Title: Organization and Business
Accounting Policies: The Schedule presents federal grant activities of the Health System and is reported on the accrual basis of accounting, in accordance with generally accepted accounting principles in the United States of America. 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 (Uniform Guidance).
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
Memorial Hermann Health System (the Health System), a Texas nonprofit membership corporation, controls and coordinates the activities of certain other affiliates. The Health Systems Board of Directors exercises governance control for the Health System and retains significant reserved powers regarding its affiliates. The Health System is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code (IRC). The Health System currently operates 17 hospitals (including 11 general acute care hospitals, one childrens hospital, one orthopedic and spine hospital, two rehabilitation hospitals, and two surgical hospitals), one nursing home, a Medicare-certified home health agency, a comprehensive network of ambulatory care facilities, three physician organizations and an independent practice association, a health plan that underwrites group health coverage, a captive casualty and liability insurance company, and an accountable care organization. Additionally, the Health System is supported by the Memorial Hermann Foundation (the Foundation).
Title: Consolidated Financial Statements
Accounting Policies: The Schedule presents federal grant activities of the Health System and is reported on the accrual basis of accounting, in accordance with generally accepted accounting principles in the United States of America. 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 (Uniform Guidance).
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The consolidated financial statements of the Health System were audited, dated September 21, 2022, except for the schedule of expenditures of federal awards (the Schedule) for which the date is March 13, 2023. The Schedule has been subjected to the auditing procedures applied in the audit of the consolidated financial statements and is fairly stated, in all material respects, in relation to the consolidated financial statements taken as a whole.
Title: Subrecipients
Accounting Policies: The Schedule presents federal grant activities of the Health System and is reported on the accrual basis of accounting, in accordance with generally accepted accounting principles in the United States of America. 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 (Uniform Guidance).
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
The Health System engaged 54 subrecipients in the performance of research and development programs during the current fiscal year. The following amounts paid to the subrecipients are included as expenditures in the accompanying schedule of expenditures of federal awards: Abilities in Motion 8,897 ABLE Center for Independent Living 48,534 Access to Independence of Cortland County Inc. 50,000 Alliance Center for Independence 50,000 American Institute for Research in the Behavioral Sciences 46,649 Prairie Independent Living Resource Center, Inc. 12,455 Brooklyn Center for Independence of the Disabled, Inc. 50,000 Center for Independence of the Disabled in New York, Inc. 49,955 Center for Independent Living of North Central PA 99,193 Cornell University 6,528 CRIL 37,714 The Curators of the University of Missouri 7,560 Disability Advocacy Center 50,000 Disability Network West Michigan 50,000 Disability Resource Center, Inc. 49,780 Disability Resource Network 22,015 Disability Rights and Resource Center 13,205 ENDependence Center of Northern Virginia 50,000 Future Choices, Inc. 50,000 Independence First, Inc. 50,000 Independence Place, Inc 48,946 Independence Resource Center, Inc. 35,344 Independent Connection, Inc. 49,777 Institute for Human Centered Design 10,000 Meeting the Challenge, Inc. 6,167 Moceans Center for Independent Living Inc. 50,000 Mounting Horizons, Inc. 47,085 Native American Disability Law Center 8,131 National Council on Independent Living 166,547 New Orleans Resources for Independent Living, Inc. 50,000 North Country Center for Independence 50,000 Northwestern Illinois Center for Independent Living 25,000 Oklahoma State University 50,937 Public Health Institute 76,698 Regional Access & Mobilization Project, Inc. 30,787 Resource Center for Disability Solutions 47,146 Rural Advocates for Independent Living, Inc. 49,355 Rural Center for Independent Living, Inc. 50,000 Self Initiated Living Options, Inc. 50,000 Solutions for Independence 49,990 Syracuse University 83,601 The Arc of Louisiana 27,400 Association of Programs for Rural Independent Living 105,224 University of Illinois 208,631 The Center for Disability Empowerment, Inc. 32,081 TransCen, Inc. 7,500 University of Arkansas 17,195 University of Montana 180,314 The University of Texas Health Science Center at Houston 205,913 University of Washington 3,117 The University of Texas Medical Branch 19,248 Walton Options for Independent Living 46,360 Western Reserve Independent Living Center 31,000 West-Central Independent Living Solutions 50,000 2,771,979
Title: Disaster Assistance Projects CFDA 97.088
Accounting Policies: The Schedule presents federal grant activities of the Health System and is reported on the accrual basis of accounting, in accordance with generally accepted accounting principles in the United States of America. 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 (Uniform Guidance).
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
On August 24, 2017, Hurricane Harvey made landfall on the Southeast coast of Texas, which included many of the service areas where the Health System owns and operates its facilities. In fiscal year 2022, the Health System received approval of disaster relief assistance of approximately $117,296 from the Federal Emergency Management Agency (FEMA) against expenditures for the approved projects of approximately $130,000 incurred for the fiscal year ended June 30, 2021. Additional projects are currently being reviewed and approved by FEMA.
Title: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribu
Accounting Policies: The Schedule presents federal grant activities of the Health System and is reported on the accrual basis of accounting, in accordance with generally accepted accounting principles in the United States of America. 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 (Uniform Guidance).
De Minimis Rate Used: N
Rate Explanation: The auditee did not use the de minimis cost rate.
On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient volumes and the related revenue for most services were significantly impacted beginning in mid-March 2020, as various policies were implemented by federal, state and local governments in response to the COVID-19 pandemic, including stay-at-home orders, business closures, social distancing and suspension of elective and nonemergent procedures. In early May, certain of these policies, such as suspension of elective and non-emergent procedures were lifted, and the Health System experienced gradual improvement in volumes and related revenue. During this time, the Health System has also experienced supply chain disruptions, including significant price increases in medical supplies, particularly personal protective equipment.Sources of pandemic relief include the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which was enacted on March 27, 2020, and the Paycheck Protection Program and Health Care Enhancement Act (PPHCE Act), which was enacted on April 24, 2020.Health and Human Services (HHS) has indicated the PRF on the Schedule be reported corresponding to reporting requirements of the 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 Periods deadline to use the funds (i.e., after the end of the Period of Availability).The Schedule includes $222,555,492 of PRF Funds received from HHS from July 1, 2020 through June 30, 2021, plus accrued interest of $455,756. PRF funds were recognized as other revenue in the fiscal year 2022 consolidated financial statements as shown in the Schedule for the year ended June 30, 2022.