Title: Basis of Presentation
Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
De Minimis Rate Used: N
Rate Explanation: Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an
accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal
organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance Listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior
audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
Title: Indirect Expenses
Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
De Minimis Rate Used: N
Rate Explanation: Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
Title: Greater Monadnock Regional Public Health Network Services
Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
De Minimis Rate Used: N
Rate Explanation: Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
Cheshire Medical Center received a pass-through award from the County of Cheshire, who were themselves a pass-through entity for their award from the New Hampshire Department of Health and Human Services. The award contract between the County of Cheshire and NH DHHS indicates that the award is funded from several Federal Agencies, programs, and Assistance Listing numbers as noted below and could not be split out by Agency. Accordingly, the total expenditures of $134,026 included on accompanying SEFA for this program are listed as one amount under the Assistance Listing #93.U01.
Title: New Hampshire Clinical and Administrative Services
Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
De Minimis Rate Used: N
Rate Explanation: Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
Mary Hitchcock Memorial Hospital received a pass-through award from the State of New Hampshire in which the total award amount of $2,550,704 was not split out by Agency listed below. Accordingly, the total expenditures of $691,452 included on accompanying SEFA for this program are listed as one amount under the Assistance Listing #93.U04.
Title: Provider Relief
Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
De Minimis Rate Used: N
Rate Explanation: Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
The Health System was the recipient of funding under Assistance Listing number 93.498, COVID-19 Provider Relief Funds and American Rescue Plan Rural Distribution (“PRF”), and as required based on guidance in the 2023 OMB Compliance Supplement, the Schedule includes all Period 4 and 5 funds received between July 1, 2021 and June 30, 2022 and expended by June 30, 2023 as reported to the
Department of Health and Human Services via the PRF Reporting Portal.
Given the timing covered by the Period 4 and 5 funds, certain of these expenses were reflected in the Health System's consolidated financial statements for the year ended June 30, 2022. Additionally, lost revenue does not represent an expenditure in the Health System’s financial statements and thus is a reconciling item between the federal expenses in the Health System’s financial statements and the amount included on the Schedule.
Title: Federal Emergency Management Agency
Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) presents the activity of federal award programs administered by Dartmouth-Hitchcock Health and Subsidiaries (the “Health System”) as defined in the notes to the consolidated financial statements and is presented on an accrual basis. The purpose of this Schedule is to present a summary of those activities of the Health System for the year ended June 30, 2023 which have been financed by the United States government (“federal awards”). For purposes of this Schedule, federal awards include all federal assistance entered into directly between the Health System and the federal government and subawards from nonfederal organizations made under federally sponsored agreements. The information in this Schedule in presented in accordance with the requirements of the Uniform Guidance. Pass-through entity identification numbers and Assistance Listing numbers have been provided where available.
Visiting Nurse and Hospice of NH and VT (“VNH”) received a Community Facilities Loan, Assistance listing #10.766, of which the proceeds were expended in 2018. The VNH had an outstanding balance of $2,343,000 as of June 30, 2023. As this loan was related to a project that was completed in the prior audit period and the terms and conditions do not impose continued compliance requirements other than to repay the loan, we have excluded the outstanding loan balance from the Schedule.
De Minimis Rate Used: N
Rate Explanation: Indirect costs are charged to certain federal grants and contracts at a federally approved predetermined indirect rate, negotiated with the Division of Cost Allocation and therefore we do not use the de minimus 10% rate. The predetermined rate provided for the year ended June 30, 2023 was 55%. Indirect costs are included in the reported federal expenditures.
The Health System applied for reimbursement of certain expenses related to the COVID-19 pandemic under Assistance Listing #97.036, FEMA Public Assistance through the Disaster Grants – Public Assistance (Presidentially Declared Disasters). Expenditures are reflected in the Schedule in the year in
which a project application is obligated and expenditures incurred. The Schedule thus includes $1,818,583 of expenditures incurred in fiscal years 2021 and 2022, which were obligated in fiscal year 2023 and represents a reconciling item between the federal expenses in the Health System’s financial statements and the amount included on the Schedule.