health care entities

ASC 205-954 sets the basic financial statement presentation requirements for health care entities, both not-for-profit business-oriented and investor-owned. It requires a complete set of statements — balance sheet, statement of operations, statement of changes in equity (or net assets), statement of cash flows, and notes (205-954-45-1) — and permits descriptive alternative titles except that the cash flow statement should be titled "Statement of Cash Flows" (205-954-45-2). Presentation is essentially the same for both ownership forms except for items that are inapplicable, such as shareholders' equity for NFPs and contributions for investor-owned entities (205-954-05-1).

ASC 225-954 formerly provided income statement presentation guidance for health care entities (e.g., the performance indicator and reporting of patient service revenue). Every paragraph in the subtopic — Sections 05, 15, 45, 50, and 55 — was superseded by Maintenance Update 2017-19, so the subtopic contains no operative guidance. Health care income statement presentation guidance now resides in Topic 954 (principally 954-205 and 954-225 as relocated) and, for revenue, in Topic 606.

ASC 305-954 was the health care industry-specific guidance on cash and cash equivalents, but it now contains no operative content — every paragraph has been superseded or is unused. Health care entities therefore follow the general guidance in Topic 305 together with the broader health care presentation rules in Topic 954.

ASC 320-954 was the health care entities industry supplement to the debt securities guidance in Topic 320, addressing scope, subsequent measurement, presentation (including where unrealized gains and losses appear in a health care entity's performance indicator) and related implementation examples. Every paragraph in the subtopic — Sections 05, 15, 35, 45 and 55 — was superseded by Accounting Standards Update No. 2016-01. As a result the subtopic contains no operative guidance; health care entities look instead to Topic 320 as amended and to Topic 321 for equity securities.

This Subtopic governs how health care entities (within the scope of Topic 954) account for investments that are NOT financial instruments — for example, investment real estate or certain oil and gas interests. Such investments are reported at amortized cost and tested for impairment under the Impairment or Disposal of Long-Lived Assets Subsections of Subtopic 360-10. Property held for investment purposes is presented within investments on the balance sheet.

This Subtopic covers "other assets and deferred costs" of health care entities — prepaid expenses, deposits, and deferred expenses, including amounts paid to physicians for future services such as administering a hospital department or providing community services that further the entity's mission (340-954-05-2). If such prepaid costs are deferred, they must be amortized over the period benefited (340-954-35-2), and all such items are classified as current or noncurrent as appropriate (340-954-45-1). The former recognition guidance (Sections 25 and part of 35) was superseded by ASU 2014-09, so contract cost questions now fall under ASC 340-40 and revenue under ASC 606.

This industry subtopic addresses how health care entities present property that is held for investment purposes rather than used in operations. Its single substantive rule is that such property is reported as part of investments (360-954-45-1), not within operating property, plant, and equipment. Its scope follows the health care entities Overall Subtopic scope in Section 954-10-15.

ASC 430-954 formerly provided the deferred revenue guidance for health care entities, principally continuing care retirement communities (CCRCs) accounting for nonrefundable advance (entrance) fees and refundable advance fees. Every paragraph in the subtopic has been superseded by ASU 2014-09 (Revenue from Contracts with Customers), and the transition paragraph 430-954-65-1 was superseded on 06/26/2015 following ASU 2012-01. The subtopic therefore contains no operative guidance; deferred revenue for health care entities is now addressed under ASC 606 and ASC 954-405/954-606.

After ASU 2014-09 superseded most of its content, ASC 605-954 retains only two pieces of health care recognition guidance: charity care and distributions from financially interrelated fundraising (recipient) entities. Charity care is never recognized as revenue, and distributions from a related fundraising foundation are generally a reduction of the health care entity's interest in that recipient entity rather than contribution revenue. Revenue from contracts with patients and other customers is now governed by Topic 606.