Title: Disaster Grants – Public Assistance (Presidentially Declared Disasters) – Federal Assistance Listing No. 97.036
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the Federal grant activity of South Nassau Communities Hospital and Subsidiaries (d/b/a Mount Sinai South Nassau) (the Hospital), reported 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). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services (HHS) Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and does not include indirect costs in the amounts reported in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
Non-Federal entities must record expenditures on the Schedule when: (1) the Federal Emergency Management Agency (FEMA) has approved the non-Federal entity’s project worksheet, and (2) the non-Federal entity has incurred the eligible expenditures. In January 2015, FEMA approved a project worksheet for the Hospital totaling approximately $171.0 million (90% funded by FEMA for a total award of approximately $154.0 million) to allow for the Hospital to either demolish, repair or restore certain facilities damaged by Super Storm Sandy. Expenditures related to the approved project worksheet are reported on the Schedule as incurred.
In September 2016, FEMA approved the Hospital’s request for an alternative project which expanded the scope of work. The original FEMA approved date for the project to be completed and funds spent was January 15, 2019. On January 15, 2019, the Hospital’s request for a time extension from the New York State Division of Homeland Security and Emergency Services and FEMA was approved to be extended through December 31, 2025.
Expenditures totaling $7,498,195, which represents the remaining portion of the original project worksheet award amount approved to be funded by FEMA, are included on the accompanying Schedule for the year ended December 31, 2023. All remaining expenditures to complete the project will be funded by other sources.
Separately, the Hospital applied for reimbursement for qualifying expenses under the FEMA COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program. In 2022, the Hospital submitted project worksheets, of which $2,781,414 were approved for reimbursement by FEMA during 2023. As a result, costs totaling $2,781,414 incurred in prior years are included on the accompanying Schedule for the year ended December 31, 2023. Subsequent to December 31, 2023, other project worksheets submitted by the Hospital totaling $8,294,485 were approved for reimbursement by FEMA and, accordingly, such amounts are excluded from the accompanying Schedule.
Title: Hurricane Sandy Community Development Block Grant Disaster Recovery Grants (CDBG-DR) – Federal Assistance Listing No. 14.269
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the Federal grant activity of South Nassau Communities Hospital and Subsidiaries (d/b/a Mount Sinai South Nassau) (the Hospital), reported 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). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services (HHS) Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and does not include indirect costs in the amounts reported in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The Hospital received approval for reimbursement for expenditures incurred in prior years related to Super Storm Sandy totaling $3,319,565 that are reported on the accompanying Schedule for the year ended December 31, 2023.
Title: Vaccines for Children Program
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the Schedule) includes the Federal grant activity of South Nassau Communities Hospital and Subsidiaries (d/b/a Mount Sinai South Nassau) (the Hospital), reported 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). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the consolidated financial statements of the Hospital. For purposes of the Schedule, federal awards include any assistance provided by a federal agency directly or indirectly in the form of grants, contracts, cooperative agreements, loan and loan guarantees, or other non-cash assistance.
Direct and indirect costs are charged to awards in accordance with cost principles contained in the United States Department of Health and Human Services (HHS) Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and does not include indirect costs in the amounts reported in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
During the year ended December 31, 2023, the Hospital participated in the New York State Department of Health Vaccines for Children Program (Federal Assistance Listing No. 93.268) through the provision of vaccinations. HHS, the federal agency that sponsors this program, has determined that the vaccines administered are considered “property in lieu of money” and, therefore, should be reported as federal awards received by the Hospital for purposes of presentation on the accompanying Schedule.