Finding 981144 (2023-001)

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Requirement
L
Questioned Costs
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Year
2023
Accepted
2024-06-28

AI Summary

  • Core Issue: UMass Memorial Health – Harrington, Inc. reported patient care revenues inaccurately, underestimating them by about $6.2 million for Q3 and Q4 of 2021.
  • Impacted Requirements: The inaccuracies violate the PRF reporting requirements for lost revenue calculations, which must reflect actual patient care revenues from January 1, 2019, to December 31, 2022.
  • Recommended Follow-Up: Implement a robust review process to ensure accurate reporting of patient care revenues before submitting to the PRF Reporting Portal.

Finding Text

2023-001 Provider Relief Fund Lost Revenue Reporting Cluster: Not applicable Grantor: Health Resources and Services Administration Award Name: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Award Year: PRF Period 4 of Availability from January 1, 2020 to December 31, 2022 Award Number: Not applicable Assistance Listing Number: 93.498 Criteria Step 8 of the Steps on Reporting on Use of Funds section of the April 22, 2024 Provider Relief Fund (PRF) General and Targeted Distribution Post-Payment Notice of Reporting Requirements requires recipients that apply PRF payments toward lost revenues, calculated as the difference between actual patient care revenues, to submit revenues from patient care in the PRF Reporting Portal by quarter from January 1, 2019 to December 31, 2022, the end of the Period 4 period of availability. Condition UMass Memorial Health – Harrington, Inc. and Affiliates (Harrington), a wholly controlled subsidiary of the System, understated patient care revenues reported in the PRF Reporting Portal for the third and fourth quarters of calendar year 2021 by approximately $6.2 million. Specifically, Harrington Hospital, Inc. (HMH) and Harrington Physician Services (HPS) reported incorrect values for patient care revenues in these quarters resulting in an understatement of patient care revenues in the PRF Reporting Portal by approximately $5.7 million and $0.5 million, respectively. This is a recurring finding that was identified as part of the Harrington program-specific standalone audit for the year ended September 30, 2022. Cause Harrington did not have an effective control in place to ensure a sufficient review was performed over the accuracy of revenues from patient care used as inputs to the lost revenue calculation prior to completing the PRF Period 4 Reporting Portal submissions. Effect While revenues from patient care were inaccurately reported in the PRF Period 4 Reporting Portal Submission, Harrington had sufficient lost revenues and unreimbursed COVID-19-related expenses to support the amount of Period 4 PRF funding received. Questioned Costs None identified. Recommendation We recommend that management ensure there is an effective control in place whereby a detailed review is performed and evidenced of the lost revenue calculation detail prior to PRF Reporting Portal submissions. Management’s Views and Corrective Action Plan Management’s Views and Corrective Action Plan are included at the end of this report after the summary schedule of prior audit findings and status.

Categories

Reporting

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
97.036 Covid-19 Disaster Grants - Public Assistance (presidentially Declared Disasters) $104.61M
93.498 Covid-19 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $9.38M
93.958 Block Grants for Community Mental Health Services $1.00M
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $712,340
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $637,907
16.575 Crime Victim Assistance $326,511
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $286,618
93.788 Opioid Str $185,702
14.241 Housing Opportunities for Persons with Aids $138,503
93.959 Block Grants for Prevention and Treatment of Substance Abuse $100,000
14.267 Continuum of Care Program $72,985
14.231 Emergency Solutions Grant Program $62,600
21.023 Emergency Rental Assistance Program $51,083
84.181 Special Education-Grants for Infants and Families $732
93.461 Covid-19 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $-868