Chapter 19 – NOT-FOR-PROFIT ENTITIES
19-2
One of the more difficult points for students to learn is the revenue recognition process
for a hospital’s general fund. Operating revenue is obtained from patient services or
patient-related services. Operating revenue also includes the fair value of donated supplies. The
value of donated services is recorded in accordance with ASC 958. The fair value of donated
services may be recognized as a contribution revenue, together with a corresponding expense, if
the services received (a) create or enhance nonfinancial assets, or (b) require specialized skills,
are provided by individuals possessing those skills, and would typically need to be purchased if
not provided by donation. Donated medical supplies are typically recorded as a contribution
revenue. Donated property and equipment are usually recorded in the plant fund until the assets
are placed into service at which time they are transferred to the general fund.
The general fund of a hospital includes investments, plant assets, and long-term debt.
Depreciation must be recognized in the general fund for the plant assets.
Not-for-profit hospitals prepare the following financial statements: (1) a balance sheet,
(2) a statement of operations (which shows a performance indicator that includes both operating
income and other income available for operations), (3) a statement of changes in net assets
(which shows the changes in each of the three net assets categories), and (4) a statement of cash
flows. The balance sheet must clearly distinguish between the three classes of net assets:
permanently restricted net assets, temporarily restricted net assets, and unrestricted net assets.
The statement of operations reports income and expenses available for operations above the
performance indicator line (often termed as the Excess of Revenues and other Support over
Expenses and Other Items), while the change in the fair value of nontrading securities and net
assets released from restrictions for acquisition of property, plant, or equipment, are shown
below the performance indicator line.
Accounting for investments is based on the type of hospital. Profit-seeking hospitals use
ASC 320 to account for their investments. Not-for-profit hospitals use ASC 958, which requires
fair value accounting and reporting of the investments. Governmental health-care organizations
use GASB 31 to account for their investments.
Voluntary Health and Welfare Organizations (VHWO) include organizations such as the
American Cancer Association, the March of Dimes, and the Red Cross. The illustration in the
chapter is adapted from the AICPA’s 1995 audit guide for Not-for-Profit Organizations, with the
financial statements prepared in accordance with ASC 958.
Larger VHWOs typically use a fund structure that normally includes both unrestricted
and restricted current funds; a current unrestricted fund, a current restricted fund, a land,
buildings, and equipment fund, and an endowment fund. VHWOs must use the accrual system
of accounting to record the full cost of offering services. VHWOs often obtain pledges which
must be recorded in accordance with ASC 958. Unconditional pledges are recognized as revenue
in the period in which the pledge is made. Conditional pledges are recognized as revenue only
when the condition has been removed. In addition, a sufficient allowance for uncollectible
pledges should be recognized. Pledges expected to be received in future years should be recorded
at their present value and an interest component should be recognized for each period on the
uncollected pledges.