Current through Register Vol. 46, No. 39, September 25, 2024
(b)
Education Expense
[3282]
(1) 8220
NURSING EDUCATION
..........................................................................................................
8221 Registered
Nurses..........................................................................................................
8222 Licensed Vocational (Practical)
Nurses..........................................................................................................
(i) Function. Hospitals may either
operate a School of Nursing or provide the clinical training activities for
student nurses when the degree is issued by a college or university. Nursing
Education is a school for educating Registered Nurses and/or Licensed
Vocational (Practical) Nurses. Additional activities include, but are not
limited to, the following:
Selecting qualified nursing students; providing
education in theory and practice conforming to approved standards; maintaining
student personnel records; counseling of students regarding professional,
personal and educational problems; selecting faculty personnel; assigning and
supervising students in giving nursing care to selected patients; and
administering aptitude and other tests for counseling and selection
purposes.
(ii) Description.
This cost center shall be used to record the direct expenses incurred in, or
providing clinical facilities for, the education of Registered Nurses and/or
Licensed Vocational (Practical) Nurses. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of FTE
nursing students. The number of FTE nursing students in the Nursing Education
cost center is defined as the sum of the percentage of time each student nurse
is enrolled in the school during the year divided by 100.
(iv) Data source. The number of FTE nursing
students in this educational program shall be the actual count maintained by
the Nursing Education cost center.
(2) 8240 POSTGRADUATE MEDICAL
EDUCATION-APPROVED PRIMARY TEACHING PROGRAM-INTERNAL MEDICINE
..........................................................................................................
8250 POSTGRADUATE MEDICAL EDUCATION-APPROVED PRIMARY
TEACHING PROGRAM-FAMILY
PRACTICE..........................................................................................................
8260 POSTGRADUATE MEDICAL EDUCATION-APPROVED PRIMARY
TEACHING
PROGRAM-PEDIATRICS..........................................................................................................
8270 POSTGRADUATE MEDICAL EDUCATION-OTHER APPROVED
TEACHING
PROGRAMS..........................................................................................................
(i) Function. A Postgraduate Medical
Education Teaching Program provides an organized program of postgraduate
medical clinical education to interns and residents. To be approved, a medical
internship or residency training program must be approved by the Council on
Medical Education of the American Medical Association or, in the case of an
osteopathic hospital, approved by the Committee on Hospitals of the Bureau of
Professional Education of the American Osteopathic Association. Intern or
residency programs in the field of dentistry in a hospital or osteopathic
hospital must have the approval of the Council on Dental Education of the
American Dental Association. Additional activities include, but are not limited
to, the following:
Selecting qualified students; providing education in
theory and practice conforming to approved standards; maintaining student
personnel records; counseling of students regarding professional, personal and
educational problems; and assigning and supervising students.
(ii) Description. This cost center shall be
used to record the direct expenses incurred in providing an approved organized
program of postgraduate medical clinical education. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services, other direct expenses and transfers. All salaries and
stipends paid to interns and residents in approved teaching programs must be
reflected in this cost center, in the "Salaries and Wages" natural expense
classification (.07).
(iii)
Standard Unit of Measure: number of FTE students. The number of FTE students in
Postgraduate Medical Education Approved programs is defined as the sum of the
percentage of time each student is enrolled in such programs during the year
divided by 100.
(iv) Data source.
The number of FTE students in these educational programs shall be the actual
count maintained in each such program.
(v) Effective dates. For the reporting of
accounts 8240 through 8270, relative to approved teaching programs, cost
reporting periods beginning on or after January 1, 1981. The Standard Unit of
Measure (FTE students) for accounts 8240 through 8260 must be collected
beginning July 1, 1981. For cost reporting periods beginning in 1980, report
all Approved Postgraduate Medical Education programs (including the Standard
Unit of Measure) under account 8270.
(3) 8280 POSTGRADUATE MEDICAL
EDUCATION-NON-APPROVED TEACHING PROGRAM
(i)
Function. A Postgraduate Medical Education program provides an organized
program of postgraduate medical clinical education to interns and residents. To
be non-approved means that a medical internship or residency training program
is not approved by the Council on Medical Education of the American Medical
Association or, in the case of an osteopathic hospital, is not approved by the
Committee on Hospitals of the Bureau of Professional Education of the American
Osteopathic Association. Intern or residency programs in the field of dentistry
in a hospital or osteopathic hospital are non-approved unless the approval of
the Council on Dental Education of the American Dental Association has been
received. Additional activities include, but are not limited to, the following:
Selecting qualified students; providing education in
theory and practice conforming to approved standards; maintaining student
personnel records; counseling of students regarding professional, personal and
educational problems, and assigning and supervising students.
(ii) Description. This cost center shall be
used to record the direct expenses incurred in providing an organized program
of postgraduate medical clinical education. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses and transfers. All salaries or stipends paid to
interns and residents in non-approved teaching programs must be reflected in
this cost center, in the "Salaries and Wages" natural expense classification
(.07).
(iii) Standard Unit of
Measure: number of FTE students. The number of FTE students in Postgraduate
Medical Education Non-Approved programs is defined as the sum of the percentage
of time each student is enrolled in such programs during the year divided by
100.
(iv) Data source. The number
of FTE students in these educational programs shall be the actual count
maintained by each such program.
(4) 8290 OTHER HEALTH PROFESSION EDUCATION
..........................................................................................................
8291 School of Medical
Technology..........................................................................................................
8292 School of X-Ray
Technology..........................................................................................................
8293 School of Respiratory
Therapy..........................................................................................................
8294 Administrative Intern
Program..........................................................................................................
8295 Medical Records Librarian
Program..........................................................................................................
(i) Function. Other Health Profession
Education is the provision of organized programs of medical clinical education
other than for nurses (RN and LVN) and doctors, and the provision of organized
education programs for administrative interns and externs, Medical Records
Librarians, and other health professionals. Additional activities include, but
are not limited to, the following:
Selecting qualified students; providing education in
theory and practice conforming to approved standards; maintaining student
personnel records; counseling of students regarding professional, personal and
educational problems; selecting faculty personnel; assigning and supervising
students in giving medical care to selected patients; and administering
aptitude and other tests for counseling and selection
purposes.
(ii) Description.
These cost centers contain the direct expenses relative to operating health
education programs other than nursing and postgraduate medical programs, such
as a School of Medical Technology, School of X-Ray Technology, School of
Respiratory Therapy, and other non-inservice education programs such as those
listed above. A separate cost center should be established for each program.
Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses and
transfers.
(iii) Standard Unit of
Measure: number of FTE students. The number of FTE students in Other Health
Profession Education programs is defined as the sum of the percentage of time
each student is enrolled in an Other Health Profession Education Program during
the year divided by 100.
(iv) Data
source. The number of FTE students in such programs shall be the actual count
maintained by each such program.
(c)
General Services.
[3283]
(1) 8310
DIETARY SERVICES
(i) Function. Dietary
Services includes the procurement, storage, processing and delivery of food and
nourishments to patients in compliance with Public Health regulations and
physicians' orders. Additional activities include, but are not limited to, the
following:
Nutritional assessment;
Teaching patients and their families nutrition and
modified diet requirements; determining patient food preferences as to type and
method of preparation; preparing selective menus for various specific diet
requirements; preparing or recommending a diet manual, approved by the medical
staff, for use by physicians and nurses; and delivering food trays to, and
collecting food trays from, patient service areas for meals and nourishments;
and incidental activities such as cleaning up of spills in preparing
food.
(ii) Description. This
cost center contains the direct expenses incurred in preparing food for
patients and delivering food to patient service areas. Infant formula must be
reported in the using cost center. Included as direct expenses are: salaries
and wages, employee benefits, professional fees, supplies, purchased services,
and other direct expenses. Also included is Dietary Service's share of common
costs of the Non-Patient Food Service and Dietary Services cost centers.
Examples of common costs include: salaries of cooks who
prepare food for both cost centers, common food costs, common minor equipment
costs, if expensed, common administrative costs, etc. These common costs shall
be distributed to the Dietary and Non-Patient Food Service cost centers, based
upon the ratio of number of meals served in each cost center. A detailed
explanation of the method to be used in computing the number of nonpatient
meals served by the Non-Patient Food Service cost center is included in the
explanation of the Non-Patient Food Service Standard Unit of
Measure.
(iii) Standard Unit
of Measure: number of patient meals. Count only regularly scheduled meals
(3-meal schedules only) and exclude snacks and fruit juices served between
regularly scheduled meals. Also excluded are tube feedings and infant
formula.
(iv) Data source. The
number of patient meals must be the actual count of patient meals maintained by
the Dietary cost center.
(2) 8320 NON-PATIENT FOOD SERVICE
(i) Function. Non-Patient Food Service
includes the procurement, storage, processing and delivery of food to employees
and other nonpatients in compliance with Public Health regulations.
(ii) Description. This cost center contains
all directly identifiable expenses incurred in preparing and delivering food to
employees and other nonpatients. Included as direct expenses are: salaries and
wages, employee benefits, professional fees, supplies, purchased services, and
other direct expenses. Also included is the Non-Patient Food Service's share of
common costs of the Non-Patient Food Service and Dietary Services cost centers.
The cost of edible supplies for vending machines serviced by the health
facility must be included in this cost center. Vending machine revenue is to be
included in other operating revenue account 5820 (Vending Machine
Commissions).
(iii) Standard Unit
of Measure: equivalent number of meals served. To obtain an equivalent meal in
a pay cafeteria, divide total Non-Patient Food Service revenue by the average
selling price of a full meal. The average full meal should include meat,
potato, vegetable, salad, beverage and dessert. When there is a selection of
entrees, desserts and so forth, that are available at different prices, use an
average in calculating the selling price of a full meal. Count a free meal
served as a full meal.
(iv) Data
source. Non-Patient Food Service revenue must be taken from the general
ledger.
(3) 8330 LAUNDRY
AND LINEN
(i) Function. Laundry and Linen
activities include picking up, storing, issuing, mending, washing, distributing
and processing of in-service linens. The services include uniforms, special
linens and disposable linen substitutes.
(ii) Description. This cost center shall
contain the direct expenses incurred in providing laundry and linen services
for hospital use, including student, nonpaid worker, and employee quarters.
Cost of disposable linen must be recorded in this cost center. Included as
direct expenses are: salaries and wages, employee benefits, professional fees,
supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of dry
and clean pounds processed. Record the weight of linen processed (laundered and
dried) plus the equivalent weight of disposable linen substitutes used. Linen
is weighed after it has been cleaned and processed. Include uniforms and linen
from personnel quarters and employee housing. If linen is not weighed, a
conversion from pieces to pounds is allowed. If soiled linen is weighed, divide
by 1.1.
(iv) Data source. The
number of dry and clean pounds processed (laundered and dried) must be taken
from actual counts maintained in the Laundry and Linen cost center. If the
hospital uses an outside laundry service, the number of dry and clean pounds
processed must be maintained and reported.
(4) 8350 SOCIAL SERVICES
(i) Function. The Social Work Services cost
center obtains, analyzes, and interprets psychosocial, environmental and
economic information to assist in diagnosis, treatment and rehabilitation of
patients. These services include: counseling of patients and families in
individual and group units; collaboration with health care staff; mobilizing
resources on behalf of patients both within a given hospital and in various
agencies outside the hospital; and participation in the development of social
and health programs in the community. Other tasks involve collecting and
revising information on community health and welfare resources, departmental
management and being accountable to responsible external organizations. Major
activities include but are not limited to: screening, which is the process
whereby a determination is made concerning the necessity for further
professional assessment and services; assessment (including family members or
significant others), which is the explication of a patient's problem or
problems and the initial determination of a course of action for resolving the
problem or problems; and the provision of problem-focused services (such as
dealing with psychosocial problems as they relate to a patient's health and/or
hospitalization, and arranging for post-discharge care of patients), which are
directed toward the resolution of identified problems.
(ii) Description. This cost center contains
the direct expenses incurred in providing social services to patients. Included
as direct expenses are: salaries and wages, employee benefits, professional
fees, supplies, purchased services, other direct expenses and
transfers.
(iii) Standard Unit of
Measure: none required; not applicable.
(5) 8360 HOUSING
..........................................................................................................
8361 Employee
Housing..........................................................................................................
8362 Nonpaid Worker
Housing..........................................................................................................
8363 Student
Housing..........................................................................................................
(i) Function. Housing is the
provision of living quarters to hospital employees and nonpaid workers; and
maintenance of residences for students, including interns and residents,
participating in education programs carried on by the hospital.
(ii) Description. This cost center shall
contain the direct expenses incurred in providing living quarters for hospital
employees, nonpaid workers, and students involved in educational programs
carried on by the hospital. Expenses of on-call rooms shall be included in this
cost center only if they are not directly identifiable to another cost center.
Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses and
transfers.
(iii) Standard Unit of
Measure: average number of persons housed. Record the number of days each
person is in the facility. Accumulate the monthly totals and divide by 12 to
obtain the average number of persons housed.
(iv) Data source. The average number of
persons housed shall be determined from the record of employees housed
maintained in the Housing cost center.
(6) 8410 PLANT OPERATIONS AND MAINTENANCE
..........................................................................................................
8410 Plant
Operations..........................................................................................................
8412 Plant
Maintenance..........................................................................................................
8413
Grounds..........................................................................................................
(i) Function. Plant Operations and
Maintenance includes the maintenance and service of utility systems such as
heat, light, water, air conditioning and air treatment; the maintenance and
repair of buildings, parking facilities, and equipment; painting; elevator
maintenance; vehicle maintenance; performance of minor renovation of buildings
and equipment; and maintenance of grounds of the institution, such as
landscaped and paved areas, streets on the property, sidewalks, fenced areas
and fencing, external recreation areas, and parking facilities. Additional
activities include, but are not restricted to, the following:
Trash disposal; boiler operation and maintenance;
service and maintenance of water treatment facilities, drainage systems and
utility transmission systems. Including all maintenance performed under
contract; technical assistance on equipment purchases and installation;
coordinating construction; establishing priorities for repairs and utility
projects.
(ii) Description.
This cost center shall contain the direct expenses incurred in the operation
and maintenance of the hospital plant and equipment except the maintenance,
repair and renovation of renal dialysis equipment used for Home Dialysis for
which the hospital has been 100 percent reimbursed by Medicare. Such costs must
be reported in the Home Program Dialysis Equipment-100 Percent cost center
(account 6810). Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, utilities (except
telephone and telegraph), other direct expenses and transfers.
(iii) Standard Unit of Measure: number of
gross square feet. Gross square feet is defined as the total
interior floor area of the hospital facility, including common areas (hallways,
stairways, elevators, lobbies, closets, etc.), measured to the center of
interior walls.
(iv) Data source.
The number of gross square feet shall be taken from current blueprints of the
hospital facility, or from actual measurement if blueprints are not
available.
(v) Expiration date.
This cost center will be replaced by account 8400 (Plant Maintenance) and
account 8410 (Plant Operation) effective with cost reporting periods beginning
in 1982.
(7) 8400 PLANT
MAINTENANCE
..........................................................................................................
(i) Description. Maintenance and repair of
buildings, grounds and fixed equipment; painting; vehicle operation (except
operation of ambulances) and maintenance; care of grounds; and performance of
minor renovations of buildings, fixed equipment, grounds, drainage systems and
utility transmission systems, including all such maintenance performed under
contract. Also included are expenses associated with technical assistance on
equipment purchases and installations; coordinating construction; establishing
priorities for repairs and utility projects; and operation, service and repair
of parking lots. Exclude the costs of maintenance, repair and renovation of
renal dialysis equipment used for Home Dialysis for which the hospital has been
100 percent reimbursed by Medicare. Such costs must be reported in the Home
Program Dialysis Equipment-100 Percent cost center (account 6810). Examples of
job titles include chief engineer, stationary engineer, carpenter, plumber,
electrician, painter, dispatcher, driver, groundskeeper, plasterer, parking lot
attendant, guard, mechanic, electromedical equipment repairman, clerk and
secretary.
(ii) Standard Unit of
Measure: gross square feet. Gross square feetis defined as the
total interior floor area of the hospital facility, including common
areas.
(iii) Data source. Square
feet shall be determined from the blueprints of the hospital facility, or
actual measurement if blueprints are not available.
(iv) Effective date. Cost reporting periods
beginning 1982 and thereafter.
(8) 8410 PLANT OPERATION
..........................................................................................................
(i) Description. Maintenance and service of
utilities, such as heat, light, water, air conditioning and air treatment;
trash disposal; hourly operation and maintenance; service and maintenance of
water treatment facilities and drainage systems. Examples of job titles
include: director of plant operations, foreman, elevator operator, tool crib
operator, incinerator and mechanic. This cost center also includes the direct
expense of utilities such as: electricity, natural gas, liquid propane or
butane gas, oil coal, purchased steam and hot water and water and sewage.
Telephone and telegraph service are not considered utilities but are included
in the Hospital Administration cost center (account 8610).
(ii) Standard Unit of Measure: gross square
feet. Gross square feetis defined as the total interior floor
area of the hospital facility, including common areas.
(iii) Data source. Square feet shall be
determined from the blueprints of the hospital facility, or actual measurement
if blueprints are not available.
(iv) Effective date. Cost reporting periods
beginning in 1982 and thereafter.
(9) 8430 SECURITY
(i) Function. The Security cost center
maintains the safety and well-being of hospital patients, personnel and
visitors, and protects the hospital's facilities.
(ii) Description. This cost center shall
include the direct expenses incurred maintaining the safety and well-being of
hospital patients, employees, visitors, and protection of the hospital
facilities. Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, other direct
expenses and transfers.
(iii)
Standard Unit of Measure: none required; not applicable.
(10) 8440 PARKING
(i) Function. Parking includes the provision
of parking facilities to patients, physicians, employees and
visitors.
(ii) Description. This
cost center shall contain the direct expenses of parking facilities owned
and/or operated by the hospital. Included as direct expenses are: salaries and
wages, employee benefits, professional fees, supplies, purchased services,
other direct expenses and transfers.
(iii) Standard Unit of Measure: none
required; not applicable.
(11) 8450 HOUSEKEEPING
(i) Function. This cost center is responsible
for the care and cleaning of the interior physical plant, including the care
(washing, waxing, stripping) of floors, walls, ceilings, partitions, windows
(inside and outside), furniture (stripping, disinfecting and making beds upon
discharge), fixtures (excluding equipment) and furnishings and emptying of room
trash containers, as well as the costs of similar services purchased from
outside organizations
(ii)
Description. This cost center shall contain the direct expenses incurred for
maintaining general cleanliness and sanitation throughout the hospital and
other areas serviced (such as student and employee quarters). Included as
direct expenses are: salaries and wages, employee benefits, professional fees,
supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: number of
square feet serviced. Square feet serviced is the interior
floor area routinely serviced by housekeeping personnel.
(iv) Data source. The number of square feet
serviced by the housekeeping unit should be taken from blueprints of the
hospital and other buildings serviced (such as student and employee quarters),
or from actual measurement if no blueprints are available.
(12) 8460 CENTRAL SERVICES AND SUPPLIES
(i) Function. Central Services and Supplies
prepares and issues medical and surgical supplies and equipment to patients and
to other cost centers. Additional activities include, but are not limited to,
the following:
Requisitioning and issuing of appropriate supply items
required for patient care; preparing sterile irrigating solutions; collecting,
assembling, sterilizing and redistributing reusable items; cleaning,
assembling, maintaining and issuing portable apparatuses.
(ii) Description. This cost center contains
the direct expenses incurred in preparing and issuing medical and surgical
supplies and equipment to other cost centers and to patients. Also included is
the expense related to reusable patient-chargeable items. Included as direct
expenses are: salaries and wages, employee benefits, professional fees,
supplies, purchased services, and other direct expenses. The invoice/inventory
cost of nonchargeable supplies and equipment issued to other cost centers shall
be reported in the using cost centers. The invoice/inventory cost of chargeable
medical and surgical supplies shall be reported in the Medical Supplies Sold
cost center (account 7110). The invoice/inventory cost of durable medical
equipment leased and rented must be reported in the Durable Medical Equipment
Leased/Rented cost center (account 7140).
(iii) Standard Unit of Measure: none
required; not applicable.
(13) 8470 PHARMACY
(i) Function. The Pharmacy procures,
preserves, stores, compounds, manufactures, packages, controls, assays,
dispenses, and distributes medications (including I.V. solutions and blood
derivatives, except packed red cells) for inpatients and outpatients under the
jurisdiction of a licensed pharmacist. Pharmacy services include maintaining
separate stocks of commonly used items in designated areas. Additional
activities include, but are not limited to, the following:
Development and maintenance of formulary(ies)
established by the medical staff; consultation and advice to medical staff and
nursing staff on drug therapy; adding drugs to I.V. solutions; determining
incompatibility of drug combinations; stocking floor drugs and dispensing
machines; preparing patient medication histories; monitoring drug therapy;
counseling patients; making patient rounds.
(ii) Description. This cost center contains
the direct expenses incurred in maintaining a pharmacy under the jurisdiction
of a licensed pharmacist. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, and other
direct expenses. The invoice cost of nonchargeable pharmaceuticals, I.V.
solutions and blood derivatives issued to other cost centers shall be
transferred to the using cost centers. The invoice cost of chargeable
pharmaceuticals, I.V. solutions and blood derivatives shall be transferred to
the Drugs Sold cost center (account 7150).
(iii) Standard Unit of Measure: none
required; not applicable.
(d)
Fiscal Services
[3284]
(1) 8510
GENERAL ACCOUNTING
(i) Function. This cost
center performs general accounting (i.e.,nonpatient billing
and accounting) activities of the hospital, such as the preparation of ledgers,
budgets and financial reports, payroll accounting, accounts payable accounting,
plant and equipment accounting, inventory accounting, nonpatient accounts
receivable accounting (tuition, sales to other institutions), etc.
(ii) Description. This cost center shall
include the direct expenses incurred in providing the general accounting
requirements of the hospital, and in providing other fiscal services not
related to patient accounting activities. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none
required; not applicable.
(2) 8520 PATIENT ACCOUNTS, ADMITTING, AND
REGISTRATION
8521 Patient
Accounting..........................................................................................................
8522 Credit and
Collection..........................................................................................................
8523
Cashiering..........................................................................................................
8524 Inpatient
Admitting..........................................................................................................
8525 Emergency Room
Registration..........................................................................................................
8526 Clinic
Registration..........................................................................................................
8527 Referred Ambulatory
Registration..........................................................................................................
8528 Other Outpatient
Registration..........................................................................................................
(i) Function. The processing of
patient charges, including processing charges to patients' accounts, preparing
claims, extending credit, collecting accounts receivable, cashiering, and other
patient-related billing and accounting activities, is handled by this cost
center. Additional activities include interviewing patients and others relative
to the extension of credit, checking references and using outside collection
agencies.
The admitting of inpatients for hospital services,
including filling out admission forms, scheduling admission times, accompanying
patients to room or service areas after admission and arrangement of admission
details, is performed by this cost center. All outpatient registration
activities are also included here, including emergency, clinic, and referred
patients.
(ii) Description.
This cost center shall include the direct expenses incurred in patient-related
credit, billing and accounting activities; inpatient admitting; and outpatient
activities registration. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, other
direct expenses and transfers.
(iii) Standard Unit of Measure: none
required; not applicable.
(iv)
Effective date. Commencing with cost reporting periods beginning in 1982, this
cost center will be replaced by Patient Accounts (account 8520), Admitting
(account 8530), and Registration (account 8540).
(3) 8520 PATIENT ACCOUNTS
..........................................................................................................
8521 Patient
Accounting..........................................................................................................
8522 Credit and
Collection..........................................................................................................
8523
Cashiering..........................................................................................................
(i) Description. The processing of
patient charges, including posting charges to patients' accounts, preparing
claims, extending credit, collecting accounts receivable, cashiering, and other
patient-related billing and accounting activities, is handled by this cost
center. Additional activities include interviewing patients and others relative
to the extension of credit, checking references and using of outside collection
agencies.
(ii) Standard Unit of
Measure: none required. Consideration is being given to the development of a
SUM for this cost center.
(iii)
Effective date. Cost reporting periods beginning in 1982.
(4) 8530
ADMITTING..........................................................................................................
(i) Function. The admitting of inpatients for
hospital services, including filling out admission forms, scheduling admission
times, accompanying patients to room or service areas after admission, and
arrangement of admission details, is performed by this cost center.
(ii) Description. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services, and other direct expenses.
(iii) Standard Unit of Measure: none
required. Consideration is being given to the development of a SUM for this
cost center.
(iv) Effective date.
Cost reporting periods beginning in 1982.
(5) 8540 REGISTRATION
..........................................................................................................
8541 Emergency Room
Registration..........................................................................................................
8542 Clinic
Registration..........................................................................................................
8543 Referred Ambulatory
Registration..........................................................................................................
8549 Other Outpatient
Registration..........................................................................................................
(i) Function. the registration of
hospital outpatients, including filling out registration forms, scheduling of
appointments, accompanying patients to room or service areas after
registration, and arrangment of registration details, is performed by this cost
center.
(ii) Description. Included
as direct expenses are: salaries and wages, employee benefits, professional
fees, supplies, purchased services, and other direct expenses.
(iii) Standard Unit of Measure: none
required. Consideration is being given to the development of a S.U.M. for this
cost center.
(iv) Effective date.
Cost reporting periods beginning in 1982.
(e)
Administrative Services
[3285]
(1) 8610
HOSPITAL ADMINISTRATION
..........................................................................................................
8611 Office of Hospital
Administrator..........................................................................................................
8612 Governing
Board..........................................................................................................
8613 Public
Relations..........................................................................................................
8614 Spiritual
Care..........................................................................................................
8615
Communications..........................................................................................................
8616
Personnel..........................................................................................................
8617 Management
Engineering..........................................................................................................
8618 Health Sciences
Library..........................................................................................................
8619 Auxiliary
Groups..........................................................................................................
8621 Data
Processing..........................................................................................................
(i) Function. Hospital Administration
performs overall management and administration of the institution. This
function also includes the following activities: public relations, spiritual
care, communications, personnel, management engineering, health sciences
library, auxiliary groups, and data processing. The functions of cost centers
8615 through 8621 are described on the following pages.
(ii) Description. This cost center contains
the direct expenses associated with the overall management and administration
of the institution, including those of the Governing Board. The expenses
associated with furnishing information for public use in maintaining the
hospital's position in the community must be included here. The expenses
associated with spiritual care (chaplaincy), communications, personnel,
management engineering, health sciences library, and auxiliary groups must be
included here. Care should be taken to ascertain that all costs included in
this cost center do not properly belong in a different cost center. For
example, expenses chargeable to hospital administration do not include legal
fees incurred in connection with the purchase of property (which should be
capitalized), nor fund raising costs which should be included in Fund Raising
(account 8780). Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, other direct
expenses and transfers.
(iii)
Standard Unit of Measure: none required; not applicable.
(2) 8615 COMMUNICATIONS
(i) Function. The Communications cost center
operates the communications systems within and outside the hospital, including
the telephone system, radio and telemetry communications systems, public
address systems, closed-circuit television, messenger services and mail
processing.
(iii) Description. This
cost center shall include the direct expenses incurred in carrying on
communications (both in and out of the hospital), including the telephone
switchboard and related telephone services, messenger activities, internal
information systems and mail services. Specific expenses include postage and
telephone company charges for equipment and monthly services. Included as
direct expenses are: salaries and wages, employee benefits, professional fees,
supplies, purchased services, other direct expenses and transfers.
(3) 8616 PERSONNEL
(i) Function. Personnel provides adequate
staffing of hospital departments and maintains employee satisfaction and
morale. Activities include recruitment, employee selection, salary and wage
administration, employee health services, fringe benefit program
administration, and procurement of temporary help (including fees paid to
temporary help agencies).
(ii)
Description. This cost center shall be used to record the direct expenses
incurred in carrying out the personnel function of the hospital. Included as
direct expenses are: salaries and wages, employee benefits, professional fees,
supplies, purchased services, other direct expenses and transfers.
(4) 8617 MANAGEMENT ENGINEERING
(i) Function. Management Engineering is an
administrative service which assists hospital administrators in performing
their managerial functions by providing specialized knowledge and skill in the
mathematical, physical and social sciences, together with the principles and
methods of engineering analysis, development and implementation. Management
Engineering performs a wide variety of services, including but not limited to
the following: productivity analysis and improvement; cost containment;
planning and control procedures; systems analysis and design; facilities
layout; computer science; operations research.
(ii) Description. This cost center contains
the direct expenses incurred by the management engineering function. Included
as direct expenses are: salaries and wages, employee benefits, professional
fees, supplies, purchased services, other direct expenses and
transfers.
(5) 8618
HEALTH SCIENCES LIBRARY
(i) Function. The
Health Sciences Library procures, stores, indexes, classifies, annotates and
abstracts books, catalogs, journals and other related published materials
principally for medical staff use and reviews library records for completeness
and compliance with established standards.
(ii) Description. This cost center contains
the direct expenses incurred in maintaining health sciences library. Included
as direct expenses are: salaries and wages, employee benefits, professional
fees, supplies, purchased services, other direct expenses and
transfers.
(6) 8619
AUXILIARY GROUPS
(i) Function. Costs incurred
in connection with hospital-related auxiliary groups, including coordinator of
auxiliary group activities and special meetings of auxiliary groups conducted
by the hospital, are maintained in this cost center.
(ii) Description. This cost center contains
the direct expenses incurred in connection with hospital auxiliary or volunteer
groups. Included as direct expenses are: salaries and wages, employee benefits,
professional fees, supplies, purchased services, other direct expenses and
transfers.
(7) 8621 DATA
PROCESSING
(i) Function. The Data Processing
cost center performs the operation of the hospital's electronic data processing
system, including keypunching of input, storage and safeguarding of data,
operating data processing equipment, data processing job scheduling,
distributing output and identifying and solving hardware and software
problems.
(ii) Description. This
cost center shall contain the costs incurred in operating an electronic data
processing center. Included as direct expenses are: salaries and wages,
employee benefits, professional fees, supplies, purchased services, other
direct expenses and transfers. Expenses incurred in the operation of terminals
of the EDP center throughout the hospital shall be included in the Data
Processing cost center. However, outside service bureau costs directly
chargeable to a specific cost center shall be included in that specific cost
center in the "Purchased Services-Data Processing" natural classification
(.75). Outside service bureau costs benefiting more than one cost center shall
be included in the Data Processing cost center. All data processing expenses
not directly charged to the using cost centers must be distributed, for
reporting purposes, to individual cost centers. The only expense remaining in
this cost center is the expense related to data processing service provided to
outside organizations. The related revenue is to be reported in account 5620,
Data Processing Services Revenue.
(8) 8690 PURCHASING AND STORES
(i) Function. Purchasing and Stores includes
the procuring of supplies, equipment and services necessary to hospital
operations, the receipt of supplies and materials from vendors and their
routing and distribution to specific using areas, and the receipt and central
storage of all non-pharmaceutical supplies and materials prior to their issue
to using departments. Additional activities include, but are not limited to,
the following:
Receipt and processing of requisitions; monitoring of
perpetual supply items; obtaining of quotes from selected vendors; and
monitoring of receipt of supplies.
(ii) Description. This cost center shall
contain the direct expenses incurred in procuring supplies, equipment and
services necessary to hospital operations. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none
required; not applicable.
(9) 8710 MEDICAL RECORDS
(i) Function. Medical Records includes the
maintenance of a records system for the use, transportation, retrieval, storage
and disposal of patient medical records; and the production of indexes,
abstracts and statistics for hospital management and medical staff uses. This
function also includes tumor registry activities.
(ii) Description. This cost center contains
the direct expenses incurred in maintaining the medical records function. Also,
costs associated with microfilming of medical records shall be included in this
account. Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, other direct
expenses and transfers.
(iii)
Standard Unit of Measure: number of inpatient discharges and number of
outpatient visits. The number of inpatient discharges should exclude routine
newborns (those newborn who are discharged with the mother). The number of
outpatient visits should exclude referred ambulatory and sold services
visits.
(iv) Data source. The
number of visits shall be the actual count maintained in the Ambulatory
Services cost centers, excluding referred ambulatory and sold services visits.
The number of discharges shall be the actual count maintained by Medical
Records
(10) 8720 MEDICAL
STAFF ADMINISTRATION
(i) Function. This cost
center is used to record certain general expenses associated with medical staff
administration, such as the salary and related expenses of the Chief of the
Medical Staff and assigned non-physician employees.
(ii) Description. This cost center contains
the direct expenses associated with medical staff administration (as described
above). Interns' and residents' salaries (or stipends) must not be included
here, but rather in the Postgraduate Medical Education-Approved Teaching
Program (account 8240) or Postgraduate Medical Education-Non-Approved Teaching
Program (account 8250) cost center, as appropriate. Compensation paid to
physicians (other than Chief of the Medical Staff) must not be included here,
but rather in the cost center where the physicians' services are rendered.
Included as direct expenses are: salaries and wages, employee benefits,
supplies, purchased services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none
required, not applicable.
(11) 8730 MEDICAL STAFF SERVICES
(i) Function. This cost center is used to
report the professional component expenses associated with services to hospital
patients provided by hospital-based physicians.
(ii) Description. This cost center contains
the professional component expenses associated with hospital-based physicians.
Interns' and residents' salaries (or stipends) must not be included here but
rather in the Postgraduate Medical Education-Approved Teaching Program (account
8240) or Postgraduate Medical Education-Non-Approved Teaching Program (account
8250) as appropriate.
(12) 8740 MEDICAL CARE REVIEW
..........................................................................................................
8741
PSRO..........................................................................................................
8749 Other Medical Care
Review..........................................................................................................
(i) Function. This cost center
conducts ongoing evaluation of the quality of care given and includes periodic
review of the utilization of the bed facilities, and of the diagnostic, nursing
and therapeutic resources of the hospital, with respect to both the
availability of these resources to all patients in accordance with their
medical need and the recognition of the medical practitioner's responsibility
for the costs of health care. This review should cover necessity of admission,
length of stay, level of care, quality of care, utilization of ancillary
services, professional services furnished, effectiveness of discharge planning
and the availability and alternate use of out-of-hospital facilities and
services. Three review programs may be included in the Medical Care Review cost
center: pre-admission screening, concurrent review (including admission
certification and continued stay review) and retrospective medical care
evaluation studies. The review committee should include medical staff, hospital
administration, nurses and home health planners.
(ii) Description. This cost center shall
contain the costs incurred in providing peer review, quality assurance,
utilization review, professional standards review and medical care evaluation
functions. Included as direct expenses are: salaries and wages, employee
benefits, professional fees, supplies, purchased services, other direct
expenses and transfers.
(iii)
Standard Unit of Measure: number of inpatient discharges (exclude newborn). The
number of inpatient discharges should exclude routine newborns (those newborn
who are discharged with the mother). Also exclude intrahouse
transfers.
(iv) Data source. The
number of inpatient discharges shall be the actual count maintained by the
Admitting Office.
(13)
8750 NURSING ADMINISTRATION
..........................................................................................................
8751 Inservice
Education-Nursing..........................................................................................................
8759 Nursing
Administration-Other..........................................................................................................
(i) Function. Nursing Administration
performs the administration and supervision of the nursing function in the
hospital, including scheduling and transfer of nurses among the services and
units, nursing staff supervision, evaluation and discipline. This cost center
also includes continuing education of hospital-employed nursing personnel
(i.e., RNs, LVNs, aides and orderlies), including regularly
scheduled classes, in-house seminars and special training sessions.
(ii) Description. This cost center shall
contain the direct expenses associated with nursing administration and with
conducting a nursing inservice education program. Included as direct expenses
are: salaries and wages, employee benefits, professional fees, supplies,
purchased services, other direct expenses and transfers. Supervisors assigned
to specific cost centers shall be included in those cost centers on a direct
basis.
The salaries, wages and fringe benefits paid float
personnel shall be recorded in the cost center in which they work. This may be
done directly, or they may be recorded originally in the Float Nursing
Personnel cost center (account 8992) and distributed (preferably at the end of
each payroll period) to using cost centers based upon hours worked. If the
latter method is used, all salaries, wages and fringe benefits of float
personnel must be transferred out of the Float Nursing Personnel cost center.
Any idle time would be allocated together with actual hours worked. Scheduling
and other administrative functions relative to float nursing personnel are
considered costs of Nursing Administration.
If hospital employees work part-time in the inservice
education program and part-time in other nursing activities, their salaries,
wages and fringe benefits shall be separated based upon number of hours spent
in each activity and distributed to the appropriate cost centers, preferably
after each payroll period. This cost center shall not include costs related to
inservice student time. These costs must remain in the cost center in which the
student works.
(iii)
Standard Unit of Measure: weighted average daily census. The weighted average
census is calculated as follows: (inpatient days [exclude newborns] + 1/4
emergency room visits + 1/3 all other outpatient visits) + number of days in
the year.
(iv) Data source. General
accounting and statistical records (daily census, emergency room log, clinic
registration log, etc.).
(14) 8760 MEDICAL PHOTOGRAPHY AND
ILLUSTRATION
(i) Function. This cost center
provides medical photography and illustration services for other cost centers
of the hospital.
(ii) Description.
This cost center shall include the direct expenses incurred in providing
medical photography and illustration services. Included as direct expenses are:
salaries and wages, employee benefits, professional fees, supplies, purchased
services, other direct expenses and transfers.
(iii) Standard Unit of Measure: none
required; not applicable.
(15) 8780 FUND RAISING
(i) Function. Fund Raising carries on
fund-raising activities such as special luncheons and other meetings and
special mailings.
(ii) Description.
This cost center contains the direct expenses associated with fund raising
(both restricted and unrestricted). Included as direct expenses are: salaries
and wages, employee benefits, professional fees, supplies, purchased services,
other direct expenses and transfers.
(iii) Standard Unit of Measure: none
required; not applicable.
(f)
Unassigned Expenses
[3286]
(1) 8810
DEPRECIATION AND AMORTIZATION-FIXED ASSETS
..........................................................................................................
8811 Land
Improvements..........................................................................................................
8812 Buildings and
Improvements..........................................................................................................
8813 Leasehold
Improvements..........................................................................................................
8814 Fixed
Equipment..........................................................................................................
Intangibles..........................................................................................................
(i) Function. Depreciation and
Amortization is a cost center for recording depreciation and amortization
expenses on land improvements, buildings and improvements, leasehold
improvements, fixed equipment and intangibles.
(ii) Description. This cost center contains
depreciation and amortization expense on land improvements, buildings and
improvements, leasehold improvements, fixed equipment, and intangibles. All
such expenses must remain in this cost center.
(iii) Standard Unit of Measure: none
required; not applicable.
(2) 8815 LEASES AND RENTALS-FIXED
ASSETS..........................................................................................................
8816
Land..........................................................................................................
8817 Buildings and
Improvements..........................................................................................................
8818 Fixed
Equipment..........................................................................................................
(i) Function. Leases and Rentals is a
center for the recording of leases and rental expenses on land, buildings and
improvements, and fixed equipment.
(ii) Description. This cost center contains
all lease and rental expenses relating to land, buildings and improvements, and
fixed equipment. All such expenses must remain in this cost center.
(iii) Standard Unit of Measure: none
required; not applicable.
(3) 8820 DEPRECIATION AND
AMORTIZATION-MOVABLE EQUIPMENT
..........................................................................................................
(i) Function. Depreciation and
Amortization-Movable Equipment is a cost center for recording depreciation and
amortization expenses on movable equipment. All such expenses must be reported
in this cost center.
(ii) Effective
Date. Cost reporting periods beginning in 1980.
(4) 8825 LEASES AND RENTALS-MOVABLE EQUIPMENT
..........................................................................................................
(i) Function. Leases and Rentals-Movable
Equipment is a cost center for recording lease and rent expense on movable
equipment. All such expenses must be reported in this cost center.
(ii) Effective date. Cost reporting periods
beginning in 1980.
(5)
8830 EMPLOYEE BENEFITS-NON-PAYROLL-RELATED
..........................................................................................................
(i) Description. This cost center must be
used to report all non-payroll-related employee benefits. Included in
non-payroll-related employee benefits are such costs as personal education,
recreation and cultural activities, and day care.
(ii) Standard Unit of Measure: FTE employees.
To calculate the number of full-time equivalent employees, sum all hours for
which employees were paid (whether worked or not) during the year and divide by
2080.
(iii) Data source. Payroll
records.
(iv) Effective date. Cost
reporting periods beginning in 1980.
(6) 8840
INSURANCE-HOSPITAL AND PROFESSIONAL MALPRACTICE
(i) Function. This cost center is used to
record all hospital and professional malpractice insurance expenses.
(ii) Description. This cost center is used to
report all hospital and professional malpractice insurance expenses incurred in
maintaining hospital and professional liability insurance policies. Also
included is the self-insurance expense related to malpractice claims.
(iii) Standard Unit of Measure: none
required; not applicable.
(7) 8850 INSURANCE-OTHER
(i) Function. This cost center is used to
record all insurance expenses except those insurance expenses which are
required in the Account Distribution Index (see chapter IV of this manual), to
be charged to specific cost centers.
(ii) Description. This cost center is used to
record all insurance expenses incurred in maintaining all insurance policies
except professional and hospital malpractice insurance and employee benefit
insurance. For example, fire, theft, employee fidelity bonds, liability
(non-professional), property damage, auto, boiler, and business interruption
insurance expense would be included here. Also included is the expense
associated with self-insurance of such losses.
(iii) Standard Unit of Measure: none
required; not applicable.
(8) 8860 LICENSES AND TAXES (OTHER THAN
INCOME TAXES)
(i) Function. This cost center
is used to record all business license expenses incidental to the operation of
the hospital, all other license expense, and all taxes (other than on
income).
(ii) Description. This
cost center contains the business license expense, other license expense
(including unassigned permits) and tax expense which are incidental to the
operation of the hospital. Fees paid to a city and/or county (or other
governmental unit, except State taxes) for doing business in city and/or county
must be recorded in this cost center.
(iii) Standard Unit of Measure: none
required; not applicable.
(9) 8870 INTEREST-SHORT-TERM
(i) Function. This cost center is used to
record all interest incurred on borrowings for working capital
purposes.
(ii) Description. This
cost center contains the interest expense relating to borrowings for hospital
operations. Interest incurred on mortgage notes and other borrowings for the
acquisition of equipment must not be included in this cost center.
(iii) Standard Unit of Measure: none
required; not applicable.
(10) 8880 INTEREST-LONG-TERM
(i) Function. This cost center contains all
interest incurred on capital, mortgages and other loans for the acquisition of
property, plant and equipment.
(ii)
Description. This cost center contains all interest expense incurred on
capital, mortgages and other loans for the acquisition of property, plant and
equipment. This includes the interest on the current portion of long-term
debt.
(iii) Standard Unit of
Measure: none required; not applicable.
(g)
Holding Accounts
[3287]
(1)
8991 CENTRAL PATIENT TRANSPORTATION
(i)
Function. Central Patient Transportation is the transporting of patients
between services in and about the hospital. This does not include the
transportation of patients to the hospital.
This holding cost center is provided for those
hospitals wishing to identify the cost of this service. However, all costs in
this cost center must be transferred to the appropriate Ancillary Services cost
center for reporting purposes.
(ii) Description. This cost center shall
contain the direct expenses incurred in Central Patient Transportation only if
there is an established Central Patient Transportation cost center. Included as
direct expenses are: salaries and wages, employee benefits, professional fees
supplies, purchased services, other direct expenses and transfers. These costs
shall then be reclassified to Ancillary Services cost centers. See section 1619
for a further discussion.
(iii)
Standard Unit of Measure. No unit of measure is prescribed since this cost
center must have a zero balance for reporting purposes.
(2) 8992 NURSING FLOAT PERSONNEL
(i) Function. To record the expenses of
nursing personnel who work in more than one cost center on a "float"
basis.
(ii) Description. The
expenses of nursing personnel who work in more than one cost center on a
"float" basis must be reported in the cost center in which they work. This may
be done directly or may be recorded originally in this account and distributed
(preferably at the end of each payroll period) to using cost centers based upon
hours worked in each cost center. Any expenses attributable to nursing float
personnel, including on-call and paid time-off, must be distributed based upon
actual hours worked by the individual nurses during the applicable payroll
period. Scheduling and other administrative functions relative to float
personnel are considered costs of nursing administration.
(iii) Standard Unit of Measure. No unit of
measure is prescribed since this cost center must have a zero balance for
reporting purposes.
(3)
8993 EMPLOYEE BENEFITS-PAYROLL-RELATED
(i)
Function. This cost center may be used to record all employee benefits and
other benefits which can be specifically identified as belonging to a
particular cost center. This cost center is provided for those hospitals
wishing to identify the cost of this service. However, all costs in this cost
center must be closed out for reporting purposes to the other functional cost
centers.
(ii) Description. Included
in Employee Benefits-Payroll-Related are such costs as FICA, SUI, vacation,
holiday and sick leave, group health insurance, group life insurance, pension
and retirement, and workers' compensation insurance.
(iii) Standard Unit of Measure. No unit of
measure is prescribed since this cost center must have a zero balance for
reporting purposes.
