FAC Explorer

Finding 1123847 (2024-002)

Significant Deficiency
Requirement
G
Questioned Costs
-
Year
2024
Accepted
2025-03-31
Audit: 351637
Organization: Trinity Health (MI)
Auditor: Deloitte & Touche LLP

AI Summary

  • Core Issue: Pittsburgh Mercy Health System did not track or review matching expenditures to confirm they were allowable.
  • Impacted Requirements: The absence of documentation and review could lead to non-compliance with matching obligations.
  • Recommended Follow-Up: Implement internal controls to ensure regular reviews and documentation of all matching expenditures.

Finding Text

Condition – Pittsburgh Mercy Health System did not track or review individual matching expenditures to ensure that the sources were allowable. Additionally, there was a lack of documentation and a review of such documentation substantiating that the total dollar threshold for matching was satisfied. However, total matching expenditures for the program were subsequently analyzed and Pittsburgh Mercy Health System did expend sufficient allowable expenditures ($481,325) to fulfill the matching requirement. Cause – Pittsburgh Mercy Health System did not design and implement controls to ensure that there were sufficient expenditures to meet the matching requirement, and that such expenditures were allowable under the Continuum of Care Program. Effect –The lack of review and documentation of matching expenditures could have resulted in a breach of contractual obligations for the matching requirement. Questioned Costs – None. Context - Pittsburgh Mercy Health System failed to establish a system to regularly monitor matching activities and review the status of federal matching to ensure compliance. Lack of tracking and reviewing of matching requirements would potentially result in insufficient and inadequate match, and repayment of funds. Repeat Finding – No. Recommendation – We recommend Pittsburgh Mercy Health System establish internal control policies and procedures to ensure reviews are performed and documented for all expenditures related to the matching requirement.

Categories

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking

Other Findings in this Audit

  • 547400 2024-001
    Significant Deficiency
  • 547401 2024-002
    Significant Deficiency
  • 547402 2024-002
    Significant Deficiency
  • 547403 2024-002
    Significant Deficiency
  • 547404 2024-002
    Significant Deficiency
  • 547405 2024-002
    Significant Deficiency
  • 1123842 2024-001
    Significant Deficiency
  • 1123843 2024-002
    Significant Deficiency
  • 1123844 2024-002
    Significant Deficiency
  • 1123845 2024-002
    Significant Deficiency
  • 1123846 2024-002
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.399 Cancer Control $3.10M
84.268 Federal Direct Student Loans $1.75M
93.988 Cooperative Agreements for Diabetes Control Programs $1.57M
93.696 Certified Community Behavioral Health Clinic Expansion Grants $1.32M
21.027 Coronavirus State and Local Fiscal Recovery Funds $786,031
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $501,297
93.917 Hiv Care Formula Grants $474,311
84.063 Federal Pell Grant Program $470,293
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $465,179
93.150 Projects for Assistance in Transition From Homelessness (path) $391,256
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $346,044
93.969 Pphf Geriatric Education Centers $319,685
93.261 Scaling the National Diabetes Prevention Program to Priority Populations $291,421
93.884 Primary Care Training and Enhancement $283,356
14.267 Continuum of Care Program $274,160
93.604 Assistance for Torture Victims $271,742
14.241 Housing Opportunities for Persons with Aids $260,876
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $220,114
93.788 Opioid Str $199,564
14.231 Emergency Solutions Grant Program $197,365
93.914 Hiv Emergency Relief Project Grants $192,205
16.575 Crime Victim Assistance $189,908
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $188,428
93.994 Maternal and Child Health Services Block Grant to the States $181,360
93.426 The National Cardiovascular Health Program $175,000
97.008 Non-Profit Security Program $144,560
93.276 Drug-Free Communities Support Program Grants $144,081
93.575 Child Care and Development Block Grant $133,332
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $124,172
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $118,725
93.566 Refugee and Entrant Assistance State/replacement Designee Administered Programs $101,268
84.007 Federal Supplemental Educational Opportunity Grants $92,938
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $86,152
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $67,029
93.940 Hiv Prevention Activities Health Department Based $61,271
84.425 Education Stabilization Fund $58,439
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $50,250
93.011 National Organizations for State and Local Officials $49,303
93.958 Block Grants for Community Mental Health Services $48,365
14.218 Community Development Block Grants/entitlement Grants $46,328
93.889 National Bioterrorism Hospital Preparedness Program $43,000
93.959 Block Grants for Prevention and Treatment of Substance Abuse $41,427
84.126 Rehabilitation Services Vocational Rehabilitation Grants to States $35,855
16.838 Comprehensive Opioid, Stimulant, and Other Substances Use Program $33,866
16.588 Violence Against Women Formula Grants $30,856
93.310 Trans-Nih Research Support $29,499
93.747 Elder Abuse Prevention Interventions Program $27,403
93.778 Medical Assistance Program $26,242
93.866 Aging Research $24,901
10.558 Child and Adult Care Food Program $21,715
93.268 Immunization Cooperative Agreements $21,500
93.839 Blood Diseases and Resources Research $17,430
93.241 State Rural Hospital Flexibility Program $15,750
93.301 Small Rural Hospital Improvement Grant Program $10,800
16.529 Education, Training, and Enhanced Services to End Violence Against and Abuse of Women with Disabilities $8,404
20.600 State and Community Highway Safety $8,015
16.017 Sexual Assault Services Formula Program $7,938
84.033 Federal Work-Study Program $6,658
10.551 Supplemental Nutrition Assistance Program $6,059
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $5,662
93.247 Advanced Nursing Education Workforce Grant Program $5,107
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $4,986
93.226 Research on Healthcare Costs, Quality and Outcomes $3,500
20.616 National Priority Safety Programs $3,457
97.067 Homeland Security Grant Program $2,906
93.283 Centers for Disease Control and Prevention Investigations and Technical Assistance $2,250
93.395 Cancer Treatment Research $2,229
93.837 Cardiovascular Diseases Research $1,500
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $1,438
93.879 Medical Library Assistance $1,200
45.025 Promotion of the Arts Partnership Agreements $1,100
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $157