Finding 966580 (2023-002)

Material Weakness
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2024-03-29
Audit: 301031
Organization: Barnes-Kasson County Hospital (PA)

AI Summary

  • Core Issue: The Hospital failed to report lost revenues accurately, leading to an understatement of $1,020,030.
  • Impacted Requirements: Non-compliance with 2 CFR 200.303(a) and U.S. Department of Health and Human Services guidance on PRF reporting.
  • Recommended Follow-Up: Management should establish procedures to ensure proper review of guidance and accurate reporting of lost revenues before submission.

Finding Text

Finding 2023-001: Material Weakness in Internal Controls over Compliance – Reporting Lost Revenues Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number: 93.498 Award Number: N/A Award Year: 2022/2023 Federal Agency: U.S. Department of Health and Human Services Passed-Through Agency: N/A Questioned Costs: None Noted Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) payments must be used for allowable expenses and lost revenue described in the PRF terms and conditions and specified in guidance issued by the U.S. Department of Health and Human Services. Activities allowed have been defined as expense used to prevent, prepare for, and respond to coronavirus, domestically or internationally, for necessary expenses to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Additionally, all recipients of PRF payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition/Context: The Hospital did not complete the PRF reporting in accordance with the U.S. Department of Health and Human Services guidance. We noted that the Hospital erroneously entered information into the lost revenue calculation, resulting in lost revenues being understated $1,020,030. The Hospital reported lost revenues amounting to $999,172 on distributions totaling $1,177,041. The Hospital had excess lost revenues from previous periods available to be used through June 30, 2023 amounting to $5,406,884. The Hospital also reported expenses of $907,051. Cause: The Hospital's review was inadequate. Effect: The amounts reported to HRSA were not in accordance with established U.S. Department of Health and Human Services guidance. Recommendation: We recommend that management implement procedures to ensure that the most recent guidance is reviewed and understood, and that information used in accumulating allowable lost revenues is reviewed, with errors addressed prior to submission. Views of Responsible Officials: The Hospital agrees with the finding.

Categories

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

Other Findings in this Audit

  • 390138 2023-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $1.18M
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $45,253
32.006 Covid-19 Telehealth Program $9,990