Finding 970271 (2021-003)

Material Weakness
Requirement
ABL
Questioned Costs
$1
Year
2021
Accepted
2024-04-19

AI Summary

  • Core Issue: The Hospital reported expenditures to HRSA that did not comply with federal requirements, leading to overstated costs.
  • Impacted Requirements: Expenses were not reduced by the Medicare cost reimbursement percentage, resulting in questioned costs of $680,482.
  • Recommended Follow-Up: The Hospital should establish clear internal controls for accurate reporting and review of program expenditures before submission.

Finding Text

Federal Program – COVID-19 – Provider Relief Fund, ALN 93.498, Award Year 2021 Criteria or Specific Requirement – Activities Allowed/Allowable Costs and Reporting– Pub. L. No. 116-136, 134 Stat. 563 Condition – Expenditures reported to HRSA were not in accordance with Pub. L. No. 116-136, 134 Stat. 563. Questioned Costs – $674,508 was the amount of expenses determined to be overreported to the federal program due to failure to reduce expenses by the Hospital’s Medicare cost reimbursement percentage. This was calculated by multiplying total Provider Relief Fund expenses reported to HRSA for Period 1 ($1,258,957) by the Hospital’s Medicare cost reimbursement percentage (50.73%). Additionally, $5,974 was the amount determined to be over-reported to the federal program due to the inclusion of an expense for which the Hospital received a credit from the vendor. This was calculated by taking the difference between the expense used in reporting adjusted for the Medicare cost reimbursement percentage and the actual expense adjusted for the Medicare cost reimbursement percentage. Additionally, the lack of review, reconciliation, and detailed record-keeping resulted in the Hospital’s inability to provide a detailed listing of all expenses reported to HRSA. Context – The Hospital did not reduce expenses included in the Hospital’s portal submission by its Medicare cost reimbursement percentage resulting in a testing population that did not agree to expenses reported. At least one expense included in the testing population was not reduced by a credit received from the vendor. Effect – Expenditures reported to HRSA were overstated. Cause – The Hospital did not have effective internal control processes in place to ensure the accurate review and reporting of program expenditures. Changes to frequently asked questions and guidance from HRSA and management’s inexperience with the program requirements resulted in an error of expenditures under the program. Identification as a Repeat Finding, if Applicable – N/A Recommendation – The Hospital should implement documented internal control processes specific to understanding the reporting of program expenditures, including review and oversight of data uploads prior to submission. Views of Responsible Officials and Planned Corrective Actions – The Hospital will continue to monitor the Department of Health and Human Resources Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements and the most recently distributed Provider Relief Fund frequently asked questions, which provide details on requirements related to the program, including further updates as they may occur.

Categories

Questioned Costs Internal Control / Segregation of Duties Allowable Costs / Cost Principles Cash Management Reporting Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 393828 2021-002
    Material Weakness
  • 393829 2021-003
    Material Weakness
  • 970270 2021-002
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $2.78M
93.889 National Bioterrorism Hospital Preparedness Program $11,446
93.301 Small Rural Hospital Improvement Grant Program $10,077