Finding 967527 (2023-005)

Significant Deficiency
Requirement
AB
Questioned Costs
$1
Year
2023
Accepted
2024-04-01
Audit: 301691
Organization: Avera Health (SD)
Auditor: Eide Bailly LLP

AI Summary

  • Core Issue: There is a significant deficiency in internal controls over compliance related to the allocation of employee time across federal grants.
  • Impacted Requirements: Noncompliance with 2 CFR 200.303 (a) due to improper allocation of payroll costs, risking submission of disallowed costs.
  • Recommended Follow-Up: Strengthen controls for grant allocation calculations to prevent future errors and ensure compliance.

Finding Text

Department of Health and Human Services Federal Financial Assistance Listing #10.331, 93.136, 93.243, 93.279, 93.310, 93.393, 93.837, 93.838, 93.865, and 93.898 Research and Development Cluster Activities Allowed and Allowable Costs Significant Deficiency in Internal Control over Compliance and Noncompliance Criteria: 2 CFR 200.303 (a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Condition: Our testing over activities allowed and allowable costs identified one instance where an employee’s time was not properly allocated between two grants. Additionally, there were four instances where the grant was under/over-charged in our recalculation of payroll and fringe benefits. Cause: The Organization changed the process for physician time in research grants which was initially in place for Medical Directorship payments. The grant team updated to a separate grant workflow which caused for the time to be allocated to the incorrect grant. Effect: The Organization’s controls did not detect or correct the error identified, which resulted in a reasonable possibility that the Organization could submit disallowed costs under the federal awards and would not be able to detect and correct noncompliance in a timely manner. Questioned Costs: $2,126 Context: A non-statistical sample of 60 payroll transactions was selected for testing, which accounted for $152,356 of $3,424,036 of federal program expenditures. Repeat Finding from Prior Year: No Recommendation: We recommend the Organization review and strengthen the controls surrounding the allocation calculation for the research grants. Views of Responsible Officials: Management agrees with the finding.

Categories

Questioned Costs Allowable Costs / Cost Principles

Other Findings in this Audit

  • 391081 2023-002
    Material Weakness
  • 391082 2023-003
    Significant Deficiency
  • 391083 2023-004
    Significant Deficiency
  • 391084 2023-005
    Significant Deficiency
  • 391085 2023-005
    Significant Deficiency
  • 391086 2023-005
    Significant Deficiency
  • 391087 2023-005
    Significant Deficiency
  • 391088 2023-005
    Significant Deficiency
  • 391089 2023-005
    Significant Deficiency
  • 391090 2023-005
    Significant Deficiency
  • 391091 2023-005
    Significant Deficiency
  • 391092 2023-005
    Significant Deficiency
  • 391093 2023-005
    Significant Deficiency
  • 391094 2023-005
    Significant Deficiency
  • 391095 2023-005
    Significant Deficiency
  • 391096 2023-005
    Significant Deficiency
  • 391097 2023-005
    Significant Deficiency
  • 391098 2023-005
    Significant Deficiency
  • 391099 2023-006
    Significant Deficiency
  • 967523 2023-002
    Material Weakness
  • 967524 2023-003
    Significant Deficiency
  • 967525 2023-004
    Significant Deficiency
  • 967526 2023-005
    Significant Deficiency
  • 967528 2023-005
    Significant Deficiency
  • 967529 2023-005
    Significant Deficiency
  • 967530 2023-005
    Significant Deficiency
  • 967531 2023-005
    Significant Deficiency
  • 967532 2023-005
    Significant Deficiency
  • 967533 2023-005
    Significant Deficiency
  • 967534 2023-005
    Significant Deficiency
  • 967535 2023-005
    Significant Deficiency
  • 967536 2023-005
    Significant Deficiency
  • 967537 2023-005
    Significant Deficiency
  • 967538 2023-005
    Significant Deficiency
  • 967539 2023-005
    Significant Deficiency
  • 967540 2023-005
    Significant Deficiency
  • 967541 2023-006
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund $39.98M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $9.39M
93.697 Covid-19 Testing for Rural Health Clinics $2.10M
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $1.40M
16.582 Crime Victim Assistance/discretionary Grants $1.28M
10.855 Distance Learning and Telemedicine Loans and Grants $860,254
93.279 Drug Abuse and Addiction Research Programs $498,726
93.393 Cancer Cause and Prevention Research $435,993
93.884 Grants for Primary Care Training and Enhancement $416,480
20.509 Formula Grants for Rural Areas and Tribal Transit Program $302,469
93.155 Rural Health Research Centers $293,589
16.589 Rural Domestic Violence, Dating Violence, Sexual Assault, and Stalking Assistance Program $245,812
93.211 Telehealth Programs $199,755
93.838 Lung Diseases Research $198,636
21.027 Coronavirus State and Local Fiscal Recovery Funds $185,714
93.395 Cancer Treatment Research $154,575
93.301 Small Rural Hospital Improvement Grant Program $117,099
93.359 Nurse Education, Practice Quality and Retention Grants $117,065
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $93,480
93.865 Child Health and Human Development Extramural Research $58,504
93.136 Injury Prevention and Control Research and State and Community Based Programs $57,316
93.461 Covid-19 Testing for the Uninsured $50,423
16.575 Crime Victim Assistance $47,000
10.331 Food Insecurity Nutrition Incentive Grants Program $46,943
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $29,447
93.837 Cardiovascular Diseases Research $25,417
93.268 Immunization Cooperative Agreements $13,790
93.994 Maternal and Child Health Services Block Grant to the States $10,195
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $8,146
93.310 Trans-Nih Research Support $7,042
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $5,137
45.025 Promotion of the Arts_partnership Agreements $1,600
93.800 Organized Approaches to Increase Colorectal Cancer Screening $661
93.069 Public Health Emergency Preparedness $462