The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) presents the activities of the federal financial assistance programs of Maimonides Medical Center (the “Medical Center”) that have been financed by the U.S. government. 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 (the Uniform Guidance). Therefore, some amounts presented in the Schedule may differ from amounts presented in or used in preparation of the consolidated financial statements. All financial assistance received directly from federal agencies, as well as financial assistance passed through other governmental agencies or non-profit organizations, are included on the Schedule. Direct and indirect costs are charged to awards in accordance with cost principles contained in the Department of Health and Human Services, U.S. Office of the Assistant Secretary Comptroller (“OASC”), OASC-3, A Guide for Hospitals. Under these cost principles, certain types of expenditures are not allowable or are limited as to reimbursement. The accompanying Schedule is presented on the accrual basis of accounting. Because the Schedule presents only a selected portion of the activities of the Medical Center, it is not intended to, and does not, present the consolidated financial position, results of operations, and changes in net assets or cash flows of the Medical Center. When applicable, the Medical Center applies the indirect cost rate approved by the granting agency at the time of the award. In cases where the granting agency does not disclose a specific rate, the Medical Center utilizes the de minimis indirect cost rate. The Medical Center did not have any federal funds passed through to subrecipients, therefore this column is excluded from the Schedule. Assistance Listing Numbers (“ALN”) are presented where available and applicable. The Schedule presents pass through entity identifying numbers or other identifying numbers if available.
During the year ended December 31, 2025, the Medical Center participated in the New York State Department of Health – Special Supplemental Nutrition Program for Women, Infants and Children (WIC) through the provision of nutritional counseling and the receipt and distribution of food vouchers. The U.S. Department of Agriculture, the federal agency that sponsors the WIC program, has determined that WIC food vouchers are considered “property in lieu of money” and, therefore, should be reported as federal awards expended by the Medical Center for the purpose of presentation in the Schedule. The amount reported in the Schedule for the WIC program under ALN 10.557 represents the federally funded value of food vouchers redeemed ($8,197,490) plus administrative costs ($1,951,810) for the year ended December 31, 2025. The WIC program may include, in addition to federal funds, support from New York State. The accompanying Schedule reflects expenditures that have been supported by federal funds, as determined based on communication of funding levels provided by the pass-through agency.
The Medical Center has mortgage loans insured under the provisions of the U.S. Department of Housing and Urban Development – Federal Housing Administration (FHA) Sections 241 mortgage insurance programs (Supplemental Loan Insurance Multifamily Rental Housing). The U.S. Department of Housing and Urban Development (HUD) has determined that the mortgage insurance program is considered a federal award (ALN 14.151) for purposes of compliance with the Uniform Guidance. At December 31, 2025, the outstanding balance of the Section 241 loans was $168,639,106. Amounts presented on the Schedule related to these loans represent outstanding balances as of January 1, 2025. Pursuant to the agreements related to the mortgages, the Medical Center is, among other things, required to maintain a mortgage reserve fund, required to maintain a specific debt service coverage ratio and other financial ratios, and required to obtain approval from HUD to incur additional debt above specified levels if profitability requirements are not met. The mortgages are collateralized by substantially all of the property, buildings and equipment and gross receipts derived from operations.
The Medical Center applied for reimbursement of certain expenses related to the COVID-19 pandemic under Assistance Listing 97.036, Federal Emergency Management Agency (“FEMA”) Public Assistance, through the State of New York. Expenditures are typically reflected in the Schedule in the year in which a project application is obligated and the related expenses have been incurred. During fiscal year 2024, the Medical Center received audit determinations from FEMA related to certain projects obligated in fiscal year 2024 that resulted in the exclusion of $19,717,023 from the 2024 Schedule pending the outcome of the appeal process. During fiscal year 2025, as a result of the appeal process, FEMA allowed $10,352,559 and this amount is included on the Schedule.
During the year ended December 31, 2025, the Medical Center participated in the New York City Department of Health and Mental Hygiene – Vaccines for Children Program through the provision of vaccinations. The U.S. Department of Health and Human Services, the federal agency that sponsors this program under ALN 93.268, provides funds to the New York City Department of Health and Mental Hygiene to develop and operate programs designed to ensure effective delivery of vaccination services to eligible children through the enrolled providers of medical care to administer the vaccines. During 2025, the Medical Center, as a vaccinating provider, received $1,798,087 of vaccines to administer to eligible children. In accordance with the 2025 OMB Compliance Supplement, the value of the vaccines received by the Medical Center is not reported on the Schedule as the vaccines are not considered expenditures under a federal award for purposes of reporting by the Medical Center as a vaccinating provider.