FAC Explorer

Audit 57160

FY End
2022-02-28
Total Expended
$3.79M
Findings
2
Programs
5
Organization: Dundy County Hospital (NE)
Year: 2022 Accepted: 2022-10-20
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
61864 2022-005 - - L
638306 2022-005 - - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $3.51M Yes 1
93.697 Rural Health Clinic Testing and Mitigation $140,678 - 0
93.461 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program $70,884 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $56,809 - 0
93.301 Small Rural Hospital Improvement Program $11,855 - 0

Contacts

Name Title Type
LCKPG545Q7M9 Alicia Aldridge Auditee
3084237001 Darren Osten Auditor
No contacts on file

Notes to SEFA

Title: Note 4: Provider Relief Funds Accounting Policies: Note 1: Basis of Presentation - The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of the Hospital under programs of the federal government for the year ended February 28, 2022. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital. Note 2: Summary of Significant Accounting Policies - Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Hospital has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. The Hospital received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund (PRF) program (Federal Financial Assistance Listing/CFDA #93.498) during the year ended February 28, 2021. The Hospital incurred eligible expenditures (including lost revenue) and, therefore, recognized revenue totaling $2,080,206 and $1,429,401 for the years ended February 28, 2022 and 2021, respectively in the financial statements. In accordance with the compliance supplement addendum, the PRF expenditures recognized on the schedule are based on the reporting to HHS for the period ending June 30, 2021, as required under the PRF program. The amount of PRF expenditures included on the schedule requires management to make estimates and assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant estimate. Estimates and assumptions may include reducing actual expenses by amounts that have been reimbursed or are obligated to be reimbursed by other sources, estimating marginal increases in expenses related to coronavirus and the calculation of lost revenue. Actual results could differ from those estimates.
Title: Note 5: Donated Personal Protective Equipment (PPE) (unaudited) Accounting Policies: Note 1: Basis of Presentation - The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of the Hospital under programs of the federal government for the year ended February 28, 2022. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital. Note 2: Summary of Significant Accounting Policies - Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Hospital has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. Nonmonetary assistance of PPE received during the emergency period of the COVID-19 pandemic was $30,225 and is based upon the estimated fair market value of PPE received. The donated PPE was general provided by donors without information about compliance or reporting requirements associated with federal financial assistance listings. The donated PPE is not included in the Schedule.

Finding Details

Finding 2022-005
Criteria: The HRSA Provider Relief Fund Reporting and Auditing Questions under calculating eligible expenses and lost revenue state that when reporting lost revenues, Reporting Entities should exclude the amount of contractual adjustments from all third party payers and charity care adjustments, as applicable when determining patient care related revenue sources. The instructions in the PRF Reporting Portal User Guide also state that patient revenue should also be reported net of uncollectible patient services revenues recognized as bad debts. Condition: Amounts reported for lost revenue were not in accordance with the terms and conditions of the Provider Relief Reporting Portal User Guide and Reporting and Auditing Questions. Cause: Management reported lost revenue based upon gross charges rather than net patient revenue. Effect: Amounts reported for lost revenue in the Provider Relief Fund reporting portal were not accurate and were overstated. Questioned costs: $0 Context: Lost revenue appears to be misreported by an estimated $225,000, which could be offset by unreimbursed expenses reported in the amount of $64,110. Recommendation: We recommend the Hospital ensure it is familiar with all reporting requirements of grant awards to ensure proper compliance. Views of Responsible Officials: We concur with the finding and will work with HRSA on an appropriate course of action. See Corrective Action Plan.
Finding 2022-005
Criteria: The HRSA Provider Relief Fund Reporting and Auditing Questions under calculating eligible expenses and lost revenue state that when reporting lost revenues, Reporting Entities should exclude the amount of contractual adjustments from all third party payers and charity care adjustments, as applicable when determining patient care related revenue sources. The instructions in the PRF Reporting Portal User Guide also state that patient revenue should also be reported net of uncollectible patient services revenues recognized as bad debts. Condition: Amounts reported for lost revenue were not in accordance with the terms and conditions of the Provider Relief Reporting Portal User Guide and Reporting and Auditing Questions. Cause: Management reported lost revenue based upon gross charges rather than net patient revenue. Effect: Amounts reported for lost revenue in the Provider Relief Fund reporting portal were not accurate and were overstated. Questioned costs: $0 Context: Lost revenue appears to be misreported by an estimated $225,000, which could be offset by unreimbursed expenses reported in the amount of $64,110. Recommendation: We recommend the Hospital ensure it is familiar with all reporting requirements of grant awards to ensure proper compliance. Views of Responsible Officials: We concur with the finding and will work with HRSA on an appropriate course of action. See Corrective Action Plan.