Audit 307412

FY End
2023-12-31
Total Expended
$3.09M
Findings
2
Programs
3

Organization Exclusion Status:

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Contacts

Name Title Type
MCN1S6CHR8F3 Brian Bailey Auditee
3015333300 Timothy E. Peters, CPA Auditor
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Notes to SEFA

Title: NOTE 1 SINGLE AUDIT OVERVIEW Accounting Policies: The accompanying schedule of expenditures of federal awards includes the federal grant activity of Mountain Laurel Medical Center and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. All costs charged to the grant are direct costs to the program. There are no indirect costs allocated to the program. De Minimis Rate Used: N Rate Explanation: The program elected not to use the 10% de minimis indirect cost rate. The Single Audit is the performance of a uniform audit of Mountain Laurel Medical Center’s federal grants in conjunction with the annual audit of the basic financial statements. The information in the Schedule of Expenditures of Federal Awards in presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). The Single Audit fulfills all the Federal agencies’ audit requirements, which cover financial, compliance and internal controls. The programs tested as major programs are indicated on the Schedule of Expenditures of Federal Awards and on the Schedule of Findings and Questioned Costs and amounted to 89% of total federal award expenditures.
Title: NOTE 2 FISCAL PERIOD AUDITED Accounting Policies: The accompanying schedule of expenditures of federal awards includes the federal grant activity of Mountain Laurel Medical Center and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. All costs charged to the grant are direct costs to the program. There are no indirect costs allocated to the program. De Minimis Rate Used: N Rate Explanation: The program elected not to use the 10% de minimis indirect cost rate. Single Audit testing procedures were performed for transactions occurring during the fiscal year ended December 31, 2023.
Title: NOTE 3 BASIS OF PRESENTATION Accounting Policies: The accompanying schedule of expenditures of federal awards includes the federal grant activity of Mountain Laurel Medical Center and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. All costs charged to the grant are direct costs to the program. There are no indirect costs allocated to the program. De Minimis Rate Used: N Rate Explanation: The program elected not to use the 10% de minimis indirect cost rate. The accompanying schedule of expenditures of federal awards includes the federal grant activity of Mountain Laurel Medical Center and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. All costs charged to the grant are direct costs to the program. There are no indirect costs allocated to the program. The program elected not to use the 10% de minimis indirect cost rate. The program had no subrecipients.
Title: NOTE 4 RECONCILIATION OF FEDERAL GRANT REVENUE TO SEFA Accounting Policies: The accompanying schedule of expenditures of federal awards includes the federal grant activity of Mountain Laurel Medical Center and is presented on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance. All costs charged to the grant are direct costs to the program. There are no indirect costs allocated to the program. De Minimis Rate Used: N Rate Explanation: The program elected not to use the 10% de minimis indirect cost rate. The accompanying schedule of expenditures of federal awards includes expenditures of federal awards that are reported differently from the way they are presented in the financial statements. Following is a reconciliation of federal expenditures per the SEFA to total federal grant revenue recognized in the financial statements:

Finding Details

Federal Assistance Listing Number 93.224/93.527 Health Center Program Special Tests and Provisions Finding 2023‐002 – Noncompliance Related to Charging Incorrect Sliding Fee Criteria: Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100% and at or below 200% of Federal Poverty Guidelines. The Center’s sliding fee scale, approved annually by the Board of Directors, is used to determine the patient’s sliding fee. Condition: For one of 25 encounters selected for testing, an incorrect calculation was used to determine the household income, which resulted in the individual being charged a lesser copay than they should have been charged. Cause: Due to a calculation error, the Center calculated a patient’s annual income by multiplying weekly income by 48 weeks instead of 52 weeks. Effect: The patient encounter was discounted to a copay of $30 when the patient qualified for a discounted copay of $35. Questioned Costs: There are no questioned costs. Context: This issue appears to be an isolated instance and is not systemic of a breakdown in internal controls over special tests and provisions. Repeat Finding: This is not a repeat finding. Recommendation: We recommend that all staff involved in reviewing sliding fee applications be reminded of the Center’s policy for calculating annual income based on support provided by a patient.
Federal Assistance Listing Number 93.224/93.527 Health Center Program Special Tests and Provisions Finding 2023‐002 – Noncompliance Related to Charging Incorrect Sliding Fee Criteria: Fees for health center services are discounted based on gradations in family size and income for individuals and families with incomes above 100% and at or below 200% of Federal Poverty Guidelines. The Center’s sliding fee scale, approved annually by the Board of Directors, is used to determine the patient’s sliding fee. Condition: For one of 25 encounters selected for testing, an incorrect calculation was used to determine the household income, which resulted in the individual being charged a lesser copay than they should have been charged. Cause: Due to a calculation error, the Center calculated a patient’s annual income by multiplying weekly income by 48 weeks instead of 52 weeks. Effect: The patient encounter was discounted to a copay of $30 when the patient qualified for a discounted copay of $35. Questioned Costs: There are no questioned costs. Context: This issue appears to be an isolated instance and is not systemic of a breakdown in internal controls over special tests and provisions. Repeat Finding: This is not a repeat finding. Recommendation: We recommend that all staff involved in reviewing sliding fee applications be reminded of the Center’s policy for calculating annual income based on support provided by a patient.