EIN: 310743167
UEI: FGJWD4RQ1HL9
Audited by: Brady Ware & Schoenfeld
Oversight agency: 93 [Department of Health and Human Services]
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Data as of August 31, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on August 30, 2026. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by March 2, 2027 (181 days from today).
What is a management decision? →FAC accepted this audit on September 23, 2025 — management decision was due March 23, 2026.
There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the financial statements from being materially misstated. Cause: One contributing factor to some of the material adjustments was related to the operational processes within the behavioral health division. Medicaid experienced difficulties in timely certification for Alvis’s behavioral health specialists causing significant delays in ability to bill for the services they provided, and some services were rendered to individuals who neither had private insurance nor were prequalified for Medicaid. These issues resulted in revenue that could not be collected and subsequently had to be written off. Another factor involved a third-party entity responsible for Alvis’s Waiver billing, which had been submitting incorrect billing for several years. Additionally, other significant adjustments were necessary due to internal errors. Effect or potential effect: Monthly internal financial statements not accurately representing the Organization's performance. Recommendation: To promote accurate billing, the Organization should collaborate closely with the Behavioral Health and Waiver billing departments, ensuring that all team members are informed about proper operating procedures. Additionally, the Organization must continue supporting and guiding newer accounting staff to maintain the highest standards of accuracy in financial reporting. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Criteria: Management is responsible for reconciling the accounts at end of year and ensuring accounting records are kept in accordance with generally accepted accounting principles (GAAP). Condition: There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the financial statements from being materially misstated. Cause: One contributing factor to some of the material adjustments was related to the operational processes within the behavioral health division. Medicaid experienced difficulties in timely certification for Alvis’s behavioral health specialists causing significant delays in ability to bill for the services they provided, and some services were rendered to individuals who neither had private insurance nor were prequalified for Medicaid. These issues resulted in revenue that could not be collected and subsequently had to be written off. Another factor involved a third-party entity responsible for Alvis’s Waiver billing, which had been submitting incorrect billing for several years. Additionally, other significant adjustments were necessary due to internal errors. Effect or potential effect: Monthly internal financial statements not accurately representing the Organization's performance. Recommendation: To promote accurate billing, the Organization should collaborate closely with the Behavioral Health and Waiver billing departments, ensuring that all team members are informed about proper operating procedures. Additionally, the Organization must continue supporting and guiding newer accounting staff to maintain the highest standards of accuracy in financial reporting. Views of responsible officials: See attached.
Finding 2024-001 – Material Adjustments We acknowledge the finding and agree that the lack of timely reconciliations and reliance on audit adjustments indicated a breakdown in internal controls over financial reporting. Cause and Context: The root cause of this issue was primarily driven by the time spent unwinding the billing from the operational team and setting them up under the new Revenue Cyle Director position in the finance department. This department will now be directly responsible for the various Medicaid AR processes. Most of the material audit adjustments were the direct result of not having this group under the Finance department so proper determination could be made on the collection of these services. Corrective Actions Taken and Planned: 1. Moving all billing functions to the finance team: This team will be able to make quarterly adjustments to the Medicaid billing receivables. 2. Third party vendors: The finance team has established routine calls with our third-party billing partners to determine collectability throughout the year vs during the audit period. 3. Training and Oversight: The billing team has now created a weekly meeting / training cadence. 4. Revenue Cycle Management Enhancements: We have established an internal Billing and Revenue Cycle Management Team and developed a Centralized Intake Team to improve billing accuracy, eligibility verification, and reduce reliance on third-party vendors. These changes are expected to reduce write-offs and improve the integrity of our receivables. We are confident that these corrective actions will address the root causes of the finding and prevent recurrence. Management remains committed to maintaining strong internal controls and ensuring compliance with all applicable accounting standards. 5. In-House Billing for Specialized Services: Billing for Developmental Disabilities (DD) and Intermediate Care Facility (ICF) services have been brought in-house. This transition has resulted in a 14% increase in DD revenue and improved responsiveness to denials, client liability tracking, and continued stay approvals. These enhancements are designed to improve financial accuracy, reduce write-offs, and ensure timely and compliant revenue recognition. We are confident that these measures will prevent recurrence and strengthen the integrity of our financial reporting going forward.
2023-001
There were insufficient internal controls or oversight on third-party Waiver billings. Cause: The Organization was relying on the expertise of the third-party billing specialist. Effect or potential effect: For several years the Waiver services revenue was overstated. Recommendation: The Organization needs to have the requisite level of knowledge to have oversight of the third-party billing experts work to ensure it is accurate. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Criteria: Management is responsible for reporting transactions in the proper accounting period. Condition: There were insufficient internal controls or oversight on third-party Waiver billings. Cause: The Organization was relying on the expertise of the third-party billing specialist. Effect or potential effect: For several years the Waiver services revenue was overstated. Recommendation: The Organization needs to have the requisite level of knowledge to have oversight of the third-party billing experts work to ensure it is accurate. Views of responsible officials: See attached.
We acknowledge the auditor’s finding and agree that the prior period restatement was the result of insufficient internal oversight of Waiver billing activities previously managed by a third-party provider. Condition and Cause: The Organization relied on the expertise of a third-party billing specialist without adequate internal oversight. This led to the overstatement of Waiver services revenue over multiple years due to improper period recognition. Corrective Actions Taken and Planned: 1. Transition to In-House Billing: Alvis, Inc. has brought all Developmental Disabilities (DD) and Intermediate Care Facility (ICF) billing functions in-house. This transition provides greater control over billing accuracy, denial management, and revenue recognition. 2. Internal Oversight and Reconciliation: We have implemented internal review procedures to validate the accuracy and timing of all Waiver-related revenue. Monthly reconciliations are now conducted to ensure alignment between billing records and financial reporting. 3. Staff Training and Capacity Building: Internal staff have been trained in Medicaid Waiver billing practices and accrual-based revenue recognition to ensure proper oversight and compliance with GAAP. 4. Process Documentation and Controls: Billing workflows and internal controls have been documented and integrated into our financial close process to ensure timely and accurate reporting. Management is confident that these corrective actions will prevent recurrence and ensure the integrity of our financial statements going forward.
2023-003
There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from having the audit completed timely. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures which caused delay in completing the audit. Effect or potential effect: The filing with Federal Audit Clearinghouse will be completed after the 9 months as required and the Organization will not be considered a low risk auditee for the next two years. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. This will ensure the audit is completed timely and Federal Audit Clearinghouse submission is also done timely. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Criteria: Management is responsible for submitting the audited financial statements with the Federal Audit Clearinghouse which is due nine months after the end of the audit period or 30 calendar days after the entity received the auditors report. Condition: There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from having the audit completed timely. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures which caused delay in completing the audit. Effect or potential effect: The filing with Federal Audit Clearinghouse will be completed after the 9 months as required and the Organization will not be considered a low risk auditee for the next two years. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. This will ensure the audit is completed timely and Federal Audit Clearinghouse submission is also done timely. Views of responsible officials: See attached.
We acknowledge the delay in submitting the 2023 audit to the Federal Audit Clearinghouse (FAC), which was caused by staffing shortages and reliance on audit-proposed adjustments that delayed audit completion in 2023. This was corrected in the 2024 audit period. We are confident these corrective actions taken in 2024 will prevent recurrence and restore our low-risk auditee status in future years.
2023-002
FAC accepted this audit on November 21, 2024 — management decision was due May 21, 2025.
There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from being materially misstated. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures. This is a repeat finding.Effect or potential effect: Most adjustments were due to staffing issues or lack of knowledge of GAAP with new staffing to properly make the required adjustments. The risk with this condition is that necessary adjustment to the consolidated financial statements to record material misstatements may be missed, and there is no control in place to detect and correct this condition. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Finding 2023-001 - Material Adjustments Criteria: Management is responsible for reconciling the accounts at end of year and ensuring accounting records are kept in accordance with generally accepted accounting principles (GAAP). Condition: There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from being materially misstated. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures. This is a repeat finding.Effect or potential effect: Most adjustments were due to staffing issues or lack of knowledge of GAAP with new staffing to properly make the required adjustments. The risk with this condition is that necessary adjustment to the consolidated financial statements to record material misstatements may be missed, and there is no control in place to detect and correct this condition. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. Views of responsible officials: See attached.
Acknowledgment of Findings We acknowledge the inadequacies in our internal controls over financial reporting that necessitated the material audit adjustments. It is our understanding that these challenges primarily resulted from staffing turnover and a lack of sufficient GAAP knowledge among our former team members. Actions Taken and Planned 1. Staffing Assessment and Recruitment We have experienced significant growth within our team over the past year. It is important to note that the issues raised by the audit are reflective of previous personnel rather than our current team members, who have taken on these responsibilities for the fiscal year ending 2024. Furthermore, we have recognized the necessity for a dedicated revenue cycle role and have recently appointed a Revenue Cycle Manager to this newly defined position. This individual will be tasked with restructuring operational components throughout the organization and redefining all related roles within the Finance department to enhance our internal controls. 2. Enhancement of Staff Development The finance department remains committed to the continuous education and training of our dedicated team members to enhance their capabilities. This initiative includes collaboration with both internal and external subject matter experts. 3. Ongoing Monitoring and Support In September 2024, we initiated the implementation of an automated accounting workflow software, FloQast (FQ). This system enables our team to streamline recurring tasks, maintain checklists, and centralize documentation, thereby improving the accuracy of our financial close data. For instance, FQ provides a consolidated view of the reconciliation status of each account, including balance comparisons to the general ledger, preparers, reviewers, and sign-off dates. Additionally, FQ automatically notifies team members when reconciliations are due or when items are ready for review and alerts them to any unexpected discrepancies. 4. Alvis Staff Responsible: Makesha West, Behavioral Health Divisional Director; Abena Oppong, Developmental Disability Divisional Director; and Jacqueline Neal, VP of Finance.
2022-001
There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from having the audit completed timely. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures which caused delay in completing the audit. Effect or potential effect: The filing with Federal Audit Clearinghouse will be completed after the 9 months as required and the Organization will not be considered a low risk auditee for the next two years. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. This will ensure the audit is completed timely and Federal Audit Clearinghouse submission is also done timely. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Finding 2023-002 - Federal Audit Clearinghouse Filing Criteria: Management is responsible for submitting the audited financial statements with the Federal Audit Clearinghouse which is due nine months after the end of the audit period or 30 calendar days after the entity received the auditors report . Condition: There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from having the audit completed timely. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures which caused delay in completing the audit. Effect or potential effect: The filing with Federal Audit Clearinghouse will be completed after the 9 months as required and the Organization will not be considered a low risk auditee for the next two years. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. This will ensure the audit is completed timely and Federal Audit Clearinghouse submission is also done timely. Views of responsible officials: See attached.
Acknowledgment of Additional Findings We recognize the critical importance of accurately reporting transactions within the appropriate accounting periods and acknowledge the internal control weaknesses that contributed to Findings 2023-002 (Federal Audit Clearinghouse Filing - Prior Period Restatement) and 2023- 003 (Prior Period Restatement). Actions Taken and Planned 1. Staffing Assessment Our organization has undergone changes within our grant leadership team. A new Grant Director was appointed in May 2023, who was not involved in the 2022 federal grant concerns . We have full confidence in our grant team's ability to report transactions in a timely and accurate manner. 2. Documentation of Processes The grants team is currently reviewing its processes and internal controls to ensure they are up to date. Moreover, we are implementing new grant reporting measures that will provide a comprehensive overview of all grants and their respective dates of receipt, thereby enhancing our understanding of the overall grant environment. 3. Alvis Staff Responsible: Angela Thompson, Grants Director and Jacqueline Neal, VP of Finance.
There were insufficient internal controls or knowledge of accrual accounting to ensure transactions reported in proper period. Cause: Due to staffing turnover and shortages one contract was signed in 2022 but the full amount of the liability was not recorded in accounts payable and property and equipment. Effect or potential effect: The 2022 consolidated financial statements were not materially correct. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Finding 2023-003 - Prior Period Restatement Criteria: Management is responsible for reporting transactions in the proper accounting period. Condition: There were insufficient internal controls or knowledge of accrual accounting to ensure transactions reported in proper period. Cause: Due to staffing turnover and shortages one contract was signed in 2022 but the full amount of the liability was not recorded in accounts payable and property and equipment. Effect or potential effect: The 2022 consolidated financial statements were not materially correct. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. Views of responsible officials: See attached.
Acknowledgment of Additional Findings We recognize the critical importance of accurately reporting transactions within the appropriate accounting periods and acknowledge the internal control weaknesses that contributed to Findings 2023-002 (Federal Audit Clearinghouse Filing - Prior Period Restatement) and 2023- 003 (Prior Period Restatement). Actions Taken and Planned 1. Staffing Assessment Our organization has undergone changes within our grant leadership team. A new Grant Director was appointed in May 2023, who was not involved in the 2022 federal grant concerns . We have full confidence in our grant team's ability to report transactions in a timely and accurate manner. 2. Documentation of Processes The grants team is currently reviewing its processes and internal controls to ensure they are up to date. Moreover, we are implementing new grant reporting measures that will provide a comprehensive overview of all grants and their respective dates of receipt, thereby enhancing our understanding of the overall grant environment. 3. Alvis Staff Responsible: Angela Thompson, Grants Director and Jacqueline Neal, VP of Finance.
FAC accepted this audit on January 9, 2024 — management decision was due July 9, 2024.
There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from being materially misstated. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures. Effect or potential effect: Most adjustments were due to staffing issues or lack of knowledge of GAAP with new staffing to properly make the required adjustments. The risk with this condition is that necessary adjustment to the financial statements to record material misstatements may be missed, and there is no control in place to detect and correct this condition. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. Views of responsible officials: See attached.
Show full finding ▾Hide full finding ▴Finding 2022-001 - Material Adjustments Criteria: Management is responsible for reconciling the accounts at end of year and ensuring accounting records are kept in accordance with generally accepted accounting principles (GAAP). Condition: There were insufficient internal controls over financial reporting requiring material audit adjustments during the audit to prevent the consolidated financial statements from being materially misstated. Cause: Due to staffing turnover and shortages all required entries needed were not recorded and management relied on auditors to propose entries after audit procedures. Effect or potential effect: Most adjustments were due to staffing issues or lack of knowledge of GAAP with new staffing to properly make the required adjustments. The risk with this condition is that necessary adjustment to the financial statements to record material misstatements may be missed, and there is no control in place to detect and correct this condition. Recommendation: The Organization and accounting industry in general have had some significant staffing issues over the past few years that have led to the issues noted. The Organization needs to: Assess accounting staff to ensure you have the correct number for size of Organization and proper skill set. Ensure processes and internal controls are documented and staff has appropriate training. Views of responsible officials: See attached.
Corrective Action Plan 2023: Alvis, Inc. recognizes that significant turnover in accounting operations and financial reporting teams resulted in a material number of adjustments, proposed by our accounting firm, in order to complete the 2022 audit. To properly address this matter, Jacqueline Neal has been tasked with improving upon the corrective actions which began in 2023 in order to comprehensively address this gap: 1) Fill vacant positions and redefine job responsibilities; 2) Implement an accounting workflow automation solution; 3} Hold internal trainings to increase our Finance Team's technical accounting knowledge and operational efficiencies. Fill vacancies and redefine job responsibilities: 1. The first order of business was to hire a seasoned payroll employee to handle all functions of payroll processing and recording related journal entries. This role was hired in September 2023. This was followed with an Accounting Manager and accounts payable coordinator hires in April 2023, which has resulted in critical accrual accounts being recorded and reconciled accurately and timely. 2. The team then redefined jobs and responsibilities of each team member, resulting in much greater communication and understanding around required job functions. This has resulted in substantial growth in our teamwork and collaboration. 3. The entire month-end close process was redefined with new expectations and tracking. This has resulted in the closing of the monthly books within 15 days after month end. Automation of month-end close workflows and centralization of reconciliations: 4. The Finance team implemented an automated accounting workflow software (FloQast or FQ) in April 2023. FQ allows the Team to streamline recurring tasks, checklists, and centralized documentation to increase the accuracy of our Close Data. For example, the system provides the team with a centralized view of the reconciliation status of each account with balance comparisons to the general ledger, preparers, reviewer, and signoff dates. Additionally, FQ sends automatic notifications when reconciliations are due, items are ready for review, or if the platform detects an unexpected out of balance condition. Internal accounting trainings 5. The team is in the process of creating an ongoing monthly hindsight meeting to review the previous month end process. This will be used to identify opportunities and training needs of the team. 6. The team plans to continue our quarterly lunch and learns which began in July 2023. •
FAC accepted this audit on July 10, 2022 — management decision was due January 10, 2023.
FAC accepted this audit on May 9, 2021 — management decision was due November 9, 2021.
FAC accepted this audit on June 30, 2020 — management decision was due December 30, 2020.
FAC accepted this audit on July 28, 2019 — management decision was due January 28, 2020.
FAC accepted this audit on April 11, 2018 — management decision was due October 11, 2018.
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