EIN: 363843377
UEI: X8RJCLCKBYF6
Audited by: Forvis Mazars
Oversight agency: 93 [Department of Health and Human Services]
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Data as of August 31, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on April 29, 2026. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by October 29, 2026 (58 days from today).
What is a management decision? →FAC accepted this audit on March 31, 2025 — management decision was due October 1, 2025.
While testing the procurement requirement for micro purchases, we noted there was one sample selection for which the Organization did not have documentation to support whether the procurement method used was appropriate. Cause: The Organization did not consistently maintain documentation to support the procurement method used. The documentation was maintained by one individual within the Organization, and that individual is no longer with the Organization. Effect: The Organization was not able to provide supporting documentation for one out of the 40 sample selections tested. The missing supporting documentation was for an expense in the amount of $4,000. Questioned Costs: $4,000 Context: We could not verify the appropriate procurement method was used for one out of 40 sample selections. Total likely questioned costs are estimated to be approximately $38,000. Recommendation: We recommend that additional training of responsible staff be performed to ensure that all documentation related to procurement is retained. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴Finding 2024-003: Lack of Support for Procurement Requirement U.S. Department of Health and Human Services Federal Programs: Health Center Program Cluster (ALN numbers 93.224/93.527) Federal Award Year: 2024 Repeat Finding: No Criteria: The Organization must follow the procurement standards set out in 2 CFR sections 200.318 through 200.327. The Organization must use its own documented procurement procedures, which reflect applicable state and local laws and regulations, provided that the procurements conform to applicable federal statutes and the procurement requirements identified in 2 CFR Part 200. Condition: While testing the procurement requirement for micro purchases, we noted there was one sample selection for which the Organization did not have documentation to support whether the procurement method used was appropriate. Cause: The Organization did not consistently maintain documentation to support the procurement method used. The documentation was maintained by one individual within the Organization, and that individual is no longer with the Organization. Effect: The Organization was not able to provide supporting documentation for one out of the 40 sample selections tested. The missing supporting documentation was for an expense in the amount of $4,000. Questioned Costs: $4,000 Context: We could not verify the appropriate procurement method was used for one out of 40 sample selections. Total likely questioned costs are estimated to be approximately $38,000. Recommendation: We recommend that additional training of responsible staff be performed to ensure that all documentation related to procurement is retained. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Identifying Number: 2024-001 Audit Finding: Accounting for Pharmacy 340B Drug Pricing Program Transactions. While testing the 340B Program, revenue and accounts receivable, we identified the following errors: • The Organization overstated 340B Program accounts receivable and revenue by double-counting a 340B Program transaction in the amount of $213,887. • The Organization understated 340B Program accounts receivable and revenue by $45,038 by not properly recording a transaction with a pharmacy. • The Organization overstated 340B Program revenue and professional services expense by $1,111,252 by posting an incorrect adjustment to true-up revenue and expense for dispensing, processing and administrative fees associated with the 340B Program. Corrective Action Taken: The Controller will utilize program data reports to perform reconciliations periodically. The reconciliations will be reviewed by the VP of Finance and stored. Additionally, the Revenue Cycle Manager and the VP of Finance will assist and monitor TPA’s setup and conditions for proper program management. This will be implemented by June 30, 2025. Identifying Number: 2024-002 Audit Finding: Inadequate Internal Controls Over Payroll Transactions. In May 2024, the Organization failed to restrict the modification of payroll reports subsequent to approval. There was no final check performed to ensure that the final submitted payroll report agreed with the approved version. Corrective Action Taken: By June 2024, the Finance Director created additional checks and balances to ensure integrity of payroll. The Director will provide a trend analysis of payroll data for each payroll for the approval process. The analysis will show changes in employee pay and trends. We will also compare the final payroll totals with the website verification after submission to ensure the totals reviewed match what was submitted. Identifying Number: 2024-003 Audit Finding: While testing the procurement requirement for micro purchases, we noted there was one sample selection for which the Organization did not have documentation to support whether the procurement method used was appropriate. Corrective Action Taken: By June 30, 2025, the Operations team and the Accounts Payable Coordinator will maintain a centralized database of vendor contracts, bids, and other information regarding purchases. To ensure continuity through changes in personnel, Tapestry will store the data on the shared drives, allowing for a repository to persist over time. Purchases, contracts, and associated back up will be monitored by both Operations and Finance teams and will be assisted by Office Managers who may perform some ordering.
FAC accepted this audit on May 29, 2024 — management decision was due November 29, 2024.
The data collection form and reporting package were not submitted within nine months after the end of the audit period of June 30, 2023. Cause: The Organization did not have adequate internal controls in place over the review of the SEFA to ensure the SEFA was complete and accurate. The errors contained in the SEFA led to inaccurate major program determination, which ultimately led to the Organization not submitting the single audit reporting package by the prescribed due date. Effect: The data collection form and reporting package were not received by the Federal Audit Clearinghouse by the prescribed due date. Recommendation: We recommend the Organization enhance its internal controls over the review of the completeness and accuracy of the SEFA. We also recommend that management ensure that the data collection form and reporting package are submitted by the prescribed due date. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴Finding 2023-002: Timely Submission of the Single Audit Reporting Package U.S. Department of Health and Human Services Federal Programs: Health Center Program Cluster (ALN numbers 93.224/93.527) (Federal Award Year 2023) and Advanced Nursing Education Workforce Grant Program (ALN number 93.247) (Federal Award Year 2023) Repeat Finding: No Criteria: In accordance with 2 CFR 200.512, the audit must be completed, and the data collection form and reporting package must be submitted within the earlier of 30 calendar days after receipt of the auditor’s report, or nine months after the end of the audit period. Additionally, as part of the data collection, a senior level representative of the auditee must attest that, among other things, the information included in its entirety is accurate and complete. In accordance with 2 CFR 200.510, the auditee must prepare a Schedule of Expenditures of Federal Awards (SEFA) for the period covered by the auditee’s financial statements which must include the total Federal awards expended as determined in accordance with 2 CFR 200.502. Condition: The data collection form and reporting package were not submitted within nine months after the end of the audit period of June 30, 2023. Cause: The Organization did not have adequate internal controls in place over the review of the SEFA to ensure the SEFA was complete and accurate. The errors contained in the SEFA led to inaccurate major program determination, which ultimately led to the Organization not submitting the single audit reporting package by the prescribed due date. Effect: The data collection form and reporting package were not received by the Federal Audit Clearinghouse by the prescribed due date. Recommendation: We recommend the Organization enhance its internal controls over the review of the completeness and accuracy of the SEFA. We also recommend that management ensure that the data collection form and reporting package are submitted by the prescribed due date. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Tapestry 360 Health will improve the timely submission of the Single Audit Reporting Package by ensuring that grant programs are tracked and reported in detail monthly, resulting in fewer errors for the SEFA. Tapestry will also perform a hard close semi-annually that will allow us to perform a mid-year analysis and reconciliation. Furthermore, contracts will be stored in a central, organized manner to facilitate the consistent use of the documents as reference. Finance and the Grants Development team will meet monthly regarding grant programs to review dates, terms, budget, for each program. The anticipated completion date to correct the Finding 2023-002 is August 15th, 2024.
The Organization had memorandum of understanding agreements with each of its subrecipients. However, these agreements did not contain the information required by 2 CFR 200.332(a)(1). The Organization did not request or review the audits of its subrecipients in order to take timely and appropriate action on deficiencies detected through audits, if applicable. The Organization did not have sufficient documentation that internal controls were in place and operating effectively over risk assessment procedures required by the subrecipient monitoring compliance requirement. Cause: The Organization did not have adequate internal controls in place to ensure the agreements with its subrecipients included the required information. Additionally, the Organization did not have adequate controls in place to properly monitor the activities of its subrecipients, or perform the necessary risk assessment procedures. Effect: We tested two out of the four subrecipients the Organization passed funds to under this grant award. Of the two we tested, we noted that the Organization did not have properly executed subrecipient agreements with either subrecipient. We also noted that the Organization did not request the audits of either subrecipient, and did not adequately document its risk assessment. Recommendation: We recommend the Organization enhance its internal controls over the preparation of subrecipient agreements to ensure all required information is contained in the agreements. We also recommend that management enhance its internal controls over subrecipient monitoring to ensure that its subrecipients are utilizing the funds for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴Finding 2023-003: Noncompliance with Subrecipient Monitoring U.S. Department of Health and Human Services Federal Program: Advanced Nursing Education Workforce Grant Program Federal Assistance Listing Number: 93.247 Federal Award Year: 2023 Repeat Finding: No Criteria: In accordance with 2 CFR 200.332(a), pass-through entities must ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the information listed in 2 CFR 200.332(a)(1) at the time of the subaward and if any of these data elements change, include the changes in subsequent subaward modification. When some of this information is not available, the pass-through entity must provide the best information available to describe the Federal award and subaward. In accordance with 2CFR 200.332(d), pass-through entities must monitor the activities of the subrecipient as necessary to ensure that the subaward is used for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward; and that subaward performance goals are achieved. Condition: The Organization had memorandum of understanding agreements with each of its subrecipients. However, these agreements did not contain the information required by 2 CFR 200.332(a)(1). The Organization did not request or review the audits of its subrecipients in order to take timely and appropriate action on deficiencies detected through audits, if applicable. The Organization did not have sufficient documentation that internal controls were in place and operating effectively over risk assessment procedures required by the subrecipient monitoring compliance requirement. Cause: The Organization did not have adequate internal controls in place to ensure the agreements with its subrecipients included the required information. Additionally, the Organization did not have adequate controls in place to properly monitor the activities of its subrecipients, or perform the necessary risk assessment procedures. Effect: We tested two out of the four subrecipients the Organization passed funds to under this grant award. Of the two we tested, we noted that the Organization did not have properly executed subrecipient agreements with either subrecipient. We also noted that the Organization did not request the audits of either subrecipient, and did not adequately document its risk assessment. Recommendation: We recommend the Organization enhance its internal controls over the preparation of subrecipient agreements to ensure all required information is contained in the agreements. We also recommend that management enhance its internal controls over subrecipient monitoring to ensure that its subrecipients are utilizing the funds for authorized purposes, in compliance with Federal statutes, regulations, and the terms and conditions of the subaward. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Tapestry’s Finance team will correct noncompliance with Subrecipient Monitoring by updating the policies and procedures and educating the Finance and Grants team regarding the necessary steps to achieve proper compliance. Furthermore, Tapestry teams will store evidence of monthly meetings with grantees, and ensure we receive proper monitoring documentation to accompany suspended & debarred searches, audits, etc. Tapestry will share these requirements with grantees and ensure our policies and contract language are updated to reflect the CFR rules. The anticipated completion date to correct the Finding 2023-003 is August 15th, 2024.
During our testing, we identified errors in the Organization’s SEFA for the year ended June 30, 2023. The errors were as follows: • Total federal expenditures for Assistance Listing Number (ALN) 93.247, Advanced Nursing Education Workforce Grant Program, were understated by $516,141. • Total federal expenditures for ALN 93.217, Family Planning Services, were overstated by $125,252. • The federal grantor for amounts passed through the Illinois Department of Public Health for ALN 93.323, Epidemiology and Laboratory Capacity for Infectious Disease (ELC), was incorrectly reported as the U.S. Department of the Treasury and should have been reported as the U.S. Department of Health and Human Services. Cause: The Organization did not have adequate internal controls in place over the review of the SEFA to ensure the SEFA was complete and accurate. . Effect: The errors contained in the SEFA led to inaccurate major program determination. After correcting the errors, an additional major program was identified. The data collection form and reporting package were not received by the Federal Audit Clearinghouse by the prescribed due date. Recommendation: We recommend the Organization enhance its internal controls over the review of the completeness and accuracy of the SEFA. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴Finding 2023-004: Inadequate Review of the Schedule of Expenditures of Federal Awards U.S. Department of Health and Human Services Federal Programs: Advanced Nursing Education Workforce Grant Program (ALN number 93.247) (Federal Award Year 2023), Family Planning Services (ALN number 93.217) (Federal Award Year 2023), and Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) (ALN number 93.323) (Federal Award Year 2023) Repeat Finding: No Criteria: In accordance with 2 CFR 200.510, the auditee must prepare a Schedule of Expenditures of Federal Awards (SEFA) for the period covered by the auditee’s financial statements which must include the total Federal awards expended as determined in accordance with 2 CFR 200.502. Condition: During our testing, we identified errors in the Organization’s SEFA for the year ended June 30, 2023. The errors were as follows: • Total federal expenditures for Assistance Listing Number (ALN) 93.247, Advanced Nursing Education Workforce Grant Program, were understated by $516,141. • Total federal expenditures for ALN 93.217, Family Planning Services, were overstated by $125,252. • The federal grantor for amounts passed through the Illinois Department of Public Health for ALN 93.323, Epidemiology and Laboratory Capacity for Infectious Disease (ELC), was incorrectly reported as the U.S. Department of the Treasury and should have been reported as the U.S. Department of Health and Human Services. Cause: The Organization did not have adequate internal controls in place over the review of the SEFA to ensure the SEFA was complete and accurate. . Effect: The errors contained in the SEFA led to inaccurate major program determination. After correcting the errors, an additional major program was identified. The data collection form and reporting package were not received by the Federal Audit Clearinghouse by the prescribed due date. Recommendation: We recommend the Organization enhance its internal controls over the review of the completeness and accuracy of the SEFA. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Tapestry management will review the SEFA and its corresponding contracts to aide in the attestation of compliance. To further enhance timely submission, Tapestry will use technology and automation to aid the tracking and organization of grant programs. Technological upgrades include using the general ledger to uniquely identify Federal grants and enhance fiscal reporting, using software to store and organize contracts. The anticipated completion date to correct the Finding 2023-004 is August 15th, 2024.
When the Organization entered into covered transactions, it did not verify that the entity was not suspended or debarred or otherwise excluded. While the Organization does have an internal control policy in place regarding the Simplified Registration Services (SAM) exclusion verifications of suspended or debarred entities, the Organization did not always adhere to the policy when entering into covered transactions. Additionally, the policy is vague and does not include details about maintaining evidence of actions taken to ensure proper suspension and debarment requirements are met. Cause: The Organization does not have procedures in place to ensure suspension and debarment checks are completed prior to entering into purchase or service agreements with vendors. Evidence of actions taken to ensure proper suspension and debarment requirements were not being maintained by the Organization. Effect: Failing to have the appropriate controls in place may result in vendors who are suspended or debarred receiving federal funds. Recommendation: We recommend that management implement controls to ensure suspension and debarment checks are completed and documented prior to entering into purchase or service agreements with vendors. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴2023-005: Inadequate Internal Controls over Suspension and Debarment Compliance Requirement U.S. Department of Health and Human Services Federal Programs: Health Center Program Cluster (ALN numbers 93.224/93.527) (Federal Award Year 2023) and Advanced Nursing Education Workforce Grant Program (ALN number 93.247) (Federal Award Year 2023) Repeat Finding: No Criteria: 2 CFR 200.303(a) requires that each 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." The Organization does not have effective suspension and debarment controls in place. 31 CFR 19.300 requires that "When you enter into a covered transaction with another person at the next lower tier, you must verify that the person with whom you intend to do business is not excluded or disqualified." Condition: When the Organization entered into covered transactions, it did not verify that the entity was not suspended or debarred or otherwise excluded. While the Organization does have an internal control policy in place regarding the Simplified Registration Services (SAM) exclusion verifications of suspended or debarred entities, the Organization did not always adhere to the policy when entering into covered transactions. Additionally, the policy is vague and does not include details about maintaining evidence of actions taken to ensure proper suspension and debarment requirements are met. Cause: The Organization does not have procedures in place to ensure suspension and debarment checks are completed prior to entering into purchase or service agreements with vendors. Evidence of actions taken to ensure proper suspension and debarment requirements were not being maintained by the Organization. Effect: Failing to have the appropriate controls in place may result in vendors who are suspended or debarred receiving federal funds. Recommendation: We recommend that management implement controls to ensure suspension and debarment checks are completed and documented prior to entering into purchase or service agreements with vendors. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Tapestry will review the policies and procedures with staff and make necessary updates. The updated Purchasing & Procurement policy will outline a specific role in the Finance department that will champion CFR rules and ensure all vendors’ contracts are tracked, managed, and comply with suspended and debarment rules. This data will be stored on our SharePoint drive for reference and will be reviewed periodically. The anticipated completion date to correct the Finding 2023-005 is August 15th, 2024.
FAC accepted this audit on March 6, 2023 — management decision was due September 6, 2023.
While testing the special tests and provisions requirement, we noted there was one patient for which the Health Center did not have documentation to support whether the sliding scale discount was appropriately provided, one patient where the sliding scale discount was erroneously calculated, and one patient who qualified for the sliding scale discount that was erroneously not provided a sliding scale discount. Cause: The Health Center did not have consistent controls for application of the sliding fee discounts. Documentation to support the usage of the sliding fee discount was not consistently maintained, and in instances where documentation was maintained, the sliding fee discounts were not calculated appropriately based on the information provided by the patient. Effect: Sliding scale adjustments totaling $4 were provided in error to one patient. Sliding scale adjustments totaling $187 were not provided to two patients that qualified for the sliding scale adjustments. Questioned Costs: $183 Context: We noted sliding scale adjustments were inappropriately applied to 3 of 60 patients tested. Repeat finding?: 2021-002 Recommendation: We recommend that additional training of responsible staff be performed to ensure that all documentation related to the sliding scale adjustments is retained and that sliding scale adjustments are applied to qualifying patients in the correct amounts. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴2022-001 Lack of Support for Allowable Cost/Cost Principles Requirement U.S. Department of Health and Human Services Health Center Cluster (93.224 and 93.527) Federal Award Year 2021-2022 Criteria: The Health Center must prepare and apply a sliding fee discount schedule so that the amounts owed for Health Center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: While testing the special tests and provisions requirement, we noted there was one patient for which the Health Center did not have documentation to support whether the sliding scale discount was appropriately provided, one patient where the sliding scale discount was erroneously calculated, and one patient who qualified for the sliding scale discount that was erroneously not provided a sliding scale discount. Cause: The Health Center did not have consistent controls for application of the sliding fee discounts. Documentation to support the usage of the sliding fee discount was not consistently maintained, and in instances where documentation was maintained, the sliding fee discounts were not calculated appropriately based on the information provided by the patient. Effect: Sliding scale adjustments totaling $4 were provided in error to one patient. Sliding scale adjustments totaling $187 were not provided to two patients that qualified for the sliding scale adjustments. Questioned Costs: $183 Context: We noted sliding scale adjustments were inappropriately applied to 3 of 60 patients tested. Repeat finding?: 2021-002 Recommendation: We recommend that additional training of responsible staff be performed to ensure that all documentation related to the sliding scale adjustments is retained and that sliding scale adjustments are applied to qualifying patients in the correct amounts. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Identifying Number: 2022-001 Finding: While testing the special tests and provisions requirement, we noted there was one patient for which the Health Center did not have documentation to support whether the sliding scale discount was appropriately provided, one patient where the sliding scale discount was erroneously calculated, and one patient who qualified for the sliding scale discount that was erroneously not provided a sliding scale discount. Corrective Actions Taken or Planned: The Health Center will update the audit tool to include the following questions: Did the employee correctly apply the sliding fee scale? Does the documentation support the sliding fee allocation? The audit tool is a questionnaire used by managers to support compliance with the sliding fee scale policy. Managers conduct bi-weekly random audits on front desk staff. Name of person responsible for corrective action: Randy Johnson Title: Chief Financial Officer Anticipated completion date: April 30, 2023
2021-002
FAC accepted this audit on February 27, 2022 — management decision was due August 27, 2022.
While testing the special tests and provisions requirement, we noted there was one patient who did not qualify for the sliding scale discount that was erroneously provided a sliding scale discount and one patient for which the Health Center did not have documentation to support whether the sliding scale discount was appropriately provided. Cause: The field within the Health Center?s billing system indicating that the patient was eligible for a discount was selected in error. Effect: Sliding scale adjustments totaling $41 were provided in error to these two patients. Questioned Costs: $41 Context: We noted there was an inappropriate sliding scale adjustment provided for 2 of 40 patients tested. Repeat finding?: No Recommendation: We recommend that additional training of responsible staff be performed to ensure that sliding scale adjustments are provided only to qualifying instances and patients. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Show full finding ▾Hide full finding ▴2021-002 COVID-19, Lack of Support for Allowable Cost/Cost Principles Requirement U.S. Department of Health and Human Services Health Center Cluster (93.224 and 93.527) Federal Award Year 2020-2021 Criteria: The Health Center must prepare and apply a sliding fee discount schedule so that the amounts owed for Health Center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: While testing the special tests and provisions requirement, we noted there was one patient who did not qualify for the sliding scale discount that was erroneously provided a sliding scale discount and one patient for which the Health Center did not have documentation to support whether the sliding scale discount was appropriately provided. Cause: The field within the Health Center?s billing system indicating that the patient was eligible for a discount was selected in error. Effect: Sliding scale adjustments totaling $41 were provided in error to these two patients. Questioned Costs: $41 Context: We noted there was an inappropriate sliding scale adjustment provided for 2 of 40 patients tested. Repeat finding?: No Recommendation: We recommend that additional training of responsible staff be performed to ensure that sliding scale adjustments are provided only to qualifying instances and patients. View of responsible officials of the auditee: Management agrees with the finding and recommendation.
Finding 2021-002: Finding: COVID-19, Lack of Support for Allowable Cost/Cost Principles Requirement - One of the patients, who did not qualify for the sliding scale discount, was erroneously provided a discount while another patient?s file did not have the proper documentation to support the sliding scale discount received. Corrective Actions Taken or Planned: Front desk staff will be made aware of the issue by their managers and reminder training will occur as needed during the last six months of fiscal year 2022.
FAC accepted this audit on February 11, 2021 — management decision was due August 11, 2021.
FAC accepted this audit on March 5, 2020 — management decision was due September 5, 2020.
FAC accepted this audit on January 10, 2019 — management decision was due July 10, 2019.
FAC accepted this audit on February 1, 2018 — management decision was due August 1, 2018.
GSA_MIGRATION
Show full finding ▾Hide full finding ▴FAC accepted this audit on April 3, 2017 — management decision was due October 3, 2017.
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