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Healthcare Fund Accounting
Funds Accounting ConceptFunds GroupsCharacteristics of Fund GroupsRevenue Recognition and ClassificationsExpenses Recognition and
ClassificationsFinancial Statements of Fund Entities.Journal Entries.
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Healthcare Fund Accounting
Fund Concepts– A fiscal & accounting entity with a self-
balancing set of accounts, recording cash & other financial resources .. Liabilities.. residual equities balances and changes therein.. Funds are segregated for carrying on specific activities .. Following specific Regulations .. Restrictions .. Limitations.
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Healthcare Fund Accounting: Governmental & Nonbusiness Organizations Governmental Funds: are those used to account for most general government
functions. Funds are accounting segregation of financial resources and uses with their own assets, liabilities and the difference between them is”Fund Balance.” It focuses on determination of financial position and changes therein, rather than income determination. The main operating statement is The Statement of Revenues, Expenditures, and Changes in
Fund Balances..Includes General Funds, Special Revenue Funds, Capital Projects Funds, Debt Service Funds.
Proprietary Funds: are used to account for those ongoing activities that are similar to those of a business entity. Net income and capital maintenance are measured. This Fund
includes: Enterprise Funds and Internal Service Funds. Governmental non-for-profit hospitals follow Proprietary Funds. GAAP & GASB pronouncements.
Fiduciary Funds: are used to account for assets held by the governmental unit in a trustee capacity or as an agent for individuals, private organizations, and other governmental units and funds. Custodial focus. Fund Category includes Trust Funds and Agency Funds.
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Healthcare Fund Accounting
Governmental Funds– General Funds: GF is the entity used to account
for all unrestricted resources except those required to be accounted for in another fund. Revenues are recognized in the period in which they become susceptible to accrual. Expenditures are decreases in financial resources. Under modified accrual basis, expenditures are normally recorded when related liability is incurred.
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Healthcare Fund Accounting
Proprietary Funds: Non-for-profit Hospitals and Voluntary Health and Welfare Organizations follow this group of funds. Full accrual accounting procedures are applicable.It has revenues and expenses, not expenditures. Fixed assets
acquired and long-term liabilities incurred by an EF are fund fixed assets and fund long-term liabilities. GASB codification permits the use of enterprise fund accounting for any service for which there is a significant potential for financing through user charges. The initial financing of an enterprise fund is that the governmental unit makes a capital contribution (transfer to general fund) or provide a long-term advance to the enterprise fund and future operations are expected to cover all costs, incliding depreciation on fixed assets so operations can continue without further capital contribution.
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Healthcare Fund Accounting
Required Financial Statements for EF:– Balance Sheet– Statement of Revenues and Expenses– Statement of Changes in Fund Balance (Retained Earnings
Statement)– Statement of Cash FlowsEnterprise Funds Do Not Pay property taxes or income taxes
and does not have capital stock or paid-in capital and in place of owner’s equity is a Fund Equity Section. It may also include transfer from and to General Funds.
Statement of Functional Expenses are required to be reported by Voluntary Health & Welfare Organizations.
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Healthcare Fund Accounting
Hospitals & Healthcare Organizations usually follow “Proprietary Funds of Governmental Accounting and nonprofit organizations.
In proprietary Funds, activities are accounted for as private sector profit-seeking business enterprise which uses accrual basis and calculate depreciation.
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Healthcare Fund Accounting
Characteristics of Nonbusiness Organizations:– Lack of Profit motive
– Resources providers do not expect economic benefits
– No ownership that can be sold
– No performance indicators but measurement of inflows and outflows of Resources .. Services .. Efforts .. Accomplishments .. And stewardship.
– Restrictions may be imposed on uses of resources
– Dependence on legislative authority (if it is government)
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Healthcare Fund Accounting
Sources of Accounting for Hospitals & Healthcare Providers
AICPA: American Institute of Certified Public Accountants “Audits of Providers of Health Care Services, 1990): applies on investor-owned & nongovernmentally-owned not-for-profit healthcare entities and governmentally-owned that uses enterprise funds accounting.
AHA: American Hospitals Association HFMA: Healthcare Financial Management Association FASB: Responsible for investor-owned and nongovernmentally
owned not-for-profit healthcare entities GASB: Responsible for state and local governmentally owned
healthcare entities.
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Healthcare Fund Accounting
Audits of all healthcare providers should follow GAAP except when such principles are not applicable:– Clinics, medical group practices, individual
practices, ambulatory organizations, contiuing care retirement communities (LTC), health maintenance organizations and other prepaid healthcare plans, home health agencies, nursing homes, organizations over-sighting entities providing healthcare services, …
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Healthcare Fund Accounting
Characteristics of Accounting for Healthcare Entities:– Uses of accrual basis of accounting
– Revenues classified by sources
– Expenses classified by functions
– Accounting separately for restricted and restricted funds
– Restricted resources are deferred until spent
– Raised fund is recorded net of expenses
– Resources received are recorded as fund balance to be closed at the end of period
– In hospitals, expenses are deducted directly from fund balance, if restricted, without using an expense account
– Pledges are not enforceable. They are required to be recorded by hospitals
– Donated services are not recorded. If recorded, an offset amount to be recognized as expenses
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Healthcare Fund Accounting Balance Sheet
Unrestricted GF Funds:– Current Assets
– Other Assets
– Current liabilities
– Long-term Liabilities
Restricted Funds: Specific Purpose Funds
(Assets Liabilities and Fund Balance)
Endowment Fund (Assets, Liabilities and Fund Balance)
Plant Replacement & Expansion Fund (Assets, Liabilities and Fund Balance)
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Healthcare Fund Accounting Funds Definition
1. General Funds: Accounts for unrestricted resources, assets with limited use, agency, property, plant and equipment, and related long-term debt. Board designated funds are included. Agency funds are accounted for under general funds but not included in the results of operations. It also includes accounting for debt proceeds if not restricted by the donors.
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Healthcare Fund Accounting Funds Definition
2. Restricted Funds:– 2.A Temporary Restricted:
• Specific Purpose Funds: restricted by donors for specific operating purpose.
• Plant Replacement and Expansion Funds: donors and third party restricted use resources for replacement of P, P & E.
• Term Endowment Funds: restricted by donors for a period of time or until restrictions are satisfied.
– 2. B Permanently Restricted: Endowment or Pure Endowment Funds account for resources that are restricted indefinitely by endowment agreement, permanently restricted as to principal.
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Healthcare Fund Accounting Statement of Revenues & Expenses of General Funds Patient Service Revenue:
– Routine Care– Nursing– Delivery & Labor Room– Emergency Room– Recovery Rooms– Medical & Surgical Supplies– Laboratory-Clinical & Pathology– Radiation Therapy– Pharmacy– Anesthesiology– Physical Therapy– Respiratory therapy– Ambulance– Speech Therapy.
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Healthcare Fund Accounting Statement of Revenues & Expenses of General Funds
– Other Operating Revenues• Research Grants (not recognized until spent)• Tuition from Medical & Educational Workshops• Miscellaneous: income from gift shop, donated medicine and supplies,
parking rental, ..– Nonoperating Gains:
• Investment Income from unrestricted • Unrestricted gifts and grants• Unrestricted income from endowment• Gains on sale of plant assts• Rental from property not used in operations• Donated services
– Charity Care: Free services to qualified patients is excluded from both patients revenue and expenses.
– Employees & contractual allowances are not expenses but revenue deductions.
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Healthcare Fund Accounting: Journal Entries
Sample Journal Entries:The following describes activities taken by
Vassar Hospital non-for-profit Healthcare Organization:
*Patient cash charges $1,800,000*Allowances charges reduction by Medicare &
insurance companies $500,000 and employees and their families courtesy discount $500,000
Expected Uncollectibles/Bad Debts $10,000
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Healthcare Fund Accounting: Journal Entries GF
Accounts receivable 1,800,000
Patient service revenue 1,800,000
Contractual allowances 500,000
Courtesy allowances 500,000
Accounts receivable 1,000,000
Provision for bad debts 10,000
Allowances for uncollectibles 10,000
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Healthcare Fund Accounting: Journal Entries
Funds donated for charity care, cafeteria income, parking income, tuition, workshops $30,000
– Cash 30,000
• Other Revenue 30,000
Revenues and Expenses are only accounted for in Funds Paid salaries
– Salaries- Nursing $30,000
– Salaries- Professional services $10,000
– Salaries- Clerical services $15,000
– Salaries- Administrative services $50,000
• Cash $105,000
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Healthcare Fund Accounting: Journal Entries Income and gains from investments, unrestricted endowments,
transfer of endowment principal to GF upon the occurance of an events are classified as nonoperating gains.
Cash 40,000• Nonoperating Gains:Endowment Income 14,000• Nonoperating Gains:Unrestricted Gifts 26,000
Purchase materials & supplies $100,000 cash and $50,000 on
credit. Materials & Supplies Inventory 150,000
Cash 100.000 A/P 50,000
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Healthcare Fund Accounting: Journal Entries
Supplies used are $25,000 general services- $60,000 nursing services-
$10,000 clerical services- General services 25,000 GFNursing services 60,000Clerical services 10,000
Materials & supplies inventory 95,000 Equipment original cost $13,000, Acumulated Depreciations $11,000, sold
for $1,500 cash.Cash 1,500Nonoperating loss- Disposal of Equipment 500A/D – Movable Equipment 11,000
Movable Equipment 13,000
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Healthcare Fund Accounting: Journal Entries
Vassar Hospital recognizes depreciation on its equipment $70,000, building $40,000
GFDeprec. Exp.-equipment 70,000
Deprec. Exp-Bldg 40,000
A/D Equip. 70,000
A/D Bldg 40,000
Rented a building to the patients’ families $800,000GF
Cash or A/R 800,000
Nonoperating Gains 800,000
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Healthcare Fund Accounting: Journal Entries
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Healthcare Fund Accounting: Journal Entries
Donated marketable securities $600,000 restricted as to income and principal to be used in purchasing of physical therapy equipment
This should be accounted for in Plant, Replacement & Expansion funds until the restriction is satisfied;
Marketable securities 600,000 Fund balance 600,000Securities worth $400,000 were sold for $500,000 and the proceeds were used to buy the
equipmentCash 500,000 Marketable securities 400,000 Fund Balance 100,000Transfer to General Fund 500,000 To reclassify from restricted to unrestricted PR&E Transfer to General Funds 500,000
Cash 500,000GF: Cash 500,000 Transfer from Plant Replacement & Expansion 500,000Equipment 500,000 Cash 500,000
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Voluntary Health & Welfare Organizations
Use Audit Guide by AICPA.
Objective of reporting:”To disclose how entity’s resources are acquired and used to accomplish the objectives of the organization.”
Donations are not recorded revenue but support or public support. Cash donation and pledges: pledges are recorded as deferred if
they are restricted. Then recorded as support when used. Allowance for uncollectible is recorded
Donated securities are recorded with the market value as support, unless restricted to be recorded in the appropriate restricted fund.
Restricted income is recorded in restricted fund
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Voluntary Health & Welfare Organizations
Review and study the financial statements of Hospitals and Voluntary Health & Welfare Organizations (VHWO) handed-in class
Review the reading materials on Healthcare and not-for Profit organizations (Handouts)
You are expected to be able to prepare the financial statements and do simple entries and multiple choice regarding income and expenses recognition and funds types and classification..
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Voluntary Health & Welfare Organizations The following are selected transactions for Neighborhood Assistance
Fund (VHWO):1. Received unrestricted cash contributions $4,0002. Unconditional promises to give $6,000, expected uncollectibles
10% of pledges.Cash 4,000
Unrestricted Contributions 4,000Pledges Receivables 6,000
Unrestricted Support 5,400Provisions for Unclollectible Pledges 600
All pledges were collected cashCash 5,400
Provision for Uncollectibles 600Pledges Receivables 6,000
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Voluntary Health & Welfare Organizations
When Temporarily Restricted Contribution is used, an entry is made to reclassify it to Unrestricted Assets.– Temp. Rest. Net Asst – Reclassification Out
• Unrestricted Net Asst – Reclassification In.