Audit 46315

FY End
2022-01-31
Total Expended
$8.80M
Findings
12
Programs
6
Organization: Northwest Health Services, Inc. (MO)
Year: 2022 Accepted: 2022-10-19
Auditor: Forvis LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
41976 2022-003 Material Weakness - I
41977 2022-003 Material Weakness - I
41978 2022-003 Material Weakness - I
41979 2022-003 Material Weakness - I
41980 2022-003 Material Weakness - I
41981 2022-002 Material Weakness - ABL
618418 2022-003 Material Weakness - I
618419 2022-003 Material Weakness - I
618420 2022-003 Material Weakness - I
618421 2022-003 Material Weakness - I
618422 2022-003 Material Weakness - I
618423 2022-002 Material Weakness - ABL

Contacts

Name Title Type
VUYACEZFVRF4 Matt Younger Auditee
8163855993 Jansen Otterness Auditor
No contacts on file

Notes to SEFA

Title: Note 3: Basis of Presentation Accounting Policies: 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 shown on the Schedule, if any, represent adjustments or credits in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: Northwest Health Services, Inc. has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Northwest Health Services, Inc. under programs of the federal government for the year ended January 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 Northwest Health Services, Inc., it is not intended to and does not present the financial position, results of operations, changes in net assets, or cash flows of Northwest Health Services, Inc.
Title: Note 4: Federal Loan Programs Accounting Policies: 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 shown on the Schedule, if any, represent adjustments or credits in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: Northwest Health Services, Inc. has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. Northwest Health Services, Inc. did not have any federal loan programs during the year ended January 31, 2022.
Title: Note 5: Personal Protective Equipment (PPE) (Unaudited) Accounting Policies: 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 shown on the Schedule, if any, represent adjustments or credits in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: Northwest Health Services, Inc. has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. Northwest Health Services, Inc. did not receive donated PPE during the year ended January 31, 2022.

Finding Details

Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Provider Relief Fund and American Rescue Plan Act (ARP) Rural Distribution Federal Assistance Listing No. 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/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) Condition ? The Organization is required to prepare and submit phase one Provider Relief Funding Reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs ? Unknown Context ? The period one Provider Relief Fund report was tested. The Organization selected option three to report lost revenues based on 2020 and 2021 quarterly budget versus actual results. The Organization used a calculation that excluded health center owned pharmacy revenues but did not disclose this election in the required narrative to the Health Resources Services Administration (HRSA). Effect ? The report provided to HRSA included adjustments that were not adequately described and disclosed through the PRF phase one report. Cause ? The narrative did not fully and accurately describe the other reasonable method for calculating lost revenue, as required by the PRF terms and conditions. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? Policies and procedures over federal grant reporting should be modified to ensure reports and supporting documentation provided to regulatory agencies is clear, accurate, and easily understood. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with federal grant reporting guidelines. Going forward, the federal grant reporting policy and procedures will be reviewed and amended to ensure that reports and documentation for regulatory agencies are provided in a clear, accurate, and easily understood manner. Additionally, all related NHS personnel will be educated on the policy and procedures.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Health Center Program Cluster Federal Assistance Listing Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award Nos. 1 H8FCS41342-01-00 and 1 C14CS39842-01-00 Program Year 2022 Criteria or Specific Requirement ? Procurement ? 45 CFR 75.329 Condition ? The Organization did not follow its policy governing procurement requirements for the purchase of goods or services charged to federal awards. Questioned Costs ? None Context ? A sample of ten procurements were tested out of a population of ninety-one procurements totaling $1,704,444. The sample was not, and is not intended to be, statistically valid. Of the ten procurements, three procurements in the amount of $248,456 did not follow the Organization?s procurement policy for vendor selection. Effect ? Purchases were made that did not adhere to the Organization?s procurement policy. Cause ? The Organization did not comply with their federal procurement policy. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with the Uniform Guidance. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with NHS? federal procurement policy. Going forward, the procurement policy will be reviewed on a regular basis to ensure that personnel involved in procurement are educated with regards to the procurement policy and procedures. Additionally, the procurement policy will be reviewed on an annual basis to ensure it is consistent with the Uniform Guidance.
Provider Relief Fund and American Rescue Plan Act (ARP) Rural Distribution Federal Assistance Listing No. 93.498 U.S. Department of Health and Human Services Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/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) Condition ? The Organization is required to prepare and submit phase one Provider Relief Funding Reporting. This report is to be prepared using accurate financial information and submitted by the deadline established. Questioned Costs ? Unknown Context ? The period one Provider Relief Fund report was tested. The Organization selected option three to report lost revenues based on 2020 and 2021 quarterly budget versus actual results. The Organization used a calculation that excluded health center owned pharmacy revenues but did not disclose this election in the required narrative to the Health Resources Services Administration (HRSA). Effect ? The report provided to HRSA included adjustments that were not adequately described and disclosed through the PRF phase one report. Cause ? The narrative did not fully and accurately describe the other reasonable method for calculating lost revenue, as required by the PRF terms and conditions. Identification as a Repeat Finding ? Not a repeat finding. Recommendation ? Policies and procedures over federal grant reporting should be modified to ensure reports and supporting documentation provided to regulatory agencies is clear, accurate, and easily understood. Views of Responsible Officials and Planned Corrective Actions ? We concur with this finding. Management recognizes the importance of complying with federal grant reporting guidelines. Going forward, the federal grant reporting policy and procedures will be reviewed and amended to ensure that reports and documentation for regulatory agencies are provided in a clear, accurate, and easily understood manner. Additionally, all related NHS personnel will be educated on the policy and procedures.