Audit 301691

FY End
2023-06-30
Total Expended
$67.44M
Findings
38
Programs
34
Organization: Avera Health (SD)
Year: 2023 Accepted: 2024-04-01
Auditor: Eide Bailly LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
391081 2023-002 Material Weakness - P
391082 2023-003 Significant Deficiency - ABH
391083 2023-004 Significant Deficiency - AB
391084 2023-005 Significant Deficiency - AB
391085 2023-005 Significant Deficiency - AB
391086 2023-005 Significant Deficiency - AB
391087 2023-005 Significant Deficiency - AB
391088 2023-005 Significant Deficiency - AB
391089 2023-005 Significant Deficiency - AB
391090 2023-005 Significant Deficiency - AB
391091 2023-005 Significant Deficiency - AB
391092 2023-005 Significant Deficiency - AB
391093 2023-005 Significant Deficiency - AB
391094 2023-005 Significant Deficiency - AB
391095 2023-005 Significant Deficiency - AB
391096 2023-005 Significant Deficiency - AB
391097 2023-005 Significant Deficiency - AB
391098 2023-005 Significant Deficiency - AB
391099 2023-006 Significant Deficiency - AB
967523 2023-002 Material Weakness - P
967524 2023-003 Significant Deficiency - ABH
967525 2023-004 Significant Deficiency - AB
967526 2023-005 Significant Deficiency - AB
967527 2023-005 Significant Deficiency - AB
967528 2023-005 Significant Deficiency - AB
967529 2023-005 Significant Deficiency - AB
967530 2023-005 Significant Deficiency - AB
967531 2023-005 Significant Deficiency - AB
967532 2023-005 Significant Deficiency - AB
967533 2023-005 Significant Deficiency - AB
967534 2023-005 Significant Deficiency - AB
967535 2023-005 Significant Deficiency - AB
967536 2023-005 Significant Deficiency - AB
967537 2023-005 Significant Deficiency - AB
967538 2023-005 Significant Deficiency - AB
967539 2023-005 Significant Deficiency - AB
967540 2023-005 Significant Deficiency - AB
967541 2023-006 Significant Deficiency - AB

Programs

ALN Program Spent Major Findings
93.498 Provider Relief Fund $39.98M Yes 2
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $9.39M Yes 1
93.697 Covid-19 Testing for Rural Health Clinics $2.10M Yes 1
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $1.40M - 0
16.582 Crime Victim Assistance/discretionary Grants $1.28M - 0
10.855 Distance Learning and Telemedicine Loans and Grants $860,254 - 0
93.279 Drug Abuse and Addiction Research Programs $498,726 Yes 1
93.393 Cancer Cause and Prevention Research $435,993 Yes 1
93.884 Grants for Primary Care Training and Enhancement $416,480 - 0
20.509 Formula Grants for Rural Areas and Tribal Transit Program $302,469 - 0
93.155 Rural Health Research Centers $293,589 - 0
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $245,812 - 0
93.211 Telehealth Programs $199,755 - 0
93.838 Lung Diseases Research $198,636 Yes 1
21.027 Coronavirus State and Local Fiscal Recovery Funds $185,714 - 0
93.395 Cancer Treatment Research $154,575 - 0
93.301 Small Rural Hospital Improvement Grant Program $117,099 - 0
93.359 Nurse Education, Practice Quality and Retention Grants $117,065 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $93,480 Yes 1
93.865 Child Health and Human Development Extramural Research $58,504 Yes 1
93.136 Injury Prevention and Control Research and State and Community Based Programs $57,316 Yes 1
93.461 Covid-19 Testing for the Uninsured $50,423 - 0
16.575 Crime Victim Assistance $47,000 - 0
10.331 Food Insecurity Nutrition Incentive Grants Program $46,943 Yes 1
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $29,447 - 0
93.837 Cardiovascular Diseases Research $25,417 Yes 1
93.268 Immunization Cooperative Agreements $13,790 - 0
93.994 Maternal and Child Health Services Block Grant to the States $10,195 - 0
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $8,146 - 0
93.310 Trans-Nih Research Support $7,042 Yes 1
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $5,137 Yes 1
45.025 Promotion of the Arts_partnership Agreements $1,600 - 0
93.800 Organized Approaches to Increase Colorectal Cancer Screening $661 - 0
93.069 Public Health Emergency Preparedness $462 - 0

Contacts

Name Title Type
N3MLDJDPQAA3 John Neth Auditee
6053224588 Ashley Brandt-Duda Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting, except for subrecipient expenditures, which are recorded on the cash basis. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: Avera Health and Avera McKennan have negotiated indirect rates. All other sponsored organizations of the Organization have elected to use the 10% de minimis cost rate. The accompanying consolidated schedule of expenditures of federal awards (the schedule) includes the federal award activity of Avera Health (Organization) under programs of the federal government for the year ended June 30, 2023. The information 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 the Organization, it is not intended to and does not present the consolidated balance sheet, consolidated statement of operations, consolidated changes in net assets or consolidated cash flows of the Organization.
Title: WIC Special Supplemental Nutrition Program for Women, Infants, and Children Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting, except for subrecipient expenditures, which are recorded on the cash basis. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: Avera Health and Avera McKennan have negotiated indirect rates. All other sponsored organizations of the Organization have elected to use the 10% de minimis cost rate. Federal reimbursements for the WIC Special Supplemental Nutrition Program for Women, Infants, and Children, CFDA #10.557, are not based upon specific expenditures. Therefore, the amounts reported in the consolidated schedule of expenditures of federal awards represent cash received rather than federal expenditures.
Title: Principles of Consolidation Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting, except for subrecipient expenditures, which are recorded on the cash basis. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: Avera Health and Avera McKennan have negotiated indirect rates. All other sponsored organizations of the Organization have elected to use the 10% de minimis cost rate. The consolidated schedule of expenditures of federal awards includes the federal grant activity of Avera Health and its consolidated subsidiaries (collectively, Avera Health) which received federal financial assistance. Significant intercompany balances and transactions have been eliminated in the consolidated schedule of expenditures of federal awards. The following entities and their associated TIN numbers included within the schedule are as follows: Avera At Home – TIN#460399291, Avera Holy Family – TIN#420680370, Avera Health – TIN#460422673, Avera St. Anthony’s – TIN#470463911, Avera St. Benedict’s – TIN#460226738, Avera Sacred Heart Hospital – TIN#460225483, Avera St. Luke’s – TIN#460224598, Avera St. Mary’s – TIN#460230199, Avera Gettysburg – TIN#460234354, Avera Granite Falls – TIN#843156881, Avera McKennan – TIN#460224743, Avera Marshall – TIN#410919153, Avera Queen of Peace – TIN#460224604, Avera Tyler – TIN#410853163, and Heart Hospital of South Dakota – TIN#562143771.
Title: Provider Relief Fund and American Rescue Plan Rural Distribution Accounting Policies: Expenditures reported in the schedule are reported on the accrual basis of accounting, except for subrecipient expenditures, which are recorded on the cash basis. When applicable, such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: Both Rate Explanation: Avera Health and Avera McKennan have negotiated indirect rates. All other sponsored organizations of the Organization have elected to use the 10% de minimis cost rate. The Organization received amounts from the U.S. Department of Health and Human Services (HHS) through the Provider Relief Fund and American Rescue Plan Rural Distribution (PRF) program (Federal Financial Assistance Listing/CFDA #93.498) during the years ended June 30, 2023 and 2022, and 2021. The PRF expenditures were not recognized on the schedule until the expenditures were included in the reporting to HHS for the funds received between July 1, 2021 and June 30, 2022, as required under the PRF program. The Organization recorded $39,983,100 of Provider Relief Funds and American Rescue Plan Rural Distribution Funds on the Schedule of Expenditures of Federal Awards as of June 30, 2023.

Finding Details

Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Funds and American Rescue Plan (ARP) Rural Distribution Preparation of the Consolidated Schedule of Expenditures of Federal Awards Material Weakness in Internal Control over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (the Schedule) and the accompanying notes to the Schedule. Condition: Management prepared the Schedule for the year ended June 30, 2023. During the audit process, changes were proposed to increase the amount reported related to the COVID-19 Provider Relief Funds and American Rescue Plan (ARP) Rural Distribution program. Cause: Controls that were in place did not detect a misstatement to the Schedule. Effect: There is a reasonable possibility that misstatements to the Schedule may not be prevented and detected in a timely fashion. Questioned Costs: None reported. Context: Sampling was not used. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the preparation of the Schedule. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Period of Performance Significant Deficiency in Internal Control over Compliance Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance 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. Condition: Our testing over activities allowed and allowable costs and period of performance identified one expenditure that fell outside of the period of performance under the grant and two expenditures that did not agree to supporting documentation. Cause: There was a lapse in oversight of the internal control process ensuring the expenditures allowed under the grant did not fall outside of the period of performance for the grant and agree to supporting documentation. Effect: The Organization’s control did not detect or correct the errors identified, which resulted in expenditures being allocated to the federal award that were outside of the period of performance and did not agree to supporting documentation. Questioned Costs: None reported. Context: A non-statistical sample of 60 transactions was selected for testing, which accounted for $1,019,224 of $2,100,000 of federal program expenditures. One expenditure was outside of the period of performance and two did not agree to supporting documentation. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the expenditures being claimed under the grant and ensuring the expenditures are within the proper period of performance and agree to supporting documentation. Views of Responsible Officials: Management agrees with the finding.
Department of Homeland Security Federal Financial Assistance Listing #97.036 Disaster Grants - Public Assistance Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where the internal control process failed to identify that the grant was charged at a rate of pay higher than the employee’s hourly approved rate of pay. Cause: There was a lapse in oversight of the internal control process ensuring an inaccurate rate of pay for an employee’s time being charged to the grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: A non-statistical sample of 34 transactions was selected for testing, which accounted for $3,450,395 of $9,388,052 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the expenditures being claimed under the grant to ensure payroll is being accurately charged using the correct rate of pay for employees. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance 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. Condition: Our testing over activities allowed and allowable costs identified four instances where the supporting documentation did not agree with the expenditures claimed in the expenditure listing for the program. Cause: There was a lapse in oversight of the internal control process ensuring the expenditures claimed in the special report to HHS agreed to supporting documentation. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None Reported Context: A non-statistical sample of 60 transactions was selected for testing, which accounted for $7,563,126 of $20,267,798 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the expenditure listings used to prepare the special reports submitted to HHS. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Funds and American Rescue Plan (ARP) Rural Distribution Preparation of the Consolidated Schedule of Expenditures of Federal Awards Material Weakness in Internal Control over Compliance - Other Criteria: Proper controls over financial reporting include the ability to prepare the consolidated schedule of expenditures of federal awards (the Schedule) and the accompanying notes to the Schedule. Condition: Management prepared the Schedule for the year ended June 30, 2023. During the audit process, changes were proposed to increase the amount reported related to the COVID-19 Provider Relief Funds and American Rescue Plan (ARP) Rural Distribution program. Cause: Controls that were in place did not detect a misstatement to the Schedule. Effect: There is a reasonable possibility that misstatements to the Schedule may not be prevented and detected in a timely fashion. Questioned Costs: None reported. Context: Sampling was not used. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the preparation of the Schedule. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #93.697 COVID-19 Testing and Mitigation for Rural Health Clinics Period of Performance Significant Deficiency in Internal Control over Compliance Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance 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. Condition: Our testing over activities allowed and allowable costs and period of performance identified one expenditure that fell outside of the period of performance under the grant and two expenditures that did not agree to supporting documentation. Cause: There was a lapse in oversight of the internal control process ensuring the expenditures allowed under the grant did not fall outside of the period of performance for the grant and agree to supporting documentation. Effect: The Organization’s control did not detect or correct the errors identified, which resulted in expenditures being allocated to the federal award that were outside of the period of performance and did not agree to supporting documentation. Questioned Costs: None reported. Context: A non-statistical sample of 60 transactions was selected for testing, which accounted for $1,019,224 of $2,100,000 of federal program expenditures. One expenditure was outside of the period of performance and two did not agree to supporting documentation. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the expenditures being claimed under the grant and ensuring the expenditures are within the proper period of performance and agree to supporting documentation. Views of Responsible Officials: Management agrees with the finding.
Department of Homeland Security Federal Financial Assistance Listing #97.036 Disaster Grants - Public Assistance Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where the internal control process failed to identify that the grant was charged at a rate of pay higher than the employee’s hourly approved rate of pay. Cause: There was a lapse in oversight of the internal control process ensuring an inaccurate rate of pay for an employee’s time being charged to the grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None reported. Context: A non-statistical sample of 34 transactions was selected for testing, which accounted for $3,450,395 of $9,388,052 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the expenditures being claimed under the grant to ensure payroll is being accurately charged using the correct rate of pay for employees. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance 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. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.
Department of Health and Human Services Federal Financial Assistance Listing #93.498 COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance 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. Condition: Our testing over activities allowed and allowable costs identified four instances where the supporting documentation did not agree with the expenditures claimed in the expenditure listing for the program. Cause: There was a lapse in oversight of the internal control process ensuring the expenditures claimed in the special report to HHS agreed to supporting documentation. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: None Reported Context: A non-statistical sample of 60 transactions was selected for testing, which accounted for $7,563,126 of $20,267,798 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the expenditure listings used to prepare the special reports submitted to HHS. Views of Responsible Officials: Management agrees with the finding.