EIN: 870276435
UEI: Q1NBBN27QBG3
Data as of August 24, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on March 27, 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 September 27, 2026 (33 days from today).
What is a management decision? →Section III ‒ Federal Award Findings and Questioned Costs 2025-001 – Policies and Procedures for United Stated Department of Agriculture Reserve Funds Federal Agency United Stated Department of Agriculture (USDA) Federal Assistance Listing Number 10.766 – Community Facilities Loans and Grants Federal Award Identification Number Not available Federal Award Years 2018-2059 Criteria [ ] Compliance Finding [ ] Significant Deficiency [X] Material Weakness The Medical Center should maintain written policies and procedures for the correct funding of required reserve accounts to ensure compliance with relevant requirements. These policies should also document how the reserve funds may be spent. Condition The Medical Center did not have written policies and procedures for the reserve accounts required by the USDA. Context This finding appears to be an isolated instance. Effect There is a risk that the Hospital may not be in compliance with the requirements of the USDA loan agreements. Cause The Medical Center did not develop written policies and procedures over relevant internal controls. Recommendation We recommend the Medical Center create policies and procedures addressing the USDA reserve account compliance requirements. Views of responsible officials and planned corrective actions We recognize the importance of maintaining formal, written policies and procedures to ensure consistent compliance with USDA reserve account requirements and to provide clear guidance on the authorized use of these funds.
Show full finding ▾Hide full finding ▴Section III ‒ Federal Award Findings and Questioned Costs 2025-001 – Policies and Procedures for United Stated Department of Agriculture Reserve Funds Federal Agency United Stated Department of Agriculture (USDA) Federal Assistance Listing Number 10.766 – Community Facilities Loans and Grants Federal Award Identification Number Not available Federal Award Years 2018-2059 Criteria [ ] Compliance Finding [ ] Significant Deficiency [X] Material Weakness The Medical Center should maintain written policies and procedures for the correct funding of required reserve accounts to ensure compliance with relevant requirements. These policies should also document how the reserve funds may be spent. Condition The Medical Center did not have written policies and procedures for the reserve accounts required by the USDA. Context This finding appears to be an isolated instance. Effect There is a risk that the Hospital may not be in compliance with the requirements of the USDA loan agreements. Cause The Medical Center did not develop written policies and procedures over relevant internal controls. Recommendation We recommend the Medical Center create policies and procedures addressing the USDA reserve account compliance requirements. Views of responsible officials and planned corrective actions We recognize the importance of maintaining formal, written policies and procedures to ensure consistent compliance with USDA reserve account requirements and to provide clear guidance on the authorized use of these funds.
2025-001 - Policies and Procedures for United Stated Department of Agriculture Reserve Funds Corrective action planned: Upon discovery of the missing documentation, the Medical Center’s finance department immediately initiated a review of the USDA loan agreement. The following actions have been taken to remediate the material weakness: ● Policy Development: Management has drafted and implemented a formal “USDA Reserve Fund Policy.” This document explicitly outlines the annual funding requirements and the specific protocols for the disbursement and use of funds. ● Internal Control Implementation: We have established a monthly reconciliation process to verify that the required amounts are transferred and maintained timely. ● Resolution of Underfunding: As noted by the auditors, any historical funding discrepancies were fully addressed and rectified by September 2025. The accounts are currently funded in accordance with the loan covenants. Anticipated completion date: Completed September 2025 Contact person responsible for corrective action: Brent Hales, CFO
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