Notes to SEFA
Title: Provider Relief Fund
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Y
Rate Explanation: The auditee used the de minimis cost rate.
For the awards related to the Provider Relief Fund (PRF) and American Rescue Plan (ARP) Rural Distribution (ALN 93.498) programs, the U.S. Department of Health and Human Services (HHS) has indicated the amounts on the Schedule be reported in accordance to the 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 by the Organization. Each period has a specified Period of Availability and related timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period(s) deadline to use the funds.The accompanying Schedule includes PRF distributions of $413,911 in Period 1, $498,813 in Period 2 and $52,799 in Period 4, all of which related to 2020 and 2021 lost revenue and expenditures. These amounts were not reported on the Schedule of Expenditures of Federal Awards in 2021 based on the initial reporting guidelines available at the date the audit of the Organizations 2021 financial statements were completed. These amounts are reported on the accompanying Schedule and were subjected to our audit and compliance testing.
Title: Coronavirus State and Local Recover Funds
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Y
Rate Explanation: The auditee used the de minimis cost rate.
The Organization received two grants from the Coronavirus State and Local Fiscal Recovery Funds (ALN 21.027) during 2022 and 2021. The first grant considered the Organization a subrecipient and those funds are included in the Schedule. The second grant deemed the Organization a beneficiary and those expenditures are not included in the Schedule.
Title: Disaster Grants Public Assistance
Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
De Minimis Rate Used: Y
Rate Explanation: The auditee used the de minimis cost rate.
For the awards related to the Disaster Grants Public Assistance (ALN 97.036) program, the Department of Homeland Security has indicated the amounts on the Schedule are recorded when the funds are approved for reimbursement and received by the Organization, instead of when the expenditures were incurred. The accompanying Schedule includes $728,557 and $490,222 of expenditures related to expenses incurred during 2021 and 2020, respectively, but received in 2022.The Organization submitted documents supporting eligible grant expenditures relating to 2020 and 2021 to the Department of Homeland Security which were reviewed and approved by FEMA for reimbursement in 2022. In August 2023, the grant to the Organization was selected for review for potential duplication of benefits with patient care revenue based on certain cost to revenue ratios. Using 2019 as the base year, certain cost groupings were compared to patient care revenues to calculate expense ceilings for 2020 and 2021. The preliminary findings of the review indicate that certain expenses reimbursed to the Organization may have exceeded those calculated ceilings and could be subject to payback. Management is currently evaluating the findings of the review and has identified certain inappropriate calculations and assumptions used in the review which they believe will reduce or eliminate the amount of any potential payback. Management is unable to determine what amount, if any, that the Organization could be required to payback upon the ultimate resolution of the review.