Finding 3685 (2023-001)

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Requirement
L
Questioned Costs
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Year
2023
Accepted
2023-12-07
Audit: 5784
Organization: Bothwell Regional Health Center (MO)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Health Center inaccurately reported revenues in the HHS Provider Relief Fund portal for multiple quarters.
  • Impacted Requirements: Reporting requirements mandate accurate documentation of fund usage, including lost revenue calculations for entities receiving over $10,000.
  • Recommended Follow-Up: The Health Center should enhance its understanding of reporting guidance and collaborate with external advisors to improve submission accuracy.

Finding Text

U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund - 93.498 Criteria or Specific Requirement - Reporting (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 (COVID-19). Entities that received 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. Condition - The Health Center did not properly report revenues by quarter in the period 4 HHS Provider Relief Fund (PRF) portal. Questioned Costs - None Context - Upon testing the period 4 report, six out of the eight quarters of actual revenues within 2021 and 2022 included in the portal did not tie to the Health Center's internal financial statements. Effect - The Health Center submitted revenues that were incorrect for the last two quarters of 2021 and all four quarters for 2022. This error in reporting did not lead to a change in the amount of lost revenues available to be used by the Health Center (all quarters reported zero lost revenues). 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. The Health Center's review processes over the portal submission failed to detect the errors. Identification as a Report Finding - Not applicable. Recommendation - The Health Center should continue to refine its understanding of the guidance related to this type of reporting and work with their external advisors to identify areas for improvement prior to submission to the Provider Relief Fund reporting portal. View of Responsible Official and Planned Corrective Actions - The Health Center agrees with this finding, however, does note that this did not in any way impact the amount of lost revenues available to be used under Provider Relief Fund program guidance. See separate auditee document for planned corrective action.

Corrective Action Plan

The Health Center incorrectly reported patient revenue figures submitted via the HHS Provider Relief Fund (PRF) portal. Personnel Responsible for Corrective Action: Steve Davis, Chief Financial Officer Anticipated Completion Date: Change is in process and full adoption is anticipated by May 31, 2023 Corrective Action Plan: While this did not lead to any additional lost revenues being made available to the Health Center, the Health Center is going to continue and improve its understanding of the guidance related to this type of reporting and work with their external advisors to ensure any future portal submissions are compliant with said guidance.

Categories

Cash Management Reporting

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 Provider Relief Fund (prf) and American Rescue Plan Rural (arp) Distribution $4.57M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $4.49M
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $99,058