Audit 360933

Title: SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Accounting Policies: Basis of Presentation The accompanying consolidated schedule of expenditures of federal awards (the “Consolidated Schedule”) includes the federal grant expenditures for Carilion Clinic and Subsidiaries (“Carilion”). Expenditures reported on the Consolidated Schedule are reported on the accrual basis of accounting. 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 consolidated financial statements. Carilion has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of Estimates The 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. Basis of Presentation The accompanying consolidated schedule of expenditures of federal awards (the “Consolidated Schedule”) includes the federal grant expenditures for Carilion Clinic and Subsidiaries (“Carilion”). Expenditures reported on the Consolidated Schedule are reported on the accrual basis of accounting. 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 consolidated financial statements. Carilion has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of Estimates The 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.

Title: GRANT CONTINGENCIES Accounting Policies: Basis of Presentation The accompanying consolidated schedule of expenditures of federal awards (the “Consolidated Schedule”) includes the federal grant expenditures for Carilion Clinic and Subsidiaries (“Carilion”). Expenditures reported on the Consolidated Schedule are reported on the accrual basis of accounting. 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 consolidated financial statements. Carilion has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of Estimates The 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: FEDERAL INSURANCE AND NONCASH ASSISTANCE Accounting Policies: Basis of Presentation The accompanying consolidated schedule of expenditures of federal awards (the “Consolidated Schedule”) includes the federal grant expenditures for Carilion Clinic and Subsidiaries (“Carilion”). Expenditures reported on the Consolidated Schedule are reported on the accrual basis of accounting. 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 consolidated financial statements. Carilion has elected to not use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Use of Estimates The 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. There were no noncash awards or federal insurance awarded.