Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Federal Program:
Provider Relief Fund and American Rescue Plan Rural Distribution
ALN:
93.498
Federal Agency:
U.S. Department of Health and Human Services
Federal Award Years:
July 1, 2023 to September 30, 2023 and January 1, 2024 to March 31, 2024.Criteria:
45 CFR section 75.303 (a) states non-federal entities must:
Establish and maintain effective internal control over the Federal award that provides reasonable
assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes,
regulations, and the terms and conditions of the Federal award. These internal controls should be in
compliance with guidance in “Standards for Internal Control in the Federal Government,” issued by the
Comptroller General of the United States or the “Internal Control Integrated Framework,” issued by the
Committee of Sponsoring Organizations of the Treadway Commission (COSO).
45 CFR section 75.303 (b) states non-federal entities must:
Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards.
Recipients of provider relief funds must support all expenses with adequate documentation and maintain
proper control documentation to substantiate that these funds were used for health care-related expenses
or lost revenues attributable to coronavirus.
Condition Found, Including Perspective:
There is not sufficient documentation to evidence management’s review of the HRSA portal submission
prior to submission to the U.S. Department of Health and Human Services.
Possible Cause and Effect:
While Grady Memorial Hospital Corporation maintains that appropriate management review did take place
prior to the portal submission, controls were not designed or implemented effectively to maintain evidence
of management’s review. Formal documentation of the review occurred subsequent to the HRSA portal
submission.
Questioned Costs:
None. Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
Yes: Finding 2022-002 – Reporting
Recommendation
We recommend that management implement appropriate controls and processes to review the grant
reports prior to submission and to provide evidence of the related review.
Views of Responsible Officials:
Grady Memorial Hospital Corporation has implemented controls and processes to ensure grant reports are
reviewed prior to submission and that evidence of review is maintained.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Finding 2023-002 – SEFA Reporting
Federal Program:
COVID-19 Coronavirus State and Local Fiscal Recovery Funds
Medicaid Assistance Program
HIV Emergency Relief Project Grants
ALNs:
21.027
93.778
93.914
Federal Agency:
U.S. Department of Treasury
U.S. Department of Health and Human Services
Federal Award Years:
January 1, 2023 – December 31, 2023
Criteria:
2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of
Federal awards for the period covered by the auditee’s financial statements which must include the total
Federal awards expended as determined in accordance with §200.502.
Condition Found, Including Perspective:
The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain
differences between federal expenditures reported and the years in which the federal awards were
expended totaling $2,790,267 related to the COVID-10 Coronavirus State and Local Fiscal Recovery
Funds, $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency
Relief Project Grants. Possible Cause and Effect:
While the System performs a review during the compilation of the SEFA, controls were not designed or
implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in
which they were expended. Questioned Costs:
None.
Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
This is not a repeat finding.
Recommendation
We recommend that management implement appropriate controls and processes to ensure that
expenditures are presented on the correct SEFA year.
Views of Responsible Officials:
Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are
properly reflected on the SEFA.
Federal Program:
Provider Relief Fund and American Rescue Plan Rural Distribution
ALN:
93.498
Federal Agency:
U.S. Department of Health and Human Services
Federal Award Years:
July 1, 2023 to September 30, 2023 and January 1, 2024 to March 31, 2024.Criteria:
45 CFR section 75.303 (a) states non-federal entities must:
Establish and maintain effective internal control over the Federal award that provides reasonable
assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes,
regulations, and the terms and conditions of the Federal award. These internal controls should be in
compliance with guidance in “Standards for Internal Control in the Federal Government,” issued by the
Comptroller General of the United States or the “Internal Control Integrated Framework,” issued by the
Committee of Sponsoring Organizations of the Treadway Commission (COSO).
45 CFR section 75.303 (b) states non-federal entities must:
Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards.
Recipients of provider relief funds must support all expenses with adequate documentation and maintain
proper control documentation to substantiate that these funds were used for health care-related expenses
or lost revenues attributable to coronavirus.
Condition Found, Including Perspective:
There is not sufficient documentation to evidence management’s review of the HRSA portal submission
prior to submission to the U.S. Department of Health and Human Services.
Possible Cause and Effect:
While Grady Memorial Hospital Corporation maintains that appropriate management review did take place
prior to the portal submission, controls were not designed or implemented effectively to maintain evidence
of management’s review. Formal documentation of the review occurred subsequent to the HRSA portal
submission.
Questioned Costs:
None. Statistical Validity:
The sample was not intended to be, and was not, a statistically valid sample.
Repeat Finding in the Prior Year:
Yes: Finding 2022-002 – Reporting
Recommendation
We recommend that management implement appropriate controls and processes to review the grant
reports prior to submission and to provide evidence of the related review.
Views of Responsible Officials:
Grady Memorial Hospital Corporation has implemented controls and processes to ensure grant reports are
reviewed prior to submission and that evidence of review is maintained.