LENAWEE COUNTY MEDICAL CARE FACILITYNon-Profit

Assistance Listing Number, Federal Agency, and Program Name - 93.498, U.S. Department of Health and Human Services, Provider Relief Fund Federal Award Identification Number and Year - Not applicable, 2020 Pass-through Entity - N/A - direct funded Finding Type - Material weakness Repeat Finding - No Criteria - The Facility should have internal controls in place to ensure lost revenue is properly calculated and reported in accordance with the Provider Relief Fund General and Targeted Distribution Post Payment Notice of Reporting Requirements dated June 11, 2021. Per the Provider Relief Fund General and Targeted Distribution Post Payment Notice of Reporting Requirements dated June 11, 2021, recipients may choose to apply PRF payments toward lost revenue using one of three options: Option i: The difference between actual patient care revenue Option ii: The difference between budgeted (prior to March 27, 2020) and actual patient care revenue Option iii: The amount calculated by any reasonable method of estimating revenue. Condition - The Facility's controls in place for reporting submissions did not identify that guidelines were not followed related to the lost revenue calculations. Questioned Costs - None Identification of How Questioned Costs Were Computed - Not applicable - refer to context below for additional information. Context - As there was a prior period adjustment, as identified in 2021-001 above, which would impact the lost patient care revenue computation as reported into the provider relief funding portal (the "portal"), the reporting submission for lost revenue did not follow the acceptable options provided by the Department of Health and Human Services. Recipients may choose to apply Provider Relief Fund payments toward lost revenue using one of three options: (i) up to the amount of the difference between actual patient care revenue, (ii) up to the amount of the difference between budgeted (if approved prior to March 27, 2020) and actual patient care revenue, or (iii) up to the amount calculated by any reasonable method of estimating revenue. The Facility used option i to calculate lost revenue but reported an incorrect total of revenue in the submission, due to a prior period adjustment, which impacted the actual patient care revenue amounts for 2020. If the Facility had reported the actual revenue amount, it still would have qualified to recognize all PRF payments received in Period 1 or Period 2. Cause and Effect - Appropriate analysis of the amounts reported into the Portal related to lost revenue as defined by Health and Human Services towards lost revenue were not performed. As a result, the report submitted was inaccurate. Recommendation - We recommend the Organization implement controls, including levels of review, to ensure reports are completed and submitted in accordance with the guidelines established by HHS. Views of Responsible Officials and Corrective Action Plan - Management is working to correct the issue.