Audit 310735

Title: Basis of Presentation Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) summarizes the federal expenditures incurred by OSF Healthcare System and Subsidiaries (OSF) under awards received from the federal government and other pass-through entities for the year ended September 30, 2023, and should be read in conjunction with the OSF consolidated financial statements. For purposes of the Schedule, federal awards include all grants, contracts, loans, and loan guarantee agreements entered into directly between OSF and agencies and departments of the federal government and other pass-through entities. For the year ended September 30, 2023, OSF had no expenditures in the form of noncash assistance and had no federally provided insurance in effect. Expenditures for federal award programs are recognized on the accrual basis of accounting. Expenditures consist of direct and indirect costs. Direct costs are those that can be easily identified with an individual Federally sponsored project; whereas, indirect costs cannot be easily identified with an individual sponsored project. Indirect costs are the costs of services and resources that benefit many sponsored projects as well as non-sponsored projects and activities. The information in this 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 (Uniform Guidance). De Minimis Rate Used: Y Rate Explanation: OSF recovers indirect costs under agreements with various U.S. departments and agencies. OSF recovered $260,795 in indirect costs for the year ended September 30, 2023. OSF has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) summarizes the federal expenditures incurred by OSF Healthcare System and Subsidiaries (OSF) under awards received from the federal government and other pass-through entities for the year ended September 30, 2023, and should be read in conjunction with the OSF consolidated financial statements. For purposes of the Schedule, federal awards include all grants, contracts, loans, and loan guarantee agreements entered into directly between OSF and agencies and departments of the federal government and other pass-through entities. For the year ended September 30, 2023, OSF had no expenditures in the form of noncash assistance and had no federally provided insurance in effect. Expenditures for federal award programs are recognized on the accrual basis of accounting. Expenditures consist of direct and indirect costs. Direct costs are those that can be easily identified with an individual Federally sponsored project; whereas, indirect costs cannot be easily identified with an individual sponsored project. Indirect costs are the costs of services and resources that benefit many sponsored projects as well as non-sponsored projects and activities. The information in this 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 (Uniform Guidance).

Title: Indirect Costs Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) summarizes the federal expenditures incurred by OSF Healthcare System and Subsidiaries (OSF) under awards received from the federal government and other pass-through entities for the year ended September 30, 2023, and should be read in conjunction with the OSF consolidated financial statements. For purposes of the Schedule, federal awards include all grants, contracts, loans, and loan guarantee agreements entered into directly between OSF and agencies and departments of the federal government and other pass-through entities. For the year ended September 30, 2023, OSF had no expenditures in the form of noncash assistance and had no federally provided insurance in effect. Expenditures for federal award programs are recognized on the accrual basis of accounting. Expenditures consist of direct and indirect costs. Direct costs are those that can be easily identified with an individual Federally sponsored project; whereas, indirect costs cannot be easily identified with an individual sponsored project. Indirect costs are the costs of services and resources that benefit many sponsored projects as well as non-sponsored projects and activities. The information in this 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 (Uniform Guidance). De Minimis Rate Used: Y Rate Explanation: OSF recovers indirect costs under agreements with various U.S. departments and agencies. OSF recovered $260,795 in indirect costs for the year ended September 30, 2023. OSF has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. OSF recovers indirect costs under agreements with various U.S. departments and agencies. OSF recovered $260,795 in indirect costs for the year ended September 30, 2023. OSF has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance.

Title: Related Parties Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) summarizes the federal expenditures incurred by OSF Healthcare System and Subsidiaries (OSF) under awards received from the federal government and other pass-through entities for the year ended September 30, 2023, and should be read in conjunction with the OSF consolidated financial statements. For purposes of the Schedule, federal awards include all grants, contracts, loans, and loan guarantee agreements entered into directly between OSF and agencies and departments of the federal government and other pass-through entities. For the year ended September 30, 2023, OSF had no expenditures in the form of noncash assistance and had no federally provided insurance in effect. Expenditures for federal award programs are recognized on the accrual basis of accounting. Expenditures consist of direct and indirect costs. Direct costs are those that can be easily identified with an individual Federally sponsored project; whereas, indirect costs cannot be easily identified with an individual sponsored project. Indirect costs are the costs of services and resources that benefit many sponsored projects as well as non-sponsored projects and activities. The information in this 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 (Uniform Guidance). De Minimis Rate Used: Y Rate Explanation: OSF recovers indirect costs under agreements with various U.S. departments and agencies. OSF recovered $260,795 in indirect costs for the year ended September 30, 2023. OSF has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Members of the Board of Directors, officers, and employees are subject to OSF’s conflict of interest policies, under which business and financial relationships must be disclosed and are subject to review and approval.