Finding Text
Federal program
Federal Assistance Listing Number 93.498
U.S. Department of Health and Human Services
COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution
Material Weakness in Internal Control over Compliance
Criteria
The Health Center should have sufficient internal controls over PRF reporting to assure amounts reported as allowable costs under the PRF program (FAL 93.498) are concurrently documented and match to individual reported categories of allowable costs. Additionally, the Health Center should have processes in place to assure all other data elements required to be reported are reviewed and accurately reported as required.
Conditions
Management provided excel workbooks of costs they determined allowable under the PRF program. Although the workbook totals for some cost reporting categories did match the PRF reporting form, there were several categories that did not. Other reporting errors were also noted during our testing of the PRF reporting document. Errors specifically noted were as follows:
Single Audit Information Section of PRF Reporting Form:
Fiscal years 2019 and 2020 were marked as “yes” subject to Audit (45 CRF 75 Subpart F) when this was true only for fiscal year 2021.
Other Assistance Section of PRF Reporting Form:
Rural Health Clinic COVID-19 Testing funds of $98,923 received in Q2 of 2020 and $100,000 in Q2 of 2021 should have been reported in this section.
Other Provider Relief Fund Payments: April 10, 2020 to June 30, 2020 Payment Period - Other PRF Expenses Section of PRF Reporting Form:
Mortgage/Rent
PRF reporting form reported costs of $9,675 when the Health Center’s supporting detail excel workbook provided showed $10,970.
Personnel
PRF reporting form reported costs of $2,173,435 when the Health Center’s supporting detail excel workbook provided showed $1,744,254.
Fringe Benefits
PRF reporting form reported costs of $478,410 when the Health Center’s supporting detail excel workbook provided showed $624,322.
Lease Payments
PRF reporting form reported costs of $0 when the Health Center’s supporting detail excel workbook provided showed $71,673.
Supplies
PRF reporting form reported costs of $476,714 when the Health Center’s supporting detail excel workbook provided showed $315,593.
Equipment
PRF reporting form reported costs of $128,046 when the Health Center’s supporting detail excel workbook provided showed $488,244.
Facilities
PRF reporting form reported costs of $75,943 when the Health Center’s supporting detail excel workbook provided showed $100,598.
Other Health Care Expenses
PRF reporting form reported costs of $0 when the Health Center’s supporting detail excel workbook provided showed $215,683.
Unreimbursed Expenses Attributable to Coronavirus Section of PRF Reporting Form:
Health Center reported for general and administrative expenses and healthcare related expenses the same line item totals as reported in the Other Provider Relief Fund Payments.
Patient Care Revenue Section of PRF Reporting Form:
The Health Center was unable to provide us with a reconciliation of its 2019 and 2020 calendar year financial statement revenues that agreed with the amounts reported in the PRF form as 2019 and 2020 actual calendar year revenue.
Personnel, Patient and Facility Metrics Section of PRF Reporting Form:
The Health Center’s provided internal data for personnel and facility metrics did not match with what was reported in the PRF reporting form.
Cause
The Health Center did not have sufficient internal controls over the PRF reporting process to assure all required reporting data, including appropriate tracking of costs and correct final reporting by cost category, was accurately reported in the PRF reporting form.
Effect and recommendation
We suggest the Health Center review its current processes associated with PRF fund reporting and filing requirements to assure all information is accurately reported.
Views of responsible officials and planned corrective actions
Management agrees with the noted finding and although we have limited personnel, we will continue to monitor and enhance our internal controls over the completion of provider relief fund reporting.