Audit 390905

FY End
2025-09-30
Total Expended
$4.92M
Findings
7
Programs
9
Year: 2025 Accepted: 2026-03-09

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
1177031 2025-001 Material Weakness Yes P
1177032 2025-001 Material Weakness Yes P
1177033 2025-001 Material Weakness Yes P
1177034 2025-001 Material Weakness Yes P
1177035 2025-001 Material Weakness Yes P
1177036 2025-001 Material Weakness Yes P
1177037 2025-001 Material Weakness Yes P

Contacts

Name Title Type
DN2PQ51JLX25 Kimberly Young Auditee
9012274080 Elyza Jain Auditor
No contacts on file

Notes to SEFA

The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2025. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC. The SEFA does not present the activity for BMHCC’s affiliate, Baptist College of Health Sciences, Inc. dba Baptist Health Sciences University (the “University”), which received $22,307,734 in federal awards during the year ended September 30, 2025. A separate audit of compliance over the University’s major programs will be performed in accordance with the requirements described in the OMB Compliance. Federal direct and indirect programs are presented by federal department and by individual federal awards. Assistance Listing Number (ALN) for federal programs, pass-through entity, and grant number are presented for all individual awards, where applicable. The SEFA has been prepared in accordance with the accrual basis of accounting and with accounting principles generally accepted in the United States of America and is consistent with the preparation of BMHCC’s combined financial statements. 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. An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. The SEFA includes Federal Emergency Management Agency (“FEMA”) funds obligated in fiscal years 2021 through 2025. The majority of these funds were received subsequent to fiscal year-end 2025, with $58,029 not yet received. These funds are included on the SEFA for the year ended September 30, 2025 in accordance with the OMB Compliance Supplement requiring expenditures to be presented on the SEFA when (1) FEMA has obligated the nonfederal entity’s project, and (2) the nonfederal entity has incurred the eligible expenditures.
BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research and the National Cancer Institute Community for Cancer Cause and Prevention Research. Grant agreements under the Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement program specify the indirect rate allowed. BMHCC uses the 15% de minimis cost rate allowed under the Uniform Guidance for all other awards where an indirect cost rate has been specified but not negotiated
Uniform Guidance defines a subrecipient as a nonfederal entity that receives a subaward from a passthrough entity to carry out part of a federal program but does not include an individual who is a beneficiary of such program or payments to a contractor. A contractor is an entity that receives a contract by which a nonfederal entity purchases property or services needed to carry out the project or program under a federal award. A nonfederal entity may concurrently receive federal funds as a recipient, subrecipient, and contractor, depending on the substance of its agreements with federal awarding agencies and pass-through entities. Therefore, BMHCC must make case-by-case determinations whether each agreement it makes for the disbursement of federal program funds casts the party receiving the funds as a subrecipient or a contractor based on the Uniform Guidance definitions and management’s judgement. No federal program funds were provided to subrecipients during the year ended September 30, 2025.
The regulations and guidelines governing the preparation of federal financial reports vary by federal agency and among programs administered by the same agency. Accordingly, the amounts reported in the federal financial reports may not necessarily agree with the amounts reported in the accompanying SEFA, which is prepared as explained in Note 1. Certain costs reflected in the schedule of the federal awards in the current year may represent costs incurred in prior years that have been approved for reimbursement by the granting agency and recorded in the current year financial statements.

Finding Details

FINDING 2025-001 Significant Deficiency in Internal Control over Compliance – Other Matter Federal Agency: Department of Homeland Security and Department of Health and Human Services Pass through Grantor: Multiple Federal Program(s): COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters and Research and Development Cluster Assistance Listing Number(s): 97.036 and multiple for Research and Development Criteria: Uniform Guidance requires the auditee to prepare a schedule of expenditures of federal awards, (the “Schedule” or “SEFA”), for the period covered by the auditee’s financial statements that includes certain required elements, including total federal awards expended for each individual federal program and ensure the accuracy and completeness of such schedule. Condition/Context: It was identified that Federal Emergency Management Agency (“FEMA”) ALN 97.036 funds totaling approximately $1.8 million were presented on the current year SEFA relating to obligated expenditures for fiscal period from 2021 through 2024. These funds were not previously reported on prior years’ SEFAs. Additionally, there were other grant funds related to the R&D Cluster not initially presented on the current year SEFA totaling approximately $517K. Cause: Management believed FEMA expenditures should be reported on the SEFA only upon reimbursement (received in 2025). However, per the Compliance Supplement, FEMA expenditures should be included when the project is obligated and eligible costs are incurred. For the R&D expenditures, management was unaware that grant funds received on a per-patient basis should be included in the SEFA. Effect: Federal program amounts may be misstated on the Schedule, potentially affecting major program determination and leading to findings or ineligibility of future funding. Recommendation: Management should prepare the Schedule timely, record expenditures when incurred (and obligated, if applicable), reconcile to the financial statements, and implement detailed controls to review the SEFA for accuracy and completeness Repeat Finding: No. Views of Responsible Officials: The Corporation agrees with our recommendation and will implement procedures by June 30, 2026. See Corrective Action Plan.