Finding 1176708 (2021-005)

Material Weakness Repeat Finding
Requirement
ABL
Questioned Costs
-
Year
2021
Accepted
2026-03-06
Audit: 390602
Organization: Beartooth Billings Clinic (MT)

AI Summary

  • Core Issue: The Organization submitted incorrect lost revenue figures in the HRSA report due to a lack of review before submission.
  • Impacted Requirements: Reporting requirements under 45 CFR 75.342 and documentation of allowable costs related to the Provider Relief Fund.
  • Recommended Follow-Up: Enhance the formal review process for HRSA reports and lost revenue calculations before submission to ensure accuracy.

Finding Text

Finding: Reporting and Activities Allowed or Unallowed, Allowable Costs/Cost Principles Federal Assistance Listing No. 93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) U.S. Department of Health and Human Services Criteria or Specific Requirement – Reporting (45 CFR 75.342) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease 2019 (COVID-19). Entities that receive more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, the Organization is required to implement and maintain internal controls over financial reporting. Condition – The Organization reported Patient Revenue on the HRSA submission that did not agree to the Patient Revenue per the audited financial statements. Questioned Costs – Unknown Context – Revenue utilized in the lost revenue calculation for Period 1 was not reconciled to patient revenue on the audited financial statements. The Organization reperformed the lost revenue calculation and provided this calculation after the submission of the Period 1 HRSA report. Effect – The Organization submitted incorrect lost revenue figures in the Period 1 HRSA submission. Cause – The Organization Regional Controller failed to review the lost revenue calculation prior to submission. Identification as a Repeat Finding – Not a repeat finding Recommendation – The Organziation should continue to improve its formal review of HRSA report and Lost Revenue Calculation prior to submission. View of Responsible Official and Planned Corrective Actions – The Organization agrees with the finding. See separate report for planned corrective actions

Corrective Action Plan

Following the Period 1 submission, the Organization identified that the patient revenue figures used in the lost revenue calculation did not reconcile to the audited financial statements. The lost revenue model was subsequently re performed using audited patient revenue data, and the corrected calculation was incorporated into the Period 4 PRF submission. To prevent recurrence, the Organization has strengthened its internal review protocols for reporting, including mandatory reconciliation of all revenue inputs to audited financial statements and secondary review by the Regional Controller prior to submission. These enhanced controls ensure that future lost revenue calculations are accurate, supportable, and compliant with HRSA reporting requirements.

Categories

Allowable Costs / Cost Principles Cash Management Reporting

Other Findings in this Audit

  • 1176706 2021-003
    Material Weakness Repeat
  • 1176707 2021-004
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 PROVIDER RELIEF FUND AND AMERICAN RESCUE PLAN (ARP) RURAL DISTRIBUTION $3.60M