FAC Explorer

Finding 392595 (2021-001)

Significant Deficiency
Requirement
B
Questioned Costs
$1
Year
2021
Accepted
2024-04-08
Audit: 302889
Organization: Self Regional Healthcare and Affiliates (SC)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Hospital reported ineligible costs of $104,407 for the Provider Relief Fund, violating the terms set by the Department of Health and Human Services.
  • Impacted Requirements: The Hospital failed to implement adequate controls to ensure compliance with PRF usage guidelines, leading to financial reporting errors.
  • Recommended Follow-Up: Establish effective controls and oversight to ensure all submitted expenses meet the required criteria to prevent future noncompliance.

Finding Text

Significant Deficiency Assistance Listing 93.498 Criteria: The Department of Health and Human Services provided terms and conditions associated with the Provider Relief Fund (“PRF”). Those terms and conditions outlined the usages of the PRF distributions received, specifically related to expenses. PRF distributions should only be used to prevent, prepare for, and respond to the coronavirus that have not been reimbursed from other sources or that other sources are not obligated to reimburse. Management should have effectively designed controls in place to prevent, or to detect and correct, noncompliance and related financial reporting misstatements. Condition: The Hospital internal control over Provider Relief Fund and American Rescue Plan (“ARP”) Rural Distributions resulted in ineligible costs reported on the Department of Health and Human Services PRF portal submission. Questioned Costs: $104,407 Effect: The Hospital overstated healthcare related expenses submitted through the Department of Health and Human Services PRF portal for the first period of availability by including ineligible expenses. Cause: Lack of effectively implemented controls, including oversight and detail review of expenditures submitted through the Department of Health and Human Services PRF portal for the first period of availability. Auditor’s Recommendation: Effective controls over compliance and financial reporting should be implemented to ensure expenditures submitted through the Department of Health and Human Services PRF portal meet the criteria established in the terms and conditions. Management Response: See corrective action plan.

Corrective Action Plan

Contact Person: Timothy Evans Managements Response: Management had claimed pharmacy costs for drugs that were reimbursed by insurance plans. We incorrectly made an assumption that all drug related expenditures for treating the coronavirus virus were allowable expenditures. We have changed our processes for inclusion of only expenditures that have not been reimbursed. Similarly we included costs of COVID testing expenditures however, some of those costs were either billed to patients or reimbursed from other sources. We have corrected that process also. Completion Date: January 2024.

Categories

Questioned Costs Internal Control / Segregation of Duties Eligibility Reporting Significant Deficiency

Other Findings in this Audit

  • 392596 2021-002
    Material Weakness
  • 969037 2021-001
    Significant Deficiency
  • 969038 2021-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $21.83M
93.461 Covid-19 Testing for the Uninsured $2.68M