Appalachian Regional Healthcare System, Inc.Local Government

2023-001 - Significant Deficiency Federal agency: U.S. Department of Health and Human Services (HHS) Federal program title: COVID-19 Provider Relief Fund (PRF) - Period 4 Assistance Listing No.: 93.498 Condition: The System over-reported expenses within the HHS Health Resources and Services Administration (HRSA) Reporting Portal Period 4 submission due to a spreadsheet allocation calculation error. Criteria: Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act and are to be used to prevent, prepare for, and respond to coronavirus. The funds shall reimburse the recipient only for expenses or lost revenues that are attributable to coronavirus. The funds may not be used to reimburse expenses or lost revenues that have been reimbursed from other sources or that other sources are obligated to reimburse. Cause: Although the System has a process in place to identify and report allowable expenses, an appropriate review process was not in place to detect and correct spreadsheet calculation errors. Effect: The System reported expenses within the HHS HRSA Reporting Portal Period 4 submission which were not accurately calculated. Questioned Costs: The spreadsheet calculation error resulted in $201,976 of questioned costs. Context: Upon testing the compliance requirements of this program, it was determined that a spreadsheet calculation error resulted in overstating expenditures. However, the Period 4 reporting submission included unused lost revenues that the System believes could offset the the issue identified above. Recommendation: We recommend the Authority design and implement controls, including levels of review, to ensure qualifying expenses submitted are in accordance with the HHS guidelines with supporting documentation retained. Views of Responsible Officials and Planned Corrective Actions: See corrective action plan.