Finding 1169431 (2023-002)

Federal Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution, Period 5 Assistance Living Number: 93.498 Federal Agencies: U.S. Department of Health and Human Services Criteria: Reporting (45 CFR 75.342) Condition: The Hospital reported COVID-19-related expenditures within the HHS Provider Relief Fund portal that were reimbursed via other sources. The Hospital’s compliance controls and report review processes were insufficient to prevent this reporting error. Questioned Costs: None Context: The Hospital is certified by Medicare as a critical access hospital. The Period 5 Provider Relief Fund report was tested. The Hospital’s calculation of allowable expenses did not consider the impact of cost reimbursement to reported healthcare expenses to document that Provider Relief Fund and American Rescue Plan (ARP) Distribution were not reimbursed by any other source. Effect: The Hospital submitted expenses under PRF that are obligated to be reimbursed by another source. Cause: The guidance provided by HHS to providers across the country as to how to report their COVID-19-related expenses and lost revenues is, at times, difficult to comprehend and apply. Internal controls were not in place to ensure the Hospital correctly applied the guidance. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports that allowable expenses reported are not reimbursed by any other source. Identification as a Repeat Finding: Not a repeat finding. Views of Responsible Officials and Planned Corrective Actions: See attached corrective action plan for the Hospital’s response to finding.