Abstract: With the strengthening of the audit work of the auditing organization, more and more hospital financial income and expenditure is included in the audit focus. In recent years, through the audit of the hospital, exposed in the financial income and expenditure in the existence of many violations of discipline.
Keywords: financial income and expenditure; audit; case; analysis
With the strengthening of the audit work of the audit institutions, more and more hospitals are included in the audit focus on financial income and expenditure. In recent years, through the audit of the hospital, exposed in the financial income and expenditure there are many violations of discipline. In order to establish and improve the internal accounting management system of hospitals, fully implement accounting laws, regulations and systems, and ensure that the accounting work is carried out in an orderly manner, the author has collected the Audit Report and Audit Decision of the auditing organization in the form of case analysis, pointing out the seriousness and harmfulness of irregularities in the financial income and expenditure and proposing improvement measures, which can help to promote the establishment of legal concepts by the accounting personnel and to strengthen the financial income and expenditure management, and protect the safety and integrity of hospital property.
1 hospital revenue lack of integrity hospital revenue is the main compensation channel for medical consumption, complete reflection of the full picture of hospital revenue, not only directly reflect the value of labor created by health care workers and the implementation of financial subsidy policies, but also to ensure the accuracy of financial results. However, the hospital revenue accounts of the mutilation and incompleteness in the hospital has a certain degree of universality.
Case 1: a hospital in 2002 to organize the opening ceremony of the second part of the sponsorship fees collected 414,000 yuan included in the "other accounts payable" account. In 2005, the collection of medical equipment clinical observation fee and drug clinical observation fee 799,000 yuan is also accounted for in the "other accounts payable" account.
Case 2: a hospital attached to the College of Traditional Chinese Medicine will be allocated by the provincial health department of the excellent Chinese medicine personnel research fees 26.0 million yuan and received housing rental fees 410,000 yuan, recorded in the "other accounts payable" account.
Case 3: A tertiary hospital collected 4.259 million yuan of organ transplantation fees, internship fees and continuing education and training fees in 2004-2005, which were hidden in the "other accounts payable" account.
Case 4: The second hospital attached to a medical college transferred 213,000 yuan of income from the collection of medical record booklets to the "other accounts payable" account.
Case 5: A provincial people's hospital transferred the funds allocated by the provincial health department for the key clinical medical specialties program to the "other accounts payable" account.
The above irregularities, the audit department in accordance with the "Chinese people's *** and the State Audit Implementation Regulations," ordered it to flush or adjust the relevant accounting entries. Analysis: The above irregularities are the result of confusing the boundaries between revenue and debt in accounting. Hospital revenue refers to the operating income obtained by the hospital in carrying out its business activities and non-reimbursable funds obtained from engaging in other activities, as well as subsidized funds obtained from the financial and competent authorities [1]. Liabilities are debts incurred by the hospital that can be measured in monetary terms and need to be repaid with assets or services. Its criterion for drawing the line between the two is to determine whether the source of funds is non-reimbursable or needs to be reimbursed. Where the hospital is engaged in other activities after the acquisition of funds, as well as financial and competent authorities to allocate funds do not require the hospital to return in installments should be accounted for in the income account; where the external units to invest in funds need to be returned to the hospital on a regular basis, it should be reflected in the liabilities of the account. Because the auditing organization is to audit the financial income and expenditure of the hospital in the previous year or the previous years, the accounts and financial accounts have been sealed, can not be adjusted in the current year's accounts, according to the current "Hospital Accounting System", can be adjusted to the "business fund" account. Improvement measures: require the relevant hospital accounting staff to study the "Hospital Accounting System", carefully grasp the concept and scope of hospital income, standardized accounting.
2 cost expenditure scope of confusion caused by the distortion of the cost of the economic substance of the cost of the decision of the cost of economic management has a very important role. Cost is a measure of compensation for medical activities, is an important factor in the development of medical service prices, but also to carry out the prerequisites for competition in the medical market. It is the basic task of cost accounting to carry out cost accounting correctly and provide true and useful cost information. In the audit practice, found two very different distortions of the cost of accounting methods --- poor economic efficiency of the hospital, in order to create performance for the dean, by all means should be included in the cost of the expenses outside, resulting in false cost reduction, false increase in profits; economic efficiency of the hospital, worried about the end of the year Better economic efficiency hospitals, worrying about the end of the year, too much balance of income and expenditure, affecting the approval of the financial subsidy targets for the coming year, through a variety of means, to expand the scope of cost expenditures, resulting in false increase in costs and false decrease in profits.
Case 6: a hospital in the previous year to buy heating coal 4.429 million yuan in the current account, not timely amortized into the cost. Investment of 4.01 million yuan of science and technology companies, the company has been dissolved and its investment can not be recovered, long-term accounts in the "other receivables". Analysis: In accordance with the provisions of the Regulations for the Implementation of the Budget Law of the People's Republic of China, the government financial departments, departments and units at the end of each year, should be cleaned up and verified throughout the year budget revenues, expenditure figures and transactions, and to do a good job of reconciling the final figures, shall not be transferred from the current year's revenues and expenditures to the next year's revenues and expenditures [2]. The cost of winter heating coal purchased by the hospital shall be accounted for under the "Amortized Costs" account, and shall be amortized to the cost in monthly installments during the heating period. Funds invested in a bankrupt company should be reported to the Ministry of Health and the Ministry of Finance for write-off based on an investigation of the situation. Carry forward the expenditure to the next year or long-term non-expenditure, is clearly a violation of the "People's Republic of China *** and the State Budget Law Implementation Regulations".
Case 7: there are two hospitals will be purchased at a unit price of less than 10.0 million yuan of fixed assets 4.038 million yuan and 1.538 million yuan, directly included in the "medical expenditures" account. Analysis: This accounting method violates the provisions of the Hospital Accounting System. According to the regulations, all constitute the standard fixed assets, its acquisition costs must be special funds in the repair and purchase fund, otherwise it will form a duplication of expenditure. This is because when fixed assets are acquired, they are included in the cost once, and at the end of the month, when the repair fund is withdrawn, they are again included in the cost. The same economic matters, twice included in the cost, will result in inflated costs, the hospital accounting staff to correctly delineate the boundaries of the normal expenditure and earmarked fund expenditure, correctly grasp the source of funds for the purchase of fixed assets channel.
Case 8: a hospital in 2005 withheld 2004 has been settled heating costs ① Huazhong University of Science and Technology, Wuhan, 4300749.7 million yuan, in 2004, 1.40 million yuan of withholding pension fund, actually paid 423,000 yuan, the difference did not offset the expenditure. Analysis: Errors are likely to occur between the withholding costs and the actual costs incurred, but after the accounting event, they must be included in the costs in accordance with the actual costs, and their excess should be offset against the expenditure, and the shortfall should be supplemented by the withholding costs, or else it will result in a false increase or decrease in the costs. It seems that it is very important to clean up the "withholding expenses" at the end of each year.
Case 9: a hospital purchased a respirator and other equipment, according to the use of 1 year of life over 3.642 million yuan of repair funds. Analysis: According to the "Hospital Accounting System" provides that medical equipment according to the annual method of withdrawal of the repair fund; the State Ministry of Finance and the Ministry of Health, medical equipment, the use of the life of between 5 to 10 years. The hospital extracted all the value of medical equipment in one year, which is a rapid depreciation method and is bound to increase the medical cost of that year. The accounting staff should be proficient in the prescribed useful life of medical equipment and calculate an accurate rate of withdrawal of funds for repairs and purchases. The state makes medical equipment purchase funds gradually transferred to the cost of medical services with its wear and tear, to prevent the medical cost of abnormally high and abnormally low.
Case 10: a hospital at the end of 2005 to withdraw 56,000 yuan of bad debt reserves. Analysis: According to the principle of prudent accounting, the hospital set up a "bad debt reserve" account, the essence of the bad debt reserve system is to anticipate the possibility of bad debt losses, prior to withdrawing from the cost of bad debt losses in order to prepare for write-offs. Currently, the hospital medical fees, some of which can not be recovered, such as not required to withdraw bad debt provision, once the bad debt, there is no reliable source of funds to write off.
3 non-independent accounting institutions are not included in the budget management hospitals organized by the non-independent accounting branch of the income and expenditure is part of the hospital's financial income and expenditure must be included in the budget management, should be combined with the hospital to prepare financial reports. The purpose of this provision of the Hospital Financial System is to reflect the concepts of "large income" and "large expenditure" and to comprehensively reflect the full picture of hospital income and expenditure. In the financial revenue and expenditure management activities, some hospitals only accounting for the hospital's financial income and expenditure, but not the hospital organized by the non-independent accounting branch of the income and expenditure of the hospital into the hospital's financial accounting, unified management, and consolidated preparation of financial reports, so that the hospital's financial income and expenditure loss of completeness.
Case 11: a medical university hospital will belong to the "ophthalmology magazine" income of 1.194 million yuan, expenditure of 998,000 yuan, in the "other accounts payable" account, the affiliated chronic disease hospitals to obtain 3.650 million yuan of medical income is not included in the financial accounts of the unified management.
Case 12: a provincial hospital affiliated with traditional Chinese medicine to the three clinics belonging to the income of 1,730,000 yuan, expenditure of 2,180,000 yuan, not combined with the hospital to prepare financial reports.
Case 13: a large hospital does not have the legal personality of the Department of logistics services accumulated losses of 3.033 million yuan, not included in the unified financial accounting; belonging to the Institute of Cancer Research income of 1.260 million yuan, expenditure of 830,000 yuan, in the "other accounts payable" account.
Case 14: a hospital parking lot parking revenue of 74,000 yuan, managed by the security department, and part of it directly for the payment of wages of temporary workers. Analysis: the hospital did not include non-independent accounting institutions affiliated with the income and expenditure of the unified financial accounting, mainly on the "non-independent accounting" institutions and the concept of insufficient understanding of the meaning of one-sidedly that as long as the affiliated institutions in the bank to establish a separate account, set up books of accounting is independent of the accounting unit.
In fact, to determine whether the hospital branch has legal personality, independent accounting is the key standard. The General Principles of Civil Law of the People's Republic of China provides that a legal person is a civil rights and civil capacity, independent enjoyment of civil rights and civil obligations in accordance with the law. A legal person shall have the following conditions: (1) be established in accordance with law; (2) have the necessary property or funds; (3) have its own name, organization and place; and (4) be able to independently assume civil liability. Therefore, most of the branches belonging to the hospital does not have legal personality, is a non-independent accounting organization, must be included in the hospital budget management.
4 underpayment of social insurance premiums and taxes social insurance is a national mandatory insurance, tax is one of the main sources of state finance, contributing units, contributing individuals should be based on the full payment of social insurance premiums and taxes. In the audit practice, omission and underpayment of social insurance fund and personal income tax are common illegal behaviors, which seriously violate the national interests. Case 15: A hospital underpaid the medical insurance fund by 22.0 million yuan, of which the unit underpaid by 17.0 million yuan and the individual employees underpaid by 5.0 million yuan. Case 16: A hospital underpaid the social security fund by 179,000 yuan, of which 76,000 yuan was paid to the medical insurance fund, 65,000 yuan was paid to the unemployed fund, and 38,000 yuan was paid to the pension insurance fund. Case 17: A hospital's International Journal of Pediatrics omitted to pay 19,000 yuan in sales tax, surcharge and value-added tax. Case 18: A hospital failed to withhold and pay personal income tax of 10,000 yuan, and another hospital underpaid personal income tax of 38,000 yuan. Case 19: A hospital has not withheld and paid personal income tax of RMB 28.0 thousand for the subsidies for staff lunches and evening meals that were charged to the normal funds. Case 20: A tertiary hospital underpaid social insurance premiums by RMB 10.0 million in one year. The Audit Decision of the relevant department required these medical institutions to pay back the social insurance premiums and taxes in accordance with the Law of the People's Republic of China on Administration of Tax Collection and the Provisional Regulations on the Collection and Payment of Social Insurance Premiums by a deadline.
Analysis: hospitals underpay social security contributions, most out of the total wage calculation error. Because both the basic medical insurance for employees, or pension insurance and unemployment insurance is the basis for the total payroll, the total payroll undercounting, resulting in underpayment of social security contributions. There are two kinds of errors in the calculation of gross wages: First, in hospitals with poor economic efficiency, gross wages are calculated not according to the payable wages but according to the actual wages. The second is that the calculation of the gross wage takes into account only the basic wage and ignores bonuses, subsidies and allowances. There are two further factors in both cases: first, the gross wages are deliberately concealed to achieve the purpose of underpayment of social security contributions. The second is that the accounting staff lacks understanding of the policy on the composition of the gross salary, resulting in an incomplete composition of the gross salary. The solution is: hospitals should set up a global concept, effectively safeguard the national interest, accounting staff should seriously study the National Bureau of Statistics issued on January 1, 1990, "the composition of the total wage regulations," to ensure the accuracy of the calculation of the total wage. 5 capital construction and the purchase of medical equipment and drugs do not fulfill the legal procedures in the financial management, the capital should strictly fulfill the invitations to bidding and control of the scale of the construction project business processes; the purchase of medical equipment and drugs do not fulfill the legal procedures in the financial management, capital should strictly fulfill the invitations to bidding and control of the size of the construction project. In terms of financial management, capital construction should strictly comply with the business procedures for soliciting and bidding and for controlling the size of construction projects; and the acquisition of medical equipment and medicines should comply with the business procedures for government procurement and centralized bidding and purchasing of drugs. Economic matters procedures are not legal is also a disciplinary action, the hospital to bear certain legal responsibility.
Case 21: a hospital to expand the interventional ward investment of 2.3 million yuan without inviting, bidding, self-selected engineering team, unauthorized construction.
Case 22: a hospital expansion of surgical ward building plan infrastructure size of 11,849 m2, the actual construction of 13,563 m2, over-scale construction of 1,714 m2.
Case 23: a hospital expansion of outpatient clinic building, the approved budget estimate of 98,760,000 yuan, the actual completion of the investment of 15,075,000 yuan, exceeding the planned investment of 52%. Analysis: the implementation of construction projects, bidding, bidding management, help to shorten the construction period, to ensure the quality of the project, reduce the cost of the project, to achieve the benefits of investment. Provinces (municipalities and autonomous regions) in accordance with the provisions of the "Chinese People's Republic of China *** and the State Bidding Law", have formulated a "construction project bidding regulations", the general provisions of the total investment of 2.0 million yuan or a building area of more than 2,000m2 of new construction, expansion, renovation and technological transformation of construction projects must be used in the form of tenders Issuing tenders. Will be required to bidding projects into pieces or other ways to avoid bidding ordered to transform, can be fined 2% to 5% of the construction cost. In order to control the blind expansion of the scale of infrastructure projects, the State Council and the National Development and Reform Commission had three orders to put forward the requirements to control the scale of investment in fixed assets, should be strictly in accordance with the approved investment budget estimates for construction, shall not exceed [3]. For those who exceed the design estimate due to subjective reasons, the competent authorities and the main person in charge of the construction unit should be held responsible. The state project department also stipulates that when it is expected that the actual investment in the construction project will exceed the budget by 10%, the construction unit shall re-prepare the feasibility study report and apply to the project department for a supplementary total project estimate. Hospitals to strictly implement the capital investment management regulations, such as touching the "high voltage line", the unit directly responsible for the competent personnel and other directly responsible personnel shall be given sanctions in accordance with the law.
References
[1]Ministry of Finance of the People's Republic of China*** and State, Ministry of Health of the People's Republic of China*** and State. Hospital Accounting System [M]. Beijing: Finance Press, 1998: 15.
[2]Decree of the President of the People's Republic of China. Budget Law of the People's Republic of China [Z].1994.
[3]State Council. Several Provisions on Controlling the Scale of Investment in Fixed Assets [Z].1986.