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Write a response of no more than 1,050 words in which you address the following questions from Case 3, Charitable Contributions and Debt: A Comparison of St. Jude Children's Research Hospital/ALSAC and Universal Health Services:

Requirement A, 1-4

Requirement B, 1-2

How would your answers to Requirements A and B differ if the government owned and operated the hospital?

Table 5.3-1: Financial Comparisons of the Not-for-Profit Entities

Fiscal Year Ended 1999	St. Jude Childrens Research Hospital Form 990*	American Lebanese Syrian Associated Charities, Inc. (ALSAC) Form 990*
Contributions, gifts, grants and similar amounts received: Direct public support	$91,978,426	$231,793,748
Indirect public support		2,906,934
Government contributions (grants)	31,469,447
Program service revenue, including government fees and contracts (i.e., health insurance revenue)	46,034,710
Accounts receivable	24,217,029	4,230,764
Pledges receivable		23,604,748
Allowance for doubtful accounts	9,363,328
Program service expenses		99,282,906
Program service expenses: Research	87,225,830
Program service expenses: Education and training	5,471,186
Program service expenses: Medical Services	93,735,602
Reconciliation of revenue, gains, and other support to audited numbers: net unrealized gains on investments	4,023,815	65,891,269
Deferred grant revenue	1,857,628 (Statement 5)
Support from American Lebanese Syrian Associated Charities, Inc.	91,978,426 (Statement 7)	91,978,426 (paid per Statements 4, 6)
Excluded contributions		2,746,295 (Statement 1)
Excess or (deficit) for the year	10,933,191	120,521,982
Net assets or fund balances at end of year	199,707,440	994,501,910
Temporarily restricted		15,715,890
Permanently restricted	14,000,000	247,147,826
Total liabilities	21,956,792	7,017,192
Schedule of deferred debits & credits by contract (FAS 116 adjustment noted to result in this deferred revenue)	157,628

1. What is meant by the reference in Table 5.3-1 to an FAS 116 adjustment?

2. How are contributions recorded? Is there a distinction between pledges receivable and accounts receivable?

3. Are there circumstances when financial statements can quantify volunteers services?

4. Can financial statement users of not-for-profit hospitals financial statements expect to be fully informed regarding affiliated parties, such as the linkages between St. Jude Childrens Research Hospital, ALSAC, and the foundation cited? Explain.

Requirement B: Revenue Mix (Strategy-Related Considerations)

The 10-K filing of Universal Health Services, Inc. describes the mix of revenue sources, as depicted in Table 5.3-3.

Table 5.3-3: Patient Revenue Mix

	PERCENTAGE OF NET PATIENT REVENUES
	2000	1999	1998	1997	1996
N/A-Not available (Source: 10-K filed 3/28/2001) 1. How does this revenue mix compare with the revenue blend of the not-for-profit entity, St. Jude Childrens Research Hospital (ALSAC)? Access the latest SEC filing and compare the reported revenue mix; has it changed? 2. What does that imply as to the strategies of investor-owned hospitals in managing risk and ensuring adequate capital relative to not-for-profit entities? An opportunity exists to explore the greater social and political questions that are frequently debated about the compatibility of profit-oriented entities and quality of health care, relative to not-for-profit entities. As background, identify what the latest SEC filings report concerning charity care.
Third Party Payors
Medicare	32.3%	33.5%	34.3%	35.6%	35.6%
Medicaid	11.5%	12.6%	11.3%	14.5%	15.3%
Managed Care (HMOs and PPOs)	34.5%	31.5%	27.2%	19.1%	N/A
Other Sources	21.7%	22.4%	27.2%	30.8%	49.1%
Total	100%	100%	100%	100%	100%