Old Dominion Emergency Medical Services Alliance, Inc.

Finding: Item 2024-001 – Financial Statements- Material Weakness Criteria: The VHHA grant and Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements of Federal Awards, requires a single audit to be performed if more than $750,000 in federal awards is received during the fiscal year. Condition/context: The Alliance was unaware that they had met the requirements of a single audit as required by the VHHA grant and 2 CFR 200. 2 CFR 200.508 (b) states the auditee must prepare appropriate financial statements, including the schedule of expenditures of federal funds. Cause: Inexperience and lack of understanding of the VHHA grant requirements as well as 2 CFR 200. Effect or potential effect:A single audit would not have been performed and inappropriate financial statements could have been issued, resulting in noncompliance with the VHHA grant and 2 CFR 200 and possible loss of grant funds. Questioned cost: Not applicable. Repeat Finding: Not applicable Recommendation: Grant documents should be reviewed thoroughly and monitored periodically to obtain an understanding of all compliance requirements. View of responsible officials: Management’s response is reported in “Corrective Action Plan” at the end of this report.

Finding: Item 2024-002 – Prior Period Adjustment- Material Weakness Criteria: Management is responsible for establishing and maintaining effective internal control over financial reporting. Condition/context: The Alliance’s financial statements required adjustments applicable to the prior year to be in conformity with accounting principles generally accepted in the United States of America (GAAP). The adjustments to the prior year were related to an over accrual of paid time off for CVHC designated employees that are not eligible. Cause: The Alliance failed to exclude ineligible employees from the accrued PTO calculation and did not identify certain necessary adjustments required to present the financial statements in accordance with GAAP. Effect or possible effect: An adjusting journal entry was proposed during the financial statement audit. Questioned cost: Not applicable. Repeat Finding: Not applicable Recommendation: Management should continue to monitor month-end and year-end closing procedures to ensure controls in place are sufficient to ensure that financial statements are prepared in accordance with GAAP. View of responsible officials: Management’s response is reported in “Corrective Action Plan” at the end of this report.

Finding: Item 2024-003 – U.S. GAAP Accounting- Material Weakness Criteria: The Organization's financial statements should be reported in accordance with U.S. GAAP. Condition/Context: Reconciliations for payroll liabilities (taxes and fringe benefits) were not completed throughout the fiscal year. Adjusting entries were recorded during the audit for the financial statements to be in accordance with U.S. GAAP. Cause: Internal control policies and procedures were not folowed or enforced. Effect or potential effect: The Organization was not able to generate interim and year-end financial statements in accordance with U.S. GAAP. Additionally, failure to reconcile the simplified employee pension liability may result in noncomplance with the plan and penalties. Questioned cost: Not applicable. Repeat Finding: Not applicable Recommendation: We recommend that reconciliations and accruals be prepared and reviewed on a timely basis, monthly at a minimum. View of responsible officials: Management’s response is reported in “Corrective Action Plan” at the end of this report.