Finding 1239137 (2025-001)

Material Weakness Repeat Finding
Requirement
F
Questioned Costs
-
Year
2025
Accepted
2026-09-30
Audit: 414000
Organization: Advocate Aurora Health, Inc. (IL)

AI Summary

  • Core Issue: The System lacks proper internal controls, leading to inadequate property records for federally funded equipment.
  • Impacted Requirements: Non-compliance with Section 200.313(d)(1) and (2) of the Uniform Guidance regarding equipment management and record-keeping.
  • Recommended Follow-Up: Implement stronger internal controls and conduct regular physical inventories to ensure accurate tracking and compliance with federal regulations.

Finding Text

Finding 2025-001 Equipment and Real Property Management Information on the federal program: Federal Agency: United States Department of Health and Human Services ALN: 93.889 National Bioterrorism Hospital Preparedness Program Pass-Through Grantor: Illinois Department of Public Health and Illinois Health and Hospital Association Pass-Through Award Number: 57280009M; 67280009N; 47280009L; 47280007L; 57280009M Pass-Through Award Period: 7/1/2023 to 6/30/2026 Criteria or Specific Requirement (Including Statutory, Regulatory, or Other Citation): Section 200.303 of the Uniform Guidance states the following regarding internal control: “The non-Federal entity must: (a) Establish, document, and maintain effective internal control over the Federal award that provides reasonable assurance that the recipient or subrecipient 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). Section 200.313(d)(1) and (2) states, “Regardless of whether equipment is acquired in part or its entirety under Federal award, the recipient or subrecipient must manage equipment (including replacement equipment) utilizing procedures that meet the following requirements: Property records must include a description of the property, a serial number or another identification number, the source of funding for the property (including FAIN), the title holder, the acquisition date, the cost of the property, the percentage of the Federal agency contributions towards the original purchase, the location, use and condition of the property, and the disposition data including the date of disposal and sale price of the property. The recipient and subrecipient are responsible for maintaining and updating property records when there is a change in the status of the property. Section III – Federal Award Findings and Questioned Costs (continued) Condition: The System did not retain property records documenting the appropriate criteria required by Section 200.313(d)(1) and (2). Cause: The System did not have sufficiently designed internal controls to ensure that property records are retained in accordance with Section 200.313(d)(1) and (2). Effect or potential effect: Federal equipment may not be maintained or disposed of in accordance with federal regulations. Questioned Costs: $8,481 Context: We tested a sample of six items from the equipment listing related to the federal program for the period January 1, 2025 through December 31, 2025. For one item selected for testing, the serial number listed on the item was not recorded in the property records to ensure the asset was appropriately designated for use in accordance with the requirements of the grant. For one item selected for testing, the item was unable to be physically located. The total National Bioterrorism Hospital Preparedness Program expenditures reported on the Schedule are $882,827 for the year ended December 31, 2025. The net book value of all assets related to this federal program was $161,020. The net book value of the assets with exceptions identified was $8,481. Identification as a repeat finding, if applicable: This is a repeat finding of 2024-005 from the prior year. Recommendation: The System should implement more robust internal controls to ensure that accurate property records are maintained. Section III – Federal Award Findings and Questioned Costs (continued) Views of responsible officials: Management agrees with the finding and will ensure that the enhanced procedures and monitoring controls already in place are consistently followed to ensure that equipment acquired with Federal grant funds is accurately recorded, properly tracked, and supported by property records that are maintained and retained in accordance with 2 CFR § 200.313(d)(1) and (2). The Program team is responsible for ensuring that physical inventories are conducted at least every two years, reconciled to the applicable property records, and that any discrepancies identified are investigated and resolved in a timely manner. These corrective actions will strengthen internal controls over federally funded equipment and support continued compliance with applicable Federal requirements.

Corrective Action Plan

Finding 2025-001 (ALN 93.889) The Organization did not have sufficiently designed internal controls to ensure that property records are retained in accordance with Section 200.313(d)(1) and (2). This is a repeat finding (2024-005) Management Response: Management agrees with the finding and will ensure that the enhanced procedures and monitoring controls already in place are consistently followed to ensure that equipment acquired with Federal grant funds is accurately recorded, properly tracked, and supported by property records that are maintained and retained in accordance with 2 CFR § 200.313(d)(1) and (2). The Program team is responsible for ensuring that physical inventories are conducted at least every two years, reconciled to the applicable property records, and that any discrepancies identified are investigated and resolved in a timely manner. These corrective actions will strengthen internal controls over federally funded equipment and support continued compliance with applicable Federal requirements. Contact Person(s) Responsible for Corrective Action: Steve Baron, Program Manager Anticipated Completion Date: December 31, 2026

Categories

Equipment & Real Property Management Subrecipient Monitoring

Other Findings in this Audit

  • 1239132 2025-001
    Material Weakness Repeat
  • 1239133 2025-001
    Material Weakness Repeat
  • 1239134 2025-001
    Material Weakness Repeat
  • 1239135 2025-001
    Material Weakness Repeat
  • 1239136 2025-001
    Material Weakness Repeat
  • 1239138 2025-002
    Material Weakness Repeat
  • 1239139 2025-002
    Material Weakness Repeat
  • 1239140 2025-002
    Material Weakness Repeat
  • 1239141 2025-002
    Material Weakness Repeat
  • 1239142 2025-002
    Material Weakness Repeat
  • 1239143 2025-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
97.036 DISASTER GRANTS - PUBLIC ASSISTANCE (PRESIDENTIALLY DECLARED DISASTERS) $1.23M
93.399 CANCER CONTROL $898,702
93.788 OPIOID STR $626,760
16.575 CRIME VICTIM ASSISTANCE $594,353
11.039 REGIONAL TECHNOLOGY AND INNOVATION HUBS $458,961
93.073 BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES - PREVENTION AND SURVEILLANCE $430,968
93.840 TRANSLATION AND IMPLEMENTATION SCIENCE RESEARCH FOR HEART, LUNG, BLOOD DISEASES, AND SLEEP DISORDERS $338,586
93.958 BLOCK GRANTS FOR COMMUNITY MENTAL HEALTH SERVICES $231,893
93.226 RESEARCH ON HEALTHCARE COSTS, QUALITY AND OUTCOMES $230,974
16.753 CONGRESSIONALLY RECOMMENDED AWARDS $195,084
93.969 PPHF GERIATRIC EDUCATION CENTERS $166,947
93.083 PREVENTION OF DISEASE, DISABILITY, AND DEATH THROUGH IMMUNIZATION AND CONTROL OF RESPIRATORY AND RELATED DISEASES $154,498
14.251 ECONOMIC DEVELOPMENT INITIATIVE, COMMUNITY PROJECT FUNDING, AND MISCELLANEOUS GRANTS $148,488
93.307 MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH $136,421
93.778 GRANTS TO STATES FOR MEDICAID $135,889
93.493 CONGRESSIONAL DIRECTIVES $133,076
17.289 COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING $102,527
20.600 STATE AND COMMUNITY HIGHWAY SAFETY $91,484
93.959 BLOCK GRANTS FOR PREVENTION AND TREATMENT OF SUBSTANCE ABUSE $89,719
16.588 VIOLENCE AGAINST WOMEN FORMULA GRANTS $88,182
93.866 AGING RESEARCH $79,086
93.889 NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS PROGRAM $75,229
93.855 ALLERGY AND INFECTIOUS DISEASES RESEARCH $59,607
93.395 CANCER TREATMENT RESEARCH $31,900
81.041 STATE ENERGY PROGRAM $30,102
93.350 NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES $28,145
93.323 EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES (ELC) $20,643
10.557 WIC SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN $17,449
93.393 CANCER CAUSE AND PREVENTION RESEARCH $15,000
84.116 FUND FOR THE IMPROVEMENT OF POSTSECONDARY EDUCATION $14,742
93.898 CANCER PREVENTION AND CONTROL PROGRAMS FOR STATE, TERRITORIAL AND TRIBAL ORGANIZATIONS $14,416
93.837 CARDIOVASCULAR DISEASES RESEARCH $10,237
93.516 PUBLIC HEALTH TRAINING CENTERS PROGRAM $10,000
93.847 DIABETES, DIGESTIVE, AND KIDNEY DISEASES EXTRAMURAL RESEARCH $9,731
93.566 REFUGEE AND ENTRANT ASSISTANCE STATE/REPLACEMENT DESIGNEE ADMINISTERED PROGRAMS $7,304
10.555 NATIONAL SCHOOL LUNCH PROGRAM $5,526
21.027 CORONAVIRUS STATE AND LOCAL FISCAL RECOVERY FUNDS $4,500
10.558 CHILD AND ADULT CARE FOOD PROGRAM $1,460