EIN: 550484469
UEI: FNEBNUE2D7V8
Audited by: Baker Tilly US, LLP
Oversight agency: 10 [Department of Agriculture]
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Data as of August 28, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on May 1, 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 November 1, 2026 (63 days from today).
What is a management decision? →FAC accepted this audit on April 2, 2025 — management decision was due October 2, 2025.
FAC accepted this audit on June 28, 2024 — management decision was due December 28, 2024.
Federal Program: Community Facilities Loans and Grants Cluster: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Pass-through Agency: N/A Award Number: N/A Award Year: 2023 Compliance Requirement: Special Tests and Provisions Questioned Costs: None Criteria: Section 4.6 of the USDA's Loan Guarantee Agreement stipulates that the borrower must maintain certain financial reporting covenants, such as debt service coverage ratio of at least 1.25, days cash on hand in excess of 65 days, and obtaining an audited fiscal year-end financial statement audited by independent certified public accountants withing one hundred ten days subsequent to year end. Additionally, section 4(d) of the Community Facilities Loan Resolution Agreement stipulates that the Hospital will establish and maintain a bookkeeping or separate bank account for the debt reserve funds. As of September 30, 2023 the Hospital had not maintained a separate account at the bank with sufficient funds, nor was a separate general ledger account established. Condition and Context: The Hospital did not maintain a days cash on hand in excess of 65 days, as of September 30, 2023. Additionally, the Hospital failed to maintain a separate account at the bank with sufficient funds, nor was a separate general ledger account established. The Hospital's audited financial statements as of September 30, 2023 were issued subsequent to one hundred ten days following September 30, 2023. Effect: The Hospital has failed to comply with the debt covenants and subsequently received waivers from the financial institution and Federal Grantor. Cause: The Hospital did not have sufficient internal controls in place to monitor on-going compliance with the loan agreement. Recommendation: We recommend that management implement procedures to ensure that all grant and loan agreements are reviewed on an on-going basis and that compliance requirements are recorded and tracked to ensure on-going compliance. Management's Corrective Action Plan: Management agrees with this finding and has implemented controls to monitor on-going compliance with both financial and non-financial covenants. Additionally, when management became aware of the non-compliance, it notified the financial institution and Federal Grantor and received waivers.
Show full finding ▾Hide full finding ▴Federal Program: Community Facilities Loans and Grants Cluster: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Pass-through Agency: N/A Award Number: N/A Award Year: 2023 Compliance Requirement: Special Tests and Provisions Questioned Costs: None Criteria: Section 4.6 of the USDA's Loan Guarantee Agreement stipulates that the borrower must maintain certain financial reporting covenants, such as debt service coverage ratio of at least 1.25, days cash on hand in excess of 65 days, and obtaining an audited fiscal year-end financial statement audited by independent certified public accountants withing one hundred ten days subsequent to year end. Additionally, section 4(d) of the Community Facilities Loan Resolution Agreement stipulates that the Hospital will establish and maintain a bookkeeping or separate bank account for the debt reserve funds. As of September 30, 2023 the Hospital had not maintained a separate account at the bank with sufficient funds, nor was a separate general ledger account established. Condition and Context: The Hospital did not maintain a days cash on hand in excess of 65 days, as of September 30, 2023. Additionally, the Hospital failed to maintain a separate account at the bank with sufficient funds, nor was a separate general ledger account established. The Hospital's audited financial statements as of September 30, 2023 were issued subsequent to one hundred ten days following September 30, 2023. Effect: The Hospital has failed to comply with the debt covenants and subsequently received waivers from the financial institution and Federal Grantor. Cause: The Hospital did not have sufficient internal controls in place to monitor on-going compliance with the loan agreement. Recommendation: We recommend that management implement procedures to ensure that all grant and loan agreements are reviewed on an on-going basis and that compliance requirements are recorded and tracked to ensure on-going compliance. Management's Corrective Action Plan: Management agrees with this finding and has implemented controls to monitor on-going compliance with both financial and non-financial covenants. Additionally, when management became aware of the non-compliance, it notified the financial institution and Federal Grantor and received waivers.
Federal Program: Community Facilities Loans and Grants Cluster: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Criteria: Section 4.6 of the USDA's Loan Guarantee Agreement stipulates that the borrower must maintain certain financial reporting covenants, such as debt service coverage ratio of at least 1.25, days cash on hand in excess of 65 days, and obtaining an audited fiscal year-end financial statement audited by independent certified public accountants withing one hundred ten days subsequent to year end. Additionally, section 4(d) of the Community Facilities Loan Resolution Agreement stipulates that the Hospital will establish and maintain a bookkeeping or separate bank account for the debt reserve funds. As of September 30, 2023 the Hospital had not maintained a separate account at the bank with sufficient funds, nor was a separate general ledger account established. Condition and Context: The Hospital did not maintain a days cash on hand in excess of 65 days, as of September 30, 2023. Additionally, the Hospital failed to maintain a separate account at the bank with sufficient funds, nor was a separate general ledger account established. The Hospital's audited financial statements as of September 30, 2023 were issued subsequent to one hundred ten days following September 30, 2023. Corrective Action Planned: Management has contacted the financial institutions and the United States Department of Agriculture, for waivers of debt covenants to prevent triggering an event of default. Additionally, management has reviewed and modified its internal controls to ensure monitoring of ongoing compliance. Name of Contact Person Responsible for Corrective Action: Amy Downey, Chief Financial Officer, 200 Hospital Drive, Spencer, WV 25276 Anticipated Completion Date: June 27, 2024
FAC accepted this audit on April 23, 2023 — management decision was due October 23, 2023.
2022-002: Debt Covenant Compliance Federal Program: Community Facilities Loans and Grants Cluster: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Pass-through Agency: N/A Award Number: N/A Award Year: 2022 Compliance Requirement: Special Tests and Provisions Questioned Costs: None Criteria: Section 4.6 of the USDA's Community Facilities Loan Agreement stipulates that the borrower must maintain a debt service coverage ratio of at least 1.25. Additionally, Section 5(j) of the Community Facilities Loan Resolution Agreement stipulates that the Hospital will not modify or amend its organizational documents, including any articles of incorporation or bylaws without the written consent of the government. Section 4.3 of the USDA's Loan Guarantee Agreement stipulates that the borrower must maintain certain financial reporting covenants, such as debt service coverage ratio of at least 1.25 days cash on hand in excess of 65 days, and obtaining an audited fiscal year-end financial statement audited by independent certified public accountants withing one hundred, ten days subsequent to year end. Condition and Context: The Hospital did not maintain a debt service coverage ratio of at least 1.25 or days cash on hand in excess of 65 days, as of September 30, 2022. Additionally, the Hospital amended its bylaws in September 2022 without written consent of the government. The Hospital?s audited financial statements as of September 30, 2022, were issued subsequent to one hundred, ten days following September 30, 2022. Effect: The Hospital has failed to comply with the debt covenants and subsequently received waivers from the financial institution and federal grantor. Cause: The Hospital did not have sufficient internal controls in place to monitor ongoing compliance with the loan agreement. Recommendation: We recommend that management implement procedures to ensure that all grant and loan agreements are reviewed on an ongoing basis and that compliance requirements are recorded and tracked to ensure ongoing compliance. View of Responsible Officials: Management agrees with this finding and has implemented controls to monitor ongoing compliance with both financial and non-financial covenants. Additionally, when management became aware of the non-compliance, it notified the financial institution and federal grantor and received waivers.
Show full finding ▾Hide full finding ▴2022-002: Debt Covenant Compliance Federal Program: Community Facilities Loans and Grants Cluster: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Federal Agency: U.S. Department of Agriculture Pass-through Agency: N/A Award Number: N/A Award Year: 2022 Compliance Requirement: Special Tests and Provisions Questioned Costs: None Criteria: Section 4.6 of the USDA's Community Facilities Loan Agreement stipulates that the borrower must maintain a debt service coverage ratio of at least 1.25. Additionally, Section 5(j) of the Community Facilities Loan Resolution Agreement stipulates that the Hospital will not modify or amend its organizational documents, including any articles of incorporation or bylaws without the written consent of the government. Section 4.3 of the USDA's Loan Guarantee Agreement stipulates that the borrower must maintain certain financial reporting covenants, such as debt service coverage ratio of at least 1.25 days cash on hand in excess of 65 days, and obtaining an audited fiscal year-end financial statement audited by independent certified public accountants withing one hundred, ten days subsequent to year end. Condition and Context: The Hospital did not maintain a debt service coverage ratio of at least 1.25 or days cash on hand in excess of 65 days, as of September 30, 2022. Additionally, the Hospital amended its bylaws in September 2022 without written consent of the government. The Hospital?s audited financial statements as of September 30, 2022, were issued subsequent to one hundred, ten days following September 30, 2022. Effect: The Hospital has failed to comply with the debt covenants and subsequently received waivers from the financial institution and federal grantor. Cause: The Hospital did not have sufficient internal controls in place to monitor ongoing compliance with the loan agreement. Recommendation: We recommend that management implement procedures to ensure that all grant and loan agreements are reviewed on an ongoing basis and that compliance requirements are recorded and tracked to ensure ongoing compliance. View of Responsible Officials: Management agrees with this finding and has implemented controls to monitor ongoing compliance with both financial and non-financial covenants. Additionally, when management became aware of the non-compliance, it notified the financial institution and federal grantor and received waivers.
Finding 2022-002 Federal Program: Community Facilities Loans and Grants Cluster: Community Facilities Loans and Grants Assistance Listing Number: 10.766 Criteria: Section 4.6 of the USDA's Community Facilities Loan Agreement stipulates that the borrower must maintain a debt service coverage ratio of at least 1.25. Additionally, Section 5(j) of the Community Facilities Loan Resolution Agreement stipulates that the Hospital will not modify or amend its organizational documents, including any articles of incorporation or bylaws without the written consent of the Government. Section 4.3 of the USDA's Loan Guarantee Agreement stipulates that the borrower must maintain certain financial reporting covenants, such as debt service coverage ratio of at least 1.25 days cash on hand in excess of 65 days, and obtaining an audited fiscal year-end financial statement audited by independent certified public accountants withing one hundred ten days subsequent to year end. Condition and Context: The Hospital did not maintain a debt service coverage ratio of at least 1.25 or days cash on hand in excess of 65 days, as of September 30, 2022. Additionally, the Hospital amended its bylaws in September 2022 without written consent of the Government. The Hospital?s audited financial statements as of September 30, 2022 were issued subsequent to one hundred ten days following September 30, 2022. Corrective Action Planned: Management has contacted the financial institutions and the United States Department of Agriculture, for waivers of debt covenants to prevent triggering an event of default. Additionally, management has reviewed and modified its internal controls to ensure monitoring of ongoing compliance. Name of Contact Person Responsible for Corrective Action: Amy Downey, Chief Financial Officer, 200 Hospital Drive, Spencer, WV 25276 Anticipated Completion Date: February 17, 2023
FAC accepted this audit on June 12, 2022 — management decision was due December 12, 2022.
2021-001 Programs: Provider Relief Funds CFDA Number: 93.498 Federal Agencies: U.S. Department of Health and Human Services Passed-Through Entities: N/A Award Number: N/A Award Year: Various Compliance Requirement: Reporting Questioned Costs: None Criteria: As required by the Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements, issued on June 11, 2021; when referring to revenues from patient care for the purposes of the calculation of lost revenues attributable to COVID-19 patient care was defined as: ??Patient care? means health care, services, and supports, as provided in a medical setting, at home/telehealth, or in the community. It should not include non-patient care revenue such as insurance, retail, or real estate revenues (exception for nursing and assisted living facilities? real estate revenues where resident fees are allowable); prescription sales revenues (exception when derived through the 340B program); grants or tuition; contractual adjustments from all third-party payors; charity care adjustments; bad debt; and any gains and/or losses on investments.? Condition and Context: Hospital Development Company (d/b/a Roane General Hospital) elected to use the Lost Revenues Reporting Method of 2019 Actual Revenue. When preparing the calculation Hospital Development Company (d/b/a Roane General Hospital) excluded 340B revenues from the calculation. Cause: Hospital Development Company (d/b/a Roane General Hospital) had misinterpreted the reporting guidelines. Although the most recent guidelines were used, management's review process did not take into account the applicable regulation which defined ?patient care? as excluding prescription sales revenues but including revenues generated from the 340B program. Effect: Hospital Development Company (d/b/a Roane General Hospital) was not in compliance with the reporting requirements for the Provider Relief Funds. Hospital Development Company (d/b/a Roane General Hospital) has misstated the lost revenues when reporting for the Provider Relief Funds. Hospital Development Company (d/b/a Roane General Hospital) does have sufficient expenditures and compliant lost revenues to recognize all funding received in the reporting period. Recommendation: It is recommended that Hospital Development Company (d/b/a Roane General Hospital) review their policies and procedures and implement additional policies to ensure that the most recent guidelines are reviewed, understood, and complied with when reporting. View of Responsible Officials: Hospital Development Company (d/b/a Roane General Hospital) agrees with the finding.
Show full finding ▾Hide full finding ▴2021-001 Programs: Provider Relief Funds CFDA Number: 93.498 Federal Agencies: U.S. Department of Health and Human Services Passed-Through Entities: N/A Award Number: N/A Award Year: Various Compliance Requirement: Reporting Questioned Costs: None Criteria: As required by the Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements, issued on June 11, 2021; when referring to revenues from patient care for the purposes of the calculation of lost revenues attributable to COVID-19 patient care was defined as: ??Patient care? means health care, services, and supports, as provided in a medical setting, at home/telehealth, or in the community. It should not include non-patient care revenue such as insurance, retail, or real estate revenues (exception for nursing and assisted living facilities? real estate revenues where resident fees are allowable); prescription sales revenues (exception when derived through the 340B program); grants or tuition; contractual adjustments from all third-party payors; charity care adjustments; bad debt; and any gains and/or losses on investments.? Condition and Context: Hospital Development Company (d/b/a Roane General Hospital) elected to use the Lost Revenues Reporting Method of 2019 Actual Revenue. When preparing the calculation Hospital Development Company (d/b/a Roane General Hospital) excluded 340B revenues from the calculation. Cause: Hospital Development Company (d/b/a Roane General Hospital) had misinterpreted the reporting guidelines. Although the most recent guidelines were used, management's review process did not take into account the applicable regulation which defined ?patient care? as excluding prescription sales revenues but including revenues generated from the 340B program. Effect: Hospital Development Company (d/b/a Roane General Hospital) was not in compliance with the reporting requirements for the Provider Relief Funds. Hospital Development Company (d/b/a Roane General Hospital) has misstated the lost revenues when reporting for the Provider Relief Funds. Hospital Development Company (d/b/a Roane General Hospital) does have sufficient expenditures and compliant lost revenues to recognize all funding received in the reporting period. Recommendation: It is recommended that Hospital Development Company (d/b/a Roane General Hospital) review their policies and procedures and implement additional policies to ensure that the most recent guidelines are reviewed, understood, and complied with when reporting. View of Responsible Officials: Hospital Development Company (d/b/a Roane General Hospital) agrees with the finding.
Corrective Action Plan for Hospital Development Company (d/b/a Roane General Hospital) (the Hospital) Single Audit Report for the fiscal year ended September 30, 2021 as required by Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Finding 2021-001: Section III ? Findings and Questioned Costs Relating to Federal Awards A significant deficiency in Internal Control over Major Programs. Criteria: As required by the Provider Relief Fund General and Targeted Distribution Post-Payment Notice of Reporting Requirements, issued on June 11, 2021; when referring to revenues from patient care for the purposes of the calculation of lost revenues attributable to Covid-19 patient care was defined as: ??Patient care? means health care, services and supports, as provided in a medical setting, at home/telehealth, or in the community. It should not include non-patient care revenue such as insurance, retail, or real estate revenues (exception for nursing and assisted living facilities? real estate revenues where resident fees are allowable); prescription sales revenues (exception when derived through the 340B program); grants or tuition; contractual adjustments from all third party payers; charity care adjustments; bad debt; and any gains and/or losses on investments.? Condition and Context: Hospital Development Company (d/b/a Roane General Hospital) elected to use the Lost Revenues Reporting Method of 2019 Actual Revenue. When preparing the calculation Hospital Development Company (d/b/a Roane General Hospital) excluded 340B revenues. Cause: Hospital Development Company (d/b/a Roane General Hospital) had misinterpreted the reporting guidelines. Although the most recent guidelines were used, management?s review process did not take into account the applicable regulation which defined ?patient care? as excluding prescription sales revenues but including revenues generated from the 340B Program. Effect: Hospital Development Company (d/b/a Roane General Hospital) was not in compliance with the reporting requirements for the Provider Relief Funds. Hospital Development Company (d/b/a Roane General Hospital) has misstated the lost revenues when reporting for the Provider Relief Funds. Hospital Development Company (d/b/a Roane General Hospital) does have sufficient expenditures and compliant lost revenues to recognize all funding received in the reporting period. Recommendation: It is recommended that Hospital Development Company (d/b/a Roane General Hospital) review their policies and procedures and implement additional policies to ensure that the most recent guidelines are reviewed, understood and complied with when reporting. Corrective Action Plan: Management will review its policies and procedures and modify as necessary to ensure the most up-to-date regulations are complied with. Additionally, in a future reporting period, management will modify the historical revenue amounts in the HRSA Portal to properly include 340B revenues. This will ensure the Hospital does not over-report in future periods. Contact Person: Amy Downey, Chief Financial Officer, 200 Hospital Drive, Spencer, WV 25276
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