Lone Star complied with applicable Federal requirements and grant terms related to its Patient Protection and Affordable Care Act-funded capital development grant. Specifically, Lone Star had adequate financial management controls over capital development grant funds, followed procurement standards in accordance with Federal requirements, met reporting requirements in accordance with the grant's terms and conditions, and claimed allowable and reasonable costs for construction. Although Lone Star did not meet its grant-established project milestone dates, it had reasonable justification for the delays that occurred. Accordingly, this report contains no recommendations.