Audit 317227

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. De Minimis Rate Used: N Rate Explanation: The Center has elected to not use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. Pass-through entity identifying numbers are presented when available. The accompanying Schedule of Expenditures of Federal Awards (the "Schedule") includes the federal award activity of Northern Oswego County Health Services, Inc. d/b/a ConnextCare (the "Center") under programs of the federal government for the year ended December 31, 2023. 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"). Because the Schedule presents only a selected portion of the operations of the Center, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Center.

Title: COVID-19 - Provider Relief Fund and American Rescue Plan ("ARP") Rural Distribution - Assistance Listing Number 93.498 Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. De Minimis Rate Used: N Rate Explanation: The Center has elected to not use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. Pass-through entity identifying numbers are presented when available. For the Department of Health and Human Services ("DHHS”) awards related to the Provider Relief Fund ("PRF") and American Rescue Plan ("ARP") Rural Distribution program, DHHS 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 DHHS 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 Schedule includes $648,982 which is made up of Period 5 funding received from DHHS between January 1, 2022 and June 30, 2022. In accordance with guidance from DHHS, this amount is presented as Period 5 funding on the Schedule. Period 5 funding was recognized as grant revenue in the financial statements in the year ended December 31, 2022.