EIN: 751584559
UEI: CHGEEXTCMRM9
Data as of August 24, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on June 28, 2024. 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 December 28, 2024 (604 days ago).
What is a management decision? →The District included certain expenditures within the Period 4 reporting that were not eligible under HRSA guidelines. Questioned costs: $1,754,432 – Calculated as the value of reported utility and insurance expenditures that were not related to the District’s prevention, preparation and/or response to the COVID-19 pandemic. Context: The Period 4 Provider Relief Fund (PRF) report was submitted and included utility and insurance expenditures. These expenditures were not directly related to the prevention, preparation, or response to the COVID-19 pandemic as required by HRSA guidelines. Cause: Internal controls were not in place to ensure the District appropriately charged expenditures to this award as required by HRSA guidelines. Effect: The District submitted expenditures under the PRF program that were not directly related to the prevention, preparation, or response to the COVID-19 pandemic as required by HRSA guidelines. Identification as a repeat finding: N/A Recommendation: Policies and procedures over federal grant reporting should be modified to ensure distributions are utilized for expenses directly related to the prevention, preparation, and response to coronavirus as required. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District’s response to finding.
Show full finding ▾Hide full finding ▴COVID-19 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria or specific requirement: Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) and Reporting (45 CFR 75.342). Condition: The District included certain expenditures within the Period 4 reporting that were not eligible under HRSA guidelines. Questioned costs: $1,754,432 – Calculated as the value of reported utility and insurance expenditures that were not related to the District’s prevention, preparation and/or response to the COVID-19 pandemic. Context: The Period 4 Provider Relief Fund (PRF) report was submitted and included utility and insurance expenditures. These expenditures were not directly related to the prevention, preparation, or response to the COVID-19 pandemic as required by HRSA guidelines. Cause: Internal controls were not in place to ensure the District appropriately charged expenditures to this award as required by HRSA guidelines. Effect: The District submitted expenditures under the PRF program that were not directly related to the prevention, preparation, or response to the COVID-19 pandemic as required by HRSA guidelines. Identification as a repeat finding: N/A Recommendation: Policies and procedures over federal grant reporting should be modified to ensure distributions are utilized for expenses directly related to the prevention, preparation, and response to coronavirus as required. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District’s response to finding.
Management agrees with the finding that the Period 4 Provider Relief Fund report included expenses for utility and insurance expenditures that were not directly related to the District's prevention, preparation and/or response to the COVID-19 pandemic. Management reviewed HRSA guidance and examples of allowable expenses prior to completing Period 4 Provider Relief Fund reporting and concluded these expenses were considered allowable as general and administrative expenses incurred during our response to the COVID-19 pandemic. Management notes that expenses and lost revenue reported exceed the amount of PRF funding received even if these expenses were excluded. We have taken corrective action for the review of completeness and accuracy for inclusion of allowable expenditures. PRF reporting, subsequent to this audit, will be reviewed prior to submission to ensure accuracy of reporting. Chief Financial Officer, Marie Castro, is responsible for ensuring the corrective action plan is followed. The corrective action plan will be implemented on June 30, 2024.
FAC accepted this audit on June 28, 2023 — management decision was due December 28, 2023.
The District included certain COVID-19 related expenditures as requests for financial assistance from other agencies. Questioned costs: None Context: Certain expenses reported by the District in the period 2 PRF report were also provided to other agencies as a request for financial assistance. A portion of the request to the second source was approved and funded subsequent to September 30, 2022, thus a portion of the Period 2 PRF expenses could be reimbursed by both PRF and the second source. The total amount to be approved and granted by the secondary source has not yet been finalized. Cause: Internal controls of compliance were not in place to ensure the District did not allocate expenses to more than one funding source. Effect: Expenses were allocated to more than one funding source. Identification as a repeat finding: Not a repeat finding. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure distributions are not used to reimbursed expenses that have been reimbursed from other sources or that other sources are obligated to reimburse. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Show full finding ▾Hide full finding ▴2022-001 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria: Reporting (45 CFR 75.342) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). Condition: The District included certain COVID-19 related expenditures as requests for financial assistance from other agencies. Questioned costs: None Context: Certain expenses reported by the District in the period 2 PRF report were also provided to other agencies as a request for financial assistance. A portion of the request to the second source was approved and funded subsequent to September 30, 2022, thus a portion of the Period 2 PRF expenses could be reimbursed by both PRF and the second source. The total amount to be approved and granted by the secondary source has not yet been finalized. Cause: Internal controls of compliance were not in place to ensure the District did not allocate expenses to more than one funding source. Effect: Expenses were allocated to more than one funding source. Identification as a repeat finding: Not a repeat finding. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure distributions are not used to reimbursed expenses that have been reimbursed from other sources or that other sources are obligated to reimburse. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Midland County Hospital District Single Audit Report FY2022 Corrective Action Plan Finding 2022-001 - Management agrees with the finding. Period 2 Provider Relief Fund (PRF) report included certain expenses that were also subsequently submitted to another funding source as a request for financial assistance. Even if these amounts were excluded, our expenses and lost revenue reported exceeded the amount of PRF funding received. These expenses were removed and corrected in the Period 4 PRF report submitted on March 30, 2023 by the Executive Director of Fiscal Services/Controller, Rebbecca Richey. The Executive Director of Fiscal Services/Controller, Rebbecca Richey will be responsible to ensure that future PRF reporting periods will not have overlapping funding source requests. The corrective action plan was implemented on March 30, 2023.
The Period 2 Provider Relief Fund report was submitted that had errors in the lost revenue calculation under Option 1. Questioned costs: Unknown Context: The District incorrectly excluded certain excluded Medicaid supplemental payments, and the District did not include negative contractual allowances when entering net revenue by payor into the reporting portal. Cause: The District did not properly calculate lost revenue in their calculation. Internal controls of compliance were not in place to ensure the District properly calculated prepared the report. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Identification as a repeat finding: Repeat finding, 2021-001 and 2021-002 Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Show full finding ▾Hide full finding ▴2022-002 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria: Reporting (45 CFR 75.342) and Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623). Condition: The Period 2 Provider Relief Fund report was submitted that had errors in the lost revenue calculation under Option 1. Questioned costs: Unknown Context: The District incorrectly excluded certain excluded Medicaid supplemental payments, and the District did not include negative contractual allowances when entering net revenue by payor into the reporting portal. Cause: The District did not properly calculate lost revenue in their calculation. Internal controls of compliance were not in place to ensure the District properly calculated prepared the report. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Identification as a repeat finding: Repeat finding, 2021-001 and 2021-002 Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Midland County Hospital District Single Audit Report FY2022 Corrective Action Plan Finding 2022-002 - Management agrees with the finding. We have developed policies and procedures over financial reporting to ensure patient service revenue includes Medicaid supplemental payments in all lost revenue that fall under the Federal assistance guidelines and ensure that total revenues are reconciled to the general ledger account balances and supporting information. net revenue was corrected for this issue dure the PRF Reporting Period #3 that was submitted September 29, 2022. Internal controls have been enacted and the Executive Director of Fiscal Services/Controller, Rebbecca Richey will be responsible to ensure all future periods will accurately reflect the lost revenues for the Hospital District. This corrective action plan was implemented on September 29, 2022.
2021-001
FAC accepted this audit on August 30, 2022 — management decision was due March 2, 2023.
The District excluded Medicaid supplemental payments in the lost revenue calculation which materially impacted the quarterly lost revenues reported. Questioned costs: Unknown Context: The period one provider relief fund report was tested. The District selected option 1 to report lost revenues based on quarterly actual amounts. A material error in the calculation of the patient service revenue for the quarters reported was identified. The District incorrectly excluded certain excluded Medicaid supplemental payments in the lost revenue calculation which materially impacted the quarterly lost revenues reported. Cause: The District selected option 1 and did not properly calculate net patient service revenue in their calculation under this option. Internal controls of compliance were not in place to ensure the District properly calculated net patient service revenue. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Identification as a repeat finding: Not a repeat finding. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Show full finding ▾Hide full finding ▴COVID-19 Provider Relief Fund Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria: Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) The District is required to prepare and submit period one provider relief fund report to the U.S. Department of Health and Human Services. This report is to be prepared using accurate financial information and submitted by the deadline established. Condition: The District excluded Medicaid supplemental payments in the lost revenue calculation which materially impacted the quarterly lost revenues reported. Questioned costs: Unknown Context: The period one provider relief fund report was tested. The District selected option 1 to report lost revenues based on quarterly actual amounts. A material error in the calculation of the patient service revenue for the quarters reported was identified. The District incorrectly excluded certain excluded Medicaid supplemental payments in the lost revenue calculation which materially impacted the quarterly lost revenues reported. Cause: The District selected option 1 and did not properly calculate net patient service revenue in their calculation under this option. Internal controls of compliance were not in place to ensure the District properly calculated net patient service revenue. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Identification as a repeat finding: Not a repeat finding. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Corrective Action Plan Finding 2021-001: We are in receipt of the Financial Statement Findings required to be reported by Government Auditing Standards, regarding the preparation of financial statements in accordance with GAAP and the design and implementation of internal controls over financial reporting. Management agrees with the finding. We will work to develop policies and procedures over financial reporting to ensure patient service revenue for quarters reported also include Medicaid supplemental payments in all lost revenue calculations that fall under the Federal assistance guidelines. The Accounting department will timely review, reconciled and ensure the accuracy and completeness of amounts to be reported on the SEFA. Although, these supplemental payments were excluded from the lost revenue calculations, our lost revenues still exceed the amount of PRF funding received. For PRF reporting period #3, the supplemental payments for these years will be updated to reflect the correct lost revenues. The Executive Director of Fiscal Services/Controller, Rebbecca Richey will be responsible to ensure that this is accomplished and will begin to implement new procedures. The corrective action plan will be implemented by September 30, 2022.
The District did not include negative contractual allowances when entering net revenue by payor into the reporting portal which resulted in net revenue being higher than actual and, therefore, lost revenue being lower than actual. Questioned costs: Unknown Context: The period one provider relief fund report was tested. The District selected option 1 to report lost revenues based on quarterly actual amounts. An error in the calculation of the patient service revenue for the quarters reported was identified whereby the District did not include negative contractual allowances when entering net revenue by payor into the reporting portal which resulted in net revenue being higher than actual and, therefore, lost revenue being lower than actual. Cause: The District did not properly calculate lost revenue in their calculation. Internal controls of compliance were not in place to ensure the District properly calculated prepared the report. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Show full finding ▾Hide full finding ▴COVID-19 Provider Relief Fund Federal Assistance Listing Number 93.498 U.S. Department of Health and Human Services Criteria: Reporting (45 CFR 75.342) and Activities Allowed/Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) The District is required to prepare and submit the period one provider relief fund report to the U.S. Department of Health and Human Services. This report is to be prepared using accurate financial information and submitted by the deadline established. Condition: The District did not include negative contractual allowances when entering net revenue by payor into the reporting portal which resulted in net revenue being higher than actual and, therefore, lost revenue being lower than actual. Questioned costs: Unknown Context: The period one provider relief fund report was tested. The District selected option 1 to report lost revenues based on quarterly actual amounts. An error in the calculation of the patient service revenue for the quarters reported was identified whereby the District did not include negative contractual allowances when entering net revenue by payor into the reporting portal which resulted in net revenue being higher than actual and, therefore, lost revenue being lower than actual. Cause: The District did not properly calculate lost revenue in their calculation. Internal controls of compliance were not in place to ensure the District properly calculated prepared the report. Effect: Errors were made in reporting quarterly total revenue/net charges for patient care for 2019, 2020 and 2021. Lost revenue was not accurately reported. Recommendation: Policies and procedures over federal grant reporting should be modified to ensure reports are prepared using complete and accurate information. Views of responsible officials and planned corrective actions: See attached corrective action plan for the District?s response to finding.
Corrective Action Plan Finding 2021-002: Management agrees with the finding. We will work to develop policies and procedures over financial reporting to ensure better and more timely review of all general ledger account balances and reconciliation to supporting information. We will contact HRSA to see if we can correct patient service revenue for quarters reported to accurately state lost revenues total and net revenues for patient care for 2019, 2020 and 2021 and the information will be reconciled to ensure the accuracy and completeness of amounts to be reported on the SEFA. For PRF reporting period #3, the lost revenues for these years will be updated to reflect the correct lost revenues. The Executive Director of Fiscal Services/Controller, Rebbecca Richey will be responsible to ensure that this is accomplished and will ensure that the lost revenues are accurately reflected. The corrective action plan will be implemented by September 30, 2022.
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