FAC Explorer

Finding 1168060 (2023-003)

Material Weakness Repeat Finding
Requirement
P
Questioned Costs
-
Year
2023
Accepted
2026-01-07
Audit: 379692
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 of Federal Awards for R&D cluster expenditures.
  • Impacted Requirements: Compliance with 2 CFR 200.303(a) regarding effective internal controls over federal awards was not met.
  • Recommended Follow-Up: Management should strengthen controls to ensure all R&D expenditures are included for timely and accurate reporting.

Finding Text

Finding 2023-003 – 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. 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 of Expenditures of Federal and State Awards (the Schedule) specific to research and development (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 previously issued 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 Schedule. Effect – Management identified additional reportable R&D cost reimbursement FAR contract related expenditures that were added to the restated Schedule. Questioned Costs – None reported. Context – Approximately $4,800,000 of additional R&D expenditures under cost reimbursement FAR contracts in relation to the restated total expenditures of approximately $23,739,000 under the R&D cluster for the year-ended December 31, 2023, were omitted from the previously issued Schedule. Repeat Finding from Prior Year – No. Recommendation – We recommend that management enhance its controls over the Schedule to ensure they include all R&D expenditures to facilitate timely, accurate completion of the Schedule.

Corrective Action Plan

Finding 2023-003 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 Health 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. Completion Date: September 30, 2025.

Categories

Allowable Costs / Cost Principles Cash Management Material Weakness Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1167998 2023-001
    Material Weakness Repeat
  • 1167999 2023-002
    Material Weakness Repeat
  • 1168000 2023-002
    Material Weakness Repeat
  • 1168001 2023-002
    Material Weakness Repeat
  • 1168002 2023-002
    Material Weakness Repeat
  • 1168003 2023-002
    Material Weakness Repeat
  • 1168004 2023-002
    Material Weakness Repeat
  • 1168005 2023-002
    Material Weakness Repeat
  • 1168006 2023-002
    Material Weakness Repeat
  • 1168007 2023-002
    Material Weakness Repeat
  • 1168008 2023-002
    Material Weakness Repeat
  • 1168009 2023-002
    Material Weakness Repeat
  • 1168010 2023-002
    Material Weakness Repeat
  • 1168011 2023-002
    Material Weakness Repeat
  • 1168012 2023-002
    Material Weakness Repeat
  • 1168013 2023-002
    Material Weakness Repeat
  • 1168014 2023-002
    Material Weakness Repeat
  • 1168015 2023-002
    Material Weakness Repeat
  • 1168016 2023-002
    Material Weakness Repeat
  • 1168017 2023-002
    Material Weakness Repeat
  • 1168018 2023-002
    Material Weakness Repeat
  • 1168019 2023-002
    Material Weakness Repeat
  • 1168020 2023-002
    Material Weakness Repeat
  • 1168021 2023-002
    Material Weakness Repeat
  • 1168022 2023-002
    Material Weakness Repeat
  • 1168023 2023-002
    Material Weakness Repeat
  • 1168024 2023-002
    Material Weakness Repeat
  • 1168025 2023-002
    Material Weakness Repeat
  • 1168026 2023-002
    Material Weakness Repeat
  • 1168027 2023-002
    Material Weakness Repeat
  • 1168028 2023-002
    Material Weakness Repeat
  • 1168029 2023-002
    Material Weakness Repeat
  • 1168030 2023-002
    Material Weakness Repeat
  • 1168031 2023-002
    Material Weakness Repeat
  • 1168032 2023-002
    Material Weakness Repeat
  • 1168033 2023-002
    Material Weakness Repeat
  • 1168034 2023-002
    Material Weakness Repeat
  • 1168035 2023-002
    Material Weakness Repeat
  • 1168036 2023-002
    Material Weakness Repeat
  • 1168037 2023-002
    Material Weakness Repeat
  • 1168038 2023-002
    Material Weakness Repeat
  • 1168039 2023-002
    Material Weakness Repeat
  • 1168040 2023-002
    Material Weakness Repeat
  • 1168041 2023-002
    Material Weakness Repeat
  • 1168042 2023-002
    Material Weakness Repeat
  • 1168043 2023-002
    Material Weakness Repeat
  • 1168044 2023-002
    Material Weakness Repeat
  • 1168045 2023-002
    Material Weakness Repeat
  • 1168046 2023-003
    Material Weakness Repeat
  • 1168047 2023-003
    Material Weakness Repeat
  • 1168048 2023-003
    Material Weakness Repeat
  • 1168049 2023-003
    Material Weakness Repeat
  • 1168050 2023-003
    Material Weakness Repeat
  • 1168051 2023-003
    Material Weakness Repeat
  • 1168052 2023-003
    Material Weakness Repeat
  • 1168053 2023-003
    Material Weakness Repeat
  • 1168054 2023-003
    Material Weakness Repeat
  • 1168055 2023-003
    Material Weakness Repeat
  • 1168056 2023-003
    Material Weakness Repeat
  • 1168057 2023-003
    Material Weakness Repeat
  • 1168058 2023-003
    Material Weakness Repeat
  • 1168059 2023-003
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
10.766 COMMUNITY FACILITIES LOANS AND GRANTS $16.29M
93.310 TRANS-NIH RESEARCH SUPPORT $11.79M
93.498 PROVIDER RELIEF FUND $4.01M
93.399 CANCER CONTROL $2.67M
93.RD COVID-19 Community Cohort $2.55M
93.350 NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES $1.11M
93.RD CONNECT FOR CANCER PREVENTION STUDY $972,523
94.006 AMERICORPS $807,289
93.RD VACCINE SAFETY DATALINK INFRASTRUCTURE $445,855
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $420,352
93.788 OPIOID STR $402,550
93.RD COVID-19 VACCINES IN THE VACCINE SAFTETY DATALINK $366,174
16.575 CRIME VICTIM ASSISTANCE $362,684
32.006 COVID-19 TELEHEALTH PROGRAM $345,061
93.959 BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE $219,744
93.155 RURAL HEALTH RESEARCH CENTERS $195,677
93.323 EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC) $151,956
93.RD RVTN - SENTINEL RESPIRATORY VIRUS TRANSMISSION NETWORK $151,691
93.866 AGING RESEARCH $138,570
93.393 CANCER CAUSE AND PREVENTION RESEARCH $92,847
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $87,410
93.RD FLU VACCINE TRIAL $87,286
10.001 AGRICULTURAL RESEARCH_BASIC AND APPLIED RESEARCH $66,822
93.396 CANCER BIOLOGY RESEARCH $59,748
10.525 FARM AND RANCH STRESS ASSISTANCE NETWORK COMPETITIVE GRANTS PROGRAM (B) $57,319
93.395 CANCER TREATMENT RESEARCH $52,312
93.RD SENTINEL $50,705
93.RD CARDIOVASCULAR DISEASES RESEARCH $49,688
93.243 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES_PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $48,822
93.RD VACCINE SAFETY DATALINK PROJECT, VSD COVID-19 INFRASTRUCTURE PARTICIPANTING SITE MONITORING FOR VACCINE-ASSOCIATED ENHANCED DISEASES $33,654
93.241 STATE RURAL HOSPITAL FLEXIBILITY PROGRAM $28,724
93.898 CANCER PREVENTION AND CONTROL PROGRAMS FOR STATE, TERRITORIAL AND TRIBAL ORGANIZATIONS $28,346
93.912 RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT $28,243
93.426 IMPROVING THE HEALTH OF AMERICANS THROUGH PREVENTION AND MANAGEMENT OF DIABETES AND HEART DISEASE AND STROKE $27,044
93.073 BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES - PREVENTION AND SURVEILLANCE $26,401
93.262 OCCUPATIONAL SAFETY AND HEALTH PROGRAM $26,232
93.RD Optimal Strategies to Estimate the Relative Effectiveness of Influenza $25,003
10.212 SMALL BUSINESS INNOVATION RESEARCH $21,373
93.643 CHILDREN'S JUSTICE GRANTS TO STATES $10,016
93.435 INNOVATIVE STATE AND LOCAL PUBLIC HEALTH STRATEGIES TO PREVENT AND MANAGE DIABETES AND HEART DISEASE AND STROKE- $10,000
93.988 COOPERATIVE AGREEMENTS FOR STATE-BASED DIABETES CONTROL PROGRAMS AND EVALUATION OF SURVEILLANCE SYSTEMS $9,747
93.421 STRENGTHENING PUBLIC HEALTH SYSTEMS AND SERVICES THROUGH NATIONAL PARTNERSHIPS TO IMPROVE AND PROTECT THE NATION’S HEALTH $9,468
93.307 MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH $6,451
93.301 SMALL RURAL HOSPITAL IMPROVEMENT GRANT PROGRAM $5,950
93.153 COORDINATED SERVICES AND ACCESS TO RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND YOUTH $5,282
93.837 CARDIOVASCULAR DISEASES RESEARCH $4,465
10.303 INTEGRATED PROGRAMS $4,416
93.279 DRUG ABUSE AND ADDICTION RESEARCH PROGRAMS $4,325
93.394 CANCER DETECTION AND DIAGNOSIS RESEARCH $2,633
93.575 CHILD CARE AND DEVELOPMENT BLOCK GRANT $1,326
93.855 ALLERGY, IMMUNOLOGY AND TRANSPLANTATION RESEARCH $1,283
93.RD ALLERGY AND INFECTIOUS DISEASES RESEARCH $945
93.211 TELEHEALTH PROGRAMS $922
93.RD VACCINE SAFETY DATALINK SHINGRIX PARTICIPATING SITE $351
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $25
93.185 IMMUNIZATION RESEARCH, DEMONSTRATION, PUBLIC INFORMATION AND EDUCATION_TRAINING AND CLINICAL SKILLS IMPROVEMENT PROJECTS $-956
93.RD EVALUATING INFLUENZA AND SARSCO V-2 VACCINE EFFECTIVENESS $-5,376