N.Y. Comp. Codes R. & Regs. tit. 10 § 444.21

Current through Register Vol. 46, No. 45, November 2, 2024

Section 444.21 - Other operating expenses description

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(a)Research Expenses

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(1) 8010 RESEARCH.

(i) Function. This cost center administers, manages, and carries on research projects funded by outside donations, grants and/or the hospital. Additional activities include: Maintenance of animal house and administration of specific research projects.

(ii) Description. This cost center contains the direct expenses incurred in overseeing all research and in carrying on research in the hospital. Separate cost centers should be maintained for each research activity for which separate accounting is required, either by a grant agreement, contract, or because of restrictions made upon donations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(b)Education Expense

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(1) 8220 NURSING EDUCATION ..........................................................................................................

8221 Registered Nurses..........................................................................................................

8222 Licensed Vocational (Practical) Nurses..........................................................................................................

(i) Function. Hospitals may either operate a School of Nursing or provide the clinical training activities for student nurses when the degree is issued by a college or university. Nursing Education is a school for educating Registered Nurses and/or Licensed Vocational (Practical) Nurses. Additional activities include, but are not limited to, the following:

Selecting qualified nursing students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling of students regarding professional, personal and educational problems; selecting faculty personnel; assigning and supervising students in giving nursing care to selected patients; and administering aptitude and other tests for counseling and selection purposes.

(ii) Description. This cost center shall be used to record the direct expenses incurred in, or providing clinical facilities for, the education of Registered Nurses and/or Licensed Vocational (Practical) Nurses. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: number of FTE nursing students. The number of FTE nursing students in the Nursing Education cost center is defined as the sum of the percentage of time each student nurse is enrolled in the school during the year divided by 100.

(iv) Data source. The number of FTE nursing students in this educational program shall be the actual count maintained by the Nursing Education cost center.

(2) 8240 POSTGRADUATE MEDICAL EDUCATION-APPROVED PRIMARY TEACHING PROGRAM-INTERNAL MEDICINE ..........................................................................................................

8250 POSTGRADUATE MEDICAL EDUCATION-APPROVED PRIMARY TEACHING PROGRAM-FAMILY PRACTICE..........................................................................................................

8260 POSTGRADUATE MEDICAL EDUCATION-APPROVED PRIMARY TEACHING PROGRAM-PEDIATRICS..........................................................................................................

8270 POSTGRADUATE MEDICAL EDUCATION-OTHER APPROVED TEACHING PROGRAMS..........................................................................................................

(i) Function. A Postgraduate Medical Education Teaching Program provides an organized program of postgraduate medical clinical education to interns and residents. To be approved, a medical internship or residency training program must be approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. Intern or residency programs in the field of dentistry in a hospital or osteopathic hospital must have the approval of the Council on Dental Education of the American Dental Association. Additional activities include, but are not limited to, the following:

(ii) Description. This cost center shall be used to record the direct expenses incurred in providing an approved organized program of postgraduate medical clinical education. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. All salaries and stipends paid to interns and residents in approved teaching programs must be reflected in this cost center, in the "Salaries and Wages" natural expense classification (.07).

(iii) Standard Unit of Measure: number of FTE students. The number of FTE students in Postgraduate Medical Education Approved programs is defined as the sum of the percentage of time each student is enrolled in such programs during the year divided by 100.

(iv) Data source. The number of FTE students in these educational programs shall be the actual count maintained in each such program.

(v) Effective dates. For the reporting of accounts 8240 through 8270, relative to approved teaching programs, cost reporting periods beginning on or after January 1, 1981. The Standard Unit of Measure (FTE students) for accounts 8240 through 8260 must be collected beginning July 1, 1981. For cost reporting periods beginning in 1980, report all Approved Postgraduate Medical Education programs (including the Standard Unit of Measure) under account 8270.

(3) 8280 POSTGRADUATE MEDICAL EDUCATION-NON-APPROVED TEACHING PROGRAM

(i) Function. A Postgraduate Medical Education program provides an organized program of postgraduate medical clinical education to interns and residents. To be non-approved means that a medical internship or residency training program is not approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, is not approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. Intern or residency programs in the field of dentistry in a hospital or osteopathic hospital are non-approved unless the approval of the Council on Dental Education of the American Dental Association has been received. Additional activities include, but are not limited to, the following:

(ii) Description. This cost center shall be used to record the direct expenses incurred in providing an organized program of postgraduate medical clinical education. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. All salaries or stipends paid to interns and residents in non-approved teaching programs must be reflected in this cost center, in the "Salaries and Wages" natural expense classification (.07).

(iii) Standard Unit of Measure: number of FTE students. The number of FTE students in Postgraduate Medical Education Non-Approved programs is defined as the sum of the percentage of time each student is enrolled in such programs during the year divided by 100.

(iv) Data source. The number of FTE students in these educational programs shall be the actual count maintained by each such program.

(4) 8290 OTHER HEALTH PROFESSION EDUCATION ..........................................................................................................

8291 School of Medical Technology..........................................................................................................

8292 School of X-Ray Technology..........................................................................................................

8293 School of Respiratory Therapy..........................................................................................................

8294 Administrative Intern Program..........................................................................................................

8295 Medical Records Librarian Program..........................................................................................................

(i) Function. Other Health Profession Education is the provision of organized programs of medical clinical education other than for nurses (RN and LVN) and doctors, and the provision of organized education programs for administrative interns and externs, Medical Records Librarians, and other health professionals. Additional activities include, but are not limited to, the following:

Selecting qualified students; providing education in theory and practice conforming to approved standards; maintaining student personnel records; counseling of students regarding professional, personal and educational problems; selecting faculty personnel; assigning and supervising students in giving medical care to selected patients; and administering aptitude and other tests for counseling and selection purposes.

(ii) Description. These cost centers contain the direct expenses relative to operating health education programs other than nursing and postgraduate medical programs, such as a School of Medical Technology, School of X-Ray Technology, School of Respiratory Therapy, and other non-inservice education programs such as those listed above. A separate cost center should be established for each program. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: number of FTE students. The number of FTE students in Other Health Profession Education programs is defined as the sum of the percentage of time each student is enrolled in an Other Health Profession Education Program during the year divided by 100.

(iv) Data source. The number of FTE students in such programs shall be the actual count maintained by each such program.

(c)General Services.

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(1) 8310 DIETARY SERVICES

(i) Function. Dietary Services includes the procurement, storage, processing and delivery of food and nourishments to patients in compliance with Public Health regulations and physicians' orders. Additional activities include, but are not limited to, the following:

Nutritional assessment;

Teaching patients and their families nutrition and modified diet requirements; determining patient food preferences as to type and method of preparation; preparing selective menus for various specific diet requirements; preparing or recommending a diet manual, approved by the medical staff, for use by physicians and nurses; and delivering food trays to, and collecting food trays from, patient service areas for meals and nourishments; and incidental activities such as cleaning up of spills in preparing food.

(ii) Description. This cost center contains the direct expenses incurred in preparing food for patients and delivering food to patient service areas. Infant formula must be reported in the using cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. Also included is Dietary Service's share of common costs of the Non-Patient Food Service and Dietary Services cost centers.

Examples of common costs include: salaries of cooks who prepare food for both cost centers, common food costs, common minor equipment costs, if expensed, common administrative costs, etc. These common costs shall be distributed to the Dietary and Non-Patient Food Service cost centers, based upon the ratio of number of meals served in each cost center. A detailed explanation of the method to be used in computing the number of nonpatient meals served by the Non-Patient Food Service cost center is included in the explanation of the Non-Patient Food Service Standard Unit of Measure.

(iii) Standard Unit of Measure: number of patient meals. Count only regularly scheduled meals (3-meal schedules only) and exclude snacks and fruit juices served between regularly scheduled meals. Also excluded are tube feedings and infant formula.

(iv) Data source. The number of patient meals must be the actual count of patient meals maintained by the Dietary cost center.

(2) 8320 NON-PATIENT FOOD SERVICE

(i) Function. Non-Patient Food Service includes the procurement, storage, processing and delivery of food to employees and other nonpatients in compliance with Public Health regulations.

(ii) Description. This cost center contains all directly identifiable expenses incurred in preparing and delivering food to employees and other nonpatients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. Also included is the Non-Patient Food Service's share of common costs of the Non-Patient Food Service and Dietary Services cost centers. The cost of edible supplies for vending machines serviced by the health facility must be included in this cost center. Vending machine revenue is to be included in other operating revenue account 5820 (Vending Machine Commissions).

(iii) Standard Unit of Measure: equivalent number of meals served. To obtain an equivalent meal in a pay cafeteria, divide total Non-Patient Food Service revenue by the average selling price of a full meal. The average full meal should include meat, potato, vegetable, salad, beverage and dessert. When there is a selection of entrees, desserts and so forth, that are available at different prices, use an average in calculating the selling price of a full meal. Count a free meal served as a full meal.

(iv) Data source. Non-Patient Food Service revenue must be taken from the general ledger.

(3) 8330 LAUNDRY AND LINEN

(i) Function. Laundry and Linen activities include picking up, storing, issuing, mending, washing, distributing and processing of in-service linens. The services include uniforms, special linens and disposable linen substitutes.

(ii) Description. This cost center shall contain the direct expenses incurred in providing laundry and linen services for hospital use, including student, nonpaid worker, and employee quarters. Cost of disposable linen must be recorded in this cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: number of dry and clean pounds processed. Record the weight of linen processed (laundered and dried) plus the equivalent weight of disposable linen substitutes used. Linen is weighed after it has been cleaned and processed. Include uniforms and linen from personnel quarters and employee housing. If linen is not weighed, a conversion from pieces to pounds is allowed. If soiled linen is weighed, divide by 1.1.

(iv) Data source. The number of dry and clean pounds processed (laundered and dried) must be taken from actual counts maintained in the Laundry and Linen cost center. If the hospital uses an outside laundry service, the number of dry and clean pounds processed must be maintained and reported.

(4) 8350 SOCIAL SERVICES

(i) Function. The Social Work Services cost center obtains, analyzes, and interprets psychosocial, environmental and economic information to assist in diagnosis, treatment and rehabilitation of patients. These services include: counseling of patients and families in individual and group units; collaboration with health care staff; mobilizing resources on behalf of patients both within a given hospital and in various agencies outside the hospital; and participation in the development of social and health programs in the community. Other tasks involve collecting and revising information on community health and welfare resources, departmental management and being accountable to responsible external organizations. Major activities include but are not limited to: screening, which is the process whereby a determination is made concerning the necessity for further professional assessment and services; assessment (including family members or significant others), which is the explication of a patient's problem or problems and the initial determination of a course of action for resolving the problem or problems; and the provision of problem-focused services (such as dealing with psychosocial problems as they relate to a patient's health and/or hospitalization, and arranging for post-discharge care of patients), which are directed toward the resolution of identified problems.

(ii) Description. This cost center contains the direct expenses incurred in providing social services to patients. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(5) 8360 HOUSING ..........................................................................................................

8361 Employee Housing..........................................................................................................

8362 Nonpaid Worker Housing..........................................................................................................

8363 Student Housing..........................................................................................................

(i) Function. Housing is the provision of living quarters to hospital employees and nonpaid workers; and maintenance of residences for students, including interns and residents, participating in education programs carried on by the hospital.

(ii) Description. This cost center shall contain the direct expenses incurred in providing living quarters for hospital employees, nonpaid workers, and students involved in educational programs carried on by the hospital. Expenses of on-call rooms shall be included in this cost center only if they are not directly identifiable to another cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: average number of persons housed. Record the number of days each person is in the facility. Accumulate the monthly totals and divide by 12 to obtain the average number of persons housed.

(iv) Data source. The average number of persons housed shall be determined from the record of employees housed maintained in the Housing cost center.

(6) 8410 PLANT OPERATIONS AND MAINTENANCE ..........................................................................................................

8410 Plant Operations..........................................................................................................

8412 Plant Maintenance..........................................................................................................

8413 Grounds..........................................................................................................

(i) Function. Plant Operations and Maintenance includes the maintenance and service of utility systems such as heat, light, water, air conditioning and air treatment; the maintenance and repair of buildings, parking facilities, and equipment; painting; elevator maintenance; vehicle maintenance; performance of minor renovation of buildings and equipment; and maintenance of grounds of the institution, such as landscaped and paved areas, streets on the property, sidewalks, fenced areas and fencing, external recreation areas, and parking facilities. Additional activities include, but are not restricted to, the following:

Trash disposal; boiler operation and maintenance; service and maintenance of water treatment facilities, drainage systems and utility transmission systems. Including all maintenance performed under contract; technical assistance on equipment purchases and installation; coordinating construction; establishing priorities for repairs and utility projects.

(ii) Description. This cost center shall contain the direct expenses incurred in the operation and maintenance of the hospital plant and equipment except the maintenance, repair and renovation of renal dialysis equipment used for Home Dialysis for which the hospital has been 100 percent reimbursed by Medicare. Such costs must be reported in the Home Program Dialysis Equipment-100 Percent cost center (account 6810). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, utilities (except telephone and telegraph), other direct expenses and transfers.

(iii) Standard Unit of Measure: number of gross square feet. Gross square feet is defined as the total interior floor area of the hospital facility, including common areas (hallways, stairways, elevators, lobbies, closets, etc.), measured to the center of interior walls.

(iv) Data source. The number of gross square feet shall be taken from current blueprints of the hospital facility, or from actual measurement if blueprints are not available.

(v) Expiration date. This cost center will be replaced by account 8400 (Plant Maintenance) and account 8410 (Plant Operation) effective with cost reporting periods beginning in 1982.

(7) 8400 PLANT MAINTENANCE ..........................................................................................................

(i) Description. Maintenance and repair of buildings, grounds and fixed equipment; painting; vehicle operation (except operation of ambulances) and maintenance; care of grounds; and performance of minor renovations of buildings, fixed equipment, grounds, drainage systems and utility transmission systems, including all such maintenance performed under contract. Also included are expenses associated with technical assistance on equipment purchases and installations; coordinating construction; establishing priorities for repairs and utility projects; and operation, service and repair of parking lots. Exclude the costs of maintenance, repair and renovation of renal dialysis equipment used for Home Dialysis for which the hospital has been 100 percent reimbursed by Medicare. Such costs must be reported in the Home Program Dialysis Equipment-100 Percent cost center (account 6810). Examples of job titles include chief engineer, stationary engineer, carpenter, plumber, electrician, painter, dispatcher, driver, groundskeeper, plasterer, parking lot attendant, guard, mechanic, electromedical equipment repairman, clerk and secretary.

(ii) Standard Unit of Measure: gross square feet. Gross square feetis defined as the total interior floor area of the hospital facility, including common areas.

(iii) Data source. Square feet shall be determined from the blueprints of the hospital facility, or actual measurement if blueprints are not available.

(iv) Effective date. Cost reporting periods beginning 1982 and thereafter.

(8) 8410 PLANT OPERATION ..........................................................................................................

(i) Description. Maintenance and service of utilities, such as heat, light, water, air conditioning and air treatment; trash disposal; hourly operation and maintenance; service and maintenance of water treatment facilities and drainage systems. Examples of job titles include: director of plant operations, foreman, elevator operator, tool crib operator, incinerator and mechanic. This cost center also includes the direct expense of utilities such as: electricity, natural gas, liquid propane or butane gas, oil coal, purchased steam and hot water and water and sewage. Telephone and telegraph service are not considered utilities but are included in the Hospital Administration cost center (account 8610).

(ii) Standard Unit of Measure: gross square feet. Gross square feetis defined as the total interior floor area of the hospital facility, including common areas.

(iii) Data source. Square feet shall be determined from the blueprints of the hospital facility, or actual measurement if blueprints are not available.

(iv) Effective date. Cost reporting periods beginning in 1982 and thereafter.

(9) 8430 SECURITY

(i) Function. The Security cost center maintains the safety and well-being of hospital patients, personnel and visitors, and protects the hospital's facilities.

(ii) Description. This cost center shall include the direct expenses incurred maintaining the safety and well-being of hospital patients, employees, visitors, and protection of the hospital facilities. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(10) 8440 PARKING

(i) Function. Parking includes the provision of parking facilities to patients, physicians, employees and visitors.

(ii) Description. This cost center shall contain the direct expenses of parking facilities owned and/or operated by the hospital. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(11) 8450 HOUSEKEEPING

(i) Function. This cost center is responsible for the care and cleaning of the interior physical plant, including the care (washing, waxing, stripping) of floors, walls, ceilings, partitions, windows (inside and outside), furniture (stripping, disinfecting and making beds upon discharge), fixtures (excluding equipment) and furnishings and emptying of room trash containers, as well as the costs of similar services purchased from outside organizations

(ii) Description. This cost center shall contain the direct expenses incurred for maintaining general cleanliness and sanitation throughout the hospital and other areas serviced (such as student and employee quarters). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: number of square feet serviced. Square feet serviced is the interior floor area routinely serviced by housekeeping personnel.

(iv) Data source. The number of square feet serviced by the housekeeping unit should be taken from blueprints of the hospital and other buildings serviced (such as student and employee quarters), or from actual measurement if no blueprints are available.

(12) 8460 CENTRAL SERVICES AND SUPPLIES

(i) Function. Central Services and Supplies prepares and issues medical and surgical supplies and equipment to patients and to other cost centers. Additional activities include, but are not limited to, the following:

Requisitioning and issuing of appropriate supply items required for patient care; preparing sterile irrigating solutions; collecting, assembling, sterilizing and redistributing reusable items; cleaning, assembling, maintaining and issuing portable apparatuses.

(ii) Description. This cost center contains the direct expenses incurred in preparing and issuing medical and surgical supplies and equipment to other cost centers and to patients. Also included is the expense related to reusable patient-chargeable items. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. The invoice/inventory cost of nonchargeable supplies and equipment issued to other cost centers shall be reported in the using cost centers. The invoice/inventory cost of chargeable medical and surgical supplies shall be reported in the Medical Supplies Sold cost center (account 7110). The invoice/inventory cost of durable medical equipment leased and rented must be reported in the Durable Medical Equipment Leased/Rented cost center (account 7140).

(iii) Standard Unit of Measure: none required; not applicable.

(13) 8470 PHARMACY

(i) Function. The Pharmacy procures, preserves, stores, compounds, manufactures, packages, controls, assays, dispenses, and distributes medications (including I.V. solutions and blood derivatives, except packed red cells) for inpatients and outpatients under the jurisdiction of a licensed pharmacist. Pharmacy services include maintaining separate stocks of commonly used items in designated areas. Additional activities include, but are not limited to, the following:

Development and maintenance of formulary(ies) established by the medical staff; consultation and advice to medical staff and nursing staff on drug therapy; adding drugs to I.V. solutions; determining incompatibility of drug combinations; stocking floor drugs and dispensing machines; preparing patient medication histories; monitoring drug therapy; counseling patients; making patient rounds.

(ii) Description. This cost center contains the direct expenses incurred in maintaining a pharmacy under the jurisdiction of a licensed pharmacist. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses. The invoice cost of nonchargeable pharmaceuticals, I.V. solutions and blood derivatives issued to other cost centers shall be transferred to the using cost centers. The invoice cost of chargeable pharmaceuticals, I.V. solutions and blood derivatives shall be transferred to the Drugs Sold cost center (account 7150).

(iii) Standard Unit of Measure: none required; not applicable.

(d)Fiscal Services

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(1) 8510 GENERAL ACCOUNTING

(i) Function. This cost center performs general accounting (i.e.,nonpatient billing and accounting) activities of the hospital, such as the preparation of ledgers, budgets and financial reports, payroll accounting, accounts payable accounting, plant and equipment accounting, inventory accounting, nonpatient accounts receivable accounting (tuition, sales to other institutions), etc.

(ii) Description. This cost center shall include the direct expenses incurred in providing the general accounting requirements of the hospital, and in providing other fiscal services not related to patient accounting activities. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(2) 8520 PATIENT ACCOUNTS, ADMITTING, AND REGISTRATION

8521 Patient Accounting..........................................................................................................

8522 Credit and Collection..........................................................................................................

8523 Cashiering..........................................................................................................

8524 Inpatient Admitting..........................................................................................................

8525 Emergency Room Registration..........................................................................................................

8526 Clinic Registration..........................................................................................................

8527 Referred Ambulatory Registration..........................................................................................................

8528 Other Outpatient Registration..........................................................................................................

(i) Function. The processing of patient charges, including processing charges to patients' accounts, preparing claims, extending credit, collecting accounts receivable, cashiering, and other patient-related billing and accounting activities, is handled by this cost center. Additional activities include interviewing patients and others relative to the extension of credit, checking references and using outside collection agencies.

The admitting of inpatients for hospital services, including filling out admission forms, scheduling admission times, accompanying patients to room or service areas after admission and arrangement of admission details, is performed by this cost center. All outpatient registration activities are also included here, including emergency, clinic, and referred patients.

(ii) Description. This cost center shall include the direct expenses incurred in patient-related credit, billing and accounting activities; inpatient admitting; and outpatient activities registration. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(iv) Effective date. Commencing with cost reporting periods beginning in 1982, this cost center will be replaced by Patient Accounts (account 8520), Admitting (account 8530), and Registration (account 8540).

(3) 8520 PATIENT ACCOUNTS ..........................................................................................................

8521 Patient Accounting..........................................................................................................

8522 Credit and Collection..........................................................................................................

8523 Cashiering..........................................................................................................

(i) Description. The processing of patient charges, including posting charges to patients' accounts, preparing claims, extending credit, collecting accounts receivable, cashiering, and other patient-related billing and accounting activities, is handled by this cost center. Additional activities include interviewing patients and others relative to the extension of credit, checking references and using of outside collection agencies.

(ii) Standard Unit of Measure: none required. Consideration is being given to the development of a SUM for this cost center.

(iii) Effective date. Cost reporting periods beginning in 1982.

(4) 8530 ADMITTING..........................................................................................................

(i) Function. The admitting of inpatients for hospital services, including filling out admission forms, scheduling admission times, accompanying patients to room or service areas after admission, and arrangement of admission details, is performed by this cost center.

(ii) Description. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.

(iii) Standard Unit of Measure: none required. Consideration is being given to the development of a SUM for this cost center.

(iv) Effective date. Cost reporting periods beginning in 1982.

(5) 8540 REGISTRATION ..........................................................................................................

8541 Emergency Room Registration..........................................................................................................

8542 Clinic Registration..........................................................................................................

8543 Referred Ambulatory Registration..........................................................................................................

8549 Other Outpatient Registration..........................................................................................................

(i) Function. the registration of hospital outpatients, including filling out registration forms, scheduling of appointments, accompanying patients to room or service areas after registration, and arrangment of registration details, is performed by this cost center.

(ii) Description. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, and other direct expenses.

(iii) Standard Unit of Measure: none required. Consideration is being given to the development of a S.U.M. for this cost center.

(iv) Effective date. Cost reporting periods beginning in 1982.

(e)Administrative Services

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(1) 8610 HOSPITAL ADMINISTRATION ..........................................................................................................

8611 Office of Hospital Administrator..........................................................................................................

8612 Governing Board..........................................................................................................

8613 Public Relations..........................................................................................................

8614 Spiritual Care..........................................................................................................

8615 Communications..........................................................................................................

8616 Personnel..........................................................................................................

8617 Management Engineering..........................................................................................................

8618 Health Sciences Library..........................................................................................................

8619 Auxiliary Groups..........................................................................................................

8621 Data Processing..........................................................................................................

(i) Function. Hospital Administration performs overall management and administration of the institution. This function also includes the following activities: public relations, spiritual care, communications, personnel, management engineering, health sciences library, auxiliary groups, and data processing. The functions of cost centers 8615 through 8621 are described on the following pages.

(ii) Description. This cost center contains the direct expenses associated with the overall management and administration of the institution, including those of the Governing Board. The expenses associated with furnishing information for public use in maintaining the hospital's position in the community must be included here. The expenses associated with spiritual care (chaplaincy), communications, personnel, management engineering, health sciences library, and auxiliary groups must be included here. Care should be taken to ascertain that all costs included in this cost center do not properly belong in a different cost center. For example, expenses chargeable to hospital administration do not include legal fees incurred in connection with the purchase of property (which should be capitalized), nor fund raising costs which should be included in Fund Raising (account 8780). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(2) 8615 COMMUNICATIONS

(i) Function. The Communications cost center operates the communications systems within and outside the hospital, including the telephone system, radio and telemetry communications systems, public address systems, closed-circuit television, messenger services and mail processing.

(iii) Description. This cost center shall include the direct expenses incurred in carrying on communications (both in and out of the hospital), including the telephone switchboard and related telephone services, messenger activities, internal information systems and mail services. Specific expenses include postage and telephone company charges for equipment and monthly services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(3) 8616 PERSONNEL

(i) Function. Personnel provides adequate staffing of hospital departments and maintains employee satisfaction and morale. Activities include recruitment, employee selection, salary and wage administration, employee health services, fringe benefit program administration, and procurement of temporary help (including fees paid to temporary help agencies).

(ii) Description. This cost center shall be used to record the direct expenses incurred in carrying out the personnel function of the hospital. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(4) 8617 MANAGEMENT ENGINEERING

(i) Function. Management Engineering is an administrative service which assists hospital administrators in performing their managerial functions by providing specialized knowledge and skill in the mathematical, physical and social sciences, together with the principles and methods of engineering analysis, development and implementation. Management Engineering performs a wide variety of services, including but not limited to the following: productivity analysis and improvement; cost containment; planning and control procedures; systems analysis and design; facilities layout; computer science; operations research.

(ii) Description. This cost center contains the direct expenses incurred by the management engineering function. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(5) 8618 HEALTH SCIENCES LIBRARY

(i) Function. The Health Sciences Library procures, stores, indexes, classifies, annotates and abstracts books, catalogs, journals and other related published materials principally for medical staff use and reviews library records for completeness and compliance with established standards.

(ii) Description. This cost center contains the direct expenses incurred in maintaining health sciences library. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(6) 8619 AUXILIARY GROUPS

(i) Function. Costs incurred in connection with hospital-related auxiliary groups, including coordinator of auxiliary group activities and special meetings of auxiliary groups conducted by the hospital, are maintained in this cost center.

(ii) Description. This cost center contains the direct expenses incurred in connection with hospital auxiliary or volunteer groups. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(7) 8621 DATA PROCESSING

(i) Function. The Data Processing cost center performs the operation of the hospital's electronic data processing system, including keypunching of input, storage and safeguarding of data, operating data processing equipment, data processing job scheduling, distributing output and identifying and solving hardware and software problems.

(ii) Description. This cost center shall contain the costs incurred in operating an electronic data processing center. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. Expenses incurred in the operation of terminals of the EDP center throughout the hospital shall be included in the Data Processing cost center. However, outside service bureau costs directly chargeable to a specific cost center shall be included in that specific cost center in the "Purchased Services-Data Processing" natural classification (.75). Outside service bureau costs benefiting more than one cost center shall be included in the Data Processing cost center. All data processing expenses not directly charged to the using cost centers must be distributed, for reporting purposes, to individual cost centers. The only expense remaining in this cost center is the expense related to data processing service provided to outside organizations. The related revenue is to be reported in account 5620, Data Processing Services Revenue.

(8) 8690 PURCHASING AND STORES

(i) Function. Purchasing and Stores includes the procuring of supplies, equipment and services necessary to hospital operations, the receipt of supplies and materials from vendors and their routing and distribution to specific using areas, and the receipt and central storage of all non-pharmaceutical supplies and materials prior to their issue to using departments. Additional activities include, but are not limited to, the following:

Receipt and processing of requisitions; monitoring of perpetual supply items; obtaining of quotes from selected vendors; and monitoring of receipt of supplies.

(ii) Description. This cost center shall contain the direct expenses incurred in procuring supplies, equipment and services necessary to hospital operations. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(9) 8710 MEDICAL RECORDS

(i) Function. Medical Records includes the maintenance of a records system for the use, transportation, retrieval, storage and disposal of patient medical records; and the production of indexes, abstracts and statistics for hospital management and medical staff uses. This function also includes tumor registry activities.

(ii) Description. This cost center contains the direct expenses incurred in maintaining the medical records function. Also, costs associated with microfilming of medical records shall be included in this account. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: number of inpatient discharges and number of outpatient visits. The number of inpatient discharges should exclude routine newborns (those newborn who are discharged with the mother). The number of outpatient visits should exclude referred ambulatory and sold services visits.

(iv) Data source. The number of visits shall be the actual count maintained in the Ambulatory Services cost centers, excluding referred ambulatory and sold services visits. The number of discharges shall be the actual count maintained by Medical Records

(10) 8720 MEDICAL STAFF ADMINISTRATION

(i) Function. This cost center is used to record certain general expenses associated with medical staff administration, such as the salary and related expenses of the Chief of the Medical Staff and assigned non-physician employees.

(ii) Description. This cost center contains the direct expenses associated with medical staff administration (as described above). Interns' and residents' salaries (or stipends) must not be included here, but rather in the Postgraduate Medical Education-Approved Teaching Program (account 8240) or Postgraduate Medical Education-Non-Approved Teaching Program (account 8250) cost center, as appropriate. Compensation paid to physicians (other than Chief of the Medical Staff) must not be included here, but rather in the cost center where the physicians' services are rendered. Included as direct expenses are: salaries and wages, employee benefits, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required, not applicable.

(11) 8730 MEDICAL STAFF SERVICES

(i) Function. This cost center is used to report the professional component expenses associated with services to hospital patients provided by hospital-based physicians.

(ii) Description. This cost center contains the professional component expenses associated with hospital-based physicians. Interns' and residents' salaries (or stipends) must not be included here but rather in the Postgraduate Medical Education-Approved Teaching Program (account 8240) or Postgraduate Medical Education-Non-Approved Teaching Program (account 8250) as appropriate.

(12) 8740 MEDICAL CARE REVIEW ..........................................................................................................

8741 PSRO..........................................................................................................

8749 Other Medical Care Review..........................................................................................................

(i) Function. This cost center conducts ongoing evaluation of the quality of care given and includes periodic review of the utilization of the bed facilities, and of the diagnostic, nursing and therapeutic resources of the hospital, with respect to both the availability of these resources to all patients in accordance with their medical need and the recognition of the medical practitioner's responsibility for the costs of health care. This review should cover necessity of admission, length of stay, level of care, quality of care, utilization of ancillary services, professional services furnished, effectiveness of discharge planning and the availability and alternate use of out-of-hospital facilities and services. Three review programs may be included in the Medical Care Review cost center: pre-admission screening, concurrent review (including admission certification and continued stay review) and retrospective medical care evaluation studies. The review committee should include medical staff, hospital administration, nurses and home health planners.

(ii) Description. This cost center shall contain the costs incurred in providing peer review, quality assurance, utilization review, professional standards review and medical care evaluation functions. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: number of inpatient discharges (exclude newborn). The number of inpatient discharges should exclude routine newborns (those newborn who are discharged with the mother). Also exclude intrahouse transfers.

(iv) Data source. The number of inpatient discharges shall be the actual count maintained by the Admitting Office.

(13) 8750 NURSING ADMINISTRATION ..........................................................................................................

8751 Inservice Education-Nursing..........................................................................................................

8759 Nursing Administration-Other..........................................................................................................

(i) Function. Nursing Administration performs the administration and supervision of the nursing function in the hospital, including scheduling and transfer of nurses among the services and units, nursing staff supervision, evaluation and discipline. This cost center also includes continuing education of hospital-employed nursing personnel (i.e., RNs, LVNs, aides and orderlies), including regularly scheduled classes, in-house seminars and special training sessions.

(ii) Description. This cost center shall contain the direct expenses associated with nursing administration and with conducting a nursing inservice education program. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers. Supervisors assigned to specific cost centers shall be included in those cost centers on a direct basis.

The salaries, wages and fringe benefits paid float personnel shall be recorded in the cost center in which they work. This may be done directly, or they may be recorded originally in the Float Nursing Personnel cost center (account 8992) and distributed (preferably at the end of each payroll period) to using cost centers based upon hours worked. If the latter method is used, all salaries, wages and fringe benefits of float personnel must be transferred out of the Float Nursing Personnel cost center. Any idle time would be allocated together with actual hours worked. Scheduling and other administrative functions relative to float nursing personnel are considered costs of Nursing Administration.

If hospital employees work part-time in the inservice education program and part-time in other nursing activities, their salaries, wages and fringe benefits shall be separated based upon number of hours spent in each activity and distributed to the appropriate cost centers, preferably after each payroll period. This cost center shall not include costs related to inservice student time. These costs must remain in the cost center in which the student works.

(iii) Standard Unit of Measure: weighted average daily census. The weighted average census is calculated as follows: (inpatient days [exclude newborns] + 1/4 emergency room visits + 1/3 all other outpatient visits) + number of days in the year.

(iv) Data source. General accounting and statistical records (daily census, emergency room log, clinic registration log, etc.).

(14) 8760 MEDICAL PHOTOGRAPHY AND ILLUSTRATION

(i) Function. This cost center provides medical photography and illustration services for other cost centers of the hospital.

(ii) Description. This cost center shall include the direct expenses incurred in providing medical photography and illustration services. Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(15) 8780 FUND RAISING

(i) Function. Fund Raising carries on fund-raising activities such as special luncheons and other meetings and special mailings.

(ii) Description. This cost center contains the direct expenses associated with fund raising (both restricted and unrestricted). Included as direct expenses are: salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.

(iii) Standard Unit of Measure: none required; not applicable.

(f)Unassigned Expenses

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(1) 8810 DEPRECIATION AND AMORTIZATION-FIXED ASSETS ..........................................................................................................

8811 Land Improvements..........................................................................................................

8812 Buildings and Improvements..........................................................................................................

8813 Leasehold Improvements..........................................................................................................

8814 Fixed Equipment..........................................................................................................

Intangibles..........................................................................................................

(i) Function. Depreciation and Amortization is a cost center for recording depreciation and amortization expenses on land improvements, buildings and improvements, leasehold improvements, fixed equipment and intangibles.

(ii) Description. This cost center contains depreciation and amortization expense on land improvements, buildings and improvements, leasehold improvements, fixed equipment, and intangibles. All such expenses must remain in this cost center.

(iii) Standard Unit of Measure: none required; not applicable.

(2) 8815 LEASES AND RENTALS-FIXED ASSETS..........................................................................................................

8816 Land..........................................................................................................

8817 Buildings and Improvements..........................................................................................................

8818 Fixed Equipment..........................................................................................................

(i) Function. Leases and Rentals is a center for the recording of leases and rental expenses on land, buildings and improvements, and fixed equipment.

(ii) Description. This cost center contains all lease and rental expenses relating to land, buildings and improvements, and fixed equipment. All such expenses must remain in this cost center.

(iii) Standard Unit of Measure: none required; not applicable.

(3) 8820 DEPRECIATION AND AMORTIZATION-MOVABLE EQUIPMENT ..........................................................................................................

(i) Function. Depreciation and Amortization-Movable Equipment is a cost center for recording depreciation and amortization expenses on movable equipment. All such expenses must be reported in this cost center.

(ii) Effective Date. Cost reporting periods beginning in 1980.

(4) 8825 LEASES AND RENTALS-MOVABLE EQUIPMENT ..........................................................................................................

(i) Function. Leases and Rentals-Movable Equipment is a cost center for recording lease and rent expense on movable equipment. All such expenses must be reported in this cost center.

(ii) Effective date. Cost reporting periods beginning in 1980.

(5) 8830 EMPLOYEE BENEFITS-NON-PAYROLL-RELATED ..........................................................................................................

(i) Description. This cost center must be used to report all non-payroll-related employee benefits. Included in non-payroll-related employee benefits are such costs as personal education, recreation and cultural activities, and day care.

(ii) Standard Unit of Measure: FTE employees. To calculate the number of full-time equivalent employees, sum all hours for which employees were paid (whether worked or not) during the year and divide by 2080.

(iii) Data source. Payroll records.

(iv) Effective date. Cost reporting periods beginning in 1980.

(6) 8840

INSURANCE-HOSPITAL AND PROFESSIONAL MALPRACTICE

(i) Function. This cost center is used to record all hospital and professional malpractice insurance expenses.

(ii) Description. This cost center is used to report all hospital and professional malpractice insurance expenses incurred in maintaining hospital and professional liability insurance policies. Also included is the self-insurance expense related to malpractice claims.

(iii) Standard Unit of Measure: none required; not applicable.

(7) 8850 INSURANCE-OTHER

(i) Function. This cost center is used to record all insurance expenses except those insurance expenses which are required in the Account Distribution Index (see chapter IV of this manual), to be charged to specific cost centers.

(ii) Description. This cost center is used to record all insurance expenses incurred in maintaining all insurance policies except professional and hospital malpractice insurance and employee benefit insurance. For example, fire, theft, employee fidelity bonds, liability (non-professional), property damage, auto, boiler, and business interruption insurance expense would be included here. Also included is the expense associated with self-insurance of such losses.

(iii) Standard Unit of Measure: none required; not applicable.

(8) 8860 LICENSES AND TAXES (OTHER THAN INCOME TAXES)

(i) Function. This cost center is used to record all business license expenses incidental to the operation of the hospital, all other license expense, and all taxes (other than on income).

(ii) Description. This cost center contains the business license expense, other license expense (including unassigned permits) and tax expense which are incidental to the operation of the hospital. Fees paid to a city and/or county (or other governmental unit, except State taxes) for doing business in city and/or county must be recorded in this cost center.

(iii) Standard Unit of Measure: none required; not applicable.

(9) 8870 INTEREST-SHORT-TERM

(i) Function. This cost center is used to record all interest incurred on borrowings for working capital purposes.

(ii) Description. This cost center contains the interest expense relating to borrowings for hospital operations. Interest incurred on mortgage notes and other borrowings for the acquisition of equipment must not be included in this cost center.

(iii) Standard Unit of Measure: none required; not applicable.

(10) 8880 INTEREST-LONG-TERM

(i) Function. This cost center contains all interest incurred on capital, mortgages and other loans for the acquisition of property, plant and equipment.

(ii) Description. This cost center contains all interest expense incurred on capital, mortgages and other loans for the acquisition of property, plant and equipment. This includes the interest on the current portion of long-term debt.

(iii) Standard Unit of Measure: none required; not applicable.

(g)Holding Accounts

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(1) 8991 CENTRAL PATIENT TRANSPORTATION

(i) Function. Central Patient Transportation is the transporting of patients between services in and about the hospital. This does not include the transportation of patients to the hospital.

This holding cost center is provided for those hospitals wishing to identify the cost of this service. However, all costs in this cost center must be transferred to the appropriate Ancillary Services cost center for reporting purposes.

(ii) Description. This cost center shall contain the direct expenses incurred in Central Patient Transportation only if there is an established Central Patient Transportation cost center. Included as direct expenses are: salaries and wages, employee benefits, professional fees supplies, purchased services, other direct expenses and transfers. These costs shall then be reclassified to Ancillary Services cost centers. See section 1619 for a further discussion.

(iii) Standard Unit of Measure. No unit of measure is prescribed since this cost center must have a zero balance for reporting purposes.

(2) 8992 NURSING FLOAT PERSONNEL

(i) Function. To record the expenses of nursing personnel who work in more than one cost center on a "float" basis.

(ii) Description. The expenses of nursing personnel who work in more than one cost center on a "float" basis must be reported in the cost center in which they work. This may be done directly or may be recorded originally in this account and distributed (preferably at the end of each payroll period) to using cost centers based upon hours worked in each cost center. Any expenses attributable to nursing float personnel, including on-call and paid time-off, must be distributed based upon actual hours worked by the individual nurses during the applicable payroll period. Scheduling and other administrative functions relative to float personnel are considered costs of nursing administration.

(iii) Standard Unit of Measure. No unit of measure is prescribed since this cost center must have a zero balance for reporting purposes.

(3) 8993 EMPLOYEE BENEFITS-PAYROLL-RELATED

(i) Function. This cost center may be used to record all employee benefits and other benefits which can be specifically identified as belonging to a particular cost center. This cost center is provided for those hospitals wishing to identify the cost of this service. However, all costs in this cost center must be closed out for reporting purposes to the other functional cost centers.

(ii) Description. Included in Employee Benefits-Payroll-Related are such costs as FICA, SUI, vacation, holiday and sick leave, group health insurance, group life insurance, pension and retirement, and workers' compensation insurance.

(iii) Standard Unit of Measure. No unit of measure is prescribed since this cost center must have a zero balance for reporting purposes.

N.Y. Comp. Codes R. & Regs. Tit. 10 § 444.21