Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
Finding 2023-001 – Reporting Information of the federal program: Federal Grantor: Department of Defense (DOD) Assistance Listing No.: 12.420, Military Medical Research and Development Pass-Through Grantor: Johns Hopkins University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.172, Human Genome Research Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.226, Research on Healthcare Costs, Quality and Outcomes Pass-Through Grantor: The Regents of the University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.242, Mental Health Research Grants Pass-Through Grantor: Rutgers State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.307, Minority Health and Health Disparities Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.310, Trans-NIH Research Support Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.350, National Center for Advancing Translational Sciences Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.351, Research Infrastructure Program Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.361, Nursing Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.368, 21st Century Cures Act – Precision Medicine Initiative Pass-Through Grantor: University of Chicago Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.394, Cancer Detection and Diagnosis Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.395, Cancer Treatment Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.396, Cancer Biology Research Pass-Through Grantor: Tulane University, Louisiana State University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.397, Cancer Centers Support Grants Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.667, Social Services Block Grant Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.837, Cardiovascular Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.838, Lung Diseases Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.847, Diabetes, Digestive, and Kidney Diseases Extramural Research Pass-Through Grantors: Northwestern University, Duke University, University of Washington, The Regents of University of Michigan Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.853, Extramural Research Programs in the Neurosciences and Neurological Disorders Pass-Through Grantor: Rush University Medical Center Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.855, Allergy, Immunology and Transplantation Research Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.859, Biomedical Research and Research Training Pass-Through Grantor: University of Wisconsin – Madison Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.865, Child Health and Human Development Extramural Research Pass-Through Grantors: Northwestern University, University of Washington, The Regents of the University of California Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.866, Aging Research Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.946, Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs Pass-Through Grantor: Northwestern University Federal Grantor: United States Department of Health and Human Services (HHS) Assistance Listing No.: 93.994, Maternal and Child Health Services Block Grant to the States Pass-Through Grantor: Northwestern Memorial Hospital Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “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).” The Uniform Guidance 2 CFR section 200.510 states, “(b) Schedule of expenditures of Federal awards. The auditee must also prepare a schedule of expenditures of federal awards (SEFA) 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 Basis for determining Federal awards expended.” Condition: Certain grants related to the Research and Development Cluster were misstated by $233,405 on the preliminary schedule of expenditures of federal awards (the Schedule) provided by management due to the inappropriate classification of costs within the general ledger; the final Schedule was corrected. In addition, an award which was not a federal grant award with expenditures of $148,388 was included on the preliminary Schedule provided by management. The final Schedule was corrected. Cause: Endeavor’s internal controls over the preparation of the Schedule were not sufficient to properly accumulate and accurately report all expenditures of federal awards. Effect or Potential Effect: Inaccurate or improper reporting of expenditures results in a misstated Schedule and can also potentially result in insufficient testing of the major programs or improper identification of major programs for audit purposes. Questioned costs: None. Context: The table below reflects the preliminary and adjusted assistance listing balances on the Schedule (only assistance listing programs which changed are included below): Assistance Listing No. Name of Federal Program Preliminary Schedule Adjusted Schedule Change 12.420 Military Medical Research and Development $ 241,025 $ 224,418 $ 16,607 93.172 Human Genome Research 14,874 15,121 (247) 93.226 Research on Healthcare Costs, Quality and Outcomes 251,325 248,842 2,483 93.242 Mental Health Research Grants 1,616,503 1,617,376 (873) 93.307 Minority Health and Health Disparities Research 17,323 15,122 2,201 93.310 Trans-NIH Research Support 313,459 313,490 (31) 93.350 National Center for Advancing Translational Sciences 516,734 518,429 (1,695) 93.351 Research Infrastructure Program 242,436 232,058 10,378 93.361 Nursing Research 8,745 7,645 1,100 93.368 21st Century Cures Act – Precision Medicine Initiative 100,324 94,609 5,715 93.394 Cancer Detection and Diagnosis Research 847,959 816,528 31,431 93.395 Cancer Treatment Research 438,349 439,286 (937) 93.396 Cancer Biology Research 93,919 88,642 5,277 93.397 Cancer Centers Support Grants 15,552 14,078 1,474 93.667 Social Services Block Grant 19,619 27,170 (7,551) 93.837 Cardiovascular Diseases Research 193,160 188,850 4,310 93.838 Lung Diseases Research 482,934 471,427 11,507 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research 1,075,493 1,035,041 40,452 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders 1,645,025 1,596,611 48,414 93.855 Allergy, Immunology and Transplantation Research 73,869 72,630 1,239 93.859 Biomedical Research and Research Training 363,336 366,791 (3,455) 93.865 Child Health and Human Development Extramural Research 3,790,797 3,733,008 57,789 93.866 Aging Research 1,101,363 1,098,891 2,472 93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs 80,039 78,033 2,006 93.994 Maternal and Child Health Services Block Grant to the States 171,995 168,656 3,339 The Role of Oral Care in Nonventilator Hospital-Acquired Pneumonia (NVHAP) Prevention 148,388 – 148,388 Total $ 13,864,545 $ 13,482,752 $ 381,793 Identification as a repeat finding, if applicable: The finding is not a repeat finding from the prior year. Recommendation: Management should implement internal controls to ensure amounts are appropriately accumulated and reported on the Schedule and all federal expenditures are appropriately identified and reported on the Schedule. Views of responsible officials: Award amounts were changed on the Schedule after management’s review was executed. Management acknowledges that implementing the new Enterprise Resource Planning (ERP) system, in 2023 presented changes to the SEFA reporting. Management has identified and addressed the reporting issues within the new system to ensure that the grant totals are appropriately captured in the SEFA. Endeavor will enhance grant management award processes by revising its procedures and adding additional controls to monitor for accuracy of the core data. Management will reinforce the importance of timeliness and accuracy of the Schedule reporting totals to facilitate accurate reporting.
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.