Audit 28698

FY End
2022-07-31
Total Expended
$14.01M
Findings
10
Programs
4
Year: 2022 Accepted: 2023-04-27
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
37972 2022-003 Material Weakness Yes P
37973 2022-004 Material Weakness Yes L
37974 2022-005 Significant Deficiency Yes N
37975 2022-006 Significant Deficiency Yes N
37976 2022-007 Significant Deficiency - F
614414 2022-003 Material Weakness Yes P
614415 2022-004 Material Weakness Yes L
614416 2022-005 Significant Deficiency Yes N
614417 2022-006 Significant Deficiency Yes N
614418 2022-007 Significant Deficiency - F

Programs

ALN Program Spent Major Findings
14.128 Mortgage Insurance_hospitals $13.44M Yes 5
93.155 Rural Health Research Centers $256,978 - 0
93.697 Covid-19 Testing for Rural Health Clinics $200,000 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $105,606 - 0

Contacts

Name Title Type
SBMQRQ2NBT83 Paul Courtney Auditee
2178543857 Renee Gravalin Auditor
No contacts on file

Notes to SEFA

Title: Loan/loan guarantee outstanding balances Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate.The Organization does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. The Organizations mortgage note payable is guaranteed under the Department of Housing and Urban Developments Section 242 program. The program guarantees 99% of the outstanding mortgage balance. The balance included on the Schedule represents 99% of the loan balance of $13,579,253 as of August 1, 2021, which is $13,443,460. The loan balance at July 31, 2022 is $12,879,980.
Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate.The Organization does not draw for indirect administrative expenses and has not elected to use the 10% de minimis cost rate. The accompanying consolidated schedule of expenditures of federal awards (Schedule) includes the federal award activity of Middle Macoupin Health Care Systems and Affiliates (Organization) under programs of the federal government for the year ended July 31, 2022. The information is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization.

Finding Details

2022-003 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Preparation of Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition: The Organization does not have an internal control system designed to provide for a complete and accurate schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause: Auditor assistance with preparation of the Schedule is not unusual as the Schedule has unique and specialized requirements and preparation is only required when the Organization meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the Organization would not be able to draft the Schedule that is correct without the assistance of the auditors. Questioned Costs: None reported. Context: Sampling was not used. Repeat Finding from Prior Years: Yes, Finding 2021-003. Recommendation: While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Organization?s schedule of expenditures of federal awards and the internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.
2022-004 Department of Housing and Urban Development Federal Financial Assistance Listing/CFDA #14.128 Section 242 ? Mortgage Insurance - Hospitals Reporting Material Weakness in Internal Control Over Compliance Criteria: The OMB Compliance Supplement requires that non-federal entities receiving federal awards establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Condition: The Section 242 ? Mortgage Insurance - Hospitals Program requires quarterly reports and certain annual reports. For the year ended July 31, 2022, the Organization failed to file the annual budget prior to the start of the year. Cause: There was turnover of key financial personnel during 2021 and 2022. The Organization did not follow their internal control policy to ensure the required reports were filed. Effect: The required reports were not submitted in accordance with loan requirements. Questioned Costs: None reported. Context: There were a total of eight reports required to be submitted for the year ended July 31, 2022. Three were selected for testing. Of the three selected, one was not submitted as required. Through additional inquiry, there were no other reports identified as not being submitted. Repeat Finding from Prior Years: Yes, Finding 2021-004. Recommendation: We recommend the Organization enhance internal control policies to ensure required reports are filed timely and accurately. Views of Responsible Officials: Management agrees with the finding.
2022-005 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance Criteria: The OMB Compliance Supplement requires that non-federal entities receiving federal awards establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Condition: During our testing, there was no documentation of review and approval of check disbursements for a portion of the sample selected. Cause: The Organization did not have an adequate internal control policy in place to ensure review and approval of cash disbursements was documented. Effect: The lack of adequate policies governing cash disbursement increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: A nonstatistical sample of 60 expenditures were selected for testing. Of these 60, 33 did not show evidence of proper review and approval prior to payment. Repeat Finding from Prior Years: Yes, Finding 2022-005. Recommendation: We recommend that the Organization enhance internal control policies to ensure all cash disbursements are reviewed and approved prior to payment to ensure that all payments are necessary and correct. Views of Responsible Officials: Management agrees with the finding.
2022-006 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance Criteria: A good system on internal controls over compliance includes processes to ensure all provisions within the agreements are fully followed as well as following generally accepted accounting principles. Condition: The Organization entered into a 5-year lease on equipment. A capital lease is identified in the Mortgage Note Insured by HUD as the incurrence of additional indebtedness which, by terms of the agreement, should be approved by HUD in advance of entering into the capital lease agreement. Cause: During the course of our engagement, we noted that management did not receive approval from HUD in advance of entering into the agreement. Management did get approval from HUD after entering into the agreement. Effect: The Organization violated a covenant within the Mortgage Note Insured by HUD agreement. Question Costs: None reported. Context/Sampling: None as there was only one lease agreement entered into during the year that was a capital lease. Repeat Finding from Prior Year: Yes, Finding 2021-006. Recommendation: We recommend that management should request and receive approval from HUD prior to entering into lease or other debt agreements. Views of Responsible Officials: Management agrees with the finding.
2022-007 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Equipment and Real Property Management Significant Deficiency in Internal Control Over Compliance and Noncompliance Not Considered Material Criteria: The OMB Compliance Supplement requires that non-federal entities receiving federal awards establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Condition: The Section 242 ? Mortgage Insurance - Hospitals Program requires an inventory of real property and equipment purchased with federal funds to be completed every two years. For the year ended July 31, 2021, the Organization failed to perform this inventory when the last had been performed for the year ended July 31, 2020. Cause: There was turnover of key financial personnel during 2022 and 2021. The Organization did not have an internal control policy to ensure the inventory of real property and equipment would be performed when there was a change in the individual responsible for ensuring the count occurred. Effect: The inventory or real property and equipment was not completed in accordance with requirements. Question Costs: None reported. Context/Sampling: None as there would only be one inventory performed. Repeat Finding from Prior Year: No Recommendation: We recommend that management should implement an internal control to make sure the inventory count is being performed despite any possible changes in staffing. Views of Responsible Officials: Management agrees with the finding.
2022-003 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Preparation of Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition: The Organization does not have an internal control system designed to provide for a complete and accurate schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause: Auditor assistance with preparation of the Schedule is not unusual as the Schedule has unique and specialized requirements and preparation is only required when the Organization meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the Organization would not be able to draft the Schedule that is correct without the assistance of the auditors. Questioned Costs: None reported. Context: Sampling was not used. Repeat Finding from Prior Years: Yes, Finding 2021-003. Recommendation: While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Organization?s schedule of expenditures of federal awards and the internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.
2022-004 Department of Housing and Urban Development Federal Financial Assistance Listing/CFDA #14.128 Section 242 ? Mortgage Insurance - Hospitals Reporting Material Weakness in Internal Control Over Compliance Criteria: The OMB Compliance Supplement requires that non-federal entities receiving federal awards establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Condition: The Section 242 ? Mortgage Insurance - Hospitals Program requires quarterly reports and certain annual reports. For the year ended July 31, 2022, the Organization failed to file the annual budget prior to the start of the year. Cause: There was turnover of key financial personnel during 2021 and 2022. The Organization did not follow their internal control policy to ensure the required reports were filed. Effect: The required reports were not submitted in accordance with loan requirements. Questioned Costs: None reported. Context: There were a total of eight reports required to be submitted for the year ended July 31, 2022. Three were selected for testing. Of the three selected, one was not submitted as required. Through additional inquiry, there were no other reports identified as not being submitted. Repeat Finding from Prior Years: Yes, Finding 2021-004. Recommendation: We recommend the Organization enhance internal control policies to ensure required reports are filed timely and accurately. Views of Responsible Officials: Management agrees with the finding.
2022-005 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance Criteria: The OMB Compliance Supplement requires that non-federal entities receiving federal awards establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Condition: During our testing, there was no documentation of review and approval of check disbursements for a portion of the sample selected. Cause: The Organization did not have an adequate internal control policy in place to ensure review and approval of cash disbursements was documented. Effect: The lack of adequate policies governing cash disbursement increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: A nonstatistical sample of 60 expenditures were selected for testing. Of these 60, 33 did not show evidence of proper review and approval prior to payment. Repeat Finding from Prior Years: Yes, Finding 2022-005. Recommendation: We recommend that the Organization enhance internal control policies to ensure all cash disbursements are reviewed and approved prior to payment to ensure that all payments are necessary and correct. Views of Responsible Officials: Management agrees with the finding.
2022-006 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance Criteria: A good system on internal controls over compliance includes processes to ensure all provisions within the agreements are fully followed as well as following generally accepted accounting principles. Condition: The Organization entered into a 5-year lease on equipment. A capital lease is identified in the Mortgage Note Insured by HUD as the incurrence of additional indebtedness which, by terms of the agreement, should be approved by HUD in advance of entering into the capital lease agreement. Cause: During the course of our engagement, we noted that management did not receive approval from HUD in advance of entering into the agreement. Management did get approval from HUD after entering into the agreement. Effect: The Organization violated a covenant within the Mortgage Note Insured by HUD agreement. Question Costs: None reported. Context/Sampling: None as there was only one lease agreement entered into during the year that was a capital lease. Repeat Finding from Prior Year: Yes, Finding 2021-006. Recommendation: We recommend that management should request and receive approval from HUD prior to entering into lease or other debt agreements. Views of Responsible Officials: Management agrees with the finding.
2022-007 Department of Housing and Urban Development Federal Financial Assistance Listing #14.128 Section 242 ? Mortgage Insurance - Hospitals Equipment and Real Property Management Significant Deficiency in Internal Control Over Compliance and Noncompliance Not Considered Material Criteria: The OMB Compliance Supplement requires that non-federal entities receiving federal awards establish and maintain internal controls designed to reasonably ensure compliance with federal laws, regulations, and program compliance requirements. Condition: The Section 242 ? Mortgage Insurance - Hospitals Program requires an inventory of real property and equipment purchased with federal funds to be completed every two years. For the year ended July 31, 2021, the Organization failed to perform this inventory when the last had been performed for the year ended July 31, 2020. Cause: There was turnover of key financial personnel during 2022 and 2021. The Organization did not have an internal control policy to ensure the inventory of real property and equipment would be performed when there was a change in the individual responsible for ensuring the count occurred. Effect: The inventory or real property and equipment was not completed in accordance with requirements. Question Costs: None reported. Context/Sampling: None as there would only be one inventory performed. Repeat Finding from Prior Year: No Recommendation: We recommend that management should implement an internal control to make sure the inventory count is being performed despite any possible changes in staffing. Views of Responsible Officials: Management agrees with the finding.