Audit 18746

Title: Note 5: Balance of Outstanding Loans Accounting Policies: Note 2: Summary of Significant Accounting Policies - Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Note 4: Indirect Costs - Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital has not elected to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. The loan balances outstanding at the beginning of the year are included in the federal expenditures presented in the Schedule. There were no new loans received during the year ending September 30, 2022. Community Facilities Loans and Grants(10.766) had balances outstanding at the end of the audit period of $9,102,115.

Title: Note 1: Basis of Presentation Accounting Policies: Note 2: Summary of Significant Accounting Policies - Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Note 4: Indirect Costs - Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital has not elected to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (Schedule) includes the federal award activity of Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital. The information in this schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the Uniform Guidance). Because the schedule presents only a selected portion of the operations of Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital, it is not intended to and does not present the financial position, changes in net assets, or cash flows of Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital.

Title: Note 4: Subrecipients Accounting Policies: Note 2: Summary of Significant Accounting Policies - Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Note 4: Indirect Costs - Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital has not elected to use the 10-percent de minimis indirect cost rate allowed under the Uniform Guidance. Excelsior Springs City Hospital d/b/a Excelsior Springs Hospital passed no federal awards through to subrecipients.