Finding 1158239 (2023-002)

Material Weakness Repeat Finding
Requirement
L
Questioned Costs
-
Year
2023
Accepted
2025-09-30
Audit: 370125
Auditor: Kpmg

AI Summary

  • Core Issue: The Schedule of Expenditures of Federal Awards (SEFA) reported discrepancies totaling $425,785 between federal expenditures and the correct reporting periods.
  • Impacted Requirements: Compliance with 2 CFR, Part 200, which mandates accurate reporting of federal awards in the SEFA.
  • Recommended Follow-Up: Management should establish stronger controls to ensure expenditures are accurately reported in the correct SEFA year.

Finding Text

Finding 2023-002 – SEFA Reporting Federal Program: Medicaid Assistance Program HIV Emergency Relief Project Grants ALNs: 93.778 93.914 Federal Agency: U.S. Department of Health and Human Services Federal Award Years: July 1, 2022 – June 30, 2024 (93.778) March 1, 2022 – February 28, 2024 (93.914) Criteria: 2 CFR, Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, §200.510(b) requires that auditees prepare a schedule of expenditures of Federal awards for the period covered by the auditee’s financial statements which must include the total Federal awards expended as determined in accordance with §200.502. Condition Found, Including Perspective: The Schedule of Expenditures of Federal Awards (SEFA) prepared by management contained certain differences between federal expenditures reported and the years in which the federal awards were expended totaling $174,977 related to the Medicaid Assistance Program and $250,808 relate to the HIV Emergency Relief Project Grants. Possible Cause and Effect: While the System performs a review during the compilation of the SEFA, controls were not designed or implemented effectively to ensure that certain amounts were properly reflected on the SEFA in the period in which they were expended. Questioned Costs: None. Statistical Validity: The sample was not intended to be, and was not, a statistically valid sample. Repeat Finding in the Prior Year: Yes – 2022-001 Recommendation We recommend that management implement appropriate controls and processes to ensure that expenditures are presented on the correct SEFA year. Views of Responsible Officials: Grady Memorial Hospital Corporation will implement a control and process to ensure that expenditures are properly reflected on the SEFA.

Corrective Action Plan

To: FY2023 Uniform Guidance Reporting Package From: David Noble, Director, Grant Administration RE: 2023 Uniform Guidance Audit Corrective Action Plan Date: September 25, 2025 Finding 2023-002 (REVISED) Federal Program: Medicaid Assistance Program HIV Emergency Relief Project Grants ALN: 93.778 / 93.914 Grady Memorial Hospital Corporation’s CFO and VP of Fiscal Services/Controller have reviewed the reporting from KPMG relating to the Uniform Guidance. We understand the recommendation set forth by KPMG and will update our controls and processes to include additional review of expenses incurred during the relevant audit period. Grady’s corrective action plan: Going forward the SEFA will be reviewed to ensure that all related expenses for the audit period are incorporated. Contact person/s responsible for the corrective action: David Noble, Director, Grant Administration Anticipated Completion Date: Consistent with 2024 Financial Audit Reportin

Categories

Reporting

Other Findings in this Audit

  • 1158234 2023-001
    Material Weakness Repeat
  • 1158235 2023-002
    Material Weakness Repeat
  • 1158236 2023-002
    Material Weakness Repeat
  • 1158237 2023-002
    Material Weakness Repeat
  • 1158238 2023-002
    Material Weakness Repeat
  • 1158240 2023-003
    Material Weakness Repeat
  • 1158241 2023-003
    Material Weakness Repeat
  • 1158242 2023-003
    Material Weakness Repeat
  • 1158243 2023-003
    Material Weakness Repeat
  • 1158244 2023-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $12.45M
93.914 Hiv Emergency Relief Project Grants $9.56M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $8.77M
21.027 Coronavirus State and Local Fiscal Recovery Funds $3.93M
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $837,549
16.575 Crime Victim Assistance $774,269
93.778 Medical Assistance Program $680,504
93.253 Poison Center Support and Enhancement Grant $677,758
16.753 Congressionally Recommended Awards $532,366
93.686 Ending the Hiv Epidemic: A Plan for America — Ryan White Hiv/aids Program Parts A and B $461,877
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $434,633
93.217 Family Planning Services $387,500
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $369,140
93.145 Hiv-Related Training and Technical Assistance $356,297
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $326,398
93.051 Alzheimer's Disease Demonstration Grants to States $325,759
93.788 Opioid Str $295,016
93.958 Block Grants for Community Mental Health Services $203,968
93.069 Public Health Emergency Preparedness $184,500
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $175,022
93.310 Trans-Nih Research Support $131,046
93.150 Projects for Assistance in Transition From Homelessness (path) $106,184
93.078 Strengthening Emergency Care Delivery in the United States Healthcare System Through Health Information and Promotion $92,925
84.063 Federal Pell Grant Program $80,527
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $78,642
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $77,576
93.924 Ryan White Hiv/aids Dental Reimbursement and Community Based Dental Partnership Grants $70,211
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $45,292
93.397 Cancer Centers Support Grants $25,025
93.136 Injury Prevention and Control Research and State and Community Based Programs $18,023
93.121 Oral Diseases and Disorders Research $17,668
93.959 Block Grants for Prevention and Treatment of Substance Abuse $6,970
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $3,464