Title: 1. Basis of Presentation
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of the New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for the Special Surgery (the Hospital) and is presented on the accrual basis of accounting. The information on 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 this 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. In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 3 and 4). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Hospital’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 for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
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 as the Hospital uses a negotiated indirect cost rate.
The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of the New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for the Special Surgery (the Hospital) and is presented on the accrual basis of accounting. The information on 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 this 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. In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 3 and 4). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Hospital’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 for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
Title: 2. Indirect Cost Rate
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of the New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for the Special Surgery (the Hospital) and is presented on the accrual basis of accounting. The information on 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 this 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. In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 3 and 4). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Hospital’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 for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
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 as the Hospital uses a negotiated indirect cost rate.
The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, the Hospital did not make this election as the Hospital uses a negotiated indirect cost rate.
Title: 3. COVID-19 – Provider Relief Fund and American Rescue Plan Rural Distribution
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of the New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for the Special Surgery (the Hospital) and is presented on the accrual basis of accounting. The information on 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 this 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. In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 3 and 4). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Hospital’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 for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
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 as the Hospital uses a negotiated indirect cost rate.
In accordance with the U.S. Department of Health and Human Services’ requirements specific to Assistance Listing No. 93.498, COVID-19 – Provider Relief Fund and American Rescue Plan Rural Distribution, the amount presented on the accompanying Schedule for the year ended December 31, 2023 for Assistance Listing No. 93.498 relates to Provider Relief Fund (PRF) payments received from January 1, 2022 through December 31, 2022 used for PRF-eligible activity for the period January 1, 2020 through December 31, 2023. This payment receipt period and activity period 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 as follows: Reporting period 5: (See table)
Reporting period 6:
The Hospital did not receive PRF payments during Reporting Period 6.
The lost revenues incurred by the Hospital during the period of availability through PRF Reporting Period 5 (January 1, 2020 through December 31, 2023) are in excess of the distributions received in PRF Reporting Periods 1 and 4 (which addressed payments received during April 10, 2020 to December 31, 2021, and previously reported on the Schedule of Expenditures of Federal Awards for the year ended December 31, 2022 and 2021) and distributions received from January 1, 2022 through December 31, 2022 and, therefore, the amounts presented in the table above and on the accompanying Schedule are limited to the amount of such distributions. The Hospital has not received PRF payments subsequent to December 31, 2022.
Title: 4. COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters)
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of the New York Society for the Relief of the Ruptured and Crippled, Maintaining the Hospital for the Special Surgery (the Hospital) and is presented on the accrual basis of accounting. The information on 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 this 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. In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Notes 3 and 4). Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Hospital’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 for awards subject to the Uniform Guidance. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement.
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 as the Hospital uses a negotiated indirect cost rate.
The Hospital 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) (Assistance Listing No. 97.036) to reimburse eligible costs. In 2023, FEMA approved $2,079,634 of eligible expenditures that were incurred in prior years. This amount has been included in the accompanying Schedule for the year ended December 31, 2023 in accordance with the guidance specific to Assistance Listing No. 97.036.