Audit 18925

FY End
2022-09-30
Total Expended
$164.89M
Findings
2
Programs
42
Organization: Tufts Medicine Inc. (MA)
Year: 2022 Accepted: 2023-03-09

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
20288 2022-001 - - L
596730 2022-001 - - L

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $87.83M Yes 1
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $34.26M Yes 0
84.268 Federal Direct Student Loans $1.98M - 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.45M - 0
93.396 Cancer Biology Research $603,747 - 0
84.425 Education Stabilization Fund $514,612 Yes 0
84.063 Federal Pell Grant Program $385,557 - 0
93.350 National Center for Advancing Translational Sciences $303,196 - 0
93.839 Blood Diseases and Resources Research $290,259 - 0
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nations Health $226,187 - 0
93.837 Cardiovascular Diseases Research $196,891 - 0
93.307 Minority Health and Health Disparities Research $163,045 - 0
93.226 Research on Healthcare Costs, Quality and Outcomes $153,362 - 0
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $103,083 - 0
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $99,869 - 0
93.103 Food and Drug Administration_research $94,691 - 0
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $93,687 - 0
64.054 Research and Development $92,256 - 0
21.019 Coronavirus Relief Fund $91,921 - 0
93.866 Aging Research $77,506 - 0
93.110 Maternal and Child Health Federal Consolidated Programs $64,757 - 0
93.RD National Institute of Health $64,750 - 0
93.865 Child Health and Human Development Extramural Research $56,475 - 0
93.855 Allergy, Immunology and Transplantation Research $47,876 - 0
84.007 Federal Supplemental Educational Opportunity Grants $40,000 - 0
93.279 Drug Abuse and Addiction Research Programs $35,565 - 0
93.838 Lung Diseases Research $31,612 - 0
93.999 National Center for Advancing Translational Sciences $28,549 - 0
93.393 Cancer Cause and Prevention Research $21,442 - 0
93.273 Alcohol Research Programs $19,226 - 0
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $13,831 - 0
93.399 Cancer Control $12,802 - 0
93.310 Trans-Nih Research Support $12,030 - 0
93.113 Environmental Health $5,944 - 0
84.033 Federal Work-Study Program $5,053 - 0
93.213 Research and Training in Complementary and Integrative Health $3,421 - 0
93.121 Oral Diseases and Disorders Research $3,239 - 0
93.867 Vision Research $3,185 - 0
93.068 Chronic Diseases: Research, Control, and Prevention $1,618 - 0
93.395 Cancer Treatment Research $150 - 0
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $71 - 0
12.420 Military Medical Research and Development $-717 - 0

Contacts

Name Title Type
FJ45DALSSU69 Susan Green Auditee
5085726790 Stacy Andreotes Auditor
No contacts on file

Notes to SEFA

Title: Federal Student Loan Programs Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the System).Operations related to the Systems federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS).Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program ClustersFor the year ended September 30, 2022, the following program clusters were identified:?Research and Development?Student Financial AssistanceMajor ProgramsMajor programs are identified in the summary of auditors results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2022 were based on approved rates as received from DHHS. Loans outstanding to students under federal programs at September 30, 2022, are summarized as follows: Nursing Student Loan Program $163,282 Federal Family Education loans are administered by outside financial institutions, and balances and transactions relating to these programs are not included in the Systems consolidated financial statements.
Title: Provider Relief Fund Recipients Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the System).Operations related to the Systems federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS).Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program ClustersFor the year ended September 30, 2022, the following program clusters were identified:?Research and Development?Student Financial AssistanceMajor ProgramsMajor programs are identified in the summary of auditors results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2022 were based on approved rates as received from DHHS. During the year ended September 30, 2022, all entities under the System who received federal funding from the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution with periods of availability from July 1, 2020, through June 30, 2021 are summarized, by tax identification number (TIN), as follows:82-3315703Cardiovascular Center at Tufts Medical Center26-2057970Circle Health OB/GYN, LLC47-1122696Circle Health Urgent Care, LLC04-2103812Circle Home, Inc.04-3140938Hallmark Health Medical Associates04-2437064Hallmark Health Visting Nurse Association, Inc.04-2435675Home Health VNA, Inc.20-5671277LGH Medical Group, LLC45-2014433LGH Merrimack Valley Cardiology Associates, LLC61-1844933LGH Professional Services, LLC04-2767880MelroseWakefield Healthcare, Inc.04-3024278Merrimack Valley Hospice, Inc.04-3148395Pratt Anesthesiology Associates, Inc.04-3148397Pratt Medical and Surgical Dermatology Associates, Inc.04-2743894Pratt Medical Group, Inc.04-3148384Pratt Neurology Associates, Inc.04-3096445Pratt Neurosurgical Associates, Inc.04-3148385Pratt OB/GYN Associates, Inc.04-3148392Pratt Opthalmology Associates, Inc.20-5129051Pratt Orthopedic Associates, Inc.04-3148381Pratt Otolaryngology - Head and Neck Surgery Associates, Inc.04-3148393Pratt Pathology Associates, Inc.04-3148394Pratt Pediatric Associates, Inc.04-3148387Pratt Psychiatric Associates, Inc.13-4340840Pratt Radiation Oncology Associates of Rhode Island, Inc.04-3148389Pratt Radiation Oncology Associates, Inc.04-3148388Pratt Radiology Associates, Inc.04-3148378Pratt Rehabiliation Medicine Associates, Inc.04-3148376Pratt Surgical Associates, Inc.04-3148379Pratt Urology Associates, Inc.04-2103590The Lowell General Hospital04-3400617Tufts Medical Center, Inc. 47-3046563 Tufts Medical Center Community Care Inc.
Title: Donated Medical Equipment (Unaudited) Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the System).Operations related to the Systems federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS).Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program ClustersFor the year ended September 30, 2022, the following program clusters were identified:?Research and Development?Student Financial AssistanceMajor ProgramsMajor programs are identified in the summary of auditors results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2022 were based on approved rates as received from DHHS. During the year ended September 30, 2022, the System did not receive any donated medical equipment from a federal awarding agency.
Title: FEDERAL PERKINS LOAN PROGRAM CLOSEOUT Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the System).Operations related to the Systems federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS).Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program ClustersFor the year ended September 30, 2022, the following program clusters were identified:?Research and Development?Student Financial AssistanceMajor ProgramsMajor programs are identified in the summary of auditors results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2022 were based on approved rates as received from DHHS. As of September 23, 2021, the System began the process of liquidating their Federal Perkins Loan Program participation. As part of that process, all loans were assigned as of September 20, 2022.The last time that the System returned funds to the Department of Education for the Federal Perkins Loan Program was on January 13, 2022 in the amount of $7,095. When all accounts were assigned in September 2022, there was no cash on hand related to the program. All required liquidation and closeout procedures have been completed.

Finding Details

FINDING 2022-001 ? LOST REVENUE REPORTING Criteria As published in the June 11, 2021 Post-Payment Notice of Reporting Requirements, Health and Human Services (HHS) guidelines require that recipients of Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Program funding select from one of three approved options to determine their methodology for calculating their lost revenue reimbursement. The data utilized and submitted to HHS must follow the selected approved option. Condition The System selected Option 3 for calculating their lost revenue reimbursement. HHS defined lost revenue under Option 3 to be calculated by any reasonable method of estimating revenues. In addition to providing patient care revenues, alternative methodology for calculating lost revenues attributable to coronavirus Reporting Entities must submit: 1) a narrative document describing methodology, an explanation of why the methodology is reasonable, and a description establishing how lost revenues were attributable to coronavirus, as opposed to a loss caused by any other source; and 2) A calculation of lost revenues attributable to coronavirus using the methodology described in the narrative document. The System has incorrectly entered the lost revenue data (2020 Q1, 2020 Q2, 2020 Q3, and 2022 Q2) within the Reporting Period 3 HHS portal submission. Cause Personnel responsible for preparation and review of the System?s portal submission failed to perform a detail review of the lost revenue calculation prior to submitting it to the HHS portal. Effect The lost revenue calculations submitted in the HHS portal for Period 3 did not agree with the underlying data, which resulted in lost revenue calculation being understated by approximately $3 million. Recommendation The Company should ensure the underlying data used to calculate lost revenue agrees to amounts submitted within in the HHS portal. This calculation and the submission should be reviewed by an individual with the appropriate knowledge of the HHS requirements.
FINDING 2022-001 ? LOST REVENUE REPORTING Criteria As published in the June 11, 2021 Post-Payment Notice of Reporting Requirements, Health and Human Services (HHS) guidelines require that recipients of Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution Program funding select from one of three approved options to determine their methodology for calculating their lost revenue reimbursement. The data utilized and submitted to HHS must follow the selected approved option. Condition The System selected Option 3 for calculating their lost revenue reimbursement. HHS defined lost revenue under Option 3 to be calculated by any reasonable method of estimating revenues. In addition to providing patient care revenues, alternative methodology for calculating lost revenues attributable to coronavirus Reporting Entities must submit: 1) a narrative document describing methodology, an explanation of why the methodology is reasonable, and a description establishing how lost revenues were attributable to coronavirus, as opposed to a loss caused by any other source; and 2) A calculation of lost revenues attributable to coronavirus using the methodology described in the narrative document. The System has incorrectly entered the lost revenue data (2020 Q1, 2020 Q2, 2020 Q3, and 2022 Q2) within the Reporting Period 3 HHS portal submission. Cause Personnel responsible for preparation and review of the System?s portal submission failed to perform a detail review of the lost revenue calculation prior to submitting it to the HHS portal. Effect The lost revenue calculations submitted in the HHS portal for Period 3 did not agree with the underlying data, which resulted in lost revenue calculation being understated by approximately $3 million. Recommendation The Company should ensure the underlying data used to calculate lost revenue agrees to amounts submitted within in the HHS portal. This calculation and the submission should be reviewed by an individual with the appropriate knowledge of the HHS requirements.