Title: COVID-19 – Provider Relief Fund
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the “Hospital.”
The Schedule 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 applicable requirements, certain programs may be presented on the Schedule in a fiscal period based on the program-specific guidance (see Notes 2, 5 and 6). 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, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The accompanying Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program.
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 for Uniform Guidance awards. 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 uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
In accordance with the U.S. Department of Health and Human Services’ requirements specific to Federal Assistance Listing number 93.498, COVID-19 – Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution, the amount presented on the accompanying Schedule for the year ended December 31, 2023 for Federal Assistance Listing number 93.498 relates to (i) PRF payments received from January 1, 2022 through December 31, 2022 (ii) used for PRF-eligible activity from the period January 1, 2020 through December 31, 2023 for expenses or January 1, 2020 through June 30, 2023 for lost revenues. This payment receipt period and the activity periods and the resulting amount presented on the accompanying Schedule for the year ended December 31, 2023 reconciles to the PRF information previously reported to the Health Resources and Services Administration (HRSA) for PRF Reporting Periods 5 and 6. See notes to the SEFA for chart. All distributions received in Reporting Periods 5 and 6 are General Distributions.
The lost revenues incurred by the Hospital during the periods of availability for PRF Reporting Periods 5 and 6 (January 1, 2020 through June 30, 2023) are in excess of the cumulative distributions received in PRF Reporting Periods 1 through 4 (which addressed payments received during April 10, 2020 to December 31, 2021, and previously reported on the 2021 and 2022 schedules of expenditures of federal awards in accordance with the guidance specific to Federal Assistance Listing number 93.498) and Periods 5 and 6. Therefore, the amounts presented in the table above and on the accompanying Schedule for the year ended December 31, 2023 are limited to distributions received in PRF Reporting Periods 5 and 6.
Title: Vaccines for Children Program
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the “Hospital.”
The Schedule 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 applicable requirements, certain programs may be presented on the Schedule in a fiscal period based on the program-specific guidance (see Notes 2, 5 and 6). 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, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The accompanying Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program.
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 for Uniform Guidance awards. 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 uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
During the year ended December 31, 2023, the Hospital participated in the New York City Department of Health and Mental Hygiene – Vaccines for Children Program through the provision of vaccinations. The U.S. Department of Health and Human Services, the federal agency that sponsors this program under Federal Assistance Listing number 93.268, has determined that the vaccines administered are considered “property in lieu of money” and, therefore, should be reported as federal awards expended by the Hospital for purposes of presentation in the accompanying Schedule.
Title: Food and Nutritional Awards
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the “Hospital.”
The Schedule 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 applicable requirements, certain programs may be presented on the Schedule in a fiscal period based on the program-specific guidance (see Notes 2, 5 and 6). 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, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The accompanying Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program.
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 for Uniform Guidance awards. 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 uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
During the year ended December 31, 2023, the Hospital participated in the State of New York Department of Health – Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) through the provision of nutritional counseling and the receipt and distribution of food vouchers. The U.S. Department of Agriculture, the federal agency that sponsors the WIC program under Federal Assistance Listing number 10.557, has determined that WIC food vouchers are considered “property in lieu of money” and, therefore, should be reported as federal awards received by the Hospital for the purpose of presentation in the Schedule. The amount reported in the Schedule for the WIC program under Federal Assistance Listing number 10.557 represents the federally funded value of food vouchers issued ($12,294,136) plus administrative costs ($3,361,094) for the year ended December 31, 2023. In addition to the federal funds received for the WIC program, in 2023 approximately 16.2% of the WIC program’s total administrative and nutritional counseling costs were funded by the State of New York Department of Health; such amounts are excluded from the accompanying Schedule.
Title: U.S. Department of Housing and Urban Development Mortgage Insurance Program
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the “Hospital.”
The Schedule 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 applicable requirements, certain programs may be presented on the Schedule in a fiscal period based on the program-specific guidance (see Notes 2, 5 and 6). 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, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The accompanying Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program.
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 for Uniform Guidance awards. 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 uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
Through October 30, 2023, NYPH had a mortgage loan insured under the provisions of the U.S. Department of Housing and Urban Development – Federal Housing Administration (FHA) Section 241 mortgage insurance program. The mortgage insurance program is to be considered a federal award for purposes of compliance with the Uniform Guidance, as determined by the U.S. Department of Housing and Urban Development (HUD). The outstanding balance of the loan is seen in the notes to the SEFA. Pursuant to the mortgage loan agreement, NYPH was, among other compliance requirements, required to maintain certain debt service funds, financial ratios, and to obtain approval from HUD to incur additional debt above specified levels if profitability requirements were not met. The mortgage was collateralized by certain NYPH property, buildings and equipment and gross receipts derived from operations.
On August 29, 2023, NYPH closed on the issuance of Dormitory Authority of the State of New York Series 2023 Revenue Bonds. The FHA Section 241 mortgage loan was fully repaid on October 30, 2023 (the Prepayment Date) with the proceeds of the Series 2023A bonds. On the Prepayment Date, the FHA-insured mortgage loan was satisfied and released.
Title: Federal Emergency Management Agency: Disaster Grants
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of The New York and Presbyterian Hospital (NYPH) including its direct and indirect subsidiaries and controlled affiliates, which include NewYork-Presbyterian/Hudson Valley (NYP/Hudson Valley), NewYork-Presbyterian/Queens (NYP/Queens) and other consolidated entities as described in Note 1 to the consolidated financial statements in the previous section. The reporting entity resulting from the consolidation of these entities is referred to herein as the “Hospital.”
The Schedule 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 applicable requirements, certain programs may be presented on the Schedule in a fiscal period based on the program-specific guidance (see Notes 2, 5 and 6). 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, loans and loan guarantees, or other noncash assistance. Pass-through programs received by the Hospital may include, in addition to federal funds, support from other sources. The accompanying Schedule reflects only those expenditures that have been supported by federal funds. Determinations as to the level of federal funding have been made based on communications of funding levels provided by the pass-through agencies. In certain circumstances, the funding levels communicated are estimated and subject to finalization upon the completion of the budget period for the program.
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 for Uniform Guidance awards. 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 uses a negotiated indirect cost rate in the accompanying Schedule.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule.
In 2023, NYPH received reimbursement payments under the Federal Emergency Management Agency (FEMA) COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Federal Assistance Listing number 97.036).
In April 2023, NYPH received approximately $174.1 million from the United States Department of Homeland Security (USDHS), the federal agency that sponsors Federal Assistance Listing number 97.036, passed-through the State of New York Division of Homeland Security and Emergency Services (NYSDHSES). The payment received in April 2023, along with other amounts received in 2020 through 2022, relate to project worksheets submitted by NYPH to FEMA since 2020 for funding of eligible costs incurred. The Hospital is finalizing other related project worksheets submitted to FEMA and intends to submit additional applications for funding of eligible costs incurred through the end of the defined period. The ultimate amount of incurred costs that the Hospital may be reimbursed is still uncertain.
In January 2023, the Hospital received approximately $93.2 million from the USDHS, passed-through the New York State Department of Health, for eligible employee support costs incurred during the period January 2020 through September 2020.
These reimbursements of costs incurred in prior years, totaling approximately $267.4 million, are included in the accompanying Schedule for the year ended December 31, 2023 in accordance with the guidance specific to Federal Assistance Listing number 97.036.