Finding 1221659 (2025-001)

Material Weakness Repeat Finding
Requirement
L
Questioned Costs
-
Year
2025
Accepted
2026-06-30
Audit: 405945
Organization: Wakemed (NC)

AI Summary

  • Core Issue: WakeMed failed to correctly identify a federal subaward, leading to the omission of $485,737 from the Schedule of Expenditures of Federal Awards (SEFA).
  • Impacted Requirements: Compliance with 2 CFR § 200.302(b)(1) and 2 CFR § 200.510(b) regarding accurate reporting of federal awards.
  • Recommended Follow-Up: Establish a process to differentiate between subrecipients and contractors, supported by a new grant governance committee and dedicated grant management staff.

Finding Text

Assistance Listing, Federal Agency, and Program Name 93.889, U.S. Department of Health and Human Services, National Bioterrorism Hospital Preparedness Program Federal Award Identification Number and Year DKT3LLBWFVL3 - 2025 Pass through Entity North Carolina Department of Health and Human Services Finding Type Material weakness Repeat Finding No Criteria WakeMed is responsible for identifying in its accounting records all federal awards received and expended and the federal programs under which they were received, including the Assistance Listing title and number, federal award identification number, award year, and federal agency or pass through entity, as applicable, in accordance with 2 CFR § 200.302(b)(1). In addition, 2 CFR § 200.510(b) requires WakeMed to prepare a schedule of expenditures of federal awards for the period covered by the financial statements that includes total federal awards expended and identifies individual federal programs by federal agency, including applicable Assistance Listing Numbers and pass through identifying information. Under 2 CFR § 200.331, the substance of the relationship is more important than the form of the agreement, and each agreement should be evaluated to determine whether the entity is acting as a subrecipient or contractor. Condition Management did not initially identify a contract with an awarding agency as a federal subaward, which resulted in ALN 93.889 being omitted from the SEFA. The amount was subsequently added to the SEFA. Questioned Costs N/A If questioned costs are not determinable, description of why known questioned costs were undetermined or otherwise could not be reported N/A Identification of How Questioned Costs Were Computed N/A Context Management incorrectly identified that they were a contractor of funds received from the North Carolina Department of Health and Human services under ALN 93.889 rather than a subrecipient. As a result, the schedule of expenditures of federal awards reported for the year ended September 30, 2025 did not originally have this grant included and was understated by $485,737. Cause and Effect Controls in place did not ensure the SEFA was complete and accurate. The lack of controls resulted in an understatement of the schedule of expenditures of federal awards for the year ended September 30, 2025. There was no impact to major program determination for the year ended September 30, 2025. Recommendation Management should implement a process to ensure appropriate identification for agreements in which they are considered a subrecipient vs a contractor. Views of Responsible Officials and Corrective Action Plan Management concurs with the finding and has implemented a new grant governance committee and process for identifying grant components before entering into grant agreements. Management also created a new grant department with staff devoted to researching, applying for, monitoring, and reporting on all grants. The accounting function for grants will be done by this team as well but with continued oversight by the Executive Director, Accounting.

Corrective Action Plan

Finding Number: 2025-001 Condition: Management concurs with the finding and has implemented a new grant governance committee and process for identifying grant components before entering into grant agreements. Management also created a new grant department with staff devoted to researching, applying for, monitoring, and reporting on all grants. The accounting function for grants will be done by this team as well but with continued oversight by the Executive Director, Accounting. Contact person responsible for corrective action: Stephanie Sessoms, Chief Financial Officer; Lynn Bailey, Executive Director, Accounting Anticipated Completion Date: 1/12/2026

Categories

Subrecipient Monitoring Reporting

Programs in Audit

ALN Program Name Expenditures
97.036 COVID-19 - DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $1.76M
93.889 NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS PROGRAM $485,737
93.361 NURSING RESEARCH $255,614
93.107 AREA HEALTH EDUCATION CENTERS $127,140
16.575 CRIME VICTIM ASSISTANCE $113,515
93.008 MEDICAL RESERVE CORPS SMALL GRANT PROGRAM $96,666
93.969 PPHF GERIATRIC EDUCATION CENTERS $4,500