Audit 388717

The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the federal grant expenditures of Emerson Health System, Inc. and its affiliates (the “Health System”) for the year ended September 30, 2025. Federal program expenditures included in the accompanying Schedule are presented on the accrual basis of accounting. 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). Therefore, some amounts presented in the Schedule may differ from amounts presented in or used in the preparation of the consolidated financial statements. Full Assistance Listing numbers and pass through numbers are provided where available. Negative amounts represent adjustments or credits to amounts reported as expenditures in prior years. The Health System follows the Uniform Guidance and the Principles for Determining Costs Applicable to Research and Development Under Grants and Contracts with Hospitals (commonly known as OASC-3), as applicable. The Health System charges the 15% de minimis indirect cost rate, as described in Section 200.414 of the Uniform Guidance, to the extent applicable.

The Schedule includes grant activity related to the COVID-19 – Disaster Grants – Public Assistance (Presidentially Declared Disasters) FEMA 4496DR-MA funds Assistance Listing Number 97.036. As required based on the guidance in the 2025 OMB Compliance Supplement, the Health System records expenditures on the Schedule when (1) FEMA has approved the project, and (2) the Health System has incurred the eligible expenditures. The Schedule thus includes $1,035,452 of expenditures that were incurred in a prior year, which were obligated in fiscal year 2025.