Title: Note 1 - Basis of Presentation
Accounting Policies: The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2023. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC.
De Minimis Rate Used: N
Rate Explanation: An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. BMHCC has not elected to use the 10% de minimus cost rate allowed under the Uniform Guidance. BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research, National Cancer Institute Community for Cancer Cause and Prevention Research, and St. Jude Children’s Research Hospital, Inc. for Blood Diseases and Resources Research. Each program’s share of indirect costs is recognized on the accompanying SEFA.
The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2023. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC.
The SEFA does not present the activity for BMHCC’s affiliate, Baptist College of Health Sciences, Inc. dba Baptist Health Sciences University (the “University”), which received $11,092,032 in federal awards during the year ended September 30, 2023. A separate audit of compliance over the University’s major programs will be performed in accordance with the requirements described in the OMB Compliance Supplement and our report thereon will be issued in January 2024.
Federal direct and indirect programs are presented by federal department and by individual federal awards. Assistance Listing Number (ALN) for federal programs, pass-through entity, and grant number are presented for all individual awards, where applicable.
Title: Note - 2 Basis of Accounting
Accounting Policies: The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2023. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC.
De Minimis Rate Used: N
Rate Explanation: An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. BMHCC has not elected to use the 10% de minimus cost rate allowed under the Uniform Guidance. BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research, National Cancer Institute Community for Cancer Cause and Prevention Research, and St. Jude Children’s Research Hospital, Inc. for Blood Diseases and Resources Research. Each program’s share of indirect costs is recognized on the accompanying SEFA.
The SEFA has been prepared in accordance with the accrual basis of accounting and with accounting principles generally accepted in the United States of America and is consistent with the preparation of BMHCC’s combined financial statements. Amounts reflected in the SEFA include only expenditures of federal awards. 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.
An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. BMHCC has not elected to use the 10% de minimus cost rate allowed under the Uniform Guidance. BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research, National Cancer Institute Community for Cancer Cause and Prevention Research, and St. Jude Children’s Research Hospital, Inc. for Blood Diseases and Resources Research. Each program’s share of indirect costs is recognized on the accompanying SEFA. The SEFA includes the amounts for the following subsidiaries, which were recorded as other revenue in the combined statements of operations and changes in net assets for the year ended September 30, 2022.
See the notes to the SEFA for chart/table.
For the U.S. Department of Health and Human Services (HHS) awards related to the Provider Relief Fund (PRF) and American Rescue Plan Rural Distribution program, HHS has indicated the amounts on the schedule be reported corresponding to reporting requirements of the Health Resources and Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to ‘Payment Received Periods’ (each, a “Period”) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period’s deadline to use the funds (i.e., after the end of the Period of Availability).
The SEFA includes $76,266,188 received from HHS between July 2021 through June 2022 (Period 4 and Period 5). In accordance with guidance from HHS, this amount was submitted to the HRSA PRF Reporting Portal for Period 4 and Period 5. Such amount was recognized as other revenue in BMHCC’s combined financial statements in the year ended September 30, 2022.
Title: Note 3 - Subrecipients
Accounting Policies: The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2023. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC.
De Minimis Rate Used: N
Rate Explanation: An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. BMHCC has not elected to use the 10% de minimus cost rate allowed under the Uniform Guidance. BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research, National Cancer Institute Community for Cancer Cause and Prevention Research, and St. Jude Children’s Research Hospital, Inc. for Blood Diseases and Resources Research. Each program’s share of indirect costs is recognized on the accompanying SEFA.
Uniform Guidance defines a subrecipient as a nonfederal entity that receives a subaward from a pass-through entity to carry out part of a federal program but does not include an individual who is a beneficiary of such program or payments to a contractor. A contractor is an entity that receives a contract by which a nonfederal entity purchases property or services needed to carry out the project or program under a federal award. A nonfederal entity may concurrently receive federal funds as a recipient, subrecipient, and contractor, depending on the substance of its agreements with federal awarding agencies and pass-through entities. Therefore, BMHCC must make case-by-case determinations whether each agreement it makes for the disbursement of federal program funds casts the party receiving the funds as a subrecipient or a contractor based on the Uniform Guidance definitions and management’s judgement. The total amount identified as provided to subrecipients during the year ended September 30, 2023 was $158,184.
Title: Note 4 - Relationship to Federal Financial Reports
Accounting Policies: The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2023. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC.
De Minimis Rate Used: N
Rate Explanation: An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. BMHCC has not elected to use the 10% de minimus cost rate allowed under the Uniform Guidance. BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research, National Cancer Institute Community for Cancer Cause and Prevention Research, and St. Jude Children’s Research Hospital, Inc. for Blood Diseases and Resources Research. Each program’s share of indirect costs is recognized on the accompanying SEFA.
The regulations and guidelines governing the preparation of federal financial reports vary by federal agency and among programs administered by the same agency. Accordingly, the amounts reported in the federal financial reports may not necessarily agree with the amounts reported in the accompanying SEFA, which is prepared as explained in the Notes above.
Title: Note 5 - Claims Reimbursement
Accounting Policies: The schedule of expenditures of federal awards (the “SEFA”) includes the federal award activity of BMHCC under programs of the federal government for the year ended September 30, 2023. The information in the SEFA 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 SEFA presents only a selected portion of the operations of BMHCC, it is not intended to and does not present the financial position, changes in net assets, or cash flows of BMHCC.
De Minimis Rate Used: N
Rate Explanation: An award is considered expended when the activity related to the award occurs. The activity generally pertains to events requiring compliance with laws, regulations, and the provisions of contract and grant agreements. BMHCC has not elected to use the 10% de minimus cost rate allowed under the Uniform Guidance. BMHCC has an approved indirect cost rate for the National Cancer Institute Community Oncology Research Program for Cancer Treatment Research, National Cancer Institute Community for Cancer Cause and Prevention Research, and St. Jude Children’s Research Hospital, Inc. for Blood Diseases and Resources Research. Each program’s share of indirect costs is recognized on the accompanying SEFA.
As of June 2023 HRSA ended program 93.461:Claims Reimbursement for the Uninsured Program and the Covid-19 Coverage Assistance Funds. Given Baptist received no additional funds for this program for fiscal year ended September 30, 2023, Baptist closed out the program and determined it included claims on the Schedule of Expenditures of Federal Awards for program 93.461 that were unfunded from HRSA during the period this program was funding claims (fiscal years ending September 30, 2020, 2021, 2022, and 2023). The Company included a total of $4,132,198 in claims on prior years’ SEFAs (fiscal years ended September 30, 2020 through 2022) that were not reimbursed by the program upon the program’s closure. The unfunded claims for program 93.461 had no impact on the September 30, 2023 SEFA reporting.