2 CFR 200 § 200.510

Findings Citing § 200.510

Financial statements.

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Section 200.510 requires organizations receiving federal funds to prepare financial statements that show their financial position and results for the fiscal year being audited. Additionally, they must create a schedule detailing expenditures of federal awards, listing individual programs by agency and including relevant information to aid understanding, which affects non-Federal entities managing federal funds.
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FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Nationwide Children's Hospital
Compliance Requirement: L
Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursi...

Finding 2022 ? 003 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No, Award Name, Award Number and Pass-through Entity: These federal awards were added to the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 93.127 Emergency Medical Services For Children EIIC University Hospitals Cleveland Medical Center 93.226 Research On Healthcare Costs, Quality and Outcomes 1R01HS029183-01 93.361 Nursing Research FY22.1180.001 University of Colorado Denver 93.575 Child Care and Development Block Grant Ohio Children?s Alliance Ohio Children?s Alliance 93.596 Child Care Mandatory And Matching Funds of the Child Care and Development Fund COVID-19 Ohio Child Care Resource and Referral Association 93.838 Lung Diseases Research 10059528-01-NWC The University of Utah 93.846 Arthritis, Musculoskeletal and Skin Diseases Research GRANT ID: GRT-00001510 Children?s Hospital of Philadelphia 93.855 Allergy and Infectious Diseases Research 034146-014 Arkansas Children?s Hospital Research Institute 93.855 Allergy and Infectious Diseases Research A635027 Emory University 93.855 Allergy and Infectious Diseases Research OS00000060/317962 Cincinnati Children?s Hospital Medical Center 93.865 Child Health and Human Development Extramural Research 9116-NCH Indiana University 93.865 Child Health and Human Development Extramural Research A21-0255-S002 UC Davis Medical Center 93.867 Vision Research CONTRACT ID 1803 JAEB Center For Health Section III?Federal Award Findings and Questioned Costs (continued) These federal awards were removed from the R&D Cluster: Assistance Listing Award Name Award Number Pass-Through Entity 16.575 Crime Victim Assistance 2022-SVAA-134716708 Crime Victims Assistance 16.575 Crime Victim Assistance 2022-VOCA-134716701 Crime Victims Assistance 16.575 Crime Victim Assistance 2022DVF42 Crime Victims Assistance 16.575 Crime Victim Assistance 2023-VOCA-135104760 Crime Victims Assistance 21.019 Coronavirus Relief Fund 2020-CARES-78 Crime Victims Assistance 93.110 Maternal and Child Health Federal Consolidated Programs 1 R40MC37541-01-00 93.110 Maternal and Child Health Federal Consolidated Programs RPPN University Hospitals Cleveland Medical Center 93.110 Maternal and Child Health Federal Consolidated Programs GR124424/SPC-1000005299 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs GR127800 SPC-1000006745 The Ohio State University 93.110 Maternal and Child Health Federal Consolidated Programs MCHB 436 22-23 Hemophilia Foundation of Michigan 93.558 Temporary Assistance for Needy Families 25-21-3536 Franklin County Department of Job And Family Services 93.575 Child Care and Development Block Grant IECMH Ohio Children?s Alliance 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Childrens Trust Fund 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246-1 Ohio Childrens Trust Fund 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR125049 The Ohio State University 93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service GR128419 The Ohio State University 93.778 Medical Assistance Program GR124661 The Ohio State University 93.870 Maternal, Infant and Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health 93.959 Block Grants for Prevention and Treatment of Substance Abuse 2200026 Ohio Department of Mental Health Section III?Federal Award Findings and Questioned Costs (continued) Criteria or specific requirement (including statutory, regulatory, or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (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).? 2 CFR 200.510 requires that the ?auditee must also 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 in accordance with Section 200.502.? 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 and the ?Internal Control Integrated Framework? issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Condition: The Schedule of Expenditures of Federal Awards prepared by the Corporation did not appropriately reflect the federal expenses related to the R&D Cluster. The final Schedule was corrected for the differences identified. Cause: The Corporation did not design internal controls over the review and approval of the Schedule to ensure the appropriate federal awards were included in the R&D Cluster. Section III?Federal Award Findings and Questioned Costs (continued) Effect or potential effect: Federal awards were inappropriately included and excluded from the R&D Cluster. Questioned costs: None Context: Total R&D Cluster expenses included on the draft Schedule were $84,223,943 for the year ended December 31, 2022. Total R&D expenses included on the final Schedule were $82,409,498 for the year ended December 31, 2022. Total expenditures on the Schedule did not change. See the federal programs added and removed from the R&D Cluster in the Information on Federal Programs section above. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: We recommend that management implement more robust management review internal controls to ensure accurate reporting of federal awards on the Schedule.

FY End: 2022-12-31
Mahoning-Youngstown Community Action Partnership, Inc.
Compliance Requirement: L
U.S DEPARTMENT OF HEALTH AND HUMAN SERVICES Material Weakness ? Internal controls over compliance ? Reporting Finding 2022-001 ? ALN 93.558 Temporary Assistance for Needy Families (TANF) Criteria ? In accordance with 2 CFR Subpart F 200.508, the auditee must prepare appropriate financial statements, including the supplemental schedule of expenditures of federal awards (SEFA) in accordance with 200.510 of this regulation. The auditee must include the total federal aw...

U.S DEPARTMENT OF HEALTH AND HUMAN SERVICES Material Weakness ? Internal controls over compliance ? Reporting Finding 2022-001 ? ALN 93.558 Temporary Assistance for Needy Families (TANF) Criteria ? In accordance with 2 CFR Subpart F 200.508, the auditee must prepare appropriate financial statements, including the supplemental schedule of expenditures of federal awards (SEFA) in accordance with 200.510 of this regulation. The auditee must include the total federal awards expended for the same period covered by the auditee?s financial statements. Condition ? The SEFA prepared by the Organization and submitted for audit did not include the TANF program and the related expenses totaling $891,795. Effect ? The initial major program determination had to be revised once the auditor identified the missing expenditures, which also resulted in the identification of an additional major program for testing. Controls over compliance for reporting required for federal programs and preparation of the SEFA were not sufficient to detect that the program and related expenditures were missing on the 2022 SEFA. The error in preparing the SEFA and not including the TANF program on the schedule could have resulted in a major program not being properly identified and tested as required by the Uniform Guidance. This also resulted in delays in completing the audit. Cause ? The TANF funds were a new source of funding for the Organization and were received from a non federal pass-through entity. When preparing the SEFA, the funds were overlooked and not included on the SEFA submitted for audit. Controls over the preparation and review processes for the SEFA were not designed effectively to detect the missing program and expenditures. Recommendation ? We recommend that the Organization determine the source of funding prior to set up of the project in the general ledger. Similar to how other federal awards are identified in the general ledger, we recommend that all federal awards be labeled in the general ledger by the federal ALN upon initial set up. In addition, a secondary review should be performed at year-end to ensure the completeness of the SEFA and determine that all expenditures related to the federal programs in the general ledger are included in the SEFA prior to submission of the SEFA for audit. View of Responsible Officials ? See Management?s Corrective Action Plan.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
County of Madison, Missouri
Compliance Requirement: P
Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic...

Federal Grantor: U.S. Department of Agriculture, U.S. Department of the Interior, U.S. Department of Transportation, U.S. Department of Treasury, Environmental Protection Agency, Election Assistance Commission, Election Assistance Commission, U.S. Department of Health and Human Services, and U.S. Department of Homeland Security. Pass-Through Grantor: Missouri Office of Administration, Missouri Department of Transportation, Missouri State Treasurer, Southeast Missouri Regional Planning & Economic Development Commission, Missouri Secretary of State and Missouri Department of Public Safety. Federal Assistance Listing Number: 10.665, 15.226, 15.438, 20.205, 20.616, 20.703, 21.019, 21.027, 66.039, 66.802, 90.401, 97.036 and 97.067. Program Title: Schools and Roads – Grants to States; Payment in Lieu of Taxes, National Forest Acquired Lands; Highway Planning and Construction; National Priority Safety Programs; COVID-19 - Coronavirus Relief Fund; COVID-19 – Coronavirus State and Local Fiscal Recovery Funds; Diesel Emissions Reduction Act; Superfund State, Political Subdivision and Indian Tribe Site-Specific Cooperative Agreement; Help America Vote Act Requirement Payments; Homeland Security Grant Program. Pass-through Entity Identifying Number: BRO-B062(011), EPA-OAP-OTAQ-20-02, DE-97784601-0, 97750001, #4317, 2017-PF-37(PWSD#1). Award Year: 2021 and 2022. Questioned Costs: None. Criteria: 2 CFR 200.510(b) requires auditees to prepare a schedule of expenditures of federal awards which must report total federal awards expended during the audit period. At a minimum, the schedule must include expenditures by individual federal program, name of the pass-through entity and identifying number for awards not received directly from the federal government, and the total amount provided to subrecipients from each federal program. The County has not implemented proper internal controls to ensure the completeness and accuracy of the SEFA. Condition: The schedules of expenditures of federal awards (SEFA) reported by the County in the 2022 and 2023 annual budget documents contained errors in amounts of federal expenditures reported. Cause: The County has not implemented a proper system of internal control over SEFA preparation, such as a reconciliation to underlying accounting records or having a separate individual review the SEFA for clerical accuracy after it has been prepared. Reasons for discrepancies in individual programs varied. Effect: The SEFA presented for audit did not accurately reflect the County’s actual expenditures of federal awards for both the years ended December 31, 2022 and 2021. Recommendation: We recommend that the County implement internal controls to ensure that the SEFA completely and accurately states the expenditures of federal awards of the County each year.

FY End: 2022-12-31
Range Mental Health Center, Inc.
Compliance Requirement: P
Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 expen...

Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 2 CFR 200.502, Basis for determining Federal awards expended. While the auditor is able to assist with SEFA preparation, management remains responsible for identifying all federal expenditures to enable the preparation of a complete and accurate SEFA. Condition: Management was unable to provide a complete listing of federal expenditures at the start of audit fieldwork. Cause: Internal controls were not in place to ensure all relevant information was captured and reported in SEFA preparation. Effect: By not having proper controls over SEFA preparation at the beginning of the audit, there is a risk that the SEFA will not reflect all the federal awards subject to the Uniform Guidance, which could lead to an incorrect major program determination and a substandard single audit. Questioned Costs: $0 Identification of Repeat Finding: Not a repeat finding. Recommendation: We recommend that Range Mental Health Center, Inc. and Subsidiary implement internal controls to ensure there is an adequate communication and review process in place to capture all federal awards expended at the correct amounts in accordance with the criteria above. Views of Responsible Officials and Corrective Action Plan: Management agrees with this finding and is in the process of developing internal controls to ensure timely and appropriate actions are made on the deficiency noted. Additional details can be found in the Organization’s Corrective Action Plan.

FY End: 2022-12-31
Range Mental Health Center, Inc.
Compliance Requirement: P
Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 expen...

Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 2 CFR 200.502, Basis for determining Federal awards expended. While the auditor is able to assist with SEFA preparation, management remains responsible for identifying all federal expenditures to enable the preparation of a complete and accurate SEFA. Condition: Management was unable to provide a complete listing of federal expenditures at the start of audit fieldwork. Cause: Internal controls were not in place to ensure all relevant information was captured and reported in SEFA preparation. Effect: By not having proper controls over SEFA preparation at the beginning of the audit, there is a risk that the SEFA will not reflect all the federal awards subject to the Uniform Guidance, which could lead to an incorrect major program determination and a substandard single audit. Questioned Costs: $0 Identification of Repeat Finding: Not a repeat finding. Recommendation: We recommend that Range Mental Health Center, Inc. and Subsidiary implement internal controls to ensure there is an adequate communication and review process in place to capture all federal awards expended at the correct amounts in accordance with the criteria above. Views of Responsible Officials and Corrective Action Plan: Management agrees with this finding and is in the process of developing internal controls to ensure timely and appropriate actions are made on the deficiency noted. Additional details can be found in the Organization’s Corrective Action Plan.

FY End: 2022-12-31
Range Mental Health Center, Inc.
Compliance Requirement: P
Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 expen...

Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 2 CFR 200.502, Basis for determining Federal awards expended. While the auditor is able to assist with SEFA preparation, management remains responsible for identifying all federal expenditures to enable the preparation of a complete and accurate SEFA. Condition: Management was unable to provide a complete listing of federal expenditures at the start of audit fieldwork. Cause: Internal controls were not in place to ensure all relevant information was captured and reported in SEFA preparation. Effect: By not having proper controls over SEFA preparation at the beginning of the audit, there is a risk that the SEFA will not reflect all the federal awards subject to the Uniform Guidance, which could lead to an incorrect major program determination and a substandard single audit. Questioned Costs: $0 Identification of Repeat Finding: Not a repeat finding. Recommendation: We recommend that Range Mental Health Center, Inc. and Subsidiary implement internal controls to ensure there is an adequate communication and review process in place to capture all federal awards expended at the correct amounts in accordance with the criteria above. Views of Responsible Officials and Corrective Action Plan: Management agrees with this finding and is in the process of developing internal controls to ensure timely and appropriate actions are made on the deficiency noted. Additional details can be found in the Organization’s Corrective Action Plan.

FY End: 2022-12-31
Range Mental Health Center, Inc.
Compliance Requirement: P
Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 expen...

Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 2 CFR 200.502, Basis for determining Federal awards expended. While the auditor is able to assist with SEFA preparation, management remains responsible for identifying all federal expenditures to enable the preparation of a complete and accurate SEFA. Condition: Management was unable to provide a complete listing of federal expenditures at the start of audit fieldwork. Cause: Internal controls were not in place to ensure all relevant information was captured and reported in SEFA preparation. Effect: By not having proper controls over SEFA preparation at the beginning of the audit, there is a risk that the SEFA will not reflect all the federal awards subject to the Uniform Guidance, which could lead to an incorrect major program determination and a substandard single audit. Questioned Costs: $0 Identification of Repeat Finding: Not a repeat finding. Recommendation: We recommend that Range Mental Health Center, Inc. and Subsidiary implement internal controls to ensure there is an adequate communication and review process in place to capture all federal awards expended at the correct amounts in accordance with the criteria above. Views of Responsible Officials and Corrective Action Plan: Management agrees with this finding and is in the process of developing internal controls to ensure timely and appropriate actions are made on the deficiency noted. Additional details can be found in the Organization’s Corrective Action Plan.

FY End: 2022-12-31
Range Mental Health Center, Inc.
Compliance Requirement: P
Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 expen...

Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 2 CFR 200.502, Basis for determining Federal awards expended. While the auditor is able to assist with SEFA preparation, management remains responsible for identifying all federal expenditures to enable the preparation of a complete and accurate SEFA. Condition: Management was unable to provide a complete listing of federal expenditures at the start of audit fieldwork. Cause: Internal controls were not in place to ensure all relevant information was captured and reported in SEFA preparation. Effect: By not having proper controls over SEFA preparation at the beginning of the audit, there is a risk that the SEFA will not reflect all the federal awards subject to the Uniform Guidance, which could lead to an incorrect major program determination and a substandard single audit. Questioned Costs: $0 Identification of Repeat Finding: Not a repeat finding. Recommendation: We recommend that Range Mental Health Center, Inc. and Subsidiary implement internal controls to ensure there is an adequate communication and review process in place to capture all federal awards expended at the correct amounts in accordance with the criteria above. Views of Responsible Officials and Corrective Action Plan: Management agrees with this finding and is in the process of developing internal controls to ensure timely and appropriate actions are made on the deficiency noted. Additional details can be found in the Organization’s Corrective Action Plan.

FY End: 2022-12-31
Range Mental Health Center, Inc.
Compliance Requirement: P
Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 expen...

Finding 2022-002: Identification of Federal Funds for Purposes of Assembling the Schedule of Expenditures of Federal Awards (SEFA) All Federal programs included in the Schedule of Expenditures of Federal Awards Compliance Findings: Other (P) Criteria: Per 2 CFR 200.510(b) Schedule of expenditures of Federal awards, “the auditee must 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 2 CFR 200.502, Basis for determining Federal awards expended. While the auditor is able to assist with SEFA preparation, management remains responsible for identifying all federal expenditures to enable the preparation of a complete and accurate SEFA. Condition: Management was unable to provide a complete listing of federal expenditures at the start of audit fieldwork. Cause: Internal controls were not in place to ensure all relevant information was captured and reported in SEFA preparation. Effect: By not having proper controls over SEFA preparation at the beginning of the audit, there is a risk that the SEFA will not reflect all the federal awards subject to the Uniform Guidance, which could lead to an incorrect major program determination and a substandard single audit. Questioned Costs: $0 Identification of Repeat Finding: Not a repeat finding. Recommendation: We recommend that Range Mental Health Center, Inc. and Subsidiary implement internal controls to ensure there is an adequate communication and review process in place to capture all federal awards expended at the correct amounts in accordance with the criteria above. Views of Responsible Officials and Corrective Action Plan: Management agrees with this finding and is in the process of developing internal controls to ensure timely and appropriate actions are made on the deficiency noted. Additional details can be found in the Organization’s Corrective Action Plan.

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