FAC Explorer

Audit 304023

FY End
2022-10-31
Total Expended
$7.35M
Findings
12
Programs
7
Organization: Care Alliance Health Center (CT)
Year: 2022 Accepted: 2024-04-19
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
393819 2022-002 Material Weakness Yes N
393820 2022-003 Material Weakness Yes L
393821 2022-002 Material Weakness Yes N
393822 2022-003 Material Weakness Yes L
393823 2022-002 Material Weakness Yes N
393824 2022-003 Material Weakness Yes L
970261 2022-002 Material Weakness Yes N
970262 2022-003 Material Weakness Yes L
970263 2022-002 Material Weakness Yes N
970264 2022-003 Material Weakness Yes L
970265 2022-002 Material Weakness Yes N
970266 2022-003 Material Weakness Yes L

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.70M Yes 2
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $2.25M Yes 2
93.498 Provider Relief Fund and American Rescue Plan(arp) Rural Distribution $311,789 - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $108,099 - 0
93.310 Trans-Nih Research Support $36,860 - 0
93.778 Medical Assistance Program $12,500 - 0
93.940 Hiv Prevention Activities_health Department Based $2,589 - 0

Contacts

Name Title Type
MCF6LSLKLDK5 Michael Finch Auditee
2167816228 James Lacroix Auditor
No contacts on file

Notes to SEFA

Title: COVID-19 - Provider Relief Fund and American Rescue Plan (“ARP”) Rural Distribution - Assistance Listing Number 93.498 Accounting Policies: The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of Care Alliance and Subsidiary (the "Organization") under programs of the federal government for the year ended October 31, 2022. The information in this 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 Organization, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Organization. De Minimis Rate Used: N Rate Explanation: 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 Organization has elected to not use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. Pass-through entity identifying numbers are presented where available. For the DHHS awards related to the Provider Relief Fund (“PRF”) and American Rescue Plan (“ARP”) Rural Distribution program, DHHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the Health Resource and Services Administration (“HRSA”) PRF Reporting Portal. Payments from DHHS for PRF are assigned to “Payment Received Periods” (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). The Schedule includes $311,789 received from DHHS between July 1, 2020 through December 31, 2020. In accordance with guidance from DHHS, this amount represents $311,789 for Period 2. Grant revenue of $311,789 was recognized as grant revenue for the year ended October 31, 2021.

Finding Details

Finding 2022-002
Finding 2022.002: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Context A test of 40 sliding fee discount transactions was performed and resulted in 30 instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-003
Finding 2022.003: Reporting Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, annual audit reports of recipients of federal funds are required to be submitted to the Federal Audit Clearing House, within the earlier of 30 days after the receipt of the audit report or 9 months after the end of the audit period. Condition The Organization did not submit their annual audit in accordance with the Uniform Guidance on a timely basis. Cause Due to turnover in the financial leadership position as well as oversight by the Organization, the Organization's finance department was not able to perform detailed review of accounts and adjust books accordingly, which delayed the filing of the annual audit report. Context The Organization did not submit their annual audit on a timely basis. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance and with DHHS grant requirements. Identification of Repeat Finding Yes Recommendation We recommend that the Organization establish controls to ensure all accounting records are analyzed and proper support is available in order to ensure that the financial statement audit is submitted on a timely basis to the federal government. The Organization should also ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Officials and Planned Corrective Actions Management and the Board of Directors agree. The reporting for the fiscal year 2022 audit was deficient due to turnover in the financial leadership position and the lack of appropriate resources in the finance department. The accounting staff has a better understanding of single audit requirements related to HRSA 330 grant reporting. The Organization expects to enact the recommendations for the fiscal year 2023 audit.
Finding 2022-002
Finding 2022.002: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Context A test of 40 sliding fee discount transactions was performed and resulted in 30 instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-003
Finding 2022.003: Reporting Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, annual audit reports of recipients of federal funds are required to be submitted to the Federal Audit Clearing House, within the earlier of 30 days after the receipt of the audit report or 9 months after the end of the audit period. Condition The Organization did not submit their annual audit in accordance with the Uniform Guidance on a timely basis. Cause Due to turnover in the financial leadership position as well as oversight by the Organization, the Organization's finance department was not able to perform detailed review of accounts and adjust books accordingly, which delayed the filing of the annual audit report. Context The Organization did not submit their annual audit on a timely basis. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance and with DHHS grant requirements. Identification of Repeat Finding Yes Recommendation We recommend that the Organization establish controls to ensure all accounting records are analyzed and proper support is available in order to ensure that the financial statement audit is submitted on a timely basis to the federal government. The Organization should also ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Officials and Planned Corrective Actions Management and the Board of Directors agree. The reporting for the fiscal year 2022 audit was deficient due to turnover in the financial leadership position and the lack of appropriate resources in the finance department. The accounting staff has a better understanding of single audit requirements related to HRSA 330 grant reporting. The Organization expects to enact the recommendations for the fiscal year 2023 audit.
Finding 2022-002
Finding 2022.002: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Context A test of 40 sliding fee discount transactions was performed and resulted in 30 instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-003
Finding 2022.003: Reporting Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, annual audit reports of recipients of federal funds are required to be submitted to the Federal Audit Clearing House, within the earlier of 30 days after the receipt of the audit report or 9 months after the end of the audit period. Condition The Organization did not submit their annual audit in accordance with the Uniform Guidance on a timely basis. Cause Due to turnover in the financial leadership position as well as oversight by the Organization, the Organization's finance department was not able to perform detailed review of accounts and adjust books accordingly, which delayed the filing of the annual audit report. Context The Organization did not submit their annual audit on a timely basis. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance and with DHHS grant requirements. Identification of Repeat Finding Yes Recommendation We recommend that the Organization establish controls to ensure all accounting records are analyzed and proper support is available in order to ensure that the financial statement audit is submitted on a timely basis to the federal government. The Organization should also ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Officials and Planned Corrective Actions Management and the Board of Directors agree. The reporting for the fiscal year 2022 audit was deficient due to turnover in the financial leadership position and the lack of appropriate resources in the finance department. The accounting staff has a better understanding of single audit requirements related to HRSA 330 grant reporting. The Organization expects to enact the recommendations for the fiscal year 2023 audit.
Finding 2022-002
Finding 2022.002: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Context A test of 40 sliding fee discount transactions was performed and resulted in 30 instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-003
Finding 2022.003: Reporting Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, annual audit reports of recipients of federal funds are required to be submitted to the Federal Audit Clearing House, within the earlier of 30 days after the receipt of the audit report or 9 months after the end of the audit period. Condition The Organization did not submit their annual audit in accordance with the Uniform Guidance on a timely basis. Cause Due to turnover in the financial leadership position as well as oversight by the Organization, the Organization's finance department was not able to perform detailed review of accounts and adjust books accordingly, which delayed the filing of the annual audit report. Context The Organization did not submit their annual audit on a timely basis. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance and with DHHS grant requirements. Identification of Repeat Finding Yes Recommendation We recommend that the Organization establish controls to ensure all accounting records are analyzed and proper support is available in order to ensure that the financial statement audit is submitted on a timely basis to the federal government. The Organization should also ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Officials and Planned Corrective Actions Management and the Board of Directors agree. The reporting for the fiscal year 2022 audit was deficient due to turnover in the financial leadership position and the lack of appropriate resources in the finance department. The accounting staff has a better understanding of single audit requirements related to HRSA 330 grant reporting. The Organization expects to enact the recommendations for the fiscal year 2023 audit.
Finding 2022-002
Finding 2022.002: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Context A test of 40 sliding fee discount transactions was performed and resulted in 30 instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-003
Finding 2022.003: Reporting Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, annual audit reports of recipients of federal funds are required to be submitted to the Federal Audit Clearing House, within the earlier of 30 days after the receipt of the audit report or 9 months after the end of the audit period. Condition The Organization did not submit their annual audit in accordance with the Uniform Guidance on a timely basis. Cause Due to turnover in the financial leadership position as well as oversight by the Organization, the Organization's finance department was not able to perform detailed review of accounts and adjust books accordingly, which delayed the filing of the annual audit report. Context The Organization did not submit their annual audit on a timely basis. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance and with DHHS grant requirements. Identification of Repeat Finding Yes Recommendation We recommend that the Organization establish controls to ensure all accounting records are analyzed and proper support is available in order to ensure that the financial statement audit is submitted on a timely basis to the federal government. The Organization should also ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Officials and Planned Corrective Actions Management and the Board of Directors agree. The reporting for the fiscal year 2022 audit was deficient due to turnover in the financial leadership position and the lack of appropriate resources in the finance department. The accounting staff has a better understanding of single audit requirements related to HRSA 330 grant reporting. The Organization expects to enact the recommendations for the fiscal year 2023 audit.
Finding 2022-002
Finding 2022.002: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always have the proper slide fee documentation readily available to ensure the proper slide fee discount was applied based on approved policies. Cause The Organization did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Context A test of 40 sliding fee discount transactions was performed and resulted in 30 instances where the Organization was unable to provide approved documentation, or the sliding fee discount was calculated incorrectly. Our sample was a statistically valid sample. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes Recommendation The Organization should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated and supported based on family size and income. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2022-003
Finding 2022.003: Reporting Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 - Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, annual audit reports of recipients of federal funds are required to be submitted to the Federal Audit Clearing House, within the earlier of 30 days after the receipt of the audit report or 9 months after the end of the audit period. Condition The Organization did not submit their annual audit in accordance with the Uniform Guidance on a timely basis. Cause Due to turnover in the financial leadership position as well as oversight by the Organization, the Organization's finance department was not able to perform detailed review of accounts and adjust books accordingly, which delayed the filing of the annual audit report. Context The Organization did not submit their annual audit on a timely basis. Questioned Costs None Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance and with DHHS grant requirements. Identification of Repeat Finding Yes Recommendation We recommend that the Organization establish controls to ensure all accounting records are analyzed and proper support is available in order to ensure that the financial statement audit is submitted on a timely basis to the federal government. The Organization should also ensure that all reporting requirements are monitored and met on a timely basis. Views of Responsible Officials and Planned Corrective Actions Management and the Board of Directors agree. The reporting for the fiscal year 2022 audit was deficient due to turnover in the financial leadership position and the lack of appropriate resources in the finance department. The accounting staff has a better understanding of single audit requirements related to HRSA 330 grant reporting. The Organization expects to enact the recommendations for the fiscal year 2023 audit.