EIN: 430915648
UEI: LB3GVNGADQN4
Audited by: Wipfli LLP
Oversight agency: 10 [Department of Agriculture]
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Data as of September 7, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on January 13, 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 July 13, 2026 (59 days ago).
What is a management decision? →The District did not meet its financial covenants required under the program during the year. Criteria The District is required to meet certain financial covenants as described in Article VIII of the Hospital Revenue Bonds Series A loan documents dated October 25, 2012. Cause: The District has had significant financial challenges and turnover within its finance department. Effect: The District was not in compliance with the program. Recommendation: We recommend that management put a plan in place to become compliant with the financial covenants of the debt. Review of Responsible Officials: Managemet acknowledges they were not in compliance with the financial covenants of the bond. Management has been in contact USDA to keep them informed on the situation and has put plans into place to improve the financial position of the District.
Show full finding ▾Hide full finding ▴Finding 2025-004 Repeat Finding: Yes Program Name: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Questioned Costs: N/A Type of Finding: Noncompliance, Significant Deficiency Compliance Requirement: Special Tests and Provisions Condition: The District did not meet its financial covenants required under the program during the year. Criteria The District is required to meet certain financial covenants as described in Article VIII of the Hospital Revenue Bonds Series A loan documents dated October 25, 2012. Cause: The District has had significant financial challenges and turnover within its finance department. Effect: The District was not in compliance with the program. Recommendation: We recommend that management put a plan in place to become compliant with the financial covenants of the debt. Review of Responsible Officials: Managemet acknowledges they were not in compliance with the financial covenants of the bond. Management has been in contact USDA to keep them informed on the situation and has put plans into place to improve the financial position of the District.
Managemet acknowledges they were not in compliance with the financial covenants ofthe bond. Management has been in contact USDA to keep them informed on thesituation and has put plans into place to improve the financial position of the District.
2024-005
FAC accepted this audit on January 20, 2025 — management decision was due July 20, 2025.
The District did not meet its financial reporting obligations under the grant during the year. The District did not complete the 2022 audit and file the Data Collection Form (SFSAC) by the due date of March 31, 2024. Criteria The District is required to complete the audit and file the Data Collection Form (SF-SAC) by March 31, 2024. Cause: The Data Collection Form was not filed within the required period due to a delay in the preparations for the audit. Effect: The District was not in compliance with federal regulations and the program. Recommendation: We recommend audit preparations are completed on a timely basis to ensure that the reporting deadline is met. Review of Responsible Officials: Managemet acknowledges there were significant delays in the audit due to capacity issues and a delay in the 2022 audit. Management has been in contact with all of its program representatives to keep them informed on the situation.
Show full finding ▾Hide full finding ▴Repeat Finding: Yes Program Name: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Questioned Costs: N/A Type of Finding: Noncompliance, Significant Deficiency Compliance Requirement: Reporting Condition: The District did not meet its financial reporting obligations under the grant during the year. The District did not complete the 2022 audit and file the Data Collection Form (SFSAC) by the due date of March 31, 2024. Criteria The District is required to complete the audit and file the Data Collection Form (SF-SAC) by March 31, 2024. Cause: The Data Collection Form was not filed within the required period due to a delay in the preparations for the audit. Effect: The District was not in compliance with federal regulations and the program. Recommendation: We recommend audit preparations are completed on a timely basis to ensure that the reporting deadline is met. Review of Responsible Officials: Managemet acknowledges there were significant delays in the audit due to capacity issues and a delay in the 2022 audit. Management has been in contact with all of its program representatives to keep them informed on the situation.
Condition: The District did not meet its financial reporting obligations under the grant during the year. The District did not complete the 2022 audit and file the Data Collection Form (SFSAC) by the due date of March 31, 2024 Response: The financial statement audit for FY 2022 is complete and we are awaiting issuance of the single audit for FY 2022. We anticipate the single audit stand-alone report will be issued prior to the end of 2025. The 2022 Report on Internal Control Over Financial Reporting and On Compliance and Other Matters Based on an Audit of Financial Statements Performed In Accordance with Government Auditing Standards has not been issued. We are currently working with our grantors and lenders to determine the appropriate course of action for not having this report. The hospital’s plan is to maintain timely completion of the financial audits in future years. Responsible Party: Meagan Weber, CEO, Brent Peirick, COO, Carolyn Davies, CFO Estimated Completion Date: 12/31/2025
2023-004
The District did not meet its financial covenants required under the program during the year, and we, as the auditors, were unable to properly calculate the required financial covenants because of potential missing or misstated financial statement information due to the adverse opinion on the 2022 financial statements and related disclaimer of opinion included in our accompanying 2023 Independent Auditor's Report. Criteria The District is required to meet certain financial covenants as described in Article VIII of the Hospital Revenue Bonds Series A loan documents dated October 25, 2012. Cause: The District has had significant financial challenges and turnover within its finance department. Effect: The District was not in compliance with the program. Recommendation: We recommend that management put a plan in place to become compliant with the financial covenants of the debt. Review of Responsible Officials: Managemet acknowledges they were not in compliance with the financial covenants of the bond. Management has been in contact USDA to keep them informed on the situation and has put plans into place to improve the financial position of the District.
Show full finding ▾Hide full finding ▴Repeat Finding: Yes Program Name: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Questioned Costs: N/A Type of Finding: Noncompliance, Significant Deficiency Compliance Requirement: Special Tests and Provisions Condition: The District did not meet its financial covenants required under the program during the year, and we, as the auditors, were unable to properly calculate the required financial covenants because of potential missing or misstated financial statement information due to the adverse opinion on the 2022 financial statements and related disclaimer of opinion included in our accompanying 2023 Independent Auditor's Report. Criteria The District is required to meet certain financial covenants as described in Article VIII of the Hospital Revenue Bonds Series A loan documents dated October 25, 2012. Cause: The District has had significant financial challenges and turnover within its finance department. Effect: The District was not in compliance with the program. Recommendation: We recommend that management put a plan in place to become compliant with the financial covenants of the debt. Review of Responsible Officials: Managemet acknowledges they were not in compliance with the financial covenants of the bond. Management has been in contact USDA to keep them informed on the situation and has put plans into place to improve the financial position of the District.
Finding # 2024-005 Condition: The District did not meet its financial covenants required under the program during the year, and we, as the auditors, were unable to properly calculate the required financial covenants because of potential missing or misstated financial statement information due to the adverse opinion on the 2022 financial statements and related disclaimer of opinion included in our accompanying 2023 Independent Auditor's Report Response: The hospital has financial covenants including: Maintaining 35 days cash on hand. We are currently at 26 Days Cash on Hand. The hospital has been as low as 6 Days Cash on Hand. To increase our Cash on Hand, we have brought all Revenue Cycle efforts in house, trained new staff, formed cross functional teams with the clinical documentation staff, set goals and work weekly with our teams to gently resolve challenges and move forward. These efforts have rewarded the hospital with increased Days Cash on Hand and improved quality processes in Revenue Cycle. One covenant requires that we maintain strong internal controls. Since the new administration have begun, each month, new internal controls are being established throughout the hospital, Finance department, Materials Management and the Revenue Cycle. On covenant requires a positive bottom line. The hospital has been losing money primarily due to the change in administration, lack of routine processes, recruitment challenges, lack of accuracy in our accounting and revenue cycle. Throughout the hospital and RHC’s, improvement teams are working to both improve quality processes, reduce costs, establish a culture to allow recruitment and improve our bottom line. The hospital has been transparent with the agency and our Board of Directors throughout our change process. More work continues. Responsible Party: Meagan Weber, CEO, Brent Peirick, COO, Carolyn Davies, CFO Estimated Completion Date: 12/31/2026
2023-005
FAC accepted this audit on December 3, 2024 — management decision was due June 3, 2025.
The District did not meet its financial reporting obligations under the grant during the year. The District did not complete the 2022 audit and file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria The District is required to complete the audit and file the Data Collection Form (SF-SAC) by March 31, 2024. Cause: The Data Collection Form was not filed within the required period due to a delay in the preparations for the audit. Effect: The District was not in compliance with federal regulations and the program. Recommendation: We recommend audit preparations are completed on a timely basis to ensure that the reporting deadline is met. Review of Responsible Officials: Managemet acknowledges there were significant delays in the audit due to capacity issues and a delay in the 2022 audit. Management has been in contact with all of its program representatives to keep them informed on the situation.
Show full finding ▾Hide full finding ▴Finding 2023-004 Repeat Finding: Yes Program Name: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Questioned Costs: N/A Type of Finding: Noncompliance, Significant Deficiency Compliance Requirement: Reporting Condition: The District did not meet its financial reporting obligations under the grant during the year. The District did not complete the 2022 audit and file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Criteria The District is required to complete the audit and file the Data Collection Form (SF-SAC) by March 31, 2024. Cause: The Data Collection Form was not filed within the required period due to a delay in the preparations for the audit. Effect: The District was not in compliance with federal regulations and the program. Recommendation: We recommend audit preparations are completed on a timely basis to ensure that the reporting deadline is met. Review of Responsible Officials: Managemet acknowledges there were significant delays in the audit due to capacity issues and a delay in the 2022 audit. Management has been in contact with all of its program representatives to keep them informed on the situation.
Condition: The District did not meet its financial reporting obligations under the grant during the year. The District did not complete the 2022 audit and file the Data Collection Form (SF-SAC) by the due date of March 31, 2024. Response: The hospital has new administration, a new finance team and has implemented additional internal controls. The 2022 financial statement audit is complete and the 2022 single audit will be issued prior to 12/31/2024. The 2024 audit is currently in progress and anticipated to be issued prior to 12/31/2024. Responsible Party: Carolyn Davies, CFO Estimated Completion Date: 12/31/2024
The District did not meet its financial covenants required under the program during the year, and we, as the auditors, were unable to properly calculate the required financial covenants because of potential missing or misstated financial statement information due to the adverse opinion on the 2022 financial statements and related disclaimer of opinion included in our accompanying 2023 Independent Auditor's Report. Criteria The District is required to meet certain financial covenants as described in Article VIII of the Hospital Revenue Bonds Series A loan documents dated October 25, 2012. Cause: The District has had significant financial challenges and turnover within its finance department. Effect: The District was not in compliance with the program. Recommendation: We recommend that management put a plan in place to become compliant with the financial covenants of the debt. Review of Responsible Officials: Managemet acknowledges they were not in compliance with the financial covenants of the bond. Management has been in contact USDA to keep them informed on the situation and has put plans into place to improve the financial position of the District.
Show full finding ▾Hide full finding ▴Finding 2023-005 Repeat Finding: Yes Program Name: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Questioned Costs: N/A Type of Finding: Noncompliance, Significant Deficiency Compliance Requirement: Special Tests and Provisions Condition: The District did not meet its financial covenants required under the program during the year, and we, as the auditors, were unable to properly calculate the required financial covenants because of potential missing or misstated financial statement information due to the adverse opinion on the 2022 financial statements and related disclaimer of opinion included in our accompanying 2023 Independent Auditor's Report. Criteria The District is required to meet certain financial covenants as described in Article VIII of the Hospital Revenue Bonds Series A loan documents dated October 25, 2012. Cause: The District has had significant financial challenges and turnover within its finance department. Effect: The District was not in compliance with the program. Recommendation: We recommend that management put a plan in place to become compliant with the financial covenants of the debt. Review of Responsible Officials: Managemet acknowledges they were not in compliance with the financial covenants of the bond. Management has been in contact USDA to keep them informed on the situation and has put plans into place to improve the financial position of the District.
Condition: The District did not meet its financial covenants required under the program during the year, and we, as the auditors, were unable to properly calculate the required financial covenants because of potential missing or misstated financial statement information due to the adverse opinion on the 2022 financial statements and related disclaimer of opinion included in our accompanying 2023 Independent Auditor's report. Response: The hospital has financial covenants including: • Maintaining 35 days cash on hand. We are currently at 26 Days Cash on Hand. The hospital has been as low as 6 Days Cash on Hand. To increase our Cash on Hand, we have brought all Revenue Cycle efforts in house, trained new staff, formed cross functional teams with the clinical documentation staff, set goals and work weekly with our teams to gently resolve challenges and move forward. These efforts have rewarded the hospital with increased Days Cash on Hand and improved quality processes in Revenue Cycle. • Lack of account reconciliation causing large numbers of year end entries. The accounting staff were not involved in Balance Sheet account reconciliation. These accounts are now being reconciled and monitored monthly. The GASB 87 rules were not adopted due to the staff not being trained. Upon our switch to WIPFLI as our new auditors, we have adopted GASB 87 (starting in FY 2023). In addition, we make the GASB 87 adjustments monthly. • One covenant requires that we maintain strong internal controls. Since the new administration have begun, each month, new internal controls are being established throughout the hospital, Finance department, Materials Management and the Revenue Cycle. • On covenant requires a positive bottom line. The hospital has been loosing money primarily due to the change in administration, lack of routine processes, recruitment challenges, lack of accuracy in our accounting and revenue cycle. Throughout the hospital and RHC’s, improvement teams are working to both improve quality processes, reduce costs, establish a culture to allow recruitment and improve our bottom line. The hospital has been transparent with the agency and our Board of Directors throughout our change process. More work continues. Segregation of duties We have a small staff. However, we have carefully been analyzing the duties and capabilities of each person. Then we have made changes to increase the segregation of duties to improve our internal controls. We improve internal controls with monthly goals. We will continue to both develop our staff, analyze segregation of duties and tighten our internal controls. We are very proud of our accomplishments. Access Internal Controls The previous administration did not have focused reviews of access to data. We have starting in FY 2024 created a team approach to reviewing job functions, access to information and the limits we need to place on the access. One of the findings has been that we had too many people with edit access to areas that were not essential to their job duties. We meet bi-monthly and review roles, data requirements and view only or edit capabilities. The process is arduous and slow, but we are steadily make progress. There have been revisions, surprises and accomplishment. Responsible Party: Meagan Weber, CEO, Carolyn Davies, CFO & Brent Peirick, COO Estimated Completion Date: 6/30/2026
FAC accepted this audit on June 29, 2023 — management decision was due December 29, 2023.
Finding: Allowable Costs/Cost Principles and Reporting U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub L. No. 116-136, 134 Stat. 563 and Pub L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease (COVID-19). Entities that received more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, management is responsible for establishing and maintaining effective internal controls over costs directly and indirectly charged to federal awards. Condition ? The District claimed and reported duplicative direct COVID-19 expenditures or amounts that were not able to be supported to the U.S. Department of Health and Human Services. Questioned costs ? $345,136 of COVID-19 equipment expenses ($154,655 once the Medicare cost rate was applied) that were charged and reported were duplicative and/or unsupported. This was calculated by taking the total amount of expenses charged twice to the program and multiplying this by the client calculated Medicare cost rate. Context ? FORVIS also noted that the Equipment Line item on the portal submission included amounts for two invoices twice in their submission resulting in $345,135.86 of unsupported equipment expenditures ($151,894.29 once the Medicare rate was applied) in their portal submission. FORVIS noted this error for one of the 15 nonpayroll items tested. The Sample was not, and is not, intended to be statistically valid. Effect ? The Other Provider Relief Fund Expanses for Payments Received included $209,781.89 of unallowable expenses on the portal submission. However, FORVIS noted this did not result in any questioned costs as the District had sufficient Lost Revenues to cover the unallowable costs. Cause ? Unallowable costs were included on the portal submission due to the District?s lack of appropriate management review. Identification as a Repeat Finding ? Not applicable. Recommendation ? The District should continue to improve understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions ? The District agrees with this finding. See separate auditee document for planned corrective action. Cause ? Unallowable costs were included on the portal submission due to the District?s lack of appropriate management review. Identification as a Repeat Finding ? Not applicable. Recommendation ? The District should continue to improve understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions ? The District agrees with this finding. See separate auditee document for planned corrective action.
Show full finding ▾Hide full finding ▴Finding: Allowable Costs/Cost Principles and Reporting U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub L. No. 116-136, 134 Stat. 563 and Pub L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease (COVID-19). Entities that received more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, management is responsible for establishing and maintaining effective internal controls over costs directly and indirectly charged to federal awards. Condition ? The District claimed and reported duplicative direct COVID-19 expenditures or amounts that were not able to be supported to the U.S. Department of Health and Human Services. Questioned costs ? $345,136 of COVID-19 equipment expenses ($154,655 once the Medicare cost rate was applied) that were charged and reported were duplicative and/or unsupported. This was calculated by taking the total amount of expenses charged twice to the program and multiplying this by the client calculated Medicare cost rate. Context ? FORVIS also noted that the Equipment Line item on the portal submission included amounts for two invoices twice in their submission resulting in $345,135.86 of unsupported equipment expenditures ($151,894.29 once the Medicare rate was applied) in their portal submission. FORVIS noted this error for one of the 15 nonpayroll items tested. The Sample was not, and is not, intended to be statistically valid. Effect ? The Other Provider Relief Fund Expanses for Payments Received included $209,781.89 of unallowable expenses on the portal submission. However, FORVIS noted this did not result in any questioned costs as the District had sufficient Lost Revenues to cover the unallowable costs. Cause ? Unallowable costs were included on the portal submission due to the District?s lack of appropriate management review. Identification as a Repeat Finding ? Not applicable. Recommendation ? The District should continue to improve understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions ? The District agrees with this finding. See separate auditee document for planned corrective action. Cause ? Unallowable costs were included on the portal submission due to the District?s lack of appropriate management review. Identification as a Repeat Finding ? Not applicable. Recommendation ? The District should continue to improve understanding of the guidance related to this type of reporting and implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions ? The District agrees with this finding. See separate auditee document for planned corrective action.
During the testing of compliance for Federal Assistance Listing No. 93.498, U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution, it was noted that noted that the Equipment Line item on the portal submission included amounts for two invoices twice in their submission resulting in $154,655 of unsupported equipment expenditures. FORVIS noted this error for one of the 15 nonpayroll items tested. As a result, the Other Provider Relief Fund Expenses for Payments Received included unallowable expenses on the portal submission. Corrective Action Plan: Management continues to improve our understanding of the nuances within the guidance as it relates to charging and reporting direct expenses. Additionally, the District continues to implement additional controls over future reporting periods to help ensure guidance is followed, which is being achieved through educational sessions and additional layers of review over future reporting periods to help ensure guidance is properly followed. As of this submission, multiple Internal Controls have been added to address this issue: ? The Board is provided a listing of paid invoices on a Monthly basis. ? For each check or ACH payment, 2 Administrative signatures are required. As payments are reviewed, the invoices are also reviewed for appropriateness. ? Variance analysis comparing expense trends and the budget are being prepared and reported on to the Board monthly. ? Processes surrounding Accounts Payable invoice entry have been trained on to eliminate duplicate invoices. Duplicate invoice numbers are flagged by the system. ? The computer system is being upgraded. During the spring of 2024, invoices will be scanned into the accounting system. It should be noted that this finding did not result in any questioned costs as the District had sufficient Lost Revenues to cover the unallowable costs. Personnel Responsible for Corrective Action: Carolyn Davies, Chief Financial Officer. Anticipated Completion Date: Change is in process and full adoption is anticipated by September 30, 2023.
Finding: Allowable Costs/Cost Principles and Reporting U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub L. No. 116-136, 134 Stat. 563 and Pub L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease (COVID-19). Entities that received more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, management is responsible for establishing and maintaining effective internal controls over costs directly and indirectly charged to federal awards. Condition ? The District claimed and reported COVID-19-related payroll expenses within the HHS Provider Relief Fund portal that were eligible to be reimbursed via other sources. Questioned Costs ? $57,688 of payroll expenses were charged and reported under the COVID-19 Provider Relief Program (ALN 93.498) which were available to be reimbursed by other sources. This was calculated by taking the payroll expenses and multiplying this amount multiplied by the District's internally calculated Medicare reimbursement rate. Context ? Upon testing the compliance requirements of this program, it was determined certain payroll expenses were being claimed and reported incorrectly as they were not "Medicate-affected" to reduce the portion of expense to be reimbursed by another source. Effect ? The District submitted and reported expenses under the PRF program which did not adhere to the terms and conditions of the award. However, FORVIS noted this did not result in any questioned costs as the District had sufficient Lost Revenues to cover the unallowable costs. Cause ? The guidance provided by HHS to providers across the country as to how to report their COVID-19-related expenses and lost revenues is, at times, difficult to comprehend and apply. The District incorrectly applied guidance. Identification as a Repeat Finding ? Not applicable. Recommendation ? The District should continue to try to improve their understanding of the nuances within the guidance as it relates to charging and reporting direct expenses. Additionally, the Hospital should implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions ? The District is going to continue and improve its understanding of the guidance related to this type of reporting and work with their external advisors to ensure future portal submissions are compliant with said guidance.
Show full finding ▾Hide full finding ▴Finding: Allowable Costs/Cost Principles and Reporting U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution Criteria or Specific Requirement ? Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Cost Principles (Pub L. No. 116-136, 134 Stat. 563 and Pub L. No. 116-139, 134 Stat. 622 and 623). The Provider Relief Fund (PRF) was established in the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) to reimburse, through grants or other mechanisms, eligible health care providers for increased expenses or lost revenue attributable to Coronavirus Disease (COVID-19). Entities that received more than $10,000 (either one time or in the aggregate) are required to report the uses of their funds, including the lost revenue reimbursement and documentation of how the lost revenue was calculated. In addition, management is responsible for establishing and maintaining effective internal controls over costs directly and indirectly charged to federal awards. Condition ? The District claimed and reported COVID-19-related payroll expenses within the HHS Provider Relief Fund portal that were eligible to be reimbursed via other sources. Questioned Costs ? $57,688 of payroll expenses were charged and reported under the COVID-19 Provider Relief Program (ALN 93.498) which were available to be reimbursed by other sources. This was calculated by taking the payroll expenses and multiplying this amount multiplied by the District's internally calculated Medicare reimbursement rate. Context ? Upon testing the compliance requirements of this program, it was determined certain payroll expenses were being claimed and reported incorrectly as they were not "Medicate-affected" to reduce the portion of expense to be reimbursed by another source. Effect ? The District submitted and reported expenses under the PRF program which did not adhere to the terms and conditions of the award. However, FORVIS noted this did not result in any questioned costs as the District had sufficient Lost Revenues to cover the unallowable costs. Cause ? The guidance provided by HHS to providers across the country as to how to report their COVID-19-related expenses and lost revenues is, at times, difficult to comprehend and apply. The District incorrectly applied guidance. Identification as a Repeat Finding ? Not applicable. Recommendation ? The District should continue to try to improve their understanding of the nuances within the guidance as it relates to charging and reporting direct expenses. Additionally, the Hospital should implement additional controls over future reporting periods to help ensure guidance is followed. View of Responsible Official and Planned Corrective Actions ? The District is going to continue and improve its understanding of the guidance related to this type of reporting and work with their external advisors to ensure future portal submissions are compliant with said guidance.
During the testing of compliance for Federal Assistance Listing No. 93.498, U.S. Department of Health and Human Services Direct Program: COVID-19 Provider Relief Fund and the American Rescue Plan (ARP) Rural Distribution, it was noted that noted that the District claimed and reported $57,688 of COVID-19-related payroll expenses within the HHS Provider Relief Fund portal that were eligible to be reimbursed via other sources. As a result, the Other Provider Relief Fund Expenses for Payments Received included unallowable expenses on the portal submission. Corrective Action Plan: Management continues to improve our understanding of the nuances within the guidance as it relates to charging and reporting direct expenses. Additionally, the District continues to implement additional controls over future reporting periods to help ensure guidance is followed, which is being achieved through educational sessions and additional layers of review over future reporting periods to help ensure guidance is properly followed. As of this submission, upon approval, Grants are entered into a Grant Tracking analysis file. The accounting for the Grant is then tracked for usage, dates, expenditures, and reporting deadlines. It should be noted that this finding did not result in any questioned costs as the District had sufficient Lost Revenues to cover the unallowable costs. Personnel Responsible for Corrective Action: Carolyn Davies, Chief Financial Officer. Anticipated Completion Date: Change is in process and full adoption is anticipated by September 30, 2023.
FAC accepted this audit on November 27, 2016 — management decision was due May 27, 2017.
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