Finding: 2022-001 Condition Found: The Organization drew down the FY 2023 Expanding COVID-19 Vaccination grant funds in full upon receipt of the award in the amount of $100,048 in advance of incurring federal expenses. The Organization incurred allowable expenses of $38,940 through December 31, 2022. During 2023, management worked with HRSA and was able to submit a budget revision which was approved by HRSA and allowed the Organization to allocate additional expenses incurred in December 2022 in the amount of $61,108 to the grant. Additionally, the Organization had a construction project during 2022 which was primarily funded by the Capital Assistance for Disaster Response and Recovery Efforts grant. During 2022, the Organization drew down the grant award based on 100% of the incurred allowable costs of the project rather than proportionate share of the grant to the total project costs in the approved budget as required by the Uniform Guidance. Individual(s) Responsible for Corrective Action: Andrew Barter, CEO Celeste Pitts, Interim CFO Corrective Action: The management that conducted and recommended these grant activities are no longer with Little Rivers Health Care, and as a result, management is longer influenced by the factors that caused this condition. The new CEO and new CFO are working with third-party technical assistance from our auditors at Berry Dunn for grant administration. Historically, grant tracking was performed singularly by one individual. Grant management is now conducted by the CEO, CFO, and a Grant Administrator with shared information and functionality, including use of grant management-specific resources in our finance and payroll systems. Capital Grants are monitored through a new Construction in Progress General Ledger account and a detailed Excel sheet that has a budget component. In May, LRHC submitted an ECV Extension Budget for our grant number H8GCS47793, and the budget was approved by Travis Wright, HRSA Grants Management Specialist and Carla Clarke, HRSA Project Officer and Investment Oversight Advisor on June 24, 2023. The budget included allowable and allocable costs for activities in the amount of $100,048 that occurred or were obligated in December 2022. These actions corrected the relevant ECV funding concern listed in finding 2022-001 as reported in the Schedule of Findings and Questioned Costs, Year Ended December 31, 2022. Anticipated Completion Date: Education of HRSA drawdown requirements has occurred with the new LRHC CEO and Interim CFO during this current audit period. Tracking functionality in our Finance and Payroll system has been set up and will be fully utilized by the third quarter of 2023.