Title: Organization and Nature of Activities
Accounting Policies: Basis of PresentationThe accompanying consolidated schedule of expenditures of federal awards (the Consolidated Schedule) includes the federal grant expenditures for the Organization. All significant intercompany balances and transactions have been eliminated. The information in this Consolidated 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 (Uniform Guidance). Therefore, some amounts presented in this Consolidated Schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.The Organization has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of EstimatesThe preparation of the Consolidated Schedule in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates and assumptions
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
Carilion Clinic is the sole member of Carilion Medical Center (CMC) (t/a Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital); Carilion New River Valley Medical Center (CNRV); Carilion Franklin Memorial Hospital (CFMH); Carilion Giles Community Hospital (CGCH); Carilion Tazewell Community Hospital (CTCH); Carilion Clinic Properties, LLC (CCP); Carilion Clinic Foundation (CF); Carilion Services, Inc. (CSI); and Carilion Rockbridge Community Hospital (CRBH), formerly known as Carilion Stonewall Jackson Hospital, (collectively, the Organization). The Organization is a non-profit organization which specializes in patient-centered care, medical education and clinical research, with a goal of providing the best possible health outcome and healthcare experience for each patient.
Title: Basis of Accounting
Accounting Policies: Basis of PresentationThe accompanying consolidated schedule of expenditures of federal awards (the Consolidated Schedule) includes the federal grant expenditures for the Organization. All significant intercompany balances and transactions have been eliminated. The information in this Consolidated 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 (Uniform Guidance). Therefore, some amounts presented in this Consolidated Schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.The Organization has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of EstimatesThe preparation of the Consolidated Schedule in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates and assumptions
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
Expenditures reported on the Consolidated Schedule are reported on the accrual basis of accounting, with the exception of lost revenues. Such expenditures are recognized following the cost principles contained in Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Lost revenues are reported based on the Health Resource and Service Administration (HRSA) Option 1 reporting of lost revenues by comparing actual revenues by quarter during the period of availability to actual revenues for similar quarters during 2019 prior to the COVID-19 Pandemic. As outlined in the April 2022 OMB Compliance Supplement, the amounts reported in the accompanying Consolidated Schedule related to the Provider Relief Fund (PRF), Assistance Listing No. 93.498, are reported based upon the PRF reporting portal submission guidelines established by HRSA. Nine separate reporting periods were established by HRSA based on the dates of receipt of PRF payments. Each reporting period has a specific period of availability which begins on January 1, 2020 and extends through specified deadlines, as indicated below: The accompanying Consolidated Schedule includes those qualifying expenditures and lost revenues that were reported in the HRSA PRF portal for Period 2. The total amount of $58,494,193 in PRF payments was recognized by Carilion Clinic as operating revenues during the fiscal year ended September 30, 2021 and 2020.
Title: Grant Contingencies
Accounting Policies: Basis of PresentationThe accompanying consolidated schedule of expenditures of federal awards (the Consolidated Schedule) includes the federal grant expenditures for the Organization. All significant intercompany balances and transactions have been eliminated. The information in this Consolidated 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 (Uniform Guidance). Therefore, some amounts presented in this Consolidated Schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.The Organization has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of EstimatesThe preparation of the Consolidated Schedule in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates and assumptions
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The federal grant programs are subject to financial and compliance audits by the grantors or their representatives. Such audits could lead to requests for reimbursement to the grantor agencies for expenditures disallowed under terms of the grants. Management believes disallowances, if any, will not be material.
Title: Categorization of Expenditures
Accounting Policies: Basis of PresentationThe accompanying consolidated schedule of expenditures of federal awards (the Consolidated Schedule) includes the federal grant expenditures for the Organization. All significant intercompany balances and transactions have been eliminated. The information in this Consolidated 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 (Uniform Guidance). Therefore, some amounts presented in this Consolidated Schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.The Organization has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of EstimatesThe preparation of the Consolidated Schedule in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates and assumptions
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The categorization of expenditures by program included in the Consolidated Schedule is based upon the grant documents. Changes in the categorization of expenditures occur based upon revisions to the Assistance Listing, which is issued in June and December of each year. The Consolidated Schedule for the year ended September 30, 2022 reflects Assistance Listing changes issued through April 2022.
Title: Subsequent Events
Accounting Policies: Basis of PresentationThe accompanying consolidated schedule of expenditures of federal awards (the Consolidated Schedule) includes the federal grant expenditures for the Organization. All significant intercompany balances and transactions have been eliminated. The information in this Consolidated 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 (Uniform Guidance). Therefore, some amounts presented in this Consolidated Schedule may differ from amounts presented in, or used in the preparation of, the basic consolidated financial statements.The Organization has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of EstimatesThe preparation of the Consolidated Schedule in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates and assumptions
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The Organization evaluated the effect subsequent events would have on the Consolidated Schedule through June 9, 2023, which is the date this Consolidated Schedule was available to be issued.