EIN: 956005449
UEI: GSA_MIGRATION
Audited by: EIDE BAILLY LLP
Oversight agency: 93 [Department of Health and Human Services]
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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 September 29, 2022. 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 March 29, 2023 (1251 days ago).
What is a management decision? →Department of Health and Human Services Federal Assistance Listing/CFDA #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 1 TIN #956005449 Material Weakness in Internal Control Over Compliance in Activities Allowed or Unallowed and Allowable Costs/Cost Principles Material Weakness in Internal Control Over Compliance in Reporting and Material Instances of Noncompliance in Reporting Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The District selected option 1 to calculate lost revenue which consists of a comparison of 2019 actual results to 2020 and 2021 actual results by quarter. Patient care-related revenue should be reported net of adjustments for all third-party payers, charity care adjustments, bad debt, and any other discounts or adjustments, as applicable when reporting patient care-related revenue sources. Condition Found: The District used an updated method to calculate the net patient service revenue utilized in the calculation of lost revenues after the Provider Relief Fund report was submitted in November 2021. The updated method included the effects of audit adjustments made to net patient service revenue as of June 30, 2021 as a result of the June 30, 2021 financial statement audit. The audit for fiscal year 2021 was completed after the Provider Relief Fund report was submitted, thus the report did not include the effects of the audit. The District claimed lost revenues and expenses that were incorrectly calculated or not supported. These were improperly included within the report and caused the report to be inaccurate. Cause: There was turnover of key financial personnel during 2021. The District was unable to prepare and facilitate a timely preparation of the financial statements which led to a delayed audit and the approval of unaudited amounts to be submitted. Effect: The lack of adequate policies governing report preparation and submission increases the risk that the report could be filed incorrectly. The lost revenue reported within the special report submitted to the Department of Health and Human Services for fiscal year 2020 was $6,069,679 and $616,691 for fiscal year 2021. Had the District entered the 2019, 2020, and 2021 net patient service revenues correctly, the lost revenue would have been $6,102,731 for fiscal year 2020 and $3,660,096 for fiscal year 2021. Lost revenue plus eligible expenses exceeded funds received. Questioned Costs: There are no questioned costs related to the lost revenue calculation as the District claimed less lost revenue than what could have been claimed. Context/Sampling: The lost revenue calculation for all applicable quarters was tested. Key line items were tested on the Period 1 Department of Health and Human Services special reports. Repeat Finding from Prior Year(s): No Recommendation: We recommend that the District enhance internal control policies to ensure that financial preparation and audit fieldwork can commence timely and that the special report is reviewed and approved prior to payment to ensure that all key line items are necessary, correct, meet the requirements of the federal program, and are properly recorded in the reports required to be submitted to the federal agency. View of responsible official and planned corrective action: Management agrees to the finding.
Show full finding ▾Hide full finding ▴Department of Health and Human Services Federal Assistance Listing/CFDA #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 1 TIN #956005449 Material Weakness in Internal Control Over Compliance in Activities Allowed or Unallowed and Allowable Costs/Cost Principles Material Weakness in Internal Control Over Compliance in Reporting and Material Instances of Noncompliance in Reporting Criteria: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. The District selected option 1 to calculate lost revenue which consists of a comparison of 2019 actual results to 2020 and 2021 actual results by quarter. Patient care-related revenue should be reported net of adjustments for all third-party payers, charity care adjustments, bad debt, and any other discounts or adjustments, as applicable when reporting patient care-related revenue sources. Condition Found: The District used an updated method to calculate the net patient service revenue utilized in the calculation of lost revenues after the Provider Relief Fund report was submitted in November 2021. The updated method included the effects of audit adjustments made to net patient service revenue as of June 30, 2021 as a result of the June 30, 2021 financial statement audit. The audit for fiscal year 2021 was completed after the Provider Relief Fund report was submitted, thus the report did not include the effects of the audit. The District claimed lost revenues and expenses that were incorrectly calculated or not supported. These were improperly included within the report and caused the report to be inaccurate. Cause: There was turnover of key financial personnel during 2021. The District was unable to prepare and facilitate a timely preparation of the financial statements which led to a delayed audit and the approval of unaudited amounts to be submitted. Effect: The lack of adequate policies governing report preparation and submission increases the risk that the report could be filed incorrectly. The lost revenue reported within the special report submitted to the Department of Health and Human Services for fiscal year 2020 was $6,069,679 and $616,691 for fiscal year 2021. Had the District entered the 2019, 2020, and 2021 net patient service revenues correctly, the lost revenue would have been $6,102,731 for fiscal year 2020 and $3,660,096 for fiscal year 2021. Lost revenue plus eligible expenses exceeded funds received. Questioned Costs: There are no questioned costs related to the lost revenue calculation as the District claimed less lost revenue than what could have been claimed. Context/Sampling: The lost revenue calculation for all applicable quarters was tested. Key line items were tested on the Period 1 Department of Health and Human Services special reports. Repeat Finding from Prior Year(s): No Recommendation: We recommend that the District enhance internal control policies to ensure that financial preparation and audit fieldwork can commence timely and that the special report is reviewed and approved prior to payment to ensure that all key line items are necessary, correct, meet the requirements of the federal program, and are properly recorded in the reports required to be submitted to the federal agency. View of responsible official and planned corrective action: Management agrees to the finding.
Department of Health and Human Services Federal Assistance Listing/CFDA #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Applicable Federal Award Number and Year ? Period 1 TIN #956005449 Material Weakness in Internal Control Over Compliance in Activities Allowed or Unallowed and Allowable Costs/Cost Principles Material Weakness in Internal Control Over Compliance in Reporting and Material Instances of Noncompliance in Reporting Planned Corrective Action: The District concurs with the findings and will implement the following corrective actions: A controller will be hired; The controller will ensure accurate record keeping and report filing; The controller will timely submit audit requests; The controller will include all audit findings in the records for use in preparation of single use audit; The controller will ensure all pertinent regulations and auditor recommendations are considered. Name of Contact Person: Kelli David, CEO Anticipated Completion Date: February 1, 2022
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