Finding 24395 (2022-002)

Significant Deficiency Repeat Finding
Requirement
ABL
Questioned Costs
-
Year
2022
Accepted
2023-06-28
Audit: 20105
Auditor: Forvis LLP

AI Summary

  • Core Issue: The District submitted an inaccurate Provider Relief Fund report due to errors in the lost revenue calculation.
  • Impacted Requirements: Compliance with reporting standards (45 CFR 75.342) and allowable costs under federal laws was not met.
  • Recommended Follow-Up: Update policies and procedures for federal grant reporting to ensure accuracy and completeness in future submissions.

Finding Text

2022-002 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 Criteria: 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). Condition: The Period 2 Provider Relief Fund report was submitted that had errors in the lost revenue calculation under Option 1. Questioned costs: Unknown Context: The District incorrectly excluded certain excluded Medicaid supplemental payments, and the District did not include negative contractual allowances when entering net revenue by payor into the reporting portal. Cause: The District did not properly calculate lost revenue in their calculation. Internal controls of compliance were not in place to ensure the District properly calculated prepared the report. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Identification as a repeat finding: Repeat finding, 2021-001 and 2021-002 Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.

Corrective Action Plan

Midland County Hospital District Single Audit Report FY2022 Corrective Action Plan Finding 2022-002 - Management agrees with the finding. We have developed policies and procedures over financial reporting to ensure patient service revenue includes Medicaid supplemental payments in all lost revenue that fall under the Federal assistance guidelines and ensure that total revenues are reconciled to the general ledger account balances and supporting information. net revenue was corrected for this issue dure the PRF Reporting Period #3 that was submitted September 29, 2022. Internal controls have been enacted and the Executive Director of Fiscal Services/Controller, Rebbecca Richey will be responsible to ensure all future periods will accurately reflect the lost revenues for the Hospital District. This corrective action plan was implemented on September 29, 2022.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 24394 2022-001
    Material Weakness
  • 600836 2022-001
    Material Weakness
  • 600837 2022-002
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $5.09M
93.461 Covid-19 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $2.63M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $270,419