Finding 383755 (2023-001)

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Requirement
L
Questioned Costs
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Year
2023
Accepted
2024-03-22

AI Summary

  • Core Issue: A $168,000 discrepancy was found between reported patient care revenues and actual revenues in the HRSA portal for Q3 2021.
  • Impacted Requirements: Reporting on lost revenues must accurately reflect patient care revenues as per the established calculation methods.
  • Recommended Follow-Up: Management should establish procedures to reconcile lost revenue calculations with the general ledger to prevent future discrepancies.

Finding Text

COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Reporting Cluster: Not applicable Federal Agency: Department of Health and Human Services (“HHS”) Award Name: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Assistance Listing #: 93.498 Assistance Listing Title: COVID-19 - Provider Relief Fund and American Rescue Plan Rural Distribution – Period 4 and Period 5 Award Year(s): January 1, 2020 – December 31, 2022 and January 1, 2020 – June 30, 2023 Criteria Step Six of the Steps on Reporting on Use of Funds section of the June 11, 2021 Provider Relief Fund (“PRF”) General and Targeted Distribution Post-Payment Notice of Reporting Requirements requires recipients that apply PRF payments toward lost revenues to use one of the following three options for calculating lost revenues: • Option (i): difference between actual patient care revenues and actuals for each quarter during the period of availability; • Option (ii): difference between budgeted (budget approved prior to March 27, 2020) and actual patient care revenues for each quarter during the period of availability; or • Option (iii): any reasonable method of estimating revenues Condition Through our testing of the JHHS affiliate, Johns Hopkins Regional Physicians’ (JHRP) period 4 HRSA reporting portal submission, we identified a $168,000 discrepancy between the actual patient care revenue amount input into the portal for Q3 2021 and the actual patient care revenue amount per JHRP’s general ledger, which supports it’s lost revenue calculation. Cause The actual patient care revenue for Q3 2021 used within the lost revenue calculation reported via the HRSA portal differed from the amount per the general ledger due to additional revenues other than patient care revenue being included in the HRSA portal reporting. Effect Inputs into the lost revenue calculation were not accurate and impacted the total lost revenue calculated by JHRP for Q3 2021. However, the amounts input incorrectly into the “Total Revenue/Net Charges from Patient Care” line for Q3 2021 did not have an impact on lost revenue that JHRP could claim in the reporting period as JHRP maintained sufficient capacity in amounts that qualified for use. Additionally, the impact from correcting the input error increased the lost revenue of JHRP for Q3 2021 by $168,000. Questioned Costs There are no questioned costs associated with this finding as the exceptions noted relate to an aspect of reporting which would have increased the potential qualifying funds of JHRP. Recommendation Management should implement procedures to ensure that the lost revenue calculation used to report data into the HRSA portal is reconciled to patient care revenues per the general ledger. Management’s Views and Corrective Action Plan Refer to Management’s Views and Corrective Action Plan at the end of this report.

Corrective Action Plan

COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Reporting Cluster: Not applicable Federal Agency: Department of Health and Human Services (“HHS”) Award Name: Provider Relief Fund and American Rescue Plan Rural Distribution Assistance Listing #: 93.498 Assistance Listing Title: COVID-19 - Provider Relief Fund and American Rescue Plan Rural Distribution – Period 4 and Period 5 Award Year(s): January 1, 2020 – December 31, 2022 and January 1, 2020 – June 30, 2023 Management agrees with the finding and recommendation. Management notes that the period 4 HRSA reporting was more conservative and reported lower lost revenue. Management further notes that none of the miscalculated lost revenues were applied to any funding received as JHRP maintained sufficient capacity in amounts that qualified for use. Management reviewed the processes and controls in place for other reporting entities and is comfortable that the error was isolated to a control breakdown for the specific JHRP filing. Management notified HRSA to report the error and advise on next steps. Per HRSA’s advice, JHRP cannot restate period 4 HRSA reporting since there are no future reporting periods for a correction to be made. Management has documented the correction should there be any additional inquiries.

Categories

Reporting

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $21.20M
84.181 Special Education-Grants for Infants and Families $1.79M
93.926 Healthy Start Initiative $1.01M
93.817 Hospital Preparedness Program (hpp) Ebola Preparedness and Response Activities $983,454
93.RD National Institute of Neurological Disorders & Stroke Direct Award $687,141
93.958 Block Grants for Community Mental Health Services $349,125
21.027 Coronavirus State and Local Fiscal Recovery Funds $204,386
16.575 Crime Victim Assistance $204,111
93.994 Maternal and Child Health Services Block Grant to the States $194,000
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $181,445
93.788 Opioid Str $107,630
93.839 Blood Diseases and Resources Research $104,330
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $84,930
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $74,311
93.969 Pphf Geriatric Education Centers $65,770
93.865 Child Health and Human Development Extramural Research $58,872
10.558 Child and Adult Care Food Program $51,837
93.395 Cancer Treatment Research $47,700
93.815 Domestic Ebola Supplement to the Epidemiology and Laboratory Capacity for Infectious Diseases (elc). $46,460
93.959 Block Grants for Prevention and Treatment of Substance Abuse $44,251
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $30,000
93.110 Maternal and Child Health Federal Consolidated Programs $15,836
93.307 Minority Health and Health Disparities Research $7,342
93.226 Research on Healthcare Costs, Quality and Outcomes $6,666
10.559 Summer Food Service Program for Children $4,905
93.461 Covid-19 Testing for the Uninsured $-1.20M