CABELL HUNTINGTON HOSPITAL, INC. AND SUBSIDIARIES

Finding 2022-001 Condition: The System did not complete the PRF Period 3 reporting in accordance with the U.S. Department of Health and Human Services guidance. The System inadvertently entered fiscal year Q1 and Q2 for Total Revenue/Net Charges from Patient Care (2022 Actuals) instead of calendar year Q1 and Q2. There was no impact on the lost revenues calculation as neither quarter had lost revenues. Corrective Action Plan: Corrective Action Planned: Cabell Huntington Hospital, Inc. and Subsidiaries agrees with the finding and has worked extensively over the past several years to monitor the changing guidelines surrounding the various programs designed to respond to the COVID-19 pandemic. Management will continue to further this effort by reading all available guidance to ensure that the most recent guidelines are followed. Additionally, management has begun the process of reviewing policies and procedures to improve internal controls over the submission of PRF reports, including implementing controls sufficient to identify and correct errors prior to the completion of PRF reporting. Name(s) of Contact Person(s) Responsible for Corrective Action: D. Monte Ward, Senior VP/CFO 1340 Hal Greer Blvd Huntington, WV 25701 Phone 304.526.2055 Monte.ward@mhnetwork.org Anticipated Completion Date: June 30, 2023

Finding 2021-001 Condition SECTION III - FEDERAL AWARD FINDINGS AND QUESTIONED COSTS A significant deficiency in internal controls over compliance for the major program Program: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution AL Number: 93.498 Federal Agencies: U.S. Department of Health and Human Services Passed-Through Entities: N/A Award Number: N/A Award Year: 2020/2021 Compliance Requirement: Reporting Questioned Costs: None Criteria: All recipients of Provider Relief Fund (PRF) payments must comply with the reporting requirements described in the PRF terms and conditions and specified in directions included within Post-Payment Notice of Reporting Requirements issued by the U.S. Department of Health and Human Services (DHHS). The guidance issued by DHHS states that PRF payment amounts (excluding SNF and Nursing Home Infection Control Distribution payments) not fully expended on health care-related expenses attributable to coronavirus may be applied to patient care lost revenues, if applicable. Recipients may choose to apply PRF payments toward lost revenues using one of three options: Option i: of the difference between actual patient care revenues; Option ii: of the difference between budgeted (prior to March 27, 2020) and actual patient care revenues; and Option iii: calculated by any reasonable method of estimating revenues. Condition and Context: In the System?s first reporting submission, the System reported lost revenues under Option ii for its Cabell Huntington Hospital, Inc. filing (TIN 550675666); however, under DHHS guidance the System should have elected Option iii. The System included fiscal year 2021 budget amounts from a budget approved subsequent to March 27, 2020 as the base period against which fiscal year 2021 revenues were compared in the reporting submission. The System?s methodology for option iii was to use budget-to-actual patient revenues compared to actual revenues, utilitizing the budget approved for each fiscal year. The 2020 fiscal year budget was approved prior to March 27, 2020 but the fiscal year 2021 budget was approved on June 30, 2020. The System had insufficient controls in place to enable it to properly follow the reporting guidance. Effect: The amounts reported to HRSA were not in accordance with established DHHS guidance. When using the proper guidance and amounts, the System had sufficient expenses and lost revenue to justify retaining the PRF received. Cause: The System has insufficient controls in place to identify and correct errors before reporting is completed. Recommendation: We recommend that Management implement procedures to ensure that the most recent guidelines are reviewed and understood and that all information is detail reviewed and errors addressed before reporting. Corrective Action Plan Corrective Action Planned: Cabell Huntington Hospital, Inc. and Subsidiaries agrees with the finding and has worked extensively over the past two years to monitor the changing guidelines surrounding the various programs designed to respond to the COVID-19 pandemic. Management will continue to further this effort by attending continuing professional education on this topic and reading all available guidance to ensure that the most recent guidelines are followed on a going-forward basis. Additionally, management has begun the process of reviewing policies and procedures to improve internal controls over the submission of PRF reports, including implementing controls sufficient to identify and correct errors prior to the completion of PRF reporting. This includes preparation of formal documentation related to option iii. Furthermore, we will make corrections to our lost revenue calculations prospectively in future PRF reporting submissions. Name(s) of Contact Person(s) Responsible for Corrective Action: D. Monte Ward, Senior VP/CFO 1340 Hal Greer Blvd Huntington, WV 25701 Phone 304.526.2055 Monte.ward@mhnetwork.org Anticipated Completion Date: June 30, 2022