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2022-001: Provider Relief Fund Reporting Cluster: Not applicable Federal Granting Agency: DHHS Health Resources and Services Administration (?HRSA?) Award Name: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Assistance Listing Title: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year: January 1, 2020 ? December 31, 2022 Criteria Step 13 ? Lost Revenues of the HRSA User Guide for Provider Relief Fund (PRF) Reporting Portal ? Reporting dated June 30, 2022 requires Reporting entities (recipients) that apply PRF payments toward lost revenues to use one of the following three options for calculating lost revenues: ? Option (i): difference between 2019 actual patient care revenues and actuals for each quarter during the period of availability; ? Option (ii): difference between budgeted and actual patient care revenues for each quarter during the period of availability; or ? Option (iii): any reasonable method of estimating revenues. Per the HRSA User Guide, recipients that select Option (ii) must submit documentation of budgets approved prior to March 27, 2020 that covers the entire period of availability. Condition The Hospital completed its Period 3 PRF Reporting Portal submissions and attested to calculating lost revenues using Option (ii). However, in order to use this option, budgets covering the entire period of availability (January 1, 2020 to December 31, 2022) were required to be approved prior to March 27, 2020. While the budget of the Hospital for the year ended December 31, 2020 was approved prior to this date, budgets for the remaining period of availability (calendar years 2021 and 2022) were not approved prior to March 27, 2020. Cause The Hospital?s budgets for the years ended December 31, 2021 and 2022 were not approved prior to March 27, 2020. Effect The Hospital?s selection of Option (ii) to calculate lost revenue in accordance with the June 11, 2021 PRF General and Targeted Distribution Post-Payment Notice of Reporting Requirements was not appropriate for its Period 3 PRF Reporting Portal Submission. The amount of lost revenues reported as the difference between budgeted and actual patient care revenues for the year ended December 31, 2020 were far in excess of the funds received (both in Period 3 and cumulatively to date through Period 3). Questioned Costs None noted. Recommendation: We recommend management design and implement an internal control around review of HRSA guidance and the subsequent submissions in order to ensure proper review of all elements of the relevant guidance prior to submission to the portal. Additionally, we recommend the Hospital contact HRSA to determine any required corrective actions related to the incorrect reporting and correct the error on all future submissions Management?s Views and Corrective Action Plan Management?s response is included in ?Management?s Views and Corrective Action Plan? included at the end of this report.