Title: Section 444.23 - Natural classification of expense
NATURAL CLASSIFICATION OF EXPENSE
444.23 Natural classification of expense. (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
.70-.79 Purchased Services
.80-.89 Other Direct Expense
(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 non-technical 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
.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
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)
.64 Disposal Service
.66 Purchased Steam
All utilities except Telephone/Telegraph are to be charged to Plant Operations and Maintenance (account 8410).
(h) .70 PURCHASED SERVICES (3370)
.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)
.83 Licenses and Taxes (Other than on Income)
.84 Dues, Books and Subscriptions
.85 Outside Training Sessions (including Travel)
.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
(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 correct cost center is then charged.
VOLUME C (Title 10)