Finding 1167912 (2024-001)

Material Weakness Repeat Finding
Requirement
M
Questioned Costs
-
Year
2024
Accepted
2026-01-06
Audit: 379429
Organization: Liberate Medical, Inc. (KY)
Auditor: LBMC PC

AI Summary

  • Core Issue: The Company failed to conduct all required subrecipient financial monitoring activities for Federal funds, impacting compliance with grant terms.
  • Impacted Requirements: Monitoring activities for 5 subawards totaling $134,695 were not fully executed, risking questioned costs.
  • Recommended Follow-Up: Develop and implement written subrecipient monitoring policies, including a review schedule to ensure compliance with Federal regulations.

Finding Text

U.S. Department of Defense 2024‐001 Military Medical Research and Development‐‐Assistance Listing No. 12.420; Grant No. W81‐ XWH2211123; Grant period: Year Ended December 31, 2024 Criteria and Condition: All subawards of these Federal funds should be subjected to proper subrecipient monitoring activities, including review of periodic award reports (financial, performance and technical) and subrecipient audit reports for compliance with federal statutes, regulations and the terms and conditions of the subaward. For the year ended December 31, 2024, there were instances where the Company did not perform all of the subrecipient financial monitoring activities. Context: There were 5 subawards of these Federal funds, which amounted to $134,695 of Federal expenditures for the year ended December 31, 2024 out of $2,510,869 of total Federal expenditures under this grant agreement. Cause: The lack of understanding of the impact of a subaward and all the related financial subrecipient monitoring requirements that accompany this type of arrangement. Effect: $134,695 of costs are likely questioned as a result of all aspects of subrecipient monitoring not having taken place throughout 2024. Recommendation: Appropriate written subrecipient monitoring policies and procedures be developed and implemented, including a schedule for various financial reviews to document that subrecipients are complying with the Federal regulations and with the terms and conditions of the subaward. Views of Responsible Officials and Planned Corrective Actions: Management agrees with this finding and is working to correct this matter as documented in the Company’s correction action plan. A Single Audit was not required in the prior year, therefore, there were no prior audit findings.

Corrective Action Plan

Section III - Federal Award Findings and Questioned Costs: U.S. Department of Defense Recommendation: Appropriate written subrecipient monitoring policies and procedures be developed and implemented, including a schedule for various financial reviews to document that subrecipients are complying with the Federal regulations and with the terms and conditions of the subaward. Management has taken the following actions with regards to the current finding. • The five subrecipients are as follows: o Chicago Association for Research and Education o Houston Methodist Research Institute o Tufts Medical Center, Inc. o University of Pittsburgh o Vanderbilt University • Verified that all subrecipients are audited and that none are suspended, debarred, or otherwise excluded from receiving Federal Funds. • Obtained most recent Single Audit Report from each subrecipient and determined that there were no audit findings related to the Company. The following was identfied in each audit report: o Chicago Association for Research and Education – Year Ended September 30, 2024 - The Company is not listed in the Single Audit Report – Management is following up with the institution. o Houston Methodist Research Institute - Year Ended December 31, 2023 - Military Medical Research and Development through Liberate Medical, LLC - W81XWH2211123 - 12.420 - $11,107 o Tufts Medical Center, Inc. - Year Ended September 30, 2023 - Military Medical Research and Development Passed Through—Liberate Medical LLC—A Randomized, Sham Controlled, Double-blinded, MulM-center Trial to Evaluate the Efficacy of the VentFree Respiratory Muscle Stmulator to Assist Ventilator Weaning in Critically III Patients - 12.420 - W81XWH2211123 - $14,770 o University of Pittsburgh - Year Ended June 30, 2024 - Liberate Medical, LLC. - 12.420 - PREVENT-LIBERATE – Planning Phase $1,415; Trial Phase $84,087 o Vanderbilt University - Year Ended June 30, 2024 - MILITARY MEDICAL RESEARCH AND DEVELOPMENT - 12.420 - Liberate Medical VUMC108554 -W81XWH2211123 $52,147 • Management is reviewing costs included in the subrecipient’s Single Audit Report noted above and working with the subrecipients to reconcile amounts to the Company’s books and records. For the year ended December 31, 2024, the Company submitted reimbursement voucher requests to the Department of Defense in the amount of $1,766,172. Amounts related to subawards for the same period were $134,695 or 7.6%. In the future management will: • Prepare a standard operating procedure (SOP) for subrecipient monitoring in accordance with CFR Part 200.332 and OMB Compliance Supplement 6-20. • For the current award: o Evaluate each subrecipient’s fraud risk and risk of noncompliance o Develop a subrecipient risk-based monitoring plan sufficient for the Company to comply with federal statues, regulations, and the terms and conditions of the award. o Follow the developed risk-based monitoring plan for the remainder of the award and implement, where appropriate, corrective actions against any noncompliant subrecipients • For future awards, perform subrecipient monitoring in accordance with the SOP described above and in compliance with CFR Part 200.332 and OMB Compliance Supplement 6-20.

Categories

Subrecipient Monitoring

Programs in Audit

ALN Program Name Expenditures
12.420 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $2.51M