Dayspring Health, Inc.Non-Profit

Information on the federal program – Assistance Listing Number 93.224, Health Center Program Cluster from the U.S. Department of Health and Human Services, Federal Award No. 6 H80CS00716 for project period February 1, 2025 through January 31, 2028. Criteria or specific requirement – Health centers must comply with federal reporting requirements. Condition – The Organization did not have support for a certain line item on the Uniform Data System (UDS) report filed. Within Table 4 of the UDS report, the amount reported within line 6 column A was unable to be supported by the Organization. Cause – There was a lack of detailed review of the amounts reported on the UDS. Effect or potential effect – Inaccurate filing of reports may result in the federal program not being properly monitored, thus resulting in potential noncompliance with program requirements. Questioned costs – None Context – 1 special report was required to be submitted during the year under audit (UDS), thus this was the only report selected for testing. On this report 10 line items were tested, and of those 10 items, 1 of the lines did not have support for the reported balance. Identification as a repeat finding – Is not a repeat finding. Recommendation – We recommend management implement an additional level of review by someone with knowledge of the reporting requirements. Views of responsible officials and planned corrective – To ensure compliance with federal reporting standards, the Health Center will require a secondary review of all federal reports submitted to granting agencies. Additionally, the Health Center will implement policies and procedures surrounding file retention of the underlying data that supports federal reports submitted.

Health Center Program Cluster; Federal Assistance Listing No. 93.224; U.S. Department of Health and Human Services; grant number H80CS26595; budget period February 1, 2021, through January 31, 2022. Criteria or specific requirement: Reporting ? 42 CFR, Part 51c. Condition: The Health Center is required to prepare and submit an annual Uniform Data System (UDS) report for the calendar year. This report is to be prepared using accurate financial information. Cause: The Health Center was unable to produce accurate supporting information for the UDS report filed for Table 8A. Effect or potential effect: Potential errors may have been reported on the annual UDS report. Questioned cost: None. Context: In testing the UDS report, the Health Center was unable to locate or provide supporting underlying data for four attributes required for testing. Identification as a repeat finding, if applicable: N/A Recommendation: We recommend management develop a procedure to compile and retain the information needed for accurate UDS reports to ensure accurate reporting. Views of responsible officials: Management agrees with the recommendation.

COVID-19, Provider Relief Fund (PRF); Federal Assistance Listing No. 93.498; U.S. Department of Health and Human Services. Criteria or specific requirement: Reporting ? 45 CFR Section 75.342. Condition: The Health Center is required to prepare and submit period one PRF reporting using accurate financial information. Cause: The information and guidance continually changed as the Health Center was completing its calculation. Effect: Errors were noted in the lost revenue calculated amounts. Questioned cost: $0. Context: In testing the PRF report, the quarterly amounts were not accurately reported and incorrectly included rate settlements and did not include 340B revenue. Effect or potential effect: Errors were noted in the lost revenue calculated amounts. Identification as a repeat finding, if applicable: N/A Recommendation: We recommend management develop a procedure to update the information for its lost revenue calculation based on the most recent guidance. Views of responsible officials: Management agrees with the recommendation.

Beginning in March 2018, Dayspring Family Health Center, Inc. (the Corporation) experienced turnover in its accounting and finance staff due to the resignations of the Corporation?s staff accountant and Chief Financial Officer. While the staff accountant position was filled in March 2018, a permanent replacement for the Chief Financial Officer was not in place until January 2019. This resulted in a significant shortage of personnel dedicated to the accounting, reporting and grant compliance monitoring functions during the year. Although the Corporation engaged three different individuals on a temporary basis throughout the year to provide accounting assistance and utilized certain internal resources, as well, the Corporation was not able to prepare comprehensive, underlying account reconciliations or to produce complete, reliable and timely financial statements for most of 2019. This condition was also a factor in the grant related compliance finding described further herein. In January 2019, the Corporation retained an experienced certified public accountant to fill the Chief Financial Officer role. Building on the work performed by the temporary accounting staff, the newly hired Chief Financial Officer was able to reconcile substantially all accounts and prepare financial statements for January 31, 2019. We recommend Dayspring Family Health Center, Inc. continue its efforts to improve the accounting and financial reporting functions by hiring another staff accountant to provide additional manpower as the Corporation?s scope of services continues to expand. We also recommend management cross-train employees, as applicable, on accounting and financial reporting functions to provide alternatives in the event that one or more of the accounting staff are not able to fulfill their assigned responsibilities.

Funding for the Health Center Program Cluster is on a cost reimbursement basis and the Uniform Guidance specifies that if funds are advanced, recipients must follow procedures to minimize the time elapsing between the transfer of funds from the U.S. Treasury and disbursement. During 2019, the Corporation made draws of federal grant funds in excess of immediate needs and prior to incurring all qualifying expenditures for Grant No. 3 H80CS00716-17-08. As of January 31, 2019, the Corporation made draws of the full award amount, which resulted in drawing $218,729 before expending the funds. Also, in May 2018, the Corporation made a draw of $15,642, which duplicates a draw made in December 2017 for $15,642 in satisfaction of an outstanding grant receivable balance related to CFDA No. 93.527, Grant No. 6 H80CS00716-14-12. As all qualifying expenditures under the specified grant were incurred and reported in prior years, the May 2018 draw appears to be in error. We understand these excess draws to be a result of the condition described in 2019-01 above. Prior to making draw requests, we recommend management prepare complete summaries of qualifying expenditures and specifically review to ensure the draw request does not include excess amounts.