Finding 623741 (2022-001)

Significant Deficiency Repeat Finding
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-04-19
Audit: 51531
Organization: Henry County Medical Center (TN)
Auditor: Lbmc PC

AI Summary

  • Core Issue: The Medical Center miscalculated lost revenues by excluding certain reimbursement settlement accounts in their reporting.
  • Impacted Requirements: Compliance with the Provider Relief Fund reporting requirements was not met, leading to inaccurate revenue reporting.
  • Recommended Follow-Up: Update policies for federal grant reporting to ensure accuracy and completeness, and adjust future lost revenue calculations accordingly.

Finding Text

2022-001 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 General and Targeted Distribution Post-Payment Notice of Reporting Requirements, issued on June 11, 2021, 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 support, 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 actual revenue. When preparing the calculation, the Medical Center excluded certain reimbursement settlement accounts. Cause: The Medical Center erroneously omitted the related settlement general ledger accounts when financial data by payor was compiled for the lost revenue calculations. 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 compliant lost revenues to recognize all funding received in the reporting period. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Management should also consider adjusting lost revenue calculations in future HRSA reporting periods. View of Responsible Official: The Medical Center agrees with this finding.

Categories

Cash Management Reporting

Other Findings in this Audit

  • 47299 2022-001
    Significant Deficiency Repeat
  • 47300 2022-002
    Significant Deficiency Repeat
  • 623742 2022-002
    Significant Deficiency Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $5.33M
21.027 Coronavirus State and Local Fiscal Recovery Funds $1.30M
93.461 Covid-19 Testing for the Uninsured $518,503
21.019 Coronavirus Relief Fund $437,928
93.155 Rural Health Research Centers $294,369
93.697 Covid-19 Testing for Rural Health Clinics $69,669
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $53,980