Finding 561750 (2024-003)

Significant Deficiency
Requirement
C
Questioned Costs
-
Year
2024
Accepted
2025-05-29
Audit: 357407
Organization: Ozarks Medical Center (MO)

AI Summary

  • Core Issue: The Medical Center did not meet the required Historical Debt Service Coverage Ratio of 1.25 and failed to fund necessary reserve accounts.
  • Impacted Requirements: This non-compliance violates the terms of the agreement with the USDA, affecting financial stability.
  • Recommended Follow-Up: Management should improve operations to meet the coverage ratio and clarify reserve account requirements with the USDA in writing.

Finding Text

Federal Agency: U.S. Department of Agriculture Program Title: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Award Period: January 1, 2024 to December 31, 2024 Type of Finding: Compliance and Significant Deficiency in Internal Control over Compliance Criteria or specific requirement: Under the terms and conditions of the agreements with the USDA the Medical Center is required to meet minimum requirements of Historical Debt Service Coverage Ratio of 1.25 and fund certain Debt Service, Reserve and Replacement accounts. Condition: The Medical Center failed to meet the minimum Historical Debt Service Coverage Ratio and has not funded the required reserve accounts for the year ended December 31, 2024. Questioned costs: None Cause: The Medical Center has experienced financial challenges since the inflationary pressures associated with the COVID-19 pandemic which has negatively impacted operating results. The Medical Center understood that the USDA did not require them to fund the required accounts under the agreement given the historical level of investments maintained by the Medical Center. Effect: The Medical Center is not in compliance with the terms and conditions of the agreement. Recommendation: Management should continue to focus on making operational improvements to achieve the minimum level of Historical Debt Service Coverage of 1.25, as required, and work with the USDA to determine what reserve accounts are required, or to the extent they are not required, properly document that understanding in writing with the USDA.

Corrective Action Plan

FINDINGS— FINDINGS AND QUESTIONED COSTS – MAJOR FEDERAL PROGRAMS DEPARTMENT OF AGRICULTURE 2024 – 003 Community Facilities Loans and Grants Recommendation: Management should continue to focus on making operational improvements to achieve the minimum level of Historical Debt Service Coverage of 1.25, as required, and work with the USDA to determine what reserve accounts are required, or to the extent they are not required, properly document that understanding in writing with the USDA. Action taken in response to finding: The Hospital will continue to make operational improvements to achieve the minimum level of Historical Debt Service Coverage of 1.25 and has worked with the USDA to agree to the reserve funding requirements. Name of the contact person responsible for corrective action: Michael Durr, Interim Chief Financial Officer. Planned completion date for corrective action plan: December 31, 2025 If the Department of Health and Human Services has questions regarding this plan, please call Michael Durr, Interim Chief Financial Officer at (417) 257 - 5801.

Categories

Significant Deficiency Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1138192 2024-003
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $48.75M