Finding 498939 (2023-001)

Significant Deficiency
Requirement
I
Questioned Costs
-
Year
2023
Accepted
2024-09-27

AI Summary

  • Core Issue: AdventHealth lacks effective internal controls for validating suspension and debarment checks performed by a third-party service provider, risking inaccurate vendor screenings.
  • Impacted Requirements: Non-compliance with 2 CFR Section 200.303, which mandates effective internal controls over federal awards.
  • Recommended Follow-Up: Implement validation controls for third-party screening results and establish a reconciliation process between AdventHealth's vendor list and the provider's results.

Finding Text

Finding 2023-001 Identification of the Federal Program: Federal Grantor: United States Department of Health and Human Services and Department of Defense Assistance Listing No.: Various; Research and Development Cluster Period of Performance: January 1, 2023 – December 31, 2023 Criteria or Specific Requirement (Including Statutory, Regulatory or Other Citation): 2 CFR Section 200.303 of the Uniform Guidance states the following regarding internal control: “The Non-Federal entity must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with 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: We noted the following matters during our testing of suspension and debarment control processes: (a) AdventHealth utilizes a third-party service provider to perform on-going monitoring and screening of its vendors and suppliers for suspension and debarment. AdventHealth relied on the results of the suspension and debarment checks performed by the third-party service provider without having a validation control to ensure the results provided by the third_x0002_party service provider were accurate. The third-party service provider does not have a SOC 1 (System and Organization Controls) Report. (b) AdventHealth does not receive a listing, from the third-party service provider, of all vendors and suppliers screened on a monthly basis. While AdventHealth does receive a listing of vendors and suppliers with a “match” or “potential match”, since the full listing of all vendors and suppliers screened was not available, it could not be determined whether all vendors and suppliers were appropriately screened by the third-party service provider. On an annual basis, AdventHealth did receive the full listing of all vendors and suppliers that were screened for suspension and debarment by the third-party service provider. However, a reconciliation between the vendor and supplier list provided by AdventHealth and the list that is received from the third-party service provider was not performed. Cause: AdventHealth did not add an additional validation control to ensure that the suspension and debarment checks performed by the third-party service provider aligned with the governmental suspension and debarment database when the search resulted in no match. In addition, AdventHealth did not have policies and procedures in place to require that documentation is retained to support the reconciliations performed between the vendor and supplier list sent to the third-party service provider and the results provided by the third-party service provider. Effect or Potential Effect: AdventHealth’s screening for suspension and debarment through the third-party service provider may not be accurate. By not performing a reconciliation between the vendor and supplier list in AdventHealth’s database and the results provided by the third-party service provider, there exists a risk that certain vendors and suppliers were not screened by the third-party service provider. Questioned costs: None Context: AdventHealth, as part of its internal control process, internally performs screening for all “new” vendors and suppliers prior to adding them in the database. We tested 40 new vendors that were added to the database in fiscal year 2023 and found no issues. As such, there exists a process to ensure that only valid and appropriately screened vendors and suppliers are contracted with. Since the issue relates to the on-going monitoring performed by the third-party service provider, for which appropriate controls were not put in place, this resulted in a deficiency in internal control process. The federal portion of expenditures subject to suspension and debarment was approximately $354,000, which represents approximately 5.5% of the total Research and Development Cluster federal expenditures. The total amount reported on the SEFA for R&D cluster is $6,392,558. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: Management should add controls to validate the accuracy of the suspension and debarment search results performed by the third-party service provider when the search results in no match. In addition, management should implement a process over the reconciliation of the vendor and supplier list to the third-party service provider list to ensure completeness of the suspension and debarment checks performed. Views of Responsible Officials: Management agrees with the finding. Management plans to add controls to validate the accuracy of the suspension and debarment search results performed by the third-party service provider when the search results in no match. In addition, management plans to implement a process over the reconciliation of the vendor and supplier list to the third-party service provider list to ensure completeness of the suspension and debarment checks performed.

Categories

Procurement, Suspension & Debarment Subrecipient Monitoring Period of Performance Reporting

Other Findings in this Audit

  • 498921 2023-001
    Significant Deficiency
  • 498922 2023-001
    Significant Deficiency
  • 498923 2023-001
    Significant Deficiency
  • 498924 2023-001
    Significant Deficiency
  • 498925 2023-001
    Significant Deficiency
  • 498926 2023-001
    Significant Deficiency
  • 498927 2023-001
    Significant Deficiency
  • 498928 2023-001
    Significant Deficiency
  • 498929 2023-001
    Significant Deficiency
  • 498930 2023-001
    Significant Deficiency
  • 498931 2023-001
    Significant Deficiency
  • 498932 2023-001
    Significant Deficiency
  • 498933 2023-001
    Significant Deficiency
  • 498934 2023-001
    Significant Deficiency
  • 498935 2023-001
    Significant Deficiency
  • 498936 2023-001
    Significant Deficiency
  • 498937 2023-001
    Significant Deficiency
  • 498938 2023-001
    Significant Deficiency
  • 498940 2023-001
    Significant Deficiency
  • 498941 2023-001
    Significant Deficiency
  • 498942 2023-001
    Significant Deficiency
  • 498943 2023-001
    Significant Deficiency
  • 498944 2023-001
    Significant Deficiency
  • 498945 2023-001
    Significant Deficiency
  • 498946 2023-001
    Significant Deficiency
  • 498947 2023-001
    Significant Deficiency
  • 498948 2023-001
    Significant Deficiency
  • 498949 2023-001
    Significant Deficiency
  • 498950 2023-001
    Significant Deficiency
  • 498951 2023-001
    Significant Deficiency
  • 498952 2023-001
    Significant Deficiency
  • 498953 2023-001
    Significant Deficiency
  • 1075363 2023-001
    Significant Deficiency
  • 1075364 2023-001
    Significant Deficiency
  • 1075365 2023-001
    Significant Deficiency
  • 1075366 2023-001
    Significant Deficiency
  • 1075367 2023-001
    Significant Deficiency
  • 1075368 2023-001
    Significant Deficiency
  • 1075369 2023-001
    Significant Deficiency
  • 1075370 2023-001
    Significant Deficiency
  • 1075371 2023-001
    Significant Deficiency
  • 1075372 2023-001
    Significant Deficiency
  • 1075373 2023-001
    Significant Deficiency
  • 1075374 2023-001
    Significant Deficiency
  • 1075375 2023-001
    Significant Deficiency
  • 1075376 2023-001
    Significant Deficiency
  • 1075377 2023-001
    Significant Deficiency
  • 1075378 2023-001
    Significant Deficiency
  • 1075379 2023-001
    Significant Deficiency
  • 1075380 2023-001
    Significant Deficiency
  • 1075381 2023-001
    Significant Deficiency
  • 1075382 2023-001
    Significant Deficiency
  • 1075383 2023-001
    Significant Deficiency
  • 1075384 2023-001
    Significant Deficiency
  • 1075385 2023-001
    Significant Deficiency
  • 1075386 2023-001
    Significant Deficiency
  • 1075387 2023-001
    Significant Deficiency
  • 1075388 2023-001
    Significant Deficiency
  • 1075389 2023-001
    Significant Deficiency
  • 1075390 2023-001
    Significant Deficiency
  • 1075391 2023-001
    Significant Deficiency
  • 1075392 2023-001
    Significant Deficiency
  • 1075393 2023-001
    Significant Deficiency
  • 1075394 2023-001
    Significant Deficiency
  • 1075395 2023-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $64.45M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $2.90M
93.310 Trans-Nih Research Support $1.01M
93.493 Congressional Directives $659,091
93.788 Opioid Str $228,440
93.866 Aging Research $160,703
93.575 Child Care and Development Block Grant $134,706
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $94,266
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $56,427
93.461 Hrsa Covid-19 Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Fund $52,256
93.395 Cancer Treatment Research $23,078
93.837 Cardiovascular Diseases Research $11,900
12.420 Military Medical Research and Development $11,430
21.027 Coronavirus State and Local Fiscal Recovery Funds $10,415
93.865 Child Health and Human Development Extramural Research $9,050
93.399 Cancer Control $4,700
93.394 Cancer Detection and Diagnosis Research $2,400