Notes to SEFA
The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Summa Health and Subsidiaries (Summa) under programs of the federal government for the nine month period ended September 30, 2025. The information in this 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). Because the Schedule presents only a selected portion of the operations of Summa, it is not intended to and does not present the financial position, changes in net assets, or cash flows of Summa.
Summa has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance.
Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance wherein certain types of expenditures are not allowable or are limited as to reimbursement
Of the federal expenditures presented in the Schedule, Summa did not provide any amounts to subrecipients.
Summa did not receive any noncash assistance during the nine month period ended September 30, 2025. There were no federal awards expended for insurance or any loans or loan guarantees outstanding as of September 30, 2025.
The Uniform Guidance Single Audit for 2025 was completed for a nine-month period (January 1, 2025 – September 30, 2025) rather than the standard twelve months. This is due to the cessation of federal grant activities and the Health Assurance Transformation Company’s asset purchase agreement to acquire all assets of the Summa Health organization. The nine-month audit was appropriate because Uniform Guidance requires the Single Audit to align with the institution’s fiscal audit period, which was shortened to nine months due to the transaction close date of the agreement. This determination was confirmed by both the U.S. Department of Health and Human Services Office of Inspector General (OIG) and the U.S. Department of Health and Human Services Resources and Services Administration (HRSA), which agreed this approach would meet all Single Audit compliance obligations.