GOVE COUNTY MEDICAL CENTERLocal Government

Finding: Activities Allowed/Unallowed, Allowable Costs/Cost Principles, and Reporting Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution ? 93.498 Criteria or specific requirement ? Reporting (45 CFR 75.342) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). The Hospital is required to prepare and submit period one and two provider relief fund reports to the U.S. Department of Health and Human Services. The reports are to be prepared using accurate financial information and submitted by the deadline established. The funds cannot be used for expenses reimbursed or obligated to be reimbursed by other sources. Condition ? The Hospital reported COVID-19 related expenditures within the HHS Provider Relief Fund and American Rescue Plan (ARP) Distribution portal that were eligible to be reimbursed via other sources. Questioned costs ? $918,000. Questioned costs were estimated by taking the total amount of PRF expenditures multiplied by the Hospital?s internally-calculated Medicare reimbursement rate. Context ? The Hospital is certified by Medicare as a Critical Access Hospital (CAH). The period one and two provider relief fund reports were tested. The Hospital?s calculation of allowable expenses did not consider the impact of cost reimbursement to reported health care expenses to document that Provider Relief Fund payments were not reimbursed by any other source. Effect ? The Hospital submitted expenses under the PRF program that are obligated to be reimbursed by other sources Cause ? The Provider Relief Fund is a new program with complex and evolving regulations and compliance requirements. Internal controls were not in place to ensure the Hospital correctly applied the guidance. Identification as a repeat finding, if applicable ? N/A Recommendation ? The Hospital should continue to improve understanding of the guidance related to this type of reporting and work to identify areas for improvement prior to submission to the Provider Relief Fund reporting portal. Management should ensure proper internal controls are put into place to ensure that allowable expenses reported are not reimbursed by other sources. View of responsible officials and planned corrective actions ? The Hospital agrees with this finding. See separate auditee document for planned corrective action.