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Accounting Rules Changes for Patient Service Revenue, Bad Debts and the Allowance for Doubtful Accounts

By Mike Rowe, CPA, Audit Partner

Accounting Standards Update (ASU) No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities was issued in July and requires health care entities to (1) present the provision for doubtful accounts as a deduction from patient service revenue in the statement of operations, rather than as an operating expense, and (2) provide enhanced disclosures concerning their policies for recognizing revenue and assessing bad debts. 

Governmental hospitals already record the provision for bad debts as a reduction of revenues. Non-governmental hospitals currently reflect the provision for bad debts as an operating expense.
ASU No. 2011-07 will result in non-governmental hospitals reflecting the provision for bad debts in a manner consistent with the existing method for governmental hospitals.

Following is a discussion of the principal amendments to the FASB Codification resulting from ASU No. 2011-07.
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FASB ASC 954-605, Health Care Entities – Revenue Recognition

FASB ASC 954-605-45 has been amended to require entities that recognize significant amounts of patient service revenue at the time services are entered without consideration of patients’ ability to pay to present the following as separate line items on the face of the statement of operations.

• Patient service revenue (net of contractual
  allowances and discounts).
• The provision for bad debts.
• The resulting net patient service revenue.

FASB ASC 954-605-50 has been amended to require health care entities to disclose the following information by major payor source of revenue:

• The entity’s policy for assessing collectibility in
  determining the timing and amount of patient
  service revenue recognized as bad debts.
• The amount of patient service revenue (net of
  contractual allowances and discounts) before
  taking into account the provision for bad debts.
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FASB ASC 954-310, Health Care Entities – Receivables

FASB ASC 954-310-50 has been amended to require the following disclosures:

• By major payor revenue source, the entity’s policy
  for assessing the timing and amount of
  uncollectible patient service revenue recognized as
  bad debts by major payor source; note that such
  identified sources should be consistent with the
  way in which the entity manages its business
  (e.g., how it assesses credit risk).

• Qualitative and quantitative information about
  significant changes in the allowance for doubtful
  accounts relating to patient accounts receivable;
  such information could include significant changes
  in estimates and underlying assumptions,
  the amount of self-pay write-offs, the amount of
  third-party payor write-offs, and other unusual
  transactions.

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Effective Date

For non-public entities, the amendments are effective for the first annual period ending after December 15, 2012, with early adoption permitted. The presentation of the provision for bad debts relating to patient service revenue in the statement of operations should be applied retrospectively to all periods presented. The new disclosures should be made for the period of adoption and subsequent reporting periods (i.e., comparative disclosures are not required for periods before initial adoption).

Questions?

If reading this article gave you more questions than it answered, please contact us and we'd be glad to help you understand what it all means for your healthcare entity.


 

Mike Rowe, CPA, Audit PartnerClick Here for Mike's bio.


Healthcare Accounting Services

Our healthcare industry professionals have significant experience serving healthcare organizations of all sizes in Colorado Springs and throughout Colorado, including urban and rural acute care hospitals, outpatient surgery centers, medical clinics, physician groups and managed care providers.

To learn more about the Healthcare Accounting Services offered by Stockman Kast Ryan + Co., please Click Here.


If you have any questions, feel free to call us at (719) 630-1186 or use our Secure Email.

 

 stockman kast & ryan co.

SKR+Co Nonprofit Newsletter
Summer 2011

8 tips for running a valid accountable plan

If you’re like many nonprofits, you probably have an accountable plan for employee business expense reimbursements. If you don’t, you’re at risk for having to add reimbursements to your employees’ wages for income tax and Social Security tax purposes. But do you have the necessary policies and procedures in place to comply with IRS requirements? Here are eight tips for making sure that your plan is beyond reproach.
  

 

When is income taxable?

Your 501(c)(3) organization generally is required to pay tax on income that isn’t related to its main purpose — even if that income keeps the not-for-profit afloat. This unrelated business income (UBI) is something to watch closely, because if your nonprofit is ever audited, the IRS will likely scrutinize your records to see whether you’ve accurately reported UBI.

Full Article

 

The ins and outs of obtaining financing

If your nonprofit needs to finance a project or program, you may be discouraged by reports that credit is still tight. But if you understand the choices available to you, your chances of securing financing will grow.

Full Article

 

 Newsbit: Executive directors in transit

About two-thirds (67%) of the not-for-profit executive directors who participated in the Daring to Lead 2011 study, sponsored by the Meyer Foundation and CompassPoint Nonprofit Services, said they plan to leave their current jobs within five years. The percentage was somewhat lower than in the prerecession 2006 study, in which 75% of participating executive directors said they’d leave their position within that five-year period.

Meet our Nonprofit Specialists

Steve Hochstetter, CPA, CVA, Audit Partner

Jeff Talus, CPA, Tax Partner


Our Nonprofit Services

Stockman Kast Ryan + CO Not-for-Profit services include:

•  Tax preparation
•  Audits and reviews of
   Financial Statements
•  Compliance audits with
   OMB Circular A-133
•  Cash flow projections
   and other consulting
   services
•  UBIT (Unrelated
   Business Income Tax)
   consulting
•  Internal control reviews
•  Bookkeeping


For more information about any of our nonprofit services, please contact us at (719) 630-1186 or through our Secure Email:

The ins and outs of obtaining financing

If your nonprofit needs to finance a project or program, you may be discouraged by reports that credit is still tight. But if you understand the choices available to you, your chances of securing financing will grow.

Lines of credit and term loans differ

Bank financing generally comes in two basic forms: line of credit or term loan. Your nonprofit’s underlying cash needs will determine which one you should pursue.

A line of credit is a negotiated amount of financing you can draw against as needed. When the goal is to smooth out cash flows over the year, it’s usually the best option. The maximum amount is available to you, but you use only what you need.

If you obtain a $200,000 credit line, for example, you may use up to the $200,000 limit. Once the line has been paid down to $180,000, you again have $20,000 available to borrow. You can continue this draw-down and repayment cycle until the credit line’s term expires. (But check with your lending officer, because some banks are terminating unused lines of credit.)

Required monthly payments may be limited to interest expense, while principal payments can be made any time cash flow permits. So you have flexibility in how much you repay each month.

When you obtain a term loan, you receive a lump sum, usually for a specific purchase. The term loan application process is usually more complicated, and approval typically takes more time. Repayment is in installments, which means you’ll make equal monthly payments consisting of interest and principal throughout the entire loan term.

Bond rates are often attractive

An alternative to a traditional bank line of credit or loan is a tax-exempt bond issued by a municipal, county or state government. The interest payments to investors aren’t subject to federal income tax and may be exempt from state and local income tax.

Tax-exempt bond financing may benefit your nonprofit because tax-exempt interest rates are generally two to three percentage points lower than on money raised from other sources. The Internal Revenue Code allows a nonprofit to use the proceeds, which are borrowed from the issuer, to further the organization’s stated charitable purpose.

The first step in planning a bond issue is to identify which local government unit has the ability to issue bonds on a nonprofit’s behalf. This unit (the issuer) then lends the bond proceeds to you.

The next step is selecting a team of specialists to work out the mechanics of the bond issue, including a bond counsel who’ll draft the documents and deliver an opinion. An underwriter advises on the bond issue’s structure and then buys the bonds from the issuer and offers them to investors.

Tax-exempt bonds make the most sense for larger capital investments. Although interest payments over the bond’s term can be significantly lower than on a term loan, the up-front legal and other fees can be substantial.

Also consider that the process may take longer due to more stringent financial disclosure requirements and tighter scrutiny overall. While a line of credit or term loan can be approved in a matter of weeks, bond financing can take six months to a year before the funds are received.

Do the advance work

In any economy — whether credit is tight or plentiful — a smart nonprofit will research and weigh its options carefully before seeking financing. Your CPA can assist you in preparing the financial documentation, such as a multiyear cash flow projection and a project budget, which you likely will need to secure financing.