Title: 1. Basis of Presentation
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Montefiore Health System, Inc. and its controlled organizations (the Health System) for the year ended December 31, 2023 and 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) other applicable requirements. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Health System’s consolidated financial statements.
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 Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. 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 Health System did not make this election and uses a negotiated indirect cost rate.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Montefiore Health System, Inc. and its controlled organizations (the Health System) for the year ended December 31, 2023 and 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) other applicable requirements. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Health System’s consolidated financial statements.
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 Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. 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 Health System did not make this election and uses a negotiated indirect cost rate.
Title: 2. Food and Nutrition Awards
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Montefiore Health System, Inc. and its controlled organizations (the Health System) for the year ended December 31, 2023 and 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) other applicable requirements. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Health System’s consolidated financial statements.
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 Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. 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 Health System did not make this election and uses a negotiated indirect cost rate.
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 Health System participated in the New York State Department of Health WIC Special Supplemental Nutrition Program for Women, Infants and Children (WIC) through the receipt and distribution of food vouchers. The U.S. Department of Agriculture has determined that such WIC food vouchers are considered “property in lieu of money” and, therefore, should be reported as federal awards received by the Health System. Federal expenditures under the WIC program are as follows:
Assistance Listing No. For the Year Ended December 31, 2023
United States Department of Agriculture:
WIC Special Supplemental Nutrition Program for Women, Infants and Children:
Pass-through New York State Department of Health 10.557 $ 30,295,069
The total amount reported as federal awards above, represents the value of food checks redeemed and administrative costs in the amount of $5,896,238, for the year ended December 31, 2023. As state funds are commingled with the federal funds received by New York State, percentages (83.8% for administrative costs and 100% for the value of checks redeemed for Federal fiscal year ended 2023) were applied to determine the total amount of federal funds to be reported above. These percentages were supplied by the New York State Department of Health.
Title: 3. 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 Montefiore Health System, Inc. and its controlled organizations (the Health System) for the year ended December 31, 2023 and 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) other applicable requirements. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Health System’s consolidated financial statements.
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 Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. 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 Health System did not make this election and uses a negotiated indirect cost rate.
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The Health System incurred certain expenditures related to the COVID-19 pandemic which are eligible for reimbursement from the Federal Emergency Management Agency (FEMA) Disaster Grants – Public Assistance (Presidentially Declared Disasters) (Assistance Listing No. 97.036). In 2023, FEMA approved $28,858,434 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.
Title: 4. Loan Program
Accounting Policies: The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Montefiore Health System, Inc. and its controlled organizations (the Health System) for the year ended December 31, 2023 and 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) other applicable requirements. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of, the Health System’s consolidated financial statements.
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 Cost Principles for Hospitals at 45 CFR Part 75 Appendix IX and 45 CFR Part 74 Appendix E, as applicable. 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 Health System did not make this election and uses a negotiated indirect cost rate.
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 Health System processed $883,055 in new loans under the Federal Direct Student Loans Program (Assistance Listing No. 84.268). Since this program is administered by outside financial institutions, new loans made in the year ended December 31, 2023 relating to this program are considered current period federal expenditures, whereas the outstanding balances are not. The new loans made in the year ended December 31, 2023 are reported in the Schedule.