Audit 321090

Title: Noncash Assistance Accounting Policies: The accompanying schedule of expenditures of federal awards (the “Schedule”) includes the federal grant activity of ProMedica Health System and Subsidiaries (the “System”) under programs of the federal government for the year ended December 31, 2023. 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”). Because the Schedule presents only a selected portion of the operations of the System, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the System. Expenditures reported in the Schedule are reported on an accrual basis of accounting with the exception of expenditures passed through the Ohio Department of Health (ODH). The ODH expenditures are reported on a cash basis in accordance with guidance provided by ODH. Expenditures are recognized following the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, wherein certain types of expenditures are not allowable or are limited as to reimbursement except for expenditures related to Assistance Listing Number (ALN) 93.498 Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution (PRF program). The PRF program does not apply the cost principles contained in Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, but rather applies the U.S. Department of Health and Human Services' (HHS) guidanceand frequently asked questions as outlined in the Compliance Supplement. For the PRF program, HHS has indicated the amounts on the Schedule should be reported corresponding to reporting requirement of the HHS PRF Reporting Portal. Payments from HHS for the PRF program are assigned to payment received periods (each, a "period") based upon the date each PRF payment was received. Each period has a specified period of availability and timing of reporting requirements. Entities report into the HHS PRF Reporting Portal after each period's deadline to use the funds (i.e., after the end of the period of availability). The pass through entity identifying numbers are presented where available. The System has elected to use the 10 percent de minimis indirect cost rate to recover indirect costs as allowed under the Uniform Guidance. De Minimis Rate Used: Y Rate Explanation: The System has elected to use the 10 percent de minimis indirect cost rate to recover indirect costs as allowed under the Uniform Guidance. The value of the noncash assistance received was determined in accordance with the provisions of the Uniform Guidance. The grantee received the following noncash assistance during the year ended December 31, 2023 that is included in the schedule of expenditures of federal awards: See the Notes to the SEFA for table