Finding 960083 (2022-003)

Material Weakness Repeat Finding
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2024-03-22
Audit: 296676
Organization: Daviess Community Hospital (IN)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Hospital inaccurately calculated and reported lost revenues for the COVID-19 Provider Relief Fund during reporting Periods 3 and 4.
  • Impacted Requirements: Internal controls were insufficient, failing to ensure compliance with 2 CFR 200.303(a) and HRSA guidance on revenue calculations.
  • Recommended Follow-Up: The Hospital should reassess lost revenues according to HRSA guidelines and prepare a revised calculation for potential review.

Finding Text

Federal Program Name: COVID – 19 Provider Relief Fund (PRF) Federal Agency: U.S. Department of Health and Human Services Federal Assistance Listing Title and Number: COVID-19 Provider Relief Fund, 93.498 Criteria or Specific Requirement: Reporting - 2 CFR 200.303(a) requires a non-Federal entity to establish and maintain effective internal control over Federal awards 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. Also, per the terms and conditions of the Provider Relief Fund, amounts are to be used to prevent, prepare for, and respond to coronavirus and payments shall only be used to reimburse the Hospital for health care related expenses or lost revenues that are attributable to coronavirus. Condition: Lost revenues attributable to COVID-19 were not properly calculated and reported for Provider Relief Fund Portal reporting Period 3 and 4. Questioned Costs: None Context: The Hospital reported lost revenues using the actual revenues for 2022 compared to actual revenues for 2019. During specific quarters in Period 3 and 4 reporting, the Hospital did not include all patient revenues including those from the nursing home supplemental payment program in its calculation of lost revenues. This presentation did not conform with guidance published by the Health Resources and Services Administration (HRSA). Errors were identified by reconciling figures to underlying financial information. Effect: The Hospital did not properly calculate, and report lost revenues. Cause: Internal controls surrounding the review and submission of required reports were not adequately applied to ensure accuracy of required elements. Repeat Findings: Yes Recommendation: We recommend the Hospital evaluate lost revenues under published HRSA guidance and prepare a revised calculation that can be provided, if necessary, upon any further review. Views of Responsible Officials and Planned Corrective Action: We concur. When evaluating all uses of Provider Relief Funds, we have adequate expenses and lost revenues to support funding reported without consideration to the lost revenues reported in Period 3 and 4.

Categories

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

Other Findings in this Audit

  • 383641 2022-003
    Material Weakness Repeat
  • 383642 2022-004
    Significant Deficiency
  • 960084 2022-004
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 - Provider Relief Fund $6.66M
93.788 Opioid Str $314,030
93.155 Covid-19 - Rural Health Research Centers $252,916
93.926 Healthy Start Initiative $244,614
93.323 Covid-19 - Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $53,000
93.959 Block Grants for Prevention and Treatment of Substance Abuse $18,500