Finding 1176647 (2025-002)

Material Weakness Repeat Finding
Requirement
ABHL
Questioned Costs
-
Year
2025
Accepted
2026-03-05

AI Summary

  • Core Issue: Management failed to keep documentation for the review and approval of FEMA expenditures before submission.
  • Impacted Requirements: This violates 2 CFR 200.303, which mandates effective internal controls over federal awards.
  • Recommended Follow-Up: Management should ensure proper documentation is retained for all future FEMA expenditure reviews and approvals.

Finding Text

Identification of the Federal Program: Department of Homeland Security Federal Agency and Program Name: COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) (FEMA) Assistance Listing #: 97.036 Pass-Through Entity: State of Tennessee Award: All FEMA Projects (Projects 435263, 550461, 684580) Award Year(s): Project 435263: 1/1/2020-7/31/2021 Project 550461: 1/1/2020-7/31/2021 Project 684580: 8/1/2020-6/30/2022 Criteria or Specific Requirement (Including Statutory, Regulatory or Other Citation): 2 CFR 200.303 requires that the non-Federal entity must “(a) establish, document and maintain effective internal control over the Federal award that provides reasonable assurance that the recipient is managing the Federal award in compliance with Federal statutes, regulations and the terms and conditions of the Federal award. These internal controls should align with the guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control - Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” Condition: Management did not retain documentation over their review and approval of FEMA expenditures prior to submission in the FEMA Portal. Cause: Management represented that FEMA expenditures were reviewed and approved prior to submission; however, supporting documentation over the review and approval was not maintained. Effect or Potential Effect: Unallowable expenditures could have been charged to the federal program. Questioned Costs: $0. Context: There were three project worksheets obligated in FY2025. Management did not maintain documentation over the review and approval over the expenditures submitted to the FEMA . We selected 40 expenditures charged to FEMA, noting no instances of non-compliance. Total FEMA expenses reported on the SEFA for the year ended June 30, 2025, is $9,857,313. Identification as a Repeat Finding: This is not a repeat finding. Recommendation: We recommend Management ensure that appropriate documentation be retained over the review and approval of FEMA expenditures. Views of Responsible Officials: Management understands that additional audit evidence must be retained at a detailed enough level to allow the auditor to meet their reperformance standard. All expenses claimed were eligible and were reviewed by management prior to the submission. The control issue identified is due to the lack of evidence to support approval. Should management have a future FEMA claim we will retain additional audit evidence to enable auditor reperformance of the controls regarding approval of expenditures.

Corrective Action Plan

Federal Program: Department of Homeland Security Assistance Listing: 97.036 Federal Agency: COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) (FEMA) Pass-Through Entity: State of Tennessee Grant Award Number: All FEMA Projects (Projects 435263,550461, 684580) Award Period: Project 435263: 1/1/2020-7/31/2021 Project 550461: 1/1/2020-7/31/2021 Project 684580: 8/1/2020-6/30/2022 Management understands that additional audit evidence must be retained at a detailed enough level to allow the auditor to meet their reperformance standard. All expenses claimed were eligible and were reviewed by management prior to the submission. The control issue identified is due to the lack of evidence to support approval. Should management have a future FEMA claim we will retain additional audit evidence to enable auditor reperformance of the controls regarding approval of expenditures. Paula Yarbrough, VUMC Director – Grants and Contracts will be responsible for the implementation by fiscal year-end 2026.

Categories

Subrecipient Monitoring Allowable Costs / Cost Principles Reporting Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1176646 2025-001
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
97.036 Public Assistance Grants $9.86M
93.145 AIDS EDUCATION AND TRAINING CENTERS $4.14M
93.317 EMERGING INFECTIONS PROGRAMS $2.07M
84.181 SPECIAL EDUCATION-GRANTS FOR INFANTS AND FAMILIES $2.06M
93.917 HIV CARE FORMULA GRANTS $836,827
93.914 HIV EMERGENCY RELIEF PROJECT GRANTS $835,781
93.941 HIV DEMONSTRATION, RESEARCH, PUBLIC AND PROFESSIONAL EDUCATION PROJECTS $833,062
93.998 AUTISM AND OTHER DEVELOPMENTAL DISABILITIES, SURVEILLANCE, RESEARCH, AND PREVENTION $805,877
93.918 COVID-19 GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE $767,832
93.225 NATIONAL RESEARCH SERVICE AWARDS_HEALTH SERVICES RESEARCH TRAINING $681,130
12.910 RESEARCH AND TECHNOLOGY DEVELOPMENT $678,313
93.351 RESEARCH INFRASTRUCTURE PROGRAMS $598,969
93.632 UNIVERSITY CENTERS FOR EXCELLENCE IN DEVELOPMENTAL DISABILITIES EDUCATION, RESEARCH, AND SERVICE $563,247
93.153 COVID-19 COORDINATED SERVICES AND ACCESS TO RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND YOUTH $544,368
43.008 EDUCATION $520,598
93.233 NATIONAL CENTER ON SLEEP DISORDERS RESEARCH $494,382
12.RD Department of Defense $417,678
93.253 COVID-19 POISON CENTER SUPPORT AND ENHANCEMENT GRANT $364,725
21.027 Coronavirus State and Local Fiscal Recovery Funds $341,953
93.687 MATERNAL OPIOID MISUSE MODEL (A) $320,732
93.279 DRUG ABUSE AND ADDICTION RESEARCH PROGRAMS $314,043
43.003 EXPLORATION $246,092
84.326 SPECIAL EDUCATION_TECHNICAL ASSISTANCE AND DISSEMINATION TO IMPROVE SERVICES AND RESULTS FOR CHILDREN WITH DISABILITIES $242,524
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $236,632
93.969 PPHF GERIATRIC EDUCATION CENTERS $210,710
93.185 IMMUNIZATION RESEARCH, DEMONSTRATION, PUBLIC INFORMATION AND EDUCATION_TRAINING AND CLINICAL SKILLS IMPROVEMENT PROJECTS $201,079
93.334 The Healthy Brain Initiative: Technical Assistance to Implement Public Health Actions related to Cognitive Health, Cognitive Impairment, and Caregiving at the State and Local Levels $192,632
93.127 EMERGENCY MEDICAL SERVICES FOR CHILDREN $191,334
93.247 ADVANCED NURSING EDUCATION GRANT PROGRAM $189,669
84.324 RESEARCH IN SPECIAL EDUCATION $189,200
93.069 Public Health Emergency Preparedness $182,482
47.070 COMPUTER AND INFORMATION SCIENCE AND ENGINEERING $176,584
12.351 BASIC SCIENTIFIC RESEARCH - COMBATING WEAPONS OF MASS DESTRUCTION $168,122
93.788 OPIOID STR $160,417
93.273 ALCOHOL RESEARCH PROGRAMS $159,401
93.104 COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES (SED) $159,159
98.001 USAID FOREIGN ASSISTANCE FOR PROGRAMS OVERSEAS $158,765
93.080 BLOOD DISORDER PROGRAM: PREVENTION, SURVEILLANCE, AND RESEARCH $148,459
93.912 Rural Health Care Services Outreach Program $144,562
93.398 CANCER RESEARCH MANPOWER $134,842
93.224 Community Health Centers $124,000
93.318 PROTECTING AND IMPROVING HEALTH GLOBALLY: BUILDING AND STRENGTHENING PUBLIC HEALTH IMPACT, SYSTEMS, CAPACITY AND SECURITY $122,535
16.053 Sexual Assault Forensic Examinations $118,696
93.898 CANCER PREVENTION AND CONTROL PROGRAMS FOR STATE, TERRITORIAL AND TRIBAL ORGANIZATIONS $115,762
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $106,957
93.866 AGING RESEARCH $104,448
93.478 PREVENTING MATERNAL DEATHS: SUPPORTING MATERNAL MORTALITY REVIEW COMMITTEES (B) $97,725
93.136 INJURY PREVENTION AND CONTROL RESEARCH AND STATE AND COMMUNITY BASED PROGRAMS $96,286
47.076 EDUCATION AND HUMAN RESOURCES $96,072
47.041 ENGINEERING $95,964
93.310 TRANS-NIH RESEARCH SUPPORT $91,843
93.958 BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES $90,573
93.838 LUNG DISEASES RESEARCH $85,169
93.315 RARE DISORDERS: RESEARCH, SURVEILLANCE, HEALTH PROMOTION, AND EDUCATION $80,583
93.172 HUMAN GENOME RESEARCH $78,788
93.847 DIABETES, DIGESTIVE, AND KIDNEY DISEASES EXTRAMURAL RESEARCH $74,283
12.750 UNIFORMED SERVICES UNIVERSITY MEDICAL RESEARCH PROJECTS $74,185
93.088 Advancing System Improvements for Key Issues in Women's Health $67,907
93.226 RESEARCH ON HEALTHCARE COSTS, QUALITY AND OUTCOMES $65,507
93.250 Geriatric Academic Career Awards Programs $63,111
93.113 ENVIRONMENTAL HEALTH $60,660
11.459 Weather and Air Quality Research $59,311
93.283 CENTERS FOR DISEASE CONTROL AND PREVENTION INVESTIGATIONS AND TECHNICAL ASSISTANCE $59,137
84.325 SPECIAL EDUCATION - PERSONNEL DEVELOPMENT TO IMPROVE SERVICES AND RESULTS FOR CHILDREN WITH DISABILITIES $58,978
93.084 PREVENTION OF DISEASE, DISABILITY, AND DEATH BY INFECTIOUS DISEASES $54,485
93.989 INTERNATIONAL RESEARCH AND RESEARCH TRAINING $53,922
93.393 CANCER CAUSE AND PREVENTION RESEARCH $53,608
93.855 ALLERGY, IMMUNOLOGY AND TRANSPLANTATION RESEARCH $52,767
47.075 SOCIAL, BEHAVIORAL, AND ECONOMIC SCIENCES $52,377
93.121 ORAL DISEASES AND DISORDERS RESEARCH $48,261
93.251 EARLY HEARING DETECTION AND INTERVENTION $47,492
93.353 21ST CENTURY CURES ACT - BEAU BIDEN CANCER MOONSHOT $44,334
93.U01 Department of Health and Human Services $44,138
93.286 DISCOVERY AND APPLIED RESEARCH FOR TECHNOLOGICAL INNOVATIONS TO IMPROVE HUMAN HEALTH $37,141
93.778 MEDICAL ASSISTANCE PROGRAM $36,364
10.216 1890 Institution Capacity Building Grants $33,802
93.384 ADVANCED RESEARCH PROJECTS AGENCY for HEALTH (ARPA-H) $33,207
93.135 Centers for Research and Demonstration for Health Promotion and Disease Prevention $30,142
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $29,535
93.396 CANCER BIOLOGY RESEARCH $29,488
93.103 FOOD AND DRUG ADMINISTRATION_RESEARCH $28,675
93.359 NURSE EDUCATION, PRACTICE QUALITY AND RETENTION GRANTS $27,828
93.323 EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC) $26,111
93.243 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $24,771
93.839 BLOOD DISEASES AND RESOURCES RESEARCH $24,642
93.884 PRIMARY CARE TRAINING AND ENHANCEMENT $24,258
93.067 GLOBAL AIDS $24,038
93.307 MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH $22,236
11.034 2023 MBDA Capital Readiness Program $20,776
93.630 DEVELOPMENTAL DISABILITIES BASIC SUPPORT AND ADVOCACY GRANTS $20,567
93.110 MATERNAL AND CHILD HEALTH FEDERAL CONSOLIDATED PROGRAMS $19,827
93.433 ACL NATIONAL INSTITUTE ON DISABILITY, INDEPENDENT LIVING, AND REHABILITATION RESEARCH $19,249
47.079 OFFICE OF INTERNATIONAL SCIENCE AND ENGINEERING $18,812
93.879 MEDICAL LIBRARY ASSISTANCE $18,728
93.397 CANCER CENTERS SUPPORT GRANTS $18,330
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $17,299
93.867 VISION RESEARCH $17,180
93.RD Department of Health and Human Services $14,784
12.420 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $14,216
93.840 TRANSLATION AND IMPLEMENTATION SCIENCE RESEARCH FOR HEART, LUNG, BLOOD DISEASES, AND SLEEP DISORDERS $14,012
47.084 NSF Technology, Innovation, and Partnerships $13,661
93.361 NURSING RESEARCH $11,416
93.350 NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES $7,746
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $7,494
47.074 BIOLOGICAL SCIENCES $7,491
93.846 ARTHRITIS, MUSCULOSKELETAL AND SKIN DISEASES RESEARCH $7,395
45.024 PROMOTION OF THE ARTS_GRANTS TO ORGANIZATIONS AND INDIVIDUALS $6,888
84.027 SPECIAL EDUCATION_GRANTS TO STATES $6,355
93.399 CANCER CONTROL $5,456
93.470 ALZHEIMER’S DISEASE PROGRAM INITIATIVE (ADPI) $4,699
93.078 Strengthening Emergency Care Delivery in the United States Healthcare System through Health Information and Promotion $4,625
93.173 RESEARCH RELATED TO DEAFNESS AND COMMUNICATION DISORDERS $4,610
93.242 MENTAL HEALTH RESEARCH GRANTS $4,545
93.394 CANCER DETECTION AND DIAGNOSIS RESEARCH $4,231
93.558 Temporary Assistance for Needy Families $2,767
93.213 RESEARCH AND TRAINING IN COMPLEMENTARY AND INTEGRATIVE HEALTH $2,717
16.838 COMPREHENSIVE OPIOID ABUSE SITE-BASED PROGRAM $1,591
93.837 CARDIOVASCULAR DISEASES RESEARCH $1,124
93.262 OCCUPATIONAL SAFETY AND HEALTH PROGRAM $871
12.300 Basic and Applied Scientific Research $428
93.395 CANCER TREATMENT RESEARCH $266
66.509 SCIENCE TO ACHIEVE RESULTS (STAR) RESEARCH PROGRAM $0
10.001 AGRICULTURAL RESEARCH_BASIC AND APPLIED RESEARCH $-58
10.001 AGRICULTURAL RESEARCH BASIC AND APPLIED RESEARCH $-1,211
81.RD Department of Energy $-1,326
93.268 IMMUNIZATION COOPERATIVE AGREEMENTS $-1,862
93.077 FAMILY SMOKING PREVENTION AND TOBACCO CONTROL ACT REGULATORY RESEARCH $-25,297
93.575 Child Care and Development Block Grant $-54,206