FAC Explorer

Audit 296298

FY End
2023-06-30
Total Expended
$56.57M
Findings
6
Programs
4
Organization: Ou Medicine, Inc. (OK)
Year: 2023 Accepted: 2024-03-21
Auditor: Ernst & Young LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
382706 2023-001 Material Weakness - AB
382707 2023-003 Material Weakness - ABL
382708 2023-002 Material Weakness Yes AB
959148 2023-001 Material Weakness - AB
959149 2023-003 Material Weakness - ABL
959150 2023-002 Material Weakness Yes AB

Programs

ALN Program Spent Major Findings
21.027 Coronavirus State and Local Fiscal Recovery Funds $44.00M Yes 1
93.498 Provider Relief Fund $9.81M Yes 1
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $1.82M Yes 1
93.493 Congressional Directives $460,796 - 0

Contacts

Name Title Type
SGKZNBX276G8 Bernard Githinji Auditee
4052715437 Debbie Kohnle Auditor
No contacts on file

Notes to SEFA

Title: 1. Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, 45 CFR, PART 75 APPENDIX IX, Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts With Hospitals, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements. De Minimis Rate Used: N Rate Explanation: OU Medicine, Inc. has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of OU Medicine, Inc. under programs of the federal government for the year ended June 30, 2023. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of OU Medicine, Inc., it is not intended to and does not present the financial position, results of operations, changes in net assets, or cash flows of OU Medicine, Inc.
Title: 2. Summary of Significant Accounting Policies Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, 45 CFR, PART 75 APPENDIX IX, Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts With Hospitals, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements. De Minimis Rate Used: N Rate Explanation: OU Medicine, Inc. has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, 45 CFR, PART 75 APPENDIX IX, Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts With Hospitals, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements. OU Medicine, Inc. has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance.
Title: 3. Nature of Activities Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, 45 CFR, PART 75 APPENDIX IX, Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts With Hospitals, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements. De Minimis Rate Used: N Rate Explanation: OU Medicine, Inc. has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. OU Medicine, Inc. receives various grants to cover costs of specified programs. Final determination of eligibility of costs will be made by the grantors. Should any costs be found ineligible, OU Medicine, Inc. will be responsible for reimbursing the grantors for these amounts. Additionally, expenditures incurred for various programs may exceed the amounts awarded from the respective pass-through entity or agency. The amounts reported on the Schedule are limited to the award amounts. Amounts in excess of this amount are paid out of non-federal sources.
Title: 4. Disaster Grants – Public Assistance (Presidentially Declared Disasters) Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, 45 CFR, PART 75 APPENDIX IX, Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts With Hospitals, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements. De Minimis Rate Used: N Rate Explanation: OU Medicine, Inc. has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. For the Federal Emergency Management Agency (FEMA), Department of Homeland Security’s (DHS) Disaster Grants – Public Assistance (Presidentially Declared disasters) (Assistance Listing Number 97.036), non-federal entities must record expenditures on the Schedule when (1) FEMA has approved the non-federal entity’s project worksheet (PW) and (2) the non-federal entity has incurred the eligible expenditures. Federal awards expended in years subsequent to the fiscal year in which the PW is approved are to be recorded on the non-federal entity’s Schedule in those subsequent years. In fiscal year 2023, OU Health received approval from the Oklahoma Department of Emergency Management for 23 PWs related to the reimbursement of eligible costs of $1,818,602 incurred in the prior fiscal year. These previous year’s expenditures are included on the Schedule in the cur- rent year in accordance with guidance provided by FEMA.
Title: 5. Provider Relief Fund Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, 45 CFR, PART 75 APPENDIX IX, Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts With Hospitals, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements. De Minimis Rate Used: N Rate Explanation: OU Medicine, Inc. has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The amount presented on the SEFA for Assistance Listing Number 93.498, COVID-19 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) is for the year ended June 30, 2023. The amount presented reconciles to the Provider Relief Fund (PRF) information reported to HRSA as follows: SEE TABLE

Finding Details

Finding 2023-001
Finding 2023-001 – Internal Control Deficiency Over Activities Allowed or Unallowed and Activities Allowed/Allowable Costs Identification of the federal program: Federal Grantor: Department of the Treasury Assistance Listing No.: 21.027, COVID-19 Coronavirus State and Local Fiscal Recovery Funds (CSLFRF) Award Period of Performance: March 2021–June 30, 2023 Criteria or Specific Requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework,” issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Per discussion with management, OU Medicine, Inc. has processes and internal controls in place to ensure expenses submitted to the CSLFRF program were allowable expenses per the grant agreement These internal controls include ensuring completeness and accuracy of the expenses to ensure the expenses comply with the terms and conditions of the award. However, management did not consistently retain documentation evidencing the performance of these controls. Cause: OU Medicine, Inc. did not consistently retain documentation to evidence the performance of internal controls over expenses charged to the federal program. Effect or potential effect: There is no consistent documentation to support the performance of internal controls for costs charged to the federal program. Questioned Costs: $0 Context: Total CSLFRF expenditures for Assistance Listing 21.027 were $44,000,000, of which management did not retain documentation of the performance of controls. Identification as a repeat finding, if applicable: The finding is not a repeat finding. Recommendation: OU Medicine, Inc. should refine its process and retain documentation evidencing that management reviewed each expense charged to the federal program to ensure the cost is allowable. View of Responsible Officials: OU Medicine, Inc. agrees with the finding; however, the program has ended. Should OU Medicine, Inc. receive funding in the future, management will implement procedures to ensure documentation of executing the controls is retained.
Finding 2023-003
Finding 2023-003 – Internal Control Deficiency Over Activities Allowed/Allowable Costs and Reporting Identification of the federal program: Federal Grantor: Federal Grantor: United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) Assistance Listing No.: Provider Relief Fund and American Rescue Plan (ARP) Rural Distributions Award Period of Performance: January 1, 2020–June 30, 2023 Criteria or Specific Requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Per discussion with management, OU Medicine, Inc. has processes and internal controls in place to comply with the terms and conditions of the award and the reporting requirements. However, management did not retain documentation evidencing the performance of these controls. Cause: OU Medicine, Inc. did not consistently retain documentation to evidence the performance of internal controls demonstrating it could comply with the terms and conditions and reporting requirements of the federal program. Effect or potential effect: Documentation is not complete to support the performance of internal controls. Questioned Costs: $0 Context: Management did not retain evidence demonstrating the controls for accepting the terms and conditions of the award and reporting. Identification as a repeat finding, if applicable: The finding is not a repeat finding. Recommendation: OU Medicine, Inc. should refine its process and retain documentation evidencing that controls were in place to ensure compliance with grant requirements. View of Responsible Officials: OU Medicine, Inc. agrees with the finding; however, the program has ended. Should OU Medicine, Inc. receive funding in the future, management will implement procedures to ensure documentation of executing the controls is retained.
Finding 2023-002
Finding 2023-002 – Internal Control Deficiency Over Activities Allowed or Unallowed and Activities Allowed/Allowable Costs Identification of the federal program: Federal Grantor: Department of Homeland Security; Federal Emergency Management Agency (FEMA) Assistance Listing No.: 97.036, Disaster Grants – Public Assistance (Presidentially Declared Disasters) Award Period of Performance: January 20, 2020–various dates through 2023 depending on the individual project worksheets Criteria or Specific Requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework,” issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Per discussion with management, OU Medicine, Inc. has processes and internal controls in place to ensure personnel expenses submitted to the FEMA program were allowable COVID-19-related expenses. These internal controls include ensuring completeness and accuracy of the expenses to ensure the expenses comply with the terms and conditions of the award. However, management did not consistently retain documentation evidencing the performance of these controls. Cause: OU Medicine, Inc. did not consistently retain documentation to evidence the performance of internal controls over personnel expenses charged to the federal program. Effect or potential effect: There is no consistent documentation to support the performance of internal controls for costs charged to the federal program. Questioned Costs: $0 Context: Total FEMA expenditures for Assistance Listing 97.036 were $1,818,602, of which $277,283 were personnel costs, of which management did not retain documentation of the performance of controls. Identification as a repeat finding, if applicable: The finding is a repeat finding of 2022-001. Recommendation: OU Medicine, Inc. should refine its process and retain documentation evidencing that management reviewed personnel expenses charged to the federal program to ensure the cost is allowable. View of Responsible Officials: OU Medicine, Inc. agrees with the finding; however, the program has ended. Should OU Medicine, Inc. receive funding in the future, management will implement procedures to ensure documentation of executing the controls is retained.
Finding 2023-001
Finding 2023-001 – Internal Control Deficiency Over Activities Allowed or Unallowed and Activities Allowed/Allowable Costs Identification of the federal program: Federal Grantor: Department of the Treasury Assistance Listing No.: 21.027, COVID-19 Coronavirus State and Local Fiscal Recovery Funds (CSLFRF) Award Period of Performance: March 2021–June 30, 2023 Criteria or Specific Requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework,” issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Per discussion with management, OU Medicine, Inc. has processes and internal controls in place to ensure expenses submitted to the CSLFRF program were allowable expenses per the grant agreement These internal controls include ensuring completeness and accuracy of the expenses to ensure the expenses comply with the terms and conditions of the award. However, management did not consistently retain documentation evidencing the performance of these controls. Cause: OU Medicine, Inc. did not consistently retain documentation to evidence the performance of internal controls over expenses charged to the federal program. Effect or potential effect: There is no consistent documentation to support the performance of internal controls for costs charged to the federal program. Questioned Costs: $0 Context: Total CSLFRF expenditures for Assistance Listing 21.027 were $44,000,000, of which management did not retain documentation of the performance of controls. Identification as a repeat finding, if applicable: The finding is not a repeat finding. Recommendation: OU Medicine, Inc. should refine its process and retain documentation evidencing that management reviewed each expense charged to the federal program to ensure the cost is allowable. View of Responsible Officials: OU Medicine, Inc. agrees with the finding; however, the program has ended. Should OU Medicine, Inc. receive funding in the future, management will implement procedures to ensure documentation of executing the controls is retained.
Finding 2023-003
Finding 2023-003 – Internal Control Deficiency Over Activities Allowed/Allowable Costs and Reporting Identification of the federal program: Federal Grantor: Federal Grantor: United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) Assistance Listing No.: Provider Relief Fund and American Rescue Plan (ARP) Rural Distributions Award Period of Performance: January 1, 2020–June 30, 2023 Criteria or Specific Requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Per discussion with management, OU Medicine, Inc. has processes and internal controls in place to comply with the terms and conditions of the award and the reporting requirements. However, management did not retain documentation evidencing the performance of these controls. Cause: OU Medicine, Inc. did not consistently retain documentation to evidence the performance of internal controls demonstrating it could comply with the terms and conditions and reporting requirements of the federal program. Effect or potential effect: Documentation is not complete to support the performance of internal controls. Questioned Costs: $0 Context: Management did not retain evidence demonstrating the controls for accepting the terms and conditions of the award and reporting. Identification as a repeat finding, if applicable: The finding is not a repeat finding. Recommendation: OU Medicine, Inc. should refine its process and retain documentation evidencing that controls were in place to ensure compliance with grant requirements. View of Responsible Officials: OU Medicine, Inc. agrees with the finding; however, the program has ended. Should OU Medicine, Inc. receive funding in the future, management will implement procedures to ensure documentation of executing the controls is retained.
Finding 2023-002
Finding 2023-002 – Internal Control Deficiency Over Activities Allowed or Unallowed and Activities Allowed/Allowable Costs Identification of the federal program: Federal Grantor: Department of Homeland Security; Federal Emergency Management Agency (FEMA) Assistance Listing No.: 97.036, Disaster Grants – Public Assistance (Presidentially Declared Disasters) Award Period of Performance: January 20, 2020–various dates through 2023 depending on the individual project worksheets Criteria or Specific Requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework,” issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: Per discussion with management, OU Medicine, Inc. has processes and internal controls in place to ensure personnel expenses submitted to the FEMA program were allowable COVID-19-related expenses. These internal controls include ensuring completeness and accuracy of the expenses to ensure the expenses comply with the terms and conditions of the award. However, management did not consistently retain documentation evidencing the performance of these controls. Cause: OU Medicine, Inc. did not consistently retain documentation to evidence the performance of internal controls over personnel expenses charged to the federal program. Effect or potential effect: There is no consistent documentation to support the performance of internal controls for costs charged to the federal program. Questioned Costs: $0 Context: Total FEMA expenditures for Assistance Listing 97.036 were $1,818,602, of which $277,283 were personnel costs, of which management did not retain documentation of the performance of controls. Identification as a repeat finding, if applicable: The finding is a repeat finding of 2022-001. Recommendation: OU Medicine, Inc. should refine its process and retain documentation evidencing that management reviewed personnel expenses charged to the federal program to ensure the cost is allowable. View of Responsible Officials: OU Medicine, Inc. agrees with the finding; however, the program has ended. Should OU Medicine, Inc. receive funding in the future, management will implement procedures to ensure documentation of executing the controls is retained.