FAC Explorer

Finding 1156218 (2024-001)

Material Weakness Repeat Finding
Requirement
P
Questioned Costs
-
Year
2024
Accepted
2025-09-29
Audit: 368574
Organization: Marshfield Clinic Health System, Inc. (WI)
Auditor: Forvis Mazars LLP

AI Summary

  • Core Issue: Inadequate controls led to omissions in the Schedule of Expenditures for R&D cluster awards.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) for effective internal controls over federal awards was not met.
  • Recommended Follow-Up: Management should strengthen controls to ensure all R&D expenditures are accurately reported and included in the Schedule on time.

Finding Text

Preparation of the Schedule of Expenditures of Federal Awards U. S. Department of Health and Human Services U. S. Department of Agriculture Research and Development (R&D) Cluster Material Weakness Criteria: Title 2 Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) requires the System to prepare a schedule of expenditures of federal awards (Schedule). 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: Inadequate controls exist over the preparation of the Schedule specific to R&D cluster awards to allow for the timely completion of a complete and accurate Schedule. Consequently, certain R&D cluster expenditures were inadvertently omitted from the preliminary Schedule. Cause: The System did not have adequate controls over identifying all R&D cost reimbursement Federal Acquisition Regulation (FAR) contract related expenditures that should be reported on the SEFA. Effect: Management identified additional reportable R&D cost reimbursement FAR contract related expenditures that were added to the Schedule late in the audit process. Questioned costs: None reported. Context: Approximately $2,600,000 of additional R&D expenditures under cost reimbursement FAR contracts in relation to total expenditures of approximately $14,395,000 under the R&D cluster for the year-ended December 31, 2024, were originally omitted from the preliminary Schedule. These changes were not identified in a timely manner resulting in delays in completing the System Single Audit. Repeat Finding from Prior Year: No Recommendation: We recommend that management enhance its controls over the Schedule to ensure they include similar R&D expenditures to facilitate timely accurate completion of the Schedule.

Corrective Action Plan

Finding 2024-001 Name of Contact Person: Debra Hansen, Finance Project Manager – Grants and Gifts Corrective Action Plan: Effective January 1, 2025, MCHS, Inc was acquired by Sanford Health. MCHS grants accounting and grants management staff joined the Sanford Health’s Office of Grants team by June 2025 and have been trained and have fully implemented Sanford procedures by September 2025, such that the Sanford Health system of controls now extend to MCHS. Specifically with these changes, grants management and accounting duties have also transitioned to the MCHS grant team which extends Sanford Health’s systems of control to MCHS to ensure accurate and timely completion of the Schedule. Proposed Completion Date: January 1, 2026

Categories

Reporting Allowable Costs / Cost Principles Cash Management Material Weakness

Other Findings in this Audit

  • 1156141 2024-001
    Material Weakness Repeat
  • 1156142 2024-001
    Material Weakness Repeat
  • 1156143 2024-001
    Material Weakness Repeat
  • 1156144 2024-001
    Material Weakness Repeat
  • 1156145 2024-001
    Material Weakness Repeat
  • 1156146 2024-001
    Material Weakness Repeat
  • 1156147 2024-001
    Material Weakness Repeat
  • 1156148 2024-001
    Material Weakness Repeat
  • 1156149 2024-001
    Material Weakness Repeat
  • 1156150 2024-001
    Material Weakness Repeat
  • 1156151 2024-001
    Material Weakness Repeat
  • 1156152 2024-001
    Material Weakness Repeat
  • 1156153 2024-001
    Material Weakness Repeat
  • 1156154 2024-001
    Material Weakness Repeat
  • 1156155 2024-001
    Material Weakness Repeat
  • 1156156 2024-001
    Material Weakness Repeat
  • 1156157 2024-001
    Material Weakness Repeat
  • 1156158 2024-001
    Material Weakness Repeat
  • 1156159 2024-001
    Material Weakness Repeat
  • 1156160 2024-001
    Material Weakness Repeat
  • 1156161 2024-001
    Material Weakness Repeat
  • 1156162 2024-001
    Material Weakness Repeat
  • 1156163 2024-001
    Material Weakness Repeat
  • 1156164 2024-001
    Material Weakness Repeat
  • 1156165 2024-001
    Material Weakness Repeat
  • 1156166 2024-001
    Material Weakness Repeat
  • 1156167 2024-001
    Material Weakness Repeat
  • 1156168 2024-001
    Material Weakness Repeat
  • 1156169 2024-001
    Material Weakness Repeat
  • 1156170 2024-001
    Material Weakness Repeat
  • 1156171 2024-001
    Material Weakness Repeat
  • 1156172 2024-001
    Material Weakness Repeat
  • 1156173 2024-001
    Material Weakness Repeat
  • 1156174 2024-001
    Material Weakness Repeat
  • 1156175 2024-001
    Material Weakness Repeat
  • 1156176 2024-001
    Material Weakness Repeat
  • 1156177 2024-002
    Material Weakness Repeat
  • 1156178 2024-002
    Material Weakness Repeat
  • 1156179 2024-002
    Material Weakness Repeat
  • 1156180 2024-002
    Material Weakness Repeat
  • 1156181 2024-002
    Material Weakness Repeat
  • 1156182 2024-002
    Material Weakness Repeat
  • 1156183 2024-002
    Material Weakness Repeat
  • 1156184 2024-002
    Material Weakness Repeat
  • 1156185 2024-002
    Material Weakness Repeat
  • 1156186 2024-002
    Material Weakness Repeat
  • 1156187 2024-002
    Material Weakness Repeat
  • 1156188 2024-002
    Material Weakness Repeat
  • 1156189 2024-002
    Material Weakness Repeat
  • 1156190 2024-002
    Material Weakness Repeat
  • 1156191 2024-002
    Material Weakness Repeat
  • 1156192 2024-002
    Material Weakness Repeat
  • 1156193 2024-002
    Material Weakness Repeat
  • 1156194 2024-002
    Material Weakness Repeat
  • 1156195 2024-002
    Material Weakness Repeat
  • 1156196 2024-002
    Material Weakness Repeat
  • 1156197 2024-002
    Material Weakness Repeat
  • 1156198 2024-002
    Material Weakness Repeat
  • 1156199 2024-002
    Material Weakness Repeat
  • 1156200 2024-002
    Material Weakness Repeat
  • 1156201 2024-002
    Material Weakness Repeat
  • 1156202 2024-002
    Material Weakness Repeat
  • 1156203 2024-002
    Material Weakness Repeat
  • 1156204 2024-002
    Material Weakness Repeat
  • 1156205 2024-002
    Material Weakness Repeat
  • 1156206 2024-002
    Material Weakness Repeat
  • 1156207 2024-002
    Material Weakness Repeat
  • 1156208 2024-002
    Material Weakness Repeat
  • 1156209 2024-002
    Material Weakness Repeat
  • 1156210 2024-002
    Material Weakness Repeat
  • 1156211 2024-002
    Material Weakness Repeat
  • 1156212 2024-002
    Material Weakness Repeat
  • 1156213 2024-002
    Material Weakness Repeat
  • 1156214 2024-002
    Material Weakness Repeat
  • 1156215 2024-002
    Material Weakness Repeat
  • 1156216 2024-001
    Material Weakness Repeat
  • 1156217 2024-001
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
10.766 Community Facilities Loans and Grants $15.73M
93.368 21st Century Cures Act - Precision Medicine Initiative $3.69M
93.399 Cancer Control $3.28M
94.006 Americorps State and National 94.006 $1.20M
93.RD Connect for Cancer Prevention Study $1.10M
93.RD Vaccine Safety Datalink Infrastructure $653,713
93.788 Opioid Str $418,328
93.350 National Center for Advancing Translational Sciences $363,785
93.859 Biomedical Research and Research Training $354,903
93.310 Trans-Nih Research Support $328,487
93.RD Rapid Cycle Analysis for Covid-19 Vaccines in the Vaccine Safety Datalink $295,302
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $265,517
93.RD Optimal Strategies to Estimate the Relative Effectiveness of Influenza Vaccines $259,721
93.073 Birth Defects and Developmental Disabilities - Prevention and Surveillance $165,488
93.575 Child Care and Development Block Grant $138,157
93.959 Block Grants for Prevention and Treatment of Substance Abuse $132,433
21.027 Coronavirus State and Local Fiscal Recovery Funds $107,835
93.393 Cancer Cause and Prevention Research $100,368
93.RD Covid-19 Vaccines in the Vaccine Safety Datalink $87,451
93.866 Aging Research $79,570
93.RD Covid-19 Community Cohort $73,415
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $60,777
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $54,997
93.301 Small Rural Hospital Improvement Grant Program $44,952
10.001 Agricultural Research Basic and Applied Research $36,135
93.396 Cancer Biology Research $35,505
93.RD Vaccine Safety Datalink, Vsd Covid-19 Infrastructure Participating Site Monitoring for Vaccine-Associated Enhanced Disease Following $34,182
93.185 Immunization Research, Demonstration, Public Information and Education Training and Clinical Skills Improvement Projects $30,414
93.RD Recipient Epidemiology and Donor Evaluation Study IV Pediatric (reds-IV-P) Phase 2 $30,325
93.262 Occupational Safety and Health Program $23,729
16.575 Crime Victim Assistance $23,551
93.395 Cancer Treatment Research $18,250
93.RD Central Data Collection Center (cdcc) - Continued Follow-Up of Plco Participants $17,663
93.RD Sentinel Initiative Year 10 Query Activity 1 $17,381
93.U01 Other Financial Assistance $15,018
93.RD Sentinel Initiative Year 10 Infrastructure $13,032
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $12,037
93.RD Sentinel Common Data Model V8.2.0 Implementation $11,220
10.212 Small Business Innovation Research (sbir) Program / Small Business Technology Transfer (sttr) Program $8,873
93.855 Allergy and Infectious Diseases Research $5,929
93.RD Sentinel Initiative Year 10 Query Activity 2 $5,794
93.837 Cardiovascular Diseases Research $5,370
93.988 Cooperative Agreements for Diabetes Control Programs $5,059
93.RD Sentinel Initiative Year 11 Infrastructure $3,833
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $1,314