2 CFR 200 § 200.510

Findings Citing § 200.510

Financial statements.

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About this section
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
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.

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
Maimonides Medical Center
Compliance Requirement: L
2022-002 – Completeness and accuracy of the Schedule of Expenditures of Federal Awards- Significant Deficiency Cluster: Not applicable Federal Granting Agency: Department of Homeland Security and Emergency Services Award Name: COVID-19 – Disaster Grants- Public Assistance (Presidentially Declared Disasters) Pass-Through from New York State Department of Homeland Security and Emergency Services Assistance Listing #: 97.036 Assistance Listing Title: COVID-19 - Disaster Grants- ...

2022-002 – Completeness and accuracy of the Schedule of Expenditures of Federal Awards- Significant Deficiency Cluster: Not applicable Federal Granting Agency: Department of Homeland Security and Emergency Services Award Name: COVID-19 – Disaster Grants- Public Assistance (Presidentially Declared Disasters) Pass-Through from New York State Department of Homeland Security and Emergency Services Assistance Listing #: 97.036 Assistance Listing Title: COVID-19 - Disaster Grants- Public Assistance (Presidentially Declared Disasters) Pass-Through from New York State Department of Homeland Security and Emergency Services Award Year: January 1, 2022- December 31, 2022 Criteria 2 CFR 200.510 Financial statements requires auditees to 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. The information presented should be consistent with the accounting records and other federal guidance. Condition FEMA funds obligated in 2022 for eligible expenditures expended in prior periods totaling $33,715,590 were excluded from the 2022 consolidated financial statements and Statement of Expenditures of Federal Awards (“SEFA”). Management has revised the consolidated financial statements as of and for the year ended December 31, 2022 and included this amount in the SEFA for the year ended December 31, 2022 (Refer to Note 1 and Note 10 in the accompanying consolidated financial statements and Note 2 and Note 7 in the accompanying SEFA). This error did not impact the major program selection for testing in 2022. Cause The status of the review and approval process by FEMA and New York State Department of Homeland Security and Emergency Services and requirement to record FEMA funds in the consolidated financial statements and SEFA when obligated by FEMA was not interpreted correctly by management. Effect A SEFA that is not complete and accurate could impact the scoping of an entity’s major programs and result in incomplete information being provided to the federal government. Questioned Costs None noted. Recommendation We recommend the Medical Center perform a reconciliation of FEMA project applications reported in the FEMA portal to the consolidated financial statements and SEFA to ensure all FEMA project funds obligated and expended are reported in the proper period. Management’s Views and Corrective Action Plan Management's views and corrective action plan is included at the end of this report after the summary schedule of prior audit findings and status.

FY End: 2022-12-31
The International Institute of Akron, Inc.
Compliance Requirement: P
Condition: During our review of the December 31, 2022 Schedule of Expenditures of Federal Awards (SEFA) prepared by management, we noted that controls over revenue recognition and preparation of the SEFA were not properly designed resulting in material adjustments to several grants and to the SEFA identified during the audit. Criteria: The Code of Federal Regulations (CFR) Section 200.510(b) states in part, “The auditee must also prepare a schedule of federal expenditures for the period covered...

Condition: During our review of the December 31, 2022 Schedule of Expenditures of Federal Awards (SEFA) prepared by management, we noted that controls over revenue recognition and preparation of the SEFA were not properly designed resulting in material adjustments to several grants and to the SEFA identified during the audit. Criteria: The Code of Federal Regulations (CFR) Section 200.510(b) states in part, “The auditee must also prepare a schedule of federal expenditures for the period covered by the auditee’s consolidated financial statements which must include the total Federal awards expended as determined in accordance with 200.502.” Also, in accordance with CFR Section 200.302(b) – Financial Management, the auditees financial management system must provide 1) identification of all federal awards received and expended; 2) accurate, current, and complete disclosure of the financial results of each federal award or program; 3) records that identify adequately the source and application of funds for federally-funded activities; 4) effective control over, and accountability for, all funds, property, and other assets; 5) comparison of expenditures with budget amounts for each Federal award; 6) written procedures to implement the requirements of section 200.305 and; 7) written procedures for determining the allowability of costs in accordance with Subpart E and the terms and conditions of the Federal award. Further, revenue from grants is to be accounted for in accordance with ASU 2018-08 (Topic 958) Clarifying the Scope and Accounting Guidance for Contributions Received and Contributions Made. As most of the Federal grants received are conditional upon expenditure and expenditure in accordance with cost principles, revenue should not be recognized until the relating conditions have been met and therefore right of return is overcome. Cause: Internal controls over revenue recognition and preparation of the SEFA are not designed effectively to ensure completeness and accuracy of revenues reported and the SEFA. Effect: As a result of the condition noted above, material audit adjustments were required to be posted to several grants and to the SEFA to properly report federal expenditures in the correct period, as well as revenues reported on the consolidated statement of activities. Recommendation: We recommend that management review current internal controls over revenue recognition and preparation and tracking of federal expenditures to ensure that revenue is properly reported and, all federal awards are captured and reported in the correct period and that internal controls are properly designed to detect and correct errors to the SEFA.

FY End: 2022-12-31
Beacon Health System, Inc.
Compliance Requirement: L
Identification of the federal program:Federal Grantor: U.S. Department of Health and Human ServicesAssistance Listing No.: 93.461, COVID-19 HRSA COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund (Uninsured Program)Award Period: January 1, 2022 ? March 31, 2022Criteria or specific requirement (including statutory, regulatory or other citation):2 CFR 200.510 requires that the ?auditee must also prepare a Schedule of Expenditures of Federal Awards for...

Identification of the federal program:Federal Grantor: U.S. Department of Health and Human ServicesAssistance Listing No.: 93.461, COVID-19 HRSA COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund (Uninsured Program)Award Period: January 1, 2022 ? March 31, 2022Criteria or specific requirement (including statutory, regulatory or other citation):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).?2 CFR 200.508 Schedule of expenditures of Federal awards. ?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 as determined in accordance with ? 200.502.? Condition:The draft Schedule of Expenditures of Federal Awards (the Schedule) prepared by the Corporation was misstated. The expenditures were understated related to the Uninsured Program. The final Schedule was corrected for the differences identified.Cause:Management did not design internal controls to ensure appropriate accumulation of the data necessary to complete the Schedule.Effect or potential effect:Federal expenditures may be inappropriately included or excluded from the Schedule.Questioned costs:None.Context:Total Uninsured Program expenses were $682,332 for the year ended December 31, 2022.Total expenses included on the draft Schedule were $40,733,999 for the year ended December 31, 2022. Total expenses included on the final Schedule were $41,416,331 for the year ended December 31, 2022.Identification as a repeat finding:No.Recommendation:Management should assess its internal controls over the identification of federal expenditures to ensure the Schedule is complete.Views of responsible officials:The Corporation agrees with the finding and has developed a plan to correct the finding. As of August 16, 2023, the Corporation has implemented the following changes, which we believe address future internal control considerations should the program be reinstated. The below controls additionally address the need to properly maintain evidence of controls. The below wording was added to the SEFA Preparation Memo, which is used to prepare the SEFA each year.a. Grants listed on the prior year are reviewed to determine if the grant is still active or if the grant has closed out.i For grants that have closed, the ending dates of the grant are verified, and current year activity is reviewed to ensure that all activity for that grant has been properly accounted for.

FY End: 2022-12-31
Save the Children Federation, INC and Related Entities
Compliance Requirement: P
Findings and Questioned Costs Relating to Federal Awards Finding 2022-001 – Material Weakness over SEFA Preparation Federal Agency U.S. Department of State Federal Program Overseas Refugee Assistance Program for Near East (ALN 19.519) Federal Award Year September 1, 2022 to August 31, 2023 Compliance Requirement Other – Inaccurate Reporting on the Schedule of Expenditures of Federal Awards Criteria According to 2 CFR 200.510(b), a recipient of federal awards is required to prepare a schedule of ...

Findings and Questioned Costs Relating to Federal Awards Finding 2022-001 – Material Weakness over SEFA Preparation Federal Agency U.S. Department of State Federal Program Overseas Refugee Assistance Program for Near East (ALN 19.519) Federal Award Year September 1, 2022 to August 31, 2023 Compliance Requirement Other – Inaccurate Reporting on the Schedule of Expenditures of Federal Awards Criteria According to 2 CFR 200.510(b), a recipient of federal awards is required to prepare a schedule of expenditures of federal awards (SEFA) for the period covered by the entity’s financial statements, which must include the federal awards expended for each federal program and the related assistance listing number (ALN). Additionally, CFR 200.303 requires non-Federal entities receiving federal awards to establish and maintain internal controls designed to reasonably ensure compliance with Federal laws, regulations, and program compliance requirements. Effective internal controls should include procedures to ensure federal expenditures are accurately and completely reported on the Schedule. Condition and Context Save the Children Federation, Inc. and Related Entities (the Organization) did not have adequate internal controls related to the reporting of expenditures for the Overseas Refugee Assistance Program for the Near East (ALN 19.519). As a result, the amounts previously reported on the SEFA for this program for the year ended December 31, 2022 did not include $407,929 of expenditures, which were previously incorrectly reported in the Investing in People in The Middle East and North African program (ALN 19.021). These expenditures represent 12% of the total ALN 19.519 program expenditures and .08% of the total SEFA expenditures. Cause and Effect The cause was human error, whereas the ALNs are manually inputted into the Organization's system. The error was not identified when management reviewed the Schedule. Failure to establish effective internal controls regarding financial reporting for the preparation of the SEFA may prevent the entity from reporting accurate program information and completing an audit in accordance with timelines set forth by the Uniform Guidance. Questioned Costs None. Statistically Valid Sample Not applicable. Repeat Finding No Recommendation We recommend that the Organization further refine the design of the internal controls that will ensure that the ALN coding for expenditures is accurate on the SEFA. Management’s Response Management agrees with the recommendation to further refine the internal controls in the identification and reporting of ALNs in the SEFA. Once STC identified the data error, management began training to raise awareness of the importance of ALN tracking, enhance the input/verification process, add periodic quality checks, and improve the SEFA review process. The identified issue did not impact compliance with more specific award terms, conditions or allowability of expenditures and the additional ALN program included in the restatement did not lead to any different audit result.

FY End: 2022-12-31
Save the Children Federation, INC and Related Entities
Compliance Requirement: P
Findings and Questioned Costs Relating to Federal Awards Finding 2022-001 – Material Weakness over SEFA Preparation Federal Agency U.S. Department of State Federal Program Overseas Refugee Assistance Program for Near East (ALN 19.519) Federal Award Year September 1, 2022 to August 31, 2023 Compliance Requirement Other – Inaccurate Reporting on the Schedule of Expenditures of Federal Awards Criteria According to 2 CFR 200.510(b), a recipient of federal awards is required to prepare a schedule of ...

Findings and Questioned Costs Relating to Federal Awards Finding 2022-001 – Material Weakness over SEFA Preparation Federal Agency U.S. Department of State Federal Program Overseas Refugee Assistance Program for Near East (ALN 19.519) Federal Award Year September 1, 2022 to August 31, 2023 Compliance Requirement Other – Inaccurate Reporting on the Schedule of Expenditures of Federal Awards Criteria According to 2 CFR 200.510(b), a recipient of federal awards is required to prepare a schedule of expenditures of federal awards (SEFA) for the period covered by the entity’s financial statements, which must include the federal awards expended for each federal program and the related assistance listing number (ALN). Additionally, CFR 200.303 requires non-Federal entities receiving federal awards to establish and maintain internal controls designed to reasonably ensure compliance with Federal laws, regulations, and program compliance requirements. Effective internal controls should include procedures to ensure federal expenditures are accurately and completely reported on the Schedule. Condition and Context Save the Children Federation, Inc. and Related Entities (the Organization) did not have adequate internal controls related to the reporting of expenditures for the Overseas Refugee Assistance Program for the Near East (ALN 19.519). As a result, the amounts previously reported on the SEFA for this program for the year ended December 31, 2022 did not include $407,929 of expenditures, which were previously incorrectly reported in the Investing in People in The Middle East and North African program (ALN 19.021). These expenditures represent 12% of the total ALN 19.519 program expenditures and .08% of the total SEFA expenditures. Cause and Effect The cause was human error, whereas the ALNs are manually inputted into the Organization's system. The error was not identified when management reviewed the Schedule. Failure to establish effective internal controls regarding financial reporting for the preparation of the SEFA may prevent the entity from reporting accurate program information and completing an audit in accordance with timelines set forth by the Uniform Guidance. Questioned Costs None. Statistically Valid Sample Not applicable. Repeat Finding No Recommendation We recommend that the Organization further refine the design of the internal controls that will ensure that the ALN coding for expenditures is accurate on the SEFA. Management’s Response Management agrees with the recommendation to further refine the internal controls in the identification and reporting of ALNs in the SEFA. Once STC identified the data error, management began training to raise awareness of the importance of ALN tracking, enhance the input/verification process, add periodic quality checks, and improve the SEFA review process. The identified issue did not impact compliance with more specific award terms, conditions or allowability of expenditures and the additional ALN program included in the restatement did not lead to any different audit result.

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