Finding Text
Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) Condition ? The Organization is required to prepare and submit period-one Provider Relief Fund (PRF) reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs ? Unknown Context ? The period one PRF report was tested. The Organization selected option one to report lost revenues based on quarterly actuals. The quarterly figures were calculated and reporting using post date versus service date. In addition, settlements related to the Medicaid cost report along with incentive revenue for 2019, 2020, and 2021 were improperly excluded from quarterly revenues related to patient care. Effect ? Errors were made in reporting quarterly Total Revenue from Patient Care. Lost revenues were not accurately reported. Cause ? The Organization calculated and reported patient service revenue by post date versus service date. The Organization also improperly excluded certain patient service revenue components in their calculation. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of Responsible Officials and Planned Corrective Actions ? During the 2022 audit of Community Health Center of Central Missouri, our auditors found two instances of the PRF calculation being calculated incorrectly. The two instances were: 1) Lost revenue was calculated on a quarterly basis using post-date instead of date of service which resulted in a negative patient service revenue balance in self pay during 2020 Quarter 1-Quarter 3 2) Lost revenue was calculated without consideration of Medicaid cost report settlement and incentive revenue. This has resulted in a finding in the current year financial statements audit. Management has evaluated the finding and reviewed whether any funds need to be repaid and evaluated its controls around future provider relief reporting cycles. It has been determined that even with the two errors identified lost revenues would have been sufficient to obligate the entire award. Therefore, we have determined no repayment is necessary. If allowed in future provider relief reporting periods, Community Health Center of Central Missouri will correct the misreporting. Toby Barnett, Chief Financial Officer, is the party that has overall responsibility for this corrective action. The anticipated completion date is unknown at this time due to reporting portal for period 1 being closed. It is unknown if HHS will allow corrections to period 1 reports.