Audit 363396

Assistance Listing, Federal Agency, and Program Name 14.128, Mortgage Insurance Hospitals Federal Award Identification Number and Year N/A Pass through Entity N/A Finding Type Material weakness and material noncompliance with laws and regulations Repeat Finding No Criteria The regulatory agreement for the mortgage requires the corporation to submit financial statements prepared in accordance with the requirements of the Secretary within 180 days after the end of the fiscal year. Condition The Corporation did not submit the financial statements to HUD within 180 days of their fiscal year. Questioned Costs N/A If questioned costs are not determinable, description of why known questioned costs were undetermined or otherwise could not be reported N/A Identification of How Questioned Costs Were Computed N/A Context During our testing the financial statements were not submitted to HUD until March 31, 2025, which was past the 180 day deadline. Cause and Effect The lack of effective controls over financial reporting lead to the untimely submission of the financial statements. Recommendation We recommend that the Corporation implement controls to ensure that the reporting deadlines are met. Views of Responsible Officials and Planned Corrective Actions Sinai Health System has developed an action plan to ensure that financial statements and other materials are submitted in a timely fashion to lenders and are compliant with the HUD Regulatory Agreements. The action plan consists of the following components: o Development of a policy that outlines HUD requirements and identifies individuals responsible for meeting the requirements ; the Senior Finance Team and Compliance team should be educated on this annually. o Regular communication (no less than quarterly) between Finance and the Compliance Officer regarding HUD deadlines and deviation from these deadlines. o Development of a checklist that will be utilized by the Compliance and Finance departments regarding HUD requirements and deadlines. o Reporting to the Audit and Compliance Committee of the Board that the checklist has been completed/deadlines have been met. This will be a regular agenda item .

Assistance Listing, Federal Agency, and Program Name 14.128, Mortgage Insurance Hospitals Federal Award Identification Number and Year N/A Pass through Entity N/A Finding Type Material weakness and material noncompliance with laws and regulations Repeat Finding No Criteria Per the HUD handbook Hospitals are required to submit a budget for the new fiscal year within 30 days of the start of the new fiscal year. Condition The Corporation did not submit the budget to HUD within 30 days of the start of their fiscal year. Questioned Costs N/A If questioned costs are not determinable, description of why known questioned costs were undetermined or otherwise could not be reported N/A Identification of How Questioned Costs Were Computed N/A Context During our testing the budget for the 6/30/2024 fiscal year was not submitted to HUD until November 16, 2023, which was over the 30 day deadline. Cause and Effect The lack of effective controls over financial reporting lead to the untimely submission of the budget. Recommendation We recommend that the Corporation implement controls to ensure that the budget is submitted timely within the deadline. Views of Responsible Officials and Planned Corrective Actions Sinai Health System has developed an action plan to ensure that financial statements and other materials are submitted in a timely fashion to lenders and are compliant with the HUD Regulatory Agreements. The action plan consists of the following components: o Development of a policy that outlines HUD requirements and identifies individuals responsible for meeting the requirements ; the Senior Finance Team and Compliance team should be educated on this annually. o Regular communication (no less than quarterly) between Finance and the Compliance Officer regarding HUD deadlines and deviation from these deadlines. o Development of a checklist that will be utilized by the Compliance and Finance departments regarding HUD requirements and deadlines. o Reporting to the Audit and Compliance Committee of the Board that the checklist has been completed/deadlines have been met. This will be a regular agenda item .

Assistance Listing, Federal Agency, and Program Name 14.128, Mortgage Insurance Hospitals Federal Award Identification Number and Year N/A Pass through Entity N/A Finding Type Material weakness and material noncompliance with laws and regulations Repeat Finding No Criteria The regulatory agreement for the mortgage requires the corporation to submit financial statements prepared in accordance with the requirements of the Secretary within 180 days after the end of the fiscal year. Condition The Corporation did not submit the financial statements to HUD within 180 days of their fiscal year. Questioned Costs N/A If questioned costs are not determinable, description of why known questioned costs were undetermined or otherwise could not be reported N/A Identification of How Questioned Costs Were Computed N/A Context During our testing the financial statements were not submitted to HUD until March 31, 2025, which was past the 180 day deadline. Cause and Effect The lack of effective controls over financial reporting lead to the untimely submission of the financial statements. Recommendation We recommend that the Corporation implement controls to ensure that the reporting deadlines are met. Views of Responsible Officials and Planned Corrective Actions Sinai Health System has developed an action plan to ensure that financial statements and other materials are submitted in a timely fashion to lenders and are compliant with the HUD Regulatory Agreements. The action plan consists of the following components: o Development of a policy that outlines HUD requirements and identifies individuals responsible for meeting the requirements ; the Senior Finance Team and Compliance team should be educated on this annually. o Regular communication (no less than quarterly) between Finance and the Compliance Officer regarding HUD deadlines and deviation from these deadlines. o Development of a checklist that will be utilized by the Compliance and Finance departments regarding HUD requirements and deadlines. o Reporting to the Audit and Compliance Committee of the Board that the checklist has been completed/deadlines have been met. This will be a regular agenda item .

Assistance Listing, Federal Agency, and Program Name 14.128, Mortgage Insurance Hospitals Federal Award Identification Number and Year N/A Pass through Entity N/A Finding Type Material weakness and material noncompliance with laws and regulations Repeat Finding No Criteria Per the HUD handbook Hospitals are required to submit a budget for the new fiscal year within 30 days of the start of the new fiscal year. Condition The Corporation did not submit the budget to HUD within 30 days of the start of their fiscal year. Questioned Costs N/A If questioned costs are not determinable, description of why known questioned costs were undetermined or otherwise could not be reported N/A Identification of How Questioned Costs Were Computed N/A Context During our testing the budget for the 6/30/2024 fiscal year was not submitted to HUD until November 16, 2023, which was over the 30 day deadline. Cause and Effect The lack of effective controls over financial reporting lead to the untimely submission of the budget. Recommendation We recommend that the Corporation implement controls to ensure that the budget is submitted timely within the deadline. Views of Responsible Officials and Planned Corrective Actions Sinai Health System has developed an action plan to ensure that financial statements and other materials are submitted in a timely fashion to lenders and are compliant with the HUD Regulatory Agreements. The action plan consists of the following components: o Development of a policy that outlines HUD requirements and identifies individuals responsible for meeting the requirements ; the Senior Finance Team and Compliance team should be educated on this annually. o Regular communication (no less than quarterly) between Finance and the Compliance Officer regarding HUD deadlines and deviation from these deadlines. o Development of a checklist that will be utilized by the Compliance and Finance departments regarding HUD requirements and deadlines. o Reporting to the Audit and Compliance Committee of the Board that the checklist has been completed/deadlines have been met. This will be a regular agenda item .