Essentials of Accounting for Governmental and Not-for-Profit Organizations Chapter 12 Accounting for...
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Transcript of Essentials of Accounting for Governmental and Not-for-Profit Organizations Chapter 12 Accounting for...
Essentials of Accounting for Governmental and
Not-for-Profit Organizations
Chapter 12
Accounting for Hospitals and Other Health Care Providers
McGraw-Hill/Irwin Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved.
12-2
Overview of Chapter 12
Who has standard setting authority? What types of entities are included? General reporting principles and
Illustrative transactions Example Financial Statements
12-3
Ownership Types
Investor Owned: Human Inc. stock is widely held and the company is listed on the New York Stock Exchange
Private Not-For-Profit:
The Hospital is owned by the (Catholic) Archdiocese of Atlanta
Government Owned: The NY City Health and Hospital Corporation was created by the NY state legislature
12-4
Ownership Types – Standard Setter
Investor Owned:
FASB – except standards specifically for not-for-profits
Private Not-For-Profit:
FASB– particularly, standards for not-for-profits such as SFAS 116 & 117
Government Owned:
GASB
12-5
Standard Setting Authority GASB - Category A GAAP
Authority over government related hospitals FASB -
Private not-for-profit hospitals Major FASBs 93, 116,117, 124, 136, 164
Investor owned hospitals Other FASBs
Additional guidance is provided by the AICPA Audit Guide for Health Care Organizations.- This is level B GAAP for government related, private not-for-profits, and business oriented
12-6
What Types of Organizations? Clinics Medical groups Individual practitioners Emergency care Laboratories Surgery care centers
Continuing care HMOs Home health agencies Hospitals Nursing homes Rehabilitation centers
12-7
Contractual Adjustments Third-party payers
commonly receive discounts for services.
The amount of these discounts are estimated and recorded at the time of service
They are reported as “contra-revenues”
12-8
Contractual Adjustments vs Charity Care Contractual
Adjustment Entry:
Contractual Adjustment …. Dr
Patient Accounts Rec. ……Cr
Charity care (no expectation of receiving payment)
No Journal entry
12-9
Hospital Financial Statements Balance Sheet,
Most use classified balance sheet – exception: continuing care communities
Statement of Operations, Statement of Changes in Net Assets (or “Changes in
Equity” if investor owned)
Statement of Cash Flows and Notes
12-10
Display Issues – Statement of Operations
Private not-for-profits and Government related entities must provide a Performance Indicator.
This a measure of income which excludes: Equity transfers, Restricted Contributions, Contributions of LT assets, Most unrealized gains and losses, Restricted investment returns, and Extraordinary items
12-11
Display Issues – Statement of Operations, cont’d
Patient service revenues are shown net of contractual adjustments.
Patient service revenue excludes charity care (service provided where there is no expectation of payment).
The estimate of uncollectible accounts is shown as an operating expense.
12-12
Display Issues – Statement of Operations, cont’d
Operating revenues are often classified as Net patient service revenues, premium (capitation) revenue, and
Other Revenue (parking lot, gift shop, cafeteria, and tuition). Unrestricted gifts may be treated as Operating or
Nonoperating depending on policy.
12-13
Display Issues – Balance Sheet
FASB vs. GASB net asset accounts: FASB: unrestricted, temporarily restricted, and
permanently restricted net assets The term restricted used only for donor restrictions; Assets whose use is limited is used to indicate board
or bond covenant restrictions.
GASB: unrestricted net assets(position), restricted net assets(position), and net investment in capital assets
12-14
Comparison of Financial Statements
Two statements take the place of the Statement of Activities: Statement of Operations:
Similar for not-for-profits, Government, Business Statement of Changes in Net Assets:
not-for-profits must show details of net changes for unrestricted, temporarily and permanently restricted
12-15
Comparison of Financial Statements
Statement of Financial Position: Classified, similar for not-for-profit, Government, and
commercial businesses except for the equity section: not-for-profit: unrestricted, temporarily and permanently
restricted net assets Government: unrestricted net assets(position), restricted net
assets(position), and net investment in capital assets Business: Contributed Capital and Retained Earnings
Statement of Cash Flows: Business and not-for-profits use the FASB format (3
sections); Governments use the GASB format (4 sections)