Title: 2. COVID-19 - Provider Relief Fund
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the Hospital. Effective October 1, 2022, New York-Presbyterian/Brooklyn Methodist (NYP/Brooklyn Methodist) excluding its affiliates, was merged with and into NYPH, with NYPH as the surviving corporation acquiring all assets and liabilities of NYP/Brooklyn Methodist. Prior to this date, NYP/Brooklyn Methodist was an indirect subsidiary of NYPH. The Schedule is presented on the accrual basis of accounting. The information in the 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). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for Uniform Guidance awards. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate elections; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
In accordance with the U.S. Department of Health and Human Services' requirements specific to Federal Assistance Listing No. 93.498, COVID-19 - Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution, the amount presented on the accompanying Schedule for the year ended December 31, 2022 for Federal Assistance Listing No. 93.498 relates to (i) PRF payments received from January 1, 2021 through December 31, 2021 (ii) used for PRF-eligible activity from the period January 1, 2020 through December 31, 2022. This payment receipt period and activity period and the resulting amount presented on the accompanying Schedule for the year ended December 31, 2022 reconciles to the PRF information previously reported to the Health Resources and Services Administration (HRSA) for PRF Reporting Periods 3 and 4. See the Notes to the SEFA for chart. The lost revenues incurred by the Hospital during the periods of availability through PRF Reporting Period 4 (January 1, 2020 through December 31, 2022) are in excess of the distributions received in PRF Reporting Periods 1 and 2 (which addressed payments received during April 10, 2020 to December 31, 2020, and previously reported on the Schedule of Expenditures of Federal Awards for the year ended December 31, 2021) and distributions received in PRF Reporting Periods 3 and 4 (January 1, 2021 through December 31, 2021) and, therefore, the amounts presented in the table in the Notes to the SEFA and on the accompanying Schedule are limited to distributions received in PRF Reporting Periods 3 and 4. The Hospital also received PRF payments of $110.5 million in PRF Reporting Period 5 (January 1, 2022 through June 30, 2022) which, pursuant to the requirements specific to Federal Assistance Listing No. 93.498, are required to be excluded from the accompanying Schedule for the year ended December 31, 2022.
Title: 3. Vaccines for Children Program
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the Hospital. Effective October 1, 2022, New York-Presbyterian/Brooklyn Methodist (NYP/Brooklyn Methodist) excluding its affiliates, was merged with and into NYPH, with NYPH as the surviving corporation acquiring all assets and liabilities of NYP/Brooklyn Methodist. Prior to this date, NYP/Brooklyn Methodist was an indirect subsidiary of NYPH. The Schedule is presented on the accrual basis of accounting. The information in the 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). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for Uniform Guidance awards. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate elections; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
During the year ended December 31, 2022, the Hospital participated in the New York City Department of Health and Mental Hygiene - Vaccines for Children Program through the provision of vaccinations. The U.S. Department of Health and Human Services, the federal agency that sponsors this program under Federal Assistance Listing number 93.268, has determined that the vaccines administered are considered "property in lieu of money" and, therefore, should be reported as federal awards expended by the Hospital for purposes of presentation in the accompanying Schedule.
Title: 4. Food and Nutritional Awards
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the Hospital. Effective October 1, 2022, New York-Presbyterian/Brooklyn Methodist (NYP/Brooklyn Methodist) excluding its affiliates, was merged with and into NYPH, with NYPH as the surviving corporation acquiring all assets and liabilities of NYP/Brooklyn Methodist. Prior to this date, NYP/Brooklyn Methodist was an indirect subsidiary of NYPH. The Schedule is presented on the accrual basis of accounting. The information in the 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). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for Uniform Guidance awards. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate elections; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
During the year ended December 31, 2022, the Hospital participated in the State of New York Department of Health - Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) through the provision of nutritional counseling and the receipt and distribution of food vouchers. The U.S. Department of Agriculture, the federal agency that sponsors the WIC program under Federal Assistance Listing Number 10.557, has determined that WIC food vouchers are considered "property in lieu of money" and, therefore, should be reported as federal awards received by the Hospital for the purpose of presentation in the Schedule. The amount reported in the Schedule for the WIC program under Federal Assistance Listing Number 10.557 represents the federally funded value of food vouchers issued ($11,078,341) plus administrative costs ($3,141,452) for the year ended December 31, 2022. In addition to the federal funds received for the WIC program, in 2022 approximately 16.2% of the WIC program's total administrative and nutritional counseling costs were funded by the State of New York Department of Health; such amounts are excluded from the Schedule.
Title: 5. U.S. Department of Housing and Urban Development Mortgage Insurance Prog
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the Hospital. Effective October 1, 2022, New York-Presbyterian/Brooklyn Methodist (NYP/Brooklyn Methodist) excluding its affiliates, was merged with and into NYPH, with NYPH as the surviving corporation acquiring all assets and liabilities of NYP/Brooklyn Methodist. Prior to this date, NYP/Brooklyn Methodist was an indirect subsidiary of NYPH. The Schedule is presented on the accrual basis of accounting. The information in the 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). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for Uniform Guidance awards. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate elections; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
NYPH has a mortgage loan insured under the provisions of the U.S. Department of Housing and Urban Development - Federal Housing Administration (FHA) Section 241 mortgage insurance program. The U.S. Department of Housing and Urban Development (HUD) has determined that the mortgage insurance program is to be considered a federal award for purposes of compliance with the Uniform Guidance. See the Notes to the SEFA for the chart showing the outstanding balance of the loan. Pursuant to the agreement related to the mortgage loan, NYPH is, among other compliance requirements, required to maintain certain debt service funds, including a mortgage reserve fund. In addition, NYPH is required to maintain certain working capital, debt service coverage, other financial ratios and financial conditions and to obtain approval from HUD to incur additional debt above specified levels if profitability requirements are not met. Compliance with such requirements is measured separately for the applicable obligated entity. The mortgage is collateralized by certain NYPH property, buildings and equipment and gross receipts derived from operations. Through December 31, 2022, NYPH was in compliance with the financial covenants. Due to the global viral outbreak caused by Coronavirus Disease 2019 (COVID-19) in 2020, in July 2022 HUD approved the continuation of NYPH's enhanced status through December 31, 2023 (the prior approval period ended on December 31, 2021), even if NYPH does not meet all of the financial tests for continued eligibility through December 31, 2023. On August 29, 2023, NYPH closed on the issuance of Dormitory Authority of the State of New York Series 2023 Revenue Bonds. On or about October 30, 2023 (the Prepayment Date), a portion of the proceeds of the Series 2023 Bonds, together with other available funds, will be applied to the repayment in full of the FHA-insured mortgage loan. On the Prepayment Date, the FHA-insured mortgage loan will be satisfied and released.
Title: 6. Federal Emergency Management Agency: Disaster Grants
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the Hospital. Effective October 1, 2022, New York-Presbyterian/Brooklyn Methodist (NYP/Brooklyn Methodist) excluding its affiliates, was merged with and into NYPH, with NYPH as the surviving corporation acquiring all assets and liabilities of NYP/Brooklyn Methodist. Prior to this date, NYP/Brooklyn Methodist was an indirect subsidiary of NYPH. The Schedule is presented on the accrual basis of accounting. The information in the 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). In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 2 and 6). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program. Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX for Uniform Guidance awards. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate elections; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
In 2022, the Hospital received reimbursement payment of approximately $2.2 million under the Federal Emergency Management Agency (FEMA) COVID-19 Disaster Relief Fund - Public Assistance (Presidentially Declared Disasters) program (Federal Assistance Listing number 97.036). This amount has been included in the accompanying Schedule for the year ended December 31, 2022 in accordance with the guidance specific to Federal Assistance Listing Number 97.036. The payment received in 2022, along with other amounts received in 2020 through 2023, relate to project worksheets totaling over $1.0 billion submitted by the Hospital to FEMA since 2020 under its expedited claim submission process and streamlined submission process. In January 2023, FEMA obligated $174.1 million of costs previously submitted by the Hospital for reimbursement; the payment to the Hospital was received in April 2023. The Hospital is finalizing project worksheets previously submitted to FEMA and intends to submit additional applications for funding of eligible costs incurred through the end of the defined period. The ultimate amount of incurred costs that the Hospital may be reimbursed is still uncertain.