FAC Explorer

Audit 300118

FY End
2023-06-30
Total Expended
$7.56M
Findings
4
Programs
13
Organization: Memorial Hospital of Laramie County D/b/a Cheyenne Regional Medical Ce (WY)
Year: 2023 Accepted: 2024-03-28
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
388327 2023-001 Significant Deficiency - L
388328 2023-002 Significant Deficiency - ABH
964769 2023-001 Significant Deficiency - L
964770 2023-002 Significant Deficiency - ABH

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $2.54M Yes 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $2.24M Yes 0
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $1.33M - 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $454,984 - 0
21.023 Emergency Rental Assistance Program $290,367 Yes 2
16.838 Comprehensive Opioid Abuse Site-Based Program $201,963 - 0
16.575 Crime Victim Assistance $170,000 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $114,926 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $104,774 - 0
93.969 Pphf Geriatric Education Centers $44,024 - 0
93.387 National and State Tobacco Control Program (b) $35,109 - 0
93.788 Opioid Str $22,563 - 0
93.516 Affordable Care Act (aca) Public Health Training Centers Program $10,000 - 0

Contacts

Name Title Type
GZM7NGLXZNC4 Dawn Swaen Auditee
3076333075 Ashley Brandt-Duda Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. When applicable, 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 Medical Center does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of the Medical Center under programs of the federal government for the year ended June 30, 2023. 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 Medical Center, it is not intended to and does not present the financial position, changes in net position, or cash flows of the Medical Center.
Title: COVID‐19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Accounting Policies: Expenditures reported in the Schedule are reported on the accrual basis of accounting. When applicable, 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 Medical Center does not draw for indirect administrative expenses and has not elected to use the 10% de minimus cost rate. The Medical Center received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program (Federal Financial Assistance Listing #93.498) in the amount of $14,702,974 as of June 30, 2023. The PRF expenditures are recognized on the Schedule when the expenditures, including lost revenue, were included in the reporting to HHS for Period 4, defined as payments received between July 1, 2021 and December 31, 2021, and Period 5, defined as payments received between January 1, 2022 and June 30, 2022. As the total $2,536,692 was included in the Period 4 report submitted to HHS, that amount is shown on the accompanying Schedule. The Medical Center did not have monies to report for the Period 5 report. The total amount of PRF expenditures included on the Schedule requires management to make estimates and assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant estimate. Estimates and assumptions may include reducing actual expenses by amounts that have been reimbursed or are obligated to be reimbursed by other sources and estimating marginal increases in expenses related to coronavirus. Actual amounts could differ from those estimates.

Finding Details

Finding 2023-001
Department of Treasury Passed through Equal Justice Wyoming and Wyoming Department of Family Services Federal Financial Assistance Listing #21.023 Emergency Rental Assistance Program Reporting Significant Deficiency in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: There was no evidence retained that the Medical Center’s compliance reports submitted to Equal Justice and Wyoming Department of Family Services (WDFS) were reviewed and approved prior to submission. Cause: The Medical Center did not have an internal control policy in place to ensure documented review and approval of the compliance and financial reports. Effect: The lack of adequate policies governing review and approval increases the risk that employees participating in the federal awards administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: A nonstatistical sample of 12 out of 32 reports were selected for detail testing and did not include evidence of a review by someone other than the preparer. Repeat Finding from Prior Years: No Recommendation: We recommend that the Medical Center enhance internal control policies to ensure that formal documentation of review and approval is obtained and retained. Views of Responsible Officials: Management agrees with the finding.
Finding 2023-002
Department of Treasury Passed through Equal Justice Wyoming and Wyoming Department of Family Services Federal Financial Assistance Listing #21.023 Emergency Rental Assistance Program Activities Allowed or Unallowed and Allowable Costs/Costs Principles and Period of Performance Significant Deficiency in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Medical Center was not able to provide supporting invoices for two of the testing selections. An additional selection contained a keying error. Cause: The Medical Center did have an internal control policy in place to ensure proper review and approval of the supporting invoices but controls did not appear to be functioning properly. Effect: The lack of adequate policies governing review and approval of the specific invoices increase the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Without this documentation, ineligible expenditures may be claimed under the program. Questioned Costs: None reported. Context: A nonstatistical sample of 62 was selected for detail testing. The Medical Center was not able to provide supporting invoices for two of the testing selections. An additional selection contained a keying error. Repeat Finding from Prior Years: No Recommendation: We recommend that the Medical Center enhance internal control policies to ensure that all support utilized for the program is retained within accounting records. We also recommend that the Medical Center enhance internal control policies to ensure future keying errors are identified during the review process. Views of Responsible Officials: Management agrees with the finding.
Finding 2023-001
Department of Treasury Passed through Equal Justice Wyoming and Wyoming Department of Family Services Federal Financial Assistance Listing #21.023 Emergency Rental Assistance Program Reporting Significant Deficiency in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: There was no evidence retained that the Medical Center’s compliance reports submitted to Equal Justice and Wyoming Department of Family Services (WDFS) were reviewed and approved prior to submission. Cause: The Medical Center did not have an internal control policy in place to ensure documented review and approval of the compliance and financial reports. Effect: The lack of adequate policies governing review and approval increases the risk that employees participating in the federal awards administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: A nonstatistical sample of 12 out of 32 reports were selected for detail testing and did not include evidence of a review by someone other than the preparer. Repeat Finding from Prior Years: No Recommendation: We recommend that the Medical Center enhance internal control policies to ensure that formal documentation of review and approval is obtained and retained. Views of Responsible Officials: Management agrees with the finding.
Finding 2023-002
Department of Treasury Passed through Equal Justice Wyoming and Wyoming Department of Family Services Federal Financial Assistance Listing #21.023 Emergency Rental Assistance Program Activities Allowed or Unallowed and Allowable Costs/Costs Principles and Period of Performance Significant Deficiency in Internal Control Over Compliance Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: The Medical Center was not able to provide supporting invoices for two of the testing selections. An additional selection contained a keying error. Cause: The Medical Center did have an internal control policy in place to ensure proper review and approval of the supporting invoices but controls did not appear to be functioning properly. Effect: The lack of adequate policies governing review and approval of the specific invoices increase the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Without this documentation, ineligible expenditures may be claimed under the program. Questioned Costs: None reported. Context: A nonstatistical sample of 62 was selected for detail testing. The Medical Center was not able to provide supporting invoices for two of the testing selections. An additional selection contained a keying error. Repeat Finding from Prior Years: No Recommendation: We recommend that the Medical Center enhance internal control policies to ensure that all support utilized for the program is retained within accounting records. We also recommend that the Medical Center enhance internal control policies to ensure future keying errors are identified during the review process. Views of Responsible Officials: Management agrees with the finding.