Audit 355389

FY End

2023-09-30

Total Expended

$3.65M

Findings

2

Programs

2

Organization: Hamilton County Hospital District (TX)

Year: 2023 Accepted: 2025-05-02

Auditor: Forvis Mazars LLP

Organization Exclusion Status:

Checking exclusion status...

ID	Ref	Severity	Repeat	Requirement
559162	2023-002	Material Weakness	-	L
1135604	2023-002	Material Weakness	-	L

ALN	Program	Spent	Major	Findings
93.498	Provider Relief Fund	$3.59M	Yes	1
93.301	Small Rural Hospital Improvement Grant Program	$10,990	-	0

Contacts

Name	Title	Type
DXG5Y91J74Y4	Tammy Schreiber	Auditee
2543861888	Cheyenne Tanner	Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance or other regulatory requirements, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts, if any, shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The District has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Hamilton County Hospital District (the District) under programs of the federal government for the year ended September 30, 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 District, it is not intended to and does not present the financial position, changes in net position or cash flows of the District.

Title: Federal Loan Programs Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance or other regulatory requirements, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts, if any, shown on the Schedule represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The District has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The District did not have any federal loan programs during the year ended September 30, 2023.

Finding Details

Finding 2023-002

COVID-19 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 Criteria: Reporting Condition: The District is required to prepare and submit the Period 4 Provider Relief Fund report to the U.S. Department of Health and Human Services. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs: None. Context: The Period 4 Provider Relief Fund report was tested. The District selected Option 3 to report lost revenues. An error in the input of lost revenues was identified that resulted in lost revenues being misstated by approximately $6.5 million. After correcting the error, there is sufficient lost revenue to cover amounts received and, as such, there are no questioned costs. Effect: Errors were made in the input of lost revenue. Lost revenue was not accurately reported. Cause: Internal controls over compliance were not in place to ensure the District properly input lost revenue in their report under Option 3. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District’s response to finding.

Finding 2023-002

COVID-19 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Assistance Listing Number 93.498 Criteria: Reporting Condition: The District is required to prepare and submit the Period 4 Provider Relief Fund report to the U.S. Department of Health and Human Services. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs: None. Context: The Period 4 Provider Relief Fund report was tested. The District selected Option 3 to report lost revenues. An error in the input of lost revenues was identified that resulted in lost revenues being misstated by approximately $6.5 million. After correcting the error, there is sufficient lost revenue to cover amounts received and, as such, there are no questioned costs. Effect: Errors were made in the input of lost revenue. Lost revenue was not accurately reported. Cause: Internal controls over compliance were not in place to ensure the District properly input lost revenue in their report under Option 3. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District’s response to finding.