Finding 946574 (2022-003)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2022
Accepted
2024-02-22

AI Summary

  • Core Issue: The Hospital miscalculated lost revenues for Period 4 by not including Medicaid supplemental payments, leading to an overstatement of $425,207.
  • Impacted Requirements: Internal controls over compliance and accurate financial reporting to HHS were inadequate, increasing the risk of incorrect submissions.
  • Recommended Follow-Up: The Hospital should enhance its internal controls and review processes to ensure accurate reporting in line with federal requirements.

Finding Text

2022-003 - Material Weakness in Internal Control over Compliance Finding Federal agency: U.S. Department of Health and Human Services (HHS) Federal program title: COVID-19 Provider Relief Fund (PRF) - Period 4 Assistance Listing No.: 93.498 Criteria: Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act and are to be used to prevent, prepare for, and respond to coronavirus. Recipients are required to establish and maintain effective internal control over the federal award and to report use of funds to HHS through the Health Resources and Services Administration (HRSA) Reporting Portal. The reporting is to be prepared using accurate financial information and be in accordance with reporting requirements. Condition: The Hospital elected to report Period 4 lost revenues utilizing Option 3, the alternative method of calculating lost revenues attributable to coronavirus. The Hospital’s alternative method did not consider the impact of Medicaid supplemental payments recognized to revenue for 2022 Quarter 1. Cause: The established internal controls did not consider the appropriate grouping of Medicaid supplemental payments when calculating Total Revenue/Net Charges from Patient Care. Effect: The lack of adequate policies governing report preparation and submission increases the risk that the report could be filed incorrectly. Questioned Costs: 2022 Quarter 1 Lost Revenue was overstated by $425,207. However, the Hospital’s Period 4 portal submission reflects $1,988,424 of remaining unused lost revenues that management believes could offset the identified questioned costs. Recommendation: We recommend the Hospital continue to design and implement controls, including levels of review, to ensure reporting is prepared using accurate financial information and in accordance with reporting requirements. Views of Responsible Officials of the Auditee: The Hospital agrees with this finding. See management’s corrective action plan.

Categories

Questioned Costs Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 370132 2022-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
40.038 Disaster Grants - Public Assistance $812,196
93.498 Provider Relief Fund $586,120
10.766 Community Facilities Loans and Grants $428,770
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $91,076
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $61,446
93.461 Covid-19 Testing for the Uninsured $24,829
93.301 Small Rural Hospital Improvement Grant Program $12,836