Finding 615225 (2022-001)

Significant Deficiency Repeat Finding
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-09-13
Audit: 44142
Organization: Stamford Health, Inc. (CT)

AI Summary

  • Core Issue: Stamford Health used an incorrect budget for calculating lost revenue in the PRF portal, violating reporting requirements.
  • Impacted Requirements: Internal controls must ensure compliance with federal guidelines for reporting lost revenue, specifically using budgets approved before March 27, 2020.
  • Recommended Follow-Up: Stamford Health should enhance its controls to align the reporting method in the PRF portal with the actual lost revenue calculation methodology.

Finding Text

Finding 2022 ? 001 Reporting Identification of the Federal Program: Grantor: Department of Health and Human Services Program Name: COVID-19 ? Provider Relief Fund Assistance Listing No.: 93.498 Criteria or Specific Requirement Title 2, Subtitle A Chapter II Part 200 Subpart D Section 200.303 of the Uniform Guidance states the following regarding internal control: ?The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in ?Standards for Internal Control in the Federal Government? issued by the Comptroller General of the United States or the ?Internal Control Integrated Framework?, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).? The terms and conditions for the award requires the recipient to submit reports as the Secretary of HHS determines are needed to ensure compliance with conditions that are imposed on the payment and such reports shall be in such form, with such content, as specified by the Secretary of HHS in future program instructions directed to all recipients. Condition: Stamford Health used Option II (2020 Budgeted Revenue Lost Revenues Reporting Model) in the PRF portal submission which requires the calculation of lost revenue as the difference between budgeted and actual patient care revenues using a budget approved before March 27, 2020. Stamford Health inappropriately used the 2021 and 2022 budget, approved in September of 2020 and 2021, to calculate lost revenue during PRF Reporting Period 2. Cause: The control performed to verify that the lost revenue reporting method selected in the PRF portal submission was consistent with the methodology used in calculating lost revenue was not sufficient. Effect or Potential Effect: Stamford Health selected a lost revenue reporting method that was inconsistent with the methodology utilized to calculate its lost revenue. Questioned Costs: There are no questioned costs related to this finding and no impact to amounts received or retained by Stamford Health. Context: In review of the lost revenue calculation, it was determined that a budget approved subsequent to March 27, 2020 was used in the lost revenue calculation. The method utilized to calculate lost revenue is allowable, however the incorrect method was selected in the PRF portal submission. Recommendation: Stamford Health should refine its controls to ensure that lost revenue reporting method selected within the PRF portal submission is consistent with the methodology utilized to calculate lost revenue. Views of Responsible Officials: Management concurs with the audit finding. Management has refined its controls to ensure the lost revenue reporting method selected in the PRF portal submission is consistent with the methodology utilized to calculate lost revenue.

Categories

Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 38783 2022-001
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $9.06M
93.461 Claims Reimbursement for the Uninsured Program $283,732
93.994 Maternal and Child Health Services Block Grant to the States $144,975
93.914 Hiv Emergency Relief Project Grants $61,793
93.268 Immunization Cooperative Agreements $19,689