Finding 44163 (2022-001)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2022
Accepted
2023-09-19
Audit: 46086
Organization: Dch Healthcare Authority (AL)
Auditor: Forvis LLP

AI Summary

  • Core Issue: There is a significant discrepancy of $24,871,110 between reported and eligible expenditures for the Provider Relief Fund.
  • Impacted Requirements: The System failed to comply with terms and conditions for allowable expenses, leading to ineligible costs being reported.
  • Recommended Follow-Up: Implement effective controls to ensure compliance with PRF guidelines and accurate reporting of expenditures and lost revenues.

Finding Text

Finding 2022-001 Material Weakness and Material Noncompliance Assistance Listing Number: 93.498 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions Criteria: Activities Allowed or Unallowed, Allowable Costs/Cost Principles, Reporting Questioned Costs ? $24,871,110. This represents the difference between the $51,502,963 of expenditures reported by the System through the Department of Health and Human Services PRF portal and the $26,631,853 determined to be eligible expenditures. The System used an incremental cost approach for expenses totaling the questioned costs. It could not be determined whether this is an acceptable approach under HRSA guidelines or whether these expenses were reimbursed by other sources. Condition: The Department of Health and Human Services provided terms and conditions associated with the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions. 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 detect and correct, noncompliance and related financial reporting misstatements. Context: The System?s internal control over Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distributions resulted in ineligible costs and inaccurate lost revenues reported on the Department of Health and Human Services PRF portal submission. Effect: The System overstated expenses and understated lost revenues submitted through the Department of Health and Human Services PRF portal for the second period of availability. Cause: Lack of effectively designed and implemented controls over expenditures and lost revenues submitted through the Department of Health and Human Services PRF portal for the second period of availability. Identification of prior year finding: N/A Recommendation: Effective controls over compliance should be implemented to ensure expenditures and lost revenues submitted through the Department of Health and Human Services PRF portal meet the criteria established in the terms and conditions. Management Response: See management?s corrective action plan included at the end of the report.

Corrective Action Plan

During the COVID-19 pandemic, DCH Health System (DCH) developed a methodology to identify eligible costs in accordance with the Health and Human Services (HHS) produced COVID-19 Provider Relief Fund (PRF) Reporting Requirements and FAQ guidance. DCH's methodology identified costs used to prevent, prepare for, and respond to coronavirus that fell into the following categories: COVID-19 specific costs, direct and indirect incremental costs due to COVID-19, and calculated lost revenue. To calculate direct and indirect incremental costs due to COVlD-19 for DCH Regional Medical Center, DCH leveraged HHS FAQ guidance from October 28, 2020, that introduced examples demonstrating how providers could calculate marginally increased expenses related to coronavirus using a reasonable methodology comparing pre-pandemic to post-pandemic average expenses for an office visit. OCH utilized this methodology to calculate direct and indirect incremental costs due to COVID-19 on a per-patient discharge basis, which is akin to an office visit for a hospital, per the HHS FAQ guidance. Though this specific example was removed in subsequent versions of the FAQ, HHS never communicated that the guidance that DCH relied upon to calculate incremental expenses was incorrect. DCH's view is that the total cost of patient discharge includes direct patient care and indirect costs (overhead and general administrative (G&A) costs). Indirect costs (e.g., facilities, maintenance, utilities, and management salaries) were incurred by DCH to prepare, prevent, and respond to COVID-19, consistent with the intention of the purpose of the PRF to 'provide financial support to providers who experienced lost revenues and increased expenses during the pandemic in order to maintain national health system capacity.' For instance, the ability to serve COVID-19 patients relied on incurring utility expenses to keep ventilators and other equipment functioning, of which the organization utilized well more than the norm which resulted in higher utility costs. These costs were vital for accommodating COVID-19 patients during the pandemic, just as they were necessary for serving other patient types before the onset of COVID-19. These incremental indirect costs were also not reimbursed through other sources. DCH allocated indirect costs in accordance with other accepted government rules as defined in various government regulations such as 2 CFR and the Federal Acquisition Regulation. The indirect costs allocated to patient care costs were considered part of the total cost of patient discharge. In addition, though DCH calculated lost revenue, DCH did not report on lost revenue as part of the system's use of funds (please note that there was one reporting period where Fayette had to report separate from DCH because of targeted funds received. Fayette did report lost revenue in that period based on a budget to actual calculation). DCH believes that the funds identified and reported are consistent with HHS guidance and the spirit of the law to maintain national health system capacity It is DCH's understanding that Single Audit Finding 2022-001 is particularly focused on DCH's approach to identifying indirect incremental costs due to COVID-19, citing these expenses as ineligible costs that were included in the HHS PRF portal submission. Similarly, DCH did not report lost revenues, resulting in 'inaccurate lost revenues reported.' Both FORVIS and DCH acknowledge that DCH incurred eligible expenses and lost revenue sufficient to cover the PRF funds received. Therefore, based on the FORVIS finding, and assuming the finding is sustained, DCH will implement processes to submit future PRF reports as suggested in Single Audit Finding 2022- 001, which includes identifying specific individual expenses incurred during the reporting period to prevent, prepare for, and respond to COVID-19, rather than utilizing the initial HHS guidance for calculating incremental costs due to COVID-19. In addition, OCH will include lost revenue in the PRF portal submission.

Categories

Questioned Costs Allowable Costs / Cost Principles Eligibility Material Weakness Reporting

Other Findings in this Audit

  • 620605 2022-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $51.75M
21.019 Coronavirus Relief Fund $2.34M