Audit 47115

FY End
2022-06-30
Total Expended
$2.66M
Findings
16
Programs
5
Year: 2022 Accepted: 2023-03-29
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
43624 2022-003 Significant Deficiency Yes P
43625 2022-003 Significant Deficiency Yes P
43626 2022-004 Significant Deficiency - N
43627 2022-003 Significant Deficiency Yes P
43628 2022-004 Significant Deficiency - N
43629 2022-003 Significant Deficiency Yes P
43630 2022-003 Significant Deficiency Yes P
43631 2022-004 Significant Deficiency - N
620066 2022-003 Significant Deficiency Yes P
620067 2022-003 Significant Deficiency Yes P
620068 2022-004 Significant Deficiency - N
620069 2022-003 Significant Deficiency Yes P
620070 2022-004 Significant Deficiency - N
620071 2022-003 Significant Deficiency Yes P
620072 2022-003 Significant Deficiency Yes P
620073 2022-004 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $668,156 Yes 2
93.697 Covid-19 Testing for Rural Health Clinics $363,868 - 1
93.155 Rural Health Research Centers $130,641 - 1
93.461 Covid-19 Testing for the Uninsured $21,368 - 0
93.301 Small Rural Hospital Improvement Grant Program $10,513 - 0

Contacts

Name Title Type
PEKXCMGQMT86 Micaela Meyer Auditee
7015842792 Renee Gravalin Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception for the COVID-19 Testing for the Uninsured program, which are recorded based on when the claim is deemed eligible as evidenced by the receipt of monies from the federal agency. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Hospital does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Jacobson Memorial Hospital Care Center and Subsidiary (Hospital) under programs of the federal government for the year ended June 30, 2022. 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 Hospital, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Hospital.
Title: Loan Programs Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception for the COVID-19 Testing for the Uninsured program, which are recorded based on when the claim is deemed eligible as evidenced by the receipt of monies from the federal agency. When applicable, 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. No federal financial assistance has been provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: The Hospital does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. Expenditures reported in this consolidated schedule consist of three separate loans. For the first two loans, the expenditures reported represents the beginning of the year outstanding loan balances plus advances made on the loans during the year, if applicable. The outstanding balances as of June 30, 2022 for these two loans were$502,446 and $917,752.The third loan is guaranteed by the United States Department of Agriculture (USDA) for up to 90% of the loan principal. Total expenditures reported represents 90% of the beginning of the year outstanding loan balances plus 9% of advances made on the loan during the year, if applicable. The outstanding balance as of June 30,2022 for this loan was $661,108, of which 90% totals $594,997.

Finding Details

2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-004 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance and Noncompliance 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. Condition - During our testing, it was noted that one of the loan reserve accounts was underfunded by approximately $4,500. Cause - The Hospital did not have an adequate internal control policy in place to ensure the proper funding of the reserve accounts. Effect ? The lack of adequate policies governing proper funding of reserve accounts increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs ? None reported Context/Sampling ? Sampling was not used. The Hospital has two reserve accounts that were tested. Repeat Findings from Prior Years ? No Recommendation - We recommend that the Hospital enhance internal control policies to ensure that there is proper funding of the reserve accounts. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-004 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance and Noncompliance 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. Condition - During our testing, it was noted that one of the loan reserve accounts was underfunded by approximately $4,500. Cause - The Hospital did not have an adequate internal control policy in place to ensure the proper funding of the reserve accounts. Effect ? The lack of adequate policies governing proper funding of reserve accounts increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs ? None reported Context/Sampling ? Sampling was not used. The Hospital has two reserve accounts that were tested. Repeat Findings from Prior Years ? No Recommendation - We recommend that the Hospital enhance internal control policies to ensure that there is proper funding of the reserve accounts. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-004 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance and Noncompliance 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. Condition - During our testing, it was noted that one of the loan reserve accounts was underfunded by approximately $4,500. Cause - The Hospital did not have an adequate internal control policy in place to ensure the proper funding of the reserve accounts. Effect ? The lack of adequate policies governing proper funding of reserve accounts increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs ? None reported Context/Sampling ? Sampling was not used. The Hospital has two reserve accounts that were tested. Repeat Findings from Prior Years ? No Recommendation - We recommend that the Hospital enhance internal control policies to ensure that there is proper funding of the reserve accounts. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-004 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance and Noncompliance 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. Condition - During our testing, it was noted that one of the loan reserve accounts was underfunded by approximately $4,500. Cause - The Hospital did not have an adequate internal control policy in place to ensure the proper funding of the reserve accounts. Effect ? The lack of adequate policies governing proper funding of reserve accounts increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs ? None reported Context/Sampling ? Sampling was not used. The Hospital has two reserve accounts that were tested. Repeat Findings from Prior Years ? No Recommendation - We recommend that the Hospital enhance internal control policies to ensure that there is proper funding of the reserve accounts. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-004 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance and Noncompliance 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. Condition - During our testing, it was noted that one of the loan reserve accounts was underfunded by approximately $4,500. Cause - The Hospital did not have an adequate internal control policy in place to ensure the proper funding of the reserve accounts. Effect ? The lack of adequate policies governing proper funding of reserve accounts increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs ? None reported Context/Sampling ? Sampling was not used. The Hospital has two reserve accounts that were tested. Repeat Findings from Prior Years ? No Recommendation - We recommend that the Hospital enhance internal control policies to ensure that there is proper funding of the reserve accounts. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-003 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Department of Health and Human Services Federal Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Department of Health and Human Services Federal Assistance Listing #93.461 Rural Health Research Centers Preparation of Consolidated Schedule of Expenditures of Federal Awards Significant Deficiency in Internal Control Over Compliance - Other Criteria - Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Condition - The Hospital does not have an internal control system designed to provide for a complete and accurate consolidated schedule of expenditures of federal awards being audited. We were requested to draft the Schedule. Cause - Auditor assistance with preparation of the Schedule is not unusual, as the Schedule has unique and specialized requirements and preparation is only required with the Hospital meets a specified threshold of federal expenditures. Effect - There is a reasonable possibility that the Hospital would not be able to draft a Schedule that is correct without assistance of the auditors. Questioned Costs - None reported. Context - Sampling was not used. Repeat Finding from Prior Years ? Yes Recommendation - While we recognize that this condition is not unusual for an organization with limited staffing, we recommend management be aware of the financial reporting requirements relating to the Hospital?s schedule of expenditures of federal awards and internal controls that impact financial reporting. Views of Responsible Officials - Management agrees with the finding.
2022-004 Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control Over Compliance and Noncompliance 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. Condition - During our testing, it was noted that one of the loan reserve accounts was underfunded by approximately $4,500. Cause - The Hospital did not have an adequate internal control policy in place to ensure the proper funding of the reserve accounts. Effect ? The lack of adequate policies governing proper funding of reserve accounts increases the risk that employees participating in the federal award administration may not be able to detect and correct noncompliance in a timely manner. Questioned Costs ? None reported Context/Sampling ? Sampling was not used. The Hospital has two reserve accounts that were tested. Repeat Findings from Prior Years ? No Recommendation - We recommend that the Hospital enhance internal control policies to ensure that there is proper funding of the reserve accounts. Views of Responsible Officials - Management agrees with the finding.