Audit 362847

FY End
2024-12-31
Total Expended
$31.23M
Findings
4
Programs
1
Organization: Western Missouri Medical Center (MO)
Year: 2024 Accepted: 2025-07-23

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
571827 2024-001 Significant Deficiency - N
571828 2024-002 Significant Deficiency Yes N
1148269 2024-001 Significant Deficiency - N
1148270 2024-002 Significant Deficiency Yes N

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $31.23M Yes 2

Contacts

Name Title Type
HG57GTLJW9N7 Dean Ohmart Auditee
6607472500 Cameron Werth Auditor
No contacts on file

Notes to SEFA

Title: Basis of presentation Accounting Policies: Expenditures on the Schedule 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant award activity of Western Missouri Medical Center (the Medical Center) under programs of the federal government for the year ended December 31, 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 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 Medical Center, it is not intended to and does not present the financial position, changes in net position, or cash flows of the Medical Center.
Title: Significant accounting policies Accounting Policies: Expenditures on the Schedule 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. Expenditures on the Schedule 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available.
Title: Indirect cost rate Accounting Policies: Expenditures on the Schedule 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses.
Title: Loans Accounting Policies: Expenditures on the Schedule 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 allowed or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Medical Center has elected not to use the 10 percent de minimis indirect cost rate allowed under Uniform Guidance. The Medical Center's federal expenditures do not include indirect administrative expenses. Expenditures on the Schedule consist of the beginning of the year outstanding loan balances plus advances made on the loans during the year. The balance of loans outstanding as of December 31, 2024, was $29,502,433.

Finding Details

Identification: 10.766 United States Department of Agriculture (USDA), Community Facilities Loans and Grants; Noncompliance Finding; Special Tests and Provisions Compliance Requirement Criteria: The USDA direct loan and guaranteed loan were entered into in 2010 for renovation of the Medical Center's healthcare facility. One direct loan and one guaranteed loan were received. In connection with the loans, the Medical Center entered into the 2010 bond trust indenture and agreed to the letter of conditions dated November 30, 2009, set forth by the USDA which the Medical Center is required to follow. Section 506 of the 2010 bond trust indenture states the facility shall maintain a Debt Service Coverage Ratio that is not less than 1.25, and maintain a balance of days cash on hand of not less than 75 days. Condition: The Medical Center did meet either the debt service coverage ratio nor the days cash on hand ratio for the year ended December 31, 2024. Cause: The Medical Center did not obtain operational results such that the financial liquidity and cash generation was sufficient to meet the debt service coverage ratio or the days cash on hand ratio. Effect: The Medical Center is not complying with Section 506 of the 2010 bond indenture. Questioned Costs: None Perspective Information: We performed an independent computation of the Medical Center's debt service coverage ratio and days cash on hand ratio. The results of our independent computations indicate the covenants were not met. Repeat Finding: No Recommendations: We recommend that the Medical Center review Section 506 of the 2010 bond trust indenture which outlines the required steps and notify the bond trustee that the debt service coverage ratio and days cash on hand ratio were not met. Views from Responsible Officials: The Medical Center notified the bond trustee in May 2025 that the debt service coverage ratio and days cash on hand ratio were not met for the year ended December 31, 2024, and will follow up with the bond trustee following completion of the audit regarding the necessary steps to take as outlined in the bond trust indenture.
Identification: 10.766 United States Department of Agriculture (USDA), Community Facilities Loans and Grants; Significant Deficiency/Noncompliance Finding; Special Tests and Provisions Compliance Requirement Criteria: The USDA direct loan and guaranteed loan were entered into in 2010 for renovation of the Medical Center's healthcare facility. One direct loan and one guaranteed loan were received. In connection with the loans, the Medical Center entered into the 2010 bond trust indenture and agreed to the letter of conditions dated November 30, 2009, set forth by the USDA which the Medical Center is required to follow. Section 510 of the 2010 bond trust indenture states the insurance coverages that the Medical Center is required to obtain which includes retaining an insurance consultant to provide a written report to the Board of Trustees on a biannual basis. Condition 34 of the letter of conditions further states the Medical Center will have fidelity bond coverage in an amount not less than the annual principal and interest becoming due on the bonds. Condition: The Medical Center did not retain an insurance consultant to provide a written report to the Board of Trustees on a biannual basis in accordance with Section 510 of the 2010 bond trust indenture and the Medical Center is not carrying a sufficient amount of fidelity bond coverage as set forth in the letter of conditions dated November 30, 2009. Cause: The Medical Center did not have adequate procedures in place to ensure it was complying with Section 510 of the 2010 bond trust indenture or the November 30, 2009, letter of conditions as it pertains to the amount of fidelity bond coverage and retaining an insurance consultant to provide a written report to the Board of Trustees on a biannual basis. Effect: The Medical Center is not complying with Section 510 of the 2010 bond indenture or Condition 34 of the letter of conditions dated November 30, 2009. Questioned Costs: None Perspective Information: We reviewed the Medical Center's insurance policies and determined the amount of fidelity bond coverage was insufficient based on annual debt service payments. Repeat Finding: Yes, 2023-001 Recommendations: We recommend that the Medical Center review Section 510 of the 2010 bond trust indenture and Condition 34 of the letter of conditions and establish procedures so that on a biannual basis the Medical Center's insurance consultant is providing a written report in accordance with Section 510 and that the Medical Center work with its insurance consultant to ensure that it is carrying a sufficient amount of fidelity bond coverage to comply with Condition 34 of the letter of conditions.
Identification: 10.766 United States Department of Agriculture (USDA), Community Facilities Loans and Grants; Noncompliance Finding; Special Tests and Provisions Compliance Requirement Criteria: The USDA direct loan and guaranteed loan were entered into in 2010 for renovation of the Medical Center's healthcare facility. One direct loan and one guaranteed loan were received. In connection with the loans, the Medical Center entered into the 2010 bond trust indenture and agreed to the letter of conditions dated November 30, 2009, set forth by the USDA which the Medical Center is required to follow. Section 506 of the 2010 bond trust indenture states the facility shall maintain a Debt Service Coverage Ratio that is not less than 1.25, and maintain a balance of days cash on hand of not less than 75 days. Condition: The Medical Center did meet either the debt service coverage ratio nor the days cash on hand ratio for the year ended December 31, 2024. Cause: The Medical Center did not obtain operational results such that the financial liquidity and cash generation was sufficient to meet the debt service coverage ratio or the days cash on hand ratio. Effect: The Medical Center is not complying with Section 506 of the 2010 bond indenture. Questioned Costs: None Perspective Information: We performed an independent computation of the Medical Center's debt service coverage ratio and days cash on hand ratio. The results of our independent computations indicate the covenants were not met. Repeat Finding: No Recommendations: We recommend that the Medical Center review Section 506 of the 2010 bond trust indenture which outlines the required steps and notify the bond trustee that the debt service coverage ratio and days cash on hand ratio were not met. Views from Responsible Officials: The Medical Center notified the bond trustee in May 2025 that the debt service coverage ratio and days cash on hand ratio were not met for the year ended December 31, 2024, and will follow up with the bond trustee following completion of the audit regarding the necessary steps to take as outlined in the bond trust indenture.
Identification: 10.766 United States Department of Agriculture (USDA), Community Facilities Loans and Grants; Significant Deficiency/Noncompliance Finding; Special Tests and Provisions Compliance Requirement Criteria: The USDA direct loan and guaranteed loan were entered into in 2010 for renovation of the Medical Center's healthcare facility. One direct loan and one guaranteed loan were received. In connection with the loans, the Medical Center entered into the 2010 bond trust indenture and agreed to the letter of conditions dated November 30, 2009, set forth by the USDA which the Medical Center is required to follow. Section 510 of the 2010 bond trust indenture states the insurance coverages that the Medical Center is required to obtain which includes retaining an insurance consultant to provide a written report to the Board of Trustees on a biannual basis. Condition 34 of the letter of conditions further states the Medical Center will have fidelity bond coverage in an amount not less than the annual principal and interest becoming due on the bonds. Condition: The Medical Center did not retain an insurance consultant to provide a written report to the Board of Trustees on a biannual basis in accordance with Section 510 of the 2010 bond trust indenture and the Medical Center is not carrying a sufficient amount of fidelity bond coverage as set forth in the letter of conditions dated November 30, 2009. Cause: The Medical Center did not have adequate procedures in place to ensure it was complying with Section 510 of the 2010 bond trust indenture or the November 30, 2009, letter of conditions as it pertains to the amount of fidelity bond coverage and retaining an insurance consultant to provide a written report to the Board of Trustees on a biannual basis. Effect: The Medical Center is not complying with Section 510 of the 2010 bond indenture or Condition 34 of the letter of conditions dated November 30, 2009. Questioned Costs: None Perspective Information: We reviewed the Medical Center's insurance policies and determined the amount of fidelity bond coverage was insufficient based on annual debt service payments. Repeat Finding: Yes, 2023-001 Recommendations: We recommend that the Medical Center review Section 510 of the 2010 bond trust indenture and Condition 34 of the letter of conditions and establish procedures so that on a biannual basis the Medical Center's insurance consultant is providing a written report in accordance with Section 510 and that the Medical Center work with its insurance consultant to ensure that it is carrying a sufficient amount of fidelity bond coverage to comply with Condition 34 of the letter of conditions.