Finding 498092 (2021-003)

Significant Deficiency
Requirement
AB
Questioned Costs
-
Year
2021
Accepted
2024-09-24

AI Summary

  • Core Issue: The Hospital's internal controls for reporting allowable costs were ineffective, leading to overstated lost revenue claims by about $585,000.
  • Impacted Requirements: Compliance with the Provider Relief Fund's terms, which mandate accurate reporting and record-keeping for three years.
  • Recommended Follow-Up: Implement stronger controls for federal grant expenditures, including regular reviews by knowledgeable individuals and monitoring of federal guidance.

Finding Text

Finding 2021-003 U.S. Department of Health and Human Services ALN #93.498 - Provider Relief Fund A - Activities Allowed or Unallowed & B - Allowable Costs/Cost Principles Condition: The Hospital’s internal controls over compliance related to reporting of allowable costs was not effective. Criteria: The Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. No. 116‐136, 134 Stat. 563) and are to be used to prevent, prepare for, and respond to coronavirus and that the funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. Per the terms and conditions of the Provider Relief Fund, all records pertaining to expenditures under the Provider Relief Fund are required to be maintained for three years from the date of the final expenditure. Cause: The Hospital did not have information available to support the lost revenue computation as reported in the portal reporting. Effect: A prior chief financial officer prepared the provider relief portal reporting for period 1 prior to terminating employment at the Hospital and did not provide the Hospital with supporting records for the submitted report. The new chief financial officer had to reconstruct supporting records for lost revenues claimed. Based on the reconstructed supporting records, lost revenues utilized in period 1 were overstated in the portal reporting by approximately $585,000. However, the Hospital was able to identify additional covid expenses to sufficiently cover the overstated lost revenue amounts. Therefore, no funds were estimated to be due back to the Provider Relief Fund. Questioned Costs: None. Recommendation: The Hospital should maintain support for federal grant expenditures. We also recommend the Hospital include in its controls over expenditures of federal awards the process of having an individual familiar with the award review and approve grant expenditures and reporting documentation and periodically review or monitor guidance that may be published by federal grantors. Views of Responsible Officials: The Hospital agrees with the finding and has prepared a corrective action plan.

Corrective Action Plan

Finding # 2021-003 Response: The interim CFO has completed improvements in account review processes and procedures and has implemented recordkeeping improvements that improve the ability of the Organization to document, retain, and retrieve support for expenditures of federal awards. Responsible Party: Jeffrey Hundman, Interim CFO Estimated Completion: 09/30/2024

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 498093 2021-004
    Significant Deficiency
  • 1074534 2021-003
    Significant Deficiency
  • 1074535 2021-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $3.50M
93.697 Covid-19 Testing for Rural Health Clinics $296,080
93.301 Small Rural Hospital Improvement Grant Program $41,375