Mitchell County Hospital DistrictLocal Government

COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing No. 93.498 U.S. Department of Health and Human Services Period 4 Expenditures Criteria or Specific Requirement – Reporting (45 CFR 75.342) and Activities Allowed/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) Condition – The District is required to prepare and submit period 4 Provider Relief Fund reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs – Unknown Context – The District selected Option 1 for the lost revenue calculation. The District was unable to provide the underlying lost revenue calculation that materially agreed to the information submitted and reported to Health Resources and Services Administration in period 4. Effect – The District could not support the lost revenues reported in period 4 with accurate financial information. Cause – The District did not retain the underlying calculations and documentation of reporting methodology when the period 4 report was completed and submitted by management. Identification as a Repeat Finding – N/A Recommendation – Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of Responsible Officials and Planned Corrective Actions – Responsible Official: Diane Moore, Chief Financial Officer Planned Corrective Actions – The District has adopted a Federal Grant Reporting Policy requiring all submissions to federal or state agencies to include complete supporting documentation retained for at least seven years. A standardized Lost Revenue Calculation Template has been created to document methodology, source data, and reconciliations to general ledger balances. The CFO will ensure all future PRF and grant reports undergo a dual review and sign-off process prior to submission. Historical data for Period 4 PRF reporting has been reconstructed from audited financial records, and the District has verified that lost revenues during the eligible reporting period exceed the total PRF funds retained, demonstrating that all funds were appropriately supported from a financial standpoint. While the original internal calculation did not agree to the exact amounts reported to HRSA, the District’s current analysis and documentation substantiate the PRF funds in accordance with HRSA’s intent and guidance. Staff have completed Uniform Guidance and HRSA PRF compliance training to ensure future submissions include all required support and reconciliation.