Finding 1205435 (2025-001)

Material Weakness Repeat Finding
Requirement
I
Questioned Costs
-
Year
2025
Accepted
2026-03-31
Audit: 397111
Organization: Avera Health (SD)
Auditor: EIDE BAILLY LLP

AI Summary

  • Core Issue: Internal controls over procurement and compliance are weak, leading to missing contract provisions in two contracts over $25,000.
  • Impacted Requirements: Contracts did not meet the standards set by 2 CFR 200.303 and 2 CFR 200 Appendix II for federal awards.
  • Recommended Follow-Up: Strengthen internal controls to ensure all contracts include necessary provisions as per Uniform Guidance.

Finding Text

Department of Treasury Passed through South Dakota Department of Social Services and South Dakota Department of Health Federal Financial Assistance Listing #21.027 Coronavirus State and Local Fiscal Recovery Funds Procurement, Suspension & Debarment Significant Deficiency in Internal Control over Compliance and Compliance Department of Health and Human Services Federal Financial Assistance Listing #93.493 Congressional Directives Procurement, Suspension & Debarment Significant Deficiency in Internal Control over Compliance and Compliance 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. 2 CFR 200 Appendix II requires certain provisions be included in contracts if criteria are applicable. Condition: Our testing over procurement suspension and debarment identified two contracts over $25,000 where some contract provisions required by Uniform Guidance were not included. Cause: There was a lapse in the internal control process in which contract provisions were not evaluated compared to Uniform Guidance contract requirements. Effect: Ineffective controls over this area of compliance resulted in contracts that did not include all contract provisions required by Uniform Guidance. Questioned Costs: None reported. Context: One contract was selected for testing for program 21.027 and one contract was selected for testing for program 93.493. Both contracts were missing some contract provisions required by Uniform Guidance. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls related to the review of contracts to ensure the contracts include the required Uniform Guidance provisions. Views of Responsible Officials: Management agrees with the finding.

Corrective Action Plan

Department of Treasury Federal Financial Assistance Listing # 21.027 Department of Health and Human Services Federal Financial Assistance Listing #93.493 Procurement, Suspension & Debarment Significant Deficiency in Internal Control over Compliance and Compliance Finding Summary: Our testing over procurement suspension and debarment identified two contracts over $25,000 where some contract provisions required by Uniform Guidance were not included. Responsible Individuals: Jamie Schaefer, John Neth Corrective Action Plan: The organization will review and strengthen the controls surrounding procurement, suspension, and debarment. The Organization will develop a Required Contract Provision Checklist/Reference Sheet that summarizes the requirements in 2 CFR § 200 Appendix II that will be utilized during the grant contract review. Anticipated Completion Date: June 30, 2026

Categories

Procurement, Suspension & Debarment

Other Findings in this Audit

  • 1205433 2025-001
    Material Weakness Repeat
  • 1205434 2025-001
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.912 RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT $2.13M
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $1.32M
93.493 CONGRESSIONAL DIRECTIVES $1.27M
93.958 BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES $1.08M
93.884 PRIMARY CARE TRAINING AND ENHANCEMENT $735,138
93.838 LUNG DISEASES RESEARCH $713,243
10.855 DISTANCE LEARNING AND TELEMEDICINE LOANS AND GRANTS $627,473
93.732 MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS $553,073
93.926 HEALTHY START INITIATIVE $476,689
97.008 NON-PROFIT SECURITY PROGRAM $450,000
20.509 FORMULA GRANTS FOR RURAL AREAS AND TRIBAL TRANSIT PROGRAM $415,811
16.582 CRIME VICTIM ASSISTANCE/DISCRETIONARY GRANTS $345,829
93.359 NURSE EDUCATION, PRACTICE, QUALITY AND RETENTION GRANTS $282,278
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $231,083
16.589 RURAL DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, AND STALKING ASSISTANCE PROGRAM $212,425
16.838 COMPREHENSIVE OPIOID, STIMULANT, AND OTHER SUBSTANCES USE PROGRAM $156,434
10.331 GUS SCHUMACHER NUTRITION INCENTIVE PROGRAM $156,109
93.310 TRANS-NIH RESEARCH SUPPORT $121,689
93.872 TRIBAL MATERNAL, INFANT, AND EARLY CHILDHOOD HOME VISITING $35,349
93.959 BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE $30,883
93.136 INJURY PREVENTION AND CONTROL RESEARCH AND STATE AND COMMUNITY BASED PROGRAMS $25,714
93.393 CANCER CAUSE AND PREVENTION RESEARCH $23,755
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $21,658
20.513 ENHANCED MOBILITY OF SENIORS AND INDIVIDUALS WITH DISABILITIES $20,000
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $18,196
93.191 GRADUATE PSYCHOLOGY EDUCATION $12,219
93.273 ALCOHOL RESEARCH PROGRAMS $10,913
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $6,678
45.025 PROMOTION OF THE ARTS PARTNERSHIP AGREEMENTS $5,900
93.301 SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM $5,843
93.279 DRUG ABUSE AND ADDICTION RESEARCH PROGRAMS $5,063
16.026 OVW RESEARCH AND EVALUATION PROGRAM $3,413
93.991 PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT $1,978