Audit 310888

FY End
2023-09-30
Total Expended
$134.91M
Findings
2
Programs
45
Year: 2023 Accepted: 2024-06-28

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
404103 2023-001 - - L
980545 2023-001 - - L

Programs

ALN Program Spent Major Findings
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $79.01M - 0
93.498 Provider Relief Fund $16.67M Yes 1
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $1.79M - 0
84.268 Federal Direct Student Loans $1.66M - 0
93.867 Vision Research $367,735 Yes 0
84.063 Federal Pell Grant Program $352,957 - 0
93.361 Nursing Research $286,689 Yes 0
84.425F Education Stabilization Fund $262,841 - 0
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $248,420 Yes 0
93.226 Research on Healthcare Costs, Quality and Outcomes $188,770 Yes 0
93.350 National Center for Advancing Translational Sciences $165,228 Yes 0
93.865 Child Health and Human Development Extramural Research $160,852 Yes 0
93.839 Blood Diseases and Resources Research $139,362 Yes 0
93.395 Cancer Treatment Research $138,702 Yes 0
93.283 Centers for Disease Control and Prevention_investigations and Technical Assistance $119,365 Yes 0
93.RD National Institute of Health $102,144 Yes 0
93.103 Food and Drug Administration_research $84,487 Yes 0
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $82,026 - 0
47.076 Education and Human Resources $61,098 Yes 0
93.310 Trans-Nih Research Support $55,210 Yes 0
93.121 Oral Diseases and Disorders Research $53,543 Yes 0
93.855 Allergy, Immunology and Transplantation Research $49,080 Yes 0
93.866 Aging Research $48,488 Yes 0
93.110 Maternal and Child Health Federal Consolidated Programs $47,600 Yes 0
64.054 Research and Development $41,679 Yes 0
84.007 Federal Supplemental Educational Opportunity Grants $40,000 - 0
93.279 Drug Abuse and Addiction Research Programs $37,555 Yes 0
93.838 Lung Diseases Research $35,033 Yes 0
84.033 Federal Work-Study Program $34,916 - 0
93.213 Research and Training in Complementary and Integrative Health $25,655 Yes 0
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $25,006 Yes 0
47.070 Computer and Information Science and Engineering $23,448 Yes 0
93.113 Environmental Health $23,165 Yes 0
93.393 Cancer Cause and Prevention Research $22,646 Yes 0
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $20,108 Yes 0
93.307 Minority Health and Health Disparities Research $19,590 Yes 0
12.420 Military Medical Research and Development $14,770 Yes 0
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $14,019 Yes 0
93.394 Cancer Detection and Diagnosis Research $7,703 Yes 0
93.396 Cancer Biology Research $6,174 Yes 0
93.399 Cancer Control $5,000 Yes 0
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $3,754 Yes 0
93.185 Immunization Research, Demonstration, Public Information and Education_training and Clinical Skills Improvement Projects $2,806 Yes 0
93.273 Alcohol Research Programs $1,571 Yes 0
93.837 Cardiovascular Diseases Research $704 Yes 0

Contacts

Name Title Type
MY2ERHGDV956 Andrew Devoe Auditee
6176360656 Stacy Andreotes Auditor
No contacts on file

Notes to SEFA

Title: 1. BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the “System”). Operations related to the System’s federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS). Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program Clusters—For the year ended September 30, 2023, the following program clusters were identified: • Research and Development • Student Financial Assistance Major Programs—Major programs are identified in the summary of auditor’s results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2023 were based on approved rates as received from DHHS. The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the “System”). Operations related to the System’s federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS). Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program Clusters—For the year ended September 30, 2023, the following program clusters were identified: • Research and Development • Student Financial Assistance Major Programs—Major programs are identified in the summary of auditor’s results section of the schedule of findings and questioned costs.
Title: 2. SUMMARY OF FACILITIES AND ADMINISTRATIVE COST RECOVERIES Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the “System”). Operations related to the System’s federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS). Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program Clusters—For the year ended September 30, 2023, the following program clusters were identified: • Research and Development • Student Financial Assistance Major Programs—Major programs are identified in the summary of auditor’s results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2023 were based on approved rates as received from DHHS. The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2023 were based on approved rates as received from DHHS.
Title: 3.FEDERAL STUDENT LOAN PROGRAMS Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the “System”). Operations related to the System’s federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS). Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program Clusters—For the year ended September 30, 2023, the following program clusters were identified: • Research and Development • Student Financial Assistance Major Programs—Major programs are identified in the summary of auditor’s results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2023 were based on approved rates as received from DHHS. Loans outstanding to students under federal programs at September 30, 2023, are summarized as follows:  Nursing Student Loan Program: $163,382 Federal Family Education loans are administered by outside financial institutions, and balances and transactions relating to these programs are not included in the System’s consolidated financial statements.
Title: 4.AUDITED ENTITIES FOR SINGLE AUDIT REPORTING Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the “System”). Operations related to the System’s federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS). Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program Clusters—For the year ended September 30, 2023, the following program clusters were identified: • Research and Development • Student Financial Assistance Major Programs—Major programs are identified in the summary of auditor’s results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2023 were based on approved rates as received from DHHS. During the year ended September 30, 2023, all entities under the System who received federal funding from the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution with periods of availability from July 1, 2021, through June 30, 2022 are summarized, by tax identification number (TIN), as follows: 27-3902914 Circle Health Physicians, Inc. 04-2103812 Circle Home, Inc. 04-3140938 Hallmark Health Medical Associates 04-2437064 Hallmark Health Visting Nurse Association, Inc. 04-2435675 Home Health VNA, Inc. 04-2767880 MelroseWakefield Healthcare, Inc. 04-3024278 Merrimack Valley Hospice, Inc 04-3148395 Pratt Anesthesiology Associates 04-2743894 Pratt Medical Group Inc 04-3148384 Pratt Neurology Associates 04-3096445 Pratt Neurosurgical Associates 04-3148385 Pratt OB GYN Associates 04-3148392 Pratt Opthalmology Associates 20-5129051 Pratt Othopaedic Associates 04-3148381 Pratt Otolaryngology 04-3148393 Pratt Pathology Associates 04-3148394 Pratt Pediatric Associates 04-3148389 Pratt Radiation Oncology Associates 04-3148388 Pratt Radiology Associates 04-3148378 Pratt Rehabiliation Medicine 04-3148376 Pratt Surgical Associates 04-3148379 Pratt Urology Associates 04-2103590 The Lowell General Hospital 04-3400617 Tufts Medical Center, Inc.
Title: 5. DONATED MEDICAL EQUIPMENT (UNAUDITED) Accounting Policies: The accompanying schedule of expenditures of federal awards presents the activity of federal financial assistance and federal cost-reimbursement contracts of Tufts Medicine, Inc. and affiliates (the “System”). Operations related to the System’s federal grant programs are included in the scope of Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. The federal oversight agency for the System is the Department of Health and Human Services (DHHS). Expenditures related to federal grant funds are recorded on the accrual basis of accounting. Program Clusters—For the year ended September 30, 2023, the following program clusters were identified: • Research and Development • Student Financial Assistance Major Programs—Major programs are identified in the summary of auditor’s results section of the schedule of findings and questioned costs. De Minimis Rate Used: N Rate Explanation: The System has elected not to use the 10% indirect cost rate allowed under the Uniform Guidance, and instead uses the modified total direct cost basis to determine the facilities and administrative rate. The rates used during 2023 were based on approved rates as received from DHHS. During the year ended September 30, 2023, the System did not receive any donated medical equipment from a federal awarding agency.

Finding Details

FINDING 2023-001 – LOST REVENUE REPORTING Criteria As published in the October 27, 2022 Post-Payment Notice of Reporting Requirements, recipients who received one or more ARP Rural Distribution payments exceeding $10,000 in the aggregate during a Payment Received Period are required to report in each applicable Reporting Time Period. For General Distribution Payments: A parent entity may report on its subsidiaries’ General Distribution payments regardless of whether the subsidiary TINs received the General Distribution payments directly from HRSA or whether General Distribution payments were transferred to them by the parent entity. The parent entity may report on these General Distribution payments regardless of whether the parent or the subsidiary attested to the Terms and Conditions. Condition Tufts Medicine received PRF funding between January 1, 2022 and June 30, 2022 and, therefore, was required to submit information for Reporting Period 5. All of the funds received during the time period were General Distribution funds. Therefore, Tufts Medicine, as the parent entity, was permitted to submit Reporting Period 5 on behalf of its subsidiaries. Tufts Medicine, as the parent entity, submitted Reporting Period 1, Reporting Period 2, Reporting Period 3, and Reporting Period 4 on behalf of its subsidiaries for all General Distribution funds received. Cause As a result of a change in staffing and internal miscommunication, Home Health Visiting Nurse Association (VNA) erroneously filed Reporting Period 5 separately from the Tufts Medicine filing, with data inconsistent with the previous filings and methodology. Effect The filing was not able to be removed or amended prior to the September 30, 2023 deadline. Consequently, the Tufts Medicine filing was not able to be submitted with the EIN of Home Health VNA. In order to file for all entities timely, the Home Health VNA EIN was excluded from the Tufts Medicine filing, but all financial data was included in the supporting lost revenue calculation. Recommendation The System should design and implement appropriate internal controls to comply with the reporting requirements, specifically to designate only certain personnel to be responsible for the PRF submissions to prevent any unauthorized submissions. Views of Responsible Officials See Corrective Action Plan
FINDING 2023-001 – LOST REVENUE REPORTING Criteria As published in the October 27, 2022 Post-Payment Notice of Reporting Requirements, recipients who received one or more ARP Rural Distribution payments exceeding $10,000 in the aggregate during a Payment Received Period are required to report in each applicable Reporting Time Period. For General Distribution Payments: A parent entity may report on its subsidiaries’ General Distribution payments regardless of whether the subsidiary TINs received the General Distribution payments directly from HRSA or whether General Distribution payments were transferred to them by the parent entity. The parent entity may report on these General Distribution payments regardless of whether the parent or the subsidiary attested to the Terms and Conditions. Condition Tufts Medicine received PRF funding between January 1, 2022 and June 30, 2022 and, therefore, was required to submit information for Reporting Period 5. All of the funds received during the time period were General Distribution funds. Therefore, Tufts Medicine, as the parent entity, was permitted to submit Reporting Period 5 on behalf of its subsidiaries. Tufts Medicine, as the parent entity, submitted Reporting Period 1, Reporting Period 2, Reporting Period 3, and Reporting Period 4 on behalf of its subsidiaries for all General Distribution funds received. Cause As a result of a change in staffing and internal miscommunication, Home Health Visiting Nurse Association (VNA) erroneously filed Reporting Period 5 separately from the Tufts Medicine filing, with data inconsistent with the previous filings and methodology. Effect The filing was not able to be removed or amended prior to the September 30, 2023 deadline. Consequently, the Tufts Medicine filing was not able to be submitted with the EIN of Home Health VNA. In order to file for all entities timely, the Home Health VNA EIN was excluded from the Tufts Medicine filing, but all financial data was included in the supporting lost revenue calculation. Recommendation The System should design and implement appropriate internal controls to comply with the reporting requirements, specifically to designate only certain personnel to be responsible for the PRF submissions to prevent any unauthorized submissions. Views of Responsible Officials See Corrective Action Plan