EIN: 371058692
UEI: QPCQDKA2MMJ7
Data as of August 21, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on March 30, 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 September 30, 2026 (40 days from today).
What is a management decision? →Institutions are required to report enrollment information under the Pell Grant and the Direct Loan programs via the NSLDS (OMB No. 1845-0035) (Pell, 34 CFR 690.83(b)(2); Direct Loan, 34 CFR 685.309; Perkins 34 CFR 674.19(f)). The NSLDS Enrollment Reporting Guide provides the requirements and guidance for reporting enrollment details using the NSLDS Enrollment Reporting Process within 60 days of an enrollment status change. Three of five samples selected for testing were not submitted to NSLDS within 60 days of the enrollment status change. Management implemented a new enrollment reporting workflow in fall, 2024. The implementation resulted in a timing gap during which enrollment status changes were not submitted timely. Inaccurate reporting of status changes could result in student financial aid being awarded when the student is not eligible due to their enrollment status. The sample was not intended to be, and was not, a statistically valid sample. Management should implement consistent and regular review of student enrollment changes to ensure timely reporting.
The College has implemented a structured NSLDS enrollment reporting control to ensure updates are reported within 60 days to NSLDS, (OMB No. 1845-0035) (Pell, 34 CFR 690.83(b)(2); Direct Loan, 34 CFR 685.309; Perkins 34 CFR 674.19(f)). The Registrar’s Office, or a representative of, generates a Monthly status-change report, which is reviewed at the Student Affairs Operations meeting. Financial Aid reviews the list for Title IV impacts, and the Director of Financial Aid completes the NSLDS Enrollment Maintenance roster review and certification on a scheduled cadence (at least biweekly; weekly during peak periods). Each submission is documented with (1) the SONIS status-change report, (2) the NSLDS Enrollment Maintenance Report/roster file, and (3) dated evidence of review/approval and submission (email/Teams sign-off plus NSLDS submission history screenshot). Exceptions approaching 45 days are escalated to leadership for same-week certification
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on March 29, 2024. 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 September 29, 2024, which was (691 days ago).
What is a management decision? →Finding #2023-001 Type: Significant Deficiency Federal Agency: Department of Health and Human Services Program Name: Research and Development Cluster AL Number: 93.399 Grant Name: Cancer Research of Wisconsin and Northern Michigan (CROWN) Consortium Grant Identification Number: 5UG1CA239769-03 Federal Award Year: August 1, 2021 through July 31, 2022 Compliance Requirement: Allowable Costs/Cost Principles Criteria In accordance with the documentation standards of 2 CFR section 200.430(i), costs of compensation for personal services are allowable to the extent the total compensation for individual employees: a. Is reasonable for the services rendered and conforms to the established written policy of the non-federal entity consistently applied to both federal and non-federal activities; b. Follows an appointment made in accordance with a non-federal entity’s rules or written policies and meets the requirements of federal statute, where applicable; and c. Is determined and supported as provided in 2 CFR section 200.430(i), including that charges to federal awards for salaries and wages must be based on records that accurately reflect the work performed. Condition Found During testwork performed over the Research and Development Cluster, for 1 of 25 payroll items selected for testing we noted that a clerical error was made for an employee’s salary as 76% of their time was allocated to the grant, instead of the actual 0.76%. As such, $12,411 of the individual’s salary allocated to the grant was deemed unallowable. There are additional known questioned costs related to fringe and indirect costs, as the base upon which those calculations were applied was misstated for the above. Cause and Possible Asserted Effect The control to reconcile the costs allocated to the grant to supporting records did not operate effectively, resulting in incorrect charges being applied to the grant. Questioned Costs Statistically Valid Sample The sample was not intended to be, and was not, a statistically valid sample. Repeat Finding from Prior Year No Recommendation We recommend a control reconciling all costs allocated to the grant to supporting records be performed on a monthly basis. Views of Responsible Officials See attached correction plan at the end of this report.
Finding #2023-001: Reconciliation of Allocated Costs CLIENT PLANNED ACTION: Hospital Sisters Health System agrees with the finding and will reevaluate the procedures in place to reconcile all costs allocated to grants. We will implement processes to ensure that all costs are substantiated with appropriate supporting detail and are reconciled and reviewed in a timely manner. CLIENT RESPONSIBLE PARTY: Steve Canny, System Director-Financial Reporting, Compliance & Internal Control COMPLETION DATE: We anticipate having these procedures in place by June 30, 2024.
Data source: This information comes from the Federal Audit Clearinghouse, the official repository of Single Audit data. All data is public domain. Verify this organization's audit history at fac.gov.
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