Title: 1. Basis of presentation
Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles
contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements
With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A
Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to
reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided
where available.
An award is considered expended when the activity related to the award occurs. The activity generally
pertains to events requiring compliance with laws, regulations, and the provisions of contract and
grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are
incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate
allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The accompanying Schedule is prepared in accordance with accounting principles generally accepted in
the United States. Because the Schedule presents only a selected portion of the Health System’s other
revenue, it is not intended to and does not present the financial position, changes in net assets, or cash
flows of the Health System.For the U.S. Department of Health and Human Services (HHS) awards related to the Provider Relief
Fund and American Rescue Plan Rural Distribution (PRF) program, HHS has indicated the amounts on
the Schedule be reported corresponding to reporting requirements of the Health Resources and
Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to
‘Payment Received Periods’ (each, a “Period”) based upon the date each payment from the PRF was
received. Each Period has a specified Period of Availability and timing of reporting requirements.
Entities report into the HRSA PRF Reporting Portal after each Period’s deadline to use the funds (i.e.,
after the end of the Period of Availability).
The Schedule includes $23,923,249 received from HHS between July 2021 through June 2022. In
accordance with guidance from HHS, this amount was submitted to the HRSA PRF Reporting Portal for
Period 4 and Period 5. The Health System did not have Period 4 or Period 5 funding remaining to
recognize for the year ended September 30, 2023. Due to the PRF Reporting requirements, this
amount is not the total PRF received and/or recognized as other revenue in the years presented in the
accompanying consolidated financial statements.
De Minimis Rate Used: N
Rate Explanation: Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The accompanying Schedule of Expenditures of Federal and State Awards (the “Schedule”) includes the
expenditures of The Moses H. Cone Memorial Hospital and affiliates (dba Cone Health) (the “Health
System”) under programs of the federal and state governments for the year ended September 30,
2023. The information in the Schedule is presented in accordance with the provisions of Title 2 U.S.
Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards (“Uniform Guidance”) and the State Single Audit Implementation Act.
Expenditures reported in the Schedule are reported on the accrual basis of accounting. This is
consistent with the basis of accounting utilized in the preparation of the Heath System’s consolidated
financial statements.
For purposes of the Schedule, federal and state awards include all grants, contracts, and similar
agreements entered into directly between the Health System and agencies and departments of the
federal and state governments and all subawards to the Health System by nonfederal organizations
pursuant to federal and state grants, contracts, and similar agreements. Assistance Listing Number
(ALN) for federal programs and pass‐through Catalog of State Financial Assistance (CSFA) numbers for
state programs and pass‐through numbers are provided when available.
Title: 2. Summary of Significant Accounting Policies for Federal and State Award Expenditures
Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles
contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements
With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A
Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to
reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided
where available.
An award is considered expended when the activity related to the award occurs. The activity generally
pertains to events requiring compliance with laws, regulations, and the provisions of contract and
grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are
incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate
allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The accompanying Schedule is prepared in accordance with accounting principles generally accepted in
the United States. Because the Schedule presents only a selected portion of the Health System’s other
revenue, it is not intended to and does not present the financial position, changes in net assets, or cash
flows of the Health System.For the U.S. Department of Health and Human Services (HHS) awards related to the Provider Relief
Fund and American Rescue Plan Rural Distribution (PRF) program, HHS has indicated the amounts on
the Schedule be reported corresponding to reporting requirements of the Health Resources and
Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to
‘Payment Received Periods’ (each, a “Period”) based upon the date each payment from the PRF was
received. Each Period has a specified Period of Availability and timing of reporting requirements.
Entities report into the HRSA PRF Reporting Portal after each Period’s deadline to use the funds (i.e.,
after the end of the Period of Availability).
The Schedule includes $23,923,249 received from HHS between July 2021 through June 2022. In
accordance with guidance from HHS, this amount was submitted to the HRSA PRF Reporting Portal for
Period 4 and Period 5. The Health System did not have Period 4 or Period 5 funding remaining to
recognize for the year ended September 30, 2023. Due to the PRF Reporting requirements, this
amount is not the total PRF received and/or recognized as other revenue in the years presented in the
accompanying consolidated financial statements.
De Minimis Rate Used: N
Rate Explanation: Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
Expenditures reported in the Schedule are recognized following the cost accounting principles
contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements
With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A
Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to
reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided
where available.
An award is considered expended when the activity related to the award occurs. The activity generally
pertains to events requiring compliance with laws, regulations, and the provisions of contract and
grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are
incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate
allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The accompanying Schedule is prepared in accordance with accounting principles generally accepted in
the United States. Because the Schedule presents only a selected portion of the Health System’s other
revenue, it is not intended to and does not present the financial position, changes in net assets, or cash
flows of the Health System.
For the U.S. Department of Health and Human Services (HHS) awards related to the Provider Relief
Fund and American Rescue Plan Rural Distribution (PRF) program, HHS has indicated the amounts on
the Schedule be reported corresponding to reporting requirements of the Health Resources and
Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to
‘Payment Received Periods’ (each, a “Period”) based upon the date each payment from the PRF was
received. Each Period has a specified Period of Availability and timing of reporting requirements.
Entities report into the HRSA PRF Reporting Portal after each Period’s deadline to use the funds (i.e.,
after the end of the Period of Availability).
The Schedule includes $23,923,249 received from HHS between July 2021 through June 2022. In
accordance with guidance from HHS, this amount was submitted to the HRSA PRF Reporting Portal for
Period 4 and Period 5. The Health System did not have Period 4 or Period 5 funding remaining to
recognize for the year ended September 30, 2023. Due to the PRF Reporting requirements, this
amount is not the total PRF received and/or recognized as other revenue in the years presented in the
accompanying consolidated financial statements.
Title: 3. Relationship to federal financial reports
Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles
contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements
With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A
Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to
reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided
where available.
An award is considered expended when the activity related to the award occurs. The activity generally
pertains to events requiring compliance with laws, regulations, and the provisions of contract and
grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are
incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate
allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The accompanying Schedule is prepared in accordance with accounting principles generally accepted in
the United States. Because the Schedule presents only a selected portion of the Health System’s other
revenue, it is not intended to and does not present the financial position, changes in net assets, or cash
flows of the Health System.For the U.S. Department of Health and Human Services (HHS) awards related to the Provider Relief
Fund and American Rescue Plan Rural Distribution (PRF) program, HHS has indicated the amounts on
the Schedule be reported corresponding to reporting requirements of the Health Resources and
Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to
‘Payment Received Periods’ (each, a “Period”) based upon the date each payment from the PRF was
received. Each Period has a specified Period of Availability and timing of reporting requirements.
Entities report into the HRSA PRF Reporting Portal after each Period’s deadline to use the funds (i.e.,
after the end of the Period of Availability).
The Schedule includes $23,923,249 received from HHS between July 2021 through June 2022. In
accordance with guidance from HHS, this amount was submitted to the HRSA PRF Reporting Portal for
Period 4 and Period 5. The Health System did not have Period 4 or Period 5 funding remaining to
recognize for the year ended September 30, 2023. Due to the PRF Reporting requirements, this
amount is not the total PRF received and/or recognized as other revenue in the years presented in the
accompanying consolidated financial statements.
De Minimis Rate Used: N
Rate Explanation: Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The regulations and guidelines governing the preparation of federal financial reports vary by federal
agency and among programs administered by the same agency. Accordingly, the amounts reported in
the federal financial reports do not necessarily agree with the amounts reported in the accompanying
Schedule, which is prepared as explained in Notes 1 and 2 above.
Title: 4. Revision to the Schedule of Expenditures of Federal and State Awards
Accounting Policies: Expenditures reported in the Schedule are recognized following the cost accounting principles
contained in OMB Circular A‐110, Uniform Administrative Requirements for Grants and Agreements
With Institutions of Higher Education, Hospitals, and Other Non‐Profit Organizations, and OASC‐3, A
Guide for Hospitals, wherein certain types of expenditures are not allowable or are limited to
reimbursement. Assistance Listing Number (ALN) numbers and pass‐through numbers are provided
where available.
An award is considered expended when the activity related to the award occurs. The activity generally
pertains to events requiring compliance with laws, regulations, and the provisions of contract and
grant agreements. Direct costs have been recognized on the accrual basis of accounting when costs are
incurred. The Health System has elected not to use the 10‐percent de minimis indirect cost rate
allowed under the Uniform Guidance. Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
The accompanying Schedule is prepared in accordance with accounting principles generally accepted in
the United States. Because the Schedule presents only a selected portion of the Health System’s other
revenue, it is not intended to and does not present the financial position, changes in net assets, or cash
flows of the Health System.For the U.S. Department of Health and Human Services (HHS) awards related to the Provider Relief
Fund and American Rescue Plan Rural Distribution (PRF) program, HHS has indicated the amounts on
the Schedule be reported corresponding to reporting requirements of the Health Resources and
Services Administration (HRSA) PRF Reporting Portal. Payments from HHS for PRF are assigned to
‘Payment Received Periods’ (each, a “Period”) based upon the date each payment from the PRF was
received. Each Period has a specified Period of Availability and timing of reporting requirements.
Entities report into the HRSA PRF Reporting Portal after each Period’s deadline to use the funds (i.e.,
after the end of the Period of Availability).
The Schedule includes $23,923,249 received from HHS between July 2021 through June 2022. In
accordance with guidance from HHS, this amount was submitted to the HRSA PRF Reporting Portal for
Period 4 and Period 5. The Health System did not have Period 4 or Period 5 funding remaining to
recognize for the year ended September 30, 2023. Due to the PRF Reporting requirements, this
amount is not the total PRF received and/or recognized as other revenue in the years presented in the
accompanying consolidated financial statements.
De Minimis Rate Used: N
Rate Explanation: Salaries, fringes, and other costs are charged to awards based
upon utilization on a direct cost basis.
Subsequent to the issuance of the Health System’s 2023 Schedule of Expenditures of Federal Awards
and State Awards, the Health System’s management determined that certain expenditures related to
ALN 97.036 totaling $10,570,106 were improperly excluded from the September 30, 2023 Schedule of
Expenditures of Federal Awards and State Awards.
The September 30, 2023 Schedule of Expenditures of Federal and State Awards and related notes have
been revised to correct the presentation of the amounts noted above.