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1 Overview and Unique Considerations of Health Care Entities 01-13 ; Purpose 01 ; Applicability 02-06 ; Classification of Health Care Entities 07-08 ; Regulatory Environment 09-13 ; Health Care Reform 12-13 ; 2 General Auditing Considerations 01-119 ; Overview 01-02 ; An Audit of Financial Statements 03-09 ; Audit Risk 05-09 ; Terms of Engagement 10-14 ; Business Associate Agreements 14 ; Audit Planning 15-18 ; Group Audits 19-24 ; Multi-Location Audits Versus Group Audits 23 ; Complex Transactions 24 ; Materiality 25-30 ; Performance Materiality 29-30 ; Qualitative Aspects of Materiality 31-32 ; Use of Assertions in Assessment of Risks of Material Misstatement 33-34 ; Risk Assessment Procedures 35-57 ; Risk Assessment Procedures and Related Activities 37-43 ; The Entity and Its Environment 44-57 ; Additional Audit Considerations 58-99 ; Analytical Procedures 58-59 ; Accounting Estimates 60-62 ; Transactions Processed by Service Organizations 63-66 ; Compliance with Laws and Regulations 67-77 ; Going-Concern Considerations 78-92 ; Written Representations 93-99 ; Independent Auditor's Reports 100-102 ; Single Audit Act and Related Audit Considerations 103-109 ; Statutory Reporting Considerations for Health Plans 110-119 ; Risk-Based Capital Requirements 114-115 ; Deficiencies in Internal Control 116 ; Communicating Internal Control Matters in an Audit 117 ; Communications with Regulators 118-119 ; 3 Unique Financial Statement Considerations for Not-for-Profit Business-Oriented Health Care Entities 01-43 ; Complete Set of Financial Statements 02-05 ; Balance Sheet 06-08 ; Statement of Operations 09-28 ; Performance Indicator 12-17 ; Other Intermediate Subtotals 18-20 ; Discontinued Operations and Accounting Changes 21-22 ; Revenues 23-25 ; Expenses 26-28 ; Statement of Changes in Net Assets (or Equity) 29-32 ; Statement of Cash Flows 33-37 ; Notes to the Financial Statements 38 ; Subsequent Events 39-41 ; Example Financial Statements 42-43 ; 4 Cash, Cash Equivalents, and Investments 01-75 ; Cash and Cash Equivalents 01-11 ; Centralized Cash Management Arrangements 03-06 ; Cash from Restricted Donations 07 ; Other Restricted or Designated Cash Amounts 08-11 ; Investments 12-73 ; Fair Value Option 17-22 ; Investments in Debt Securities and Certain Equity Securities with a Readily Determinable Fair Value That Are Not Recorded Under the Fair Value Option 23-35 ; Investments in Certain Other Financial Instruments without a Readily Determinable Fair Value That Are Not Recorded Under the Fair Value Option 36-38 ; Investment Pools 39-47 ; Fair Value Measurements 48 ; Impairment of Investments 49-59 ; Securities Lending Activities 60 ; Transfers of Assets to an NFP or Charitable Trust for Investment 61-63 ; Regulation 64 ; Other Financial Statement Presentation Matters 65-73 ; Auditing 74-75 ; 5 Derivatives 01-44 ; Introduction 01-05 ; General Guidance 06-07 ; Accounting for Changes in Fair Value of Derivative Instruments 08-12 ; Fair Value Hedges 09 ; Cash Flow Hedges 10-11 ; Derivatives Not Designated as a Hedging Instrument 12 ; Hedge Accounting Requirements 13-28 ; Shortcut Method 20-28 ; Hybrid Instruments, Host Contracts, and Embedded Derivatives 29-37 ; Calls and Puts in Debt 33-34 ; Derivatives Embedded in Split-Interest Agreements 35-37 ; Other Matters 38-43 ; Changes in Fair Value of Hedged Item 38 ; Termination of Cash Flow Hedge by Debt Extinguishment 39 ; Additional Presentation and Disclosure Requirements for NFP Business-Oriented Health Care Entities 40-43 ; Auditing 44 ; 6 Property and Equipment and Other Assets 01-53 ; Overview 01-05 ; Capitalized Interest 06-11 ; Supplies, Rebates, and Discounts 12-13 ; Lessee Involvement in Fixed Asset Construction 14-17 ; Asset Retirement and Environmental Remediation Obligations 18-20 ; Impairment or Disposal 21-31 ; Discontinued Operations 28-31 ; Nonreciprocal Transfers 32-34 ; Other Long-Lived Assets 35-43 ; Financial Statement Presentation 44-47 ; Auditing 48-53 ; 7 Municipal Bond Financing 01-124 ; Introduction 01-13 ; Conduit Bonds That Trade in Public Markets 06-08 ; Credit Enhancement 09-11 ; Issuance of Municipal Bonds 12-13 ; Extinguishment and Modification Transactions 14-17 ; Calls and Mode Conversions 18-39 ; Defeasance 20-26 ; Modifications 27-31 ; Gain or Loss on Debt Extinguishment 32-33 ; Debt Issuance Costs Incurred in Connection With an ; Exchange or Modification of Debt Instruments 34-36 ; Puts or Tender Options 37-39 ; IRS Considerations 40-44 ; Financial Statement Presentation and Disclosure 45-72 ; Balance Sheet 45-63 ; Statement of Operations 64-65 ; Disclosures 66-72 ; Obligated Group Reporting 73-74 ; Interim Financial Reporting 75-76 ; Auditing 77-123 ; General 77-85 ; Auditor Involvement with Municipal Securities Filings 86-112 ; Letters for Underwriters and Other Requesting Parties 113-119 ; Reference to the Auditor as an "Expert" 120 ; Attestation Engagements Related to Municipal Securities Issuance 121-123 ; Appendix -- Municipal Securities Regulation 124 ; 8 Contingencies and Other Liabilities 01-129 ; Contingencies and Commitments 02-61 ; The Essentials of Recognition, Measurement, and Disclosure for Contingencies 03-09 ; Managing Risk of Loss 10-12 ; Medical Malpractice 13-47 ; Disclosures for Medical Malpractice 48-53 ; Physician Guarantees and Other Agreements With Physicians 54-61 ; Other Liabilities 62-86 ; Asset Retirement Obligations 62-64 ; Compensation and Related Benefits 65-76 ; Joint and Several Liability Arrangements 77-82 ; Agency Funds 83-84 ; Fees Paid to the Federal Government by Health Insurers 85-86 ; Tax Considerations for NFP Health Care Entities 87-101 ; Private Inurement and Intermediate Sanctions 94-95 ; Unrelated Business Income 96 ; State and Local Taxes 97 ; Tax Positions 98-99 ; Medicaid Voluntary Contribution or Taxation Programs 100-101 ; Risks and Uncertainties 102-108 ; Auditing Contingencies and Other Liabilities 109-127 ; Auditing Medical Malpractice Loss Contingencies 110-113 ; Auditing Accounting Estimates 114-119 ; Use of Actuaries and Actuarial Methods 120-123 ; Evaluating Lawyers' Responses 124-127 ; Income Taxes 128 ; Auditing Considerations 129 ; 9 Net Assets (Equity) 01-38 ; Investor-Owned Health Care Entities 01 ; Not-for-Profit Entities 02-25 ; Net Asset Classes 05-18 ; Reclassifications 19-25 ; Classification of Donor-Restricted Endowment Funds 26-32 ; Disclosure 33-37 ; Auditing 38 ; 10 Health Care Service Revenue and Related Receivables 01-61 ; Overview of the Health Care Environment 01-15 ; Rate Setting With Third-Party Payors 05-10 ; The Government Payor Environment 11-14 ; Charity Care 15 ; Types of Health Care Revenue 16 ; Types of Payment Methodologies 17 ; Patient (or Resident) Service Revenue 18-36 ; Revenue Recognition 18-29 ; Accounting and Financial Reporting Requirements 30-36 ; Premium and Capitation Revenues 37-40 ; Patient Receivables 41-45