Finding 943828 (2022-006)

Material Weakness
Requirement
L
Questioned Costs
$1
Year
2022
Accepted
2024-02-14

AI Summary

  • Core Issue: The Medical Center's change in lost revenue calculation methodology for Period 4 led to a $1,491,516 shortfall in reported revenues for Period 1.
  • Impacted Requirements: Compliance with Provider Relief Fund reporting requirements was violated, resulting in $1,038,921 in questioned costs due to unused funds.
  • Recommended Follow-Up: Strengthen policies and procedures for federal grant reporting to ensure accurate calculations and review processes for lost revenues.

Finding Text

2022-006 Period 1 revised lost revenue calculation Identification: 93.498 United States Department of Health and Human Services, Provider Relief Fund; Noncompliance Finding/Material Weakness; Reporting Compliance Requirement Criteria: The Provider Relief Fund (PRF) was established under the Coronavirus, Aid, Relief, and Economic Security Act (Pub. L. No. 116‐136, 134 Stat. 563) and the Coronavirus Relief and Response Supplemental Appropriations Act (Pub. L. No. 116‐260). Eligible health care providers received PRF appropriations for health care related expenses or lost revenues attributable to coronavirus. Recipients who received one or more payments exceeding $10,000 are required to report in each applicable reporting period. Condition: The Medical Center elected to calculate lost revenues under option iii, "Alternate Reasonable Methodology" for the Period 1 and the Period 4 reporting submissions. The Medical Center, however, changed the methodology for calculating lost revenues for the Period 4 reporting submission. The change in the methodology resulted in the revenues reported for the Period 1 (January 1, 2020 through June 30, 2021) to be $1,491,516 lower than what was needed to cover the total funding received for the Period 1 when combined with the healthcare related expenses for Period 1. Cause: The Medical Center did not review the total revised lost revenues for Period 1 to ensure that the change in methodology for the calculation of lost revenues resulted in an amount equal to or greater than what was reported and needed to cover the Period 1 funding received. Effect: The Medical Center changed its lost revenue calculation for Period 1 which resulted in $1,491,516 in unused Period 1 funds. Questioned Costs: Known $1,038,921. The reported lost revenue computation for Period 1 was changed which resulted in $1,491,516 of unused Period 1 provider relief funds. When you net the $452,595 understatement error in the lost revenue calculation noted in 2022-005, it results in $1,038,921 in unused Period 1 funds. Perspective Information: We tested the information reported for Period 1 within the Period 4 reporting submission to supporting documentation to determine if the report was calculated based on underlying accounting data. Repeat Finding: This finding was not reported in previous year. Recommendations: We recommend policies and procedures over federal grant reporting to be strengthened to ensure that changes in the methodology for the calculation of lost revenues results in total lost revenues equal to or greater than what was reported and needed to cover prior funding received. Views of Responsible Officials: The Medical Center experienced turnover in key accounting personnel during the month leading up to the deadline for the Period 4 reporting submission. It was not the intent of management to change Period 1 reporting methodology, however, we encountered difficulties in transitioning the PRF accounting from the prior CFO to the interim CFO. Prior to completing future submissions, we will implement a procedure to double check the computations and review revised lost revenue calculations for prior reporting periods.

Categories

Questioned Costs Material Weakness Reporting

Other Findings in this Audit

  • 367384 2022-004
    Material Weakness
  • 367385 2022-005
    Material Weakness Repeat
  • 367386 2022-006
    Material Weakness
  • 943826 2022-004
    Material Weakness
  • 943827 2022-005
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $1.90M
93.461 Covid-19 Testing for the Uninsured $215,284
10.766 Community Facilities Loans and Grants $142,352
93.994 Maternal and Child Health Services Block Grant to the States $36,301