Finding 964116 (2023-001)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-03-28
Audit: 299747
Organization: Ohiohealth Corporation (OH)

AI Summary

  • Core Issue: The Corporation failed to follow HHS guidelines for reporting lost revenue, leading to incorrect submissions in Period 4.
  • Impacted Requirements: Compliance with the Provider Relief Fund reporting requirements, specifically regarding the calculation of lost revenue based on net charges from patient care.
  • Recommended Follow-up: Implement enhanced review controls to ensure accurate reporting and adherence to HHS guidelines in future submissions.

Finding Text

Assistance Listing. Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services (HHS), COVID-19: Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Federal Award Identification Number and Year - N/A Pass-through Entity - N/A - Direct funded Finding Type - Material weakness and material noncompliance with laws and regulations Repeat Finding - No Criteria - Per the Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements dated April 7, 2023, recipients must meet compliance with reporting requirements as outlined in the Terms and Conditions of the funding received. The Terms and Conditions require that the funding recipient certify that it will not use the payments received to reimburse it for expenses or losses that have been reimbursed from other sources, or that other sources are obligated to reimburse. In addition, the Terms and Conditions state that net charges from patient care are to be used to calculate lost revenue amounts reported by quarter. Condition - The Corporation's controls in place for reporting submissions did not identify that the General and Targeted Distribution Post-Payment Notice of Reporting Requirements guidelines were not followed related to certain reported lost revenue amounts in the Corporation’s Period 4 portal submissions. In addition, the Corporation's controls in place did not identify that lost revenue amounts for one subsidiary were reported at gross charges from patient care (compared to recording these amounts at net charges from patient care). Questioned Costs - None Identification of How Questioned Costs Were Computed - N/A Context - The single audit for the Corporation included four portal submissions related to funding received in Period 4. As a result of the funding received, the Organization was required to attest to the applicable expenses and lost revenues incurred, which are defined by HHS, as noted in the criteria above. In two Period 4 portal submissions, available lost revenue amounts reported by the Corporation were duplicated, resulting in approximately $58.2 million of lost revenue for one subsidiary being reported on two separate Period 4 portal submissions. In addition, the lost revenue amounts for one subsidiary were incorrectly reported at gross patient service revenues. This resulted in the reporting of approximately S6.4 million of lost revenue during the period of availability. The correct amount of lost revenues to be reported by the organization should have been $1.6 million. Cause and Effect - Appropriate review of the reporting submissions was not completed to ensure the reports followed required guidelines. As a result, the Corporation reported incorrect totals for lost revenue for the period 4 portal submissions. Recommendation - We recommended that the Corporation implement controls, including levels of review, to ensure that reports are completed and submitted in accordance with the guidelines established by HHS. Views of Responsible Officials and Corrective Action Plan - The Corporation will review its processes surrounding the methodologies used to report lost revenue and will implement additional levels of review to ensure that the proper lost revenue amounts are used in future reporting periods.

Categories

Subrecipient Monitoring Material Weakness Reporting

Other Findings in this Audit

  • 387674 2023-001
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Covid-19 - Provider Relief Fund and American Rescue Plan Rural Distribution $55.05M
93.732 Mental and Behavioral Health Education and Training Grants $515,141
93.011 National Organizations of State and Local Officials $374,643
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $337,318
16.575 Crime Victim Assistance $223,308
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $220,541
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $136,395
93.155 Rural Health Research Centers $103,509
32.006 Covid-19 - Telehealth Program $87,708
16.738 Edward Byrne Memorial Justice Assistance Grant Program $30,666
93.788 Opioid Str $30,564
93.889 National Bioterrorism Hospital Preparedness Program $25,887
16.588 Violence Against Women Formula Grants $22,804
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $22,365
21.027 Covid-19 Coronavirus State and Local Fiscal Recovery Funds $10,411
93.991 Preventive Health and Health Services Block Grant $10,000
93.136 Injury Prevention and Control Research and State and Community Based Programs $290
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $278