Grand View Hospital

Finding 2021-001: Significant Deficiency in Internal Control - Reporting Assistance Listing Number.: 93.498 COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Federal Agency: U.S. Department of Health and Human Services Pass-Through Agency: Not applicable Award Number / Year: N/A / 2020 Criteria: Non-federal entities in receipt of federal funds must comply with the requirements of 2 CFR 200.303(a), which require an entity to establish and maintain effective internal control over the Federal award to ensure compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Recipients of Provider Relief Funds (PRF) payments must also comply with the reporting requirements described in the PRF terms and conditions and specified in directions issued by the U.S. Department of Health and Human Services. Condition/Context: The Hospital reported $2,726,123 of total other PRF expenses in the period 1 submission. However, upon request, the Hospital was unable to initially provide the detailed listing of expenditures that reconciled to this amount. The amount reported in the submission was less than the total amount of expenses the Hospital identified and incurred related to eligible uses of the PRF. Effect: The amounts reported to Health Resources & Services Administration (HRSA) did not have the necessary supporting documentation that was used to prepare and submit the initial reporting. Questioned Costs: None Reported. Cause: Due to staff turnover, the Hospital had difficulty locating the original support that reconciled to the submission. Recommendation: We recommend that management implement procedures to ensure that the most recent guidance is reviewed and understood, and that information used in preparation of the reports are reviewed, with errors addressed, and maintained prior to reporting. Views of Responsible Officials: Management agrees with the finding and has subsequently supported lost revenue and eligible expenses that were not included in the original submission. These amounts well exceeded the funding received.

CORRECTIVE ACTION PLAN Jun 28, 2023 U.S. Department of Health and Human Services Grand View Hospital respectfully submits the following corrective action plan for the year ended June 30, 2021. Name and address of independent public accounting firm: Baker Tilly U.S., LLP One Liberty Place, 1650 Market Street, Suite 4500, Philadelphia, PA 19103 Audit period: Year Ending June 30, 2021 The finding from the June 30, 2021 schedule of findings and questioned costs are discussed below. The finding is numbered consistently with the number assigned in the schedule. Significant Deficiency in Internal Control - Reporting Finding 2021-001 Recommendation: We recommend that management implement procedures to ensure that the most recent guidance is reviewed and understood and that information used in preparation of the reports are reviewed, with errors addressed, and maintained prior to reporting. Action Taken: Grandview Hospital has educated itself on the reporting requirements within the URSA portal. The $4,391,120 received was used to continue to maintain its staff of nurses and physicians as well as offsetting the material loss in operating revenues to prevent, prepare for and respond to the COVID-19 public health emergency. Grandview Hospital's lost operating revenue of approximately $50 million far exceeded the Provider Relief funding. By way of this response, Grand View Hospital is confirming that they did indeed utilize the Provider Relief funding to prevent, prepare for and respond to the COVID19 public health emergency.