Finding 580463 (2023-004)

Provider Relief Fund and American Rescue Plan Rural Distribution Assistance Listing No. 93.498 U.S. Department of Heath and Human Services Criteria or Specific Requirement – 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). The Hospital is required to ensure funding is only used to prevent, prepare for , and respond to conronavirus and COVID-19. Condition – The Hospital reported COVID-19-related expenditures within the HHS Provider Relief Fund (PRF) portal that did not have supporting documentation showing expenditures were related to the prevention, preperation or response to COVID-19. Questioned Costs – $1,144 Context – The Hospital did not retain supporting documentation for certain expenses showing their relation to the prevention, preperation or response to COVID-19. We tested a random sample of 40 expenditures reported under the PRF program from a total of 290 expenditures. Four expenditures in the amount of $1,910 out of the sample of 40 expenditures did not have supporting documentation. Effect – The Hospital reported expenses that did not have support necessary to demonstrate the expenses were reasonably related to the prevention, preparation or response to COVID-19. Cause – Internal controls and grant-related expense review processes were not in place to ensure support was retained for expenditures report and that expendiutres were not obligated to be reimbursed by other sources. Identification as a Repeat Finding – Not applicable Recommendation – Policies and procedures over federal grant reporting and grant management should be modified to ensure expenditures are allowable with supporting documentation retained. View of Responsible Officials and Planned Corrective Actions – Managment considers the expenditures reported to be in compliance with program regulations. Management agrees with the finding that additional supporting documentation should be retained. Going forward, for subsequent reporting periods related to the Provider Relief Fund and American Rescue Plan Rural Distribution management will implement controls to ensure all underlying support related to expenses is documented and retained.