Finding 387562 (2023-002)

-
Requirement
H
Questioned Costs
-
Year
2023
Accepted
2024-03-28
Audit: 299676
Organization: Trinity Health (MI)

AI Summary

  • Core Issue: The Corporation failed to report $2,000,000 in CSLFRF grant expenditures from Saint Agnes Medical Center in its SEFA for the year ended June 30, 2022.
  • Impacted Requirements: This omission violates federal regulations requiring a complete schedule of federal awards as per § 200.510(b) of the CFR.
  • Recommended Follow-Up: Implement stronger policies and procedures to ensure all grant expenditures are accurately reported in the consolidated SEFA moving forward.

Finding Text

Condition – The Corporation did not report $2,000,000 of CSLFRF grant expenditures received by Saint Agnes Medical Center Fresno (“Fresno”) in the consolidated SEFA for the year ended June 30, 2022. This resulted in an understatement of CSLFRF expenditures on the Corporation’s SEFA for the year ended June 30, 2022. This issue was discussed with the County of Fresno, the pass-through granting agency for this program, who requested the omitted CSLFRF expenditures be tested and included in the Corporation’s SEFA for the year ended June 30, 2023. Criteria – According to § 200.510(b) of the Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, “The auditee must also prepare a schedule of expenditures of Federal awards for the period covered by the auditee's financial statements which must include the total Federal awards expended as determined in accordance with § 200.502.” Cause – The Fresno accounting department reported the CSLFRF grant to the Trinity Health Financial Reporting team incorrectly which resulted in the Fresno CSLFRF grant not being included in ALN 21.027, which was a major program for the year ended June 30, 2022. Effect – The Corporation’s SEFA for the year ended June 30, 2022 was understated by $2,000,000. Consequences for failure to comply with grant conditions may include a reduction of overall award and/or a restriction or reduction in future awards. Questioned costs – None Context – The Corporation did not report $2,000,000 of CSLFRF funds on its prior year SEFA. Repeat Finding from Prior Year – No Recommendation – The Corporation should institute additional policies and procedures to ensure grant expenditures reported by all locations are appropriately and completely included in the consolidated SEFA.

Corrective Action Plan

Management has instituted measures to ensure that future reporting is accurate and complete. This includes review of all grant expenditure activity as transacted in the financial general ledger, as well as a full review of all funding received identified as either a grant or award. All supporting documentation shall be obtained and reviewed for proper designation of funding source, with determination as to whether funding is federal in nature. This information will be used to populate the SEFA template to ensure accurate reporting before submission into the Corporation’s consolidated SEFA. Support obtained from funding sources will also be used to correctly identify the federal ALN that in turn will be reported on the SEFA. Final review of the SEFA with supporting documentation and sign off will be performed by the Regional Controller.

Categories

Reporting

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $126.50M
84.268 Federal Direct Student Loans $2.96M
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.00M
93.261 National Diabetes Prevention Program: Preventing Type 2 Diabetes Among People at High Risk $1.88M
84.063 Federal Pell Grant Program $1.65M
84.425 Education Stabilization Fund $1.11M
93.074 Hospital Preparedness Program (hpp) and Public Health Emergency Preparedness (phep) Aligned Cooperative Agreements $609,919
16.575 Crime Victim Assistance $594,600
93.829 Section 223 Demonstration Programs to Improve Community Mental Health Services $489,220
93.650 Accountable Health Communities $430,090
93.917 Hiv Care Formula Grants $397,044
93.969 Pphf Geriatric Education Centers $353,271
93.150 Projects for Assistance in Transition From Homelessness (path) $342,150
93.778 Medical Assistance Program $325,526
93.889 National Bioterrorism Hospital Preparedness Program $292,008
14.241 Housing Opportunities for Persons with Aids $261,942
14.267 Continuum of Care Program $259,663
93.011 National Organizations of State and Local Officials $257,306
93.994 Maternal and Child Health Services Block Grant to the States $216,013
14.231 Emergency Solutions Grant Program $197,000
93.604 Assistance for Torture Victims $183,095
93.276 Drug-Free Communities Support Program Grants $174,133
97.024 Emergency Food and Shelter National Board Program $174,078
93.914 Hiv Emergency Relief Project Grants $152,809
93.667 Social Services Block Grant $152,319
21.019 Coronavirus Relief Fund $102,179
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $100,527
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $92,190
93.788 Opioid Str $80,483
84.007 Federal Supplemental Educational Opportunity Grants $78,897
93.359 Nurse Education, Practice Quality and Retention Grants $78,672
93.426 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke $75,000
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $63,556
93.940 Hiv Prevention Activities_health Department Based $54,871
93.461 Covid-19 Testing for the Uninsured $52,956
93.958 Block Grants for Community Mental Health Services $50,000
16.838 Comprehensive Opioid Abuse Site-Based Program $47,795
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $46,713
16.831 Children of Incarcerated Parents $43,964
93.301 Small Rural Hospital Improvement Grant Program $39,200
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $37,972
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $37,803
93.399 Cancer Control $37,649
16.588 Violence Against Women Formula Grants $36,779
93.310 Trans-Nih Research Support $26,549
14.218 Community Development Block Grants/entitlement Grants $26,000
93.268 Immunization Cooperative Agreements $24,819
93.747 Elder Abuse Prevention Interventions Program $22,175
93.247 Advanced Nursing Education Grant Program $21,728
93.069 Public Health Emergency Preparedness $19,300
10.558 Child and Adult Care Food Program $16,918
16.529 Education, Training, and Enhanced Services to End Violence Against and Abuse of Women with Disabilities $16,197
93.839 Blood Diseases and Resources Research $15,000
93.364 Nursing Student Loans $14,750
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $14,556
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $14,003
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $11,276
84.033 Federal Work-Study Program $9,484
93.959 Block Grants for Prevention and Treatment of Substance Abuse $9,300
16.017 Sexual Assault Services Formula Program $8,391
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $6,965
93.395 Cancer Treatment Research $4,847
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $4,568
20.600 State and Community Highway Safety $4,133
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $4,125
93.837 Cardiovascular Diseases Research $4,000
93.566 Refugee and Entrant Assistance_state Administered Programs $3,427
93.283 Centers for Disease Control and Prevention_investigations and Technical Assistance $3,300
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $2,633
93.697 Covid-19 Testing for Rural Health Clinics $2,037
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $1,975
93.575 Child Care and Development Block Grant $1,603
93.866 Aging Research $1,558
93.879 Medical Library Assistance $1,200