Audit 323560

FY End
2022-03-31
Total Expended
$9.57M
Findings
2
Programs
4
Year: 2022 Accepted: 2024-10-01
Auditor: D & CO LLP

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
501492 2022-002 Material Weakness - B
1077934 2022-002 Material Weakness - B

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $8.75M Yes 1
93.461 Covid-19 Testing for the Uninsured $634,675 - 0
93.697 Covid-19 Testing for Rural Health Clinics $149,461 - 0
93.301 Small Rural Hospital Improvement Grant Program $22,111 - 0

Contacts

Name Title Type
ZHCSWDBRPUL3 Colby Reeves Auditee
8068722183 Melissa Haigood Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the SEFA 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. De Minimis Rate Used: N Rate Explanation: The District has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying Schedule of Expenditures of Federal Awards (the “SEFA”) includes the federal award activity of Dawson County Hospital District, d/b/a Medical Arts Hospital, under programs of the federal government for the year ended March 31, 2022. The information in the SEFA 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 SEFA presents only a selected portion of the operations of the District, it is not intended to and does not present the financial position, revenues, expenses, and changes in net position, or cash flows of the District.
Title: Subrecipients Accounting Policies: Expenditures reported on the SEFA 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. De Minimis Rate Used: N Rate Explanation: The District has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The District did not provide any federal awards to subrecipients during the year ended March 31, 2022.
Title: Provider Relief Funds (93.498) Accounting Policies: Expenditures reported on the SEFA 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. De Minimis Rate Used: N Rate Explanation: The District has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Expenditures under CFDA 93.498, Provider Relief Fund (PRF) applies the guidance of the U.S. Department of Health and Human Services (HHS). For the PRF program, the amount on the SEFA is reported based on the PRF portal submission guidelines. Payments from HHS for the PRF are assigned to one of four Payment Received Periods based upon the date each payment from the PRF was received. Each period has a specified Period of Availability and timing of reporting requirements. The SEFA includes those qualifying expenditures and/or lost revenues that were reported in the PRF portal for Period 1 (Payments Received Periods from April 10, 2020 to June 30, 2020 and July 1, 2020 to December 31, 2020, respectively; and Periods of Availability from January 1, 2020 to June 30, 2021 and January 1, 2020 to December 31, 2021, respectively). As such, the amount presented in the SEFA will differ from amounts presented in the statement of revenues, expenses, and changes in net position.
Title: Personal Protective Equipment (PPE) (Unaudited) Accounting Policies: Expenditures reported on the SEFA 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. De Minimis Rate Used: N Rate Explanation: The District has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. For the year ended March 31, 2022, Dawson County Hospital District, d/b/a Medical Arts Hospital received $-0- in federally donated personal protective equipment in response to the COVID-19 pandemic (unaudited).

Finding Details

U.S. Department of Health and Human Services COVID-19 - Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution - Period 1 Activities Allowed/Unallowed and Allowable Costs - Assistance Listing Number 93.498 Condition: The District reported expenditures to the U.S. Department of Health and Human Services through the PRF reporting portal for the first period of availability that did not meet the criteria of allowable costs in accordance with the terms and conditions. Additionally, the District did not establish adequate internal controls over compliance related to a major federal award program with respect to the allowable costs compliance requirement. Criteria: Specific terms and conditions were provided by the U.S. Department of Health and Human Services associated with the Provider Relief Fund (PRF). In accordance with the terms and conditions, PRF distributions can only be used to reimburse expenditures incurred to prevent, prepare for, or respond to the coronavirus that have not been reimbursed from other sources, and that other sources are not obligated to reimburse. Management is responsible for establishing effective internal controls over compliance requirements related to each major federal award program. Cause: Proper internal controls over compliance were not in place to identify unallowable costs in accordance with the PRF terms and conditions. Effect: The District reported costs that were not allowable to the U.S. Department of Health and Human Services through the PRF reporting portal for the first period of availability, resulting in a material noncompliance with respect to a major federal award program. Questioned Costs: For the year ended March 31, 2022, the District reported unallowable costs in the amount of $710,269. Recommendation: Effective internal controls over compliance should be designed and implemented to ensure all expenses being reported to the U.S. Department of Health and Human Services are allowable in accordance with the terms and conditions prior to claiming and reporting the expense as allowable through the PRF reporting portal. Views of Responsible Officials - See attached corrective action plan for the District's response to finding.
U.S. Department of Health and Human Services COVID-19 - Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution - Period 1 Activities Allowed/Unallowed and Allowable Costs - Assistance Listing Number 93.498 Condition: The District reported expenditures to the U.S. Department of Health and Human Services through the PRF reporting portal for the first period of availability that did not meet the criteria of allowable costs in accordance with the terms and conditions. Additionally, the District did not establish adequate internal controls over compliance related to a major federal award program with respect to the allowable costs compliance requirement. Criteria: Specific terms and conditions were provided by the U.S. Department of Health and Human Services associated with the Provider Relief Fund (PRF). In accordance with the terms and conditions, PRF distributions can only be used to reimburse expenditures incurred to prevent, prepare for, or respond to the coronavirus that have not been reimbursed from other sources, and that other sources are not obligated to reimburse. Management is responsible for establishing effective internal controls over compliance requirements related to each major federal award program. Cause: Proper internal controls over compliance were not in place to identify unallowable costs in accordance with the PRF terms and conditions. Effect: The District reported costs that were not allowable to the U.S. Department of Health and Human Services through the PRF reporting portal for the first period of availability, resulting in a material noncompliance with respect to a major federal award program. Questioned Costs: For the year ended March 31, 2022, the District reported unallowable costs in the amount of $710,269. Recommendation: Effective internal controls over compliance should be designed and implemented to ensure all expenses being reported to the U.S. Department of Health and Human Services are allowable in accordance with the terms and conditions prior to claiming and reporting the expense as allowable through the PRF reporting portal. Views of Responsible Officials - See attached corrective action plan for the District's response to finding.