Finding 634928 (2022-007)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-09-28
Audit: 54656
Organization: Regional West Health Services (NE)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: RWHS inaccurately calculated lost revenue by using projected payor deductions instead of actual deductions, violating federal award terms.
  • Impacted Requirements: Internal controls over federal awards must ensure compliance with 2 CFR 200.303(a) regarding accurate financial reporting.
  • Recommended Follow-Up: Enhance internal control processes to ensure future lost revenue calculations align with federal program requirements.

Finding Text

Identification of the Federal Program: U.S. Department of Health and Human Services ? COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Distribution ? 93.498 Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: RWHS selected option I to calculate lost revenue for its subsidiary, which consists of reporting quarterly net revenue by payor during the period of availability. Net revenue was determined by projecting payor deductions instead of using actual deductions as required by the terms and conditions of the award. Cause: RWHS did not have an effective internal control process in place to ensure review and approval of the lost revenue calculation claimed under the federal program and the use of option I was accurate and in accordance with the terms and conditions of the federal award. Effect: The reporting to HHS for Period 4 was considered incorrect. Quarterly amounts reported were not based on actual net revenue by payor. Questioned Costs: None reported. Context: Key line items were tested on the Period 4 PRF report. Repeat Finding from Prior Year: No Recommendation: We recommend RWHS enhance its existing internal control processes to ensure the lost revenue calculation claimed meets the requirements of the federal program. Views of Responsible Officials: Management agrees with the noted finding and will continue to refine processes to more diligently review the lost revenue calculation to ensure such amounts are in accordance with the terms and conditions of the federal award.

Categories

Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 58484 2022-005
    Material Weakness
  • 58485 2022-006
    Material Weakness
  • 58486 2022-007
    Material Weakness
  • 634926 2022-005
    Material Weakness
  • 634927 2022-006
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $5.90M
93.697 Testing for Rural Health Clinics $149,462
93.461 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $123