Not-for-profit entities and state and local government organizations are small in comparison to the federal government. The federal government has many different segments that cross boundaries of private and public sectors. All of these segments need accounting, and each needs to be accountable to the taxpayers who pay for them. The federal government also has individual corporations, such as the U.S. Postal Service, that are part of the federal government as separate businesses. These corporations receive sustenance from the services that they provide but are still supported by the federal government if the services do not generate enough funds. The U.S. Postal Service is a prime example of a corporation with continued losses that still operates. The federal government is responsible for the mail and ensures that everyone receives their mail.

Even though the size of the federal government is massive, accounting, reporting, and analyzing are still a requirement. Just like huge corporations or state and local governments, the size of the federal government is broken down into divisions and segments, each of which is responsible for its own reporting. Each segment is required to prepare an annual performance report (APR) and audited annual financial statements. These reports are then included in their performance and accountability report (PAR). It is the same strategy as all businesses: The sum of all of the parts makes the whole. The same is true for health care entities.

Like the federal government, health care organizations are complex entities that cross boundaries of private and public segments. Some health care entities are government organizations, whereas others are NFP or owned by investors. These multiple ownership forms result in entities that receive their sustenance from a multitude of different sources, such as patient payments, third-party payers, investment funds, donor donations, or some mixture of each. In addition to the multiple ownership forms, health care organizations become even more complex when you take into consideration all of the related entity consolidations and affiliations that exist. Depending on the structure of the related entities, separate accounting, reporting, and analysis might exist, or consolidated accounting, reporting, and analysis might be needed. Regardless of what structure health care organizations maintain, each entity needs to be accountable to the patients it cares for.

Please answer the following questions:

1. What objectives does the Statement of Federal Financial Accounting Concepts (SFFAC) No. 1 for federal financial reporting identify?
2. What is a basic financial statement that is required for federal agencies?
3. What federal fund is most like a custodial fund used by state and local governments?
4. Describe a component of a consolidated PAR?
5. What mathematical relationship is used among proprietary account balances?
6. Identify the role of the Government Accountability Office in federal financial accounting and reporting.
7. What financial statements would an NFP hospital present?
8. The Fund Balance with the Treasury would be considered equivalent to what accounts?
9. What would be most helpful to assess the financial profitability of an NFP health care organization?
10. Name an example of an asset that is limited as to its use.