Audit 412747

FY End
2025-12-31
Total Expended
$11.35M
Findings
2
Programs
11
Organization: Cahaba Medical Care Foundation (AL)
Year: 2025 Accepted: 2026-09-29
Auditor: DZA PLLC

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
1237969 2025-002 Material Weakness Yes AB
1237970 2025-002 Material Weakness Yes AB

Contacts

Name Title Type
PB8JEHXP9TS3 Monique Dumond Auditee
5092155606 Shaun Johnson Auditor
No contacts on file

Notes to SEFA

The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Cahaba Medical Care Foundation (the Organization) under programs of the federal government for the year ended December 31, 2025. The information in this Schedule is presented 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). Because the Schedule presents only a selected portion of the operations of the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization.
The Organization received and expended funds from the Affordable Care Act – Teaching Health Center Graduate Medical Education (THCGME) Payments Program. The amounts of funds, $10,640,709, received during the period under audit are not included on the Schedule of Expenditures of Federal Awards above as the program is exempt from the Uniform Guidance requirements per the program description.

Finding Details

Federal Agency: U.S Department of Health and Human Services Assistance Listing Numbers: 93.224 and 93.527 Health Center Program Cluster Award Numbers: H80CS24177, H8N54116, H8HCS44965, Q8J54475, H2E50157, and Q8M49126 Criteria: In accordance with the Uniform Guidance’s compensation requirements (2 CFR 200.430 Compensation – personal services), payroll expenses must be based on records that accurately reflect the work performed and supported by a system of internal controls that provides reasonable assurances that charges are accurate; allowable and reasonable; and properly allocated. The Uniform Guidance allows for use of budget estimates on an interim basis. When using budget estimates on an interim basis, grantees must reconcile estimates against actual time or effort on a regular basis to ensure that estimates conform to actual staff activity. Grantees must make adjustments in the payroll distribution to align with actual time. [X] Compliance Finding [X ] Significant Deficiency [ ] Material Weakness Condition: During fiscal year 2025, the Organization charged payroll costs to federal programs based on predetermined budgeted percentages rather than actual time and effort of employees. Cause: The Organization did not have a process or controls in place to track and document the time and effort employees spent toward each federal award. Effect: Noncompliance with documentation of personnel expense standards; improper allocation of salary and fringe benefits. Questioned Costs: Indeterminable. The Organization’s payroll expenditures for personnel providing in-scope services appear to be sufficient to cover the amounts of grant funding drawn. However, we were not able to verify employee time and effort toward providing program services. Recommendation We recommend the Organization enhance its timekeeping processes to ensure payroll charges accurately reflect actual work performed on federal awards. If budget estimates continue to be used, they should be reconciled regularly against actual effort. Alternatively, the Organization could implement an after-the-fact certification system to document that salaries charged to federal programs are reasonable and consistent with actual work performed. Views of responsible officials and planned corrective action Management agrees with the finding. During fiscal year 2025, payroll costs charged to federal awards were allocated based on budgeted percentages rather than documented actual time and effort. Management acknowledges that controls were not sufficient to ensure compliance with Uniform Guidance requirements for documenting and allocating personnel costs charged to federal programs. Management is committed to strengthening internal controls over payroll allocations to ensure personnel costs charged to federal awards are supported by appropriate documentation and accurately reflect work performed.