Audit 33101

FY End
2022-12-31
Total Expended
$7.57M
Findings
4
Programs
10
Organization: Kootenai Health (ID)
Year: 2022 Accepted: 2023-09-27
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
32228 2022-002 Material Weakness - P
32229 2022-002 Material Weakness - P
608670 2022-002 Material Weakness - P
608671 2022-002 Material Weakness - P

Contacts

Name Title Type
GN6WBRFDWL36 Kimberley Jones Auditee
2086254158 Renee Gravalin Auditor
No contacts on file

Notes to SEFA

Title: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception for the COVID19 Testing for the Uninsured program, which are recorded based on when the claim is deemed eligible as evidenced by the receipt of monies from the federal agency. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The District does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. The District received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program (Federal Financial Assistance Listing #93.498) during the year ended December 31, 2022. The District incurred eligible expenses, and therefore, for the years ended December 31, 2022, recognized $1,641,321 as revenue, included as nonoperating activities on the statement of revenues, expenses, and changes in net position. In accordance with the Compliance Supplement addendum, the PRF expenditures were recognized on the Schedule when the expenditures were included in the reporting to HHS as required under the PRF program.The following summarizes the Provider Relief Funds and the timing of when the amounts were recognized in the financial statements: The amount of PRF expenditures included in the Schedule requires management to make estimates and assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant estimate. Estimates and assumptions may include reducing actual expenses by amounts that have been reimbursed or are obligated to be reimbursed by other sources and estimating marginal increases in expenses related to coronavirus. Actual amounts could differ from those estimates.(See chart in report)
Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception for the COVID19 Testing for the Uninsured program, which are recorded based on when the claim is deemed eligible as evidenced by the receipt of monies from the federal agency. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The District does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Kootenai Hospital District dba Kootenai Health (the District) under programs of the federal government for the year ended December 31, 2022. The information is presented in accordance with the requirements of Title 2U.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 District, it is not intended to and does not present the financial position, changes in net position, or cash flows of the District.
Title: Blended Component Units Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception for the COVID19 Testing for the Uninsured program, which are recorded based on when the claim is deemed eligible as evidenced by the receipt of monies from the federal agency. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The District does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. The accompanying Schedule includes the federal grant activity of the District and its blended component units, Clearwater Valley Hospital and Clinics and St. Marys Hospital, as the District is the sole member of each respective entity. The accompanying Schedule also includes the federal grant activity of the blended component unit, Kootenai Outpatient Surgery, as the District has a 51% ownership interest in the entity.

Finding Details

2022-002 Department of Homeland Security and the State of Idaho Department of Health & Welfare Federal Financial Assistance Listing #97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters) Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 4 TIN #820523354, #820231746, #820497771, and #820226453 Preparation of the Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition: The District does not have an internal control system designed to provide for a complete and accurate schedule of expenditures of federal awards being audited. The Schedule did not include the Disaster Grant ? Public Assistance (Presidentially Declared Disasters) and PRF for one of the blended component units. Cause: Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the District meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the District would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs: None reported. Context/Sampling: Sampling was not used. Repeat Finding from Prior Years: No Recommendation: We recommend management be aware of the financial reporting requirements relating to the District?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.
2022-002 Department of Homeland Security and the State of Idaho Department of Health & Welfare Federal Financial Assistance Listing #97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters) Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 4 TIN #820523354, #820231746, #820497771, and #820226453 Preparation of the Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition: The District does not have an internal control system designed to provide for a complete and accurate schedule of expenditures of federal awards being audited. The Schedule did not include the Disaster Grant ? Public Assistance (Presidentially Declared Disasters) and PRF for one of the blended component units. Cause: Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the District meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the District would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs: None reported. Context/Sampling: Sampling was not used. Repeat Finding from Prior Years: No Recommendation: We recommend management be aware of the financial reporting requirements relating to the District?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.
2022-002 Department of Homeland Security and the State of Idaho Department of Health & Welfare Federal Financial Assistance Listing #97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters) Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 4 TIN #820523354, #820231746, #820497771, and #820226453 Preparation of the Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition: The District does not have an internal control system designed to provide for a complete and accurate schedule of expenditures of federal awards being audited. The Schedule did not include the Disaster Grant ? Public Assistance (Presidentially Declared Disasters) and PRF for one of the blended component units. Cause: Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the District meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the District would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs: None reported. Context/Sampling: Sampling was not used. Repeat Finding from Prior Years: No Recommendation: We recommend management be aware of the financial reporting requirements relating to the District?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.
2022-002 Department of Homeland Security and the State of Idaho Department of Health & Welfare Federal Financial Assistance Listing #97.036 Disaster Grants - Public Assistance (Presidentially Declared Disasters) Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 4 TIN #820523354, #820231746, #820497771, and #820226453 Preparation of the Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition: The District does not have an internal control system designed to provide for a complete and accurate schedule of expenditures of federal awards being audited. The Schedule did not include the Disaster Grant ? Public Assistance (Presidentially Declared Disasters) and PRF for one of the blended component units. Cause: Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the District meets a specified threshold of federal expenditures. Effect: There is a reasonable possibility that the District would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs: None reported. Context/Sampling: Sampling was not used. Repeat Finding from Prior Years: No Recommendation: We recommend management be aware of the financial reporting requirements relating to the District?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials: Management agrees with the finding.