NATIONAL TRAINING PROGRAM

IN PUBLIC ACCOUNTING

Section 02. T4/ PHASE I

TEACHER MEMBER

Carlos Bonillo Oriana Piñ a CI 27,878,917

Section, 02.

MAY 2020.
 As any entity dedicated to a public or private service activity must conduct a
study of its costs to produce a service and generate profits, or manage a general state
budget, in the same way, both public and private hospitals must keep a record of their
daily transactions.

ANALYTICAL ACCOUNTING

This is known as a subset of Management Accounting. That is, that branch of

accounting that has as its objective the capture, measurement and assessment of
internal circulation, as well as its rationalization and control, in order to be able to
provide the organization with the necessary information for decision-making in the
management area. It should be noted that Management Accounting is called to inform
managers about the situation of the organization; in general, each of the different
centers of responsibility, in particular to control the degree of performance of each of
the centers with the help of budget control, in order to motivate and incentivize
people, doctors who can influence the results achieved by each center, and thus be
able to achieve a more efficient cost structure and in making decisions that may affect
investors, income and costs. The purpose sought with the introduction of this
accounting is not only to determine costs or to control professionals or centers and
services, but also to offer them information that supports the choices and decisions
that must be made daily. all this for the purpose of planning and control.

HOSPITAL ACCOUNTING

Analytical accounting allows us to know the cost and productivity of the

services in which the hospital is structured, identify areas of economic inefficiency
within the hospital or even within the sections themselves and, therefore, assess the
efficiency of hospital management in general. Additionally, it allows comparisons to be
made between different hospital centers or between sections of them.

PURPOSE OF HOSPITAL ACCOUNTING

The general accounting, prepared through the application of the General

Accounting Plan, has as its fundamental objective the determination of the financial
situation of the hospital and its results.

 It allows us to know to what extent each specific product or service

participates in the final result, which is essential for making correct decisions.
 It allows you to decide if a specific section (hospital) produces a certain
product or if it is more profitable to acquire it from abroad, subcontracting it
to another center. Additionally, it allows us to know if it is more profitable to
have a maintenance, repair or other type of service or acquire them externally.
 It allows you to make decisions about the replacement of machinery and know
 the repercussions that a change in manufacturing procedures or technology
has on the final product, facilitating the choice between different technologies
for carrying out tests.
 It allows you to set rates and calculate the profitability threshold, that is, the
minimum price at which you must invoice to start making profits.
 It allows for productivity analysis of each service, comparing hospitalized
statistics with the costs incurred for its production, and profitability analysis,
comparing costs with income.
 Validate whether operating and operational costs adjust to the profit margin
of the service units.

RULES THAT GOVERN IT

It is governed by external rules or rigid principles and aims to inform, in

addition to the directors, third parties, such as shareholders, creditors or public
administrations. Knowledge of the financial result and the information provided by it
is of great importance to carry out control and evaluation of the center's management.
However, this information is insufficient to ensure a detailed and accurate
appreciation of the functioning of the various activities and sections that have given
rise to this result. Consequently, other tools are needed that allow us to know at all
times what decision has to be made and that lead, as a consequence, to good hospital
management.

AREAS OF RESPONSIBILITY

Accounting requires the prioritization of the areas of responsibility, in order to

systematize the appropriate record. These areas usually include the controller,
accounting department, internal audit, Billing, plus operational departments: Cash,
Accounts Receivable, Warehouse, Accounts Payable, among others.

• Comptroller's Office: Designs and controls the establishment of accounting

policies or control procedures, based on generally accepted accounting
standards and principles appropriate to the activity.

• Accounting: Keeps a chronological and systematic record of the entity's

financial transactions in accordance with the appropriate accounting
standards and principles applicable to the entity. Likewise, it must prepare
periodic financial reports intended to present relevant and timely
information on the financial situation and operational results.

• Internal Audit: Responsible for the planning and execution of audit

examination work to evaluate performance, deviations from internal control
and suggest pertinent recommendations, through observation, inspection,
 examination, calculations, among other audit tests... The presentation of
reports on the audits carried out. Supervise all those internal control measures
that are deemed appropriate to guarantee the proper use of the assets.

• Billing: Responsible for preparing the necessary collection documents, global

or partial reconciliation of the data provided for its preparation and
management, preparing invoices, accounting documents and correspondence
to your immediate superior, reviewing invoices and documents that are
presented for payment to the institution.

INTERNAL ACCOUNTING CONTROL

To have adequate accounting control within hospitals it is necessary:

 Record transactions daily, mainly accounts receivable and accounts payable,

maintain adequate cash flow.
 Organize the flow of documents in the department in a systematic way.
 Maintain interaction with the organization's administration.
 Reconcile weekly balances to have good tax planning.
 Plan of accounts structured to the needs of the company.
 Control over insurance accounts.
 Control of inventories of medical-surgical material and medicines. This is to
avoid their loss, since in all these institutions they always tend to escape the
control of the person in charge of the warehouse.

FINANCIAL STATEMENT

As in any business or company, users of financial information need to have

sufficient elements to make decisions regarding the continuity of operations.
Therefore, like any company, the financial statements required by international
accounting standards, balance sheet, income statement, changes in equity and cash
flow must be prepared and presented. All these Financial Statements are prepared at
historical cost and are represented by adjusting them for exposure to inflation at the
request of the owners of the company. They must be presented to the Board of
Directors annually within 3 months following the closing date of the fiscal year.
economic.

SPECIAL REPORTS
 Apart from knowing the results of the Financial Statements, Management
wishes to know the results of a given period for the departments and the clinic as a
whole. To do this, statistical reports are prepared that show the following:

The cost per patient day of the total components of each department.
The cost per patient day of the Clinic's general expenses.
THE Cost per patient day of administration and office expenses.
The cost of food per meal.

BOOKKEEPING

In addition to the books required by law (Diary, Ledger and Inventories),

Hospitals and Clinics keep the following auxiliary books:

 Accounts Receivable Assistant

 Accounts Payable Assistant
 Cashier Assistant
 Banking Assistant
 Shopping assistant
 Warehouse Assistant
 Policy assistant.

The Ledgers verify the following:

 General Ledger: Contains all control accounts, balance sheet accounts,

assets, liabilities and capital, detailed income and expense accounts. The
latter are grouped by department.

 Patient Account Ledger: Contains detailed records of transactions with

patients.

 Fixed Asset Ledger: These include detailed accounts for each item of
equipment or groups of special types of supplies.

 Creditors' Ledger: It is a file of policies or vouchers or detailed

accounts of transactions with creditors (where the policy system is
not used).

 Inventories: These are detailed warehouse records, which control stocks by

groups, according to their situation.

 Payroll Record: Divided into two sections, one contains the time record and
the payroll summary (from which the distribution is made to the
departments) and the other includes the continuous record of each
 employee, with the accumulation of accrued salaries, social security
deductions and other relevant information.

In addition to the above, other records may be needed to facilitate medical

statistics to different Hospitals and Clinics. In general terms, the accounting policies
managed in Hospitals and Clinics are the same or similar to other companies, the
difference lies in some accounts that are used to record transactions.

PLAN OF ACCOUNTS

The classification is similar to that of other accounting systems:

1. Asset
2. Passive
3. Heritage
4. Income
5. Bills
6. Costs
7. Production costs
8. Debtor memorandum accounts
9. Order accounts per contra

The income accounts generated by hospitals and clinics refer to the professional
services provided and hospitalizations. Such is the case of:

o Emergency and Observation Income

o Hospitalization income
o Diagnostic Income
o Laboratory Revenue
o Income from Outpatient Consultation (rentals)

HOSPITAL COST INFORMATION SYSTEM

A system of information of costs hospital should take

into consideration the following aspects:
Budget preparation: Hospital institutions, even though they usually prepare their budgets
annually, these are prepared to comply with a government requirement to obtain financing; Its
preparation must be rethought in order to have a budget that quantitatively expresses the strategic
objectives of the hospitals. The budget is necessary to control the cost and evaluate the performance
of the people responsible for its execution in each responsibility center; it allows determining the
variationsbetweenwhatwasbudgetedandwhatwasactuallyexecuted.

Definition of the level of normal capacity: The level of normal or average

capacity is that obtained by considering the use of the institution with the
accumulation of accrued remuneration, social security deductions and other
relevant information.

COST SYSTEMS

Healthcare facilities, such as hospitals and clinics, use cost accounting

systems to determine the cost of patient care. This is a measure by which a
hospital or clinic determines the efficiency of patient care. For example,
hospital managers can determine how many patients are served for a given
budget. Information obtained from cost accounting systems for healthcare
institutions can provide data on the cost of a variety of diseases, demographic
information associated with increased treatment costs, and the cost-
effectiveness of treatments and services.

EXAMPLE OF FINANCIAL STATEMENT:

SANTA ROSA CLINIC.

Statement of income
II January 1 to December 31, 2015

Departmental Revenue Bs.900,000

(-) Cost of services 1.000
Gross operating profit Bs.800,000
(-) Operating costs 250.000
Net Operating Income Bs.550.OOH
(+ -)Other Net Income and 50.000