Audit 397111

FY End
2025-06-30
Total Expended
$18.95M
Findings
3
Programs
33
Organization: Avera Health (SD)
Year: 2025 Accepted: 2026-03-31
Auditor: EIDE BAILLY LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
1205433 2025-001 Material Weakness Yes I
1205434 2025-001 Material Weakness Yes I
1205435 2025-001 Material Weakness Yes I

Programs

ALN Program Spent Major Findings
93.912 RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT $2.13M Yes 0
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $1.32M Yes 0
93.493 CONGRESSIONAL DIRECTIVES $1.27M Yes 1
93.958 BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES $1.08M Yes 0
93.884 PRIMARY CARE TRAINING AND ENHANCEMENT $735,138 Yes 0
93.838 LUNG DISEASES RESEARCH $713,243 Yes 0
10.855 DISTANCE LEARNING AND TELEMEDICINE LOANS AND GRANTS $627,473 Yes 0
93.732 MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS $553,073 Yes 0
93.926 HEALTHY START INITIATIVE $476,689 Yes 0
97.008 NON-PROFIT SECURITY PROGRAM $450,000 Yes 0
20.509 FORMULA GRANTS FOR RURAL AREAS AND TRIBAL TRANSIT PROGRAM $415,811 Yes 0
16.582 CRIME VICTIM ASSISTANCE/DISCRETIONARY GRANTS $345,829 Yes 0
93.359 NURSE EDUCATION, PRACTICE, QUALITY AND RETENTION GRANTS $282,278 Yes 0
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $231,083 Yes 1
16.589 RURAL DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING ASSISTANCE PROGRAM $212,425 Yes 0
16.838 COMPREHENSIVE OPIOID, STIMULANT, AND OTHER SUBSTANCES USE PROGRAM $156,434 Yes 0
10.331 GUS SCHUMACHER NUTRITION INCENTIVE PROGRAM $156,109 Yes 0
93.310 TRANS-NIH RESEARCH SUPPORT $121,689 Yes 0
93.872 TRIBAL MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING $35,349 Yes 0
93.959 BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE $30,883 Yes 0
93.136 INJURY PREVENTION AND CONTROL RESEARCH AND STATE AND COMMUNITY BASED PROGRAMS $25,714 Yes 0
93.393 CANCER CAUSE AND PREVENTION RESEARCH $23,755 Yes 0
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $21,658 Yes 0
20.513 ENHANCED MOBILITY OF SENIORS AND INDIVIDUALS WITH DISABILITIES $20,000 Yes 0
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $18,196 Yes 0
93.191 GRADUATE PSYCHOLOGY EDUCATION $12,219 Yes 0
93.273 ALCOHOL RESEARCH PROGRAMS $10,913 Yes 0
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $6,678 Yes 0
45.025 PROMOTION OF THE ARTS PARTNERSHIP AGREEMENTS $5,900 Yes 0
93.301 SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM $5,843 Yes 0
93.279 DRUG ABUSE AND ADDICTION RESEARCH PROGRAMS $5,063 Yes 0
16.026 OVW RESEARCH AND EVALUATION PROGRAM $3,413 Yes 0
93.991 PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT $1,978 Yes 0

Contacts

Name Title Type
N3MLDJDPQAA3 John Neth Auditee
6053224588 Ashley Brandt-Duda Auditor
No contacts on file

Notes to SEFA

The accompanying consolidated schedule of expenditures of federal awards (the schedule) includes the federal award activity of Avera Health (Organization) under programs of the federal government for the year ended June 30, 2025. The information 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 Organization, it is not intended to and does not present the consolidated balance sheet, consolidated statement of operations, consolidated changes in net assets or consolidated cash flows of the Organization.
The consolidated schedule of expenditures of federal awards includes the federal grant activity of Avera Health and its consolidated subsidiaries (collectively, Avera Health) which received federal financial assistance. Significant intercompany balances and transactions have been eliminated in the consolidated schedule of expenditures of federal awards. The following entities and their associated TIN numbers included within the schedule are as follows: Avera At Home – TIN#460399291, Avera Holy Family – TIN#420680370, Avera Health – TIN#460422673, Avera St. Anthony’s – TIN#470463911, Avera St. Benedict’s – TIN#460226738, Avera Sacred Heart Hospital – TIN#460225483, Avera St. Luke’s – TIN#460224598, Avera St. Mary’s – TIN#460230199, Avera Gettysburg – TIN#460234354, Avera Granite Falls – TIN#843156881, Avera McKennan – TIN#460224743, Avera Marshall – TIN#410919153, Avera Queen of Peace – TIN#460224604, and Avera Tyler – TIN#410853163.

Finding Details

Department of Treasury Passed through South Dakota Department of Social Services and South Dakota Department of Health Federal Financial Assistance Listing #21.027 Coronavirus State and Local Fiscal Recovery Funds Procurement, Suspension & Debarment Significant Deficiency in Internal Control over Compliance and Compliance Department of Health and Human Services Federal Financial Assistance Listing #93.493 Congressional Directives Procurement, Suspension & Debarment Significant Deficiency in Internal Control over Compliance and Compliance Criteria: 2 CFR 200.303 (a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. 2 CFR 200 Appendix II requires certain provisions be included in contracts if criteria are applicable. Condition: Our testing over procurement suspension and debarment identified two contracts over $25,000 where some contract provisions required by Uniform Guidance were not included. Cause: There was a lapse in the internal control process in which contract provisions were not evaluated compared to Uniform Guidance contract requirements. Effect: Ineffective controls over this area of compliance resulted in contracts that did not include all contract provisions required by Uniform Guidance. Questioned Costs: None reported. Context: One contract was selected for testing for program 21.027 and one contract was selected for testing for program 93.493. Both contracts were missing some contract provisions required by Uniform Guidance. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls related to the review of contracts to ensure the contracts include the required Uniform Guidance provisions. Views of Responsible Officials: Management agrees with the finding.