Audit 44520

Title: 4.Provider Relief Fund and American Rescue Plan Rural Distribution Accounting Policies: 1.Basis of PresentationThe accompanying schedule of expenditures of federal awards (the Schedule) includes the federal awards activity of Vail Health Services and Subsidiaries (the Organization) under programs of the federal government for the year ended October 31, 2022. 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 the Organization, it is not intended to and does not present the financial position, changes in net position or cash flows of Vail Health Services and Subsidiaries. 2.Summary of Significant Accounting PoliciesExpenditures reported on the Schedule are reported on the accrual basis of accounting, with the exception of expenditures associated with the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF) and the expenditures associated with Disaster Grants Public Assistance (Presidentially Declare Disasters). 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. ?PRF expenditures are reported based upon the timing of reporting periods in accordance with guidance provided by the Health Resources and Services Administration (HRSA). The terms and conditions of the award allow for reimbursement of lost revenues. The Organization's methodology for calculating lost revenues was an alternative reasonable methodology under Option 3 for Vail Clinic, Inc. d/b/a Vail Health Hospital and Colorado Mountain Medical, LLC. See Note 2 in the accompanying consolidated financial statements for a description on how the PRF funds were recorded in accordance with GAAP for 2022 and 2021.?Expenditures related to disaster grants are reported when the Organization has expended the necessary funds and the Federal Emergency Management Agency (FEMA) and its pass-through agency, the Colorado Division of Homeland Security and Emergency Management (DHSEM), have approved the expenditures for reimbursement. Expenditures on the Schedule that occurred period to the reporting period and approved by FEMA/DHSEM during the reporting period were $151,607. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. For the U.S. Department of Health and Human Services (HHS) awards related to the PRF program, HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the HRS 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 for the year ended October 31, 2022 includes amounts reported in the Period 2 Reports. Period 2 includes funds received between July 1, 2020 and December 31, 2020, and the deadline to use such funds was December 31, 2021. Such amounts were recognized as a component of COVID-19 grant income in the Organizations consolidated statements of operations and changes in net assets during the years ended October 31, 2022 and 2021. Due to the PRF Reporting requirements, these amounts are not the total PRF received and/or recognized as COVID-19 grant income in the year presented in the Schedule. The Schedule includes the following entities that received funding under the PRF program:Legal Entity NameTax Identification NumberPRF AmountIncluded in the Schedule:Vail Clinic, Inc. d/b/a Vail Health Hospital84-0563230$11,101,079Colorado Mountain Medical, LLC84-1887834398,413