FAC Explorer

Finding 639120 (2022-001)

Material Weakness
Requirement
I
Questioned Costs
-
Year
2022
Accepted
2023-10-01
Audit: 54476
Organization: Nationwide Children's Hospital (OH)
Auditor: Ernst & Young

AI Summary

  • Core Issue: Nationwide Children’s Hospital lacks proper documentation and internal controls for suspension and debarment checks, risking compliance with federal regulations.
  • Impacted Requirements: This finding violates Section 200.303 and Section 200.214 of the Uniform Guidance, which mandate effective internal controls and proper documentation for federal awards.
  • Recommended Follow-Up: Implement a process to maintain documentation for all suspension and debarment checks and establish internal controls to verify third-party results and reconcile vendor lists.

Finding Text

Finding 2022 ? 001 Identification of the federal program: Federal Agency: Department of Health and Human Services Assistance Listing No., Award Name, Award Number and Pass-through Agency: Assistance Listing Award Name Award Number Pass-Through Agency 93.127 Emergency Medical Services For Children 5 U03MC28844-07-00 93.136 Injury Prevention And Control Research And State And Community Based Programs 5 R49CE003074-03-00 93.136 Injury Prevention And Control Research And State And Community Based Programs 1 R01CE003349-01-00 93.136 Injury Prevention And Control Research And State And Community Based Programs 5 R49CE003074-03-00 93.137 Community Programs To Improve Minority Health Grant Program 5 CPIMP201202-02-00 93.242 Mental Health Research Grants 5R01MH117594-04 93.297 Teenage Pregnancy Prevention Program 5 TP1AH000212-02-00 93.297 Teenage Pregnancy Prevention Program 5 TP1AH000212-03-00 93.353 21ST Century Cures Act ? Beau Biden Cancer Moonshot 1U54CA231641-01 93.353 21ST Century Cures Act ? Beau Biden Cancer Moonshot 1U01CA232488-01 93.378 Integrated Care For Kids Model 2B2CMS331798-03-00 Centers for Medicare & Medicaid Services 93.590 Community-Based Child Abuse Prevention Grants G-2223-22-0246 Ohio Children?s Trust Fund 93.837 Cardiovascular Disease Research 5R01HL135103-05 93.837 Cardiovascular Disease Research 5R01HL157491-02 93.838 Lung Disease Research 1R01HL157039-01 93.838 Lung Disease Research 5R01HL157039-02 93.839 Blood Disease And Resources Research 1R01HL157208-01A1 93.846 Arthritis, Musculoskeletal And Skin Disease Research 5R01AR073908-03Assistance Listing Award Name Award Number Pass-Through Agency 93.846 Arthritis, Musculoskeletal And Skin Disease Research 1R01AR078395-01A1 93.846 Arthritis, Musculoskeletal And Skin Disease Research 5R01AR073311-04 93.847 Diabetes, Digestive, And Kidney Disease Extramural Research 1R01DK128088-01A1 93.847 Diabetes, Digestive, And Kidney Disease Extramural Research 5U01DK100866-09 93.855 Allergy And Infectious Disease Research 1R01AI151175-01A1 93.855 Allergy And Infectious Disease Research 5R01AI126890-05 93.855 Allergy And Infectious Disease Research 5R01AI096882-09 93.855 Allergy And Infectious Disease Research 5R01AI146581-02 93.855 Allergy And Infectious Disease Research 5R01AI096882-09 93.855 Allergy And Infectious Disease Research 5R01AI116917-08 93.855 Allergy And Infectious Disease Research 5R01AI114581-07 93.865 Child Health And Human Development Extramural Research 5R01HD095976-03 93.865 Child Health And Human Development Extramural Research 5R01HD091347-04 93.865 Child Health And Human Development Extramural Research 5R01HD098175-02 93.865 Child Health And Human Development Extramural Research 5R01HD100420-02 93.870 Maternal, Infant And Early Childhood Home Visiting Grant 02560511MH0622 93.870 Maternal, Infant And Early Childhood Home Visiting Grant 02560511MH0622 Ohio Department of Health Criteria or specific requirement (including statutory, regulatory or other citation): Section 200.303 of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) states the following regarding internal control:?The non-Federal entity must: (a) 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).? Section 200.214 Suspension and Debarment ?Non-Federal entities are subject to the non-procurement debarment and suspension regulations implementing Executive Orders 12549 and 12689, 2 CFR part 180. The regulations in 2 CFR part 180 restrict awards, subawards, and contracts with certain parties that are debarred, suspended, or otherwise excluded from or ineligible for participation in Federal assistance programs or activities.? Condition: Nationwide Children?s Hospital (the Corporation) uses a third-party to perform its suspension and debarment checks on a monthly basis. However, we noted the following matters: ? The Corporation did not retain the monthly supporting documentation related to the monthly suspension and debarment check. The suspension and debarment checks performed at year-end were retained. ? The Corporation does not have a process to reconcile the vendor list provided to the thirdparty with the results received from the third-party vendor after the suspension and debarment checks are performed to ensure the listing is complete. ? The third-party vendor does not have a SOC 1 (System and Organization Controls) Report. The Corporation relied on the results of the suspension and debarment checks performed by the third-party vendor without implementing an internal process to ensure the results provided by the third-party vendor were accurate.In addition, the Corporation performs a suspension and debarment check of all new vendors prior to activating them in the procurement system. The Corporation did not consistently maintain supporting documentation to support the vendor was checked for suspension and debarment before the ?new? vendor was set up in the procurement system. Cause: The Corporation does not have internal controls in place to require supporting documentation be maintained over the monthly suspension and debarment checks including documentation of management?s review and approval. The Corporation does not have internal controls in place to review the accuracy of third-party reports and to require a reconciliation between the vendor list sent to the third-party vendor and the results provided by the third-party vendor. The Corporation does not have internal controls in place to require supporting documentation be maintained over the suspension and debarment check performed on new vendors. Effect or potential effect: The Corporation?s vendors may not be screened for suspension and debarment, or the suspension and debarment results may not be accurate. A vendor may be set up in the procurement system that is suspended or debarred. Questioned costs: None Context: We tested a sample of 40 new vendors set up in the procurement system in 2022 and noted four instances where management did not retain the supporting documents of its review of suspension and debarment for the vendor.The federal portion of procurement expenditures subject to suspension and debarment was $10,415,440 which represents approximately 12.3% of the R&D Cluster federal expenditures. The total amount reported on the SEFA for the R&D cluster is $82,409,498. Identification as a repeat finding, if applicable: Not a repeat finding Recommendation: The Corporation should implement the following internal controls: ? The monthly suspension and debarment review process ? Reconciliation of the number of vendor files sent to the third-party vendor with the number of files received from the third-party vendor with the suspension and debarment results and review of the accuracy of the suspension and debarment results performed by the thirdparty vendor ? Maintenance of the supporting documentation over the suspension and debarment checks performed on new vendors

Categories

Procurement, Suspension & Debarment

Other Findings in this Audit

  • 60743 2022-003
    Material Weakness
  • 60744 2022-003
    Material Weakness
  • 60745 2022-003
    Material Weakness
  • 60746 2022-003
    Material Weakness
  • 60747 2022-003
    Material Weakness
  • 60748 2022-003
    Material Weakness
  • 60749 2022-003
    Material Weakness
  • 60750 2022-003
    Material Weakness
  • 60751 2022-003
    Material Weakness
  • 60752 2022-003
    Material Weakness
  • 60753 2022-003
    Material Weakness
  • 60754 2022-003
    Material Weakness
  • 60755 2022-003
    Material Weakness
  • 60756 2022-003
    Material Weakness
  • 60757 2022-003
    Material Weakness
  • 60758 2022-003
    Material Weakness
  • 60759 2022-003
    Material Weakness
  • 60760 2022-003
    Material Weakness
  • 60761 2022-003
    Material Weakness
  • 60762 2022-003
    Material Weakness
  • 60763 2022-003
    Material Weakness
  • 60764 2022-003
    Material Weakness
  • 60765 2022-003
    Material Weakness
  • 60766 2022-001
    Material Weakness
  • 60767 2022-001
    Material Weakness
  • 60768 2022-001
    Material Weakness
  • 60769 2022-001
    Material Weakness
  • 62642 2022-001
    Material Weakness
  • 62643 2022-001
    Material Weakness
  • 62644 2022-002
    Material Weakness
  • 62645 2022-001
    Material Weakness
  • 62646 2022-001
    Material Weakness
  • 62647 2022-001
    Material Weakness
  • 62648 2022-001
    Material Weakness
  • 62649 2022-003
    Material Weakness
  • 62650 2022-003
    Material Weakness
  • 62651 2022-003
    Material Weakness
  • 62652 2022-001
    Material Weakness
  • 62653 2022-003
    Material Weakness
  • 62654 2022-003
    Material Weakness
  • 62655 2022-003
    Material Weakness
  • 62656 2022-003
    Material Weakness
  • 62657 2022-001
    Material Weakness
  • 62658 2022-001
    Material Weakness
  • 62659 2022-001
    Material Weakness
  • 62660 2022-001
    Material Weakness
  • 62661 2022-001
    Material Weakness
  • 62662 2022-001
    Material Weakness
  • 62663 2022-001
    Material Weakness
  • 62664 2022-001
    Material Weakness
  • 62665 2022-001
    Material Weakness
  • 62666 2022-001
    Material Weakness
  • 62667 2022-001
    Material Weakness
  • 62668 2022-002
    Material Weakness
  • 62669 2022-002
    Material Weakness
  • 62670 2022-001
    Material Weakness
  • 62671 2022-001
    Material Weakness
  • 62672 2022-001
    Material Weakness
  • 62673 2022-002
    Material Weakness
  • 62674 2022-001
    Material Weakness
  • 62675 2022-001
    Material Weakness
  • 62676 2022-001
    Material Weakness
  • 62677 2022-001
    Material Weakness
  • 62678 2022-001
    Material Weakness
  • 62679 2022-001
    Material Weakness
  • 62680 2022-003
    Material Weakness
  • 62681 2022-001
    Material Weakness
  • 62682 2022-003
    Material Weakness
  • 637185 2022-003
    Material Weakness
  • 637186 2022-003
    Material Weakness
  • 637187 2022-003
    Material Weakness
  • 637188 2022-003
    Material Weakness
  • 637189 2022-003
    Material Weakness
  • 637190 2022-003
    Material Weakness
  • 637191 2022-003
    Material Weakness
  • 637192 2022-003
    Material Weakness
  • 637193 2022-003
    Material Weakness
  • 637194 2022-003
    Material Weakness
  • 637195 2022-003
    Material Weakness
  • 637196 2022-003
    Material Weakness
  • 637197 2022-003
    Material Weakness
  • 637198 2022-003
    Material Weakness
  • 637199 2022-003
    Material Weakness
  • 637200 2022-003
    Material Weakness
  • 637201 2022-003
    Material Weakness
  • 637202 2022-003
    Material Weakness
  • 637203 2022-003
    Material Weakness
  • 637204 2022-003
    Material Weakness
  • 637205 2022-003
    Material Weakness
  • 637206 2022-003
    Material Weakness
  • 637207 2022-003
    Material Weakness
  • 637208 2022-001
    Material Weakness
  • 637209 2022-001
    Material Weakness
  • 637210 2022-001
    Material Weakness
  • 637211 2022-001
    Material Weakness
  • 639084 2022-001
    Material Weakness
  • 639085 2022-001
    Material Weakness
  • 639086 2022-002
    Material Weakness
  • 639087 2022-001
    Material Weakness
  • 639088 2022-001
    Material Weakness
  • 639089 2022-001
    Material Weakness
  • 639090 2022-001
    Material Weakness
  • 639091 2022-003
    Material Weakness
  • 639092 2022-003
    Material Weakness
  • 639093 2022-003
    Material Weakness
  • 639094 2022-001
    Material Weakness
  • 639095 2022-003
    Material Weakness
  • 639096 2022-003
    Material Weakness
  • 639097 2022-003
    Material Weakness
  • 639098 2022-003
    Material Weakness
  • 639099 2022-001
    Material Weakness
  • 639100 2022-001
    Material Weakness
  • 639101 2022-001
    Material Weakness
  • 639102 2022-001
    Material Weakness
  • 639103 2022-001
    Material Weakness
  • 639104 2022-001
    Material Weakness
  • 639105 2022-001
    Material Weakness
  • 639106 2022-001
    Material Weakness
  • 639107 2022-001
    Material Weakness
  • 639108 2022-001
    Material Weakness
  • 639109 2022-001
    Material Weakness
  • 639110 2022-002
    Material Weakness
  • 639111 2022-002
    Material Weakness
  • 639112 2022-001
    Material Weakness
  • 639113 2022-001
    Material Weakness
  • 639114 2022-001
    Material Weakness
  • 639115 2022-002
    Material Weakness
  • 639116 2022-001
    Material Weakness
  • 639117 2022-001
    Material Weakness
  • 639118 2022-001
    Material Weakness
  • 639119 2022-001
    Material Weakness
  • 639121 2022-001
    Material Weakness
  • 639122 2022-003
    Material Weakness
  • 639123 2022-001
    Material Weakness
  • 639124 2022-003
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.RD Leidos Ctsmc - to F1 $2.62M
93.378 Integrated Care for Kids Model $2.19M
93.RD Bcr Task Order #1 Task A-Bpc $933,883
93.RD Hrsa Idiq - To1 (2022) $787,644
32.006 Covid-19 Telehealth Program $722,609
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $714,558
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $658,395
93.RD Ccg-Bcr $578,349
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $565,184
93.732 Mental and Behavioral Health Education and Training Grants $485,353
93.297 Teenage Pregnancy Prevention Program $446,429
93.RD Mp2prt - Cosgrove $303,854
93.321 Dietary Supplement Research Program $273,780
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $260,168
93.RD Neiss $240,447
93.RD 17x033 To: Q3 Bpu Etctn Ncln $217,170
93.103 Food and Drug Administration Research $211,646
93.RD Etctn Ncln Biobank $202,772
93.RD Mount Sinai Flu Study $202,390
93.RD Pediatric Nci - Match Apec1621 $201,697
93.059 Training in General, Pediatric, and Public Health Dentistry $190,333
16.320 Services for Trafficking Victims $178,455
93.172 Human Genome Research $162,626
93.RD Working Canine Genetic Mapping $156,414
93.127 Emergency Medical Services for Children $155,969
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $152,165
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $150,178
93.394 Cancer Detection and Diagnosis Research $144,216
93.RD Opna Exposure $141,270
93.253 Poison Center Support and Enhancement Grant $117,213
93.RD Pediatric Nci-Match $113,208
93.173 Research Related to Deafness and Communication Disorders $100,889
16.831 Children of Incarcerated Parents $99,239
93.RD Nci Bcr To#2 Base $94,520
93.213 Research and Training in Complementary and Integrative Health $85,719
93.958 Block Grants for Community Mental Health Services $71,940
93.917 Hiv Care Formula Grants $68,637
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $63,218
93.RD Bcr Task Order #1 Task B-Cba $61,114
93.959 Block Grants for Prevention and Treatment of Substance Abuse $59,673
93.RD Hrsa Idiq - To3 (2022) $59,146
93.353 21st Century Cures Act - Beau Biden Cancer Moonshot $58,506
93.069 Public Health Emergency Preparedness $57,533
84.047 Trio Upward Bound $55,551
93.137 Community Programs to Improve Minority Health Grant Program $53,933
93.866 Aging Research $48,493
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $47,571
84.181 Special Education-Grants for Infants and Families $47,309
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $47,104
93.RD To6: Nucleic Acid Extractions $46,783
93.914 Hiv Emergency Relief Project Grants $43,934
93.361 Nursing Research $42,117
16.575 Crime Victim Assistance $37,969
93.RD Adenovirus - Option 3 $35,582
93.233 National Center on Sleep Disorders Research $34,764
93.226 Research on Healthcare Costs, Quality and Outcomes $33,552
93.RD Hrsa Idiq - To4 (2022) $33,418
93.397 Cancer Centers Support Grants $32,448
93.242 Mental Health Research Grants $32,365
93.RD Htmcp New Cycle $31,735
94.006 Americorps State and National $31,313
93.RD Bpc Eomi To7 $30,955
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nations Health $30,602
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $28,893
93.273 Alcohol Research Programs $27,082
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $26,626
93.558 Temporary Assistance for Needy Families $25,764
47.075 Social, Behavioral, and Economic Sciences $25,292
93.393 Cancer Cause and Prevention Research $25,125
93.092 Affordable Care Act (aca) Personal Responsibility Education Program $24,948
93.778 Medical Assistance Program $21,846
93.121 Oral Diseases and Disorders Research $20,990
93.398 Cancer Research Manpower $20,949
16.758 Improving the Investigation and Prosecution of Child Abuse and the Regional and Local Children's Advocacy Centers $20,000
93.RD 19x092q1-Leidos-Loh Study $18,821
93.RD 19x092q3 - Leidos - Tewari $18,748
93.495 Community Health Workers for Public Health Response and Resilient $18,459
93.865 Child Health and Human Development Extramural Research $16,930
16.590 Grants to Encourage Arrest Policies and Enforcement of Protection Orders Program $16,187
93.310 Trans-Nih Research Support $16,163
93.994 Maternal and Child Health Services Block Grant to the States $16,049
93.RD Mp2prt Leidos To3 $14,804
47.074 Biological Sciences $14,758
93.350 National Center for Advancing Translational Sciences $11,962
93.855 Allergy and Infectious Diseases Research $11,909
93.838 Lung Diseases Research $11,218
93.136 Injury Prevention and Control Research and State and Community Based Programs $11,043
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $10,433
16.738 Edward Byrne Memorial Justice Assistance Grant Program $10,121
93.837 Cardiovascular Diseases Research $10,108
93.590 Community-Based Child Abuse Prevention Grants $9,304
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $9,225
93.433 Acl National Institute on Disability, Independent Living, and Rehabilitation Research $7,737
93.945 Assistance Programs for Chronic Disease Prevention and Control $7,141
93.RD Nci Bcr To#2 Int Ship $7,084
93.395 Cancer Treatment Research $6,954
12.420 Military Medical Research and Development $6,612
93.632 University Centers for Excellence in Developmental Disabilities Education, Research, and Service $6,340
93.307 Minority Health and Health Disparities Research $5,597
93.913 Grants to States for Operation of State Offices of Rural Health $5,423
93.080 Blood Disorder Program: Prevention, Surveillance, and Research $5,411
10.310 Agriculture and Food Research Initiative (afri) $5,109
93.867 Vision Research $4,810
93.RD Nci Bcr To#2 Cba $4,782
93.396 Cancer Biology Research $4,268
93.RD Oral Valganciclovir $4,244
93.068 Chronic Diseases: Research, Control, and Prevention $3,880
93.424 Non-Aca/pphfbuilding Capacity of the Public Health System to Improve Population Health Through National Nonprofit Organizations $3,728
93.839 Blood Diseases and Resources Research $3,650
93.575 Child Care and Development Block Grant $3,369
93.RD Ccg Bpc Dceg $3,348
93.RD Cmv Profiling in Infants $3,231
16.585 Drug Court Discretionary Grant Program $2,878
93.399 Cancer Control $2,398
93.RD Mis-C Sub Study $2,310
93.926 Healthy Start Initiative $1,873
93.859 Biomedical Research and Research Training $1,756
93.RD Influenza Vaccine Effectivenes $1,539
93.110 Maternal and Child Health Federal Consolidated Programs $1,528
93.279 Drug Abuse and Addiction Research Programs $1,286
93.RD Nci Bcr To#2 Travel $891
93.RD Mdnet Imatch Support $454
21.019 Covid-19 Coronavirus Relief Fund $312
93.RD Adenovirus - Option 2 $268
93.RD Mp2prt-Npc Arar0331 $217
21.027 Covid-19 Coronavirus State and Local Fiscal Recovery Funds $200
93.RD Blgsp $103
93.RD Adenovirus Stem Cell $79
93.RD 12xs383 Htmcp Data Collection $59
93.RD Hrsa Task Order 8 $-1
12.351 Scientific Research - Combating Weapons of Mass Destruction $-847
93.889 National Bioterrorism Hospital Preparedness Program $-7,796
93.RD A Targeted Approach to A Safer $-8,300