Audit 303788

FY End

2023-10-31

Total Expended

$1.43M

Findings

4

Programs

3

Organization: Ray County Memorial Hospital (MO)

Year: 2023 Accepted: 2024-04-17

Auditor: Dingus Zarecor & Associates PLLC

Organization Exclusion Status:

Checking exclusion status...

ID	Ref	Severity	Repeat	Requirement
393645	2023-001	Significant Deficiency	-	ABL
393646	2023-002	Material Weakness	-	L
970087	2023-001	Significant Deficiency	-	ABL
970088	2023-002	Material Weakness	-	L

ALN	Program	Spent	Major	Findings
93.498	Provider Relief Fund	$1.16M	Yes	2
93.940	Hiv Prevention Activities_health Department Based	$258,376	-	0
93.301	Small Rural Hospital Improvement Grant Program	$10,933	-	0

Contacts

Name	Title	Type
XGDWSQ5RPKE5	David Usher	Auditee
8164707387	Tom Dingus	Auditor
No contacts on file

Notes to SEFA

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. The Hospital has not elected to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. De Minimis Rate Used: N Rate Explanation: The Hospital has not elected to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Ray County Memorial Hospital (the Hospital) under programs of the federal government for the year ended October 31, 2023. Amounts reported on the Schedule for Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution are based upon the December 31, 2022, Provider Relief Fund report. The information in the Schedule 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 Hospital, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Hospital.

Finding Details

Finding 2023-001

2023-001 Policies and Procedures for Federal Awards Federal Agency U.S. Department of Health and Human Services Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Criteria [ ] Compliance Finding [ X ] Significant Deficiency [ ] Material Weakness Recipients of federal awards should maintain written policies and procedures for the tracking and usage of federal awards. Condition The Hospital did not have written policies and procedures with all of the required elements for federal awards for the year ended October 31, 2023. Context This finding appears to be a systemic problem. Cause Management is still developing and implementing internal controls as of October 31, 2023. Effect There is a risk federal funds may be expended out of conformity with federal regulations and compliance requirements. Recommendation We recommend the Hospital write policies and procedures for the tracking and usage of federal awards that conform to federal regulations and compliance requirements. Views of responsible officials and planned corrective actions Management is in the process of writing policies and procedures to ensure appropriate tracking and usage of federal awards to ensure that federal regulations and compliance requirements are met.

Finding 2023-002

2023-002 Provider Relief Fund Reporting of Lost Revenue Federal Agency Department of Health and Human Services Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan Rural Distribution Criteria [ X ] Compliance Finding [ ] Significant Deficiency [ X ] Material Weakness Under the terms and conditions of the award, the recipient certifies it will report actual net patient service revenues for the periods reported on in its reporting of actual net patient service revenues for its calculation of lost revenues due to coronavirus. Condition Lost revenues reported were less than actual lost revenues. Context This finding appears to be an isolated problem. Cause The summary of net patient service revenue used in reporting contained a clerical error that understated reported lost revenue. Effect Reported lost revenues were materially understated. If the correct amount of net patient service revenues had been reported, the Hospital would still have sufficient lost revenues to use all of the Provider Relief Fund amounts received. Therefore, there is no effect on the Hospital’s retention of the Provider Relief Funds. Recommendation We recommend the Hospital’s management correct its lost revenue calculation for any future reporting for the Provider Relief Fund. Views of responsible officials and planned corrective actions Finding is noted and corrections will be made to the lost revenues schedule as noted. Future reports for PRF will be correct.

Finding 2023-001

2023-001 Policies and Procedures for Federal Awards Federal Agency U.S. Department of Health and Human Services Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Criteria [ ] Compliance Finding [ X ] Significant Deficiency [ ] Material Weakness Recipients of federal awards should maintain written policies and procedures for the tracking and usage of federal awards. Condition The Hospital did not have written policies and procedures with all of the required elements for federal awards for the year ended October 31, 2023. Context This finding appears to be a systemic problem. Cause Management is still developing and implementing internal controls as of October 31, 2023. Effect There is a risk federal funds may be expended out of conformity with federal regulations and compliance requirements. Recommendation We recommend the Hospital write policies and procedures for the tracking and usage of federal awards that conform to federal regulations and compliance requirements. Views of responsible officials and planned corrective actions Management is in the process of writing policies and procedures to ensure appropriate tracking and usage of federal awards to ensure that federal regulations and compliance requirements are met.

Finding 2023-002

2023-002 Provider Relief Fund Reporting of Lost Revenue Federal Agency Department of Health and Human Services Federal Assistance Listing Number 93.498 – Provider Relief Fund and American Rescue Plan Rural Distribution Criteria [ X ] Compliance Finding [ ] Significant Deficiency [ X ] Material Weakness Under the terms and conditions of the award, the recipient certifies it will report actual net patient service revenues for the periods reported on in its reporting of actual net patient service revenues for its calculation of lost revenues due to coronavirus. Condition Lost revenues reported were less than actual lost revenues. Context This finding appears to be an isolated problem. Cause The summary of net patient service revenue used in reporting contained a clerical error that understated reported lost revenue. Effect Reported lost revenues were materially understated. If the correct amount of net patient service revenues had been reported, the Hospital would still have sufficient lost revenues to use all of the Provider Relief Fund amounts received. Therefore, there is no effect on the Hospital’s retention of the Provider Relief Funds. Recommendation We recommend the Hospital’s management correct its lost revenue calculation for any future reporting for the Provider Relief Fund. Views of responsible officials and planned corrective actions Finding is noted and corrections will be made to the lost revenues schedule as noted. Future reports for PRF will be correct.