Audit 46943

Finding No. 2022-001 Grantor: U.S. Department of Health and Human Services Program Names: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program Federal Assistance Listing Number: 93.498 Criteria: Management is required to report on the use of the Provider Relief Funds in portal submissions to the Department of Health and Human Services (HHS). Condition and Context: Management failed to report total other assistance received from FEMA in the amount of $1,237,253 for the Period 4 Provider Relief Fund Reporting Period. Cause: Management's unfamiliarity with the requirements of a federal award program and lack of internal controls over financial reporting for federal awards. Effect or potential effect: Management utilized lost revenues and infection control expenses in excess of the PRF funding received in Periods 1 through 4. The total expenditures reimbursed through FEMA were not reported correctly in Period 4. No PRF expenses reported in Period 4 were reimbursed from any other source. It is noted that at this time there is not a mechanism to amend the portal submission. Questioned Costs: None Recommendation: We recommend that management review its internal policies to ensure that all guidance is followed for each submission. Views of responsible officials: Management has acknowledged the PRF report submitted to the HRSA PRF reporting portal was missing other funding received from FEMA.

Finding No. 2022-002 Grantor: U.S. Department of Health and Human Services Program Names: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program Federal Assistance Listing Number: 93.498 Criteria: Management is required to report on the use of the Provider Relief Funds in portal submissions to the Department of Health and Human Services (HHS). Condition and Context: Management failed to report the use of Provider Relief Funds for the proper year the expenses were incurred for the Period 4 Provider Relief Fund Reporting Period Expenses should have been allocated for the years 2020, 2021 and 2022. Cause: Management's unfamiliarity with the requirements of a federal award program and lack of internal controls over financial reporting for federal awards. Effect or potential effect: Management utilized lost revenues and infection control expenses in excess of the funding reported in Periods 1 through 4. No expenses reported in Period 4 were reimbursed from any other source. It is noted that at this time there is not a mechanism to amend the portal submission. Questioned Costs: None Recommendation: We recommend that management review its internal policies to ensure that all guidance is followed for each submission. Views of responsible officials: Management has acknowledged the PRF report submitted to the HRSA PRF reporting portal was not allocated properly for the periods expenses were incurred.

Finding No. 2022-001 Grantor: U.S. Department of Health and Human Services Program Names: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program Federal Assistance Listing Number: 93.498 Criteria: Management is required to report on the use of the Provider Relief Funds in portal submissions to the Department of Health and Human Services (HHS). Condition and Context: Management failed to report total other assistance received from FEMA in the amount of $1,237,253 for the Period 4 Provider Relief Fund Reporting Period. Cause: Management's unfamiliarity with the requirements of a federal award program and lack of internal controls over financial reporting for federal awards. Effect or potential effect: Management utilized lost revenues and infection control expenses in excess of the PRF funding received in Periods 1 through 4. The total expenditures reimbursed through FEMA were not reported correctly in Period 4. No PRF expenses reported in Period 4 were reimbursed from any other source. It is noted that at this time there is not a mechanism to amend the portal submission. Questioned Costs: None Recommendation: We recommend that management review its internal policies to ensure that all guidance is followed for each submission. Views of responsible officials: Management has acknowledged the PRF report submitted to the HRSA PRF reporting portal was missing other funding received from FEMA.

Finding No. 2022-002 Grantor: U.S. Department of Health and Human Services Program Names: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program Federal Assistance Listing Number: 93.498 Criteria: Management is required to report on the use of the Provider Relief Funds in portal submissions to the Department of Health and Human Services (HHS). Condition and Context: Management failed to report the use of Provider Relief Funds for the proper year the expenses were incurred for the Period 4 Provider Relief Fund Reporting Period Expenses should have been allocated for the years 2020, 2021 and 2022. Cause: Management's unfamiliarity with the requirements of a federal award program and lack of internal controls over financial reporting for federal awards. Effect or potential effect: Management utilized lost revenues and infection control expenses in excess of the funding reported in Periods 1 through 4. No expenses reported in Period 4 were reimbursed from any other source. It is noted that at this time there is not a mechanism to amend the portal submission. Questioned Costs: None Recommendation: We recommend that management review its internal policies to ensure that all guidance is followed for each submission. Views of responsible officials: Management has acknowledged the PRF report submitted to the HRSA PRF reporting portal was not allocated properly for the periods expenses were incurred.