Finding 1176871 (2024-001)

Material Weakness Repeat Finding
Requirement
A
Questioned Costs
-
Year
2024
Accepted
2026-03-06
Audit: 390719
Auditor: KPMG LLP

AI Summary

  • Core Issue: An error in calculating temporary labor costs led to an overstatement of $353,420 in claims for reimbursement under the Disaster Grants program.
  • Impacted Requirements: Costs must be necessary, reasonable, and based on accurate records as per 2 CFR 200.403 and 2 CFR 200.430(g).
  • Recommended Follow-Up: Strengthen internal controls by revising invoice review procedures to ensure accurate reconciliation of hours and wages, and collaborate with the granting agency to address questioned costs.

Finding Text

Criteria Per 2 CFR 200.403, for a cost to be allowable under a Federal award, it must be necessary and reasonable for the performance of the award. Furthermore, 2 CFR 200.430(g) requires that charges for salaries and wages be based on records that accurately reflect the work performed. These records must be supported by a system of internal controls which provides reasonable assurance that the charges are accurate, allowable, and properly allocated. Condition Management's calculation for allowable temporary labor costs charged to the Disaster Grants – Public Assistance program (ALN 97.036) included an error in the data file used for the calculations. Total temporary labor costs charged to this award were $12,770,434. This error led to using incorrect wages for temporary workers who worked standard hours and overtime hours on the same day. This error occurred only for workers from one temporary labor vendor based on the formatting of the invoice information from that vendor. As a result, the temporary labor costs claimed for reimbursement for these workers were overstated by $353,420. Cause and Effect Brown Health’s control for reviewing the allowability of temporary labor invoices was not designed to include a detailed reconciliation of vendor provided data. Specifically, the review process did not verify that the wages for workers that had standard and overtime hours were consistent with the underlying invoice, which allowed the error to be undetected. The control deficiency caused Brown Health to claim temporary labor costs in excess of the actual amounts incurred. As a result, the claim was not in compliance with the Federal cost principles, which require costs to be accurate and based on records that correctly reflect the work performed. The overstated portion of the labor costs claimed for reimbursement are considered questioned costs. Questioned costs $353,420 Statistical Sample The sample was not intended to be, and was not, a statistically valid sample. Repeat Finding This is not a repeat finding. Recommendation We recommend that Brown Health management strengthen its internal controls over the review of temporary labor costs to ensure compliance with Federal regulations. Specifically, Brown Health should revise its invoice review procedures to include a detailed reconciliation of hours and wage calculations for temporary labor. Additionally, Brown Health should work with the granting agency to resolve the resulting questioned costs. View of Responsible Officials Brown Health management concurs with this finding. We have already initiated a detailed review to identify and quantify the total amount of the labor cost overstatement. We will report our results to the granting agency and work with them to resolve the questioned costs by May 31, 2026. To prevent recurrence, management will revise our review control of project applications to reconcile the calculation file to invoice support to verify accuracy.

Corrective Action Plan

Corrective Action Plan Year Ended September 30, 2024 Finding 2024-001 AL Numbers: 97.036 Program: Disaster Grants – Public Assistance (Presidentially Declared Disasters) Correction Action: We will identify and quantify the total amount of the labor cost overstatement. We will report our results to the granting agency and work with them to resolve the questioned costs by May 31, 2026. To prevent recurrence, management will revise our review control of project applications to reconcile the calculation file to invoice support to verify accuracy. Contacts: Stephen Almonte, VP of Finance and Corporate Controller Salmonte3@brownhealth.org Mark Adelman, Director Public Policy and Federal Advocacy Madelman@brownhealth.org Planned Completion Date: May 31, 2026

Categories

Allowable Costs / Cost Principles Internal Control / Segregation of Duties

Other Findings in this Audit

  • 1176872 2024-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
97.036 DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $28.79M
93.837 CARDIOVASCULAR DISEASES RESEARCH $7.00M
93.696 CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC EXPANSION GRANTS $1.38M
93.958 BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES $1.32M
84.419 PRESCHOOL DEVELOPMENT GRANTS $979,064
93.233 NATIONAL CENTER ON SLEEP DISORDERS RESEARCH $883,790
93.918 GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE $818,046
14.879 MAINSTREAM VOUCHERS $738,566
10.555 NATIONAL SCHOOL LUNCH PROGRAM $713,289
93.110 MATERNAL AND CHILD HEALTH FEDERAL CONSOLIDATED PROGRAMS $646,077
93.575 CHILD CARE AND DEVELOPMENT BLOCK GRANT $525,164
93.U01 NON-RESEARCH Other $504,749
93.870 MATERNAL, INFANT AND EARLY CHILDHOOD HOME VISITING GRANT $243,861
93.788 OPIOID STR $219,458
93.044 SPECIAL PROGRAMS FOR THE AGING, TITLE III, PART B, GRANTS FOR SUPPORTIVE SERVICES AND SENIOR CENTERS $204,145
93.859 BIOMEDICAL RESEARCH AND RESEARCH TRAINING $200,927
20.616 NATIONAL PRIORITY SAFETY PROGRAMS $186,762
93.349 PACKAGING AND SPREADING PROVEN PEDIATRIC WEIGHT MANAGEMENT INTERVENTIONS FOR USE BY LOW-INCOME FAMILIES $183,962
93.495 COMMUNITY HEALTH WORKERS FOR PUBLIC HEALTH RESPONSE AND RESILIENT $167,893
93.928 SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE $159,366
93.242 MENTAL HEALTH RESEARCH GRANTS $135,979
93.083 PREVENTION OF DISEASE, DISABILITY, AND DEATH THROUGH IMMUNIZATION AND CONTROL OF RESPIRATORY AND RELATED DISEASES $115,166
16.575 CRIME VICTIM ASSISTANCE $105,016
93.113 ENVIRONMENTAL HEALTH $104,960
17.258 WIOA ADULT PROGRAM $81,171
93.994 MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT TO THE STATES $76,437
93.394 CANCER DETECTION AND DIAGNOSIS RESEARCH $74,687
93.226 RESEARCH ON HEALTHCARE COSTS, QUALITY AND OUTCOMES $64,389
93.121 ORAL DISEASES AND DISORDERS RESEARCH $63,359
93.866 AGING RESEARCH $60,529
93.365 SICKLE CELL TREATMENT DEMONSTRATION PROGRAM $49,025
12.750 UNIFORMED SERVICES UNIVERSITY MEDICAL RESEARCH PROJECTS $48,356
93.310 TRANS-NIH RESEARCH SUPPORT $46,382
93.879 MEDICAL LIBRARY ASSISTANCE $44,814
93.153 COORDINATED SERVICES AND ACCESS TO RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND YOUTH $43,549
10.561 STATE ADMINISTRATIVE MATCHING GRANTS FOR THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM $43,476
43.083 INTEGRATIVE ACTIVITIES $43,299
93.421 STRENGTHENING PUBLIC HEALTH SYSTEMS AND SERVICES THROUGH NATIONAL PARTNERSHIPS TO IMPROVE AND PROTECT THE NATION’S HEALTH $43,102
14.218 COMMUNITY DEVELOPMENT BLOCK GRANTS/ENTITLEMENT GRANTS $42,961
93.788 Rhode Island Department of Behavioral Health $42,852
93.U03 NON-RESEARCH Other $41,890
16.015 MISSING ALZHEIMER'S DISEASE PATIENT ASSISTANCE PROGRAM $40,718
94.013 AMERICORPS VOLUNTEERS IN SERVICE TO AMERICA 94.013 $40,464
93.847 DIABETES, DIGESTIVE, AND KIDNEY DISEASES EXTRAMURAL RESEARCH $38,557
93.127 EMERGENCY MEDICAL SERVICES FOR CHILDREN $37,252
47.070 COMPUTER AND INFORMATION SCIENCE AND ENGINEERING $36,816
93.977 SEXUALLY TRANSMITTED DISEASES (STD) PREVENTION AND CONTROL GRANTS $36,316
10.553 SCHOOL BREAKFAST PROGRAM $33,024
93.273 ALCOHOL RESEARCH PROGRAMS $31,165
93.989 INTERNATIONAL RESEARCH AND RESEARCH TRAINING $29,455
93.145 HIV-RELATED TRAINING AND TECHNICAL ASSISTANCE $29,351
12.910 RESEARCH AND TECHNOLOGY DEVELOPMENT $28,901
16.560 NATIONAL INSTITUTE OF JUSTICE RESEARCH, EVALUATION, AND DEVELOPMENT PROJECT GRANTS $24,867
93.307 MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH $24,775
93.397 CANCER CENTERS SUPPORT GRANTS $23,486
93.137 COMMUNITY PROGRAMS TO IMPROVE MINORITY HEALTH $21,230
93.080 BLOOD DISORDER PROGRAM: PREVENTION, SURVEILLANCE, AND RESEARCH $19,404
93.838 LUNG DISEASES RESEARCH $19,368
93.247 ADVANCED NURSING EDUCATION WORKFORCE GRANT PROGRAM $18,535
93.RD RESEARCH $18,163
93.286 DISCOVERY AND APPLIED RESEARCH FOR TECHNOLOGICAL INNOVATIONS TO IMPROVE HUMAN HEALTH $17,115
93.393 21ST CENTURY CURES ACT - BEAU BIDEN CANCER MOONSHOT $17,114
93.855 ALLERGY AND INFECTIOUS DISEASES RESEARCH $12,407
93.279 DRUG USE AND ADDICTION RESEARCH PROGRAMS $12,338
47.041 ENGINEERING $12,131
93.361 NURSING RESEARCH $11,410
12.RD RESEARCH OTHER $10,815
64.999 Veteran Affairs $9,431
93.396 CANCER BIOLOGY RESEARCH $9,136
93.865 CHILD HEALTH AND HUMAN DEVELOPMENT EXTRAMURAL RESEARCH $7,685
93.395 CANCER TREATMENT RESEARCH $7,434
10.582 FRESH FRUIT AND VEGETABLE PROGRAM $6,484
20.600 STATE AND COMMUNITY HIGHWAY SAFETY $5,428
93.U02 NON-RESEARCH Other $5,338
93.243 SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES PROJECTS OF REGIONAL AND NATIONAL SIGNIFICANCE $4,237
93.839 BLOOD DISEASES AND RESOURCES RESEARCH $2,486
93.846 ARTHRITIS, MUSCULOSKELETAL AND SKIN DISEASES RESEARCH $1,376
12.750 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $1,121
93.853 EXTRAMURAL RESEARCH PROGRAMS IN THE NEUROSCIENCES AND NEUROLOGICAL DISORDERS $1,072
93.213 RESEARCH AND TRAINING IN COMPLEMENTARY AND INTEGRATIVE HEALTH $355
12.420 MILITARY MEDICAL RESEARCH AND DEVELOPMENT $268
93.070 ENVIRONMENTAL PUBLIC HEALTH AND EMERGENCY RESPONSE $-360
93.270 VIRAL HEPATITIS PREVENTION AND CONTROL $-648
93.136 INJURY PREVENTION AND CONTROL RESEARCH AND STATE AND COMMUNITY BASED PROGRAMS $-1,277
93.353 21ST CENTURY CURES ACT - BEAU BIDEN CANCER MOONSHOT $-23,153
93.665 EMERGENCY GRANTS TO ADDRESS MENTAL AND SUBSTANCE USE DISORDERS DURING COVID-19 $-30,958