Audit 348880

FY End
2024-06-30
Total Expended
$1.56M
Findings
2
Programs
4
Organization: Boone Memorial Hospital, Inc. (WV)
Year: 2024 Accepted: 2025-03-27
Auditor: Forvis Mazars

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
537611 2024-001 Significant Deficiency - I
1114053 2024-001 Significant Deficiency - I

Contacts

Name Title Type
VEB7KBEMDA34 Douglas Cole Malcolm Auditee
3043692922 Norman Mosrie Auditor
No contacts on file

Notes to SEFA

Title: Note 3. Contingencies Accounting Policies: Note 1. Basis of Presentation The accompanying schedule of expenditures of federal and state awards (Schedule) includes the federal and state award activity of Boone Memorial Hospital, Inc. (Hospital) under the programs of the federal and state of West Virginia government for the year ended June 30, 2024. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administration Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). All federal and state awards received directly and indirectly from federal and state agencies are included in this Schedule. Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital. Note 2. Basis of Accounting Expenditures are reported in the Schedule on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The Hospital did not pass through any funding to subrecipients. De Minimis Rate Used: Y Rate Explanation: The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The grant programs are subject to financial and compliance audits by the grantors or their representatives. Such audits could lead to requests for reimbursement to the grantor agencies for expenditures disallowed under terms of the grants. The amount, if any, of expenditures which may be disallowed by the grantor agencies cannot be determined at this time, although the Hospital expects such amounts, if any, to be immaterial.
Title: Note 4. Categorization of Expenditures Accounting Policies: Note 1. Basis of Presentation The accompanying schedule of expenditures of federal and state awards (Schedule) includes the federal and state award activity of Boone Memorial Hospital, Inc. (Hospital) under the programs of the federal and state of West Virginia government for the year ended June 30, 2024. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administration Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). All federal and state awards received directly and indirectly from federal and state agencies are included in this Schedule. Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital. Note 2. Basis of Accounting Expenditures are reported in the Schedule on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The Hospital did not pass through any funding to subrecipients. De Minimis Rate Used: Y Rate Explanation: The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The categorization of expenditures by program included in the Schedule is based upon the grant documents. Changes in the categorization of expenditures occur based upon revisions to the Assistance Listing. The Schedule for the year ended June 30, 2024 reflects Assistance Listing changes through May 2024.
Title: Note 5. Subsequent Events Accounting Policies: Note 1. Basis of Presentation The accompanying schedule of expenditures of federal and state awards (Schedule) includes the federal and state award activity of Boone Memorial Hospital, Inc. (Hospital) under the programs of the federal and state of West Virginia government for the year ended June 30, 2024. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administration Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). All federal and state awards received directly and indirectly from federal and state agencies are included in this Schedule. Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital. Note 2. Basis of Accounting Expenditures are reported in the Schedule on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The Hospital did not pass through any funding to subrecipients. De Minimis Rate Used: Y Rate Explanation: The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The Hospital has evaluated subsequent events through March 25, 2025, which is the date the Schedule was available to be issued.
Title: Note 6. Schedule of State of West Virginia (State) Grant Receipts and Expenditures Accounting Policies: Note 1. Basis of Presentation The accompanying schedule of expenditures of federal and state awards (Schedule) includes the federal and state award activity of Boone Memorial Hospital, Inc. (Hospital) under the programs of the federal and state of West Virginia government for the year ended June 30, 2024. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administration Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). All federal and state awards received directly and indirectly from federal and state agencies are included in this Schedule. Because the Schedule presents only a selected portion of the operations of the Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital. Note 2. Basis of Accounting Expenditures are reported in the Schedule on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The Hospital did not pass through any funding to subrecipients. De Minimis Rate Used: Y Rate Explanation: The Hospital has elected to use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance where applicable. The Hospital received and expended State grant awards for the year ended June 30, 2024 as summarized below: Total Current Total Current Year State Year State Under (Over) Grant Award Award Expended Grant Name Number Receipts Expenditures End of Year Coal Miners Respiratory Impairment Treatment Clinics and Services G220874 $ - $ 16,988 $ - G230678 9,655 16,988 - G240877 - 16,988 - Recruitment and Retention Community Program G220457 - 15,000 - G230623 - 30,000 - G240418 20,000 20,000 - Grants to States for Loan Repayment G240776 25,800 25,800 - COVID-19 Relief to Hospitals G220938 - 310,087 - Madison Farmers Market and Greenhouse Project N/A 805,545 - 805,545 $ 861,000 $ 451,851 $ 805,545

Finding Details

Assistance Listing #93.788 Opioid STR Significant Deficiency Criteria: The Uniform Guidance procurement regulations outlined in 2 CFR Part 200 Subpart D and applicable state and entity-level regulations require appropriate internal controls over the acquisition of goods and services to ensure compliance with such regulations, including maintaining formal written documentation of compliance with regulations depending on the dollar amount of purchase or for a non-competitive situation. Proper supervisory review controls to ensure compliance with such regulations are an important part of the internal control framework. Condition: During our procurement testing procedures, we noted a purchase of $10,000 for marketing services for which management failed to obtain and document compliance with the requirement to obtain price quotations from a reasonable number of qualified marketing service providers. Additionally, we noted an additional purchase for which management did not maintain contemporaneous formal written documentation supporting a non-competitive single source purchase. Management was later able to provide documentation supporting that this purchase met the qualifying requirements for a non-competitive situation. Cause: Management indicated that they did not obtain quotes for the marketing services as they felt that the quote obtained from the Hospital’s current external marketing service provider was reasonable in all material respects. Management noted that the failure to maintain contemporaneous documentation was an oversight due to turnover of various staff involved in the grants oversight process. Effect: Price quotations from a reasonable number of qualified service providers were not obtained for the purchased marketing services: thus, it is unknown if such services could have been provided for a lower amount. Questioned Costs: $10,000 Context: The population of expenses subject to procurement standards were sampled and a sample of two items greater than the micro-purchase threshold were selected for testing. Of those sampled, the one marketing purchase noted above was found to not be supported by quotes from a reasonable number of qualified sources. The sample was not considered statistically valid. Identification as a Repeat Finding: N/A Recommendation: The Hospital should ensure that individuals involved in the grants administration process receive the appropriate training to ensure their understanding of the Uniform Guidance, state and Hospital procurement requirements. For purchases greater than the micro-purchase threshold (i.e., $10,000 and greater), internal controls should be enhanced to ensure supervisory review for compliance with contemporaneous formal written documentation for quotes, bids, or qualification for non-competitive proposal requirements. Regulations specify at least three quotes from qualified sources, as applicable. Views of Responsible Officials: See corrective action plan.
Assistance Listing #93.788 Opioid STR Significant Deficiency Criteria: The Uniform Guidance procurement regulations outlined in 2 CFR Part 200 Subpart D and applicable state and entity-level regulations require appropriate internal controls over the acquisition of goods and services to ensure compliance with such regulations, including maintaining formal written documentation of compliance with regulations depending on the dollar amount of purchase or for a non-competitive situation. Proper supervisory review controls to ensure compliance with such regulations are an important part of the internal control framework. Condition: During our procurement testing procedures, we noted a purchase of $10,000 for marketing services for which management failed to obtain and document compliance with the requirement to obtain price quotations from a reasonable number of qualified marketing service providers. Additionally, we noted an additional purchase for which management did not maintain contemporaneous formal written documentation supporting a non-competitive single source purchase. Management was later able to provide documentation supporting that this purchase met the qualifying requirements for a non-competitive situation. Cause: Management indicated that they did not obtain quotes for the marketing services as they felt that the quote obtained from the Hospital’s current external marketing service provider was reasonable in all material respects. Management noted that the failure to maintain contemporaneous documentation was an oversight due to turnover of various staff involved in the grants oversight process. Effect: Price quotations from a reasonable number of qualified service providers were not obtained for the purchased marketing services: thus, it is unknown if such services could have been provided for a lower amount. Questioned Costs: $10,000 Context: The population of expenses subject to procurement standards were sampled and a sample of two items greater than the micro-purchase threshold were selected for testing. Of those sampled, the one marketing purchase noted above was found to not be supported by quotes from a reasonable number of qualified sources. The sample was not considered statistically valid. Identification as a Repeat Finding: N/A Recommendation: The Hospital should ensure that individuals involved in the grants administration process receive the appropriate training to ensure their understanding of the Uniform Guidance, state and Hospital procurement requirements. For purchases greater than the micro-purchase threshold (i.e., $10,000 and greater), internal controls should be enhanced to ensure supervisory review for compliance with contemporaneous formal written documentation for quotes, bids, or qualification for non-competitive proposal requirements. Regulations specify at least three quotes from qualified sources, as applicable. Views of Responsible Officials: See corrective action plan.