Finding 980664 (2023-004)

Material Weakness
Requirement
N
Questioned Costs
-
Year
2023
Accepted
2024-06-28
Audit: 310986
Organization: Atrium Health, Inc. (NC)
Auditor: Ernst and Young

AI Summary

  • Core Issue: Atrium Health CMHA failed to provide required notification letters to students regarding Direct Loan disbursements due to IT system limitations.
  • Impacted Requirements: Compliance with federal regulations under Section 200.303 and 34 CFR 668.165(a)(1) for notifying students about loan amounts and disbursement details.
  • Recommended Follow-Up: Implement internal controls to ensure retention of all disbursement notification letters, either through IT system upgrades or maintaining hard copies.

Finding Text

Finding 2023-004: Notification of Disbursements to or on Behalf of Students Identification of the federal program: Federal Agency: United States Department of Education Federal Cluster: Student Financial Assistance Assistance Listing No.: 84.268 Federal Direct Student Loans (Direct Loans), 84.063 Federal Pell Grant Program Award Periods: July 1, 2022 through June 30, 2023; July 1, 2023 through June 30, 2024 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).” 34 CFR 668.165(a)(1) – Before an institution disburses title IV, HEA program funds for any award year, the institution must notify a student of the amount of funds that the student or his or her parent can expect to receive under each title IV, HEA program, and how and when those funds will be disbursed. If those funds include Direct Loan program funds, the notice must indicate which funds are from subsidized loans, which are from unsubsidized loans, and which are from PLUS loans. Condition: When Direct Loans are being credited to a student’s account, an institution must notify the student, or parent, in writing of (1) the date and amount of the disbursement; (2) the student’s right, or parent’s right, to cancel all or a portion of that loan or loan disbursement and have the loan proceeds returned to the holder of that loan; and (3) the procedure and time by which the student or parent must notify the institution that he or she wishes to cancel the loan. Atrium Health CMHA was unable to provide the notification letters sent to the student as they are not maintained. Cause: The current IT system does not allow for the letters sent to be saved. Effect or potential effect: The disbursement notification letters may not have be sent in accordance with the regulations. Questioned costs: None. Context: Total expenditures for the Student Financial Assistance Cluster were $2,006,561 for the year ended December 31, 2023. Identification as a repeat finding, if applicable: This finding is not a repeat finding from the prior year. Recommendation: Atrium Health CMHA should implement internal controls to retain all disbursement notification letters sent to students.  Views of responsible officials: Atrium Health CMHA management will develop a plan to ensure that the IT systems are changed such that notification letters can be retained or a control exists whereby hard-copies of notification letters are maintained.

Categories

Student Financial Aid Matching / Level of Effort / Earmarking Allowable Costs / Cost Principles

Other Findings in this Audit

  • 404220 2023-002
    Material Weakness
  • 404221 2023-003
    Material Weakness
  • 404222 2023-004
    Material Weakness
  • 404223 2023-005
    Material Weakness
  • 404224 2023-002
    Material Weakness
  • 404225 2023-003
    Material Weakness
  • 404226 2023-004
    Material Weakness
  • 404227 2023-005
    Material Weakness
  • 404228 2023-002
    Material Weakness
  • 404229 2023-003
    Material Weakness
  • 404230 2023-004
    Material Weakness
  • 404231 2023-005
    Material Weakness
  • 980662 2023-002
    Material Weakness
  • 980663 2023-003
    Material Weakness
  • 980665 2023-005
    Material Weakness
  • 980666 2023-002
    Material Weakness
  • 980667 2023-003
    Material Weakness
  • 980668 2023-004
    Material Weakness
  • 980669 2023-005
    Material Weakness
  • 980670 2023-002
    Material Weakness
  • 980671 2023-003
    Material Weakness
  • 980672 2023-004
    Material Weakness
  • 980673 2023-005
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $50.60M
93.121 Oral Diseases and Disorders Research $2.07M
84.268 Federal Direct Student Loans $1.59M
32.006 Covid-19 Telehealth Program $1.32M
12.RD The Mobility Toolkit: Electronically Augmented Assessment of Functional Recovery Following Lower-Extremity Trauma $916,072
93.253 Poison Center Support and Enhancement Grants $520,967
93.840 Primary Care Implementation and Evaluation of Coach McLungs™ An Asthma Shared Decision-Making Intervention, Across A Large Healthcare System $440,590
93.889 Metrolina Healthcare Preparedness Region 22-23 $407,320
84.063 Federal Pell Grant Program $393,436
21.027 Coronavirus State and Local Fiscal Recovery Fund $389,570
93.391 Community Health Workers Model 2021-2023 $374,207
93.958 Implementing A Coordinated Specialty Care (csc) Model Program in Mecklenburg County – Block Grants for Community Mental Health Services $372,054
12.420 The Major Extremity Trauma Research Consortium (metrc) $356,647
12.420 Injury Risk in Special Forces Operations $349,399
93.958 First Episode Psychosis Program $326,195
93.361 Nursing Research $323,034
93.395 Dual Pi3k/brd4 Inhibitory Chemotype for Maximum Inhibition of Myc and Cancer $308,104
93.137 Minority Systemic Lupus $292,445
93.078 Through Military-Civilian Partnerships at Atrium Health's Carolina Medical Center $285,000
84.425E Covid-19 – Heerf Education Emergency Relief Fund (heerf) Student Aid Portion $280,330
93.323 Birth Defects and Developmental Disabilities – Prevention and Surveillance $196,736
93.273 Alcohol Research Programs $173,509
93.837 Metabolic Pathways to Cardiovascular Disease $173,473
93.686 Recast Training $172,604
93.396 Role of Pten and Pi-3 Kinase in Medulloblastomagenesis $157,723
16.575 Stanly Butterfly House 2022-2024 $152,976
93.488 Emergency Medicine Service Line $144,572
93.145 Hiv Linkage $131,477
93.323 North Carolina Coronavirus Variant Sequencing (corvaseq) Initiative $123,784
93.866 Pragmatic Evaluation of Events and Benefits of Lipid-Lowering in Older Adults (preventable) $117,155
16.575 Cabarrus – Jeff Gordon Children’s Advocacy Center 2022-2024 $116,427
93.994 Perinatal/neonatal Program (2023-2024) $114,109
12.420 The Major Extremity Trauma and Rehabilitation Research Consortium $113,879
93.137 Speech Profiles and Cue Responsiveness After Left Hemisphere Stroke $111,198
16.320 Services for Trafficking Victims $93,894
93.395 Repurposing Leflunomide to Delay Progression of Smoldering Multiple Myeloma in African Americans $91,308
93.994 Perinatal/neonatal Program Region III $83,363
93.914 Ryan White – Part A $78,354
12.420 Metrc III $76,092
93.137 Covid-19 Resources with Ahec $75,437
93.323 Public Health Epidemiologist 2022-2023 $73,713
20.600 T- Sbirt - Traffic Counseling Toward Impaired Drivers and Seatbelt Use in A Trauma Center (2022-2023) $71,633
93.958 Project Seed Expansion $71,158
12.420 Prophylactic Nail $68,274
93.846 The Local Infiltration Therapy (lit) Trial for Pain Control Following Hip Fracture Fixation $66,613
93.365 Sickle Cell Treatment Demonstration Program $58,932
12.420 Effect of Early Weight Bearing $57,705
93.958 Cbcrp Pilot $49,469
93.865 A Randomized Controlled Trial of Frozen Embryo Transfers Performed in Modified Natural Versus Programmed Cycles (natpro) $47,390
93.865 Using Interactive Virtual Presence to Remotely Assist Parents with Child Restraint $46,725
10.310 A Nutrimetabolomics Approach to Identify the Biomarkers of Whole Grain Intake $46,088
93.914 Covid-19 – Hiv Emergency Relief Project Grants $45,863
93.847 Aldh1l1 Polymorphisms in Regulation of Glycine Metabolism $40,435
93.394 Cancer Detection and Diagnosis Research $40,184
93.837 Heartshare $35,597
93.RD A Phase Ii, Single-Stage, Single Arm Investigation of Oral Valganciclovir Therapy in Infants with Asymptomatic Congenital Cytomegalovirus Infection $35,535
93.855 A Phase 2b, Multicenter, Randomized, Open-Label, Assessor-Blinded Superiority Study to Compare the Efficacy and Safety of Dalbavancin to Standard of Care Antibiotic Therapy for the Completion of Treatment of Patients with Complicated S. Aureus Bacteremia $29,375
93.226 Personalized Clinical Decision Support to Improve Participation in Hospital at Home $26,378
93.839 Blood and Marrow Transplant Clinical Trials Network $26,283
84.007 Federal Supplemental Education Opportunity Grant Program $25,474
93.395 Phase III Prospective Randomized Trial of Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Chemoradiation for Locally-Advanced Non-Small Cell Lung Cancer $22,800
93.667 Cac Dhhs 2023-2024 $21,996
93.073 Birth Defects and Developmental Disabilities – Prevention and Surveillance $20,000
93.395 Nrg-Gu009: Parallel Phase III Randomized Trials for High-Risk Prostate Cancer Evaluating De-Intensification for Lower Genomic Risk and Intensification of Concurrent Therapy for Higher Genomic Risk with Radiation (predict-Rt) $19,550
93.395 Phase III Study of Daratumumab/rhuph20 + Lenalidomide Or Lenalidomide As Post-Autologous Stem Cell Transplant $18,972
93.558 2022-2023 Cacnc Butterfly House Dhhs $18,374
93.855 Congenital and Perinatal Infections Rare Diseases $18,000
93.360 A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Intravenous Ganaxolone in Status Epilepticus $17,795
20.600 T- Sbirt - Traffic Counseling Toward Impaired Drivers and Seatbelt Use in A Trauma Center $17,040
93.839 Sickle Cell Disease and Cardiovascular Risk – Red Cell Exchange Trial (scd-Carre) $16,821
93.889 North Carolina Covid-19 Hospital Preparedness Program $16,500
93.395 A Randomized Phase III Trial Comparing Conventional-Dose Chemotherapy Using Paclitaxel, Ifosfamide, and Cisplatin (tip) with High-Dose Chemotherapy Using Mobilizing Paclitaxel Plus Ifosfamide Followed by High-Dose Carboplatin $15,900
93.395 A Randomized, Phase III Trial to Evaluate the Efficacy and Safety of Mk-3475 (pembrolizumab) As Adjuvant Therapy for Triple Receptor-Negative Breast Cancer with >/=1 Cm Residual Invasive Cancer Or Positive Lymph Nodes (ypn+) After Neoadjuvant Chemotherapy $14,790
93.667 Dhhs Cabarrus Jeff Gordon 2023-2024 $14,780
93.884 Primary Care Training Enhancement (pcte) $14,627
93.310 Trials and Research Network for Even More (transform-2) $14,046
93.080 Public Health Surveillance for the Prevention of Complications of Bleeding Disorders $13,957
93.853 Sleep Smart $12,545
93.127 Pecarn $11,232
93.395 A Randomized Phase III Trial of Pre-Operative Compared to Post-Operative Stereotactic Radiosurgeryin Patients with Resectable Brain Metastases $10,800
93.421 Pediatric Public Health Partnership on Fetal Alcohol Spectrum Disorders $10,000
93.395 Phase III Randomized Trial of Standard Systemic Therapy (sst) Versus Standard Systemic Therapy Plus Definitive Treatment (surgery Or Radiation) of the Primary Tumor in Metastatic Prostate Cancer $9,450
93.847 Gene Discoveries in Subjects with Crohn's Disease of African Descent $9,257
93.853 Strategies to Innovate Emergency Care Clinical Trials Network (siren) $8,886
93.853 Pediatric Dose Optimization for Seizures in Ems (pedidose) $8,815
93.395 Preoperative Thp and Postoperative De-Escalation in Patients Who Achieve A Pathologic Complete Response $8,725
93.395 A Randomized Phase Iii, Two-Arm Trial of Paclitaxel/carboplatin/maintenance Letrozole Versus Letrozole Monotherapy in Patients with Stage II-Iv, Primary Low-Grade Serous Carcinoma of the Ovary Or Peritoneum $8,250
93.838 The Capture Study: Validating A Unique Copd Screening Tool in Primary Care $8,215
93.839 A Comparison of Individualized Vs. Weight Based Protocols to Treat Vaso-Occlusive Episodes in Sickle Cell Disease (compare-Voe) $7,980
93.395 A Randomized Phase Ii/iii Trial of De-Intensified Radiation Therapy for Patients with Early-Stage, P16-Positive, Non-Smoking Associated Oropharyngeal $7,875
93.399 National Surgical Adjuvant Breast and Bowel Project $7,725
93.395 Nrg-Lu005: Limited Stage Small Cell Lung Cancer (ls-Sclc): A Phase Ii/iii Randomized Study of Chemoradiation Versus Chemoradiation Plus Atezolizumab $7,001
93.395 National Surgical Adjuvant Breast and Bowel Project (nsabp)/radiation Therapy Oncology Group (rtog)/gynecologic Oncology Group (gog) $7,000
93.395 Southwest Oncology Group Network Group Operations Center of the Nctn $6,700
93.RD Research on Viral Infections $6,019
93.433 Traumatic Brain Injury Model Systems National Data and Statistical Center $6,000
93.RD Alliance for Clinical Trials in Oncology $5,900
93.866 A Multifaceted Digital Health Platform to Advance Alzheimer's Disease Patient Monitoring, Safety, Caregiving, and Research $5,673
93.853 Statins Use in Intracerebral Hemorrhage Patients (saturn) Study $5,627
93.395 Randomized Trial of Standard Chemotherapy Alone Or Combined with Atezolizumab As Adjuvant Therapy for Patients with Stage III Colon Cancer and Deficient Dna Mismatch Repair $4,804
93.395 Randomized Phase Ii/iii Trial of Adjuvant Radiation Therapy with Cisplatin, Docetaxel-Cetuximab, Or Cisplatin-Atezolizumab in Pathologic High-Risk Squamous Cell Cancer of the Head and Neck $4,350
93.837 Coronary Artery Calcium in Pragmatic Evaluation of Events and Benefits of Lipid-Lowering in Older Adults (cac Preventable Ancillary Study) $3,500
93.110 Hemophilia Treatment Centers (sprans Yr5-10) $3,420
93.395 Randomized Phase Ii/iii Trial of Radiotherapy with Concurrent Durvalumab Vs. Radiotherapy with Concurrent Cetuximab in Patients with Stage III-Ivb Head and Neck Cancer with A Contraindication to Cisplatin $3,195
93.RD A Randomized Phase III Trial of Consolidation with Autologous Hematopoietic Cell Transplantation Followed by Maintenance $3,000
93.395 Treatment of Newly Diagnosed Diffuse Anaplastic Wilms Tumors (dawt) and Relapsed Favorable Histology Wilms Tumors (fhwt) $2,700
93.839 Predicting Progression of Chronic Kidney Disease in Sickle Cell Anemia Using MacHine Learning Models (premier) $2,642
12.420 Novel Topical Antibiotic Therapy to Reduce Infection After Operative Treatment of Fracturesat High Risk of Infection: Tobra -A Multicenter Randomized, Controlled Trial $2,250
93.395 A Phase Iii, Randomized Study of Nivolumab (opdivo) Or Brentuximab Vedotin (adcetris) Plus Avd in Patients (age >/= 12 Years) with Newly Diagnosed Advanced Stage Classical Hodgkin Lympho $2,100
93.853 Transnasal Cooling for Migraine $2,020
12.420 Randomized Trial of Early Hemodynamic Management of Patients Following Acute Spinal Cord Injury – Temple $2,000
93.360 Biomedical Advanced Research and Development Authority (barda), Biodefense Medical Countermeasure Development $1,917
12.420 Effect of Early Weight Bearing on Rehabilitation $1,876
93.837 Comparison of Methods of Pulmonary Blood Flow Augmentation in Neonates: Shunt Versus Stent (the Compass Trial) $1,875
93.847 Neptune 3 $1,408
93.395 Children’s Oncology Group $1,100
93.395 A Phase 3 Randomized Trial of Inotuzumab Ozogamicin for Newly Diagnosed High-Risk B-All; Risk-Adapted Post-Induction Therapy for High-Risk B-All, Mixed Phenotype Acute Leukemia, and Disseminated B-Lly $1,000
93.889 Metrolina Healthcare Preparedness Region 21-22 $985
12.420 Evaluation of A New Strategy for Protocolized Antibiotic Care for Severe Open Fractures $891
93.839 Clinical Transplant-Related Long-Term Outcomes of Alternative Donor Allogeneic Transplantation (ctrl-Alt-D) Bmt $771
12.420 Rehabilitation Enhanced by Partial Arterial Inflow Restriction $565
93.669 Cac Dhhs 2023-2024 $253
93.669 2022-2023 Cacnc Butterfly House Dhhs $209
93.395 A Multicenter Phase II Trial of Paclitaxel with and Without Nivolumab in Taxane Naïve, and Nivolumab and Cabozantinib in Taxane Pretreated Subjects with Angiosarcoma $200
93.669 Dhhs Cabarrus Jeff Gordon 2023-2024 $170
93.395 Maintenance Systemic Therapy Versus Consolidative Stereotactic Body Radiation Therapy (sbrt) Plus Maintenance Systemic Therapy for Limited Metastatic Non-Small Cell Lung Cancer (nsclc) $150
93.395 A Randomized Phase Ii/iii Trial of Prophylactic Cranial Irradiation with Or Without Hippocampal Avoidance for Small Cell Lung Cancer $50
93.395 Phase Ii/iii Study of Circulating Tumor Dna As A Predictive Biomarker in Adjuvant Chemotherapy in Patients with Stage Iia Colon Cancer (cobra) $50
93.879 Medical Library Assistance $-515
93.136 Injury Prevention and Control Research and State and Community Based Programs $-18,394