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Training Certification Program For Senior Financial Administrators Session I

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Title: Training Certification Program For Senior Financial Administrators Session I


1
Training Certification ProgramFor Senior
Financial AdministratorsSession I
January 2005
2
Agenda
2
3
Goals and Objectives
  • CUMC is growing more people and s to manage
  • Highly regulated
  • Need for formal training
  • Team building
  • Reinforcement of CU Policies and Procedures
  • Professional development

3
4
Steering Committee Members
  • Michael OConnor, Ed.D.
  • David M. Cohen
  • Gary Herrmann
  • Galene Kessin
  • Michael McGuire
  • Lisa Franciosa

5
Goals and Objectives
  • Strengthen areas that are weak
  • Reputation risk
  • Minimize and risks
  • Validate goal performance
  • Raise professional standards
  • Administrators role
  • Dual responsibility to CU and Chair
  • Strengthen financial controls

5
6
Columbia Organization ChartLines of Reporting
Board of Trustees
PRESIDENT
Gerald D. Fischbach Executive Vice President for
Health and Biomedical Sciences Dean of the
Faculty of Medicine
Ira Lamster Dean, School of Dental and Oral
Surgery
Allan Rosenfield Dean, Mailman School of Public
Health
Mary Mundinger Dean, School of Nursing
Institute Center Directors
Department Chairs
Joanna Rubinstein Senior Associate Dean for
Institutional and Global Initiatives
Harvey Colten Vice President and Senior
Associate Dean for Academic Affairs
Michael OConnor Vice President and Senior
Associate Dean for Budget and Finance
Eric Rose Associate Dean For Translational
Research
Kevin Kirby Chief Operating Officer and
Vice President and Senior Associate Dean for
Administration
Edward Shortliffe Deputy Vice President and
Senior Associate Dean for Information Technology
Susan Stalcup Interim Vice President for
Development
Joseph Tenenbaum Senior Associate Dean
for Clinical Affairs
Marilyn Castaldi Deputy Vice President for
Communications
Kathleen ODonnell Vice President and Senior
Associate Dean for Clinical Administration
6
7
CUMC General Background
  • 1.2 billion budget
  • One-half of total University money and personnel
  • 2,700 full-time and 4,000 part-time faculty
    (including affiliates) 4000 non-faculty staff
  • 2,900 students in four schools
  • Sponsored research grants of 401 million
  • Faculty practice revenues of 382 million
  • Endowment of 947 million 112 endowed chairs

7
8
CUMC 2004-2005 Projected Revenues
School
8
9
CUMC 2003-2004Source of Operating Funds
Total 1.2 Billion
Note Other includes gifts, endowment, patent
and miscellaneous revenues
9
10
Introduction
  • Overview of training program
  • Reasons for conducting training
  • Requirements for certification
  • Complete 40 hours
  • Participate
  • Complete evaluation
  • Case studies
  • Lab exercises

10
11
List Of Training Seminars
  • 1 Intro Higher Ed, Fundamentals of Accounting
  • 2 Fundamentals of Budgeting/ Monitoring Budget
    Performance
  • 3 Financial Reporting
  • 4 Revenue Cycle
  • 5 Gifts, Pledges, Endowments
  • 6 Cost Recoveries for Higher Education, OMB
    Circular A-21
  • 7 Grant Compliance, OMB Circulars A-110 and
    A-133
  • 8 Cash Management and Payroll Accounting
  • 9 Capstone Summary and Conclusions

11
12
Dealing With Ethical Issues
  • Its a New Environment
  • Since the enactment of the Sarbanes-Oxley Act of
    2002, there has been unprecedented focus on the
    role of board members and officers in ensuring
    their institutions are carrying out their
    missions faithfully, without extravagance, waste
    or the appearance of self-dealing.
  • Although Sarbanes does not apply directly to
    college, universities, and other not-for-profit
    educational institutions, its influence is being
    felt in the education sector. Many institutions
    are voluntarily adopting some of the principles
    of Sarbanes.

12
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Sarbanes-Oxley Why Should We Care?
  • Technically, Sarbanes is not applicable to public
    interest entities
  • However
  • Sarbanes objectives are compelling
  • Enhanced integrity of senior management
  • Enhanced integrity of financial reporting
  • Enhanced role of Board oversight
  • Enhanced effectiveness of internal controls
  • There are increased public entity stakeholder
    expectations
  • Regulators and state governments
  • Board members from corporate world
  • Donors
  • Service buyers and patrons

13
14
Sarbanes-Oxley Why Should We Care?
  • Action within the Education/Non-profit community
  • There is an emerging emphasis on the spirit of
    Sarbanes
  • Donors and grantors expect
  • -Management integrity
  • -Use of funds in accordance with restrictions
  • -Active, effective Board oversight
  • -Appropriate, understandable financial reporting
  • Buyers and patrons expect
  • -Appropriate use of public money
  • -Impeccable ethical behavior
  • -Effective management in light of price
    increases

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15
Sarbanes-Oxley Federal Non-Profit Initiatives
  • If enacted, it would
  • Provide that the CEO/CFO certify annual report
  • If gross revenues lt 1 million/assets lt 3
    million, then verify that report fairly
    presents the financial condition
  • If gross revenues gt 1 million/assets gt 3
    million, then verify fairly presents and a) no
    false statements, b) controls are adequate, c)
    deficiencies disclosed to board/auditors
  • Encourage NFPs, especially if large, to have
    audit committees that
  • Are independent, oversee auditor, establish
    system for complaints
  • Govern the activities of interested directors and
    officers (i.e., with regards to related party
    transactions)

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Dealing With Ethical Issues
  • NACUBO Recommends
  • Senior management implement a code of conduct
    that should
  • Inventory, assess and update as needed existing
    codes of conduct, including conflict of interest
    policies
  • Establish appropriate codes if they do not
    already exist
  • Require sign off by senior leaders acknowledging
    the code
  • Be comprehensive and clear
  • Be easy to access, understand, and implement
  • Be communicated broadly
  • Include a confidential mechanism to report code
    violations

16
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Dealing With Ethical Issues
  • Code of Conduct Promotes
  • Honest, ethical conduct
  • Full, fair, accurate, timely, and understandable
    disclosure in reports and documents
  • Compliance with applicable governmental laws,
    rules and regulations
  • Prompt internal reporting of code violations to a
    designated person or place
  • Accountability for adherence to the code

17
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Dealing With Ethical Issues
  • If You See Something, Say Something
  • Examples
  • Signing onto University System and approving on
    behalf of someone else
  • Example FFE, APCAR, and RASCAL
  • Nepotism
  • No direct reporting relationship
  • Reporting relationship must be disclosed
  • No input into compensation of another
  • Appearance of impropriety

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Dealing With Ethical Issues
  • Being asked to submit reports to external
    sponsors or internally where you know information
    is inaccurate
  • Misuse/inappropriate use of University resources
  • Using University assets for personal gain
  • Charging personal side trips made on business
    trips
  • Violating Conflict of Interest Policy
    (https//www.rascal.columbia.edu/coi/coiframe.html
    )
  • Use of restricted funds for other purposes

19
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Dealing With Ethical Issues
  • Reporting Misconduct Barriers to Reporting
  • The National Business Ethics 2003 survey by the
    Ethics Resource Center found that while there had
    been overall increase in employee reporting of
    misconduct, the majority of employees (40 - 70)
    stated they would not report misconduct.
  • There are many reasons for non-reporting,
    including
  • Loyalty to group or department
  • Fear of retaliation
  • Concern that leadership will not act to correct
    misconduct
  • Believing that co-workers would not report
  • Not knowing where to report

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Dealing With Ethical Issues
  • Reporting Misconduct Barriers to Reporting
  • Improper practices that are not corrected early
    can escalate into more destructive situations
  • Consequences of escalation include damage to
    individuals and University image loss of funds,
    property, physical security and job security
    delays in research progress, disrespect for
    ethical values
  • A culture of non-reporting may imply distrust in
    leadership, cynicism about University ethics,
    lack of employee identification with
    institutional goals, and low employee morale
  • Demoralization among employees may result in a
    culture of permission to cut corners and
    participate in impropriety, values confusion,
    diminished performance, increased turnover and
    instability

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Dealing With Ethical Issues
  • Conflict of Interest Individuals to call if
    there is an ethical issue
  • Gerald Fischbach 305-2752 Executive VP of CUMC
  • Michael OConnor 305-3719 CUMC Budget and
    Finance
  • Marsha Wagner 854-1234 Ombuds Officer
  • Galene Kessin 305-3671 Human Resources
  • Alan Brinkley 854-2403 Provost
  • Patricia Catapano 854-4521 Office of General
    Counsel

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BREAK
24
SESSION 1Part 1 Intro to Higher EducationPart
2 Fundamentals of Accounting
25
Session Objectives
  • Identify characteristics and types of
    not-for-profit organizations, including colleges
    and universities
  • Understand the following
  • Differences between not-for-profits and
    commercial entities
  • Fiduciary responsibilities of not-for-profit
    organizations
  • Higher Education market segment and its
    challenges
  • Basic principles of fund accounting
  • Net asset classifications per SFAS 116 and 117
    and be able to relate fund accounting to them

25
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PART 1Higher Education / NFP Industry Overview
27
What is aNot-for-Profit Organization?
  • A 501 C(3) entity possesses the following
    characteristics
  • Contributions of significant amounts from
    resource providers who do not expect commensurate
    return existence heavily dependent on private
    and public support
  • Operating purposes are other than to provide
    goods or services at a profit typically serves a
    social, moral, or ethical purpose which is
    usually reflected in the mission statement
  • Absence of ownership interests
  • Tax-exempt status


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What is aNot-for-Profit Organization?
  • Hospitals and medical research organizations.   A
    hospital is an organization whose principal
    purpose or function is to provide hospital or
    medical care or either medical education or
    medical research. A rehabilitation institution,
    outpatient clinic, or community mental health or
    drug treatment center may qualify as a hospital
    if its principal purpose or function is providing
    hospital or medical care. If the accommodations
    of an organization qualify as being part of a
    skilled nursing facility, that organization may
    qualify as a hospital if its principal purpose or
    function is providing hospital or medical care. A
    cooperative hospital service organization that
    meets the requirements of section 501(e) will
    qualify as a hospital.


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What is aNot-for-Profit Organization?
  • Hospitals and medical research organizations.
       The term hospital does not include
    convalescent homes, homes for children or the
    aged, or institutions whose principal purpose or
    function is to train handicapped individuals to
    pursue a vocation. An organization that mainly
    provides medical education or medical research
    will not be considered a hospital, unless it is
    also actively engaged in providing medical or
    hospital care to patients on its premises or in
    its facilities, on an in-patient or out-patient
    basis, as an integral part of its medical
    education or medical research functions.
  • Medical research organization.   A medical
    research organization must be directly engaged in
    the continuous active conduct of medical research
    in conjunction with a hospital, and that activity
    must be the organization's principal purpose or
    function.


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Not-for-Profit vs. Commercial Organizations
  • Not-for-Profit Organizations
  • Resources received without expected repayment
  • Operate to fulfill a need, purpose or cause
  • Surplus or deficit
  • CU Educate, Discover, Care, and Lead
  • Commercial Enterprises
  • Resources received with possible repayment or
    economic benefit
  • Operates to make a profit and provide returns to
    shareholders
  • Net income or net loss
  • Provide service to make money


more ?
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Not-for-Profit vs. Commercial Organizations
  • Not-for-Profit Organizations
  • Absence of defined ownership interest
  • Use Net Asset classification
  • May receive donated assets and services
  • Tax-exempt status granted
  • Board of Trustees - fiduciary responsibility to
    society, community, and clients
  • Commercial Enterprises
  • Have defined ownership interest (i.e., stock)
  • Use Equity classification
  • Usually there are no donations to commercial
    enterprises
  • Taxable entities
  • Board of Directors - fiduciary responsibility to
    shareholders


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Fund Balance AccountingDefinitions
  • Endowment fund grouping includes three types of
    funds classified as endowment and similar
    funds
  • True Endowment donor has stipulated that the
    principal is to be kept intact in perpetuity and
    only the income therefrom can be expended either
    for general purposes or for a restricted purpose.
    Revenue and net assets of these funds are
    reported in the permanently restricted class of
    net assets.
  • Term Endowment donor has provided that upon the
    passage of time or the happening of a specific
    event, the endowment principal can then be
    utilized either for a specific purpose or for the
    general operation of the institution. Revenue and
    net assets of these funds are reported in the
    temporary restricted class of net assets.
  • Quasi-Endowment the board, as distinct from the
    donor, has set aside unrestricted amounts to be
    used as endowment at least for some time. Revenue
    and net assets of these funds are reported in the
    unrestricted class of net assets.


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Fund Balance AccountingDefinitions
  • Gifts
  • Unrestricted Contributions
  • Current Restricted Contributions contributions
    that can be used to meet the current expenses of
    the organization, although restricted to use for
    some specific purpose, or during or after some
    specified time
  • Investment Securities contributions in the form
    of stocks and bonds
  • Gifts-In-Kind unrestricted or temporarily
    restricted
  • Fixed Assets land, building, and equipment
  • Museum Collections
  • Pledges (promise to give) A promise to
    contribute to an organization at a later date or
    in installment payments. May or may not be
    legally enforceable.


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Fund Balance AccountingDefinitions
  • Statement of Financial Position (Balance Sheet)
  • Reports the assets, liabilities and net assets of
    the organization
  • Is presented on the accrual basis of accounting
  • The assets and liabilities are grouped into
    homogeneous groups such as
  • Cash and Cash equivalents
  • Accounts and notes receivable
  • Accrued employee benefits
  • Short and long term liabilities
  • Each FAS Account has a balance sheet and revenues
    and expenses


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Fund Balance AccountingBalance Sheet
Statement of Financial Position (Balance
Sheet) Six Basic Totals Required

NFP Organization Balance Sheet XX/XX/XX
Total Assets XXX Total Liabilities XXX Net
Assets Unrestricted XXX Temporarily
Restricted XXX Permanently Restricted XXX Total
Net Assets XXX
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Fund Balance AccountingBalance Sheet
  • Statement of Financial Position (Balance Sheet)
  • Other Information Required
  • Classification of Assets and Liabilities
  • Liquidity Information
  • Restrictions on Assets and Net Assets


NFP Organization Balance Sheet XX/XX/XX
Cash XXX Total Assets XXX Accounts
Payable XXX Total Liabilities XXX Total Net
Assets XXX
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Fund Balance AccountingBalance Sheet
Each fund has its own assets, liabilities, net
assets (fund balance), revenues, and expenses.

Plant fund
Operating fund
A L N.A. R - E N.A.
A L N.A. R - E N.A.
Total entity
Endowment fund
A L N.A. R - E N.A.
A L N.A. R - E N.A.
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Fund Balance AccountingBalance Sheet

Example Balance Sheet
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Fund Balance AccountingStatement of Activities
  • Statement of Activities (Revenue/Expense
    statement)
  • Summarizes all of the activity of the
    organization for the entire period.
  • Depicts how the resources of the organization are
    used in providing programs or services in order
    to meet its mission
  • Revenues (Sources)
  • Expenses (Uses)
  • Reported by natural or functional groupings
  • Reports revenue and expenses at gross amount and
    gains and losses at net amount


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Fund Balance AccountingStatement of Activities

Example Revenue and Expenses
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Fund Balance AccountingStatement of Cash Flows
  • Statement of Cash Flows
  • The statement of cash flows analyzes the movement
    of actual cash
  • The cash flow statement indicates
  • - The organizations ability to meet its
    obligations, and
  • - The reasons for the differences between the
    total changes in net assets, and the receipts and
    payments of cash during the period.


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Fund Balance AccountingStatement of Cash Flows
(Cont.)
  • The statement of cash flows classifies receipts
    and payments of cash in three categories
  • Operating
  • All amounts not defined as investing or financing
  • Investing
  • Making or collecting loans to other entities
  • Acquisition or disposal of property, plant and
    equipment
  • Sales or purchases of marketable securities
  • Financing
  • Borrowing or repaying amounts borrowed by the
    organization
  • Proceeds from contributions received for
    long-term purposes
  • Receipt or payment of annuity obligations
  • Deposits with bond trustees


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Fund Balance AccountingCash Flow Statement

Example Cash Flow Statement
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Net Assets Classification
  • Permanently Restricted
  • Resources subject to donor-imposed restrictions
    requiring that the original contribution be
    retained inviolate and in perpetuity but permit
    the use of investments earnings for general or
    specific purposes. The primary component of these
    assets is true endowments whose appreciation is
    either restricted to specific uses, such as
    support for financial aid or a faculty chair, or
    else is available for general university
    purposes.
  • Example Endowment Principal accounted in
  • General Ledger 0-60000 through 0-69999

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Net Assets Classification
  • Temporarily Restricted
  • Resources subject to donor-imposed restrictions
    that will be met by actions of the University or
    the passage of time. These net assets are
    primarily comprised of gifts in the form of cash
    or pledges for specific purposes, such as
    financial aid, capital constriction or research
    activities, and the unspent net realized and
    unrealized gains and net reinvested income
    generated by permanently restricted assets
    subject to donor-imposed restrictions on their
    use.
  • Example Gift Accounts accounted in
  • General Ledger 0-42000 through 0-44999
  • -Once expired, moved to Unrestricted Net Assets

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Net Assets Classification
  • Unrestricted
  • Resources which are not subject to donor-imposed
    restrictions.
  • Example Ledger 2 - Unrestricted budget
  • Ledger 4 - Internally restricted
  • Someone in department decides how to spend
    through budget process

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Reporting Considerations
  • Similarity to Profit-Oriented Reporting
  • A complete set of Financial Statements are
    required
  • Statement of financial position (balance sheet)
  • Statement of activities (revenue / expense
    account)
  • Statement of cash flows
  • Accompanying notes


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Reporting ConsiderationsFinancial Report
http//www.columbia.edu/cu/finance/

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Role of DA Stewardship
  • Safeguard Assets
  • Net assets are an asset of the University
  • Deans, Chairmen and DAs are custodians
  • Fiduciary responsibility
  • Agency relationship
  • Monitor positive fund balance and transactions
  • Review transactions
  • TE expenses on DARTS
  • Acknowledge donors money, how money should be
    spent, reporting to donors
  • Reviewing and reconciling monthly reports on a
    timely basis
  • Making corrections as needed


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Time Value of Money
  • Cost of doing business when account is in
    overdraft
  • Overdrafts are funded by the University
  • Not collected AR forfeited funds
  • Aggravation factor / Time waster

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PART 2Fundamentals ofAccounting
52
Cash vs. Accrual Accounting
CASH ? Revenues are recognized when cash is
received and deposited and expenses are recorded
in the accounting period when bills are
paid ACCRUAL ? The most commonly used accounting
method, which reports income when earned and
expenses when incurred Receivables when earning
process is complete (since 1996 in terms of
faculty practice) Liabilities when there is a
legal claim against assets. (Includes Physician
Incentive payments) MODIFIED ACCRUAL ? Revenue
and Expenditures handled daily on a cash basis,
but converted to accrual with periodic
adjustments

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Cash vs. Accrual Accounting

Balance Sheet Example
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Cash vs. Accrual Accounting
ADVANTAGES
  • ACCRUAL BASIS
  • Accurately presents financial picture of the
    organization
  • This basis is more meaningful for organizations
    that have substantial unpaid bills or uncollected
    income at the end of each period and these
    amounts vary from period to period.
  • The cash basis would provide great difficulty in
    knowing exactly where the organization stood
  • CASH BASIS
  • Simplicity
  • A simple checkbook may be all that is needed to
    keep the financial records of an organization,
    provided a complete description is recorded in
    the checkbook stubs.
  • Accrual basis adds a level of complexity that is
    unnecessary in some organizations

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Cash Example
  • Deposits
  • Faculty Practice Patient Receipts
  • Gifts Receipts
  • Employee Reimbursements
  • Disbursements
  • Invoice Payments
  • Payroll

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Accrual Example
  • Departmental Accruals
  • AR Patient invoices in IDX
  • AR hospital agreements (NYPH, MD, Clinical
    Assess)
  • AP NYPH and other affiliates
  • AP MD incentives and on call payment
  • AP Clinical assessment
  • AR/AP- Clinical Trials
  • AR/AP- Nongovernment grants


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Modified Accrual Example
  • Grant Accounting
  • Revenue is recognized, up to the budgeted amount,
    when expenditures are incurred
  • Revenues equals Expenses
  • Endowment Income
  • Income Distributed Quarterly
  • Principal adjusted at year end to reflect actual


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BREAK
59
Expectations of Managing Cash
  • Reconciliation of lockboxes
  • Timely Deposit
  • Safeguard / custody (within 24hrs needs to be
    deposited)
  • Reconcile to FAS (DARTS)


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Budget, Actuals, andEncumbrances
Budget ? A budget is a plan of action. It
represents the organizations blueprint for the
coming months, or years, expressed in monetary
terms. An organization must have specific goals
before preparing a budget. Actuals ?
Transactions which represent actual revenues and
expenditures example payrolls, supplies,
equipment, etc Encumbrances ? Represents
commitments based on SAFs project salary
allocation example POs in Purchasing
system Balance Available ? Budget Actuals
Encumbrances Budget Available

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CUMC Fund Accounting
  • Accounts in FAS
  • General Ledger (0 Ledger)
  • 0-XXXXX-XXXX
  • Revenues/Expenses or Subsidiary Ledgers
  • 1-XXXXX-XXXX
  • 2-XXXXX-XXXX
  • .
  • 9-XXXXX-XXXX
  • Remember Every Revenue/Expense Ledger must be
    related to a General Ledger (0 Ledger) account


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CUMC Fund Accounting
Accounts in FAS General Ledger Structure Assets,
Liabilities, Fund Balances 0-XXXXX-XXXX Acco
unt Control Account Identification Ledge
r Example of General Ledger Account 0-44320-4220

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CUMC Fund Accounting
Accounts in FAS Subsidiary Ledger
Structure Assets, Liabilities, Fund
Balances 1-XXXXX-XXXX through
9-XXXXX-XXXX Subcode Account
Identification Ledger Example of
Revenue/Expense Account 1-60114-0790

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CUMC Fund Accounting
Subsidiary Ledgers (Revenues/Expenses)
1-XXXXX Current Unrestricted Revenues include
unrestricted gifts and other unrestricted
resources earned such as student tuition and
fees, Indirect Cost Recovery,
etc. 2-XXXXX Current Unrestricted Expenditures
include economic resources which are
expendable for any purpose in performing the
primary objectives of the institution, i.e.,
instruction, research, and public service, and
which have not been designated by outside donors
or the governing board for other
purposes. 3-XXXXX Auxiliary Enterprises and
Other Activities include revenues and
expenditures for faculty practice, residence
halls, and dining services
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CUMC Fund Accounting
Subsidiary Ledgers (Revenues/Expenses)
4-XXXXX Internally Restricted (Designated)
include revenues and expenditures of funds,
expendable for operating purposes but restricted
by the Universitys governing boards as to the
specific purpose for which they may be
expended, i.e., discretionary funds. 5-XXXXX Curr
ent Restricted Expenditures Government Grants
and Contracts include grants from governmental
sources for research, training, or other
sponsored programs. 6-XXXXX Current Restricted
Expenditures Other include private gifts and
endowment income restricted to a school or a
department or restricted for specific operating
purposes such as scholarship grants,
professorships, purchase of library books,
etc.
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CUMC Fund Accounting
Subsidiary Ledgers (Revenues/Expenses)
continued
7-XXXXX Plant Fund / Clinical Trials
Expenditures Plant funds are used for the
acquisition, renewal and replacement, and
retirement of indebtedness on physical
properties for institutional purposes.
Clinical trials are used for the study in
human subjects involving a therapeutic or
diagnostic intervention with a drug, device, or
health care product. 8-XXXXX Not
Assigned 9-XXXXX Agency Funds include revenues
and expenditures of funds held by the
institution as custodian or fiscal agent for
others such as student organizations,
individual students, or faculty members.
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CUMC Fund Accounting
Prime and Scope Accounts ? General Ledger
accounts may have more than one sub-ledger
account. The first sub-ledger account is called
prime and the others are called scope
accounts. Map Code ? Every sub-ledger account
carries a map code which tells the reader to
which General ledger account it belongs. The map
code is simply the General Ledger account number
with out the leading zero number. Note
Sub-ledger accounts do not have to be in the same
department as the corresponding general ledger.
This allows one department to hold the funds
(General Ledger account) and allow other
departments to spend some of these funds
(Subsidiary Ledger account).
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CUMC Fund Accounting
Subsidiary General Ledger Relationship Unrestric
ted

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CUMC Fund Accounting
Subsidiary General Ledger Relationship Unrestric
ted (continued)

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CUMC Fund Accounting
Subsidiary General Ledger Relationship Restricte
d

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CUMC Fund Accounting
Subsidiary General Ledger Relationship Restricte
d (continued)

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CUMC Fund Accounting
Subsidiary General Ledger Relationship
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Clinical, Affiliates, Practice Plans
  • Clinical ? Doctors rendering services for patient
    care
  • Affiliates ? Other institutions where CUMC
    provides patient care or teaching
  • Practice Plans ? 3 Types
  • Federated Unified resources are pooled in one
    departmental plan
  • Divisional Divisions operate on padded basis
    and incurred department O/H charges
  • Individual Practitioner Accounts Autonomous
    self sufficient, need to cover costs individually

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Questions
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Summary
  • Education is what remains after one has
    forgotten everything he learned in school.
  • Einstein

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Course Evaluation
  • Please complete course evaluation form

Session 1
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