Audit 48987

FY End
2022-06-30
Total Expended
$17.49M
Findings
2
Programs
4
Organization: Buchanan County Health Center (IA)
Year: 2022 Accepted: 2023-03-21
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
44202 2022-004 Material Weakness Yes P
620644 2022-004 Material Weakness Yes P

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $16.88M Yes 1
93.697 Covid-19 Testing for Rural Health Clinics $300,000 - 0
93.498 Provider Relief Fund $293,728 - 0
21.019 Coronavirus Relief Fund $17,038 - 0

Contacts

Name Title Type
CMNLAFR83JJ5 Jeffrey Rummel Auditee
3193320880 Brian Unsen Auditor
No contacts on file

Notes to SEFA

Title: Loan and Grant Programs Accounting Policies: Expenditures reported on the schedule are reported on the accrual basis of accounting. 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 auditee did not use the de minimis cost rate. Expenditures reported on this schedule under the Community Facilities Loans and Grants Program consists of the beginning of the year outstanding loan balance of the Health Centers USDA direct loans of $16,882,995. If applicable, advances made on the loans during the year are reported on the Schedule. The Health Center made no advances on the loans during the year ended June 30, 2022. The Health Centers outstanding loan balance for the direct loan as of June 30, 2022, is $16,405,450.
Title: Basis of Presentation Accounting Policies: Expenditures reported on the schedule are reported on the accrual basis of accounting. 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 auditee did not use the de minimis cost rate. The accompanying schedule of expenditures of federal awards (the schedule) includes the federal award activity of People's Memorial Hospital, d/b/a Buchanan County Health Center (Health Center) 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 Health Center, it is not intended to and does not present the financial position, changes in net position, or cash flows of the Health Center.
Title: Provider Relief Funds Accounting Policies: Expenditures reported on the schedule are reported on the accrual basis of accounting. 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 auditee did not use the de minimis cost rate. The Health Center received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan Rural Distribution (PRF) program (Federal Financial Assistance Listing #93.498) during the years ended June 30, 2020, 2021, and 2022. The PRF expenditures were not recognized on the Schedule until the expenditures were included in the reporting to HHS as required under the PRF program. The amount of PRF expenditures included in the Schedule requires management to make estimates and assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant estimate. Estimates and assumptions may include reducing actual expenses by amounts that have been reimbursed or are obligated to be reimbursed by other sources and estimating marginal increases in expenses related to coronavirus. Actual amounts could differ from those estimates.

Finding Details

Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Preparation of the Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: A properly designed system of internal control over financial reporting includes the ability to prepare the schedule of expenditures of federal awards (the schedule) that are materially correct and include all required disclosures. Condition: The Health Center does not have an internal control system designed to provide for the preparation of the schedule of expenditures of federal awards being audited. We were also requested to draft the schedule. Cause: The Health Center has limited staff to prepare the schedule. Effect: There is a reasonable possibility that the Health Center would not be able to draft the schedule that is correct without the assistance of the auditors. Questioned Costs: None reported. Context: Sampling was not used. Eide Bailly drafted the schedule. Repeat Finding from Prior Years: Yes Recommendation: While we recognize that this condition is not unusual for an organization with limited staffing, it is important that the Health Center is aware of this condition for financial reporting purposes. Management and the board of directors should continually be aware of the financial accounting and reporting of the Health Center and changes in the accounting and reporting requirements. Views of Responsible Officials: Management agrees with the finding.
Department of Agriculture Federal Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Preparation of the Schedule of Expenditures of Federal Awards Material Weakness in Internal Control Over Compliance - Other Criteria: A properly designed system of internal control over financial reporting includes the ability to prepare the schedule of expenditures of federal awards (the schedule) that are materially correct and include all required disclosures. Condition: The Health Center does not have an internal control system designed to provide for the preparation of the schedule of expenditures of federal awards being audited. We were also requested to draft the schedule. Cause: The Health Center has limited staff to prepare the schedule. Effect: There is a reasonable possibility that the Health Center would not be able to draft the schedule that is correct without the assistance of the auditors. Questioned Costs: None reported. Context: Sampling was not used. Eide Bailly drafted the schedule. Repeat Finding from Prior Years: Yes Recommendation: While we recognize that this condition is not unusual for an organization with limited staffing, it is important that the Health Center is aware of this condition for financial reporting purposes. Management and the board of directors should continually be aware of the financial accounting and reporting of the Health Center and changes in the accounting and reporting requirements. Views of Responsible Officials: Management agrees with the finding.