Finding 1079496 (2022-003)

Material Weakness Repeat Finding
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2024-10-17
Audit: 325024
Organization: Tyler County Hospital District (TX)

AI Summary

  • Core Issue: The District failed to accurately report lost revenues for the COVID-19 Provider Relief Fund, leading to significant discrepancies in quarterly revenue reporting.
  • Impacted Requirements: Reporting must align with 45 CFR 75.342, requiring accurate financial reconciliation and adherence to the chosen reporting option.
  • Recommended Follow-Up: Revise policies for federal grant reporting to ensure accuracy and completeness, and correct the lost revenue calculations to comply with the appropriate reporting option.

Finding Text

COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Period 2 and Period 3 Funds Criteria: Reporting (45 CFR 75.342) Condition: The District is required to prepare and submit period two and three Provider Relief Fund reporting. These reports are to be prepared using accurate financial information and submitted by the deadline established. The District did not reconcile revenues to financial statements issued, did not consider timing of deductions, and excluded revenue from a nursing facility that they did not own for entire period covered in the lost revenue calculation which is not allowed under option 1. These resulted in material differences in reported quarterly revenue. Questioned costs: None Context: The period two and period three provider relief fund reports were tested. The District selected option 1 to report lost revenues based on quarterly actual amounts. When testing the underlying financial information, errors in the information were identified whereby revenues did not reconcile to audited financial statements, did not consider timing of deductions, and excluded revenue from a nursing facility that they did not own for entire period covered in the lost revenue calculation which is not allowed under option 1. The District should have selected option 3 when reporting and also should have submitted a narrative explaining the methodology of estimating revenues under option 3. The District utilized allowable costs for the Period 2 and 3 funding received, so that no lost revenues were utilized as a basis for the funds received. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for each year, 2019, 2020, 2021, and 2022. Lost revenue was not accurately reported under option 1. By selecting the incorrect option, the District did not submit the required narrative information in the PRF reporting portal. Cause: The District did not correctly summarize patient service revenue in their calculation. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. The District should correct the lost revenue reporting to reflect both the appropriate option and appropriate amounts. Identification as a repeat finding: 2021-002 Views of responsible officials and planned corrective actions: See attached corrective action plan for the District’s response to finding.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 503054 2022-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $953,696
93.301 Small Rural Hospital Improvement Grant Program $250,814
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $49,529