Audit 410999

FY End
2025-12-31
Total Expended
$16.21M
Findings
3
Programs
27
Organization: Inova Health System (VA)
Year: 2025 Accepted: 2026-09-15

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
1229761 2025-001 Material Weakness Yes I
1229762 2025-001 Material Weakness Yes I
1229763 2025-001 Material Weakness Yes I

Programs

ALN Program Spent Major Findings
12.750 UNIFORMED SERVICES UNIVERSITY MEDICAL RESEARCH PROJECTS $4.10M Yes 0
93.918 GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE $2.56M Yes 0
93.917 HIV CARE FORMULA GRANTS $2.17M Yes 0
93.939 HIV PREVENTION ACTIVITIES NON-GOVERNMENTAL ORGANIZATION BASED $1.02M Yes 1
93.153 COORDINATED SERVICES AND ACCESS TO RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND YOUTH $585,392 Yes 1
20.614 NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION (NHTSA) DISCRETIONARY SAFETY GRANTS AND COOPERATIVE AGREEMENTS $445,741 Yes 0
93.399 CANCER CONTROL $348,489 Yes 0
93.145 HIV-RELATED TRAINING AND TECHNICAL ASSISTANCE $285,160 Yes 1
16.753 CONGRESSIONALLY RECOMMENDED AWARDS $256,831 Yes 0
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $218,351 Yes 0
93.767 CHILDREN'S HEALTH INSURANCE PROGRAM $159,537 Yes 0
93.RD Population Health Research Support $134,318 Yes 0
93.866 AGING RESEARCH $131,819 Yes 0
93.121 ORAL DISEASES AND DISORDERS RESEARCH $85,571 Yes 0
93.RD NHLBI/Inova Pulmonary Vascular Program $61,516 Yes 0
93.RD NHLBI Graft Sample and Data Collection Project $56,812 Yes 0
93.914 HIV EMERGENCY RELIEF PROJECT GRANTS $36,818 Yes 0
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $36,247 Yes 0
93.279 DRUG USE AND ADDICTION RESEARCH PROGRAMS $27,861 Yes 0
93.838 LUNG DISEASES RESEARCH $20,625 Yes 0
93.RD Observational Prospective Study-The Diversification of the Pregnant Vaginal Microbiome $20,000 Yes 0
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $9,828 Yes 0
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $8,839 Yes 0
93.088 ADVANCING SYSTEM IMPROVEMENTS FOR KEY ISSUES IN WOMEN'S HEALTH $3,756 Yes 0
12.420 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $3,340 Yes 0
93.837 CARDIOVASCULAR DISEASES RESEARCH $3,232 Yes 0
93.RD NHLBI Graft Protocol Transition Support Services $2,494 Yes 0

Contacts

Name Title Type
WQCEDBM284L6 Christopher Smith Auditee
7034349230 Amber Auditor
No contacts on file

Notes to SEFA

The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) includes all federal grant activity of the Inova Health System (“IHS” or “System”) including federal awards passed through other agencies. The accompanying Schedule is presented using the accrual basis of accounting and 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).
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for Uniform Guidance awards. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 15% de minimis indirect cost rate election (previously 10%), however, IHS did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
IHS did not receive any noncash Federal assistance for the year ended December 31, 2025.

Finding Details

Federal Program Information Federal Agencies: Department of Health and Human Services (“HHS”) Awards: Assistance Listing 93.145 – HIV Related Training and Technical Assistance; Assistance Listing 93.153 – Coordinated Services and Access to Research for Women, Infants, Children, and Youth; Assistance Listing 93.939 – HIV Prevention Activities Non-Governmental Organization Based Pass-Through Entity: Assistance Listing 93.145 – University of Pittsburgh (93.145); N/A; N/A Pass-Through Entity Number: Assistance Listing 93.145 – Subaward AWD00009525; N/A; N/A Award Periods: Assistance Listing 93.145 – July 1, 2024 – June 30, 2025; July 1, 2025 – June 30, 2026; Assistance Listing 93.153 – August 1, 2024 – July 31, 2025; August 1, 2025 – July 31, 2026; Assistance Listing 93.939 – April 1, 2024 – March 31, 2025; July 1, 2024 – June 30, 2025; April 1, 2025 – March 31, 2026; July 1, 2025 – June 30, 2026 Section III – Federal Award Findings and Questioned Costs (continued) Criteria In accordance with Title 2 U.S. Code of Federal Regulations, Part 200.303, Internal controls, “The Non-Federal entity must: (a) 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).” Condition Management, through the use of a service provider, validates that vendors are reviewed on a monthly basis to ensure they are not suspended or debarred. There was insufficient evidence to support management’s control activities addressing completeness and accuracy of the vendor list provided to the service provider to check for suspension and debarment. Specifically, in the evaluation of the design of the control in operation during 2025, we noted the following: 1. Lack of evidence retained of management’s review of the system generated master vendor listing used as input data prior to validation for the control. 2. Lack of second-level review over manual manipulation and filtering of data in the preparation of the master vendor listing prior to screening. 3. Incomplete identification of vendors subject to federal suspension and debarment requirements. 4. Lack of evidence retained of management’s considerations around the completeness and accuracy of information used in the exercise of the control by the service provider. Cause The System did not perform a review or retain documentation to support the completeness and accuracy of the master vendor list used for suspension and debarment. Effect or potential effect The vendor list used for suspension and debarment screening may not be complete and accurate, increasing the risk that vendors or contractors subject to federal suspension and debarment are not identified before expending federal funds. Section III – Federal Award Findings and Questioned Costs (continued) Questioned costs None. Identification of a repeat finding Not a repeat finding. Context The System utilizes a third-party service provider to perform suspension and debarment screenings. Under the System's policy, all vendors providing goods or services to federally funded programs are required to be included in the suspension and debarment screening process. Given we were aware of the conditions and cause mentioned above at the time of testing, our testing included 100% of the vendors for each of the major programs. We noted control exceptions for the major programs summarized below: • Assistance Listing 93.145 – HIV–Related Training and Technical Assistance: We identified two vendors, which throughout the audit period were not subject to the System’s search of exclusion lists for suspension and debarment. Transactions under these vendors for the period under audit totalled $1,156, which is not material to the major program. A subsequent search for these vendors for the period under audit did not yield any matches, indicating these control failures did not result in a compliance exceptions. • Assistance Listing 93.153 – Coordinated Services and Access to Research for Women, Infants, Children, and Youth: No exceptions were identified. • Assistance Listing 93.939 – HIV Prevention Activities Non–Governmental Organization Based: We identified one vendor that throughout the audit period was not subject to the System’s search of exclusion lists for suspension and debarment. Transactions under this vendor for the period under audit totalled $1,500, which is not material to the major program. A subsequent search for the vendor for the period under audit did not yield any matches, indicating these control failures did not result in a compliance exception. Given the control deficiency relates to the process used to identify vendors to be included in the screening population, the deficiency impacts the control's ability to operate effectively across the major programs above that were subject to testing. Although the omitted vendors were not identified as suspended or debarred, the exceptions demonstrate that the population used for suspension and debarment screening was not complete. Recommendation Management should enhance its suspension and debarment control to ensure all vendors associated with federally funded programs are included in the screening population. Management should maintain evidence of its review of the completeness and accuracy of the vendor population provided to the third-party service provider and the results of the screening process. View of responsible officials There is no disagreement with the audit finding.