Alpha Covenant Holdings · Sector Map · as of 2026-10-08 · SHA-256 1652256ec431eed41111180add7468087fe4ef188549f594855a0a4aac8eebe8 · https://alphacovenantholdings.com/maps/pa-hospital

A hospital or health system in Pennsylvania

Who this is for: Hospitals, health systems and their credentialing, supply-chain and grants offices

Why these forms: Medicaid enrollment and MA/Part D participation create monthly exclusion-screening duties on staff, vendors and FDRs; federal grants (HRSA, Ryan White, CDC) bring 2 CFR 180/200 on every vendor and subaward and a single audit each year.

A reference map, not a receipt and not advice: the forms whose lines a dated public-record receipt supports for this kind of organisation, the Duty Sheet behind each, the official record each rests on, how this platform reads it, and what a read cannot prove. Whether a given line applies to a given organisation is decided by its awards, contracts and agencies — not here.

7 form lines · sources read: fac, leie, nppes, sam, state, usaspending_subawards

2 CFR 180.300 · 2 CFR 200.214 · 2 CFR 200.318(h) — Lower-tier covered transaction check for federal awards (grants, cooperative agreements, loans) — recipient's procurement file

The line: 180.300: before entering a covered transaction the participant must (a) check SAM Exclusions, (b) collect a certification from the other party, or (c) add a clause. 200.214 applies it to every federal award; 200.318(h) to every procurement.

Citation: 2 CFR 180.300; 2 CFR 200.214; 2 CFR 200.318(h) · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: That the vendor is the same entity as a same-named row (a name match is a candidate, not identity); that the award exceeded the threshold.

Finding pattern(s): Suspension & debarment check not documented, or evidence not retained; Payment to an ineligible party; insufficient documentation at invoice · register · procedure as written

SF-424B · SF-424D — SF-424B Assurances — Non-Construction Programs · SF-424D Assurances — Construction Programs

The line: The applicant assures it will comply with all applicable requirements of federal laws, executive orders, regulations and policies governing the program — which include 2 CFR 180 and 2 CFR 200.

Citation: SF-424B item 18 / SF-424D item 19 (as numbered on the current OMB form); 2 CFR 200.214 · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: Any other assurance on the form (civil rights, environmental, labor standards, reporting).

Finding pattern(s): Suspension & debarment check not documented, or evidence not retained · register · procedure as written

SF-SAC — SF-SAC Data Collection Form for Reporting on Audits of States, Local Governments and Non-Profit Organizations

The line: Part III findings: reference number, compliance requirement type (I = Procurement and Suspension and Debarment; M = Subrecipient Monitoring), material weakness, repeat. The pass-through entity's duty to obtain the subrecipient's audit sits in 2 CFR 200.332(f) and 200.501.

Citation: 2 CFR 200.512 (submission); 2 CFR 200.332(f); 2 CFR 200.501 · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: The content of the audit beyond what FAC prints; whether the pass-through entity's monitoring was adequate.

Finding pattern(s): Subrecipient single audit not obtained; no additional monitoring · register · procedure as written

CMS-855A · 855B · 855I · 855S — CMS-855A / 855B / 855I / 855S Medicare Enrollment Applications — Section 3 Final Adverse Legal Actions

The line: Section 3 asks the applicant to list exclusions, debarments, revocations and license suspensions; 42 CFR 424.516 requires reporting changes within 30 days; 42 CFR 424.535 lists revocation grounds.

Citation: 42 CFR 424.516; 42 CFR 424.535; 42 CFR 1001.1901 · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: Identity (a name match is a candidate); whether a disclosure was owed; the outcome of enrollment.

Finding pattern(s): Provider exclusion screening not performed at enrollment or monthly · register · procedure as written

42 CFR 455.104 · 455.105 · 455.106 · 455.436 — State Medicaid provider enrollment application and disclosures (ownership and control, business transactions, criminal convictions) — one form per state

The line: 455.436(b)–(c): the state agency checks the LEIE and SAM exclusions at enrollment, re-enrollment and monthly thereafter; 455.104–106: the provider discloses owners, managing employees and convictions on the state's form.

Citation: 42 CFR 455.436; 42 CFR 455.104–455.106 · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: Enrollment status; that disclosed owners were screened; identity behind a name match.

Finding pattern(s): Provider exclusion screening not performed at enrollment or monthly · register · procedure as written

42 CFR 422.503(b)(4)(vi)(F) · 423.504(b)(4)(vi)(F) — Medicare Advantage / Part D compliance program — first-tier, downstream and related entity (FDR) exclusion screening attestation (HPMS)

The line: The sponsor's compliance program must screen employees, governing body and FDRs against the OIG LEIE and SAM before hire or contract and monthly thereafter; attested annually in HPMS.

Citation: 42 CFR 422.503(b)(4)(vi)(F); 42 CFR 423.504(b)(4)(vi)(F) · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: That the compliance program is effective; CMS audit outcome.

Finding pattern(s): Provider exclusion screening not performed at enrollment or monthly · register · procedure as written

FAR 52.204-10 · FFATA — Reporting Executive Compensation and First-Tier Subcontract Awards (FSRS / SAM.gov)

The line: (d): the contractor reports each first-tier subcontract of $30,000 or more, with the subcontractor's UEI; the report is published through USAspending.

Citation: 48 CFR 52.204-10; 2 CFR 170 (grants); Pub. L. 109-282 (FFATA) · text · official page

Duty Sheet(s):

The step where a dated receipt is the record:

Official record it rests on, and how this platform reads it:

What a read cannot prove: That every reportable subcontract was reported; dollar accuracy.

Finding pattern(s): Subrecipient single audit not obtained; no additional monitoring · register · procedure as written

State layer — PA

Pennsylvania DHS: Medicheck List · https://www.pa.gov/agencies/dhs/report-fraud/medicheck-list (portal)

Cite as

Alpha Covenant Holdings, Sector Map: A hospital or health system in Pennsylvania (as of 2026-10-08), https://alphacovenantholdings.com/maps/pa-hospital

Not legal advice, not a compliance determination, not a statement that any filer's certification is true or false. Form numbers and line numbers are as published on the date noted and may be renumbered by their agencies; the official page controls. Audit findings quoted are the auditor's words as filed at the Federal Audit Clearinghouse, cited by report id; they describe a documentation gap, not a conclusion about any party.