FAC Explorer

Audit 25165

FY End
2022-12-31
Total Expended
$36.65M
Findings
4
Programs
47
Organization: Children's Hospital and Health System, Inc. and Affiliates (WI)
Year: 2022 Accepted: 2023-07-19
Auditor: Deloitte and Touche LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
29505 2022-001 - - L
29506 2022-001 - - L
605947 2022-001 - - L
605948 2022-001 - - L

Programs

ALN Program Spent Major Findings
93.658 Foster Care_title IV-E $4.94M - 0
93.498 Provider Relief Fund $2.45M Yes 1
93.767 Children's Health Insurance Program $1.58M - 0
93.659 Adoption Assistance $1.18M Yes 0
16.575 Crime Victim Assistance $982,142 - 0
93.926 Healthy Start Initiative $960,930 - 0
93.865 Child Health and Human Development Extramural Research $603,399 - 0
93.959 Block Grants for Prevention and Treatment of Substance Abuse $522,200 - 0
93.253 Poison Center Support and Enhancement Grant $397,147 - 0
93.493 Congressional Directives $360,116 - 0
93.556 Promoting Safe and Stable Families $290,575 - 0
84.425 Education Stabilization Fund $235,650 - 0
20.616 National Priority Safety Programs $233,214 - 0
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $173,941 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $143,290 - 0
93.127 Emergency Medical Services for Children $136,935 - 0
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $135,956 - 0
16.582 Crime Victim Assistance/discretionary Grants $122,932 - 0
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $116,189 - 0
93.315 Rare Disorders: Research, Surveillance, Health Promotion, and Education $99,776 - 0
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $91,482 - 0
93.917 Hiv Care Formula Grants $83,266 - 0
84.215 Fund for the Improvement of Education $79,346 - 0
93.566 Refugee and Entrant Assistance_state Administered Programs $75,027 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $72,251 - 0
16.021 Justice Systems Response to Families $65,089 - 0
93.493 Community Funded Programs $60,506 - 0
16.818 Children Exposed to Violence $60,498 - 0
93.590 Community-Based Child Abuse Prevention Grants $59,909 - 0
93.994 Maternal and Child Health Services Block Grant to the States $56,738 - 0
93.603 Adoption Incentive Payments $55,050 - 0
93.070 Environmental Public Health and Emergency Response $45,432 - 0
93.889 National Bioterrorism Hospital Preparedness Program $31,670 - 0
93.645 Stephanie Tubbs Jones Child Welfare Services Program $29,271 - 0
93.307 Minority Health and Health Disparities Research $24,997 - 0
93.600 Head Start $22,165 - 0
93.236 Grants to States to Support Oral Health Workforce Activities $19,531 - 0
93.361 Nursing Research $15,684 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $14,667 - 0
93.325 Paralysis Resource Center $11,812 - 0
93.558 Temporary Assistance for Needy Families $11,138 - 0
93.778 Medical Assistance Program $8,770 - 0
93.395 Cancer Treatment Research $8,629 - 0
93.251 Early Hearing Detection and Intervention $8,582 - 0
14.218 Community Development Block Grants/entitlement Grants $6,617 - 0
93.667 Social Services Block Grant $3,865 - 0
93.669 Child Abuse and Neglect State Grants $3,000 - 0

Contacts

Name Title Type
HXLWMH3H2HK5 Marc Cadieux Auditee
4142667613 Sarah Anne Hughes Auditor
No contacts on file

Notes to SEFA

Title: Note 4 : Federal Insurance and Noncash Assistance Accounting Policies: The accompanying schedule of expenditures of federal and state awards includes the federal and state grant activity of Children's Hospital and Health System, Inc. and Affiliates (CHHS) and is presented on the accrual basis of accounting. The schedule includes a column labeled "Provider Agency" to present the respective CHHS affiliates with grant activity. For the year ended December 31, 2022, the five affiliates that had federal and state activity were Children's Hospital and Health System, Inc. (CHS), Children's Hospital of Wisconsin, Inc. (CHW), Children's Service Society of Wisconsin (CSSW), Children's Medical Group (CMG), and Surgicenter of Greater Milwaukee, LLC. (SGM). The information in this schedule is presented in accordance with the requirements of Uniform Guidance and the State Single Audit Guidelines. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The auditee has a federal indirect rate for CSSW of 25.00% and for CHW of 48.00%. There were no noncash awards or federal insurance awarded.
Title: Note 5 : Provider Relief Funds and American Rescue Plan Rural Distribution Accounting Policies: The accompanying schedule of expenditures of federal and state awards includes the federal and state grant activity of Children's Hospital and Health System, Inc. and Affiliates (CHHS) and is presented on the accrual basis of accounting. The schedule includes a column labeled "Provider Agency" to present the respective CHHS affiliates with grant activity. For the year ended December 31, 2022, the five affiliates that had federal and state activity were Children's Hospital and Health System, Inc. (CHS), Children's Hospital of Wisconsin, Inc. (CHW), Children's Service Society of Wisconsin (CSSW), Children's Medical Group (CMG), and Surgicenter of Greater Milwaukee, LLC. (SGM). The information in this schedule is presented in accordance with the requirements of Uniform Guidance and the State Single Audit Guidelines. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The auditee has a federal indirect rate for CSSW of 25.00% and for CHW of 48.00%. The following Children's entities and the related tax ID numbers are reported within the Provider Relief Funds (PRF) and American Rescue Plan (ARP) Rural Distribution amounts received in 2021: CHW Tax ID Number 390812532 Amount Reported $2,147,300 ; CMG Tax ID Number 391789197 Amount Reported $9,535,257 and CHS Tax ID Number 391500074 Amount Reported $3,596,826. For the HHS awards related to the PRF and ARP Rural Distribution Program, HHS has indicated that the amounts on the schedule should be reported corresponding to reporting requirements on the HRSA PRF Reporting Portal. The schedule includes both PRF3 and PRF4 respectively received from HHS between January 1,2021 and June 30,2021, and July 1, 2021 to December 31, 2021.
Title: Note 3 : CHHS' Contributions Accounting Policies: The accompanying schedule of expenditures of federal and state awards includes the federal and state grant activity of Children's Hospital and Health System, Inc. and Affiliates (CHHS) and is presented on the accrual basis of accounting. The schedule includes a column labeled "Provider Agency" to present the respective CHHS affiliates with grant activity. For the year ended December 31, 2022, the five affiliates that had federal and state activity were Children's Hospital and Health System, Inc. (CHS), Children's Hospital of Wisconsin, Inc. (CHW), Children's Service Society of Wisconsin (CSSW), Children's Medical Group (CMG), and Surgicenter of Greater Milwaukee, LLC. (SGM). The information in this schedule is presented in accordance with the requirements of Uniform Guidance and the State Single Audit Guidelines. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The auditee has a federal indirect rate for CSSW of 25.00% and for CHW of 48.00%. Included is a summary of CHHS' Contributions made in support of the federal and state programs for the year ended December 31, 2022: See Notes to the SEFA.

Finding Details

Finding 2022-001
Criteria - Upon receiving direct PRF and ARP Rural Funding distributed by Health Resources and Services Administration (HRSA), recipients of these funds agreed to terms and conditions which require compliance with reporting requirements. PRF payments were received throughout various periods (?Payment Received Periods?) and subject to respective ?Periods of Availability?. Each tranche of PRF money is designated by each period for which the payment was received. PRF 4 refers to the Payment Received Period between July 1, 2021 and December 31, 2021 (?period 4?). Payments received during period 4 must be used for eligible expenses incurred for the Period of Availability from January 1, 2020 to December 31, 2022. Each PRF report is designed to show how PRF payments received during the corresponding period were applied toward expenses or lost revenue during the correlated period of availability. Condition ? For the year ending December 31, 2022, there were two PRF 3 and three PRF 4 reports submitted to the HRSA reporting portal. For two of the PRF4 reports (for CHS and CMG), the quarterly expenses that were reimbursed by and reported for PRF 3 were repeated in the PRF 4 report. Although sufficient audit evidence was obtained to support that CHHS had no intent to claim any expenses for PRF 4 due to sufficient available lost revenues, the expenses were reported as cumulative when the intent of the portal reporting was to report expenses utilized just for PRF 4. Cause ? It was challenging for the management to keep up with various PRF reporting portal updates released by HRSA around the report due date. Although the management successfully accounted for PRF 4 payments applied outside of the HRSA reporting portal, the time and effort required to understand each step for data entry within the system was burdensome especially when not all data fields are editable. Effect ? Expenses were reported as applied to PRF 4 payments in the HRSA portal when management only intended to report utilizing lost revenue. There was no impact on the amount of PRF 4 revenue that was recognized. Questioned Costs ? None Repeat Finding from Prior Year ? No Recommendation ? Management should continue their efforts to ensure they understand all reporting requirements related to their federal awards.
Finding 2022-001
Criteria - Upon receiving direct PRF and ARP Rural Funding distributed by Health Resources and Services Administration (HRSA), recipients of these funds agreed to terms and conditions which require compliance with reporting requirements. PRF payments were received throughout various periods (?Payment Received Periods?) and subject to respective ?Periods of Availability?. Each tranche of PRF money is designated by each period for which the payment was received. PRF 4 refers to the Payment Received Period between July 1, 2021 and December 31, 2021 (?period 4?). Payments received during period 4 must be used for eligible expenses incurred for the Period of Availability from January 1, 2020 to December 31, 2022. Each PRF report is designed to show how PRF payments received during the corresponding period were applied toward expenses or lost revenue during the correlated period of availability. Condition ? For the year ending December 31, 2022, there were two PRF 3 and three PRF 4 reports submitted to the HRSA reporting portal. For two of the PRF4 reports (for CHS and CMG), the quarterly expenses that were reimbursed by and reported for PRF 3 were repeated in the PRF 4 report. Although sufficient audit evidence was obtained to support that CHHS had no intent to claim any expenses for PRF 4 due to sufficient available lost revenues, the expenses were reported as cumulative when the intent of the portal reporting was to report expenses utilized just for PRF 4. Cause ? It was challenging for the management to keep up with various PRF reporting portal updates released by HRSA around the report due date. Although the management successfully accounted for PRF 4 payments applied outside of the HRSA reporting portal, the time and effort required to understand each step for data entry within the system was burdensome especially when not all data fields are editable. Effect ? Expenses were reported as applied to PRF 4 payments in the HRSA portal when management only intended to report utilizing lost revenue. There was no impact on the amount of PRF 4 revenue that was recognized. Questioned Costs ? None Repeat Finding from Prior Year ? No Recommendation ? Management should continue their efforts to ensure they understand all reporting requirements related to their federal awards.
Finding 2022-001
Criteria - Upon receiving direct PRF and ARP Rural Funding distributed by Health Resources and Services Administration (HRSA), recipients of these funds agreed to terms and conditions which require compliance with reporting requirements. PRF payments were received throughout various periods (?Payment Received Periods?) and subject to respective ?Periods of Availability?. Each tranche of PRF money is designated by each period for which the payment was received. PRF 4 refers to the Payment Received Period between July 1, 2021 and December 31, 2021 (?period 4?). Payments received during period 4 must be used for eligible expenses incurred for the Period of Availability from January 1, 2020 to December 31, 2022. Each PRF report is designed to show how PRF payments received during the corresponding period were applied toward expenses or lost revenue during the correlated period of availability. Condition ? For the year ending December 31, 2022, there were two PRF 3 and three PRF 4 reports submitted to the HRSA reporting portal. For two of the PRF4 reports (for CHS and CMG), the quarterly expenses that were reimbursed by and reported for PRF 3 were repeated in the PRF 4 report. Although sufficient audit evidence was obtained to support that CHHS had no intent to claim any expenses for PRF 4 due to sufficient available lost revenues, the expenses were reported as cumulative when the intent of the portal reporting was to report expenses utilized just for PRF 4. Cause ? It was challenging for the management to keep up with various PRF reporting portal updates released by HRSA around the report due date. Although the management successfully accounted for PRF 4 payments applied outside of the HRSA reporting portal, the time and effort required to understand each step for data entry within the system was burdensome especially when not all data fields are editable. Effect ? Expenses were reported as applied to PRF 4 payments in the HRSA portal when management only intended to report utilizing lost revenue. There was no impact on the amount of PRF 4 revenue that was recognized. Questioned Costs ? None Repeat Finding from Prior Year ? No Recommendation ? Management should continue their efforts to ensure they understand all reporting requirements related to their federal awards.
Finding 2022-001
Criteria - Upon receiving direct PRF and ARP Rural Funding distributed by Health Resources and Services Administration (HRSA), recipients of these funds agreed to terms and conditions which require compliance with reporting requirements. PRF payments were received throughout various periods (?Payment Received Periods?) and subject to respective ?Periods of Availability?. Each tranche of PRF money is designated by each period for which the payment was received. PRF 4 refers to the Payment Received Period between July 1, 2021 and December 31, 2021 (?period 4?). Payments received during period 4 must be used for eligible expenses incurred for the Period of Availability from January 1, 2020 to December 31, 2022. Each PRF report is designed to show how PRF payments received during the corresponding period were applied toward expenses or lost revenue during the correlated period of availability. Condition ? For the year ending December 31, 2022, there were two PRF 3 and three PRF 4 reports submitted to the HRSA reporting portal. For two of the PRF4 reports (for CHS and CMG), the quarterly expenses that were reimbursed by and reported for PRF 3 were repeated in the PRF 4 report. Although sufficient audit evidence was obtained to support that CHHS had no intent to claim any expenses for PRF 4 due to sufficient available lost revenues, the expenses were reported as cumulative when the intent of the portal reporting was to report expenses utilized just for PRF 4. Cause ? It was challenging for the management to keep up with various PRF reporting portal updates released by HRSA around the report due date. Although the management successfully accounted for PRF 4 payments applied outside of the HRSA reporting portal, the time and effort required to understand each step for data entry within the system was burdensome especially when not all data fields are editable. Effect ? Expenses were reported as applied to PRF 4 payments in the HRSA portal when management only intended to report utilizing lost revenue. There was no impact on the amount of PRF 4 revenue that was recognized. Questioned Costs ? None Repeat Finding from Prior Year ? No Recommendation ? Management should continue their efforts to ensure they understand all reporting requirements related to their federal awards.