Audit 356707

FY End
2024-09-30
Total Expended
$31.28M
Findings
2
Programs
15
Year: 2024 Accepted: 2025-05-20

Organization Exclusion Status:

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Contacts

Name Title Type
DAK5U8MA29G5 Alicia Bolton Auditee
3368328044 Jim Minessale Auditor
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Notes to SEFA

Title: 1. Basis of Presentation Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided where available. An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis. De Minimis Rate Used: N Rate Explanation: Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis. The accompanying Schedule of Expenditures of Federal and State Awards (the “Schedule”) includes the expenditures of The Moses H. Cone Memorial Hospital and affiliates (dba Cone Health) (the “Health System”) under programs of the federal and state governments for the year ended September 30, 2024. The information in the Schedule is presented in accordance with the provisions of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”) and the State Single Audit Implementation Act. Expenditures reported in the Schedule are reported on the accrual basis of accounting. This is consistent with the basis of accounting utilized in the preparation of the Heath System’s consolidated financial statements. For purposes of the Schedule, federal and state awards include all grants, contracts, and similar agreements entered into directly between the Health System and agencies and departments of the federal and state governments and all subawards to the Health System by nonfederal organizations pursuant to federal and state grants, contracts, and similar agreements. Assistance Listing Number (ALN) for federal programs and pass‐through Catalog of State Financial Assistance (CSFA) numbers for state programs and pass‐through numbers are provided when available.
Title: 2. Summary of Significant Accounting Policies for Federal and State Award Expenditures Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided where available. An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis. De Minimis Rate Used: N Rate Explanation: Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis. Expenditures reported in the Schedule are recognized following the cost accounting principles contained in OMB Circular A-110, Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations, and OASC-3, A Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. Assistance Listing Number (ALN) numbers and pass-through numbers are provided where available. An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are incurred. The Health System has elected not to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis.
Title: 3. Relationship to Federal Financial Reports Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided where available. An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis. De Minimis Rate Used: N Rate Explanation: Salaries, fringes, and other costs are charged to awards based upon utilization on a direct cost basis. The regulations and guidelines governing the preparation of federal financial reports vary by federal agency and among programs administered by the same agency. Accordingly, the amounts reported in the federal financial reports do not necessarily agree with the amounts reported in the accompanying Schedule, which is prepared as explained in Notes 1 and 2 above.

Finding Details

FINDING 2024-001 Significant Deficiency in Internal Controls Over Compliance – Reporting Federal Agency: Department of Treasury Pass through Grantor: Guilford County, North Carolina Federal Program(s): Coronavirus State and Local Fiscal Recovery Funds Assistance Listing Number(s): 21.027 Criteria: As per the grant agreement the Health System is to submit reports quarterly to the pass-through agency. Condition/Context: Of the two (2) quarterly reports sampled, there was no evidence of review for the sampled reports. Cause: Grant program managers meet in person to discuss reports prior to submission to the granting agency, but these discussions do not include documentation that reports have been reviewed prior to submission. Effect: The Health System could have submitted a report that is incomplete or contains inaccurate information. Questioned Costs: None. Recommendation: The Health System should enhance their control procedures such that the appropriate individuals are aware that review of the reports should be documented with either electronic or manual signature prior to submission to the granting agency(ies). Views of Responsible Officials: See Corrective Action Plan.
FINDING 2024-001 Significant Deficiency in Internal Controls Over Compliance – Reporting Federal Agency: Department of Treasury Pass through Grantor: Guilford County, North Carolina Federal Program(s): Coronavirus State and Local Fiscal Recovery Funds Assistance Listing Number(s): 21.027 Criteria: As per the grant agreement the Health System is to submit reports quarterly to the pass-through agency. Condition/Context: Of the two (2) quarterly reports sampled, there was no evidence of review for the sampled reports. Cause: Grant program managers meet in person to discuss reports prior to submission to the granting agency, but these discussions do not include documentation that reports have been reviewed prior to submission. Effect: The Health System could have submitted a report that is incomplete or contains inaccurate information. Questioned Costs: None. Recommendation: The Health System should enhance their control procedures such that the appropriate individuals are aware that review of the reports should be documented with either electronic or manual signature prior to submission to the granting agency(ies). Views of Responsible Officials: See Corrective Action Plan.