FAC Explorer

Finding 588292 (2022-002)

Significant Deficiency
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2024-02-06
Audit: 15702
Organization: Grady Memorial Hospital Corporation (GA)
Auditor: Kpmg

AI Summary

  • Core Issue: Lack of documentation showing management reviewed the HRSA portal submission before it was sent to the U.S. Department of Health and Human Services.
  • Impacted Requirements: Non-compliance with 45 CFR section 75.303(a) and (b) regarding internal controls and proper documentation for federal funds.
  • Recommended Follow-up: Implement stronger controls to ensure management reviews are documented and maintain adequate records for all federal award expenses.

Finding Text

Criteria: 45 CFR section 75.303 (a) states non-federal entities 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). 45 CFR section 75.303 (b) states non-federal entities must: Comply with Federal statutes, regulations, and the terms and conditions of the Federal awards. Recipients of provider relief funds must support all expenses with adequate documentation and maintain proper control documentation to substantiate that these funds were used for health care-related expenses or lost revenues attributable to coronavirus. Condition Found, Including Perspective: There is no documentation to evidence of management’s review of the HRSA portal submission prior to their submission to the U.S. Department of Health and Human Services. Possible Cause and Effect: While the System maintains that review did take place prior to the portal submission, controls were not designed or implemented effectively to maintain evidence of management’s review. Questioned Costs: None.

Categories

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties

Other Findings in this Audit

  • 11850 2022-002
    Significant Deficiency
  • 11851 2022-001
    Significant Deficiency
  • 11852 2022-001
    Significant Deficiency
  • 11853 2022-001
    Significant Deficiency
  • 11854 2022-001
    Significant Deficiency
  • 11855 2022-001
    Significant Deficiency
  • 11856 2022-001
    Significant Deficiency
  • 11857 2022-001
    Significant Deficiency
  • 11858 2022-001
    Significant Deficiency
  • 11859 2022-001
    Significant Deficiency
  • 11860 2022-001
    Significant Deficiency
  • 588293 2022-001
    Significant Deficiency
  • 588294 2022-001
    Significant Deficiency
  • 588295 2022-001
    Significant Deficiency
  • 588296 2022-001
    Significant Deficiency
  • 588297 2022-001
    Significant Deficiency
  • 588298 2022-001
    Significant Deficiency
  • 588299 2022-001
    Significant Deficiency
  • 588300 2022-001
    Significant Deficiency
  • 588301 2022-001
    Significant Deficiency
  • 588302 2022-001
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.914 Hiv Emergency Relief Project Grants $9.18M
21.027 Coronavirus State and Local Fiscal Recovery Funds $4.07M
93.461 Covid-19 Testing for the Uninsured $1.71M
93.498 Provider Relief Fund $1.46M
93.778 Medical Assistance Program $1.32M
16.575 Crime Victim Assistance $995,016
93.253 Poison Center Support and Enhancement Grant $664,123
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $457,347
93.217 Family Planning_services $412,138
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $376,576
93.686 Ending the Hiv Epidemic: A Plan for America — Ryan White Hiv/aids Program Parts A and B (b) $336,380
93.145 Aids Education and Training Centers $315,660
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $308,548
93.959 Block Grants for Prevention and Treatment of Substance Abuse $257,839
93.310 Trans-Nih Research Support $191,324
93.069 Public Health Emergency Preparedness $181,200
93.051 Alzheimer's Disease Demonstration Grants to States $174,922
93.150 Projects for Assistance in Transition From Homelessness (path) $139,425
84.063 Federal Pell Grant Program $129,521
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $127,891
93.924 Ryan White Hiv/aids Dental Reimbursement and Community Based Dental Partnership Grants $107,297
84.425 Education Stabilization Fund $93,000
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $77,576
93.928 Special Projects of National Significance $67,500
16.034 Coronavirus Emergency Supplemental Funding Program $64,127
93.958 Block Grants for Community Mental Health Services $38,150
14.231 Emergency Solutions Grant Program $37,102
93.136 Injury Prevention and Control Research and State and Community Based Programs $34,377
93.665 Emergency Grants to Address Mental and Substance Use Disorders During Covid-19 $11,589
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $8,086
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $4,982
93.121 Oral Diseases and Disorders Research $1,677