, so the Hospital has already identified other costs not reimbursed by federal programs that are allowable under the PRF program. We anticipate these additional controls to be in place by February 28, 2023 with the Hospital?s Administrator being responsible for implementation.

Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 U.S. Department of Health and Human Services Program Year 2020-2021 Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) Condition ? The Hospital is required to prepare and submit period one Provider Relief Fund reporting. This report is to be prepared using accurate financial information and submitted by the deadline established, including individually identifiable expenses to support all reported expenses. Questioned Costs ? No questioned costs were identified in our sampling procedures, however, the Hospital claimed $605,987 of other PRF expenses, while only providing $568,518 of actual expenditures, resulting in questioned costs of $37,469. Context ? The Hospital provided a listing of expenses by Provider Relief Fund category that does not agree to the amount claimed on HRSA submission by $37,469 due to not identifying the actual expenses. Effect ? A recipient?s failure to determine the expenditure is eligible for reimbursement can lead to repayment of the grant award. Prior Year Auditing Finding ? N/A Cause ? The Hospital did not specifically identify expenses to provide support for difference in their expenditure detail and amount claimed. Recommendation ? The Hospital should implement a process to ensure adequate detail review of allowable expenses in comparison to terms and conditions and that all reported expenses are supported by individually identified items. Views of Responsible Officials and Planned Corrective Actions ? Management concurs with the finding and will implement additional internal controls over the identification of eligible expenditures for the Provider Relief Fund program and the completion of the required reports. The identified expenditures included gross payroll without consideration of allowable fringes, so the Hospital has already identified other costs not reimbursed by federal programs that are allowable under the PRF program. We anticipate these additional controls to be in place by February 28, 2023 with the Hospital?s Administrator being responsible for implementation.