Finding 1169012 (2025-001)

Material Weakness Repeat Finding
Requirement
J
Questioned Costs
-
Year
2025
Accepted
2026-01-14
Audit: 381668
Organization: Tandem Health Sc (SC)

AI Summary

  • Core Issue: The Organization did not have adequate procedures to monitor and account for program income from grant-related services.
  • Impacted Requirements: Noncompliance with 45 CFR §75.307 and Ryan White legislation increases the risk of federal funding issues.
  • Recommended Follow-Up: Develop formal policies to track program income and ensure compliance with funding requirements, including regular reviews.

Finding Text

Section lll - Federal Award Findings and Questioned Costs Finding 2025-001 - Significant Deficiency Finding Condition: Adequate procedures were not in place to ensure all program incomewas considered as a part of program income and level of effort requirements. Program income generated from net patient service revenue related to services provided under the grant was not included in the Organization’s monitoring. Criteria: Per 45 CFR §75.307, program income must be properly accounted for and used in accordance with the terms and conditions of the federal award. Additionally, the Ryan White legislation (42 USC 300ff-22(d)(2)(B)) requires recipients to ensure that federal funds supplement and do not supplant other funding sources. Cause: The Organization lacked formal policies and procedures to ensure complete monitoring of program income and verifying compliance with the supplement-not-supplant requirement. Effect: Noncompliance with requirements to monitor program income and demonstrate that federal funds supplemented, rather than supplanted, other funding sources increases the risk of noncompliance with federal regulations, potential disallowance of costs, and inaccurate reporting to the awarding agency. Recommendation: We recommend that the Organization develop and implement writtenpolicies and procedures to ensure all elements of program incomeare properly tracked, reported, and utilized in accordance with federal requirements. We recommend that the Organization establish a process for documenting compliance with the supplement-notsupplant requirement, including periodic reviews of funding sources and expenditures related to services provided under the grant. View of Responsible Officials and Planned Corrective Actions: Management agrees with the finding. See management's corrective action plan.

Corrective Action Plan

HIV Formula Care Grant (AL93.917) - Significant Deficiency 2025-001 Management agrees with the finding and will enhance the current processes. Subsequent to year end, management created a tool to ensure all elements of program income, as well as related expenses incurred, are properly tracked, reported, and utilized in accordance with federal requirements. Additionally, written policies are being drafted to reflect these procedures. Implementation is expected by January 31, 2026.

Categories

Reporting Program Income Subrecipient Monitoring Significant Deficiency Matching / Level of Effort / Earmarking

Programs in Audit

ALN Program Name Expenditures
93.224 CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, AND PUBLIC HOUSING PRIMARY CARE) $2.64M
93.917 HIV CARE FORMULA GRANTS $841,734
93.527 AFFORDABLE CARE ACT (ACA) GRANTS FOR NEW AND EXPANDED SERVICES UNDER THE HEALTH CENTER PROGRAM $6,446