Finding 391338 (2023-001)

Material Weakness
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2024-04-01
Audit: 301904
Organization: Lifespire, Inc. (NY)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Agency reported patient care revenues inaccurately in the provider relief fund portal, leading to discrepancies with audited financial statements.
  • Impacted Requirements: Reporting standards (45 CFR 75.342) and allowable costs principles were not met due to insufficient support for reported revenue amounts.
  • Recommended Follow-Up: Implement stronger internal controls to ensure future reporting is accurate, complete, and properly reviewed.

Finding Text

U.S. Department of Health and Human Services Assistance Listing No. 93.498 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution 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 Agency’s portal reporting submission included errors. Questioned Costs: Unknown Context: The Agency chose to report lost revenues using option i. Under this option, the difference between actual patient care revenues is to be reported. Patient care revenue includes healthcare services and support, as provided in a medical setting at home/telehealth, or in the community. The patient care revenues reported in the provider relief fund portal did not agree to the audited financial statements. The Agency did not provide sufficient support for the patient revenue amounts reported in the provider relief portal. Effect: The revenues submitted in the provider relief fund portal do not agree to the audited financial statements, resulting in an understatement of lost revenue reported. Cause: The Agency’s internal controls were not adequate to detect these reporting errors. Identification as a Repeat Finding: Not applicable. Recommendation: We recommend implementing controls to ensure amounts reported are accurate, complete and reviewed. Views of Responsible Officials and Planned Corrective Actions: Management concurs with the finding and recommendation; however, the errors did not result in materially different lost revenues claimed.

Corrective Action Plan

The main reason for the discrepancy in income was a result of using actual units/services billed (from the billing software) and not what is recorded in the financials because, usually what is recorded every month in the financials is based on estimates and later adjusted based on actual billing and payments for services received. With this approach we were comfortable that, if necessary, we could trace the income to the actual service rather than an estimate. An unintended consequence was that income received in a year for a service in a prior year was not accounted for. While, immaterial, this resulted in discrepancies. We are committed that in the future, we would take additional steps to review the information by other employees who are not involved in the process in order to get a different perspective, and seek outside help, like a CPA, if necessary.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 967780 2023-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $2.49M