Title: 3. Consolidated Reporting
Accounting Policies: 1. Background, Summary of Significant Accounting Policies and Basis of Presentation
Financial Assistance
Various departments and agencies of the federal government have provided financial assistance to Nuvance Health and Subsidiaries (the “System”) through grants and other awards in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the Uniform Guidance). Those financial assistance programs provide funding for several programs.
Summary of Significant Accounting Policies
The accounting policies of the System conform to accounting principles generally accepted in the United States of America as applicable to not-for-profit health care entities. The following is a summary of the more significant policies relating to the aforementioned grant programs.
Basis of Presentation
The consolidated financial statements contained in the System’s annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.
The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant activity of the System and is presented on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). In accordance with these requirements, certain grants are not dependent on expenditure activity, and accordingly, are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures columns of the Schedule. Additionally, in accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 5, 6 and 7). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the System’s consolidated financial statements.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Both
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The System uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program.
The federal award activity of the entities noted below is included in the accompanying Schedule for the year ended September 30, 2023: See Notes to SEFA for chart/table.
Title: 4. Non-Cash Assistance
Accounting Policies: 1. Background, Summary of Significant Accounting Policies and Basis of Presentation
Financial Assistance
Various departments and agencies of the federal government have provided financial assistance to Nuvance Health and Subsidiaries (the “System”) through grants and other awards in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the Uniform Guidance). Those financial assistance programs provide funding for several programs.
Summary of Significant Accounting Policies
The accounting policies of the System conform to accounting principles generally accepted in the United States of America as applicable to not-for-profit health care entities. The following is a summary of the more significant policies relating to the aforementioned grant programs.
Basis of Presentation
The consolidated financial statements contained in the System’s annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.
The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant activity of the System and is presented on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). In accordance with these requirements, certain grants are not dependent on expenditure activity, and accordingly, are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures columns of the Schedule. Additionally, in accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 5, 6 and 7). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the System’s consolidated financial statements.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Both
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The System uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program.
During the year ended September 30, 2023, the U.S. Department of Health and Human Services issued $52,783 in federally funded vaccines to the System through the Immunization Cooperative Agreements program (Assistance Listing No. (ALN) 93.268). This non-cash assistance, which was passed through the State of Connecticut Department of Public Health, is included in the accompanying Schedule.
Title: 5. Universal Service Fund – Rural Health Care
Accounting Policies: 1. Background, Summary of Significant Accounting Policies and Basis of Presentation
Financial Assistance
Various departments and agencies of the federal government have provided financial assistance to Nuvance Health and Subsidiaries (the “System”) through grants and other awards in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the Uniform Guidance). Those financial assistance programs provide funding for several programs.
Summary of Significant Accounting Policies
The accounting policies of the System conform to accounting principles generally accepted in the United States of America as applicable to not-for-profit health care entities. The following is a summary of the more significant policies relating to the aforementioned grant programs.
Basis of Presentation
The consolidated financial statements contained in the System’s annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.
The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant activity of the System and is presented on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). In accordance with these requirements, certain grants are not dependent on expenditure activity, and accordingly, are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures columns of the Schedule. Additionally, in accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 5, 6 and 7). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the System’s consolidated financial statements.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Both
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The System uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program.
The System received funding from the Federal Communications Commission (FCC) through the Universal Service Fund – Rural Health Care (ALN 32.005) to reimburse eligible costs. In fiscal year 2023, the FCC approved $681,654 of eligible expenditures, inclusive of $173,976 of expenditures that were incurred in prior fiscal years. This amount has been included in the accompanying Schedule for the year ended September 30, 2023 in accordance with the guidance specific to ALN 32.005.
Title: 6. COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters)
Accounting Policies: 1. Background, Summary of Significant Accounting Policies and Basis of Presentation
Financial Assistance
Various departments and agencies of the federal government have provided financial assistance to Nuvance Health and Subsidiaries (the “System”) through grants and other awards in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the Uniform Guidance). Those financial assistance programs provide funding for several programs.
Summary of Significant Accounting Policies
The accounting policies of the System conform to accounting principles generally accepted in the United States of America as applicable to not-for-profit health care entities. The following is a summary of the more significant policies relating to the aforementioned grant programs.
Basis of Presentation
The consolidated financial statements contained in the System’s annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.
The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant activity of the System and is presented on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). In accordance with these requirements, certain grants are not dependent on expenditure activity, and accordingly, are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures columns of the Schedule. Additionally, in accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 5, 6 and 7). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the System’s consolidated financial statements.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Both
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The System uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program.
The System incurred eligible disaster expenditures related to the COVID-19 pandemic. After a presidentially declared disaster, the Federal Emergency Management Agency (FEMA) provides Disaster Grants – Public Assistance (Presidentially Declared Disasters) (ALN 97.036) to reimburse eligible costs. In fiscal year 2023, FEMA approved $9,121,718 of eligible expenditures that were incurred in prior fiscal years. This amount has been included in the accompanying Schedule for the year ended September 30, 2023 in accordance with the guidance specific to ALN 97.036.
Title: 7. COVID-19 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution
Accounting Policies: 1. Background, Summary of Significant Accounting Policies and Basis of Presentation
Financial Assistance
Various departments and agencies of the federal government have provided financial assistance to Nuvance Health and Subsidiaries (the “System”) through grants and other awards in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (the Uniform Guidance). Those financial assistance programs provide funding for several programs.
Summary of Significant Accounting Policies
The accounting policies of the System conform to accounting principles generally accepted in the United States of America as applicable to not-for-profit health care entities. The following is a summary of the more significant policies relating to the aforementioned grant programs.
Basis of Presentation
The consolidated financial statements contained in the System’s annual audit report are prepared on the accrual basis of accounting. Refer to the notes to the consolidated financial statements for a summary of the significant accounting policies.
The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the federal grant activity of the System and is presented on the accrual basis of accounting. The information in the 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 (the Uniform Guidance). In accordance with these requirements, certain grants are not dependent on expenditure activity, and accordingly, are considered to be expended in the fiscal year of receipt; the grant program receipts of such awards are reflected in the expenditures columns of the Schedule. Additionally, in accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 5, 6 and 7). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the System’s consolidated financial statements.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Both
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election. The System uses a combination of a federally negotiated rate, award-specific rates, or the 10% de minimis rate by entity and program.
In accordance with the requirements specific to ALN 93.498, COVID-19 – Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution, the amount presented on the accompanying Schedule for the year ended September 30, 2023 for ALN 93.498 relates to (i) activity from the period January 1, 2020 through June 30, 2023 for (ii) Provider Relief Fund (PRF) payments received from July 1, 2021 through June 30, 2022. This activity period and payment receipt period and the resulting amount presented reconciles to the PRF information previously reported to the Health Resources and Services Administration (HRSA) for PRF Reporting Periods 4 and 5 as follows: See Notes to SEFA for Chart/table.
The expenses attributable to Coronavirus Disease 2019 (COVID-19) and lost revenues incurred by the System during the period of availability for PRF Reporting Period 4 (January 1, 2020 through December 31, 2022) and PRF Reporting Period 5 (January 1, 2020 through June 30, 2023) are in excess of the general and targeted distributions received in PRF Reporting Periods 1 through 3 (which addressed payments received during April 10, 2020 to June 30, 2021, and previously reported on the schedule of expenditures of federal awards for the years ended September 30, 2022 and 2021) and distributions received from July 1, 2021 through June 30, 2022 and, therefore, the amounts presented in the table above and on the accompanying Schedule are limited to the amount of such distributions.