FAC Explorer

Audit 303568

FY End
2023-06-30
Total Expended
$39.14M
Findings
2
Programs
3
Organization: Jamestown Regional Medical Center (ND)
Year: 2023 Accepted: 2024-04-16
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
393278 2023-002 Significant Deficiency - L
969720 2023-002 Significant Deficiency - L

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $11.04M Yes 0
93.498 Provider Relief Fund $1.60M Yes 1
93.301 Small Rural Hospital Improvement Grant Program $241,816 - 0

Contacts

Name Title Type
J2LKAGMKLNQ7 Beverly Fiferlick Auditee
7019524802 Ashley Brandt-Duda Auditor
No contacts on file

Notes to SEFA

Title: Note 1 ‐ Basis of Presentation Accounting Policies: Expenditures reported on 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 has not elected to use the 10% de minimis cost rate. The accompanying schedule of expenditures of federal awards (the schedule) includes the federal award activity of Jamestown Regional Medical Center (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 consolidated financial position, changes in net assets, or cash flows of the Medical Center.
Title: Note 4 ‐ Provider Relief Funds and American Rescue Plan (ARP) Rural Distribution Accounting Policies: Expenditures reported on 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 has not elected to use the 10% de minimis 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). The Medical Center incurred eligible expenditures and therefore recognized revenue totaling $141,892 and $1,456,309 for the years ended June 30, 2023 and 2022 on the consolidated financial statements. However, the PRF expenditures were recognized on the Schedule when the expenditures 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 amount of $1,598,201 was included on the Period 4 and Period 5 reports submitted to HHS, that amount is shown on the accompanying Schedule.
Title: Note 5 ‐ Loan Programs Accounting Policies: Expenditures reported on 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 has not elected to use the 10% de minimis cost rate. Expenditures reported on this consolidated schedule consists of two separate loans. For the first loan, the expenditures reported represents the beginning of the year outstanding loan balances plus advances made on the loans during the year, if applicable. The outstanding balance as of June 30, 2023 for this loan was $25,693,149. The second loan is guaranteed by the United States Department of Agriculture (USDA) for 90% of the loan principal. Total expenditures reported represents 90% of the beginning of the year outstanding loan balances. The outstanding as of June 30, 2023 for this loan was $11,889,000, of which 90% totals $10,700,100.

Finding Details

Finding 2023-002
Department of Health and Human Services Federal Assistance Listing #93.498 COVID‐19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 and Period 5 TIN #450231181 Reporting Significant Deficiency in Internal Control Over Compliance and Noncompliance 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 improperly reported expenses in the Period 5 report submission due to an amount improperly carried forward from a previous report. Cause The Medical Center did not have an adequate internal control policy in place to ensure that expenses were properly reported in future submissions in accordance with the terms and conditions of the grant. Effect While the error provided a difference between reported expenses and supportable expenses, the Medical Center had excess lost revenues available to be applied to future periods. This error also indicated there is a lack of policies governing the review and approval of the expense reporting to the HHS special report. Questioned Costs None reported. Reported expenses were overstated by $66,659 on the Period 5 report, however, the Medical Center had $94,302 of excess lost revenue to offset this error. Context/Sampling: All key line items from the Period 4 and Period 5 reports were tested. Repeat Finding from Prior Years: No Recommendation We recommend that the Medical Center enhance internal control policies to ensure all reports are reviewed and approved to ensure the proper reporting and meet the requirements of the federal program. Views of Responsible Officials Management agrees with the finding.
Finding 2023-002
Department of Health and Human Services Federal Assistance Listing #93.498 COVID‐19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year – Period 4 and Period 5 TIN #450231181 Reporting Significant Deficiency in Internal Control Over Compliance and Noncompliance 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 improperly reported expenses in the Period 5 report submission due to an amount improperly carried forward from a previous report. Cause The Medical Center did not have an adequate internal control policy in place to ensure that expenses were properly reported in future submissions in accordance with the terms and conditions of the grant. Effect While the error provided a difference between reported expenses and supportable expenses, the Medical Center had excess lost revenues available to be applied to future periods. This error also indicated there is a lack of policies governing the review and approval of the expense reporting to the HHS special report. Questioned Costs None reported. Reported expenses were overstated by $66,659 on the Period 5 report, however, the Medical Center had $94,302 of excess lost revenue to offset this error. Context/Sampling: All key line items from the Period 4 and Period 5 reports were tested. Repeat Finding from Prior Years: No Recommendation We recommend that the Medical Center enhance internal control policies to ensure all reports are reviewed and approved to ensure the proper reporting and meet the requirements of the federal program. Views of Responsible Officials Management agrees with the finding.