Finding Text
2023-001
Programs: COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution
CFDA Number: 93.498
Federal Agencies: U.S. Department of Health and Human Services
Passed-Through Entities: N/A
Award Number: N/A
Award Year: Various
Compliance Requirement: Reporting
Questioned Costs: None
Criteria: As required by the Provider Relief Fund Distributions and American Rescue Plan Rural Distribution Post-Payment Notice of Reporting Requirements, when referring to revenues from patient care for the purposes of the calculation of lost revenues attributable to COVID-19 patient care was defined as: ““Patient care” means health care, services, and supports, as provided in a medical setting, at home/telehealth, or in the community. It should not include non-patient care revenue such as insurance, retail, or real estate revenues (exception for nursing and assisted living facilities’ real estate revenues where resident fees are allowable); prescription sales revenues (exception when derived through the 340B program); grants or tuition; contractual adjustments from all third-party payors; charity care adjustments; bad debt; and any gains and/or losses on investments.”
Condition and Context: The Medical Center elected to use the Lost Revenues Reporting Method of comparing 2019 actual revenue to 2020-2022 actual revenue. When preparing the calculation, the Medical Center excluded certain reimbursement settlement accounts during 2020-2021. This was corrected beginning January 2022 and forward, but previous quarters were not adjusted.
Cause: The Medical Center erroneously omitted the related settlement general ledger accounts when financial data by the payor was compiled for the lost revenue calculations for 2020 and 2021.
Effect: The Medical Center has misstated the lost revenues when reporting the revenues within the Health Resources and Services Administration ("HRSA") reporting portal. However, the Medical Center does have sufficient expenditures and eligible lost revenues to recognize all funding received in the reporting period.
Recommendation: Management should adjust the internal lost revenue calculations to address the item noted above. In the event the Medical Center receives a request from the federal agency or another party to audit the use of the funds, the most accurate and up-to-date information should be available to support the use of the funds.
View of Responsible Official: The Medical Center agrees with this finding.