Condition – Cumberland Memorial Hospital, Inc. d/b/a Cumberland Healthcare’s (the “Organization”) internal control over financial reporting does not end at the general ledger but extends to the financial statements and notes. As part of our professional services for the year ended June 30, 2024, we were requested to draft the financial statements and accompanying notes to the financial statements. It is the responsibility of management and those charged with governance to make the decision about whether to accept the degree of risk associated with this condition because of cost or other considerations. Because the Organization relies on Wipfli LLP to provide the necessary understanding of current accounting and disclosure principles in the preparation of the financial statements and notes, a material weakness exists in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.001.
Criteria – Government Auditing Standards consider the inability to report financial data reliably in accordance with GAAP to be an internal control deficiency.
Effect – The completeness of the financial statement disclosures and the accuracy of the overall financial presentation may be negatively impacted, since outside auditors do not have the same comprehensive understanding of the Organization as its internal staff.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources and staff to prepare the financial statements and notes but will continue to oversee the auditor’s services and review and approve the financial statements and notes.
Condition – The size of the Organization’s staff in charge of accounting and reporting precludes a proper segregation of duties to ensure adequate internal controls. The basic premise is that no one employee should have access to both physical assets and the related accounting records or to all phases of a transaction. The following segregation of duties issues were noted during the audit, and primarily center around certain functions or access within the information systems:
• Individuals involved in the payroll process also have access to personnel changes.
• Individuals with the ability to establish new patients also have access to charge posting, cash receipts posting, and ability to post adjustments within the system.
• The individual responsible for reconciling the general checking account and payroll account also prepares checks issued by the Organization.
• The individual authorized to make deposits and withdrawals from the investment accounts also reconciles the investment accounts.
• Individuals authorized to post adjusting journal entries into the accounting system also prepare reconciliations of the same accounts with limited review by additional personnel.
The Board of Directors should be aware of these conditions and realize that a concentration of duties and responsibilities in a limited number of individuals is not desirable for an effective system of internal control. Under these conditions, the most effective control is the Board of Directors’ knowledge of matters relating to the Organization’s operations. This is a material weakness in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.002.
Criteria – The lack of proper segregation of duties is considered an internal control weakness.
Effect – Without adequate segregation of duties, the likelihood that unauthorized or false transactions will be prevented or detected in a timely fashion is significantly diminished, which may result in misstated financial statements.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources available to increase staff size and address this internal control deficiency. The Board of Directors and management are aware of the incompatible duties and will continue to provide oversight and monitor the Organization’s operations.
Condition – During our audit, Wipfli LLP proposed a number of adjusting journal entries. Although the net impact of the adjustments to the financial statements only resulted in a reduction in the decrease in net assets reported of approximately $700,000, there were still a number of material adjustments which net to this overall change amount, including the Organization’s cash account which needed additional reconciliation due to information systems transaction posting issues. The adjusting journal entries were based on financial calculations and audit procedures performed by Wipfli LLP that were not performed during the Organization’s normal financial close process. Management of the Organization did not the cash balance needed additional review and requested assistance during the audit process with this area. Since the Organization’s internal control did not discover these adjustments prior to our audit, a material weakness exists in the Organization’s controls. This is a repeat finding from 2023, Finding 2023.003.
Criteria – Material adjusting journal entries not prepared by the Organization are considered to be an internal control weakness.
Effect – Proper recording and reporting of financial information may not occur in a timely manner.
Recommendation – We recommend that all accounts be reconciled and adjustments be posted to the accounting records on a quarterly basis, at a minimum.
Management’s Response – The Organization will work to establish policies and procedures to reduce the number of adjusting journal entries proposed by the auditors.
Condition – Cumberland Memorial Hospital, Inc. d/b/a Cumberland Healthcare’s (the “Organization”) internal control over financial reporting does not end at the general ledger but extends to the financial statements and notes. As part of our professional services for the year ended June 30, 2024, we were requested to draft the financial statements and accompanying notes to the financial statements. It is the responsibility of management and those charged with governance to make the decision about whether to accept the degree of risk associated with this condition because of cost or other considerations. Because the Organization relies on Wipfli LLP to provide the necessary understanding of current accounting and disclosure principles in the preparation of the financial statements and notes, a material weakness exists in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.001.
Criteria – Government Auditing Standards consider the inability to report financial data reliably in accordance with GAAP to be an internal control deficiency.
Effect – The completeness of the financial statement disclosures and the accuracy of the overall financial presentation may be negatively impacted, since outside auditors do not have the same comprehensive understanding of the Organization as its internal staff.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources and staff to prepare the financial statements and notes but will continue to oversee the auditor’s services and review and approve the financial statements and notes.
Condition – The size of the Organization’s staff in charge of accounting and reporting precludes a proper segregation of duties to ensure adequate internal controls. The basic premise is that no one employee should have access to both physical assets and the related accounting records or to all phases of a transaction. The following segregation of duties issues were noted during the audit, and primarily center around certain functions or access within the information systems:
• Individuals involved in the payroll process also have access to personnel changes.
• Individuals with the ability to establish new patients also have access to charge posting, cash receipts posting, and ability to post adjustments within the system.
• The individual responsible for reconciling the general checking account and payroll account also prepares checks issued by the Organization.
• The individual authorized to make deposits and withdrawals from the investment accounts also reconciles the investment accounts.
• Individuals authorized to post adjusting journal entries into the accounting system also prepare reconciliations of the same accounts with limited review by additional personnel.
The Board of Directors should be aware of these conditions and realize that a concentration of duties and responsibilities in a limited number of individuals is not desirable for an effective system of internal control. Under these conditions, the most effective control is the Board of Directors’ knowledge of matters relating to the Organization’s operations. This is a material weakness in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.002.
Criteria – The lack of proper segregation of duties is considered an internal control weakness.
Effect – Without adequate segregation of duties, the likelihood that unauthorized or false transactions will be prevented or detected in a timely fashion is significantly diminished, which may result in misstated financial statements.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources available to increase staff size and address this internal control deficiency. The Board of Directors and management are aware of the incompatible duties and will continue to provide oversight and monitor the Organization’s operations.
Condition – During our audit, Wipfli LLP proposed a number of adjusting journal entries. Although the net impact of the adjustments to the financial statements only resulted in a reduction in the decrease in net assets reported of approximately $700,000, there were still a number of material adjustments which net to this overall change amount, including the Organization’s cash account which needed additional reconciliation due to information systems transaction posting issues. The adjusting journal entries were based on financial calculations and audit procedures performed by Wipfli LLP that were not performed during the Organization’s normal financial close process. Management of the Organization did not the cash balance needed additional review and requested assistance during the audit process with this area. Since the Organization’s internal control did not discover these adjustments prior to our audit, a material weakness exists in the Organization’s controls. This is a repeat finding from 2023, Finding 2023.003.
Criteria – Material adjusting journal entries not prepared by the Organization are considered to be an internal control weakness.
Effect – Proper recording and reporting of financial information may not occur in a timely manner.
Recommendation – We recommend that all accounts be reconciled and adjustments be posted to the accounting records on a quarterly basis, at a minimum.
Management’s Response – The Organization will work to establish policies and procedures to reduce the number of adjusting journal entries proposed by the auditors.
Condition – Cumberland Memorial Hospital, Inc. d/b/a Cumberland Healthcare’s (the “Organization”) internal control over financial reporting does not end at the general ledger but extends to the financial statements and notes. As part of our professional services for the year ended June 30, 2024, we were requested to draft the financial statements and accompanying notes to the financial statements. It is the responsibility of management and those charged with governance to make the decision about whether to accept the degree of risk associated with this condition because of cost or other considerations. Because the Organization relies on Wipfli LLP to provide the necessary understanding of current accounting and disclosure principles in the preparation of the financial statements and notes, a material weakness exists in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.001.
Criteria – Government Auditing Standards consider the inability to report financial data reliably in accordance with GAAP to be an internal control deficiency.
Effect – The completeness of the financial statement disclosures and the accuracy of the overall financial presentation may be negatively impacted, since outside auditors do not have the same comprehensive understanding of the Organization as its internal staff.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources and staff to prepare the financial statements and notes but will continue to oversee the auditor’s services and review and approve the financial statements and notes.
Condition – The size of the Organization’s staff in charge of accounting and reporting precludes a proper segregation of duties to ensure adequate internal controls. The basic premise is that no one employee should have access to both physical assets and the related accounting records or to all phases of a transaction. The following segregation of duties issues were noted during the audit, and primarily center around certain functions or access within the information systems:
• Individuals involved in the payroll process also have access to personnel changes.
• Individuals with the ability to establish new patients also have access to charge posting, cash receipts posting, and ability to post adjustments within the system.
• The individual responsible for reconciling the general checking account and payroll account also prepares checks issued by the Organization.
• The individual authorized to make deposits and withdrawals from the investment accounts also reconciles the investment accounts.
• Individuals authorized to post adjusting journal entries into the accounting system also prepare reconciliations of the same accounts with limited review by additional personnel.
The Board of Directors should be aware of these conditions and realize that a concentration of duties and responsibilities in a limited number of individuals is not desirable for an effective system of internal control. Under these conditions, the most effective control is the Board of Directors’ knowledge of matters relating to the Organization’s operations. This is a material weakness in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.002.
Criteria – The lack of proper segregation of duties is considered an internal control weakness.
Effect – Without adequate segregation of duties, the likelihood that unauthorized or false transactions will be prevented or detected in a timely fashion is significantly diminished, which may result in misstated financial statements.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources available to increase staff size and address this internal control deficiency. The Board of Directors and management are aware of the incompatible duties and will continue to provide oversight and monitor the Organization’s operations.
Condition – During our audit, Wipfli LLP proposed a number of adjusting journal entries. Although the net impact of the adjustments to the financial statements only resulted in a reduction in the decrease in net assets reported of approximately $700,000, there were still a number of material adjustments which net to this overall change amount, including the Organization’s cash account which needed additional reconciliation due to information systems transaction posting issues. The adjusting journal entries were based on financial calculations and audit procedures performed by Wipfli LLP that were not performed during the Organization’s normal financial close process. Management of the Organization did not the cash balance needed additional review and requested assistance during the audit process with this area. Since the Organization’s internal control did not discover these adjustments prior to our audit, a material weakness exists in the Organization’s controls. This is a repeat finding from 2023, Finding 2023.003.
Criteria – Material adjusting journal entries not prepared by the Organization are considered to be an internal control weakness.
Effect – Proper recording and reporting of financial information may not occur in a timely manner.
Recommendation – We recommend that all accounts be reconciled and adjustments be posted to the accounting records on a quarterly basis, at a minimum.
Management’s Response – The Organization will work to establish policies and procedures to reduce the number of adjusting journal entries proposed by the auditors.
Condition – Cumberland Memorial Hospital, Inc. d/b/a Cumberland Healthcare’s (the “Organization”) internal control over financial reporting does not end at the general ledger but extends to the financial statements and notes. As part of our professional services for the year ended June 30, 2024, we were requested to draft the financial statements and accompanying notes to the financial statements. It is the responsibility of management and those charged with governance to make the decision about whether to accept the degree of risk associated with this condition because of cost or other considerations. Because the Organization relies on Wipfli LLP to provide the necessary understanding of current accounting and disclosure principles in the preparation of the financial statements and notes, a material weakness exists in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.001.
Criteria – Government Auditing Standards consider the inability to report financial data reliably in accordance with GAAP to be an internal control deficiency.
Effect – The completeness of the financial statement disclosures and the accuracy of the overall financial presentation may be negatively impacted, since outside auditors do not have the same comprehensive understanding of the Organization as its internal staff.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources and staff to prepare the financial statements and notes but will continue to oversee the auditor’s services and review and approve the financial statements and notes.
Condition – The size of the Organization’s staff in charge of accounting and reporting precludes a proper segregation of duties to ensure adequate internal controls. The basic premise is that no one employee should have access to both physical assets and the related accounting records or to all phases of a transaction. The following segregation of duties issues were noted during the audit, and primarily center around certain functions or access within the information systems:
• Individuals involved in the payroll process also have access to personnel changes.
• Individuals with the ability to establish new patients also have access to charge posting, cash receipts posting, and ability to post adjustments within the system.
• The individual responsible for reconciling the general checking account and payroll account also prepares checks issued by the Organization.
• The individual authorized to make deposits and withdrawals from the investment accounts also reconciles the investment accounts.
• Individuals authorized to post adjusting journal entries into the accounting system also prepare reconciliations of the same accounts with limited review by additional personnel.
The Board of Directors should be aware of these conditions and realize that a concentration of duties and responsibilities in a limited number of individuals is not desirable for an effective system of internal control. Under these conditions, the most effective control is the Board of Directors’ knowledge of matters relating to the Organization’s operations. This is a material weakness in the Organization’s internal controls. This is a repeat finding from 2023, Finding 2023.002.
Criteria – The lack of proper segregation of duties is considered an internal control weakness.
Effect – Without adequate segregation of duties, the likelihood that unauthorized or false transactions will be prevented or detected in a timely fashion is significantly diminished, which may result in misstated financial statements.
Recommendation – We recommend management and those charged with governance continue to evaluate whether to accept the degree of risk associated with this condition because of cost or other considerations.
Management’s Response – The Organization does not have the resources available to increase staff size and address this internal control deficiency. The Board of Directors and management are aware of the incompatible duties and will continue to provide oversight and monitor the Organization’s operations.
Condition – During our audit, Wipfli LLP proposed a number of adjusting journal entries. Although the net impact of the adjustments to the financial statements only resulted in a reduction in the decrease in net assets reported of approximately $700,000, there were still a number of material adjustments which net to this overall change amount, including the Organization’s cash account which needed additional reconciliation due to information systems transaction posting issues. The adjusting journal entries were based on financial calculations and audit procedures performed by Wipfli LLP that were not performed during the Organization’s normal financial close process. Management of the Organization did not the cash balance needed additional review and requested assistance during the audit process with this area. Since the Organization’s internal control did not discover these adjustments prior to our audit, a material weakness exists in the Organization’s controls. This is a repeat finding from 2023, Finding 2023.003.
Criteria – Material adjusting journal entries not prepared by the Organization are considered to be an internal control weakness.
Effect – Proper recording and reporting of financial information may not occur in a timely manner.
Recommendation – We recommend that all accounts be reconciled and adjustments be posted to the accounting records on a quarterly basis, at a minimum.
Management’s Response – The Organization will work to establish policies and procedures to reduce the number of adjusting journal entries proposed by the auditors.