Title: Basis of Presentation
Accounting Policies: The Schedules reflect federal award program expenditures recognized on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America. JHHS has not elected to use the 10% de minimis rate for indirect costs. Indirect costs are billed based upon negotiated and budgeted rates.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The accompanying Schedules of Expenditures of federal awards and Florida state financial assistance (the "Schedules") include the federal and state grant transactions of the Johns Hopkins Health System Corporation and its affiliates ("JHHS") under programs of the federal government and state of Florida for the year ended June 30, 2023. Because the Schedules present only a selected portion of the operations of JHHS, they are not intended to and do not present the financial position, results of operations and changes in net assets, or cash flows of JHHS.
For purposes of the Schedules, federal and state awards include all awards in the form of grants, contracts, and similar agreements entered into directly between JHHS and the agencies, the departments of the federal government, the non-federal pass-through entities, and the state of Florida. Federal Assistance Listing information, Catalog of State Financial Assistance (“CSFA”), and pass-through identification numbers are included when available.
Title: Summary of Significant Accounting Policies
Accounting Policies: The Schedules reflect federal award program expenditures recognized on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America. JHHS has not elected to use the 10% de minimis rate for indirect costs. Indirect costs are billed based upon negotiated and budgeted rates.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The Schedules reflect federal and state award program expenditures recognized on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America. JHHS has not elected to use the 10% de minimis rate for indirect costs. Indirect costs are billed based upon negotiated and budgeted rates.
Title: HRSA COVID-19 Testing and Treatment for the Uninsured
Accounting Policies: The Schedules reflect federal award program expenditures recognized on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America. JHHS has not elected to use the 10% de minimis rate for indirect costs. Indirect costs are billed based upon negotiated and budgeted rates.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
JHHS conducted COVID-19 testing and/or provided treatment for uninsured individuals with a COVID-19 primary diagnosis on or after February 4, 2020 and as such requested claims reimbursement under Assistance Listing # 93.461 Health Resources and Services Administration's ("HRSA") COVID-19 Testing and Treatment for the Uninsured. JHHS recorded $(1.2) million on the Schedule consisting of refunds and adjustments reported in fiscal year 2023 relating to claims submitted and reported with service dates in fiscal years 2020, 2021, and 2022 for $(313) thousand, $(600) thousand, and $(284) thousand, respectively. The Uninsured program stopped accepting claims due to a lack of sufficient funds. No claims submitted after March 22, 2022 for testing or treatment and claims for vaccine administration after April 5, 2022, will be processed for adjudication and payment.
Title: Department of Health and Human Services COVID-19 Provider Relief Funds and American Rescue Plan Rural Distribution
Accounting Policies: The Schedules reflect federal award program expenditures recognized on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America. JHHS has not elected to use the 10% de minimis rate for indirect costs. Indirect costs are billed based upon negotiated and budgeted rates.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The Schedule includes Period 4 funds received between July 1, 2021 and December 31, 2021 expended by December 31, 2022 and Period 5 funds received between January 1, 2022 and June 30, 2022 expended by June 30, 2023 as reported to HRSA via the Provider Relief Funds and American Rescue Plan Rural Reporting Portal. The grant activity associated with Assistance Listing #93.498 is attributable to lost revenues and direct expenditures. The total amount recognized in the Schedule of $21.2 million for the year ended June 30, 2023, includes $12.6 million of direct expenditures and $8.6 million of lost revenue.
The affiliate ACHS included in the Schedule represents Provider Relief Funds totaling $1.2 million, of which $1.1 million were reported for Pediatric Physician Services, Inc. and $43 thousand were reported for West Coast Neonatology, Inc.
Title: Federal Emergency Management Agency Disaster Grants – Public Assistance (Presidentially Declared Disasters)
Accounting Policies: The Schedules reflect federal award program expenditures recognized on the accrual basis of accounting in accordance with accounting principles generally accepted in the United States of America. JHHS has not elected to use the 10% de minimis rate for indirect costs. Indirect costs are billed based upon negotiated and budgeted rates.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
In fiscal year 2023, the affiliate Johns Hopkins All Children’s Hospital (“JHACH”) received approval of their project related to Federal Emergency Management Agency (“FEMA”) Disaster Grants – Public Assistance (Presidentially Declared Disasters) funding passed thru from the Florida Division of Emergency Management. As required by the OMB Compliance Supplement, non-federal entities must record expenditures on the Schedule when (1) FEMA has obligated the non-federal entity’s project, and (2) the non-federal entity has incurred the eligible expenditures. JHACH, as such, recorded $74,311 in expenditures on the Schedule, all of which were obligated and incurred in fiscal year 2023. In addition, there are $132,870 in expenditures that were incurred in fiscal year 2023 but not obligated by FEMA until fiscal year 2024 and therefore will be reported on the fiscal year 2024 Schedule.