Finding 582133 (2021-004)

Material Weakness
Requirement
BL
Questioned Costs
$1
Year
2021
Accepted
2023-12-20
Audit: 7666
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Hospital inaccurately reported lost revenue for the COVID-19 Provider Relief Fund due to using an incorrect budget period for calculations.
  • Impacted Requirements: Reporting requirements under 45 CFR 75.342 and cost principles from the CARES Act mandate accurate financial reporting and internal controls.
  • Recommended Follow-Up: The Hospital should enhance its understanding of reporting guidelines and strengthen internal controls for future submissions.

Finding Text

2021-004 Finding: Allowable Costs/Cost Principles and Reporting U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution - 93.498 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). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease (COVID-19). Entities that received more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, management is responsible for establishing and maintaining effective internal controls over costs directly and indirectly charged to federal awards. Condition – The Hospital is required to prepare and submit period one PRF reporting to the U.S. Department of Health and Human Services. This report is to be prepared using accurate financial information; however, the Hospital incorrectly reported lost revenue for Period 1. Questioned Costs – Unknown Context – We tested the Period 1 PRF report submitted by the Hospital and total lost revenue calculation. The Hospital elected to use lost revenue calculation Option II, Budget to Actual. Option II requires that an approved budget prior to March 27, 2020, which covers the entire period of availability, be utilized to calculate lost revenues. While the budget period relating to calendar year 2020 was approved prior to March 27, 2020, the budget period relating to calendar year 2021 was approved subsequent to March 27, 2020. Thus, the budget approved prior to March 27, 2020 did not cover the entire period of availability and the budget relating to calendar year 2021 was not approved within required time parameters. Effect – The Hospital claimed and reported lost revenues under the PRF program that are not within the framework prescribed with selecting Option II - Budget to Actual. Cause – The Hospital selected Option II - Budget to Actual and should have selected Option III - Alternative Reasonable Method of estimating revenues because the budget period related to calendar year 2021 was not approved by March 27, 2020. Internal controls were not in place to ensure the Hospital correctly applied the guidance. Identification as a Repeat Finding – Not applicable. Recommendation – The Hospital should continue to improve understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions – The Hospital agrees with this finding. See separate auditee document for planned corrective action.

Categories

Questioned Costs Allowable Costs / Cost Principles Cash Management Reporting

Other Findings in this Audit

  • 5691 2021-004
    Material Weakness
  • 5692 2021-005
    Significant Deficiency
  • 582134 2021-005
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $11.52M
93.498 Provider Relief Fund $4.50M
93.697 Covid-19 Testing for Rural Health Clinics $597,846
21.019 Coronavirus Relief Fund $161,327
93.107 Area Health Education Centers Point of Service Maintenance and Enhancement Awards $144,026
93.301 Small Rural Hospital Improvement Grant Program $10,833
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $8,000