Finding 974609 (2023-001)

Significant Deficiency
Requirement
ABL
Questioned Costs
$1
Year
2023
Accepted
2024-05-22
Audit: 306883
Organization: Coxhealth (MO)
Auditor: Forvis LLP

AI Summary

  • Core Issue: The Health System inaccurately reported lost revenues for Provider Relief Funds, affecting compliance with DHHS requirements.
  • Impacted Requirements: Reports must be based on accurate financial data and submitted on time, as outlined in federal regulations.
  • Recommended Follow-Up: Update policies and procedures to ensure accurate and complete reporting for federal grants.

Finding Text

Provider Relief Funds CFDA No. 93.498 U.S. Department of Health and Human Services (DHHS) Criteria or Specific Requirement – Activities Allowed/Unallowed and Allowable Costs/Cost Principles (Pub. L No 116-136, 134 Stat. 563 and Pub L. No 116-139, 134 Stat. 622 and 623) and Reporting (45 CFR 75.342) Condition – The Health System is required to prepare and submit period 4 provider relief fund reporting. These reports are to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs – $326,960 Context – The Health System was required to submit 5 period 4 provider relief fund reports. We selected all reports to be tested. The Health System selected option iii to report lost revenues based on DHHS' alternative method. Amounts reported for 9 our of 70 attributes tested in the 5 period 4 provider relief fund reports were not calculated accurately. Effect – The Health System's reporting of lost revenues to DHHS for Period 4 was not prepared in accordance with the requirements determined by DHHS. When these errors are considered, the Health System's total provider relief fund payments applied to lost revenues did not change from what was originally reported in period 4 for four out of five reports filed. Cause – The Health System included certain general ledger accounts in their calculation of lost revenues that did not meet DHHS' definition of patient service revenue. Identification as a repeat finding – Not a repeat finding. Recommendation – Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information.

Categories

Questioned Costs Allowable Costs / Cost Principles Reporting

Other Findings in this Audit

  • 398167 2023-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $25.09M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $24.96M
84.268 Federal Direct Student Loans $6.72M
84.063 Federal Pell Grant Program $1.08M
84.425 Education Stabilization Fund $628,282
32.006 Covid-19 Telehealth Program $553,551
93.884 Grants for Primary Care Training and Enhancement $416,959
93.211 Telehealth Programs $325,402
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $179,634
16.575 Crime Victim Assistance $114,396
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $58,418
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $55,300
84.007 Federal Supplemental Educational Opportunity Grants $43,200
21.027 Coronavirus State and Local Fiscal Recovery Funds $39,249
93.680 Medical Student Education $29,029
93.913 Grants to States for Operation of Offices of Rural Health $26,878
84.033 Federal Work-Study Program $22,264
93.301 Small Rural Hospital Improvement Grant Program $10,933
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $4,235