Audit 51260

Finding 2022-001 ? Reporting ? Significant Deficiency in Internal Control Over Compliance Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution (Assistance Listing #93.498) Federal Agency: U.S. Department of Health and Human Services Award Year: 2020-2021 Criteria: Under the COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program, providers are required to submit reporting to the Health Resources Services Administration (HRSA) that describes the uses of the funds and how the provider complied with the terms and conditions of the program. Condition: During our testing of the reporting of expenses that were reimbursed by Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program funds, expenses previously reported for Period 1 reimbursement were also included in the Period 2 reporting. Cause: The specific terms and conditions of the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program are complex and have evolved over the duration of the program. Valley Children?s Healthcare?s processes over Period 2 reporting were not sufficient to interpret the complexities of the terms and conditions of the program, which was the primary cause of the condition noted above. Effect or potential effect: Due to the above noted cause, duplicate expenses that were previously reported for Period 1 were reported again in Period 2 reporting. Questioned costs: None to be reported. Context: During the fiscal year ended September 30, 2022, the specific terms and conditions of the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program evolved and included complexities. As a result, Valley Children's Healthcare?s processes did not identify the discrepancy in reporting. However, Valley Children?s Healthcare has sufficient unreimbursed lost revenues and additional, unreported expenses in the appropriate period of availability to cover the duplicate expenses reported in Period 2 reporting. Identification as a repeat finding, if applicable: This is not a repeat finding. Recommendation: We recommend that Valley Children's Healthcare update processes and review controls to comply with the terms and conditions of the COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program. . Views of responsible officials: Beginning with Period 3 reporting, Valley Children?s Healthcare has corrected their process and added an additional layer of review control over the completeness and accuracy of expenditures and calculations included in all submissions.

Finding 2022-001 ? Reporting ? Significant Deficiency in Internal Control Over Compliance Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution (Assistance Listing #93.498) Federal Agency: U.S. Department of Health and Human Services Award Year: 2020-2021 Criteria: Under the COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program, providers are required to submit reporting to the Health Resources Services Administration (HRSA) that describes the uses of the funds and how the provider complied with the terms and conditions of the program. Condition: During our testing of the reporting of expenses that were reimbursed by Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program funds, expenses previously reported for Period 1 reimbursement were also included in the Period 2 reporting. Cause: The specific terms and conditions of the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program are complex and have evolved over the duration of the program. Valley Children?s Healthcare?s processes over Period 2 reporting were not sufficient to interpret the complexities of the terms and conditions of the program, which was the primary cause of the condition noted above. Effect or potential effect: Due to the above noted cause, duplicate expenses that were previously reported for Period 1 were reported again in Period 2 reporting. Questioned costs: None to be reported. Context: During the fiscal year ended September 30, 2022, the specific terms and conditions of the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program evolved and included complexities. As a result, Valley Children's Healthcare?s processes did not identify the discrepancy in reporting. However, Valley Children?s Healthcare has sufficient unreimbursed lost revenues and additional, unreported expenses in the appropriate period of availability to cover the duplicate expenses reported in Period 2 reporting. Identification as a repeat finding, if applicable: This is not a repeat finding. Recommendation: We recommend that Valley Children's Healthcare update processes and review controls to comply with the terms and conditions of the COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Program. . Views of responsible officials: Beginning with Period 3 reporting, Valley Children?s Healthcare has corrected their process and added an additional layer of review control over the completeness and accuracy of expenditures and calculations included in all submissions.