Finding 393828 (2021-002)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2021
Accepted
2024-04-19

AI Summary

  • Core Issue: Lost revenues reported to HRSA were overstated due to incorrect calculations.
  • Impacted Requirements: Reporting must align with Pub. L. No. 116-136, which outlines allowable costs and activities.
  • Recommended Follow-Up: Implement internal controls for accurate reporting and ensure data review before submission.

Finding Text

Federal Program – COVID-19 Provider Relief Fund, ALN 93.498, Award Year 2021 Criteria or specific requirement – Activities Allowed/Allowable Costs and Reporting– Pub. L. No. 116-136, 134 Stat. 563 Condition – Lost revenues reported to Health Resources and Services Administrator (HRSA) were not in accordance with Pub L. No. 116-136, 134 Stat. 563. Questioned Costs – $893,925 was the total amount of lost revenues determined to be over-reported to the federal program. This was calculated by taking the difference between reported quarterly gross patient service revenues and estimated quarterly patient service revenues net of contractual adjustments from third-party payors and bad debt. Context – The Hospital calculated lost revenues using gross patient service revenues. Effect – Lost revenues reported to HRSA were overstated. Cause – The Hospital did not have effective internal control processes in place to ensure the accurate calculation and reporting of lost revenues. Changes to frequently asked questions and guidance from HRSA and management’s inexperience with the program requirements resulted in a material error under the program. Identification as a Repeat Finding, if Applicable – N/A Recommendation – The Hospital should implement documented internal control processes specific to understanding and reporting of lost revenues, including review and oversight of data prior to submission. Views of Responsible Officials and Planned Corrective Actions – The Hospital will continue to monitor the Department of Health and Human Resources Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements and the most recently distributed Provider Relief Fund frequently asked questions, which provide details on requirements related to the program, including further updates as they may occur.

Corrective Action Plan

Given the complexity of the reporting requirements, including changing FAQ's, reporting deadline extensions, and the inability to update reporting to reflect expenses incurred within the guidelines such as lost revenue the Authority will apply such expenses as offsets to its provider relief fund distributions. The Authority will continue to monitor the Health and Human Resources Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements and the most recently distributed Provide Relief Fund frequently asked questions which provide details on requirements related to the program.

Categories

Questioned Costs Internal Control / Segregation of Duties Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 393829 2021-003
    Material Weakness
  • 970270 2021-002
    Material Weakness
  • 970271 2021-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $2.78M
93.889 National Bioterrorism Hospital Preparedness Program $11,446
93.301 Small Rural Hospital Improvement Grant Program $10,077