Audit 344192

Title: Federal Emergency Management Agency: Disaster Grants Accounting Policies: The accompanying Schedule of Expenditures of Federal and State of New Jersey Awards (the Schedule) has been prepared to present a summary of those activities of The Cooper Health System (the Health System) for the year ended December 31, 2023, which have been financed by the U.S. Government (federal awards) and the State of New Jersey (state awards). The Health System records expenditures of federal and State of New Jersey program funds 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), New Jersey OMB Circular Letter 15-08-OMB, Single Audit Policy for Recipients of Federal Grants, State Grants, and State Aid (NJ OMB 15-08-OMB), and the City of Philadelphia Subrecipient Audit Guide. In accordance with applicable requirements, certain programs may be presented in a fiscal period based on the program-specific guidance (see Note 2). 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 the purpose of the Schedule, federal and state awards include all financial assistance relationships entered into directly between the Health System and the federal and state governments and subawards from non-federal organizations made under federally sponsored agreements. Federal awards have been classified as either direct (awards received directly from a federal agency) or pass-through awards (awards received from a non-federal agency). The state awards reflect expenditures from the State of New Jersey Department of Health, the State of New Jersey Department of Treasury, the State of New Jersey Department of Human Services, and the State of New Jersey Department of Law and Public Safety, and exclude other state-funded programs which are not in the form grants or other financial assistance as described in NJ OMB 15-08-OMB. 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 Health System 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 Health System did not make this election and uses a negotiated indirect cost rate in the accompanying Schedule. The Health System incurred certain expenditures related to the COVID-19 pandemic totaling approximately $29.6 million which were obligated for reimbursement under an award from the Federal Emergency Management Agency (FEMA) under the COVID-19 Disaster Grants – Public Assistance (Presidentially Declared Disasters) program (Assistance Listing No. 97.036). This amount is included in the accompanying Schedule for the year ended December 31, 2023 in accordance with the guidance specific to Assistance Listing No. 97.036. FEMA projects are subject to final close-out reviews upon which amounts paid during the project are finalized.