Current through Register Vol. 46, No. 39, September 25, 2024
[3300]
(a)
General.
(1) The fifth and sixth digits of the
hospital's expense accounts are used to record the Natural Classification of
Expense. There are nine major account classification categories with
subaccounts. The required level of reporting for the natural classification of
expense is the major natural account classification categories ending in zero,
except for salaries and wages. Salaries and wages subaccounts must be reported.
While the reporting of the remaining subaccounts is not required, they are
recommended to achieve greater uniformity in accounting and
reporting.
(2) The major categories
are as follows:
.00-.19 Salaries and Wages
.20-.29 Employee Benefits
.30-.39 Professional Fees
.40-.49 Medical and Surgical Supplies
.50-.59 Non-Medical and Non-Surgical Supplies
.60-.69 Utilities
.70-.79 Purchased Services
.80-.89 Other Direct Expense
.90-.97 Depreciation/Rent/Transfers
(3) A hospital desiring a more detailed
identification of expenses may at its option use an additional digit or digits
to obtain the desired detail.
(b)
.00, .10 Salaries and Wages.
[3310]
(1) Salaries and wages and
full-time equivalent (FTE) employees must be reported by 12 sub-classification
of salaries and wages for both paid employees and nonpaid workers. The hospital
is required to report salaries and wages and paid FTE's for all personnel whose
compensation is included on the payroll, including exempt personnel, and for
nonpaid workers. FTE's are computed by dividing total paid hours by 2080. Paid
hours include both worked and nonworked hours for which employees are
compensated.
(2) Overtime hours are
hours for which an overtime pay rate is used. The actual overtime hours are not
treated differently from regular worked hours; it is the rate that
changes.
(3) On-call and/or standby
pay is compensation to an employee for being available to work. During that
period when the employee is on call or on standby, he might or might not
actually perform work. The Fair Labor Standards Act differentiates between
restricted and unrestricted on-call situations. All restricted on-call hours
are compensable and contribute to the total hours used for determining overtime
pay. Unrestricted on-call hours do not contribute to total hours, but
unrestricted on-call compensation does contribute to the salary base used for
calculating overtime premiums only. Thus all restricted on-call hours must be
accounted for, but only those hours worked need be accounted for when employees
are on unrestricted on-call duty.
(4) In those instances where the hospital has
a policy to pay for a minimum number of hours whenever an employee is called
back to work, and the employee works less than the minimum number of hours, the
worked time recorded will include only the number of hours actually worked. For
example, a four-hour minimum is guaranteed; the employee works two hours and
returns home. The hospital will record only two hours as worked time.
(5) Salaries and wages are defined as (i) all
remuneration, payable in cash, for services performed by an employee for the
hospital, and (ii) the fair market value of donated services when there is the
equivalent of an employer-employee relationship. The value of donated services
may be evidenced by a contractual relationship which may provide the basis for
valuation. If persons donating the services are not paid (or are paid less than
fair market value of their services), the lay-equivalent salaries (or the
difference between lay-equivalent salaries and salaries paid) must be reported
as expense with the offsetting amount reported as nonoperating revenue in
account 9030, Donated Services. Do not include services rendered by persons
such as candy stripers unless the hospital would actually hire someone to
perform such services. Reimbursement of independent contractors such as private
duty nurses must be excluded.
(6)
The classifications of salaries and wages are defined below. See Part 445 of
this Article for a list of job titles and the natural classification to which
assigned.
(i) .01 Management and Supervision.
Employees included in this classification are primarily involved in the
direction, supervision and coordination of hospital activities. Usually
included here are job titles such as Administrator, Manager, Department Head,
Supervisor, Director and Foreman.
(ii) .02 Technician and Specialist. Employees
included in this classification usually perform activities of a creative or
complex nature. Includes such job titles as Coordinator, Technologist,
Technician, Therapist, Instructor and Accountant. These employees are often
licensed or registered. Some of these positions are exempt from Federal wage
and hour laws as administrative or professional. Lead positions of Chief, Head,
etc. must be classified as Management and Supervision (.01) if they provide
direct supervision of five or more other employees.
(iii) .03 Registered Nurses. This
classification includes only Registered Nurses employed in the performance of
direct nursing care to patients. Registered Nurses performing supervisory
functions must be classified as Management and Supervision (.01). Those
functioning as instructors and coordinators must be classified as Technical
(.02). Lead nurses must be classified as Management and Supervision (.01) if
they provide direct supervision of five or more other employees.
(iv) .04 Licensed Vocational (Practical)
Nurses. This classification includes Licensed Vocational (Practical) Nurses
employed in the performance of direct nursing care to patients. Those Licensed
Vocational (Practical) Nurses not providing direct patient care should be
classified as Technical (.02).
(v)
.05 Aides, Orderlies and Attendants. Included in this classification are
nontechnical personnel employed for providing direct nursing care to patients.
Included are job titles such as aide, orderly and nurse assistant. These
employees are subject to Federal wage and hour laws.
(vi) .06 Physicians. Include in this
classification all salaries paid to physicians. This employee must possess a
Doctor of Medicine or Doctor of Osteopathy degree and be licensed to practice
medicine. Include physicians as Management and Supervision (.01) if they
provide direct supervision to five or more other employees.
(vii) .07 Dentists. Include in this
classification all salaries paid to dentists. This employee must possess a
doctoral degree in dentistry and be licensed to practice dentistry. Include
dentists as Management and Supervision (.01) if they provide direct supervision
to five or more other employees.
(viii) .08 Resident and Fellow. Employees
included in this classification are employed for consulting, diagnosing,
prescribing and providing treatment for patients. Also included would be
stipends paid to residents, which would be reported only in the Postgraduate
Medical Education-Approved Teaching Program (account 8240) or Postgraduate
Medical Education-Non-Approved Teaching Program (account 8250).
(ix) .09 Non-Physician Medical Practitioners.
Employees included in this classification are employed to consult, diagnose,
prescribe and treat patients under the direction of, or in consultation and
collaboration with a physician. Includes such job titles as nurse practitioner,
physician's assistant, licensed midwife or medic.
(x) .11 Environment, Hotel, and Food Service
Employees. This classification includes personnel employed in providing basic
services related to food and accommodations. They perform routine work of a
non-technical nature and are subject to Federal wage and hour laws. Examples of
job titles are maintenance man, housekeeping aide, cooks' helper, flatwork
finisher, guard, food service worker, wall washer, and wash person.
(xi) .12 Clerical and Other Administrative
Employees. Included in this classification are non-technical personnel employed
in the performance of recordkeeping, communication and other administrative
functions. Examples of job titles are accounting clerk, admitting clerk,
messenger, keypunch operator, secretary, telephone operator, clerk-typist,
cashier and receptionist. These employees are subject to Federal wage and hour
laws.
(xii) .19 Other Employee
Classifications. This classification includes personnel not included in the job
classes described above.
(c)
Employee Benefits. [3320]
(1) The following employee benefits are to be
included as direct costs of all cost centers whose employees received such
benefits:
(i) .21 FICA.
(ii) .22 SUI and FUI. These classifications
are charged with the employer's portion of the Social Security tax, State
Unemployment Insurance, and Federal Unemployment Insurance.
(iii) .23 Group Health Insurance
(iv) .24 Group Life Insurance
(v) .25 Pension and Retirement
(vi) .26 Workers' Compensation
Insurance
(vii) .27 Union Health
and Welfare
(viii) .28 Other
Payroll-Related Employee Benefits
(ix) .29 Employee Benefits
(Non-Payroll-Related)
(2)
Classifications.23 -.28 are to be charged with the cost of employee benefits
specified by the respective account titles. Classification.29,
non-payroll-related employee benefits, are to be reported in the Employee
Benefits-Non-Payroll-Related cost center (account 8830).
(d)
Professional Fees. [3330]
(1) Fees and other amounts (almost
exclusively labor- related expense) paid for professional services of people
who are not on the hospital payroll include the following classifications:
physicians, therapists and other medical non-physician personnel (such as
registry nurses), consulting and management fees, legal fees, audit fees,
accounting fees and other professional fees. Management Fees paid to related
organizations are to be reported as Purchased Services in the appropriate
functional cost centers.
(2) .31
Medical-Physicians. Include in this classification all fees paid to physicians.
See section 1680 (Physician Remuneration).
(3) .32 Medical-Therapists and Other
Non-Physicians. This classification is charged with amounts paid to medical
personnel, other than physicians, not on the payroll, such as registered
physical therapists and registry nurses.
(4) .33 Consulting and Management Fees. This
classification is charged with amounts paid to consultants and management firms
when such consultants and firms are not a related organization. Amounts paid to
related organizations are charged to natural classification "Management and
Contracted Services" (.76).
(5) .34
Legal Fees.
.35 Audit Fees.
.39 Other Fees.
These classifications are to be charged with the amount
of legal fees, audit fees, and other fees not included
elsewhere.
(e)
.40 MEDICAL AND SURGICAL SUPPLIES. [3340]
(1) The following classifications are used to
record the costs of the various types of medical and surgical supplies used by
a hospital. The fair market value of donated supplies is charged to these
classifications if the commodity otherwise would be purchased by the hospital,
An offsetting credit is made to "Donated Commodities" (account 5760).
(2) .41 Prostheses. The cost of replacements
for parts of the body, and substitutes or aids to permanently impaired
functions of the body, is charged to this classification. This includes such
items as artificial limbs and eyes, dentures, bone plates, permanent braces,
eyeglasses, implanted pacemakers, corrective footwear, etc. Also included are
components used in the assembling and fitting of such items.
(3) .42 Surgical Supplies-General. The cost
of sutures, surgical needles, surgical packs and sheets and all other surgical
supplies not described elsewhere is charged to this classification.
(4) .43 Anesthetic Materials. This
classification should be charged with the cost of gaseous and volatile agents
used in inhalation anesthesia such as cyclopropane, fluothane, halothane,
nitrous oxide, ether and chloroform.
(5) .44 Oxygen and Other Medical Gases. The
cost of gases, other than anesthesia gases, used in treatment of patients, such
as oxygen and carbon dioxide mixtures, should be charged to this
classification. Oxygen used to drive equipment such as fog generators and
atomizers should be also charged here.
(6) .45 I.V. Solutions
.46 Pharmaceuticals
.47 Radioactive Materials
.48 Radiology Films
.49 Other Medical Care Materials and Supplies
These classifications (.45 -.49) should be charged with
the cost of I.V. solutions, pharmaceutical supplies, radioactive materials,
radiology films, and other medical care materials and supplies,
respectively.
(f)
.50 NON-MEDICAL AND NON-SURGICAL SUPPLIES [3350]
(1) .51 Food-Meats, Fish and Poultry
.52 Food-Other
Food purchased for dietary, kitchen or the cafeteria
should be charged to these classifications.
(2)
.53 Tableware and Kitchen Utensils
.54 Linen and Bedding
.55 Cleaning Supplies
.56 Office and Administrative Supplies
.57 Employee Wearing Apparel
These classifications should be charged with the cost
of tableware and kitchen utensils, linen and bedding, cleaning supplies, office
and administrative supplies, and employee wearing apparel
(3) .58 Instruments and Minor Equipment.
The cost of minor equipment, as previously defined in
section 1385, is charged to this classification.
(4) .59 Other Non-Medical and Non-Surgical
Supplies.
This classification should be charged with the cost of
non-medical and non-surgical supplies not included elsewhere. Included here is
the cost of miscellaneous supplies used for the personal care of
patients.
(g) .60
UTILITIES [3360] .61 Electricity
.62 Fuel
.63 Water
.64 Disposal Service
.65 Telephone/Telegraph
.66 Purchased Steam
.67 Utilities-Other
All utilities except Telephone/Telegraph are to be
charged to Plant Operations and Maintenance (account 8410).
(h) .70 PURCHASED SERVICES [3370] .71 Medical
.72 Maintenance and Repairs
.73 Medical School Contracts
.74 Laundry and Linen
.75 Data Processing
.76 Management and Contracted Services
.77 Collection Agency
.78 Transcription Services
.79 Other Purchased Services
These classifications should be used to record the
costs of purchased services. For instance, if the laboratory function is
purchased outside the hospital, the expense would be charged to
classification.71-Medical in Laboratory Services-Clinical (account 7210) or
Laboratory Services-Pathological (account 7230), as appropriate. Medical School
Contracts natural classification would only appear in the Education cost
centers. The Management and Contracted Services Account (.76) is to include
only fees paid to related organizations. Include expenses incurred for
temporary help services in classification.79, Other Purchased
Services.
(i) .80 OTHER
DIRECT EXPENSES. [3380] .81 Insurance
82 Interest
.83 Licenses and Taxes (Other than on Income)
.84 Dues, Books and Subscriptions
.85 Outside Training Sessions (including Travel)
.86 Travel-Other
.87 Postage
.88 Printing and Duplicating
.89 Other Expenses
Other direct expenses such as those indicated above are
included in these classifications.
(j) .90 DEPRECIATION/RENT [3390] .91
Depreciation and Amortization-Buildings and Building Improvements
.92 Depreciation-Fixed Equipment
.93 Depreciation-Movable Equipment
.94 Depreciation and Amortization-Land Improvements and
Other
.95 Lease/Rentals-Buildings, Improvements and Fixed
Equipment
.96 Lease/Rentals-Movable Equipment
.97 Lease/Rentals-Other
(k)
Interdepartmental transfers of
direct expense..
In order to maintain the integrity of the Natural
Classifications, all transfers of direct expenses to cost centers must be
debited and credited to the appropriate Natural Classification within the cost
center expense accounts. The effect of this entry is the same as if the initial
charge was incorrect and the cost center is then
charged.
