Finding 403356 (2023-004)

of Health and Human Services Federal Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 TIN #390992883 Reporting Material Weakness in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Medical Center’s narrative outlining lost revenues did not accurately reflect the calculation utilized for the lost revenue calculated and reported to the Department of Health and Human Services (HHS). Cause: The Medical Center did not have an adequate internal control policy in place to ensure that the lost revenue calculation was consistent with its submitted lost revenue calculation memos. Effect: There is a potential that the lost revenue calculation may contain errors based upon the narrative outlining the calculation. Questioned Costs: None. Context: All key line items were tested on the Period 4 HHS special report. Repeat Finding from Prior Years: Yes, finding 2021-004. Recommendation: We recommend the Medical Center implement procedures to ensure the narrative submitted to HHS be consistent with the calculation of lost revenue claimed on the reports to HHS. Views of Responsible Officials: Management agrees with the finding.