Title: Note 1 – Basis of Presentation
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has
been provided to a subrecipient.
De Minimis Rate Used: N
Rate Explanation: The Hospital has not elected to use the 10% de minimis cost rate.
The accompanying schedule of expenditures of federal awards (Schedule) includes the federal award activity of
Van Buren County Hospital (Hospital) under programs of the federal government for the year ended June 30,
2023. The information 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 (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of the
Hospital, it is not intended to and does not present the financial position, changes in net position, or cash flows
of the Hospital.
Title: Note 2 – Significant Accounting Policies
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has
been provided to a subrecipient.
De Minimis Rate Used: N
Rate Explanation: The Hospital has not elected to use the 10% de minimis cost rate.
Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has
been provided to a subrecipient.
Title: Note 3 – Indirect Cost Rate
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has
been provided to a subrecipient.
De Minimis Rate Used: N
Rate Explanation: The Hospital has not elected to use the 10% de minimis cost rate.
The Hospital has not elected to use the 10% de minimis cost rate.
Title: Note 4 – Loan and Grant Programs
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has
been provided to a subrecipient.
De Minimis Rate Used: N
Rate Explanation: The Hospital has not elected to use the 10% de minimis cost rate.
Expenditures reported on this Schedule under the Community Facilities Loans and Grants Program consists of
the beginning of the year outstanding loan balance of the Hospital’s USDA direct loans of $2,698,083, as well as
$108,806, which is 90% of the beginning of the year outstanding balance of the Hospital’s USDA guaranteed
loan. If applicable, advances made on the loans during the year are reported on the Schedule. The Hospital
made no advances on the loans during the year ended June 30, 2023. The Hospital’s outstanding loan balance
for the direct loan and the guaranteed loan as of June 30, 2023, are $2,606,424 and $100,361, respectively. In
addition to outstanding loans the Community Facilities Loans and Grants Program reported $419,700 of current
expenditures related to the USDA Emergency Rural Health Care (ERHC) Track One grant and $55,600 of current
expenditures related to the USDA Rural Housing Service‐Community Facilities grant.
Title: Noted 5 ‐ Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. When applicable, 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. No federal financial assistance has
been provided to a subrecipient.
De Minimis Rate Used: N
Rate Explanation: The Hospital has not elected to use the 10% de minimis cost rate.
The Hospital received amounts from the U.S. Department of Health and Human Services (HHS) through the
Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) program (Federal Financial
Assistance Listing #93.498) during the year ended June 30, 2022. The Hospital incurred eligible expenses and,
therefore recognized revenue on the financial statements. In accordance with the 2023 Compliance
Supplement, the PRF expenditures recognized on the Schedule are based on the reporting to HHS for Periods 4
and 5, defined as payments received during July 1, 2021 to June 30, 2022 of $527,438, plus interest earned of
$1,160, as required under the PRF program.
The amount of PRF expenditures included in the Schedule requires management to make estimates and
assumptions that affect the reported amounts. Accordingly, such expenditures are considered a significant
estimate. Estimates and assumptions may include reducing actual expenses by amounts that have been
reimbursed or are obligated to be reimbursed by other sources and estimating marginal increases in expenses
related to coronavirus. Actual amounts could differ from those estimates.