FAC Explorer

Audit 308159

FY End
2023-12-31
Total Expended
$32.91M
Findings
2
Programs
1
Organization: Western Missouri Medical Center (MO)
Year: 2023 Accepted: 2024-06-05
Auditor: Wendling Noe Nelson & Johnson LLC

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
399982 2023-001 Significant Deficiency - N
976424 2023-001 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $32.91M Yes 1

Contacts

Name Title Type
HG57GTLJW9N7 Dean Ohmart Auditee
6607472500 Cameron Werth Auditor
No contacts on file

Notes to SEFA

Title: Basis of presentation Accounting Policies: Expenditures 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant award activity of Western Missouri Medical Center (the Medical Center) under programs of the federal government for the year ended December 31, 2023. 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 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: Significant accounting policies Accounting Policies: Expenditures 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. Expenditures 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available.
Title: Indirect cost rate Accounting Policies: Expenditures 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses.
Title: Loans Accounting Policies: Expenditures 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. Expenditures on the Schedule consist of the beginning of the year outstanding loan balances plus advances made on the loans during the year. The balance of loans outstanding as of December 31, 2023, was $31,233,126.

Finding Details

Finding 2023-001
Identification: 10.766 United States Department of Agriculture (USDA), Community Facilities Loans and Grants Cluster; Noncompliance Finding; Special Tests and Provisions Compliance Requirement Criteria: The USDA direct loan and guaranteed loan were entered into in 2010 for renovation of the Medical Center's healthcare facility. One direct loan and one guaranteed loan were received. In connection with the loans, the Medical Center entered into the 2010 bond trust indenture and agreed to the letter of conditions dated November 30, 2009, set forth by the USDA which the Medical Center isrequired to follow. Section 510 of the 2010 bond trust indenture states the insurance coverages that the Medical Center is required to obtain which includes retaining an insurance consultant to provide a written report to the Board of Trustees on a biannual basis. Condition 34 of the letter of conditions further states the Medical Center will have fidelity bond coverage in an amount not less than the annual principal and interest becoming due on the bonds. Condition: The Medical Center did not retain an insurance consultant to provide a written report to the Board of Trustees on a biannual basis in accordance with Section 510 of the 2010 bond trust indenture and the Medical Center is not carrying a sufficient amount of fidelity bond coverage as set forth in the letter of conditions dated November 30, 2009. Cause: The Medical Center did not have adequate procedures in place to ensure it was complying with Section 510 of the 2010 bond trust indenture or the November 30, 2009, letter of conditions as it pertains to the amount of fidelity bond coverage. Effect: The Medical Center is not complying with Section 510 of the 2010 bond indenture or Condition 34 of the letter of conditions dated November 30, 2009. Questioned Costs: None Perspective Information: We reviewed the Medical Center's insurance policies and determined the amount of fidelity bond coverage was insufficient based on annual debt service payments. Repeat Finding: Not applicable Recommendations: We recommend that the Medical Center review Section 510 of the 2010 bond trust indenture and Condition 34 of the letter of conditions and establish procedures so that on a biannual basis the Medical Center's insurance consultant is providing a written report in accordance with Section 510 and that the Medical Center work with its insurance consultant to ensure that it is carrying a sufficient amount of fidelity bond coverage to comply with Condition 34 of the letter of conditions. Views from Responsible Officials: The Medical Center was not aware of the insurance consultant's report on a biannual basis or the fidelity bond coverage requirement until 2023 and the USDA has never questioned us on either of these matters. We will communicate with our USDA representative for guidance on these matters.
Finding 2023-001
Identification: 10.766 United States Department of Agriculture (USDA), Community Facilities Loans and Grants Cluster; Noncompliance Finding; Special Tests and Provisions Compliance Requirement Criteria: The USDA direct loan and guaranteed loan were entered into in 2010 for renovation of the Medical Center's healthcare facility. One direct loan and one guaranteed loan were received. In connection with the loans, the Medical Center entered into the 2010 bond trust indenture and agreed to the letter of conditions dated November 30, 2009, set forth by the USDA which the Medical Center isrequired to follow. Section 510 of the 2010 bond trust indenture states the insurance coverages that the Medical Center is required to obtain which includes retaining an insurance consultant to provide a written report to the Board of Trustees on a biannual basis. Condition 34 of the letter of conditions further states the Medical Center will have fidelity bond coverage in an amount not less than the annual principal and interest becoming due on the bonds. Condition: The Medical Center did not retain an insurance consultant to provide a written report to the Board of Trustees on a biannual basis in accordance with Section 510 of the 2010 bond trust indenture and the Medical Center is not carrying a sufficient amount of fidelity bond coverage as set forth in the letter of conditions dated November 30, 2009. Cause: The Medical Center did not have adequate procedures in place to ensure it was complying with Section 510 of the 2010 bond trust indenture or the November 30, 2009, letter of conditions as it pertains to the amount of fidelity bond coverage. Effect: The Medical Center is not complying with Section 510 of the 2010 bond indenture or Condition 34 of the letter of conditions dated November 30, 2009. Questioned Costs: None Perspective Information: We reviewed the Medical Center's insurance policies and determined the amount of fidelity bond coverage was insufficient based on annual debt service payments. Repeat Finding: Not applicable Recommendations: We recommend that the Medical Center review Section 510 of the 2010 bond trust indenture and Condition 34 of the letter of conditions and establish procedures so that on a biannual basis the Medical Center's insurance consultant is providing a written report in accordance with Section 510 and that the Medical Center work with its insurance consultant to ensure that it is carrying a sufficient amount of fidelity bond coverage to comply with Condition 34 of the letter of conditions. Views from Responsible Officials: The Medical Center was not aware of the insurance consultant's report on a biannual basis or the fidelity bond coverage requirement until 2023 and the USDA has never questioned us on either of these matters. We will communicate with our USDA representative for guidance on these matters.