On 26 October, 2020, Kshs.380,028,749 was transferred from the KCB Account Number 1150668849 to the Covid-19 Emergency Account Number 1279777397 at KCB. It was noted that, the Jaramogi Oginga Odinga Teaching and Referral Hospital transferred Kshs.380,028,749 to the Special Purpose Account (SPA) instead of the Kshs. 400,000,000. The explanation given was that the difference of Kshs. 19,971,251 was utilized for the Covid-19 related expenses which were paid from the operations account before opening the Special Purpose Account. The Management availed payment vouchers in support of the expenditure of Kshs. 19,971,251. The Ministry of Health (MoH) vide a letter Reference No. MOH/ADM/1/1/171 Vol. I (280) dated 22 June, 2020 to all County Executive Committee Members for Health and Chief Officers, instructed all Counties to open a Special Purpose Account (SPA) for the COVID-19 grant. The letter also refers to the Ministry of Health framework for the management of the additional conditional grants for the COVID-19 emergency response for guidance on transfers of the funds including transfers to the special purpose accounts. It was established that as at 31 July, 2020, the Jaramogi Oginga Odinga Teaching and Referral Hospital had not opened a Special Purpose Account (SPA) for the COVID 19 grant. The Chief Executive Officer (CEO) of the Jaramogi Oginga Odinga Teaching and Referral Hospital requested the Chief Officer for Health for the authority to open a Covid 19 Account at Equity Bank on 29 September, 2020. Further, a reminder was sent on 14 October 2020 vide a letter reference number ACCT/1/VOL.XII (104). Approval to open the SPA was granted vide a letter reference number KC/FIN/B.ACCNTS/305 dated 15 October, 2020 from CECM Finance and Economic Planning to the Manager Kenya Commercial Bank Kisumu. It is not clear why Chief Officer Health delayed granting approval to open the Special Purporse Account leading to the delay in service delivery in the Hospital as stated by the CEO in his reminder letter of 14 October, 2020.