Audit 402115

FY End
2025-09-30
Total Expended
$55.69M
Findings
2
Programs
46
Year: 2025 Accepted: 2026-05-26

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
1215474 2025-001 Material Weakness Yes E
1215475 2025-001 Material Weakness Yes E

Programs

ALN Program Spent Major Findings
97.036 DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $9.55M Yes 0
10.557 SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN $1.96M Yes 0
84.268 FEDERAL DIRECT STUDENT LOANS $1.75M Yes 1
93.394 CANCER DETECTION AND DIAGNOSIS RESEARCH $1.44M Yes 0
93.396 CANCER BIOLOGY RESEARCH $575,102 Yes 0
84.063 FEDERAL PELL GRANT PROGRAM $558,827 Yes 1
93.866 AGING RESEARCH $326,259 Yes 0
93.867 VISION RESEARCH $254,486 Yes 0
93.879 MEDICAL LIBRARY ASSISTANCE $166,796 Yes 0
93.350 NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES $129,415 Yes 0
93.185 IMMUNIZATION RESEARCH, DEMONSTRATION, PUBLIC INFORMATION AND EDUCATION_TRAINING AND CLINICAL SKILLS IMPROVEMENT PROJECTS $127,196 Yes 0
93.870 MATERNAL, INFANT AND EARLY CHILDHOOD HOME VISITING GRANT $117,660 Yes 0
47.076 EDUCATION AND HUMAN RESOURCES $112,673 Yes 0
93.838 LUNG DISEASES RESEARCH $99,214 Yes 0
93.837 CARDIOVASCULAR DISEASES RESEARCH $98,233 Yes 0
93.846 ARTHRITIS, MUSCULOSKELETAL AND SKIN DISEASES RESEARCH $90,135 Yes 0
93.RD National Institute of Health $82,337 Yes 0
93.103 FOOD AND DRUG ADMINISTRATION_RESEARCH $76,160 Yes 0
93.073 BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES - PREVENTION AND SURVEILLANCE $67,529 Yes 0
93.286 DISCOVERY AND APPLIED RESEARCH FOR TECHNOLOGICAL INNOVATIONS TO IMPROVE HUMAN HEALTH $62,907 Yes 0
93.361 NURSING RESEARCH $57,298 Yes 0
93.110 MATERNAL AND CHILD HEALTH FEDERAL CONSOLIDATED PROGRAMS $54,624 Yes 0
93.855 ALLERGY, IMMUNOLOGY AND TRANSPLANTATION RESEARCH $54,007 Yes 0
93.393 CANCER CAUSE AND PREVENTION RESEARCH $53,143 Yes 0
84.007 FEDERAL SUPPLEMENTAL EDUCATIONAL OPPORTUNITY GRANTS $40,000 Yes 0
93.273 ALCOHOL RESEARCH PROGRAMS $38,539 Yes 0
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $35,237 Yes 0
93.279 DRUG ABUSE AND ADDICTION RESEARCH PROGRAMS $33,891 Yes 0
93.061 INNOVATIONS IN APPLIED PUBLIC HEALTH RESEARCH $32,431 Yes 0
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $30,000 Yes 0
93.113 ENVIRONMENTAL HEALTH $29,785 Yes 0
93.839 BLOOD DISEASES AND RESOURCES RESEARCH $28,089 Yes 0
93.307 MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH $26,383 Yes 0
84.033 FEDERAL WORK-STUDY PROGRAM $25,985 Yes 0
12.420 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $23,806 Yes 0
93.077 FAMILY SMOKING PREVENTION AND TOBACCO CONTROL ACT REGULATORY RESEARCH $19,945 Yes 0
93.847 DIABETES, DIGESTIVE, AND KIDNEY DISEASES EXTRAMURAL RESEARCH $18,845 Yes 0
93.310 TRANS-NIH RESEARCH SUPPORT $18,005 Yes 0
93.121 ORAL DISEASES AND DISORDERS RESEARCH $16,720 Yes 0
93.213 RESEARCH AND TRAINING IN COMPLEMENTARY AND INTEGRATIVE HEALTH $9,590 Yes 0
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $7,979 Yes 0
93.399 CANCER CONTROL $3,000 Yes 0
93.395 CANCER TREATMENT RESEARCH $2,088 Yes 0
93.283 CENTERS FOR DISEASE CONTROL AND PREVENTION_INVESTIGATIONS AND TECHNICAL ASSISTANCE $-3,153 Yes 0
93.421 STRENGTHENING PUBLIC HEALTH SYSTEMS AND SERVICES THROUGH NATIONAL PARTNERSHIPS TO IMPROVE AND PROTECT THE NATION’S HEALTH $-4,968 Yes 0
93.226 RESEARCH ON HEALTHCARE COSTS, QUALITY AND OUTCOMES $-73,105 Yes 0

Contacts

Name Title Type
MY2ERHGDV956 Andrew Devoe Auditee
6176360656 Michael Sorelle Auditor
No contacts on file

Notes to SEFA

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, 2025, 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.
The System has elected not to use the 15% 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 2025 were based on approved rates as received from DHHS.
As of September 30, 2025, there were no loans outstanding to students under federal programs, as the Nursing Student Loan Program had been discontinued. 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.
During the year ended September 30, 2025, the System did not receive any donated medical equipment from a federal awarding agency.
The System applied for reimbursement of certain expenses related to the COVID-19 pandemic under Assistance Listing Number 97.036, FEMA Public Assistance through the Commonwealth of Massachusetts. Expenditures thus includes $9,533,161 of expenditures incurred in fiscal years 2022 through 2024, which were obligated in fiscal year 2025 and represents a reconciling item between the federal expenses in the System's financial statements and the amount included on the Schedule.

Finding Details

Finding 2025-001 – Incorrect student status Student Financial Assistance Cluster (ALNs: 84.063 and 84.268) Compliance Requirement: Eligibility Criteria - Federal regulations governing the Student Financial Assistance (SFA) programs require institutions to accurately determine and document student eligibility, including enrollment status, prior to disbursement of federal financial aid. Condition - During testing of six student academic files selected for compliance with eligibility requirements, we identified three instances (50%) in which student status was incorrectly reported and/or not supported by appropriate documentation. Student enrollment status was not recorded within the National Student Loan Data System (NSLDS) to match supporting academic records from the school’s academic system (e.g., registrar documentation or transcripts) Cause - The condition was primarily attributable to staff turnover associated with the closure/termination of the Lawrence Memorial Hospital School of Nursing, which resulted in loss of personnel responsible for maintaining and verifying student eligibility information and disruption in established processes for updating and reviewing enrollment status. As a result, key eligibility determination and review controls were not performed consistently during the period under audit. Effect - The System is at risk of disbursing federal funds to ineligible students or awarding incorrect amounts. There is also an increased likelihood of noncompliance with federal eligibility requirements. In addition, absence of effective controls increases the risk that errors will not be detected or prevented on a timely basis. We did not quantify questioned costs for these exceptions; however, due to the nature of the errors, questioned costs may exist and could be material when extrapolated to the population. Recommendation - We recommend that management strengthen internal controls over eligibility determination and student status reporting by: • Implementing formal procedures to ensure student enrollment status is accurately recorded and timely updated, • Establishing a secondary review control over eligibility determinations prior to aid disbursement, • Developing transition/contingency procedures to maintain control effectiveness during periods of staffing changes or organizational disruption, and • Correcting any incorrect student status identified within NSLDS timely. Views of Responsible Officials and Planned Corrective Action - See Corrective Action Plan