Audit 34812

FY End
2022-12-31
Total Expended
$9.18M
Findings
2
Programs
1
Organization: Fairfield Medical Center (OH)
Year: 2022 Accepted: 2023-09-28
Auditor: Blue and CO LLC

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
32235 2022-001 Material Weakness - L
608677 2022-001 Material Weakness - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $9.18M Yes 1

Contacts

Name Title Type
FYMXH7LRAX83 Julie Grow Auditee
7406878011 Larry King Auditor
No contacts on file

Notes to SEFA

Title: Amounts Passed Through to Subrecipients Accounting Policies: Expenditures reported on the SEFA are reported on the accrual basis of accounting. 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. The Organization has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The Organization did not pass through any federal awards to subrecipients.
Title: Basis of Presentation Accounting Policies: Expenditures reported on the SEFA are reported on the accrual basis of accounting. 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. The Organization has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The accompanying schedule of expenditures of federal awards (SEFA) for the year ended December 31, 2022 includes the federal grant activity that Fairfield Medical Center & Subsidiaries, (collectively the Organization) received and is presented on the accrual basis of accounting. The information in this schedule is presented in accordance with requirements of the 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 of the amounts presented in this schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements.
Title: Provider Relief Fund and American Rescue Plan Reporting Accounting Policies: Expenditures reported on the SEFA are reported on the accrual basis of accounting. 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. The Organization has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Under the terms and conditions of the Provider Relief Funds (PRF) and American Rescue Plan (ARP) Rural Distribution grant under the Coronavirus Aids, Relief, and Economic Security Act, the Organization was required to report the Coronavirus (COVID-19) related expenses and lost revenue to the US Department of Health and Human Services (HHS)/Health Resources and Services Administration (HRSA). Guidance from HHS has required the reporting of the COVID-19 related expenses and lost revenue in certain reporting periods based on when the funds were received. The 2022 SEFA includes PRF and ARP of approximately $9,183,580 which was received by the Organization between January 1, 2021 and December 31, 2021, the dates designated by HHS for its third and fourth PRF reporting periods. The Organization recognized $7,290,351 and $9,183,580 as revenue in its 2022 and 2021 consolidated statement of operations and changes in net assets as the terms and conditions of the PRF and ARP grants were satisfied by the Organization. HHS required $9,183,580 to be reported on the 2022 SEFA.
Title: Fair Market Value of Donated Personnel Protective Equipment (Unaudited) Accounting Policies: Expenditures reported on the SEFA are reported on the accrual basis of accounting. 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. The Organization has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. During 2022, the Organization did not receive donated personnel protective equipment from federal sources.

Finding Details

2022-001 Material Weakness Assistance Listing Number, Federal Agency, and Program Name: 93.498, U.S. Department of Health and Human Services, COVID-19 ? Provider Relief Fund. Criteria: The Provider Relief Fund (PRF) grant requires providers to prepare and submit a report on their use of funding utilizing various options, in addition to other information about the Organization that is relevant to administration of the award. Step five of the Steps on Reporting on Use of Funds section of the Provider Relief Fund Distributions and American Rescue Plan Rural Distributions Post- Payment Notice of Reporting Requirements dated October 27, 2022, requires recipients to apply PRF payments toward lost revenue using one of the three following options for calculation lost revenue: Option i: The difference between actual patient care revenues. Option ii: The difference between budgeted (approved prior to March 27, 2020) and actual patient care revenues. Option iii: Calculated by any reasonable method of estimating revenues. Condition: The Organization does not have a review process in place related to reviewing the PRF submissions. The Organization calculated its period 4 PRF payments applied towards lost revenue using option ii and attested to using budgets approved prior to March 27, 2020. Cause: The lack of review allowed for the completion of the period 4 filing without consideration of other allowable lost revenue calculation options and the inclusion of certain allowable expenses. Effect: There are no known or likely questioned costs related to this error in reporting since management is able to demonstrate sufficient lost revenues and expenses under allowable methods. See views of responsible officials and planned corrective action below. Recommendation: We recommend the Organization implement a process for reviewing the reporting submission before it is finalized. We also recommend the Organization update its lost revenue calculation methodology in the period 5 filing. Views of Responsible Officials and Corrective Action Plan: Management agrees with the finding and will implement a process to ensure review of the reporting submissions prior to finalization. Management has updated its method for calculating lost revenues in the period 5 submission by comparing 2020 budget to 2020 ? 2023 actual revenues. Management believes this is an allowable method under option iii.
2022-001 Material Weakness Assistance Listing Number, Federal Agency, and Program Name: 93.498, U.S. Department of Health and Human Services, COVID-19 ? Provider Relief Fund. Criteria: The Provider Relief Fund (PRF) grant requires providers to prepare and submit a report on their use of funding utilizing various options, in addition to other information about the Organization that is relevant to administration of the award. Step five of the Steps on Reporting on Use of Funds section of the Provider Relief Fund Distributions and American Rescue Plan Rural Distributions Post- Payment Notice of Reporting Requirements dated October 27, 2022, requires recipients to apply PRF payments toward lost revenue using one of the three following options for calculation lost revenue: Option i: The difference between actual patient care revenues. Option ii: The difference between budgeted (approved prior to March 27, 2020) and actual patient care revenues. Option iii: Calculated by any reasonable method of estimating revenues. Condition: The Organization does not have a review process in place related to reviewing the PRF submissions. The Organization calculated its period 4 PRF payments applied towards lost revenue using option ii and attested to using budgets approved prior to March 27, 2020. Cause: The lack of review allowed for the completion of the period 4 filing without consideration of other allowable lost revenue calculation options and the inclusion of certain allowable expenses. Effect: There are no known or likely questioned costs related to this error in reporting since management is able to demonstrate sufficient lost revenues and expenses under allowable methods. See views of responsible officials and planned corrective action below. Recommendation: We recommend the Organization implement a process for reviewing the reporting submission before it is finalized. We also recommend the Organization update its lost revenue calculation methodology in the period 5 filing. Views of Responsible Officials and Corrective Action Plan: Management agrees with the finding and will implement a process to ensure review of the reporting submissions prior to finalization. Management has updated its method for calculating lost revenues in the period 5 submission by comparing 2020 budget to 2020 ? 2023 actual revenues. Management believes this is an allowable method under option iii.