FAC Explorer

Audit 367503

FY End
2022-12-31
Total Expended
$1.88M
Findings
1
Programs
5
Organization: Comanche County Medical Center (TX)
Year: 2022 Accepted: 2025-09-25
Auditor: Forvis Mazars LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
1155271 2022-003 Material Weakness Yes ABHL

Programs

ALN Program Spent Major Findings
10.766 Usda Community Facilities Loans and Grants $1.00M Yes 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $565,347 Yes 1
93.697 Covid-19 Rhc Payments $200,000 Yes 0
93.912 Covid-19 Rhc Vaccine Confidence (rhcvc) $99,058 Yes 0
93.301 Covid-19 Small Rural Hospital Improvement Grant Program $10,969 Yes 0

Contacts

Name Title Type
CLH9Y4WLUTH7 Hong Wade Auditee
2548794900 Cheyenne Tanner Auditor
No contacts on file

Notes to SEFA

The accompanying schedule of expenditures of federal awards (the “Schedule”) includes the federal award activity of Comanche County Medical Center Company (Hospital) under programs of the federal government for the year ended December 31, 2022. 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 Hospital, it is not intended to and does not present the financial position, changes in net assets or cash flows of the Hospital.
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, 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.
The Hospital has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance.
The Hospital did not have any federal loan programs during the year ended December 31, 2022.
Non-federal entities must record expenditures for Federal Emergency Agency (FEMA) projects on the Schedule when: 1) FEMA has approved the non-federal entity’s project worksheet and, 2) the non-federal entity has incurred eligible expenditures. The 2022 expenditures for Federal Assistance Listing Number 97.036 were incurred by the Hospital prior to fiscal year 2022 and the project worksheet was approved in fiscal year 2021.
For the year ended December 31, 2022, the Hospital received $0 in donated PPE in response to the COVID-19 pandemic.

Finding Details

Finding 2022-003
Federal Programs: Disaster Grants – Public Assistance (Presidentially Declared Disasters) Assistance Listing Numbers 97.036 Federal Agencies: U.S. Department of Homeland Security Pass-Through Entity, Applicable Only to Disaster Grants – Public Assistance (Presidentially Declared Disasters): Texas Division of Emergency Management Criteria: Reporting (45 CFR 75.342 and 2 CFR 200.303) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623 and 44 CFR 206.228). Condition: The Hospital reported COVID-19-related expenditures within the Disaster Grants – Public Assistance (Presidentially Declared Disasters) (FEMA) portal that were reimbursed via other sources. Questioned Costs: Questioned costs were estimated by taking the total amount of acceptable expenditures for each of the programs multiplied by the Hospital’s internally-calculated Medicare reimbursement rate. See costs by applicable assistance listing number below: Program: Presidentially Declared Disasters; Assistance Listing No. 97.036; Questioned Costs: $173,180 Context: The Hospital is certified by Medicare as a critical access hospital. The period one provider relief fund report and FEMA payments were tested. The Hospital’s calculation of allowable expenses did not consider the impact of cost reimbursement to reported health care expenses to document that FEMA payments were not reimbursed by any other source. Effect: The Hospital submitted expenses under the FEMA program that are obligated to be reimbursed by another source. Cause: The guidance provided by DHS to providers across the country as to how to report their COVID-19-related expenses and lost revenues is, at times, difficult to comprehend and apply. Internal controls were not in place to ensure the Hospital correctly applied the guidance. Identification as a repeat finding: This is a repeat finding. See 2021-002. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure that allowable expenses reported are not reimbursed by any other source. Views of responsible officials and planned corrective actions: See corrective action plan for the Hospital’s response to finding.