Audit 26156

Title: COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant activity of The New York Eye and Ear Infirmary and Affiliates (the Organization) and is presented on the accrual basis of accounting. The information on 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 Note 3). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the presentation of, the consolidated financial statements of the Organization. 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 awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Organization did not make this election. In accordance with HHS requirements specific to Federal Assistance Listing No. 93.498, COVID-19 Provider Relief Fund 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 Provider Relief Fund (PRF) payments received from January 1, 2021 through December 31, 2021 used for PRF-eligible activity from the period January 1, 2020 through December 31, 2022. The amounts presented on the accompanying Schedule for the year ended December 31, 2022 reconcile to the PRF information previously reported to the Health Resources and Services Administration (HRSA) for PRF Reporting Periods 3 and 4 (See Notes to Schedule of Expenditures of Federal Awards for table). The lost revenues incurred by the Organization during the period of availability for PRF Reporting Period 3 (January 1, 2020 through June 30, 2022) and PRF Reporting Period 4 (January 1, 2020 through December 31, 2022) are in excess of the distributions received from January 1, 2021 through December 31, 2021, therefore, the amounts presented in the table above and on the accompanying Schedule are limited to the amount of such distributions. The Organization also received PRF payments subsequent to December 31, 2021 which are required to be reported in subsequent HRSA PRF Reporting Periods and, accordingly, pursuant to the requirements specific to Federal Assistance Listing No. 93.498, activity related to such payments is excluded from the accompanying Schedule.