FAC Explorer

Finding 522264 (2023-002)

Material Weakness Repeat Finding
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2025-02-06
Audit: 341545
Organization: Children's Hospital of Chicago Medical Center and Affiliated Corporati (IL)
Auditor: Rsm US LLP

AI Summary

  • Core Issue: The Medical Center inaccurately reported lost revenue for the third quarter of 2021, leading to an understatement of actual revenues by $1,095,540 for two entities.
  • Impacted Requirements: Reporting did not align with HHS criteria, specifically the methodology for calculating lost revenue under Option iii, resulting in a repeat finding from the previous year.
  • Recommended Follow-Up: Management should enhance the review process for lost revenue calculations, ensuring all supporting documentation is verified before submission to the PRF reporting portal.

Finding Text

Federal program: U.S. Department of Health and Human Services—ALN 93.498, Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Criteria: Specific criteria are established by the U.S. Department of Health and Human Services (HHS) with respect to allowable cost and reporting requirements for this program, including: -Funds shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. -Entities may elect to calculate and report lost revenue using one of three options. For entities electing to report lost revenues using Option iii, the alternative method used to calculate lost revenue should be consistent with a narrative description of the methodology as submitted in the PRF reporting portal. Condition: In the Medical Center’s Period 5 reporting in the PRF reporting portal, the Medical Center reported lost revenue using Option iii for each reporting entity included in the schedule of expenditures of federal awards that received PRF. The alternative method used to calculate lost revenues was budget-toactual revenues for the period from January 2020 through August 2020 and year-over-year actual revenues for the period from September 2020 through August 2021. In the lost revenue calculation for the third quarter of calendar year 2021 for two of the Medical Center’s reporting entities, the Medical Center understated actual revenues by $1,095,540 in total. Context: The Medical Center did not report lost revenues for the third quarter of 2021 for any entity, because actual revenue exceeded the prior year’s actual revenue for each entity. Had the correct amounts of actual revenue been reported for the third quarter of 2021, actual revenue for the quarter still would have exceeded the prior year’s actual revenue for each entity and no lost revenue would be reported. Cause: In preparing the Period 5 reports, management used preliminary estimates of revenue for the month of August 2021 in error. Review processes were performed before the reports were submitted, but these reviews did not detect and correct the errors before submission. Effect: The Medical Center’s Period 5 reporting in the PRF reporting portal included an inaccurate amount of actual revenue for the third quarter of calendar year 2021 for two reporting entities, which was not consistent with methodology described in the Option iii narrative submitted. The PRF reporting correctly reported no lost revenue for the quarter. Questioned costs: None. Repeat finding: Yes, the misreporting of actual revenues for the third quarter of 2021 for all of the Medical Center’s reporting entities was also included in finding 2022-001 in the prior year. This error was corrected in the Period 4 and/or Period 5 reports for the Medical Center’s reporting entities except for two reporting entities. Recommendation: We recommend that management’s review of the lost revenue calculations and reporting in the PRF reporting portal include review of documentation supporting each dollar amount included in lost revenue calculation. Views of responsible officials of the auditee: Management agrees with the finding and the auditor’s recommendation.

Corrective Action Plan

Finding 2023‐002 – Reporting Requirements Grantor: U.S. Department of Health and Human Services Program: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing #: 93.498 Title: COVID-19 Provider Relief Fund Award Year: Fiscal year 2023 9/1/22-8/31/23 Award Number: Not Listed Management understands the importance of accurate reporting for the Provider Relief Fund reporting. At the time of the second and third reporting submissions,the proper review and tie out of final net revenue was not completed for August 2021 net revenue. Corrective Action Plan and Anticipated Completion Date: The net revenue amounts reported in error for August 2021 will be revised from the reported estimated amounts in subsequent filings, if required by HRSA. With no lost revenue being claimed beyond what has already been reported to HRSA, management will also update methodology narrative to reference the last month with lost revenues was March 2021 and no additional revenue will be reported.

Categories

Reporting Allowable Costs / Cost Principles

Other Findings in this Audit

  • 522265 2023-002
    Material Weakness Repeat
  • 522266 2023-002
    Material Weakness Repeat
  • 522267 2023-002
    Material Weakness Repeat
  • 522268 2023-002
    Material Weakness Repeat
  • 522269 2023-003
    Material Weakness
  • 522270 2023-003
    Material Weakness
  • 522271 2023-003
    Material Weakness
  • 522272 2023-003
    Material Weakness
  • 522273 2023-003
    Material Weakness
  • 522274 2023-004
    Material Weakness
  • 522275 2023-005
    -
  • 1098706 2023-002
    Material Weakness Repeat
  • 1098707 2023-002
    Material Weakness Repeat
  • 1098708 2023-002
    Material Weakness Repeat
  • 1098709 2023-002
    Material Weakness Repeat
  • 1098710 2023-002
    Material Weakness Repeat
  • 1098711 2023-003
    Material Weakness
  • 1098712 2023-003
    Material Weakness
  • 1098713 2023-003
    Material Weakness
  • 1098714 2023-003
    Material Weakness
  • 1098715 2023-003
    Material Weakness
  • 1098716 2023-004
    Material Weakness
  • 1098717 2023-005
    -

Programs in Audit

ALN Program Name Expenditures
93.378 Integrated Care for Kids Model (a) $2.90M
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.00M
93.498 Provider Relief Fund $1.16M
93.866 Aging Research $497,804
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $428,870
16.575 Crime Victim Assistance $392,896
93.121 Oral Diseases and Disorders Research $305,914
93.RD Group A Streptococcus Molecular Epidemiology During the Covid-19 Pandemic $253,828
93.943 Epidemiologic Research Studies of Acquired Immunodeficiency Syndrome (aids) and Human Immunodeficiency Virus (hiv) Infection in Selected Population Groups $248,341
14.218 Community Development Block Grants/entitlement Grants $246,925
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $168,323
93.173 Research Related to Deafness and Communication Disorders $165,272
93.297 Teenage Pregnancy Prevention Program $159,993
93.945 Assistance Programs for Chronic Disease Prevention and Control $147,237
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $142,094
20.600 State and Community Highway Safety $136,757
93.575 Child Care and Development Block Grant $133,832
93.318 Protecting and Improving Health Globally: Building and Strengthening Public Health Impact, Systems, Capacity and Security $110,358
93.RD Ma Covid-19 and Prams for Dads $109,729
93.600 Head Start $105,127
11.RD I Can Res3cue $88,813
93.859 Biomedical Research and Research Training $88,080
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $85,579
93.353 21st Century Cures Act - Beau Biden Cancer Moonshot $77,375
93.RD Towards Elimination of Hepatitis C: A Focus on Pregnancy and Exposed Infants $73,058
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $71,003
93.889 National Bioterrorism Hospital Preparedness Program $66,727
93.307 Minority Health and Health Disparities Research $58,658
93.838 Lung Diseases Research $57,974
93.839 Blood Diseases and Resources Research $42,982
93.RD Operations and Statistics for the Retrospective Tumor Characterization Project (mp2prt) for the Perlman Study ? Leidos Biomedical Research, INC $36,151
84.425 Education Stabilization Fund $35,822
93.226 Research on Healthcare Costs, Quality and Outcomes $29,945
16.560 National Institute of Justice Research, Evaluation, and Development Project Grants $29,661
93.242 Mental Health Research Grants $29,547
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $29,446
93.279 Drug Abuse and Addiction Research Programs $27,097
93.313 Nih Office of Research on Women's Health $26,822
93.113 Environmental Health $25,931
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $25,040
93.394 Cancer Detection and Diagnosis Research $22,799
93.778 Medical Assistance Program $21,852
93.361 Nursing Research $21,802
93.103 Food and Drug Administration_research $21,440
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $19,197
93.914 Hiv Emergency Relief Project Grants $19,018
93.172 Human Genome Research $18,847
93.RD Group A Streptococcus Molecular Epidemiology and Ecology $17,953
93.110 Maternal and Child Health Federal Consolidated Programs $17,452
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $17,134
93.865 Child Health and Human Development Extramural Research $16,985
93.315 Rare Disorders: Research, Surveillance, Health Promotion, and Education $16,542
93.RD Development and Psychometric Testing of A Pediatric Chronic Graft-Versus-Host Disease (gvhd) Symptom Scale (pcss) $15,244
93.989 International Research and Research Training $13,670
93.350 National Center for Advancing Translational Sciences $10,318
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $9,969
93.837 Cardiovascular Diseases Research $9,846
93.310 Trans-Nih Research Support $9,332
93.396 Cancer Biology Research $8,917
93.RD Pop02: Pharmacokinetics, Pharmacodynamics, and Safety Profile of Understudied Drugs Administered to Children Per Standard of Care $8,749
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $7,130
93.283 Centers for Disease Control and Prevention_investigations and Technical Assistance $6,450
93.273 Alcohol Research Programs $6,421
93.RD Afm Natural History Study: A Prospective Study of Acute Flaccid Myelitis (afm) to Define Natural History, Risk, and Pathogenetic Mechanisms (dmid19-0005) $4,441
93.884 Grants for Primary Care Training and Enhancement $3,799
93.395 Cancer Treatment Research $2,300
93.RD Bpca Data Closeout and Dissemination $1,395
93.940 Hiv Prevention Activities_health Department Based $1,386
93.268 Immunization Cooperative Agreements $787
93.399 Cancer Control $760
12.420 Military Medical Research and Development $581
93.994 Maternal and Child Health Services Block Grant to the States $325
93.RD Comparative Safety of Complex Feeding Device Types Among Nicu Graduates $215
27.011 Intergovernmental Personnel Act (ipa) Mobility Program $204
93.867 Vision Research $139
93.855 Allergy, Immunology and Transplantation Research $106
93.136 Injury Prevention and Control Research and State and Community Based Programs $61
93.397 Cancer Centers Support Grants $-84
93.266 Health Systems Strengthening and Hiv/aids Prevention, Care and Treatment Under the President's Emergency Plan for Aids Relief $-183
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $-229
93.879 Medical Library Assistance $-267
93.393 Cancer Cause and Prevention Research $-1,606
93.939 Hiv Prevention Activities_non-Governmental Organization Based $-3,459