VAN WERT COUNTY HOSPITAL ASSOCIATION AND SUBSIDIARIESNon-Profit

Information on the federal program ? Department of Health and Human Services - Health Resources and Services Administration (HRSA) ? ALN 93.498 ? COVID-19: Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Criteria or specific requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). HRSA has indicated that entities which received Provider Relief Fund distributions exceeding $10,000 in the aggregate during a Payment Received Period are required to report in each applicable Reporting Period. Funds received can be applied toward allowable expenses that were necessary to support patient care efforts to prevent, prepare for, or respond to the coronavirus that another source has not already reimbursed or is obligated to reimburse, or lost revenues. Condition ? Entities are permitted to utilize one of three different methods for reporting lost revenues. HRSA has set forth various guidelines for each method of reporting. Questioned costs ? Unknown Context ? When calculating 2021 lost revenues, the Association used a 2021 budget which was not approved prior to March 27, 2020. Effect ? The Association submitted its reporting information inconsistently with guidelines set forth by HRSA, as it pertains to using the budget-to-actual method for calculating lost revenues. Cause ? The Association selected the budget-to-actual method for reporting lost revenues (commonly referred to as Option ii or #2) during the Reporting Period applicable to distributions received between July 1, 2021 and December 31, 2021. A comprehensive review of the Chief Financial Officer?s reporting submission was not performed prior to finalization. Identification as a repeat finding ? Repeat finding. See prior year finding 2021-003. Recommendation ? Management should implement a more stringent review process for future applicable Reporting Periods. Views of responsible officials ? The recommendation to implement a more stringent review process for future applicable Reporting Periods was followed. Starting with the 2022 reporting period, the Association used actual operating expenses to justify the funds we received from the Provider Relief Fund.

Information on the federal program ? Department of Health and Human Services - Health Resources and Services Administration (HRSA) ? ALN 93.498 ? COVID-19: Provider Relief Fund ? 2020 Criteria or specific requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). HRSA has indicated that entities which received Provider Relief Fund distributions exceeding $10,000 in the aggregate during a Payment Received Period are required to report in each applicable Reporting Period. Funds received can be applied toward allowable expenses that were necessary to support patient care efforts to prevent, prepare for, or respond to the coronavirus that another source has not already reimbursed or is obligated to reimburse, or lost revenues. Condition ? Entities are permitted to utilize one of three different methods for reporting lost revenues. HRSA has set forth various guidelines for each method of reporting. Cause ? The Association selected the budget-to-actual method for reporting lost revenues (commonly referred to as Option ii or #2) during the Reporting Period applicable to distributions received between April 1, 2020 and June 30, 2020. A comprehensive review of the Chief Financial Officer?s reporting submission was not performed prior to finalization. Effect or potential effect ? The Association submitted its reporting information inconsistently with guidelines set forth by HRSA, as it pertains to using the budget-to-actual method for calculating lost revenues. Questioned costs ? Unknown Context ? When calculating 2020 lost revenues, the Association used a 2020 budget which had been approved prior to March 27, 2020 but did not cover the entire period of availability (January 1, 2020 to June 30, 2021). Instead, the 2020 budget covered calendar year 2020 only. When calculating lost revenues for the first two calendar quarters of 2021, the Association used a 2021 budget that was not approved prior to March 27, 2020. Identification as a repeat finding ? Not applicable. Recommendation ? Management should implement a more stringent review process for future applicable Reporting Periods. Views of responsible officials ? The Association agrees with this finding, however, does note that their remaining COVID-related expenses and lost revenues still exceeded the amount of the Provider Relief Fund program money they received. See separate auditee document for planned corrective action.