Audit 395627

FY End
2025-06-30
Total Expended
$9.13M
Findings
3
Programs
1
Organization: St Luke's Health Corporation (MO)
Year: 2025 Accepted: 2026-03-30
Auditor: ERNST & YOUNG LP

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
1191810 2025-001 Material Weakness Yes AB
1191811 2025-001 Material Weakness Yes AB
1191812 2025-002 Material Weakness Yes G

Programs

ALN Program Spent Major Findings
97.036 DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $770,709 Yes 1

Contacts

Name Title Type
NFJGFKGKMYB3 Stefanie Collins Auditee
6366857822 David Nathan Auditor
No contacts on file

Notes to SEFA

The accompanying Schedule of Expenditures of Federal Awards (the Schedule) summarizes the expenditures of St. Luke’s Health Corporation (St. Luke’s) under programs of the U.S. government for the year ended June 30, 2025. For purposes of the Schedule, federal awards include all grants, contracts, and similar agreements entered into directly between St. Luke’s and agencies and departments of the federal government and all subawards made to St. Luke’s by nonfederal organizations pursuant to federal grants, contracts, and similar agreements. The awards are classified into program categories in accordance with the provisions of the Uniform Guidance. This Schedule is presented using the accrual basis of accounting. The information in this schedule is presented in accordance with the requirements of the Uniform Guidance.
St. Luke’s has elected not to use the 10% de minimus indirect cost rate allowed under the Uniform Guidance.
Expenditures for disaster grants from the U.S. Department of Homeland Security are recorded on the Schedule when the funds are obligated by the federal agency through the approval of the Project Worksheets and eligible expenditures have been incurred. Disaster grant expenditures included in the Schedule for the year ended June 30, 2025, that were incurred in prior fiscal years were $9,130,496.

Finding Details

Finding 2025-001 – Allowability and Period of Performance Information of the federal program: Federal Grantor: United States Department of Homeland Security Assistance Listing No.: 97.036, Disaster Grants – Public Assistance (Presidentially Declared Disasters) Criteria or specific requirement (including statutory, regulatory or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” Condition: The timekeeping system used by management did not require timecards to be reviewed and approved. Further, there was no process in place to review wage rates to ensure they were reasonable. Cause: Management had not implemented adequate internal control procedures to require supervisory review and approval of timecards or verification of wage rates. Effect or potential effect: The absence of supervisory review and verification controls increases the risk that unallowable payroll costs could be charged to the award, that inaccurate or unsupported labor costs could be reported, and that noncompliance with Federal requirements could occur. Questioned costs: None Context: The population consisted of $6,727,441 of salaries expense. A sample of 40 items was selected, and all 40 items contained exceptions related to the absence of review and approval of timecards and the lack of review of pay rates for reasonableness. Identification as a repeat finding, if applicable: This finding is not a repeat finding. Recommendation: Management should implement and document internal control procedures to ensure all timecards are independently reviewed and approved by supervisors and that wage rates charged to the award are reviewed for reasonableness. Controls should operate consistently and be designed to prevent and detect errors or unsupported charges. Views of responsible officials: Management concurs with the finding and has developed a plan to correct the finding.
Finding 2025-002 – Earmarking Information of the federal program: Federal Grantor: United States Department of Homeland Security Assistance Listing No.: 97.036, Disaster Grants – Public Assistance (Presidentially Declared Disasters) Criteria or specific requirement (including statutory, regulatory or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” Section 516b(b)(2)(B) of Title 42 of the United States Code establishes that management costs are subject to a statutory cap of 5 percent of the total FEMA obligation. Amounts exceeding this cap are unallowable. Condition: Management costs exceeded the 5 percent statutory limitation. The total FEMA obligation was $14,897,837, resulting in the allowable management cost cap amount being $744,892. The Company received $770,709 in management costs, which exceeded the allowable amount. Cause: Management did not implement adequate monitoring controls to ensure that management costs remained within the 5 percent statutory cap. Effect or potential effect: The lack of monitoring procedures resulted in excess management costs being charged to the award. Exceeding the statutory cap increases the risk of noncompliance and financial exposure to repayment. Questioned costs: Questioned costs total $25,817. This represents the amount by which management costs received ($770,709) exceeded the 5 percent allowable cap ($744,892). Context: The population consisted of $770,709 in total management cost charges. We identified one exception related to the Company exceeding the statutory 5 percent management cost cap. Identification as a repeat finding, if applicable: This finding is not a repeat finding. Recommendation: Management should establish monitoring procedures to ensure management costs charged to FEMA awards do not exceed the statutory 5 percent threshold. Monitoring should occur on a recurring basis to ensure compliance with earmarking requirements. Views of responsible officials: Management concurs with the finding and has developed a plan to correct the finding.