Audit 54209

(3) Findings and Questioned Costs relating to Federal Awards Finding 2022-011 Compliance Requirement: Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program: Covid-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution - AL No. 93.498 ALN Number: 93.498 Award Year: January 1, 2021 - December 31, 2021 Criteria: The reporting requirements for American Rescue Plan Act (ARPA) state that ARPA payments applied to expenditures should be reported by calendar year quarterly periods within the period of performance. Condition: The Period 4 report submission applied $260,233 of ARPA distributions to expenditures, all of which were reported as expenditures incurred during Q1 2022. However, $246,537 of these expenditures were incurred in quarters Q1 2020 through Q4 2020. Cause: The Entity interpreted Provider Relief Fund (PRF) reporting requirements in such a way that ARPA payments applied to expenditures did not need to be classified and reported by the quarterly period incurred. Effect: The Period 4 report submission reported $260,233 of ARPA payments as Q1 2022 expenses when $246,537 of the payments should have been reported in previous quarters in the Period 4 report. No findings were identified over the period of performance. Identification of Questioned Costs: None Repeat finding: Finding 2022-011 is not a repeat finding Recommendation: We recommend that Nebraska Pediatric Practice strengthen their system of internal controls around the review of HRSA guidance to ensure that all reporting is consistent with requirements and instructions as provided by regulatory agencies. View of Responsible Officials: Management agrees with the finding. Although reported in the incorrect quarter, the Entity did incur expenses in excess of the amount of ARPA funds received. In addition, the Entity also suffered lost revenues in excess of the ARPA funds received. Management will refine its review process of HRSA guidance and data entry into the portal to ensure appropriate designation between reporting periods.

(3) Findings and Questioned Costs relating to Federal Awards Finding 2022-011 Compliance Requirement: Reporting Federal Agency: U.S. Department of Health and Human Services Federal Program: Covid-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution - AL No. 93.498 ALN Number: 93.498 Award Year: January 1, 2021 - December 31, 2021 Criteria: The reporting requirements for American Rescue Plan Act (ARPA) state that ARPA payments applied to expenditures should be reported by calendar year quarterly periods within the period of performance. Condition: The Period 4 report submission applied $260,233 of ARPA distributions to expenditures, all of which were reported as expenditures incurred during Q1 2022. However, $246,537 of these expenditures were incurred in quarters Q1 2020 through Q4 2020. Cause: The Entity interpreted Provider Relief Fund (PRF) reporting requirements in such a way that ARPA payments applied to expenditures did not need to be classified and reported by the quarterly period incurred. Effect: The Period 4 report submission reported $260,233 of ARPA payments as Q1 2022 expenses when $246,537 of the payments should have been reported in previous quarters in the Period 4 report. No findings were identified over the period of performance. Identification of Questioned Costs: None Repeat finding: Finding 2022-011 is not a repeat finding Recommendation: We recommend that Nebraska Pediatric Practice strengthen their system of internal controls around the review of HRSA guidance to ensure that all reporting is consistent with requirements and instructions as provided by regulatory agencies. View of Responsible Officials: Management agrees with the finding. Although reported in the incorrect quarter, the Entity did incur expenses in excess of the amount of ARPA funds received. In addition, the Entity also suffered lost revenues in excess of the ARPA funds received. Management will refine its review process of HRSA guidance and data entry into the portal to ensure appropriate designation between reporting periods.