Finding 576843 (2023-001)

Significant Deficiency Repeat Finding
Requirement
ABL
Questioned Costs
-
Year
2023
Accepted
2023-10-19
Audit: 836
Organization: Community Health Care, Inc. (IA)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Organization failed to accurately report lost revenues for dental and pediatric services in the Provider Relief Fund report.
  • Impacted Requirements: Reporting must adhere to 45 CFR 75.342 and related cost principles, ensuring accurate financial information is submitted by deadlines.
  • Recommended Follow-Up: Revise internal allocation processes, particularly for Iowa Medicaid wrap payments, to ensure accurate reporting across all service lines.

Finding Text

Provider Relief Fund and American Rescue Plan Act (ARP) Rural Distribution Federal Assistance Listing No. 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 four Provider Relief Funding Reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs – Unknown Context – The period four Provider Relief Fund report was tested. The Organization selected option three to report lost revenues based on quarterly actual results of the dental and pediatrics service lines. The Organization did not account for the Iowa Medicaid wraparound payments within the 2020, 2021, and 2022 quarters. After including these amounts in a subsequent evaluation, the Organization was able to demonstrate the error did not affect its ability to fully obligate the distributions received based on the proposed methodology. Effect – The lost revenue reported did not fully reflect the Organization’s activities within the dental and pediatric service lines. Cause – Nine of fifteen attributes tested that disclose lost revenues for the dental and pediatric service lines were inconsistent with the audited financial results of those service lines. Identification As a Repeat Finding – Repeat finding 2022-001. Recommendation - The Organization should revise its internal allocation processes, specifically the Iowa Medicaid wrap payment mechanism, to ensure activity is fully and accurately reported across departments and activities at the health center.

Categories

Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 401 2023-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $3.56M
93.224 American Rescue Plan Act Funding for Health Centers $1.53M
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.17M
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $883,826
93.498 Provider Relief Fund $849,803
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $849,037
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $275,762
93.224 Capital Assistance for Disaster Response and Recovery Efforts $198,988
93.217 Family Planning_services $188,182
93.268 Immunization Cooperative Agreements $125,537
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $102,856
93.224 Health Center Program Service Expansion - School Based Service Sites $63,877
93.800 Organized Approaches to Increase Colorectal Cancer Screening $57,244
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $44,080
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $29,643
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $13,750
93.224 Fy 2023 Expanding Covid-19 Vaccination $13,383
93.778 Medical Assistance Program $10,500
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $10,000
93.461 Covid-19 Testing for the Uninsured $-39,159