Audit 39579

Criteria: Reporting (45 CFR 75.342) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease 2019 (COVID-19). Entities that receive more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, the Organization is required to implement and maintain internal controls over financial reporting. Condition: During our review of the Period 3 report submitted, we noted the Organization included revenue items that should not have been included in the lost revenue calculation and indicated that the calculation was under Option 2 but should have reported under Option 3. In addition, actual revenues and budgeted revenues included in the lost revenue calculation did not agree to the underlying accounting records and approved budgets. Questioned Costs: Unknown Context: Pharmacy revenue and grant revenue should not have been included in the lost revenue calculation and Option 2 required a budget to be approved by March 27, 2020 and not all of the budgets utilized in the reporting of Period 3 were approved by that deadline. The lost revenue calculation included actual and budgeted revenue amounts that did not agree to the underlying accounting records and approved budgets. Effect: The federal government relies on the information reported in the Health Resources and Services Administration (HRSA) to be accurate for monitoring purposes. Errors were made in reporting quarterly total revenue/net charges from patient care for each year, 2020, 2021, and 2022. and by selecting the incorrect option, the Organization did not submit the required narrative information to HRSA. Cause: The Organization did not have adequate internal controls in place to identify revenue amounts that should not have been included in the lost revenue calculation, that option 3 should have been selected for reporting and that the actual and budgeted revenues reported did not agree to the underlying accounting records and approved budgets. Identification as a repeat finding: Not a repeat finding. Recommendation: The Organization should continue to improve their understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. Views of responsible officials: The Organization agrees with the finding. See separate report for planned corrective actions.

Criteria: Reporting (45 CFR 75.342) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease 2019 (COVID-19). Entities that receive more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, the Organization is required to implement and maintain internal controls over financial reporting. Condition: During our review of the Period 3 report submitted, we noted the Organization included revenue items that should not have been included in the lost revenue calculation and indicated that the calculation was under Option 2 but should have reported under Option 3. In addition, actual revenues and budgeted revenues included in the lost revenue calculation did not agree to the underlying accounting records and approved budgets. Questioned Costs: Unknown Context: Pharmacy revenue and grant revenue should not have been included in the lost revenue calculation and Option 2 required a budget to be approved by March 27, 2020 and not all of the budgets utilized in the reporting of Period 3 were approved by that deadline. The lost revenue calculation included actual and budgeted revenue amounts that did not agree to the underlying accounting records and approved budgets. Effect: The federal government relies on the information reported in the Health Resources and Services Administration (HRSA) to be accurate for monitoring purposes. Errors were made in reporting quarterly total revenue/net charges from patient care for each year, 2020, 2021, and 2022. and by selecting the incorrect option, the Organization did not submit the required narrative information to HRSA. Cause: The Organization did not have adequate internal controls in place to identify revenue amounts that should not have been included in the lost revenue calculation, that option 3 should have been selected for reporting and that the actual and budgeted revenues reported did not agree to the underlying accounting records and approved budgets. Identification as a repeat finding: Not a repeat finding. Recommendation: The Organization should continue to improve their understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. Views of responsible officials: The Organization agrees with the finding. See separate report for planned corrective actions.