Audit 52761

FY End
2022-12-31
Total Expended
$14.52M
Findings
2
Programs
3
Organization: Southwest Healthcare Services (ND)
Year: 2022 Accepted: 2023-10-01
Auditor: Eide Bailly LLP

Organization Exclusion Status:

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Findings

ID Ref Severity Repeat Requirement
50951 2022-004 Significant Deficiency - N
627393 2022-004 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $13.79M Yes 1
93.498 Provider Relief Fund $576,410 - 0
93.301 Small Rural Hospital Improvement Grant Program $154,903 - 0

Contacts

Name Title Type
KPA8D8KNA3J9 Amanda Loughman Auditee
7015233214 Renee Gravalin Auditor
No contacts on file

Notes to SEFA

Title: Loan Programs Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, suchexpenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certaintypes of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance hasbeen provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: Southwest does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. Expenditures reported on this schedule consist of two separate loans. The expenditures reported represents thebeginning of the year outstanding loan balances plus advances made on the loan during the year, if applicable.The outstanding loan balance as of December 31, 2022 for the loans was $13,464,563.
Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, suchexpenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certaintypes of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance hasbeen provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: Southwest 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 activityof Southwest Healthcare Services (Southwest) under programs of the federal government for the year endedDecember 31, 2022. The information is presented in accordance with the requirements of Title 2 U.S. Code ofFederal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements forFederal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations ofSouthwest it is not intended to and does not present the financial position, changes in net assets, or cash flowsof Southwest.
Title: Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, suchexpenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certaintypes of expenditures are not allowable or are limited as to reimbursement. No federal financial assistance hasbeen provided to a subrecipient. De Minimis Rate Used: N Rate Explanation: Southwest does not draw for indirect administrative expenses and has not elected to use the 10% de minimiscost rate. Southwest received amounts from the U.S. Department of Health and Human Services (HHS) through theCOVID19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program (FederalFinancial Assistance Listing #93.498). In accordance with the compliance supplement, the PRF expenditureswere recognized on the Schedule when the expenditures were included in the reporting to HHS for Period 3(received $72,940), defined as payments received during January 1, 2021 to June 30, 2021, and Period 4(received $503,470), defined as payments received during July 1, 2021 to December 31, 2021.The total amount of PRF expenditures included on the Schedule requires management to make estimates andassumptions that affect the reported amounts. Accordingly, such expenditures are considered a significantestimate. Estimates and assumptions may include reducing actual expenses by amounts that have beenreimbursed or are obligated to be reimbursed by other sources and estimating marginal increases in expensesrelated to coronavirus. Actual amounts could differ from those estimates.

Finding Details

Department of Agriculture Federal Financial Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control over Compliance Criteria ? 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal awards. Condition ? During our testing, there was no formal review separate from the preparer over the reserve fund reconciliations for the federal program. Cause ? Southwest did not have an adequate internal control policy in place to ensure review and approval over the reserve funds. Effect ? The lack of adequate policies governing review 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 was not used. Repeat Finding from Prior Years ? No Recommendation ? We recommend Southwest enhance internal control policies to ensure that formal documentation of reviews is present. Views of Responsible Officials - Management agrees with the finding.
Department of Agriculture Federal Financial Assistance Listing #10.766 Community Facilities Loans and Grants Cluster Special Tests and Provisions Significant Deficiency in Internal Control over Compliance Criteria ? 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal awards. Condition ? During our testing, there was no formal review separate from the preparer over the reserve fund reconciliations for the federal program. Cause ? Southwest did not have an adequate internal control policy in place to ensure review and approval over the reserve funds. Effect ? The lack of adequate policies governing review 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 was not used. Repeat Finding from Prior Years ? No Recommendation ? We recommend Southwest enhance internal control policies to ensure that formal documentation of reviews is present. Views of Responsible Officials - Management agrees with the finding.