Finding 38928 (2022-001)

Material Weakness
Requirement
ABL
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 46543
Auditor: Forvis

AI Summary

  • Core Issue: The Hospital miscalculated and misreported lost revenues for COVID-19 Provider Relief Fund reporting periods, failing to follow HRSA guidance.
  • Impacted Requirements: Reporting accuracy and allowable cost principles were not met due to improper calculations and lack of approved budget periods.
  • Recommended Follow-Up: The Hospital should create internal documentation for lost revenue calculations that aligns with HRSA guidance and enhance internal controls for report accuracy.

Finding Text

2022-001 Federal Program Name: COVID ? 19 Provider Relief Fund (PRF) Federal Agency: U.S. Department of Health and Human Services Federal Assistance Listing Title and Number: COVID-19 Provider Relief Fund, 93.498 Criteria or Specific Requirement: Activities Allowed or Unallowed, Allowable Costs/Cost Principles, and Reporting Condition: Lost revenues attributable to COVID-19 were not properly calculated and reported for Provider Relief Fund Portal reporting Periods 3 and 4. Questioned Costs: None Context: The Hospital reported lost revenues using the budget vs. actual method. Net patient service revenue used in the calculation did not include bad debt expense and did not include certain adjustments to patient service revenue recorded during the year-end reporting process. Also, the budgetary periods used in calculations for 2021 and 2022 were not calculated based on budgets approved prior to March 27, 2020. This presentation did not conform with guidance published by the Health Resources and Services Administration (HRSA). Errors were identified by testing the entirety of the lost revenue calculations and reconciling back to underlying financial information. Effect: The Hospital did not properly calculate and report lost revenues. Cause: Internal controls surrounding the review and submission of required reports were not adequately applied to ensure accuracy of required elements. Repeat Findings: No Recommendation: We recommend the Hospital prepare internal documentation supporting lost revenue calculations in an approved manner based on HRSA published guidance. Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Under a revised calculation, we have adequate expenses and lost revenues to support funding reported for all periods of Provider Relief Fund reporting

Corrective Action Plan

Finding Reported by Uniform Guidance ? The following steps have been taken or will be taken to address Finding 2022-001: ? Reid Hospital and Health Services, Inc. plans to monitor controls related to reporting to ensure amounts are appropriately stated. ? Reid Hospital and Health Services, Inc. has maintained documentation under a revised calculation which supports adequate expenses and lost revenues in excess of funding reported for all periods of Provider Relief Fund reporting.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 615370 2022-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $18.14M
93.461 Covid-19 Testing for the Uninsured $254,185
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $27,720
93.994 Maternal and Child Health Services Block Grant to the States $26,025
93.211 Telehealth Programs $15,000
93.297 Teenage Pregnancy Prevention Program $5,000