EIN: 030185556
UEI: LJ42FSDNFW29
Data as of August 24, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on February 19, 2023. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by August 19, 2023 (1101 days ago).
What is a management decision? →Criteria or Specific Requirement ? Reporting (45 CFR 75.342) Questioned Costs ? None Context ? The Period 1 provider relief fund report was tested. The Health System selected Option 1 to report lost revenues based on 2019 quarterly actual amounts. Amounts reported for each quarter were not calculated accurately. Effect ? Errors were identified in quarterly lost revenues reported to HHS; however, when these errors are considered, the Hospital?s total Provider Relief Fund payments applied to lost revenues did not change from what was originally reported in Period 1. Cause ? The Health System did not identify certain patient service revenue adjustment accounts in their calculation of lost revenues. 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.
Show full finding ▾Hide full finding ▴Criteria or Specific Requirement ? Reporting (45 CFR 75.342) Questioned Costs ? None Context ? The Period 1 provider relief fund report was tested. The Health System selected Option 1 to report lost revenues based on 2019 quarterly actual amounts. Amounts reported for each quarter were not calculated accurately. Effect ? Errors were identified in quarterly lost revenues reported to HHS; however, when these errors are considered, the Hospital?s total Provider Relief Fund payments applied to lost revenues did not change from what was originally reported in Period 1. Cause ? The Health System did not identify certain patient service revenue adjustment accounts in their calculation of lost revenues. 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.
Management concurs with the audit findings and will review in detail the future Provider Relief Fund (PRF) reporting submissions. Regardless of the errors made in the initial reporting submission, the Health System has sufficient lost revenues during the period of availability to support PRF payments.
Criteria or Specific Requirement ? Allowable Costs and Cost Principles, and Activities Allowed and Unallowed (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116?139, 134 Stat. 622 and 623) Condition ? Allowable costs related to the program must be expenses that are unreimbursed by other sources and that other sources are not obligated to reimburse. Cause ? The Health System claimed expenses that were reimbursed by Medicare through the Health System?s Critical Access Hospital (CAH) designation. Questioned Costs - Approximately $310,000 calculated as expenses expected to be reimbursed through the Health System's Medicare reimbursement rate. Context ? The reimbursement from Medicare was identified as not applied to the population of allowable costs. Effect ? The amount reported in Period 1 reporting included expenses obligated to be reimbursed by other sources. Identification as a repeat finding ? Not a repeat finding Recommendation ? The Health System should apply guidance for cost-based reimbursement to expenses claimed on the Period 1 report. Refer to the HHS Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements dated June 11, 2021, and the most recently distributed Provider Relief Fund frequently asked questions which provide details on requirements related to the program.
Show full finding ▾Hide full finding ▴Criteria or Specific Requirement ? Allowable Costs and Cost Principles, and Activities Allowed and Unallowed (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116?139, 134 Stat. 622 and 623) Condition ? Allowable costs related to the program must be expenses that are unreimbursed by other sources and that other sources are not obligated to reimburse. Cause ? The Health System claimed expenses that were reimbursed by Medicare through the Health System?s Critical Access Hospital (CAH) designation. Questioned Costs - Approximately $310,000 calculated as expenses expected to be reimbursed through the Health System's Medicare reimbursement rate. Context ? The reimbursement from Medicare was identified as not applied to the population of allowable costs. Effect ? The amount reported in Period 1 reporting included expenses obligated to be reimbursed by other sources. Identification as a repeat finding ? Not a repeat finding Recommendation ? The Health System should apply guidance for cost-based reimbursement to expenses claimed on the Period 1 report. Refer to the HHS Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements dated June 11, 2021, and the most recently distributed Provider Relief Fund frequently asked questions which provide details on requirements related to the program.
Management concurs with the audit findings and will exclude costs reimbursed by Medicare on any future or revised Provider Relief Fund (PRF) submissions. Regardless of the errors made in the initial reporting submission, the Health System has sufficient lost revenues during the period of availability to support PRF payments.
Data source: This information comes from the Federal Audit Clearinghouse, the official repository of Single Audit data. All data is public domain. Verify this organization's audit history at fac.gov.
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