Corrective Action Plans

Finding 50989 (2022-002)

Material Weakness 2022

Union County

NC

Questioned Costs Eligibility Material Weakness

Finding 2022-002-Repeat Finding, Material Weakness and Nonmaterial Noncompliance-Eligibility Response/Corrective Action: Since 2017, the Medicaid program has seen a 25% increase in the caseload volume. In addition to the increase in caseload, we currently have 12 Eligibility Specialist positions vac...

Finding 2022-002-Repeat Finding, Material Weakness and Nonmaterial Noncompliance-Eligibility Response/Corrective Action: Since 2017, the Medicaid program has seen a 25% increase in the caseload volume. In addition to the increase in caseload, we currently have 12 Eligibility Specialist positions vacant. Many of these vacancies have occurred within the last year, which has caused an additional substantial increase in the workload of the Eligibility staff. Like most counties across the state, we are struggling to fill the vacancies, but are working diligently to recruit and hire new staff. We currently have less than 30% of staff with more than 1- 2 years of experience in the program. In response to the errors cited, Union County provided education training for staff on citizenship codes in OVS on November 8th and 10th 2022. Responsible Parties: Michelle Lancaster, Deputy County Manager / Human Services Director Beverly Liles, Finance Director

View Audit 45126 Questioned Costs: $1

Finding 50981 (2022-003)

Significant Deficiency 2022

Union County

NC

Questioned Costs Allowable Costs / Cost Principles Cash Management

Responsible Parties: Michelle Lancaster, Deputy County Manager / Human Services Director Beverly Liles, Finance Director ...

Responsible Parties: Michelle Lancaster, Deputy County Manager / Human Services Director Beverly Liles, Finance Director Finding 2022-003, Significant Deficiency and Nonmaterial Noncompliance - Special Test and Provisions See Corrective Action Plan for chart / table.

View Audit 45126 Questioned Costs: $1

Finding 50979 (2022-001)

Significant Deficiency 2022

The Montessori Network

IL

Allowable Costs / Cost Principles Cash Management Internal Control / Segregation of Duties

Corrective Action Plan Finding 2022-001 Audit Recommendation: Procedures should be consistently applied requiring the reconciliation of submitted personnel activity reports to the employees' actual costs allocated and charged to federal and other programs. Planned Corrective Actions: This finding wa...

Corrective Action Plan Finding 2022-001 Audit Recommendation: Procedures should be consistently applied requiring the reconciliation of submitted personnel activity reports to the employees' actual costs allocated and charged to federal and other programs. Planned Corrective Actions: This finding was initially identified during fiscal year 2020, and corrective actions were taken by the School in 2021. To address the issue, the School implemented new procedures that require a monthly review by management, which includes a detailed reconciliation of submitted personnel activity reports to vouchers prepared for federal and other programs. This reconciliation process helps to ensure that payroll cost allocation accurately reflects the submitted personnel activity reports. In addition, the School has made changes to its payroll system to ensure accurate time tracking for its various programs. This includes changing the service provider responsible for voucher submissions. These changes will help to prevent similar issues from occurring in the future and ensure that employee-related costs are accurately allocated to the appropriate programs. As of 2022, the School has successfully implemented these changes and continues to review and monitor its procedures to maintain compliance with federal and other program regulations. Anticipated Completion Date: June 30, 2022 Contact Person: Rita Nolan, Executive Director

View Audit 45124

Finding 50977 (2022-002)

Significant Deficiency 2022

The Montessori Network

IL

Cash Management Internal Control / Segregation of Duties

Corrective Action Plan Finding 2002-002 Audit Recommendation: Procedures should be implemented requiring the reconciliation of submitted reimbursement requests to the related support (such as bills, invoices, etc.) retained. Planned Corrective Actions: Management will develop written procedures outl...

Corrective Action Plan Finding 2002-002 Audit Recommendation: Procedures should be implemented requiring the reconciliation of submitted reimbursement requests to the related support (such as bills, invoices, etc.) retained. Planned Corrective Actions: Management will develop written procedures outlining the steps required to reconcile submitted reimbursement requests to related support retained, such as bills, invoices, receipts, etc. The procedures will include a review and approval process to ensure compliance with federal and other program regulations. All staff members and contractors responsible for preparing and submitting reimbursement requests will receive training on the new procedures. This will include instruction on the importance of reconciling reimbursement requests to supporting documentation. Management will assign a responsible staff member to regularly monitor the reimbursement request process to ensure compliance with established procedures. This individual will be responsible for reviewing a sample of reimbursement requests each month to ensure they are accurate and properly supported. Management will regularly review and evaluate the effectiveness of the new procedures and make necessary adjustments as needed. Anticipated Completion Date: February 28, 2023 Contact Person: Rita Nolan, Executive Director

View Audit 45124

Finding 50976 (2022-001)

Material Weakness 2022

Ou Medicine, Inc.

OK

Questioned Costs Allowable Costs / Cost Principles Internal Control / Segregation of Duties

Corrective Action Plan Finding 2022-001 Internal Control Deficiency Allowed/Allowable Costs At the beginning of the pandemic, OU Health created working groups to evaluate the requirements for COVID-19 funding received and ensure the funds were only used for allowable purposes. The working groups w...

Corrective Action Plan Finding 2022-001 Internal Control Deficiency Allowed/Allowable Costs At the beginning of the pandemic, OU Health created working groups to evaluate the requirements for COVID-19 funding received and ensure the funds were only used for allowable purposes. The working groups were assisted by outside consultants to stay updated on the reporting requirements as the continued to evolve. As part of the Uniform Guidance audit, OU Health provided documentation of the FEMA review process that explained how eligible costs were identified and submitted. To ensure internal controls are documented to the level necessary under current audit standards, OU Health will develop a checklist to document the review and approval of supporting documentation of personnel costs as reported as FEMA federal expenditures. The supporting documentation will be reviewed by management to ensure expenses charged to the federal program are allowable and have not been reimbursed under another federal program. The checklist will be retained with the existing report. Responsible Official: Michael Milligan, Vice President of Accounting Anticipated Completion Date: March 31, 2023

View Audit 40950 Questioned Costs: $1

Finding 50972 (2022-002)

Significant Deficiency 2022

Community Unit School District No. 196

IL

Reporting

Condition: It was noted that the there was an inconsistency when comparing the general ledger to what twas report on the expenditure report. Recommendation: We recommend reviewing the general ledger to the expenditure report before submitting to review for accuracy. Management Response: The Dis...

Condition: It was noted that the there was an inconsistency when comparing the general ledger to what twas report on the expenditure report. Recommendation: We recommend reviewing the general ledger to the expenditure report before submitting to review for accuracy. Management Response: The District will review the general ledger to the expenditure report before submitting. Anticipated date of completion: June 30, 2023.

View Audit 40946

Finding 50970 (2022-002)

Significant Deficiency 2022

Catholic Eldercare Community Foundation

MN

Reporting § 200.512

Finding 2022-002: Filing of Single Audit Report Finding: The Organization did not timely submit the Single Audit Reporting Package for the fiscal year ended September 30, 2021 within nine months after the end of the audit period. Response: Agree Explanation/Corrective Action: The fiscal year e...

Finding 2022-002: Filing of Single Audit Report Finding: The Organization did not timely submit the Single Audit Reporting Package for the fiscal year ended September 30, 2021 within nine months after the end of the audit period. Response: Agree Explanation/Corrective Action: The fiscal year end September 30, 2021, audit was delayed as it was unclear if a single audit was required. The Organization will file the Single Audit Reporting related to the fiscal year end September 30, 2021 and does not expect delays to continue for fiscal year ended September 30, 2022.

View Audit 48822

Finding 50967 (2022-001)

Material Weakness 2022

Reardan-Edwall School District No. 9

WA

Procurement, Suspension & Debarment

Reardan-Edwall School District September 1, 2021 through August 31, 2022 This schedule presents the corrective action the School District is planning to take for findings included in this report in accordance with Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requi...

Reardan-Edwall School District September 1, 2021 through August 31, 2022 This schedule presents the corrective action the School District is planning to take for findings included in this report in accordance with Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Finding ref number: 2022-001 Finding caption: The District?s internal controls were inadequate for ensuring the compliance with federal procurement and suspension and debarment requirements. Name, address, and telephone of School District contact person: Justin Flaa, Finance Director Reardan-Edwall School District No. 9 215 East Spokane Avenue Reardan, WA 99029 Corrective action the auditee plans to take in response to the finding: Regarding suspension and debarment, the District will identify vendors it anticipates will require suspension and debarment checks at the end of each fiscal year and will run a suspension and debarment check for those vendors before the next year starts. In addition, new vendors, not already checked and who are anticipated to exceed the threshold for suspension and debarment checks, will be checked before contracting with those vendors. Regarding general procurement requirement, the District will evaluate federal procurement requirements in advance of procuring goods or services with federal resources. The district will identify applicable procurement requirements related to each purchase to ensure those requirements are met. The Director responsible for each purchase will ensure procurement requirements are met before payment is made to vendors with federal resources. Anticipated date to complete the corrective action: August 31, 2024.

View Audit 43706

Finding 50966 (2022-001)

Significant Deficiency 2022

Carver County

MN

Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking Significant Deficiency

Carver County ? Corrective Action Plan Year Ended December 31,2022 U.S. Department of Health and Human Services Carver County respectfully submits the following corrective action plan for the year ended December 31, 2022. Audit period: 1/1/2022 to 12/31/2022 The findings from the schedule of finding...

Carver County ? Corrective Action Plan Year Ended December 31,2022 U.S. Department of Health and Human Services Carver County respectfully submits the following corrective action plan for the year ended December 31, 2022. Audit period: 1/1/2022 to 12/31/2022 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS?FINANCIAL STATEMENT AUDIT None FINDINGS?FEDERAL AWARD PROGRAMS AUDITS U.S. Department of Health and Human Services 2022-001 Medical Assistance ? Assistance Listing No. 93.778 Recommendation: We recommend the County reviews its procedures for giving timely notice of an individual?s termination to other departments. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will incorporate procedures and controls to ensure timely notice is given to other departments of an individual?s termination. Name of the contact person responsible for corrective action: Mary Kaye Wahl (Assistant Financial Services Director) Planned completion date for corrective action plan: December 31, 2023. If the U.S. Department of Health and Human Services has questions regarding this plan, please call Mary Kaye Wahl at 962-361-1938.

View Audit 43619

Finding 50962 (2022-004)

Significant Deficiency 2022

Fremont County, Wyoming

WY

§ 200.501

For reasons mostly due to employee turnover, extended staffing shortages and lack of expertise by county staff to perform monthly and year-end accounting tasks and schedule preparation, the schedules and accruals for the county's fund financials have been significantly delayed for the past three yea...

For reasons mostly due to employee turnover, extended staffing shortages and lack of expertise by county staff to perform monthly and year-end accounting tasks and schedule preparation, the schedules and accruals for the county's fund financials have been significantly delayed for the past three years. This lag in receiving final trial balances has resulted in our auditors not have adequate time to complete their review and preparation of the final audited financial statements for Fremont County in accordance with state and federal requirements. For the fiscal year 2023 audit, the county has budgeted for external audit assistance and will solicit a local CPA consultant to provide direct assistance, training and guidance while internal staff continue to gain the needed experience.

View Audit 42128

Finding 50961 (2022-003)

Significant Deficiency 2022

Fremont County, Wyoming

WY

Procurement, Suspension & Debarment § 200.318

The Fremont County Clerk is responsible for paying the bills for the county and was not aware that we should be verifying the vendors that they were not debarred, suspended, or otherwise excluded per 2 CRF 200.318(h) and 2 CFR 180. We will set a policy to use going forward, that will be attached to ...

The Fremont County Clerk is responsible for paying the bills for the county and was not aware that we should be verifying the vendors that they were not debarred, suspended, or otherwise excluded per 2 CRF 200.318(h) and 2 CFR 180. We will set a policy to use going forward, that will be attached to the voucher for these vendors showing that we have done our due diligence in these matters. The proposed policy is to work with the Commissioners (who approve contracts), accounts payable department and Treasurer on steps to verify the companies upon the receipt of their contract. Contracts are approved by the County Attorney, and once they are approved, I will add a step to have a member of our staff do the verification and attach a form stating the date and outcome of the verification prior to accepting the contract by the vendor.

View Audit 42128

Finding 50960 (2022-001)

Material Weakness 2022

City of New Albany

IN

Procurement, Suspension & Debarment Subrecipient Monitoring § 200.303

FINDING 2022-001 Contact Person Responsible for Corrective Action: Linda Moeller Contact Phone Number: 812-948-5333 Views of Responsible Official: Concur With Finding Description of Corrective Action Plan: The City does not dispute the finding regarding suspension and disbarment as stated in the aud...

FINDING 2022-001 Contact Person Responsible for Corrective Action: Linda Moeller Contact Phone Number: 812-948-5333 Views of Responsible Official: Concur With Finding Description of Corrective Action Plan: The City does not dispute the finding regarding suspension and disbarment as stated in the audit. This is, unfortunately, a carryover from the 2021 audit which was not finalized and published till November 22, 2022. The city was aware during the finalization of the 2021 audit and discussed with auditors that this would be a problem for 2022 due to the timing of notification of the issue and the City?s inability to implement a corrective action for matters that occurred prior to November 22, 2022. The process for verification of suspension and disbarment was completed in late 2022/early 2023. Staff verifies prior to any recipient receiving funds that they are not federally suspended or disbarred from doing business at the federal level. A review of all recipients for 2022 confirmed that none of them had any issues with the federal suspension and disbarment requirement verification. The City rejects the classification of ?systemic? issues with SLRF funding and application of processes, but acknowledged the previous issues regarding suspension/disbarment as the only audited issue. As stated previously, the City implemented a process upon awareness of the finding and continues to follow it. A designated staff person verifies that any recipient of funds is not subject to suspension and/or disbarment for business at the federal level prior to any funding. Anticipated Completion Date: Done

View Audit 42127

Finding 50959 (2022-009)

Significant Deficiency 2022

Ucan

IL

Questioned Costs Period of Performance Allowable Costs / Cost Principles § 200.403

Identifying Number: 2022-009 Finding: Period of Performance: payroll costs Corrective Actions Taken or Planned: UCAN agrees with this finding and is committed to strengthening internal controls to ensure that amounts are properly recorded and reported. UCAN has already taken steps to insure that i...

Identifying Number: 2022-009 Finding: Period of Performance: payroll costs Corrective Actions Taken or Planned: UCAN agrees with this finding and is committed to strengthening internal controls to ensure that amounts are properly recorded and reported. UCAN has already taken steps to insure that items are billed in the period incurred and only items that fall into the grant period are billed. We believe that significant turnover in the finance department led to this deficiency, so we are actively documenting procedures and cross-training employees, so we always have coverage. All vouchers will also go through a review process before they are sent to the funder. This is a repeat finding, with the original corrective action plan to be completed before June 30, 2023. We do believe that corrective actions that have been taken have resolved this issue. Contact person is Kimberly Parish, Chief Financial Officer and she can be reached at kim.parish@ucanchicago.org.

View Audit 53429 Questioned Costs: $1

Finding 50958 (2022-008)

Material Weakness 2022

Ucan

IL

Questioned Costs Allowable Costs / Cost Principles Internal Control / Segregation of Duties § 200.430

Identifying Number: 2022-008 Finding: Unallowable cost ? salary certification and personnel activity reports Corrective Actions Taken or Planned: UCAN agrees with this finding and believes the turnover in personnel affected this area as there was a misunderstanding on what was required. Employees ...

Identifying Number: 2022-008 Finding: Unallowable cost ? salary certification and personnel activity reports Corrective Actions Taken or Planned: UCAN agrees with this finding and believes the turnover in personnel affected this area as there was a misunderstanding on what was required. Employees in leadership positions have been trained on what is required and are ensuring that all staff certifications are being gathered monthly. This is a repeat finding, with the original corrective action plan to be completed before December 31, 2022. We do believe that corrective actions that have been taken have resolved this issue. Contact person is Kimberly Parish, Chief Financial Officer and she can be reached at kim.parish@ucanchicago.org.

View Audit 53429 Questioned Costs: $1

Finding 50957 (2022-014)

Significant Deficiency 2022

City of Baton Rouge - Parish of East Baton Rouge

LA

Questioned Costs Allowable Costs / Cost Principles

2022-014) Allowable Costs Management?s response and corrective action is as follows: In developing the Cost Allocation Plan, the City-Parish previously excluded risk management costs in the calculation of the rate for the Head Start program. When the City-Parish began utilizing a new consultant t...

2022-014) Allowable Costs Management?s response and corrective action is as follows: In developing the Cost Allocation Plan, the City-Parish previously excluded risk management costs in the calculation of the rate for the Head Start program. When the City-Parish began utilizing a new consultant to prepare the Cost Allocation Plan, the consultant included those costs in the rate calculation when they should have been excluded. The 2023 report will be revised to exclude costs for risk management functions and will continue to be excluded for future plans. The City-Parish does not charge the full amount of indirect costs that would be allowable based on the approved indirect cost rate to the grant programs that paid for the insurance policies. In 2022, the indirect cost allowable based on the approved rate was $1,410,223.04; however, only $131,232.00 was directly charged to the Head Start grant and $955,904.84 was used as in-kind match leaving a balance of $323,086.20 in allowable indirect cost that was not charged. Expected Implementation Date: June 2023 Contact person: Shalanda Nalencz, Accounting Manager, Finance Department

View Audit 53428 Questioned Costs: $1

Finding 50956 (2022-013)

Significant Deficiency 2022

City of Baton Rouge - Parish of East Baton Rouge

LA

Reporting

2022-013) Reporting Management?s response and corrective action is as follows: The Head Start Program Administrator began working with Grants Management Solutions in December 2022 to obtain authorization to submit the report timely in Grants Management. After many conversations, the error by Gran...

2022-013) Reporting Management?s response and corrective action is as follows: The Head Start Program Administrator began working with Grants Management Solutions in December 2022 to obtain authorization to submit the report timely in Grants Management. After many conversations, the error by Grants Management Solution was resolved in May 2023 and the report was submitted and certified. Expected Implementation Date: May 2023 Contact person: Vernadine Mabry, Director, Division of Human Development and Services

View Audit 53428

Finding 50955 (2022-005)

Significant Deficiency 2022

City of Baton Rouge - Parish of East Baton Rouge

LA

Questioned Costs Allowable Costs / Cost Principles

2022-005) Allowable Costs Management?s response and corrective action is as follows: In an effort to avoid non-compliance with the federal grant program, all employee payroll charges will be transferred to an alternative City-Parish funding source. If a federal grant program is used in the future...

2022-005) Allowable Costs Management?s response and corrective action is as follows: In an effort to avoid non-compliance with the federal grant program, all employee payroll charges will be transferred to an alternative City-Parish funding source. If a federal grant program is used in the future for employee payroll charges, the employees will be trained on the applicable federal guidelines prior to use. Expected Implementation Date: June 2023 Contact person: Adam Smith, Interim Director, Environmental Services

View Audit 53428 Questioned Costs: $1

Finding 50954 (2022-004)

Significant Deficiency 2022

City of Baton Rouge - Parish of East Baton Rouge

LA

Questioned Costs Eligibility

2022-004) Allowable Activities Management?s response and corrective action is as follows: After reviewing the project scope, along with the U. S. Treasury Final Rule, the City-Parish believes that the bridge replacement is an allowable use of funds. Twin Oaks bridge was closed in 2015 in a very ...

2022-004) Allowable Activities Management?s response and corrective action is as follows: After reviewing the project scope, along with the U. S. Treasury Final Rule, the City-Parish believes that the bridge replacement is an allowable use of funds. Twin Oaks bridge was closed in 2015 in a very rural area. During the pandemic it became evident that citizens were unable to access healthcare quickly with the bridge closure. In addition, the bridge is causing major drainage issues in the Baker Canal. The replacement bridge will use watertight expansion joints so that all surface water can drain off the structure and collect in inlets placed at the bridge ends. The downstream ends of bridges need special attention which will collect and concentrate the stormwater away from the bridge. The concentrated flow will be directed into a low-risk erosion area. All runoff shall be directed away from wing walls, fill slopes, and embankments, so that no material is susceptible to erosion. Bridge drains are designed to reduce the amount of concentrated flows off a structure. The replacement of the bridge allows the Parish to address the subsurface drainage issues as well as respond to the public health and negative economic impacts of the pandemic. U.S. Treasury has specifically enumerated the flexibility provided under this expenditure category in the Final Rule excerpt: (second paragraph on the page 4411) ?Although the meaning of water and sewer infrastructure for purposes of sections 602(c)(1)(D) and 603(c)(1)(D) of the Social Security Act does not include all water-related uses, Treasury has made clear in this final rule that investments to infrastructure include a wide variety of projects. Treasury interprets the word ``infrastructure?? in this context broadly to mean the underlying framework or system for achieving the given public purpose, whether it be provision of drinking water or management of wastewater or stormwater. As discussed below, this can include not just storm drains and culverts for the management of stormwater, for example, but also bioretention basins and rain barrels implemented across a watershed, including on both public and private property, that together reduce the amount of runoff that needs to be managed by traditional infrastructure.? Expected Implementation Date: June 2023 Contact person: Tom Stephens, Chief Engineer, Transportation and Drainage Department Angie Savoy, Assistant Director, Finance Department

View Audit 53428 Questioned Costs: $1

Finding 50952 (2022-001)

Significant Deficiency 2022

St John's Health Care Corporation

NY

HUD Housing Programs Matching / Level of Effort / Earmarking

Recommendation: Adhere to the HUD regulatory agreement in relation to obtaining prior written approval from HUD before encumbering the Project. Action Taken: During 2022, the Home received approval for the entirety of the loan balance and recognized the proceeds of the Small Business Administratio...

Recommendation: Adhere to the HUD regulatory agreement in relation to obtaining prior written approval from HUD before encumbering the Project. Action Taken: During 2022, the Home received approval for the entirety of the loan balance and recognized the proceeds of the Small Business Administration loan as of December 31, 2022. The Home obtained the Small Business Administration loan as a prudent business decision to meet operating expenses. The Home will obtain prior written approval from HUD before encumbering the Project in the future.

View Audit 53719

Finding 50951 (2022-004)

Significant Deficiency 2022

Southwest Healthcare Services

ND

Special Tests & Provisions Significant Deficiency Matching / Level of Effort / Earmarking § 200.303

Finding Summary: Southwest completed the Provider Relief Fund reporting requirement without factoring in the amounts of expenses that were reimbursed by other sources. This specifically relates to the amount that Southwest was reimbursed by Medicare as a result of being a critical access hospital th...

Finding Summary: Southwest completed the Provider Relief Fund reporting requirement without factoring in the amounts of expenses that were reimbursed by other sources. This specifically relates to the amount that Southwest was reimbursed by Medicare as a result of being a critical access hospital that get reimbursed based on cost. Responsible Individuals: Dennis Goebel, Chief Executive Officer; Amanda Loughman, Chief Financial Officer. Corrective Action Plan: Management will ensure to factor in a portion of the Provider Relief Fund expenses that are being reimbursed by other sources when completing the reporting requirements. Anticipated Completion Date: 12/31/2023

View Audit 52761

Finding 50949 (2022-001)

Significant Deficiency 2022

Multnomah Education Service District

OR

HUD Housing Programs Significant Deficiency Matching / Level of Effort / Earmarking § 200.326

November 15, 2022 Oregon Secretary of state, Audits Division 255 Capito! St. NE, Suite #500 Salem, OR 97310 Plan of Action for Multnomah Education Service District The Multnomah Education Service District respectfully submits the following corrective action plan in response to deficiencies reported ...

November 15, 2022 Oregon Secretary of state, Audits Division 255 Capito! St. NE, Suite #500 Salem, OR 97310 Plan of Action for Multnomah Education Service District The Multnomah Education Service District respectfully submits the following corrective action plan in response to deficiencies reported In our audit of fiscal year ended June 30, 2022. The audit was completed by the independent auditing firm Talbot, Korvola and Warwick, and reported the deficiency listed below. The plan of action was adopted by the governing body at their meeting on November 15, 2022, as indicated by signatures below. Finding 2022.001: Significant deficiency Condition: The provisions for the prevailing wage rates requirements were not included in the construction contracts in excess of $2,000 financed by ESF funds and that the required certified payrolls were not obtained. The related deficiency in internal controls over compliance is considered to be a significant deficiency. As the District does not typically fund construction projects with federal fund, the District's staff were unaware of the $2,000 threshold for construction contacts financed by ESF funds to include prevailing wage rates requirements and used a threshold of $50,000, the Oregon Bureau of Labor & Industries' threshold for prevailing wage rate requirements for public works projects in Oregon. Cause: Effect or potential effect: Without adequate internal controls over wage rate requirements and Including the required provisions in construrtion contracts in excess of $2,000 financed by ESF funds, the District cannot demonstrate compliance with the wage rate requirements of the Davis-Bacon Act requirements. Questioned Costs: Questioned costs, if any, are indeterminable. Out of nine capital projects totaling $123,558, a sample of three capital projects was haphazardly selected. The capital projects were between $9,405 and $14,360 and totaled $26,024. Context; Recommendation: The District should obtain an understanding of all compliance requirements and implement controls to ensure compliance with federal wage rate requirements. Superintendent Dr. Faul Coakley Board of Directors Jessica Ariate ? Mary Botkin ? Kristin Corniielle < Katrina Doughty ? Dr. Samuel Henry ? Deny.se Peterson ? Helen Ying I !611 NE ??ns\?orth Circle ? Portland. Oregon 97220 ? (502) 255-18^1 ? MultnofiialiESD.org p!an ?? action: The Director oi Business & Operations is responsible for implementing the plan of action. All construction projects are managed by the MESD Facilities office. The Director instructed the MESD Contract and Risk Manager, meet with the Facilities office to inform staff of the Davis-Bacon prevailing wage requirements for construction contracts in excess of $ ? 2,00 . Facilities will include the consideration of Davis-Bacon requirements when reviewing a project request that is or has the potential of being federally funded. Facilities will implement the requirements of the Davis-Bacon Act as needed. Timeframe: The meeting took place on November 2, 2022. Facilities has updated their internal procedures. ? ' Multnora ESD Board Chair, Denyse Peterson Superintendent, Dr. Paul Coakley

View Audit 53728

Finding 50948 (2022-004)

Material Weakness 2022

McIntosh Senior Living

MN

Special Tests & Provisions Material Weakness Matching / Level of Effort / Earmarking § 200.303

Finding 2022-004 Federal Agency Name Department of Agriculture Program Name Community Facilities Loans and Grants Cluster Federal Financial Assistance Listing #10.766 Finding Summary The reserve account was not separately identified and there was no formal review separate from the preparer over t...

Finding 2022-004 Federal Agency Name Department of Agriculture Program Name Community Facilities Loans and Grants Cluster Federal Financial Assistance Listing #10.766 Finding Summary The reserve account was not separately identified and there was no formal review separate from the preparer over the reserve fund reconciliation. Responsible Individuals Sharlene Knutson, Administrator Corrective Action Plan We have adopted a policy to enhance internal control to ensure the reserve fund reconciliation has a secondary review and approval that is documents. Anticipated Completion Date September 30, 2023

View Audit 52757

Finding 50947 (2022-003)

Material Weakness 2022

McIntosh Senior Living

MN

Reporting Material Weakness Matching / Level of Effort / Earmarking

Finding 2022-003 Federal Agency Name Department of Agriculture Program Name Community Facilities Loans and Grants Cluster Federal Financial Assistance Listing #10.766 Finding Summary Eide Bailly LLP prepared our schedule of expenditures of federal awards (Schedule) and accompanying notes to the S...

Finding 2022-003 Federal Agency Name Department of Agriculture Program Name Community Facilities Loans and Grants Cluster Federal Financial Assistance Listing #10.766 Finding Summary Eide Bailly LLP prepared our schedule of expenditures of federal awards (Schedule) and accompanying notes to the Schedule. Responsible Individuals Sharlene Knutson, Administrator Corrective Action Plan Having auditors assist with preparing the schedule of expenditures of federal awards (SEFA) is not unusual. We will continue to be aware of the financial reporting requirements relating to the Organization?s schedules of expenditures of federal awards and internal control that impact reporting. Anticipated Completion Date Ongoing

View Audit 52757

Finding 50946 (2022-001)

Significant Deficiency 2022

Piedmont Healthcare, Inc.

GA

Allowable Costs / Cost Principles Reporting Matching / Level of Effort / Earmarking § 200.303

Finding No. 2022-001 ? Activities Allowed and Unallowable/Allowable Costs Program: COVID -19 Provider Relief Fund Award Year: January 1, 2020 through June 30, 2022 (a) Criteria or Requirement Per 2 CFR 200.303, the non-Federal entity must establish and maintain effective internal control over th...

Finding No. 2022-001 ? Activities Allowed and Unallowable/Allowable Costs Program: COVID -19 Provider Relief Fund Award Year: January 1, 2020 through June 30, 2022 (a) Criteria or Requirement Per 2 CFR 200.303, the non-Federal entity must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. (b) Condition Found, Including Perspective During our test work, we selected a sample of 40 incentive bonus payments made during the fiscal year 2022 reporting period. We noted that PHC was unable to provide evidence of management review and approval for each of the incentive bonus payments sampled. These disbursements were made for allowable costs under the terms and conditions of the program. (c) Possible Cause PHC was unable to provide evidence of certain management reviews and approvals because the control was not designed to require the retention of documentation of management review at the transactional level. (d) Questioned Cost None. (e) Effect Evidence of the effective operation of management review controls was not maintained in accordance with Federal requirements. (f) Statistical Validity The sample was not intended to be, and was not, a statistically valid sample. (g) Repeat Finding in the Prior Year Repeat of prior year Finding No. 2021-001. (h) Recommendation We recommend that PHC strengthen controls over the management review process to enhance the retention of evidence of management review and approval. (i) View of Responsible Officials Management concurs with the finding. While we believe appropriate controls exist relating to the management review and approval of allowable costs at the transactional level, we concur that procedures relating to obtaining and maintaining documentation of such reviews need to be strengthened. (j) Corrective Action Plan Management will ensure communication of the finding to the reviewers and submitters of allowable costs and revise procedures to ensure documentation of reviews and approvals is obtained and maintained. Prior to submitting allowable costs to Health Resources and Services Administration (?HRSA?), we will obtain documentation of the approval of these costs and maintain this documentation in the same manner as the documentation of the submission of the costs to HRSA. (k) Anticipated Completion Date Correction of corrective action anticipated by August 31, 2023. (l) Name of Person for Corrective Action Marie Gaffney, Vice President Corporate Finance: (470) 271-6007.

View Audit 53715

Finding 50945 (2022-001)

Material Weakness 2022

Garrett Regional Medical Center

MD

Questioned Costs Allowable Costs / Cost Principles Special Tests & Provisions § 200.303

Finding 2022-001- Allowable Costs, Activities Allowed and Special Tests and Provisions Contact Person: Lori Dixon Management?s Response: GRMC management will implement the following processes/procedures as a result of the finding of the 2022 Single Audit. During the audit review, FEMA hours we...

Finding 2022-001- Allowable Costs, Activities Allowed and Special Tests and Provisions Contact Person: Lori Dixon Management?s Response: GRMC management will implement the following processes/procedures as a result of the finding of the 2022 Single Audit. During the audit review, FEMA hours were found to be unallowable on sample patients treated for COVID. Management reviewed the findings and identified additional patients/hours not covered by other funding sources to replace the unallowed data totaling $8,550. Completion Date: The steps above will be completed by October 31, 2023.

View Audit 52431 Questioned Costs: $1

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