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Author: 
 
 Thorne, William Van 
 Schoonhoven 
 
 Title: 
 
 Hospital accounting and 
 statistics 
 
 Place: 
 
 New York 
 
 Date: 
 
 1918 
 
MASTER NEGATIVE # 
 
 COLUMBIA UNIVERSITY LIBRARIES 
 PRESERVATION DIVISION 
 
 BIBLIOGRAPHIC MICROFORM TARGET 
 
 ORIGINAL MATERIAL AS FILMED - EXISTING BIBLIOGRAPHIC RECORD 
 
 mfi^fm 
 
 480.393 
 
 y39 Thome, William Van Schoonhoven, 1865- comp, 
 
 J^ Hospital accounting and statistics, -^ed. Comp. and 
 ^arranged by William V. S. Thorne. ... New York, E. P. 
 Button & CO., -191& 1918. 
 
 4 p. UWp. forms (5 fold.) 24'". 
 
 1. Hospitals — Accounting. i. Title. 
 
 Library of Congress 
 
 17-21662 
 
 RA971.T5 1916 
 
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 School of Business 
 
Hospital 
 Accounting and Statistics 
 
Charitable Institutions may obtain a copy of this 
 book free of charge by request of their proper officer 
 upon the Treasurer of the Presbyterian Hospital, 41 
 East 70th Street, New York City. Other copies may 
 be secured from E. P. Button & Co., for the price 
 of $1^0 each, postage paid, enclosed with order. 
 
 Hospital 
 Accounting and Statistics 
 
 4th Edition 
 
 Compiled and Arranged by 
 
 WiUiam V. S. Thome 
 
 Treasurer and Member of the Board of Managers of The Presbyterian 
 Hospital m the City of New York, Chairman of the Executive Com- 
 mittee and Member of the Board of Governors of the Woman's Hospital 
 in the State of New York, Member of the Board of Directors of the 
 Manhattan Maternity and Dispensary. 
 
 Author of the booklet entitled "A Central Purchasing Agency for the 
 Hospitals of New York" (The Hospital Bureau of Standards and 
 Supplies was organized in New York in March, 1 9 1 0, in accordance 
 with the suggestions outlined in the booklet referred to. and has now 
 been in successful operation for over eight years and includes a member- 
 ship of forty-nine hospitals of which thirty arc located outside the limits 
 of Greater New York). 
 
 New York 
 
 E. P. DUTTON & CO. 
 1918 
 
\ p V ^ 
 
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 • '" 
 
 j4 
 
 PREFACE 
 
 As a result of numerous conferences in the years 1906 and 1908 
 between the Superintendents, Treasurers and Accountants of 
 some of the larger hospitals the Schedules shown in the first 
 thirteen pages of this book and the "Instructions regarding Distri- 
 bution of Hospital Operating and Corporation or Other Current 
 Expenses" were agreed upon as illustrating desirable forms in 
 which hospitals might present their financial reports and statistics. 
 
 The object was to encourage and assist hospitals in adopting a 
 simple and mtelligentsystemof accountingapprovedby certifiedpub- 
 lic accountants and by those experienced in hospital management. 
 
 The forms of accounts and statistics described (with slight 
 modifications to suit the special requirements of certain hospitals) 
 would readily set forth in a neariy uniform manner the statements 
 of revenue and expenses, assets and liabilities, etc., desired by 
 most hospital managers and by the public for their information 
 and for inteUigent comparison with similar reports or statements 
 of other hospitals. 
 
 Unless such accounts and statistics are made up on some uni- 
 form basis they are apt to be misleading and valueless for purposes 
 of comparison. 
 
 The method of accounting herein described has now been 
 adopted as standard by a large number of hospitals throughout 
 the United States and Canada. 
 
 The Hospital Saturday and Sunday Association of New York 
 City (now known as The United Hospital Fund of New York), 
 m its Thirty-third Annual Report for the year ended September 
 30, 1912, pages 42 and 43, stated as follows: 
 
 "Improvement in Hospital Statistics and Accounts 
 
 •• 
 
 "Under the instruction of the Trustees a new form of Schedule 
 was introduced for the reports of hospitals to this Association, 
 prepared in consultation with hospital authorities and experts in 
 accounting and statistics. It was well received by the hospitals, 
 and has been the means of securing fuller and more significant 
 data regarding the *Work Done,* the * Expenses,' and the * In- 
 come' of the Associated Hospitals. The results are tabulated 
 in the large * Statistical Sheet' inserted at the end of this report, 
 and will interest general contributors and those responsible for 
 hospital management. 
 " It is evident that the requirement by the Association of these de- 
 
tailed reports has called attention to defects in methods of keeping 
 accounts and statistics to some degree, and has led to improvement. 
 This is one of the main objects of the Association and points the 
 w.y to greater economy and efficiency in hospital management. 
 
 "The new Schedule for reports to the Association calls foF 
 items which the management of any well-regulated hospital should 
 know. The labor of preparing it is reduced to a minimum since 
 it is m harmony with the data required by the State Board of 
 Charities and with the Uniform System of Accounts and Statistics 
 already in use among the leading hospitals of this and other cities 
 and which all would find it advantageous to adopt." 
 
 At a meeting held on May 14, 1913, the Philadelphia County 
 Medical Society appointed a Committee on Hospital EflBciency 
 "for the purpose of considering ways and means by which the 
 efficiency of the hospitals in Philadelphia may be increased." 
 
 After making a very careful and thorough study of the hospital 
 situation in Philadelphia the Committee on June 17th and Novem- 
 ber 26, 1913, and on October 21, 1914, submitted its reports con- 
 taining a summary of the facts gathered and, based on these facts, 
 a series of recommendations. 
 
 One of these recommendations was: 
 
 "That the County Medical Society urge every hospital in 
 Philadelphia, public or private: 
 
 "To adopt a uniform system of hospital records and reports in 
 order to furnish a common basis for the comparison of financial 
 records and statistics and medical records and statistics. 
 
 "To use as a basis for the proposed system of uniform reports 
 the forms recommended to other hospitals by various institutions 
 in New York and other cities in the volume entitled Hospital 
 Accounting and Statistics.** 
 
 This fourth edition of the book describes more fully than 
 previous editions matters concerning the rendering of bills against 
 patients and also refers to new and improved forms of Superin- 
 tendent's Bill Book, Bill Register, Patients' Ledger Account 
 Cards and Cash Receipt Book, which should help minimize clerical 
 labor in the Superintendent's office in keeping proper and accurate 
 accounts and records. 
 
 It also contains, in addition to the matter included in the 
 previous edition, a description and illustrations (on pages 101 
 to 119) of desirable forms for use in computing statistics, etc., 
 concerning patients treated, referred to in Schedule 6, on pages 
 11 to 13. 
 
 Dix:ember, 1918. 
 
 CONTENTS 
 
 Schedule 1, Statement of Current Revenue 
 
 " 8, Statement of Current Expenses 
 
 '* 8, Surplus and Deficit Account 
 
 ** 4, Balance Sheet, Treasurer's 
 
 " 5, Statement of Increase or Decrease of Principal of Capital 
 Reserve Funds ....-.*• 
 
 " 6, Statistics Concerning Patients 
 
 Instructions regarding Distribution of Expenses .... 
 Advantages of Uniform and Intelligent Financial Reports and Statistics 
 Applicability of this System of Accounting to all Sorts of Charitable 
 
 Institutions 
 
 Double Entry System of Bookkeeping 
 
 Sopehintendent's Accounts 25 to 60, 
 
 Vouchers 
 
 Expenses Paid by Vouchers through the Superintendent's OflBce 
 
 Pay Rolls 
 
 Unclaimed Wages . «8, 29. 31. 32 
 
 Time Checks 
 
 Advances Paid Account Salaries and Wages 
 
 Card Record of Unclaimed Wages 
 
 Transfer of Unclaimed Wages to Surplus and Deficit Account 
 Voucher Register ....•••• 
 Bills Rendered to Pay Patients . . 
 
 Bill Register . ; . 
 
 Statements of Account 
 
 Card Ledger Accounts with Patients and Others 
 
 Charges for Special Nursing and Other Miscellaneous Charges 
 
 Checking Amount of Special Nursing Charges . 
 
 Charges against Patients for Telephone Messages 
 
 Bills for Advance Payments 
 
 Bills for Hospital Earnings Accrued 
 
 Hospital Earnings Cash Receipt Book .... 
 Superintendent's General Cash Book .... 
 
 Cash Remittances by Treasurer to Superintendent 
 •• " by Superintendent to Treasurer 
 
 Superintendent's Bank Accounts 
 
 •• Petty Cash Book 
 
 " Journal and Journal Entries 
 
 •• General Material Account 
 
 Sale of Supplies Credited to Current Expenses 
 
 PACKS 
 
 2.3 
 
 4.5.6 
 
 7 
 
 8, 9 
 
 10 
 
 11, 12, 18 
 
 14 to 22 
 
 24 
 
 24 
 
 101 to 119 
 
 25.26 
 
 26 
 
 26 to 29 
 
 SO 
 
 30.31 
 
 31.32 
 
 32 
 
 32,38 
 
 33 to 41 
 
 35 
 
 86 
 
 36 to 39 
 
 38.39 
 
 39 
 
 39 
 
 89.40 
 
 40.41 
 
 41.42 
 
 42 to 44 
 
 45.46 
 
 46 
 
 46,47 
 
 47,48 
 
 48 to 53 
 
 51 
 
 51.52 
 
CONTENTS 
 
 PAGES 
 
 How Supplies Donated may be Charged to Current Expenses, if 
 
 desired 58 
 
 Journal Entries to be made by Superintendent in opening a new 
 
 set of books 52, 53 
 
 Superintendent's Ledger Accounts 54 to 58 
 
 Trial Balance 57 
 
 Monthly Report of Superintendent to Treasurer. . 59, 60 
 
 Superintendent's Monthly Statements of Revenue. Expenses and 
 
 Statistics 59, 101 
 
 Superintendent's Comparative Month and To Date Statements . 59, 1 18, 1 19 
 
 TB£ASUB£B*a ACCOUNTS. 61 to 100 
 
 Treasurer's Cash Book 61 to 64 
 
 *• Journal and Journal Entries 64 to 71 
 
 Journal Entries to be made by Treasurer in opening a new set of 
 
 books 70,71 
 
 Treasurer's General Ledger Accounts 72 to 87 
 
 Trial Balance 87 
 
 " Income Ledger Accounts 87 to 96 
 
 Amortization or Accumulation on Bonds 97 to 99 
 
 Treasurer's Endowed Bed Ledger Accounts . 99, 100 
 
 Statistics 
 
 Forms used in computing Statistics concerning Numbers of Patients 
 
 Treated, Days Treatment, Visits, etc., referred to in Schedule 6 101 to 119 
 
 Hospital Patients Statistics 101 to 108 
 
 Method of figuring Cost per Patient per Day or per Visit . . 108 
 
 Out Patient Department Statistics 108 to 115 
 
 Social Service Department Statistics 1 15 to 1 18 
 
 Comparative Statistical Figures for a Period of Months or Years 118. 119 
 
 Hospital 
 Accounting and Statistics 
 
 i, 
 
SCHEDULE 1 
 
 Detailed Statement of Current Revenue 
 
 HOSPITAL EARNINGS (OR OPERATING EARNINGS): 
 
 1917 1918 
 
 Private Room Patients 
 
 Board of Friends of Patients 
 
 Semi-Private Patients 
 
 Ward Patients 
 
 Special Nursing 
 
 Operating Room Fees 
 
 X-Ray Service 
 
 fDispensary 
 
 fEmergency Ward 
 
 Pharmacy 
 
 Ambulance Fees 
 
 Telephone and Telegraph 
 
 Scrap Material Sold 
 
 Miscellaneous 
 
 SCHEDULE 1— Continued 
 
 APPROPRIATIONS FROM SPECIAL FUNDS TO MEET CURRENT 
 
 EXPENSES: 
 
 Total Hospital Earnings 
 
 OTHER REVENUE OR INCOME: 
 
 From the Public Treasury 
 
 ^Donations from Individuals to meet Current 
 
 Expenses 
 
 Donations from Churches to meet Current 
 
 Expenses 
 
 From The United Hospital Fund of New 
 
 Donations* Special 
 
 Net Receipts from Entertainments, Fairs, 
 
 F^tes, etc 
 
 •Legacies, unrestricted 
 
 Income from Investments held in Endowed 
 
 Bed Fund . 
 
 Income from Investments held in General 
 
 Endowment Fund 
 
 Income from Investments held in Other Funds 
 (enumerate) the income of which is to 
 be used to meet Operating Expenses, 
 Schedule 2, and is not to be added to 
 the principal 
 
 Income from unrestricted Investments '. . 
 
 Miscellaneous 
 
 Total other Revenue or Income 
 
 •(Show appropriation from each fund sepa- 
 rately.) 
 
 1917 
 
 1916 
 
 • • • • 
 
 Total Appropriations from Special Funds 
 to meet Current Expenses 
 
 Grand Total Current Revenue 
 
 Excess of Current Expenses over Current 
 
 Revenue 
 
 Total 
 
 •Note.— Reference should be made to some page or pages in the Annual Re- 
 port showing briefly the purpose for which each special fund is to be used. 
 
 fOr Out Patient Department. 
 
 •The amounts shown for Unrestricted Donations or Legacies should include 
 the value of investments (not including accrued interest) given to the Hospital 
 without restriction. 
 
 Note. — It may be found preferable to credit "Unrestricted Legacies" direct 
 to Endowment Fund or to a General Fund and not to consider them a part of 
 Current Revenue. 
 
cr'Tn7"nTTn? o 
 
 OKjilMhUVljMii z 
 
 1 
 
 i 
 
 i 
 
 Detailed Statement of Current Expenses Including 
 Operating, Corporation and Other 
 
 ADMINISTRATION EXPENSES: 
 
 1917 
 
 1916 
 
 Salaries, Officers and Clerks 
 
 Office Expenses 
 
 Stationery, Printing and Postage 
 
 Telephone and Telegraph 
 
 Legal Expenses 
 
 Miscellaneous 
 
 Total Administration Expenses 
 
 PROFESSIONAL CARE OF PATIENTS 
 
 Salaries and Wages: 
 
 Physicians 
 
 Anesthetists 
 
 Directress of Nurses, Assistant and In- 
 structors 
 
 Nurses 
 
 Special Nurses 
 
 Orderlies 
 
 Special Orderlies 
 
 Ward Employes 
 
 Pharmacy Employes 
 
 Medical and Surgical Supplies: 
 
 Apparatus and Instruments 
 
 tMedical and Surgical Supplies, 
 
 Alcohol, Liquors, Wines, etc 
 
 CLorraNG, etc., for use of Patients in Hos- 
 pital 
 
 Equipment for Nurses: 
 
 Uniforms 
 
 Books. 
 
 Instruments 
 
 Uniforms, etc., for Staff and Orderlies 
 
 Pathological 
 Department: 
 
 j Salaries and Labor.. 
 
 ^Supplies 
 
 ( Salaries and Labor.. 
 
 t Supplies 
 
 j Salaries and Labor. . 
 ( Supplies 
 
 {Salaries 
 Supplies 
 
 {Salaries and Labor. 
 Supplies 
 
 Total Professional Care of Patients . . . 
 *0r Out-Patient Department 
 
 tNoTE.— As " Drugs and Druggist's Sundries " make up a large part of " Medical 
 and Surgical Supplies" it may be found desirable to subdivide this last mentioned 
 item into "Drugs and Druggist's Sundries" and "Other Medical and Surgical 
 SuppUes." 
 
 •Dispensary: 
 
 •Emergency Ward: 
 
 Social Service 
 Department: 
 
 X-Ray Service: 
 
 schedule St-^oniinued 
 department EXPENSES: 
 
 1917 
 
 1916 
 
 Ambulance: 
 
 Training School: 
 
 Housekeeping: 
 
 Kitchen: 
 
 Laundry: 
 
 I Labor 
 
 1 Supplies 
 
 ( Salaries and Labor. , 
 
 ( Supplies 
 
 j Labor 
 
 C Supplies 
 
 ( Labor 
 
 ( Supplies 
 
 j Labor 
 
 ( Supplies 
 
 Steward's Department: 
 
 Labor 
 
 Provisions: 
 
 Bread 
 
 Milk and Cream 
 
 Groceries 
 
 Butter and Eggs 
 
 Fruits and Vegetables 
 
 Meat, Poultry and Fish 
 
 Total Steward's Department 
 
 Total Department Expenses 
 
 • • • • • 
 
 • » ■ • 
 
 GENERAL HOUSE AND PROPERTY EXPENSES: 
 
 ♦Electric Lighting . . 
 Fuel, Oil and Waste 
 Gas 
 
 Ice 
 
 Insurance 
 
 ♦Maintenance, Real Estate and Buildings. 
 
 ♦Maintenance, Machinery and Tools 
 
 ♦Plumbing and SteamBtting 
 
 Rent 
 
 Miscellaneous 
 
 Total General House and Property Exps. 
 
 Total Operating Expenses 
 
 • It may be found desirable to subdivide the items marked with an asterisk 
 into "Labor" and "Supplies" so as to show how much the pay-roll charges were 
 for each account. 
 
e 
 
 SCHEDULE i-^oniinued 
 
 CORPORATION EXPENSES 
 
 1917 
 
 Salaries. Officers and Clerks 
 
 Pensions 
 
 Office Expenses 
 
 Stationery, Printing and Postage 
 
 Legal Expenses 
 
 Interest on Mortgages or Loans Payable 
 
 Taxes 
 
 Miscellaneous 
 
 1910 
 
 Total Corporation Expenses 
 
 CURRENT EXPENSES FROM SPECIAL FUNDS FOR STATED PUR 
 POSES. OTHER THAN REGULAR HOSPITAL CURRENT EXPENSES 
 
 •(Show expenditure from each fund separately.) 
 
 ...... ...• •••••• •••• 
 
 , ...••« •••• »....• •••• 
 
 Total Current Expenses from Special 
 
 Funds for Stated Purposes i^^i^lii^ ^in^^^M^^^^ 
 
 Grand Total Current Expenses 
 
 Excess of Current Revenue over Current 
 
 Expenses 
 
 Total • •••• • 
 
 •Note.— Reference should be made to some page or pages in the Annual Report 
 showing briefly the purpose for which each special fund is used. 
 
 \M 
 
 } 
 
 "i 
 
MHipiii Ni!!!ii JiiiiHii«iiii«ii«#i«i"ii» 
 
 Pi 
 
 SCHEDULE 4 
 
 Comparative Balance Sheet 
 
 A* of Septmnber SO, 1917 and 1916 
 CAPITAL ASSETS: 
 
 1917 1»1« Increase 
 
 HoflPiTAL Pbopebties AND EovmoNt: 
 
 Sites and Grounds 
 
 Buildings 
 
 Furniture and Fixtures 
 
 Machinery and Tools 
 
 Apparatus and Instruments. . 
 Ambulances, Live Stock, etc . 
 Miscellaneous 
 
 jTotal 
 
 Investments: 
 Mortgages Receivable 
 
 Bonds 
 
 Stocks 
 
 Other Investments 
 
 Total Investments 
 
 CURRENT ASSETS: 
 
 Decrease 
 
 • • • • • 
 
 Cash in hands o! Treasurer. . .. 
 Cash m hands of Superintendent 
 Loans and Notes Receivable . . . 
 Treasurer's Accounts Receivable 
 Superintendent's Accounts Re- 
 ceivable 
 
 Accounts Receivable from Pub- 
 lic Treasury 
 
 General Material on Hand 
 
 Advances: 
 
 Interest Purchased 
 
 Prepaid Insurance 
 
 Other Prepaid Expenses 
 
 Total Current Assets 
 
 Grand Total Assets 
 
 Deficit 
 
 tTotal 
 
 f • • • - ' 
 
 . . . • • • 
 
 . . • • • • 
 
 . ■ • • • • 
 
 . . • • • • 
 
 « • . • • • 
 
 . • . • • • 
 
 . • • • • • 
 
 . . • • • • 
 
 '•* 
 
 SCHEDULE 4 
 
 Comparative Balance Sheet 
 
 As of September SO, 1917 and 1916 
 CAPITAL LIABILITIES: 
 
 1917 
 
 1916 
 
 Increase Decrease 
 
 • Capital Account (Hospital Prop- 
 
 erties and Equipment) 
 
 •Reserve for Depreciation of Hos- 
 pital Properties and Equip- 
 ment (if any) 
 
 * Bonds Outstanding or Mortgages 
 
 Payable on Hospital Prop- 
 erty (if any) 
 
 tTotal 
 
 Endowed Bed Fund Account. . . . 
 
 Partly Endowed Bed Fund Ac- 
 count 
 
 General Endowment Fund Ac- 
 count 
 
 Other Fund Reserve Accounts. . . 
 (List each separately.) 
 
 • • • 
 
 • ■ 
 
 Total Fund Reserve Accounts 
 
 CURRENT LIABILITIES: 
 
 Loans and Notes Payable 
 
 Audited Vouchers Unpaid or Ac- 
 counts Payable 
 
 Over-Payments by Patients 
 
 Unpaid Wages of Latest Payroll 
 
 Unclaimed Wages of Previous 
 Pay Rolls 
 
 Advance Payments by Patients. . 
 
 Total Current Liabilities. . . . 
 
 Grand Total Liabilities 
 
 Surplus 
 
 JTotal 
 
 I 
 
 •Note. — For detailed explanation concerning "Capital Account" and "Re- 
 serve for Depreciation of Hospital Properties and Equipment," and " Bonds Out- 
 standing or Mortgages Payable on Hospital Property " see pages 80 and 81. 
 
 tThe total book value of "Hospital Properties and Equipment," as shown 
 under the heading Capital Assets should equal the total of the amounts shown as 
 " Capital Account," " Reserve for Depreciation of Hospital Properties and Equip- 
 ment," and Bonds Outstanding or Mortgages Payable on Hospital Property as 
 shown under the heading Capital Liabilities. 
 
 t These totals should agree. 
 
 8 
 
SCHEDULE 6 
 
 It 
 
 'h 
 
 fll 
 
 11, 1' 
 
 P 
 
 CO 
 
 
 
 I 
 
 C0MPARA.TIVE Statistics of Patients Tbeateo 
 
 During Years ended September 30, 1917 and 1916 
 HOSPITAL WARDS AND PRIVATE ROOMS 
 
 Male Female 
 
 TaUd 
 
 Patients in Hospital First of Ybab: 
 In Medical Wards 
 
 In Surgical Wards . 
 In Private Rooms . 
 
 Total 
 
 Patients Admitted during Year: 
 To Medical Wards 
 
 To Surgical Wards. 
 To Private Rooms. 
 
 Total 
 
 Total Patients Treated in Hospital 
 
 Wards and Private Rooiis during Year: 
 
 Patients Discharged During Year: 
 Cured 
 
 Improved 
 
 Unimproved 
 
 Transferred to other institutions — 
 
 Died. 
 
 Total 
 
 1917 
 1916 
 1917 
 1916 
 1917 
 1916 
 
 1917 
 1916 
 
 1917 
 1916 
 1917 
 1916 
 1917 
 1916 
 
 1917 
 1916 
 
 1917 
 1916 
 
 1917 
 1916 
 1917 
 1916 
 1917 
 1916 
 1917 
 1916 
 1917 
 1916 
 
 1917 
 
 1916 
 
 > 
 
 It 
 
 Note. — For description and illustrations of desirable forms for use in com- 
 puting statistics, etc., of patients cared for, etc., as shown by Schedule 6 on pages 
 11, 12, and IS, see pages 101 to 119 inclusive and Exhibits 1 to 19, inclusive. 
 
 For distinctive purposes previous year's figures should be shown in italics or red. 
 
 11 
 
12 
 
 SCHEDULE Q—ConHnued 
 
 Patiknts in Hospital End of Ykab: 
 In Medical Wards 1917 
 
 1916 
 In Surgical Wards 1917 
 
 1916 
 In Private Rooms 1917 
 
 1916 
 
 Total 1917 
 
 1916 
 
 Male Female Total 
 
 • • • • 
 
 Free Endowed Pay 
 Ward Bed Ward 
 
 Private Total 
 Room 
 
 Total Patient 
 Days Treatment: 
 
 Percentage . 
 
 Average Patients per day 
 
 1917 
 1916 
 1917 
 1916 
 1917 
 1916 
 
 Average Days per Patient in Hospital 
 
 Daily average Cost per Private Room Patient. 
 Daily Average Cost per Ward Patient 
 
 1917 
 
 1916 
 
 OUT-PATIENT DEPARTMENT 
 
 Former Patients Treated, who have been 
 treated in some previous fiscal year 
 
 Male Female Total 
 
 New Patients Treated. 
 Total Patients treated. 
 
 1917 
 1916 
 1917 
 1916 
 
 1917 
 1916 
 
 Free Pay Total 
 
 Visits made. 
 
 Average Visits per day . 
 
 1917 
 1916 
 1917 
 1916 
 
 1917 
 
 Average Visits per Patient. 
 
 Average Cost per Visit 
 
 Surgical Dressings Made . . 
 Prescriptions Filled 
 
 1916 
 
 SCHEDULE ^—Continued 
 
 AMBULANCE 
 
 18 
 
 1917 1916 
 
 Ambulance Calls during year 
 
 Average Calls per day 
 
 Average Cost per Ambulance Call 
 
 Patients Treated by Ambulance Surgeon in 
 
 Emergency Ward and Transferred 
 
 Patients Treated by Ambulance Surgeon and 
 
 left at place of call or transferred direct to 
 
 other Institutions or to their homes 
 
 SUMMARY 
 
 Total Patients Treated at the Hospital during 
 
 year in all Departments 
 
 Average Patients per day in all Departments 
 Daily Average number of Employes Boarded 
 
 in Hospital 
 
 Daily Cost per capita for Provisions for all 
 
 persons supported 
 
 SOCIAL SERVICE DEPARTMENT 
 
 Former Cases Cared for, who have been cared 
 
 for in some previous fiscal year 
 
 New Cases Cared for 
 
 Total Cases Cared for 
 
 Visits to Homes for Social Service 
 
 Visits to Homes of Patients for Nursing Care 
 Visits to Ward Patients needing Social Service 
 
 Care 
 
 Visits Made at Social Service OflSce 
 
 Total Visits 
 
 Former Cases Given Material Relief who 
 
 have received such relief in some previous 
 
 fiscal year 
 
 New Cases Given Material Relief 
 
 Total Cases Given Material Relief 
 
 Cases referred to Organizations for Material 
 
 Relief or Employment 
 
 Patients sent to Convalescent Homes and 
 
 Sanatoria 
 
 Patients sent to Hospitals, Homes for Incur- 
 ables and Aged 
 
 Patients sent to Fresh Air Homes 
 
 • • 
 
rasTRUcnoNS regarding distribution of 
 
 EXPENSES INCLUDING OPERATING, 
 CORPORATION, AND OTHER 
 
 ADMINISTRATION EXPENSES 
 
 1. Salabieb, Officers and Clbbks 
 
 This account includes the salaries of general officers of the 
 Hospital and their assistants or clerks, whose salaries are not 
 directly chargeable to any department. 
 
 This account should not include salaries of officers or clerks, 
 who arc exclusively engaged with the management of the corpo- 
 ration> estate or sources of revenue outside of the ordinary receipts 
 of the hospital proper. If certain officers or clerks are partly 
 engaged in this manner, a proper proportion of their salaries 
 should be charged accordingly. 
 
 2. Office Expenses 
 
 This account includes car fares, express charges, messenger 
 service, subscriptions to newspapers and periodicals, office furni- 
 ture and fixtures, and such other office supplies as are not properly 
 chargeable to any other subdivision of Administration Expenses 
 or to Corporation Expenses. 
 
 3. Stationery, Printing and Postage. 
 
 This account includes the cost of printing annual reports, 
 blank books, blank forms, paper, stationery, stationery supplies, 
 etc., used in the general work of the hospital. It should not 
 include expenditures of this nature made for corporation purposes. 
 
 The following is a list of the more important items which may 
 be chargeable to this account: 
 
 Armregti 
 Binders 
 Blank cards 
 Blank paper 
 Blank tableto 
 Bbtters 
 Blotting paper 
 Calendars 
 Carbon paper 
 Cardboard 
 Cards 
 
 Circulars 
 
 Copy (impression) books 
 
 Dating stamps 
 
 Envelopes 
 
 Erasers 
 
 Eyelet punches. 
 
 Eyelets 
 
 Hektographi 
 
 Indexes 
 
 Ink 
 
 14 
 
 Invoice books 
 Legal cap paper 
 Letter paper 
 Manifold paper 
 Mimeographs 
 Mucilage 
 Mucilage brasbei 
 Notices 
 
 Numbering stamps 
 Oilpaper 
 Orders 
 
 DISTRIBUTION OF EXPENSES 
 
 li 
 
 Pins 
 
 Shipping tags 
 
 Postage 
 
 Shorthand books 
 
 Printed cards 
 
 Sponge cups 
 
 Printed teblets 
 
 Sponges 
 
 Rubber bands 
 
 Telegraph blanks 
 
 Rubber stamps 
 
 Tissue (impression) paper 
 
 Rulers 
 
 Twine 
 
 Ruling pens 
 
 Typewrite* supplies 
 
 Scrap books 
 
 Waste baskets 
 
 Sealing wax 
 
 Water holders 
 
 Seals 
 
 Wrapping paper, etc 
 
 Shears 
 
 
 Paper 
 
 Paper baskets 
 Paperclips 
 Paper cutters 
 Paper fasteners 
 Paper files 
 Paper weights 
 Pencil erasers 
 Pencils 
 Penholders 
 Pen racks 
 Pens 
 
 4. Telegraph and Telephone. 
 
 This account includes all expenditures, account telegraph 
 messages, rent of telephones, salaries of operators or maintenance 
 of telephones and telephone lines. 
 
 5. Legal Expenses. 
 
 This account includes all fees and retainers paid for services 
 of attorneys, costs of suits and all legal and court expenses in- 
 curred in the operation of the Hospital. It should not include 
 expenditures of this nature made for corporation purposes. 
 
 6. Miscellaneous. 
 
 This account includes such other Administration Expenses as 
 are not directly chargeable to any of the foregoing accounts, or 
 to Corporation Expenses. 
 
 PROFESSIONAL CARE OF PATIENTS 
 
 7. Salaries and Wages. 
 
 This account includes the salaries and wages of employes 
 under the various headings named. 
 
 8. Medical and Subgical Supplies. 
 
 This account includes the cost of apparatus and instruments, 
 medical and surreal supplies, and alcohol, liquors, wines, etc., 
 purchased for the general use of the Hospital, not specifically 
 chargeable to any department. 
 
 It would not, however, include the purchase of new and addi- 
 tional apparatus and instruments in large quantities, which 
 should be charged to capital account, under the heading provided 
 therefor. 
 
 9. Clothing, etc., for Use of Patients in Hospital. 
 This account includes the cost of clothing, slippers, tooth- 
 
 hi 
 
16 
 
 DISTRIBUTION OF EXPENSES 
 
 DISTRIBUTION OF EXPENSES 
 
 17 
 
 brushes, etc., for patients' use while in the hospital. If any such 
 articles are made in the hospital the cost of the material used and 
 labor employed should be charged to this account. 
 
 10. Equipment for Nurses. 
 
 This account includes the cost of uniforms, books and instru- 
 ments, if furnished to the nurses by the Hospital. 
 
 If uniforms, books and instruments are purchased by the 
 Hospital, to be paid for later by the nurses, they should be charged 
 to the General Material Account, and that account should be 
 credited when these are paid for by the nurses. 
 
 11. Uniforms, etc., for Staff and Orderlies. 
 
 This account includes the cost of uniforms, operating gowns, 
 etc., for staff and orderiies. If any such articles are made in the 
 hospital the cost of the material used and labor employed should 
 be charged to this account. 
 
 12. Pathological Department. 
 
 (a) Salaries and Labor, This account includes the salaries 
 and wages of physicians, assistants, and any other employes in 
 this department, including amounts paid for cost of labor in 
 making repairs or maintaining the equipment of this department. 
 
 (b) Supplies. This account includes the cost of all apparatus 
 and instruments, medical and surgical supplies, and any other 
 supplies whatsoever, which are properly chargeable to this de- 
 partment; also, the cost of any materials used in making repairs 
 or maintaining the equipment of this department. 
 
 13. Dispensary or Out-Patient Department. 
 
 (a) Salaries and Labor. This account includes the salaries 
 and wages of physicians, assistants, nurses, and any other em- 
 ployes in this department. 
 
 (b) Supplies, This account includes the cost of all apparatus 
 and instruments, medical and surgical supplies, and any other 
 supplies whatsoever, which are properly chargeable to this depart- 
 ment. 
 
 14. Emergency Ward or Out-Patient Department. 
 
 (a) Salaries and Labor. This account includes the salaries 
 and wages of physicians, assistants, nurses, and any other em- 
 ployes in this department. 
 
 (6) Supplies, This account includes the cost of all apparatus 
 and instruments, medical and surgical supplies, and any other 
 supplies whatsoever, which are properly chargeable to this depart- 
 ment. 
 
 15. Social Service Department. 
 
 (a) Salaries. This account includes the salaries of nurses 
 or other employes in this service. 
 
 (b) Supplies. This account includes the cost of all medical 
 and surgical supplies, food, clothing, or any other supplies pur- 
 chased for this service for use of patients, etc. 
 
 16. X~Ray Service. 
 
 (a) Salaries and Labor, This account includes the salaries 
 and wages of physicians, operators and any other employes in 
 this service. 
 
 (6) Supplies. This account includes the cost of apparatus 
 and supplies which are properly chargeable to this service. 
 
 DEPARTMENT EXPENSES 
 
 17. Ambulance. 
 
 (a) Labor, This account includes the wages of all employes in 
 this department; also thecostof any other labor in connection with 
 making repairs or maintaining the equipment of this department. 
 
 (b) Supplies, This account includes the cost of all equip- 
 ment and supplies of any nature which are properly chargeable 
 to this department; also, the cost of any material used m making 
 repairs or maintaining the equipment of this department. It 
 should not include, however, new and additional equipment, 
 such as ambulances, live stock, etc., as it is considered more proper 
 to charge such new equipment to capital account, under the heading 
 provided therefor. 
 
 18. Training School. 
 
 (a) Salaries and Labor, This account includes the salaries 
 and wages of officers, instructors, and any other employes which 
 are chargeable exclusively to the cost of operating and maintain- 
 ing the training school, and which can not properly be charged 
 to any other account. 
 
 (b) Supplies, This account includes the cost of supplies and 
 materials which are directly chargeable to the cost of operating 
 and maintaining the training school exclusively, but does not 
 include the cost of supplies for housekeeping, kitchen, laundry, 
 steward's department, and general house and property expenses 
 in connection with the training school, which should be charged 
 under their respective headings elsewhere, together with other 
 expenses of similar character for the general hospital, as it does 
 not seem desirable to further subdivide the training school account. 
 
 M 
 
 ,A 
 
 I.' 
 
18 
 
 DISTRIBUTION OF EXPENSES 
 
 19. Housekeeping. 
 
 (a) Labor. This account includes the salaries and wages of 
 the housekeeper and all persons employed in this department, 
 including waitresses, chambermaids, scrubwomen, porters, etc.; 
 also, all persons employed in making and maintaining house- 
 keeping supplies and in cleaning, etc., chargeable to the general 
 hospital and training school, and not chargeable to any other 
 
 department. 
 
 (6) Supplies, This account includes the cost of furniture 
 and fixtures, such as beds, bedding, chairs, Ubles, tableware, 
 linen, and all other housekeeping supplies. It also includes the 
 repau^ of same. It should not include, however, large quantities 
 of new and additional furniture, as it is considered more proper to 
 charge these to capital account, under the heading provided 
 therefor. 
 
 20. Kitchen. 
 
 (a) Labor. This account includes wages and labor of all 
 persons employed in this department, in connection with the 
 preparation and general distribution of all food. 
 
 (6) Supplies. This account includes the cost of all kitchen 
 utensils, fuel used in the kitchen range and other supplies and 
 materials chargeable to the operation and maintenance of the 
 kitchen, not including, however, provisions mentioned under the 
 heading of steward's department. 
 
 21. Laundry. 
 
 (a) Labor. This account includes the wages of employes 
 engaged in this department or the cost of laundry work done out- 
 side. It also includes the cost of any labor in connection with 
 repairs or maintenance of equipment of this department. 
 
 (6) Supplies, This account includes the cost of all supplies used 
 in this department, including the materials used m connection with 
 operating and maintaining the equipment of this department 
 
 22. Steward's Department. 
 
 (a) Labor, This account mcludes the wages of all persons 
 employed in receiving, storing and distributing the supplies of 
 this department. 
 
 (6) Provisions. 
 
 Bread.— This account mcludes the cost of all bread, cake, 
 
 pastry, etc., purchased. 
 
 Milk and Cream.— This account includes the cost of aU milk, 
 cream, cheese and ice cream purchased. 
 
 DISTRIBUTION OF EXPENSES 
 
 
 Groceries. — ^This account includes the cost of aU groceries* 
 canned goods, flour, dried fruit, etc. 
 
 Butter and Eggs. — ^This account includes the cost of all butter 
 and eggs. 
 
 Fruits and Vegetables. — This account includes the cost of aU 
 fresh fruits and fresh vegetables. 
 
 Meat, Poultry and Fish. — ^This account includes the cost of 
 all meat, whether fresh, dried or smoked, and of poultry, game, 
 fish and all sea food. 
 
 
 GENERAL HOUSE AND PROPERTY EXPENSES 
 
 23. Electric Lighting. 
 
 This account includes the cost of all labor, supplies and ma- 
 terials used in connection with operating and maintaining the 
 electric lighting plant, not including, however, the cost of main- 
 taining machinery used in connection with same, which is charge- 
 able to maintenance, machinery and tools. It includes the cost 
 of maintaining electric lamps, fixtures or wiring, but does not 
 include the cost of operating steam plant or dynamos, which is 
 chargeable to maintenance, machinery and tools. This account 
 of electric lighting includes the cost of any electric light, if fur- 
 nished from outside. 
 
 24. Fuel, Oil and Waste. 
 
 This account includes the cost of all fuel, oil and waste used 
 in connection with operating and maintaining the power, lighting 
 and heating plant, but does not include the cost of fuel used in the 
 kitchen or laundry range. 
 
 25. Gas. 
 
 This account includes the cost of all gas. 
 
 26. Ice. 
 
 This account includes the cost of all ice. 
 
 (If Refrigerating Plant is used, indicate by foot-note.) 
 
 27. Insurance. 
 
 This account includes the cost of all insurance for accoimt of 
 the hospital, except fidelity insurance, which should be charged to 
 Miscellaneous Administration expenses. 
 
 28. Maintenance Real Estate and Buildings. 
 
 This account includes the cost of all labor and materials used 
 in connection with repairs and maintenance of real estate and 
 buildings in the hospital group. It includes the cost of repairs 
 
DISTRIBUTION OF EXPENSES 
 
 DISTRIBUTION OF EXPENSES 
 
 m. 
 
 to fences, sidewalks, and the cost of keeping sidewalks and grounds 
 in good order, shoveling snow, etc. 
 
 This account should not be charged with repairs and renewals 
 of furniture and fixtures such as beds, bedding, chairs, tables, 
 tableware, etc., which are chargeable to housekeeping supplies. 
 
 This account does not include the cost of new and additional 
 real estate and buildings. It is thought more proper to charge 
 the cost of these to capital account, under the headings provided 
 for sites and grounds or buildings. 
 
 29. Maintenance, Machinery and Tools. 
 
 This account includes the cost of all labor or materials used 
 in connection with repairs, maintenance and renewals of boilers, 
 stationary engines, dynamos, pumps, elevators and other machinery, 
 including the shafting, belting and other appliances for running 
 machinery and all tools and fixtures used in connection therewith. 
 
 It includes the wages of engineers, firemen, elevator-men, etc., 
 not directly chargeable to other accounts. 
 
 This account should not include the cost of expensive new 
 machinery and tools, except in so far as these replace old machinery 
 and tools. It is considered that new additional machinery and 
 tools are more properly chargeable to this heading under capital 
 account. 
 
 30. Plumbing and Steamfitting. 
 
 This account includes the cost of all labor and materials used 
 in connection with repairs and renewals of all water, gas or steam 
 pipes and fittmgs. 
 
 31. Rent. 
 
 This account includes the cost of rental of buildings used in 
 connection with hospital work. 
 
 32. Miscellaneous. 
 
 This account includes the cost of any labor and materials 
 chargeable to general house and property expenses, not included 
 in any of the headings already provided for. 
 
 CORPORATION EXPENSES 
 
 33. Salaries Officers and Clerks. 
 
 This account includes salaries of oflScers and clerks, who are 
 exclusively engaged with the management of the corporation, 
 estate or other sources of revenue outside of the ordinary receipts 
 of the hospital proper. 
 
 If certain officers or clerks are partly engaged in this manner 
 
 a proper proportion of their salaries should be charged accordingly. 
 
 34. Office Expenses. 
 
 This account includes such corporation expenses as car fares, 
 express charges, messenger service, subscriptions to newspapers 
 and periodicals, rent of safe deposit box, office furniture and 
 fixtures and such other office supplies as are not properly charge- 
 able to any other subdivision of Corporation Expenses or Admin- 
 istration Expenses. 
 
 35. Stationery, Printing and Postage. 
 
 This account includes expenditures of this nature for corpora- 
 tion purposes and for soliciting Donations, etc. 
 
 36. Legal Expenses. 
 
 This account includes expenditures of this nature made for 
 corporation purposes. 
 
 37. Interest on Mortgages and Loans Payable. 
 This heading explains itself. 
 
 38. Taxes. 
 
 This account includes all taxes, if any, paid on property used 
 for hospital purposes. 
 
 Taxes paid on property held for investment and not used for 
 hospital purposes should be debited to income, if any, from such 
 investment. If there is no income from such investment, these 
 expenses may be debited to the capital account of such invest- 
 ment, if the prospective value of the investment seems to justify 
 such action. Otherwise such taxes may be charged as a part of 
 Corporation Expenses. 
 
 39. Miscellaneous. 
 
 To this account should be charged any other corporation 
 current expenses not properly chargeable to any of the other 
 headings provided, including petty current expenses paid on 
 account of investments. 
 
 Current expenses other than petty current expenses paid on 
 property held for investment and not used for hospital purposes 
 should be debited to income, if any, from such investment. If 
 there is no income from such investment, these expenses may be 
 debited to the capital account of such investment if the prospective 
 value of the investment seems to justify such action. Otherwise 
 such expenses may be charged as a part of Corporation Expenses. 
 
 40. Current Expenses from Special Funds for Stated 
 Purposes, other than regular Current Hospital Expenses. 
 
 (Show expenditure from each fund separately.) 
 This account explains itself. 
 
 (• 
 
 f) 
 
DISTRIBUTION OF EXPENSES 
 
 CAPITAL EXPENDITURES 
 
 41. To Sites and Grounds Account, Buildings Account, Furni- 
 ture and Fixtures Account, Machinery and Tools Account, Appa- 
 ratus and Instruments Account, or Ambulances, Live Stock, etc.. 
 Account, under the heading "Capital Expenditures" (Schedule 
 3) may be charged the cost of any such new and additional Hos- 
 pital Property or Equipment to such extent as it does not renew 
 or replace property or equipment already in use and to such ex- 
 tent as it increases the value or eflSciency of the assets concerned. 
 Ordinarily it would hardly seem worth while to charge small 
 expenses of such nature to Capital Account unless the aggregate 
 amount of such small expenditures, in the opinion of the hospital 
 ofBcials concerned, seemed to justify such action. 
 
 APPENDIX 
 
 Advantages or Uniform and Intelligent Hospital Financlal 
 
 Reports and Statistics 
 
 Some advantages to hospitals or other similar institutions of 
 adopting financial and statistical reports in form similar to that 
 recommended in this book are as follows; 
 
 First,— It provides an intelligent and accurate system of 
 accounting, which has proved entirely satisfactory to a number of 
 different institutions, and is recommended by many practical 
 hospital experts and by certified public accountants. 
 
 Second.— The system of bookkeeping herein recommended 
 involves less work, considering results obtained, than any other 
 system of accounting heretofore recommended for general adop- 
 tion by hospitals. 
 
 Third. — ^Where a uniform system of accounts and statistics 
 is used by different hospitals, comparisons can be made on a fair 
 and intelligent basis. These comparisons are of much value and 
 interest not only to officials of hospitals, but also to the public 
 who may be interested in the work and results obtained by such 
 institutions. 
 
 Fourth, — ^As many hospitals and other similar institutions are 
 largely maintained by contributions from the public, such insti- 
 tutions should inform the public by means of comprehensive and 
 uniform financial reports and statistics as to assets and liabilities, 
 revenue and expenses, work accomplished and cost of same. 
 Where such information is furnished in some uniform manner 
 it is much more easily understood by all interested, than if each 
 different institution makes reports in some manner peculiar to 
 itself with which the public is not familiar. 
 
 Object of this Appendix 
 
 In order to explain as clearly as possible to those who are not 
 accountants just what forms and account books may be used and 
 how the various entries and statements may be made in keeping 
 accounts in accordance with this system, there are given in this 
 Appendix descriptions and illustrations of the forms and entries 
 used by The Presbyterian Hospital in the City of New York. 
 
 1 
 
 f )i 
 
 ifHW 
 
 : 1...A- .— _ — .J. . 
 
\¥ 
 
 •t DOUBLE ENTRY BOOKKEEPING 
 
 Appucabilitt of this System of Accounting to all SoBxa 
 
 OF Charitable Institutions 
 
 With slight modifications to suit varying conditions, the sys- 
 tem of accounting described herein should be applicable to any 
 hospital, large or small. In the case of small institutions, many 
 of the subdivisions shown on the schedules and elsewhere, if not 
 needed, may be omitted entirely, which would simplify the state- 
 ments and accounts. For very large hospitals or for those doing 
 special work, it may be desirable to have some additional or 
 different subdivisions than those shown in the Schedules, but 
 the method of keeping the accounts, and the general arrangement 
 of the forms and statements should be about the same in any 
 case. The same system of accounting with proper modifications 
 of details could likewise be applied in keeping the accounts of 
 any other kind of charitable institution. 
 
 Double Entry System of Bookkeeping 
 
 Under the double entry system of bookkeeping, now generally 
 used by up-to-date corporations, any expense incurred or paid, 
 or any loss or depreciation charged must be debited to some 
 General Ledger Account, and credited to another, and any reve- 
 nue, receipt or profit accrued or received must be credited to 
 some General Ledger Account and debited to another. If the 
 debit sides of all these Ledger Accounts are then totaled, the 
 results should equal the sum of all the totals on the credit side of 
 all Ledger Accounts. 
 
 In these same General Ledger Accounts, if the difference only 
 in the totals of the entries on the debit side and the credit side, 
 or the balance of each account is entered upon what is called a 
 Balance Sheet on the debit side of the Balance Sheet, opposite 
 accounts in which the debits exceed the credits, and on the credit 
 side of the Balance Sheet, opposite accounts in which the credits 
 exceed the debits, the total of all these balances on the debit side 
 of the Balance Sheet should, of course, agree with the total of all 
 the balances on the credit side of the Balance Sheet, if the entries 
 have been correctly made and footed. 
 
 If these totals do not agree, it is evident some error has been 
 made, which must be found and rectified. 
 
 The advantages of this double entry system of accounting are 
 that it enables its users to easily and accurately test the correctness 
 
 SUPEEINTENDENT'S VOUCHERS 
 
 25 
 
 I 
 
 of the entries and footings made on the books, and to determine 
 the proper debit or credit balance of any General Ledger Account. 
 
 SUPERINTENDENT'S ACCOUNTS 
 
 The following paragraphs describe the various forms used in 
 the Superintendent's ojffice of the Presbyterian Hospital and the 
 manner in which entries are made to the accounts referred to. 
 
 Vouchers 
 
 Vouchers are used for convenience to provide a imiform size 
 and kind of blank on which to describe each respective bill, as 
 illustrated on Exhibit A. They also bear suitable certificates 
 for clerks and officials to sign, stating that all extensions, additions 
 and calculations in the account have been examined and found 
 correct, and that the account has been properly entered on the 
 books and has not been previously entered or paid, and also that 
 the account is correct and has been incurred for the benefit of the 
 Hospital. 
 
 Provision is also made so that the party in whose favor a 
 voucher is made may sign his receipt thereon of the amount called 
 for by the voucher. 
 
 On the back cf each voucher it is found convenient to print 
 all of the headings adopted in the classification of expenses, to 
 which any expense paid by voucher might be charged, not includ- 
 ing pay-roll expenses, as a similar provision can be made on the 
 back of some of the pay-roll sheets, so that distribution of pay- 
 rolls to the proper headings can be recorded on the back of the 
 last sheet of the pay-roll in the same way, as the pay-roll is treated 
 as one voucher. 
 
 A clear record may thus be kept on each voucher and in a 
 Voucher Register showing to what account or accounts each 
 voucher has been charged. 
 
 Vouchers should be consecutively numbered, to correspond 
 with the number given in the Voucher Register. It is suggested 
 that each voucher be dated with the date that the Cash Book 
 shows it has been paid. After being paid vouchers should be filed 
 for reference in consecutive numerical order, so they may be 
 easily referred to if desired. 
 
 The vouchers only are usually sent out of the Superintendent's 
 office between the 10th and 15th of each month, when bills for 
 the preceding month are ready for payment, having been approved 
 
 ,H 
 
If 
 
 M SUPEKINTENDENTS PAY-ROLLS 
 
 by the Superintendent and some member of the Board of Man- 
 agers. Where special discounts are offered for more prompt 
 payment vouchers may be paid more promptly. As the Su- 
 perintendent has a complete record of each voucher on his 
 Voucher Register and also has in his office the original bills to 
 which each voucher refers, the extra labor and expense of making 
 separate checks is not considered necessary. Considerable labor 
 will be saved if vouchers are made in the form of and used as a 
 check, as illustrated on Exhibit A. When such vouchers are 
 mailed in payment of bills, they are almost invariably receipted 
 and returned promptly to the Hospital through the bank at which 
 they are payable. 
 
 Expenses Paid by Vouchers thbough the Superintendent's 
 
 Officjb 
 
 It will simplify the keeping of accounts if all current expenses 
 indicated on Schedule 2 and capital expenditures indicated on 
 Schedule 3 are paid by vouchers through the Superintendent's 
 office. 
 
 Large bills for prepaid insurance may be paid, when rendered, 
 direct by the Treasurer and apportioned monthly to Operating 
 Expenses, as explained in footnote under heading Prepaid Insur- 
 ance Account on page 79. 
 
 Expenditures for assessments, which may increase the value 
 of property held in investment account or for additions and better- 
 ments to property held in investment account, should be paid 
 direct by Treasurer's check and charged on the Treasurer's books 
 to the investment account concerned to the extent that such 
 expenditures increase the value of the investment concerned. 
 
 Taxes and current expenses, other than petty current expenses, 
 on property held for investment may be paid direct by Treasurer's 
 check and charged against income, if any, of the investment 
 concerned. If there is no income it may be found preferable to 
 charge such expenses to capital account of the investment con- 
 cerned, if the prospective value of the property seems to justify 
 so doing. Otherwise such expenses may be paid by Superinten- 
 dent's voucher and charged as a part of Corporation Expenses. 
 
 Pay-Rolia 
 
 Sample pay-roll sheets are illustrated on Exhibits B and Bl. 
 The distribution of pay-roll expenses is printed on the back of 
 
 
 EXHIBIT A 
 
 1901 fitCCtbcD of THE PRESBYTERIAN HOSPITAL IN THE CITY OF NEW YORK. 
 
 f I Vf HiiMnafn twifntv,six and Afl/inQv: x •>: i m •■: ^ y v: » •>: .-: » <•: a -a •>: a fV/A»rr^ jf* 
 
 JLPfllL 18TH 
 
 in full for th« following account: 
 
 {Sign here\. 
 
 ^-_i^.i!<2^<^*<-^ 
 
 
 iuil»t NOT t»<: cut vfT (rooi th 
 
 ( bodj* of (his vv>uch«* 
 
 n ■uinonij I or io 
 
 MARCH 
 
 5. 
 LI 
 
 2A 
 
 il 
 
 Por GLASS SLIDES, SPEClMgN GLASSgS AND Tf ST TUBES 
 
 QPFRATIWtS TABIF UNO SURfitCAL INSTRUUENTS 
 
 riTRUT, PUSS RASIWS, ftURRFR SHFrTING AMD TARt F Tnt 
 
 REPAIRING. SHARPENING AND REPLAUNG INSTRUMENTS 
 
 EXHIBIT A 
 
 ArTllAI SI7 F M THIs'vnur.HFft ft X Q.l/d 
 
 as per biUs of dates shown. 
 
 I ciniijr itI^niS7RSISiDS^TinRt1^B3oai^3Bmon^»D^Ml«!uIio»nD 
 Iht above acoouM and find thtn oomct. aad kavc catered the accwiDt ea the 
 booka of lbf,H^fiul aod the aam« ha* not been preWoaalj enttrcd orj 
 
 and ha* bcca iDcvrrcd fe/_aie^nefit o( 
 
 8 
 
 lU. 
 
 23. 
 
 22. 
 
 35. 
 
 ApprOTed 
 
 5:2 
 
 ABu^ 
 
 Mtll^lt09t, 
 
 THE PRESBYTERIAN HOSPITAL 
 ' IN THE CITY^QF NEW. YORK, 
 
 ^New Tork City, N. r.,APRIL 15TH 
 
 /p^ 
 
 To litaJOriARLES .1 a. XtAllSU- 
 
 Br. 
 
 for the above account^ 
 
 Address J5$i. DEAILJSIREET. BMQiai!!tU!L.-_y-*_ 
 
 This voucher, when alfncd by the proper officials of ihc Hospital. Is payable In current funds at the FIDELITY BANK. 
 NEW YORK CITY, when receipted In accordance 4vitb the directions at>ove. printed in red Ink. 
 PLEASE COLLECT THIS VOUCHER PROMPTLY SO THAT THE HOSPITAL MAY BE ASSURED OF ITS RECEIPT. 
 
 NOTE: The iadvantage of having a ▼oucher i>rinted as indicated above is that it may be folded once and 
 placed in> an outlook envelope so that the name and address of the party in whose favor the voucher is made, as 
 shown on the voucher, serves as the mailing address, thereby avoiding additional labor. 
 
 By the sample voucher it will be noted that provision has been made for approval by some member of the Board 
 •f Managers. The President or Executive Committee might from time to time designate the manager, whose 
 duty it would be to approve vouchers, if found correct. Such rotation of responsibility might increase the interest 
 of the managers and make them more familiar with the actual workings and expenditures of the Hospital. 
 
 It also increases the likelihood of valuable suggestions as to improving the management. 
 
 In case it is desired to have a member of some committee also approve such vouchers as concern his particular 
 committee, additional endorsements may be made accordingly. 
 
 It would, of course, be optional with the hospital authorities as to whether they instruct the bank to honor 
 Touchers when signed ooly by the Superintendent or Assistant Superintendent and by the Chief Clerk or Assistant 
 Chief Clerk or whether the voucher must also bear the signature of any other hospital official. " 
 
PAYABLE AT 
 
 FIDELITY BANK, 
 
 NEW YORK CITY. 
 
 Pay NASSAU NATIONAL BANK. 
 of Brooklyn, or order, 
 CHARLES T. DAVIS. 
 
 Exhibit "A" 
 (Bad of Voucher) 
 
 
 Tne PRESBYTERIAN HOSPITAL 
 IN THE CITY OP NEW YORK. 
 A««iM Mkl fM ■<« Mm Vwft. M. r. 
 
 reuchtr X». .370 5 Jinutunt, 
 r,M«^^f pHARiPS T. pAVIS 
 
 I5i 
 
 !fiu 
 
 A 
 
 1 
 
 
 
 Monikof MARCM 1908 
 
 DISTRIBUTION 
 
 AdmlBlimiioo Expvnae* 
 
 
 
 
 
 
 
 Offic* BxD«a«<« 
 
 
 
 
 
 
 
 SuthnnT, Priatinc and PoiUee 
 
 
 
 
 
 
 
 TelrpboBC and Tclexntph 
 
 
 
 
 
 
 
 Lccal BxpcBM* 
 
 
 
 
 
 
 
 Hoapiul Bureau of Standur'f and Suppliea 
 
 
 
 
 
 
 
 MiKtllanfooa 
 
 
 
 
 
 
 
 ProlMria— 1 Car* of Pailaau 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 MtOICAL AMD SOaOICAt SOPPLIES : 
 
 
 
 
 
 
 
 Apparatui and lottruments 
 
 
 4 
 
 1 
 
 U 
 
 37 
 
 
 Medical and Sariical SuBplica 
 
 
 
 3 
 
 ? 
 
 40 
 
 
 
 
 
 
 
 
 
 Clothios. etc for Patienti ia Hospital 
 
 
 
 
 
 
 
 lOOIPMINT OF Nuatis 
 
 
 
 
 
 
 
 L'ailorini 
 
 
 
 
 
 
 
 Books 
 
 
 
 
 
 
 
 InitramcDt* 
 
 
 
 
 
 
 
 Cniformt lor SUff and Orderlies 
 
 
 
 
 
 
 
 LAno.AToaiKS P; THOLOG 1 C/y L 
 
 
 
 2 
 
 
 Q4 
 
 
 
 
 
 1 
 
 
 25 
 
 
 
 
 
 
 
 
 
 
 
 
 ' 
 
 
 
 
 faoTocaaPHic SaavKB 
 
 
 
 
 
 
 
 Dvparioicot Espaascs 
 
 
 
 
 
 
 
 AMICI.AHC« S«»VIC« 
 
 
 
 1 
 
 6 
 
 \\ 
 
 
 HaawkfeBiBO' SuDolica 
 
 
 
 1 
 
 4 
 
 IX 
 
 
 Kitchen Supplies 
 
 
 
 
 
 **-d- 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Bread 
 
 
 
 
 
 
 
 Milk and Cream 
 
 
 
 
 
 
 
 Groceries 
 
 
 
 
 
 
 
 ■utter and Beks 
 
 
 
 
 
 
 
 Fruris and VetcUbles 
 
 
 
 
 
 
 
 Meat. Poultry and Fish 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ~ 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 — 
 
 
 
 
 TOTAI.. 
 
 
 5 
 
 2 
 
 ^ 
 
 Ah. 
 
 
 
 
 
 
 
 
 
EXHIBIT B 
 
 VOUCMM H»/^^^._ 
 
 AMOUNT 
 
 PAY ROLL DISTRIBUTION 
 
 '<^mcr^__ B^.M/mtJZjfj± 
 
 AilmMMrallM: 
 
 '' '■'■' •- --' "r ii - i. ni i|ih 
 
 ■III m BhilNdJUlUOuJj^ 
 
 ■^-'* -'hrh'ii .... 
 
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Pay Roil for. 
 
 UHIBZT Bi Aotual •!■• ll«z 17* 
 
 Zllustratlng style of pay roll wtaaz* addroaaograph 
 or ottaor Hating ouMshlne la used. 
 
 THE PRESBYTERIAN HOSPITAL 
 
 NAME 
 
 KATB 
 
 Awtmmi krmtfkt ftnmrd. 
 
 KITCHDI 
 
 LEE.JOSCPHINE 
 
 MATRON 
 
 215 
 CHEF 
 
 214 SHULTZ. HENRY 
 COOK 
 
 2njGEN30N.HILDA 
 
 VCG CK 
 
 21C|WEI L.LOUIS 
 »T CK 
 
 22C| 
 MA 1 D 
 
 222 
 
 MAiD 
 
 223 
 MAID 
 
 224 
 HBLPCI) 
 
 220 
 HELPER 
 
 227 
 
 SWEfNEY.AGNCS 
 QASEY.MARY 
 
 OONNER.ANNA 
 CALLAHAN. NORA 
 
 JONES.WILLIAM 
 ClHTISS.ALrCE 
 
 $75. HO. 
 S80.MO. 
 S60.MO. 
 S35.MO. 
 $30. MO. 
 S23.M0. 
 S2S.M0. 
 $25. MO. 
 S35.M0. 
 $23. MO. 
 
 CH. CNQ 
 
 266 
 
 1 K E 
 
 267 
 
 2 A E 
 
 268 
 
 3 A E 
 269 
 
 ELECT 
 
 270 
 OILER 
 
 271 
 FIREM 
 
 275 
 FIREM 
 
 277 
 
 PAIMT 
 
 279 
 ELEV 
 
 280 
 
 riim 
 
 284 
 CARP 
 
 287 
 OILER 
 
 289 
 CARP 
 
 290 
 PLUM 
 
 291 
 ELEV 
 
 293 
 ELEV 
 
 296 
 ELEV 
 
 297 
 
 ENQIHBERS DBPT 
 PRENTICE. JOHN 8. $150. MO. 
 BANKS. GEORGE $125. MO. 
 BRENNEN. JOSEPH $110. MQ. 
 ANDERSON. WILL 1AM $100. MO. 
 DUANE'. ROBERT $85. MO.. 
 WILLIAMS. HARRY K.$75.MO.. 
 FANNING. THOMAS $90. MO. 
 KENNEDY. WILLI AM $90. MO.. 
 MAHONEY. PETER J. $80. MO. 
 FOSTER. ANDREW $35. MO. 
 
 STANOISH. CHARLES $90. MO. 
 HARE? I S.ALFRED L. $90. MO. 
 CASSIDY. FRANCIS $75. MO. 
 MURPHY. JOHN J. $65. MO. 
 CARTER. ARTHUR V. $80. MO. 
 KEENAN. WALTER $40. MO. 
 BENDER. DAN I EL $35. MO. 
 CARLSON. EDWIN P. $40. MO. 
 
 N^«C 
 
 
 TMal 4>r Carried fortmri. 
 
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 MONATURB 
 
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 S3'oo 
 
 £^000 
 
 RBMARKS 
 
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 I *c«rtlf r that tbf •bovc mentiooed penooa I entlf 7 that I haw tsaaiiMd all cztnulou, additloaa Aporavtd' 
 sptofcdaathownaiMlthattherctpMtiTt uid calcalatkMn ia tte abort aoooant and find them eor- 
 ia(«dMth««a.ietfoftli. ««a*l haw n;ta«d th. acwMt o. th. b«4i ol th. 
 
 or 
 
 Paid M afaevccaept u noted 
 
 ^./is-i^t^ 
 
 \fa^m. Data arrjpi^., a^taraa 
 
 This Form should have faintly-ruled horizontal lines. They have been omitted here for the sake of clearness.] 
 
LISTING MACHINE FOR MAKING PAY-ROLLS. ETC. 
 
 97 
 
 only a small percentage of the pay-roll sheets, as this distribution 
 need be shown only on the last sheet of the monthly pay-roll, 
 from which the expenses chargeable to each account can be posted 
 to the Voucher Register, as is done in the case of other vouchers. 
 
 It will be found convenient to have pay-roll sheets printed in 
 loose leaf form so that they can be carried in suitable binder in the 
 order and number desired, in order to properly protect them, and so 
 that when no longer needed for frequent reference these pay-roll 
 sheets can be removed from the binder and can be properly filed. 
 
 Use of Listing Machine yob. Making Pay-Rolls, Etc. 
 
 At the Presbyterian Hospital it has been found desirable to 
 use an automatic Usting machine for listing names, numbers, 
 occupations and rates of pay of employes on pay-rolls, and names, 
 numbers and occupations on time clock cards, numbers, names 
 and amounts on pay envelopes and preparing lists showing names 
 and occupations of all employes. 
 
 Such a machine insures accuracy, lessens expense and expe- 
 dites the work. The name plates give a current card index of 
 employes. 
 
 This machine is equipped with automatic listmg attachments 
 for listing employes' names on pay sheets, and can be adjusted 
 to print to almost any horizontal ruHng. It is equipped with a 
 duplicating and repeatmg attachment, which permits printing 
 the same name twice, if desired, so that printing can be done on 
 both sides of a time clock card. Only one plate is required for 
 each employe for the printing above mentioned on time cards, 
 pay-roll sheets and pay envelopes. 
 
 Cut-offs are furnished for omitting the impression of certain 
 portions of the name plate, when desired. The rate can be 
 omitted from printing when making out the employes' time clock 
 cards and pay envelopes, etc. 
 
 In listing the pay-roll sheet. Exhibit Bl, illustrated herewith, 
 the cut-off is used for omitting the printing of the large time 
 clock number where it appears on the name plate. The name 
 plates usually consist of three parts, the frame, the proof -card, 
 and the indestructible printing plate in one or two sections. The 
 use of the two-section plate greatly minimizes the cost of main- 
 tenance. The lower section is made to show the employe's name 
 and rate of pay and can be slipped out and discarded, if an em- 
 
 1^ 
 
 m > 
 
 .1 
 
I 
 
 PAY-ROLLS 
 
 ploye 18 dropped from the pay-roll, or can be slipped into another 
 frame with another number when an employe is transferred 
 from one department to another. The upper section of the plate 
 with the number and occupation remains intact. 
 
 Where pay-rolls are large or subject to frequent changes and 
 additions, it will be found more economical and satisfactory to 
 purchase and keep in the oflSce also, a machine for embossing the 
 employes' name plates, rather than to have this work done by 
 outside parties. 
 
 Changes and additions can thus be made immediately as 
 they occur, and the name plates of employes kept accurately up 
 to date at all times. The name plates can be kept sorted accord- 
 ing to departments or filed alphabetically. 
 
 On the morning of the sixteenth, and on the morning of the 
 first of each month, it is the practice of The Presbyterian Hospital 
 to make on plain sheets of paper a complete list of all persons em- 
 ployed during the previous half month. 
 
 The time cards are removed from the time clock rack, and the 
 number of days that an employe is entitled to be paid for as 
 shown by the time card, is posted opposite the employe's name, 
 and the amount of pay he is entitled to is posted opposite his 
 name. 
 
 These extensions are then listed on an adding machine, and 
 the desired totals are obtained. 
 
 These preliminary pay-roll sheets, if it is considered necessary, 
 are submitted to heads of departments concerned for approval. 
 When approved, small pay envelopes are made up bearing name 
 and time card number of employe and amount of payment. 
 
 The amounts shown on the pay envelopes are then totaled 
 on the adding machine to see that the grand total of these agrees 
 with the grand total of the preliminary pay-roll. 
 
 When these amounts have been proved name plates are again 
 run through the listing machine to make a final copy of the pay- 
 roll on the regular pay-roll sheets. 
 
 Pay-rolls may thus be easily prepared and ready for payment 
 within two or three days after the close of the period paid for. 
 
 Pay-Rolls and Unclaimed Wages 
 
 At the end of each month when the pay-roll is made up, or 
 aemi-monthly, if pay-rolls are paid semi-monthly, the Superin- 
 tendent makes a voucher in favor of himself for the amount of 
 
 
 AND UNCLAIMED WAGES 
 
 29 
 
 the pay-roll and draws from his Voucher Bank Account the 
 amount of cash required for the pay-roll. 
 
 At the end of each month the total amount of the pay-rolls is 
 distributed on the Voucher Register and is posted directly to the 
 credit side of a ledger account entitled "Salaries and Wages " and is 
 not included in the total amount of vouchers registered during the 
 month that is posted to the credit side of Voucher Account. 
 
 On pay-day the pay-clerk in the Superintendent's oflSce puts 
 the amount of cash due each employe (except those who may 
 already have been paid by time-check, as explained later) in a 
 separate envelope bearing a number which corresponds with a 
 number assigned to such employe on the pay-roll. He then visits 
 each of the different departments of the hospital and in the pres- 
 ence of the head of that department, or his or her representative, 
 who can identify employes, distributes cash to parties entitled 
 thereto, who acknowledge receipt of same by signing their names 
 in the signature column of the pay-roll. 
 
 In case some employes are not on hand ready to receive their 
 pay the Superintendent may hold such unclaimed wages in his 
 safe for a period not to exceed two weeks, to see if they are called 
 for, and if not by that time claimed, they may then be redeposited 
 in the Superintendent's General Cash Bank Account. There- 
 after, as any such unclaimed wages are called for, it has been found 
 preferable to pay these by checks drawn on the Superintendent's 
 General Cash Account. 
 
 In case an employe is not present on pay-day to collect his 
 cash and desires to have his pay forwarded by mail, the Super- 
 intendent redeposits in the bank the cash, if any, he may be hold- 
 ing m his safe for account of such employe and sends him a check 
 drawn against the Superintendent's General Cash Bank Account 
 for the amount due. Where pay-checks are drawn the check 
 number and date should be noted opposite the employe's name in 
 the signature column on the pay-roll. 
 
 As salaries and wages are paid by cash or by check the total 
 amount paid out on that account (including payments made by 
 pay-roll cash to reimburse Petty Cash Account for time-checks 
 paid or for Advances on account of salaries made through Petty 
 Cash) is entered from time to time in the column headed "Sala- 
 ries and Wages Paid" on the credit side of the General Cash Book. 
 At the end of each month the total of this column is posted direct 
 to the debit side of the "Salaries and Wages Account" on the 
 Superintendent's Ledger, as shown later. 
 
SUPERINTENDENT'S TIME CHECKS 
 
 Time Checks 
 
 In case employes leave the service of the Hospital and it is 
 desired to pay them their salary or wages before the regular month- 
 ly pay-roll is made up, Time Checks, size 73^"x33^", consecu- 
 tively numbered, in the following form are issued and properly 
 certified and record of same is kept on a stub as indicated. It 
 has been found convenient to have these time checks bound in 
 small books with manila paper cover, containing 100 checks each, 
 one check per page. 
 
 I 
 
 No 
 
 THE PRESBYTERIAN HOSPITAL 
 
 TIME CHECK— NOT NEGOTIABLE 
 
 NewYork, 190.. 
 
 OTlB Certifies, That employed at 
 
 has icorked days in month of 190. . 
 
 ai $ per and is eniiiled to dollars and 
 
 cents, 
 
 No, 
 
 .190 
 
 Favor qf 
 
 OccupaHon. . . 
 
 pays 
 
 Rate, 
 
 Amount $. 
 
 Issued by . 
 
 Time given has been noted 
 in time book opposite name 
 
 SUPERINTENDENT 
 Received payment in full. 
 
 Witness, 
 
 Amount $. 
 
 WTien such time-checks are receipted by the parties in whose 
 favor they are made, they are then paid in cash and are carried 
 in the Superintendent's Petty Cash Account until the next regular 
 pay-day. 
 
 When the pay-roll is made up records of time-checks issued 
 are noted thereon as indicated on Exhibit B, and the Super- 
 intendent's Petty Cash Account is reimbursed from the pay-roll 
 cash the amount of money advanced from his " Petty Cash," as 
 shown by the receipted time-checks carried in his Petty Cash. 
 These receipted time-checks should then be filed with the receipted 
 pay-rolls as evidence that the employes concerned had received 
 their pay. 
 
 Advances Paid on Account of Salaries and Wages 
 
 If pay-rolls are paid twice a month it should be entirely un- 
 necessary to make any payments on account of salaries or wages 
 
 CARD RECORD OF UNCLAIMED WAGES M 
 
 in advance of pay-day, except perhaps in some cases to employes 
 leaving the service to whom time-checks may be given and cashed 
 in advance of the regular pay-day. 
 
 If, however, pay-rolls are paid only once a month and if, in 
 cases of emergency, it is deemed advisable to pay certain em- 
 ployes, who are not leaving the service, part of their salary or 
 wages on account before pay-day, part payments in cash may be 
 made from Petty Cash and entered in detail on the credit side 
 of the Superintendent's Petty Cash Book. For such payment 
 a receipt should be taken from the employe concerned reading 
 about as follows: 
 
 THE HOSPITAL, 
 
 • 
 
 New York 19. . . 
 
 This certifies that 
 
 is entitled to Dollars on account 
 
 for services rendered during 
 
 Head of. Department or Chief Clerk 
 
 Received the above named amouiU 
 
 These receipts for advance salary or wages should be carried 
 by the Superintendent in his Petty Cash Drawer. 
 
 At the end of the month, when the pay-envelopes are made 
 up, these receipts should be returned to the employes concerned 
 in their pay-envelopes together with the remaining amount of 
 cash due them for services rendered during the month, and receipt 
 for payment in full should be taken from the employe concerned 
 in the signature column of the monthly pay-roll, and Petty Cash 
 should be reimbursed with pay-roll cash accordingly. 
 
 Card Record of Unclaimed Wages 
 
 In order to facilitate keeping track of exactly what unclaimed 
 salaries and wages go to make up the total amount of unclaimed 
 salaries and wages at any time, a small card record is kept for 
 each individual to whom unclaimed salary or wages may be due. 
 This card record is made when any unclaimed salaries or wages 
 are deposited by the Superintendent in the bank. 
 
 ,i 
 
 

 SUPERINTENDENTS VOUCHER REGISTER 
 
 1 1 
 
 Each card shows the name of the person, the individual monthly 
 reference number on the pay-roll, the amount of salary or wages 
 due and the month for which such amount is due. 
 
 As salaries or wages formerly unclaimed, are called for, refer- 
 ence is made to the card record of the individual concerned, which 
 facilitates reference to the original pay-roll. Superintendent's 
 checks are then issued accordingly and the card record for the 
 individual concerned is then destroyed and the number and date 
 of the pay-check is noted on the pay-roll in the signature column 
 opposite the name of the party paid unless the latter acknowledges 
 receipt by signing the pay-roll. 
 
 At the end of each month, when the Superintendent's Ledger 
 Account of Salaries and Wages is balanced, that part of the 
 balance shown on the credit side which represents Unclaimed 
 Wages, as explained in footnote under "Salaries and Wages 
 Account" on page 55, must agree with the total amount of un- 
 claimed salaries or wages, as shown in detail on the card records 
 of such unclaimed salaries and wages referred to above. 
 
 Unclaimed Wages Transferred to Surplus and Defictt 
 Account through the Treasurer's Books 
 
 From time to time the Superintendent carefully examines the 
 card records of unclaimed wages and before closing his books at 
 the end of each fiscal year he authorizes Journal Entry No. 7 
 as shown on page 50, whereby salaries and wages unclaimed for 
 more than one year, which probably will never be claimed, are 
 credited to Superintendent's Account with Treasurer, if such 
 action is approved by the proper oflScial. 
 
 SUPEKINTENDENT'S VOUCHER REGISTER 
 In order to avoid making separate entries to General Ledger 
 Accounts for each individual expense mcurred, and so that en- 
 tries need be made for the totals only at the end of each month, 
 and to economize time and labor in recapitulating results, a Super- 
 intendent's Voucher Register is used with headings properiy 
 arranged in separate columns to correspond closely with the 
 classification of expenses agreed upon, as illustrated on Exhibit C. 
 It will be found advantageous to have a Voucher Register in 
 loose leaf form, as it is economical to have at least several hundred 
 pages of the Voucher Register printed at one time. On account 
 of the size and weight of these pages, however, the book will be 
 lighter and more easily handled if only a part of these pages are 
 inserted in the binder at one time. 
 
EXHIBIT C 
 
 //^? 
 
 THE PRESBYTERIAN HOSPITAL in the Qty of New York 
 
EXHIBIT C 
 
 Vouchers registered during month of (l/^(ZPc^ I5^i£. 
 
 //^o 
 
 \ 
 
 
 \ DI^ARTHERT IXPENSIS 1 GENERAL HOUSE AND PROPERTY EXPENSES [1 <-OKP0KATiail uraou 
 
 
 
 
 
 
 
 
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 and Waste , *■"''' 
 
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 «d 1 Machinery 1 and Steam 
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BILLS RENDERED PAY PATIENTS 
 
 33 
 
 If there are apt to be only two or three bOls per month for 
 any one subdivision of expenses, it is not necessary to have a 
 separate column for such a subdivision, but it may be grouped 
 with some other expenses under the proper general heading and 
 in a vertical column headed Distribution, the subdivision to which 
 it belongs can be indicated on the same line. 
 
 For smaller Institutions than the Presbyterian Hospital having 
 less monthly bills to pay and less subdivisions of expenses, a cor- 
 respondingly smaller Voucher Register than that illustrated on 
 Exhibit C would be entirely suitable. 
 
 For a small hospital, for example, all Administration Expenses 
 may be entered in one vertical column headed Administration 
 Expenses, and in the column headed "Distribution** the sub- 
 division or subdivisions of Administration Expenses to which any 
 vouchers are chargeable may be designated. In such cases where 
 the monthly entries in any one column are not very numerous, 
 it would not be difficult at the end of each month to recapitulate 
 the total amounts chargeable to each subdivision of expenses. 
 
 After all the vouchers for the month have been entered upon 
 the Voucher Register, it is then a simple matter to make the 
 necessary footings and recapitulation, so as to show the total 
 expenses for each and all of the different subdivisions called for 
 by the classification of expenses (Schedules 2 and 3). 
 
 These totals which represent expenses mcurred, but are not 
 cash transactions, are then both debited and credited direct to 
 the proper General Ledger accounts, as indicated hereafter. 
 
 References should be made on the Voucher Register to the 
 pages of the Ledger on which totals are posted. The figures 
 required to show the details of Current Expenses (Schedule 2) 
 and Capital Expenditures (Schedule 3) are taken by the Superin- 
 tendent direct from the Voucher Register. 
 
 BILI^ RENDERED PAY PATIENTS 
 
 At the Presbyterian Hospital it has been found desirable to 
 have only one form of bill, as shown below, for use in billing any 
 pay patients for board, special nursing, etc., or for billing other 
 parties for any Hospital Earnings (Schedule 1). 
 
 These bills, each six inches by four inches in size, are printed 
 and consecutively numbered in triplicate in sheets fourteen inches 
 by sixteen inches, each sheet being composed of eight bills with 
 
 ■| 
 
 
 I 
 
 . I 
 
S4 
 
 BILLS RENDERED PAY PATIE^fTS 
 
 a two inch margin on the left side for binding. For convenience 
 in handling, the original, duplicate and triplicate copies ai« bound 
 in proper order in books with card board covers, e^ book con- 
 taining 100 sheets (or 800 biUs) in triplicate. The originals are 
 
 New York City,. 
 
 .19. 
 
 To THE PRESBYTERIAN HOSPITAL, Di. 
 
 41 EAST to™ street 
 
 For ctre of 
 
 
 Ward 
 Private Rofln 
 
 -Dtft from. 
 
 -to- 
 
 ■ incl. (tt 
 
 8p«dal Nuntng Dayt from. 
 
 Um of Opcndiif Room 
 
 X^Rkt Serviog 
 
 M>- 
 
 ITi^hone aii4 Tcleffnph- 
 Oth«r Cittrg— 
 
 printed on white paper and the duplicates and triplicates on buff 
 paper, so that the originals can be easily distinguished. The ori- 
 gin^ and duplicate copies are perforated on the^ges so that one 
 bill at a time may be detached, as desired. The triplicate copies 
 of thebillsarenotperforatedasthey remain in the bo^k for record. 
 On the back of each original biU is printed the following: 
 
 fttrXiBS CONCBRNmO fiXUS RBND8RBD PATIBMT3 
 
 {fk euteriBg tlie Bo«^tal tach Pay Ward Wtieot and Semi-Private Patient is expected 10 
 nake an advance pajrmeat of at least the eqiuvalent of one week's chargea for care. 
 
 It will be dlacretionary with the Superintendent in the case of each Private Room Patient 
 •a to whether or not any advance paTments must be made on account. 
 
 At the end of each week of the patient's stay a bill will ordinarily be rendered for care, 
 €tc., famished. Bills when rendered must be paid promptly and if h is expected that the 
 patient is to remain longer in the Hospital the Superintendent will also retain the original 
 advance payment until it is determined when the patient is to leavt the Hospital, when the 
 account must be settled in fnlL 
 
 Patients admitted to the Hospital before two P.M. will be charged for a full day and if 
 admitted after two P.M. wiU be charged for due-half day's care on the day of admittance. 
 If they leave the Hospital before two P.M. they will be charged for one-half day and if they 
 leave after two P.M. they will be charged for a full day's care on the day of discharge. 
 
 At the end of each month bills will be rendered for such fractional part of a week as may 
 be doe and neceaaary to include the last days of the patient'* stay during such month not 
 already billed for. 
 
 Money paid in advance for care, special huralng, etc, will bt tcfnnded at the samt rate, 
 when the aervice'paid for is not rendered. 
 
 This bill does not include the phyaidaa'a or -rargcon'a fee for Pirtvalc Room or Seod* 
 Piimto Patients, uqIcm w wn»gti. 
 
snowing Distribution of Hospital 
 
 in^Uistnbution o 
 
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 [This Form shotild have faintly-ruled horizontal lines. They have been omitted here for the sake of clearness.) 
 
 >: 
 
 LOOSE LEAF BILL REGISTER 
 
 Sff 
 
 When the original bills are made out by indelible pencil carbon 
 duplicate and triplicate copies are made at the same time. The 
 original bill is sent to the patient or the patient's representative. 
 The duplicate copy is attached to the "Ledger Account Card" 
 of the patient or other party concerned, as described later, and 
 serves to show the details of the total charge on the bill that has 
 been debited to the ledger account concerned. The Bill Books 
 containing the triplicate copies of bills, when used, are marked 
 on the front cover to show the period covered and are filed for 
 at least a year for future reference, if needed. 
 
 LOOSE LEAF BILL REGISTER 
 
 It has been found desirable to have a Bill Register, composed 
 of loose leaf sheets, eight and one half inches by fourteen inches, 
 as illustrated on the opposite page. From the book containing 
 triplicate copies of bills rendered for patients cared for, etc., 
 postings are made from day to day to the Bill Register, so that 
 the total monthly Hospital Earnings from Patients or other parties, 
 classified as desired, as represented by the bills rendered, may 
 be obtained promptly after the close of each month, without much 
 extra labor at that period. 
 
 Separate sheets of the Bill Register are used to show the distri- 
 bution of earnings from Private Room, Semi-Private and Ward 
 Patients, and from Others than Patients, in order to obtain the 
 total earnings from each class, as shown by bills rendered. As 
 entries are made daily in the Bill Register, it is difficult to tell 
 at the first of the month just how much space will be required in 
 the Bill Register to list separately the bills rendered to Private, 
 Semi-Private, or Ward Patients, etc., during the month. It has 
 been found preferable, therefore, to have the Bill Register in 
 loose leaf form with a suitable canvass covered ring binder to hold 
 the loose leafs at the top. 
 
 It has also been found convenient for reference to keep filed 
 together the Bill Register sheets referring to the same class of 
 patients, etc., and to number these consecutively beginning with 
 number one the first of each fiscal year. 
 
 Bill Register sheets, showing earnings for four or five months pre- 
 vious, which would probably only be needed for reference again 
 when the Superintendent's accounts are audited, may be removed 
 from the binder and properly filled for reference, thereby making the 
 Bill Register a light book of comparatively small size, easily handled^ 
 
90 
 
 STATEMENT OF ACCOUNT 
 
 CARD LEDGER ACCOUNT 
 
 87 
 
 €t 
 
 Statement of Account" Forms 
 
 In case bills rendered are not paid promptly by patients, 
 supplementary statements, size 5^'x5", as shown below, are sent 
 to the delinquent patients, but these supplementary statements 
 are not posted to the statement showing distribution of Hospital 
 Earnings, as that, of course, would be duplicating entries and 
 would give incorrect results. 
 
 n' 
 
 STATEMENT OF ACCOUNT 
 
 The Presby'I'erian Hospital. /> 
 
 41 Eatt 70th Street, New Yoik Qty 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 Dut on AccoufU 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 L _ 
 
 ^^— ^ 
 
 1^^- 
 
 Cabo Ledger Account with Each Pay Patient or Other Party 
 
 In order to keep proper records of amounts due and amounts 
 paid a Ledger Account on a card, size six inches by four inches, 
 is kept with each pay patient or other party with whom an account 
 which concerns Hospital Earnings (Schedule 1), is kept. These 
 cards are printed differently on each side, as shown on page 37. 
 
 From the triplicate copy of each bill rendered any patient or 
 other party, the date, bill number and total amount of such bill 
 is posted to the debit side of the card ledger account of the patient 
 or other party concerned. 
 
 From the Superintendent's Hospital Earnings Cash Receipt 
 Book, described later, in which is recorded each amount paid by 
 
 or for a patient, the date, receipt number and amount paid in 
 payment of bills rendered is posted to the credit side of the card 
 
 DATE 
 
 MONtMV 
 
 tuesoAv 
 
 WEO**€SOAV 
 
 TMUBSOAY 
 
 I 
 
 FRIDAY 
 
 SATUAOAV 
 
 NAME 
 
 ADOMCSS 
 
 
 
 J^/. 
 
 ^r 
 
 X4£. 
 
 BUI NUMKd 
 
 AMOUNT OUE 
 
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 f1:9 
 
 "^^ai^^^ZMdotiU^ 
 
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 DATE 
 
 Ofu. 
 
 
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 RECEIPT NUMBER 
 
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 ^^/ouooC2^ 
 
 AMOUNT PAID 
 
 fib tsi JuEi 
 
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 jU 
 
 ledger account of the patient or other party concerned. At the 
 end of each month or when a patient is discharged, after all of the 
 
 Month 
 
 DATES OP SPECIAL NURSING SERVICE Total| 
 
 -•.«.o«^o»2 = 32=S 2|s|2|2|8|5S|!3|a|sls|S5|K|a|8|8|S I 
 
 Cf-LM. 
 
 Day 
 
 / / f / / i f ^ f f Jff 
 
 t 
 
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 P^y. . . . //////////////// 
 
 f f il if 
 
 9a 
 
 Night 
 
 - / 
 
 
 Jg.«.fie^.53.^.1f^ II II 
 
 
 ^•«^» ,^?«£--^^^55£*' 
 
 ^.M...:'kliJ^ 1 II 
 
 
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 ^ < « ^ 
 
 '¥>^.,:^,. ' ! ? 5 
 
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 i^^i^,,*e.,>-'5- iX!t!iV* 
 
 
 
 
 debits and credits have been properly posted to each card ledger 
 account, any balance shown on the debit side of such an account 
 represents an Account Receivable and any balance shown on the 
 
 
 I'l 
 
NURSING AND OTHER MISCELLANEOUS CHARGES 
 
 SPECUL NURSING CHARGES 
 
 30 
 
 credit side of the account represents an Advance Payment, if the 
 patient concerned is still in the hospital or an Overpayment, if 
 the patient had left the hospital, when the account was balanced. 
 
 From the Superintendent's Cash Book, described later, each 
 "Overpayment by a Patient Refunded'* is posted to the debit 
 side of the card ledger account of the patient concerned, which 
 closes the account. 
 
 K Overpayments by Patients are charged off the books, on 
 account of not being liable to be claimed by patients, as per Super- 
 intendent's Journal Entry No. 4 this fact is noted and the amount 
 is debited on the card ledger account of the patient concerned, 
 which closes the account. 
 
 Charges for Special Nursing and Other Miscel- 
 laneous Charges 
 
 In order to keep a record of charges against patients for special 
 nursing the following method has been found very satisfactory. 
 
 Each morning the Directress of Nurses sends to the Superin- 
 tendent's office a statement showing the following information: 
 
 Name of 
 Patient 
 
 special nurses employed 
 24 hours ending 7 a.m., June 6, 1918 
 
 Name of Day Name of Night 
 Nurse Nurse 
 
 Room Ward 
 
 Directress of Nurses 
 
 By reference to the reverse side of the Patient's Ledger Ac- 
 count card, illustrated above, it will be noted that space has been 
 provided on which the Superintendent's clerk can easily post each 
 day from the report received from the Directress of Nurses, a 
 record of such day and night special nursing as may have been 
 furnished to the patient concerned. Space is also provided in 
 which the month, date, amount and character of any other charges 
 against the patient concerned may easily be posted from requisi- 
 tions or other memoranda which are sent to the office. After 
 having been posted, these memoranda are kept properly filed 
 for future reference for a reasonable period. 
 
 Checking Amount of Specla.l Nursing Charges 
 
 The Bill Register shows each month the total hospital earnings 
 from special nursing. Dividing this amount by the price per day 
 charged patients for special nursing will show the number of days 
 of special nursing for which patients were charged. 
 
 By dividing the total of the hospital's monthly pay-roll for 
 special nurses by the amount per day, which the hospital pays 
 the special nurses, the number of days for which special nurses 
 have been paid is found. By comparing these results it is easy 
 to see each month whether patients have been charged for all of 
 the special nursing paid for by the hospital. If not, it should be 
 an easy matter for the Superintendent's clerk to show from his 
 records, exactly what special nursing has been paid for by the 
 hospital and not charged to patients. 
 
 Charge against Patients for Telephone Messages 
 
 In order to keep a simple and proper record of charges to be 
 made against patients or others, who cannot conveniently pay 
 cash at a time telephone calls are made, it has been found con- 
 venient to have the telephone operator make a report daily to 
 the Superintendent's office on a form headed as follows: 
 
 Telephone Calls- 
 
 -19 — to be charged for 
 
 Phone No. Exchange Overtime Amount Charge to 
 
 From this list of telephone calls the Superintendent's clerk posts 
 promptly the amounts chargeable to each patient under the 
 heading "Other Charges" on the reverse side of the card ledger 
 account of the patient concerned, as illustrated on page 37, so 
 that when the next bill is rendered against the patient concerned 
 the proper telephone charges will be included. 
 
 Bills for Advance Payments 
 
 When it is desired to have a patient make an advance payment 
 on account, as in the case of ward pay patients on entering the 
 hospital or in other cases, such payments are ordinarily requested 
 verbally and when paid a receipt from the Superintendent's 
 Hospital Earnings Cash Receipt Book, described hereafter, is given 
 for same. If, however, it should be desired to send a bill by mail 
 
 i> 
 
 \ 
 
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 J ! I 
 
 w 
 
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 t 
 
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 ! 
 
 J1 
 
 I 
 
40 
 
 BILLS FOR HOSPITAL EARNINGS ACCRUED 
 
 for an advance payment on account, before services to be paid 
 for are rendered, the form entitled "Statement of Account" 
 described on page 36 should be used. 
 
 Bills for advance payments on account are not listed in the 
 "Bill Register showing Distribution of Hospital Earnings as per 
 bills rendered patients" referred to on page 35, as the Bill Register 
 refers only to bills which are rendered for Hospital Earnings 
 actually accrued. 
 
 In some few cases, where the patients have received care for a 
 week or more and have promised to pay, but have not paid, and 
 when it seems very doubtful that the patient can pay, it may be 
 found preferable to render the bill on the statement of account 
 form and not use the regular bill form and not post the earnings 
 accrued on the Bill Register, until some satisfactory assurance 
 is had that the bill has been or will be paid. A bill on the regular 
 form can then be rendered and posted to the Bill Register. 
 
 Bills fob Hospital Earnings Accrued 
 
 I 
 
 Bills, of the form described on page 34, are rendered each 
 month for all hospital earnings, which have accrued on account 
 of each pay patient during such month, regardless of any other 
 bills, which may have been rendered for advance payments only 
 and regardless of whether or not any advance payments have 
 been paid. 
 
 1 The object of this is so that the Bill Book and the Bill Re- 
 gister heretofore referred to, may contain a complete record of 
 all Hospital Earnings from Patients. 
 
 The rules printed on the back of each bill rendered to pay 
 patients shown on page 84 indicate the practice which the Presby- 
 terian Hospital has found desirable. 
 
 When a bill is to be rendered to or for account of a patient 
 the Superintendent's clerk examines the card ah^ady mentioned 
 which shows that patient's ledger account. 
 
 This card shows the date the patient was admitted to the hos- 
 pital and if any bills for care, etc., furnished have been rendered 
 to such patient the duplicate copies of such bills should be found 
 attached by a small paper fastener to the ledger account card of 
 the patient concerned. 
 
 The clerk can thus see for just what period any new bills should 
 be rendered and by examining the record, already referred to. 
 
i 
 
 il 
 
 
 Distribution of Ci 
 
 uh R«c«ivo<l Account Hocpilal Ewrning* During Month of- 
 
 Sfa^€ 
 
 Brought forward 
 
 ifa^*^ 7ysud ^^f* 
 
 
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 262 . 
 
 Received IxoxidicUaiJSZAS^ 
 
 y t^. -~ Arrpiinr nf dc^J^ 
 
 
 
 THE PRESBYTERIAN HOSPITAL ^^ 
 
 Sapctiouodeol, par )i(C^/3 
 
 264 ^^ 19/^ 
 
 Received fron <^^ c^j^^ o/^.'/A^/ 
 
 $ 3^ .. r; A ccouiu of ^<-/ /feA-*^ "f^^^ 
 
 "thepresbyterian hospital ^^ 
 
 SupciiMcadcu, per *7iCS. /9- 
 
 266 ^g 19/^ 
 
 Received froHC^ — ^.^m/^i^n^ratfia/^. 
 
 y /gyA* A rrniint of <^tf:^C^^^ 
 
 THE PRESBYTERIAN HOSPITAL . 
 
 Supcrimtiident, per S(7 a ^. 
 
 268 
 
 Received f ■ <^^< ^^^y ryt^ 
 
 ^ Vccttuatof f i^r/ r^rrVf^^r Xtf<V 
 
 •?^tf 19£ZL 
 
 »ITAL 
 
 THE PRESBYTERIAN HOSFII/xi. ^ 
 
 270 
 
 Received fror 
 
 .^^^MujoC 
 
 ^/ tQ//* 
 
 THE PRESBYTERIAN HOSPITAL ^ 
 
 Sapctinlcodcnt, per ST ^ >^ 
 
 272 ^A 19/i^ 
 
 Receiv^^rofiTig^^..,^;^/^, /^^X/tM;^ 
 
 $/^.^ Account of ^.4^ 
 
 "^ 
 
 THE PRESBYTERIAN HOSPITAL ^ 
 
 Suptriolcndciit, per ^^e /^ 
 
 274 
 
 Received f rortf'^^t^^irfr^.^' '^i^ n ^(f^t/f/-/ 
 
 Account oi^jsa^^L. 
 
 T 
 
 THE PRESBYTERIAN HOSPITAL ^ 
 
 SupcriDtrndent, per ^jj; ft /3 
 
 276 
 
 Received fro 
 
 19/ZL 
 
 ■$ K^.^ Account ^ »<^^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Superinlradcnt, per "i(^ K /^ 
 
 278 
 
 Received frr^m OCdt^^ jK. "^4 
 
 $ r.-* Account fif LcitaL*.-^^ ^ y^Kei^Jir 
 
 THE PRESBYTERIAN HOSPITAL _ 
 
 SupcrinundcDt, per "-^G. ^t 
 
 J02.^£i 
 
 > ^/ , 19^1_ 
 
 k^^ - ^ 
 
 280 
 
 Received from 
 
 f >^- ""^ A rmunt <^f /^/*MAy ^^^ ->^^-^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Superintendcot, p«r ^l^-^/^ 
 
 282 
 
 Received from 
 
 § Account of_ 
 
 .19. 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Superiotcndeot, per 
 
 284 
 
 Received from 
 
 S Account of 
 
 .19. 
 
 THE PRESBYTERIAN iiOSPITAL 
 
 SMperiiurndeai, per 
 
 Mr Vv JL ^m, mmmmgmmt^^m^mm^a.^^^ ft f gii 
 
 Received_fronr^^j^/fe^ ^^(M^€i4Pr. 
 
 mMT' mmmHittmi 
 
 % y> -> A nmyir^t Qi^^-€4at^jli^ <r^^^t4^ 
 
 THE PRESBYTERLW HOSPITAi; y,^^ 
 Suf^trndeot, pcf >V<>/9 
 
 263 ^ 
 
 Received ir^('<^^ J^'jf c^^^ ^L^^i^ 
 
 X^uL. 
 
 f /-^ — ' Arrniinr cL^^Zf. t/^2^£g. ^^<€^ietar 
 
 THE PRESBYTERIAN HOSPITAL ^?y- 
 
 Supcrimcndciid per *<^'6./?> 
 
 265 
 
 Received fmm (j^u^a ^- 'gciJrfSidrr 
 
 ^ /<y, -' Arrniint of. £fr44m^<tM^<^<€/MU}iiZ. 
 
 m^j^LtfrnSiiiimi^^iiimii^am MtftiaJKimmmm 
 
 THE PRESBYTERLVN HOSPITAL ^ 
 
 267 . ^>t_ 
 
 Received iTn,..'P'(?4^c^ -/C^^jT:^ 
 
 %^^r^ Ati^UDt of r «^,trf 4An .^. w/fe?<i^ 
 
 W^i^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 SupcriMeodrat. per 5<^J{f^ 
 
 269 
 
 Received froira^^ 
 
 ? yy.'^ Account 
 
 frs**ai 
 
 ^fU^ 
 
 of_^^ 
 
 
 .Viat. 
 
 \»^jf 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Superiatodcat. per ^{^{f/^ 
 
 271 
 
 Received frof 
 
 j^^. 19/^ 
 
 "o^j^^A.^^^^ 
 
 $j!^2^£_Accounli:;&^ik^.^<i5i*-,,^i!L»€^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Superimcndciu, per "jf^^ff/^ 
 
 f>/ 19Z>1. 273 
 
 Received from 
 
 ~ -Ac^unt oL^^ 
 
 ^£^ 
 
 ^/^/ Vil£. 
 
 ta^ 
 
 ^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Supcrinteodeot, per VT^T/S 
 
 275 
 
 Received fror 
 
 _^^L_l9^zl 
 
 ^ •.- — Acrount of 5(^«<*^ 
 
 
 THE PRESBYTERIAN HOSPITAL 
 
 SupcniUfndeo^ per '-J^^ /^ 
 
 y^' IP//' 277 
 
 ^^/ lQ/>- 
 
 Received f mrr O^ 'ig^^^ c/h.c^yir^y 
 
 >y^ — — 
 
 $ /ir • Arrniinr nf f7yejJ-/j^A:i^.Z j<9e^^ yfJ ^^^^ ^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Suptrimendcot. per • "jC O-/^ 
 
 279 
 
 ^/, I9<^i^. 
 
 Received Uox^^^^Si-^jM-^lAtt^ 
 
 % //■'^ Arrnnnr of ^A/tY,m^/:i^^^ iJ^^^^gL. 
 
 ^:!^^ 
 
 e:^*^l/^s^^ 
 
 THE PRESBYTERIAN HDSPlfAL 
 
 SupcrioAvdent. per <^Z~ ^^ 
 
 Received frnm<:Z r:^/^Ay. 
 
 ^/ 19zg. 
 
 $ /f^.'^ Account oiJ^jBi^^i^^ 
 
 J^<^ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Soperioiendeqt, per v?!<fc/^ 
 
 283 
 
 Received from 
 
 $ Account of. 
 
 .I9_ 
 
 THE PRESBYTERIAN HOSPITAL 
 
 Supcrinicndmi, per 
 
SUPT.'S HOSPITAL EARNINGS CASH RECEIPT BOOK 41 
 
 on the reverse side of the ledger account card can also see just 
 what charges should be made for special nursing and other charges 
 for the period to be covered by the bill. 
 
 At the Presbyterian Hospital it is customary to render bills 
 weekly and when the patient is discharged. 
 
 The last bill rendered to a patient in any month should in- 
 clude charges for the last day, which the patient spent in the 
 hospital during such month. 
 
 If a patient spent the entire month in the hospital bills would 
 ordmarily be rendered on the 7th, 14th, 21st and last day of the 
 month. 
 
 The object of having the words, Monday, Tuesday, Wed- 
 nesday, Thursday, Friday and Saturday at the top of the ledger 
 account card is so that the Superintendent's clerk can place a 
 small paper fastener on the card over one of these days and thus 
 see at a glance, even if the card is in the file, on what day of the 
 week the next bill should be sent to the patient concerned. 
 
 SUPERINTENDENT'S HOSPITAL EARNINGS CASH 
 
 RECEIPT BOOK 
 
 It has been found desirable to have forms of receipts issued for 
 all payments received on account of Hospital Earnings (Schedule 1) . 
 
 When a patient pays a bill that has been rendered there is no 
 reason why the Superintendent's clerk should not receipt and 
 return the bill to the patient, but at the same time a receipt 
 should also be made out by indelible pencil in the Superintendent's 
 Cash Receipt Book for the amount received, so that the Receipt 
 Book will contain a complete carbon copy record of all receipts 
 account hospital earnings. 
 
 The form" of receipts illustrated on the preceding page have 
 been found very satisfactory. 
 
 These receipts, size 4J^ inches by 1J4 inches, are printed in 
 duplicate on pages 11 inches by 18 inches composed of two vertical 
 rows of twenty-four receipts per page with a margin two inches 
 wide on the left side for binding. There are 125 pages in dupli- 
 cate per book, which is bound with cardboard covers. The ori- 
 ginal receipts are printed on cheap white paper and are perforated 
 so they may be easily detached. The duplicates are used for 
 carbon copies. They remain in the book for record and are not 
 perforated and are printed on buff colored paper to distinguish 
 them from originals. 
 
 Ill 
 
 _nt 
 
42 
 
 SUPERINTENDENTS GENERAL CASH BOOK 
 
 On the backs of the pages of the duplicate receipts, which re- 
 main in the book, columns are printed with heading showing the 
 classifications of cash receipts desired, as illustrated. 
 
 In these columns the amounts indicated by each of the receipts 
 on the opposite page are entered opposite the respective receipte 
 under the proper headings. ^. , . • 
 
 At the Presbyterian Hospital it is customary for the clerk m 
 the Out-Patient Department and the Pharmacist to turn m their 
 earnings, which are their cash receipts, at the Superintendent s 
 office at the end of each day and obtain a receipt therefor. 
 
 By totaling these columns from day to day and carrymg for- 
 ward the totals, the receipts of cash from patients, the Out-Patient 
 Department, Pharmacy, etc.. may be easily ascertained at any 
 time during the month and very promptly after the close of the 
 month without much labor at such penod. 
 
 From the duplicate copies of these receipU showmg payments 
 made by patients or other parties, with whom card ledger accounts 
 are kept, postings are made to the credit side of the card led^r 
 account of each patient or other party concerned to show the 
 date and amount of each payment. . 
 
 \t the end of each month the totals only of cash receipts from 
 patients, the Out-Patient Department, the Pharmacy and others, 
 properly classified as shown by the Superintendent s Cash Re- 
 ceipt Book, are entered in the Superintendents General Cash 
 
 Book, as shown later. ., , „ • n„^v. 
 
 By keeping in the Superintendent's Hospital Earmngs Ca.sh 
 Receipt Book such a detailed record as that described of b\\ cash 
 receiv^ account Hospital Earnings (Schedule 1), this Receipt 
 Book becomes really a part of the Superintendent s General Cash 
 Book and by entering the monthly totals only, properly classified 
 as suggested, in the General Cash Book at the end of each month 
 considerable time, labor and space will be conserved and there 
 will nevertheless be a complete and satisfactory record of each 
 cash transaction. 
 
 SUPERINTENDENT'S GENERAL CASH BOOK 
 
 Sample pages of the Superintendent's General Cash Book 
 
 used at the Presbyterian Hospital are shown following page 44. 
 
 • The total amount of Cash on band at first of month plus the 
 
 SUPERINTENDENT'S GENERAL CASH BOOK 
 
 48 
 
 I 
 
 cash received during month, as shown in the debit column of the 
 Cash Book (including receipts shown by the Superintendent's 
 Hospital Earnings Cash Receipt Book, if not already posted in 
 the General Cash Book), less the total amount of cash paid out 
 during month, as shown in the credit columns of the Cash Book, 
 will indicate at any time the amount of cash that should be in 
 the hands of the Superintendent. 
 
 At the end of each month a recapitulation of the total amount 
 of cash received by the Superintendent during the month should 
 be made in about the following form: 
 
 Cash on hand at first of month, not including Petty Cash 
 
 Cash Received during Month Accx)unt Hospital Earnings: 
 
 From Patients, as per Cash Receipt Book 
 
 From Out-Patient Department, as per Cash Receipt 
 
 Book 
 
 From Pharmacy, as per Cash Receipt Book 
 
 From other Miscellaneous Hospital Earnings, as per 
 
 Cash Receipt Book (enumerate) 
 
 Total cash received during month Account Hospital 
 
 Earnings 
 
 Cost price of General Material sold during month • 
 
 Cash received from Petty Cash Account dwing month. . 
 
 Cash received from Treasurer during month J^^^m^ 
 
 ♦Total 
 
 At the end of each month a recapitulation of the total amount 
 of cash paid out by the Superintendent during the month should 
 be made in about the following form: 
 
 Vouchers paid during month. . . : 
 
 Salaries and Wages paid during month 
 
 Cash refunded to Patients by Superintendent during month account 
 "Overpayments by Patients" for care or services never rendered 
 and not to be rendered 
 
 Cash remitted to Treasurer during month account cash received by 
 Superintendent in payment of Bills rendered Patients and includ- 
 ing Out-Patient Department, Pharmacy and other Miscellaneous 
 Receipts, account Hospital Earnings or account General Material 
 
 Sold 
 
 Cash advanced to Petty Cash Account during month 
 
 Cash on hand at end of month, not including Petty Cash 
 
 ♦Total 
 
 • These totals should agree 
 
 in 
 
 'J 
 r. I 
 
 
 1? 
 
 *l 
 
u 
 
 SUPERINTENDENTS GENERAL CASH BOOK 
 
 If these above mentioned recapitulations are made at the end 
 of each month on the Superintendent's Cash Book, this Cash Book 
 can be considered as the Superintendent's Cash Ledger Account, 
 and there will be no necessity of his carrying a Cash Account 
 on his Ledger in addition. 
 
 From the Superintendent's Cash Book each "Overpayment 
 by a Patient Refunded" is posted to the debit side of the Card 
 Ledger Account of the patient concerned. 
 
 At the end of each month the following credits and debits 
 are posted from the Cash Book direct to the accounts mentioned 
 in the Superintendent's Ledger. 
 
 The total "Cash Received during month account Hospital 
 Earnings" as shown in the debit column, is credited to "Bill 
 Account." 
 
 Cash received account cost price of General Material sold 
 and account handling charges on General Material sold, if bills 
 were rendered, is credited to "Bill Account." 
 
 Cash received account cost price of General Material sold for 
 cash, if no bills were rendered, is credited direct to General Mate- 
 rial Account. 
 
 Cash received account handling charges on General Material 
 sold for cash, if no bills were rendered, is treated as a part of 
 Hospital Earnings. 
 
 "Cash received from Treasurer during month" is credited to 
 "Superintendent's Account with Treasurer." 
 
 The total "Vouchers Paid during month" as shown on the 
 credit side, is debited to "Voucher Account." 
 
 "Salaries and Wages Paid during month" is debited to "Sala- 
 ries and Wages Account." 
 
 "Cash Refunded to Patients by Superintendent during 
 month account Overpayments by Patients" is debited to "Bill 
 Account." 
 
 "Cash remitted to Treasurer during month" account cash 
 received by Superintendent account Hospital Earnings and Gene- 
 ral Material sold is debited to "Superintendent's Account with 
 Treasurer." 
 
 Proper references are made on the Cash Book in each case to 
 the pages of the Ledger to which postings are made and references 
 are made in the Ledger to the pages of the Cash Book from which 
 postings are made. 
 
66 
 
 Gish for the Month of 0i€l^:e^ 
 
 Dr. 
 
 1918. 
 
 Cr. 
 
 DaTb 
 
 WMM^WMMBii — Ifti I f II 
 
 M 
 
 'a^ 
 
 
 tf/ 
 
 ACCOUNTS AND REMARKS 
 
 Bbought FonWABD 
 
 CASH 
 RRCEIVED 
 
 1 
 
 /ifOjf 
 
 7 
 
 /£ 
 
 <^c 
 
 oS 
 
 
 ^J 
 
 * &o 
 
 ^^t*y^. o-^Oi/^^ ^.a-m^^ap. h^tMJ^n Sv^ 
 
 <Ei«£*y(/^ ^^^yitf^ Gi*,e^ £^^ty 
 J^,w^ ^uuw y^$i^-^a 
 
 S/ xXtUt/^ ^^a^ /^aAt4,,t4^ x^j<SU^' '^^<id4^ 
 
 5/ 
 
 ^^d^a^ici/^^44C^^*ty^M»^^M-.*£*u.^^ ') ^¥^c 
 
 iy 
 
 
 SJ-X4^ 
 
 /^.ffCC 
 
 J22± 
 
 Voucher 
 Number 
 
 CASH PAYMENTS 
 
 VOUCHERS 
 FAID 
 
 //,/^A*/i 
 
 ¥3 
 
 
 M^' 
 
 7 
 
 /^ i> ^/ 
 
 /^J 
 
 7 
 
 52/ 
 
 '/ 
 
 .J 
 
 /^¥7^ 
 
 Overpnyitieiili| 
 
 by Patitnts I 
 
 Reluntltnl I 
 
 SnUriex and 
 Wages raid 
 
 ^ 
 
 "^ 
 
 /J 
 
 /i 
 
 -^ 
 
 z 
 
 JZ'T^ 
 
 
 Mt^ 
 
 ■<o 
 
 O Cf 
 
 ££ 
 
 /y 
 
 Miscellaneous 
 Payments 
 
 ^ay K 
 
 s-t 
 
 O 
 
 sy^^ 
 
 ff_^^0 
 
 srsh 
 
 /.:• 
 
 /»r>. 
 
 /¥.ff/ 
 
 c^ 
 
 » o 
 
 » o 
 
 Cash for the Month of /M^'J"^ 
 
 Dr. 
 
 1918. 
 Cr. 
 
 f. 
 
 7 
 
 BROUGHT FOHWAKU 
 
 ACCOUNTS AND REMARKS 
 
 CASH 
 
 RECEIVED 
 
 <^>^,S^^JfMJ.4^})^^ / " 
 
 
 '-^ ctZLuiiu 
 
 %€^/rt' 
 
 Vouclicr [ 
 
 VOUCHERS 
 Number H PAID 
 
 CASH PAYMENTS 
 
 Ovcrpayraents 
 
 by Patients 
 
 Reiunded 
 
 9^^ 
 
 f<U^ 
 
 
 uJk\ y^o^ 
 
 v/^. 
 
 ^t^ 'SjaKi*<.e*/A 
 
 r 
 
 
 
 xI^**4m04/\ 
 
 
 J-c 
 
 ffO 
 
 Silaries and 
 Wages Paid 
 
 Miscellaneous 
 Payments 
 
 ffO\ 
 
 ^ f*.*Ac -& 
 
 ^^^d4C4/ 
 
 f^7f 
 
 ^a 
 
 f o 
 
 So 
 
 J/Z/o 
 
 
 <^^U44/ 
 
 
 
 
 
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 ^ V<«T "^P-JH-i /u/t/ ^tf"**- u.,^ 
 
 'e««.^^- t'O^ /^o 9^1^ 
 
 
 Z^efO^ju^ijX 
 
 ■^te- 
 
 vu^u/ 
 
 '- 
 
 (^^ (A "^^0^*44/ Y I '^^o 
 
 .tciet tV< 
 
 o <T 
 
 //' 
 
 y'*A< 
 
 J2^ 
 
 fAy 
 
 
 ^<f 
 
 /<f. 
 
 ±L 
 
 3c 
 
 ^£^ eA ^a 
 
 <?/= 
 
 ¥3 
 
 6" 
 
 
 
 J- 
 
 ^yySc 
 
 t> o 
 
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 -»* 3 
 
 j^3 
 
 o o 
 
 oo 
 
 ^M^c 
 
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 [These Pages should have faintly-ruled horizontal lines. They have been omitted here for the sake of clearness.] 
 
^ 
 
 10 
 
 .^ 
 
 I 1 
 
 4)> 
 
 1 
 
 C 
 t 
 
 S ^ 
 
 .5 
 
 I 
 
 s 
 
 
 
 I: 
 
 fS I 
 
 Is" 
 
 •5* 
 
 ai 
 V 
 
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 1 
 
 i 
 
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 \l 
 
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 I 
 
 i5 
 
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 i i 
 
 i 
 
 !l 
 
 CASH REMITTANCES BY TREASUBER TO 
 SUPERINTENDENT 
 
 At the Presbyterian Hospital, where pay-rolls are paid about 
 the eighteenth of each month for the first fifteen days of the 
 month and where payrolls for the last half of each month 
 are paid about the third of the followmg month, it is customaiy 
 for the Superintendent, about the tenth or twelfth of each 
 month, to make a careful estimate of the probable amount of 
 the pay-roU for the first half of that month. This he does by 
 knowing exactly what the pay-roll was for the first half of the 
 previous month and by considering the probable amount of m- 
 crease or decrease due to increase or decrease in force made smce 
 
 the previous month. 
 
 By the tenth or twelfth of each month the Super- 
 intendent also knows, from his Voucher Register, the total 
 amount of properly approved audited vouchers covermg bills 
 for the previous month, which, at the Presbyterian Hospital, it 
 is the practice to pay about the fifteenth of the month, except 
 
 as noted below. ,, m 
 
 The Superintendent then draws a draft on the Treasurer 
 for the amount of money he expects to require to pay the pay- 
 roU for the first half of the month plus the total amount of 
 his audited vouchers for the previous month, as shown by his 
 Voucher Register not mcluding pay-roU charges shown by the 
 
 Voucher Register. 
 
 n any two members of the Executive Committee, approve 
 and sign this draft it is forwarded to the Treasurer and authorizes 
 him to remit to the Superintendent a check for the amount 
 
 requested. ^i # i. 
 
 Likewise about the twenty-fifth or twenty-seventh of each 
 
 month the Superintendent draws a draft on the Treasurer 
 
 for the estimated amount of the pay-roll for the last half of 
 
 the month. A check for this amount, in due course, is for- 
 
 warded to him by the Treasurer upon receipt of a draft signed 
 
 by two members of the Executive Conunittee authorizing such 
 
 remittance. 
 
 The form of draft, size 7^ inches by S% inches, and the stub 
 on which record of same is kept are as illustrated below. The 
 drafts and stubs are consecutively numbered. It has been found 
 
 45 
 
I 
 
 !<l 
 
 lil 
 
 46 
 
 CASH REMITTANCES BY SUPT. TO TREAS. 
 
 convenient to have them printed in books containing about 200 
 drafts per book, with two drafts per page. 
 
 Inasmuch, however, as there is always a large percentage of 
 monthly biUs on which a discount of one or two per cent, can be 
 obtained if payments are made within ten days from date of m- 
 voice, it has been found advantageous to avail of such discounts, 
 when there is no question about the correctness of the biU, by 
 paying such bills promptly. For that purpose the Treasurer hw 
 given to the Superintendent for deposit in the latter's "Voucher 
 Bank Account" a working fund of about $7,000.00 on which the 
 Superintendent can temporarily draw, untU the working fund is 
 reimbursed by the usual remittances from the Treasurer to the 
 Superintendent. 
 
 CASH REMITTANCES BY SUPERINTENDENT 
 
 TO TREASURER 
 
 About the fifteenth and thirtieth of each month, or oftener if 
 desked, the Superintendent remits to the Treasurer a check on 
 account of cash received by Superintendent in payment of bills 
 against patients and including Out-Patient Department, Phar- 
 macy and other Miscellaneous Receipts account Hospital Earn- 
 ings or for General Material sold. 
 
 When the Superintendent makes the remittances referred to 
 he should always retain in his general cash account a smaU bal- 
 ance sufficient to meet any further immediate requirements of 
 his Petty Cash Account, described later, or to meet any immediate 
 payments he may be called on to make in refunding any Over- 
 payments by Patients. 
 
 THE SUPERINTENDENT'S BANK ACCOUNTS 
 
 The Superintendent will ordmarily find it most convenient to 
 Lave two separate accounts with the bank in which he deposits 
 funds, as this will f acihtate balancing his bank accounts or locating 
 
 any error. . , , tt i. 
 
 The first account is called the "Supenntendent s Voucher 
 Bank Account*' or simply "Superintendent's Voucher Account." 
 In this account the Superintendent deposits the checks he re- 
 ceives from the Treasurer and also any cash receipts that are 
 treated as credits to current expenses. From this account are 
 
 
 
 SUPERINTENDENT'S PETTY CASH BOOK 
 
 47 
 
 paid the voucher checks drawn by the Supermtendent in favor of 
 various parties for current expenses or capital expenditures of 
 
 the Hospital paid through his office. . , , ^, ^ oi 
 
 The second account is called the "Supenntendent s General 
 Cash Bank Account" or simply "Superintendent's Account. 
 In this account is deposited the cash received through the Super- 
 intendent's office account Hospital Earnings, General Material 
 sold and also unclaimed wages deposited temporarily in this ac- 
 count and any remittances of surplus cash or checks from tne 
 Superintendent's Petty Cash Account described later. 
 
 From the Superintendent's General Cash Account are paid 
 by Superintendent's check, some pay-checks and also checks 
 covering refunds on account of overpayments made by or on 
 account of patients (as the endorsement on the check serves as a 
 receipt for the payment), and the various remittances made by the 
 Superintendent to the Treasurer on account of Hospital Earnings, 
 and also checks in favor of the Superintendent for advances to 
 Petty Cash to enable him to pay mmor Miscellaneous Hospital 
 Petty Cash Expenditures and to cash such time-checks or other 
 checks, etc., as are absolutely necessary. 
 
 SUPERINTENDENT'S PETTY CASH BOOK 
 
 In order to economize space in the Superintendent's General 
 Cash Book, and to have some suitable record in which certem 
 Petty Cash expenditures can be originally entered before they 
 are finally grouped together and covered by suitable vouchers m 
 the usual manner, it will be found advantageous and economical 
 for the Superintendent to have a Petty Cash Book in addition to 
 
 his General Cash Book. , j i 
 
 This Petty Cash Book should have on each page columns headed 
 
 as follows: 
 
 PETTY CASH FOR MONTH 191 
 
 Dr. Cr. 
 
 Date 
 
 Degcription 
 
 Receipts 
 
 Time^hecks 
 Paid 
 
 Miscellaneoiu 
 Payments 
 
 If many advances on account of salaries and wages are paid 
 before pay-day, it may be found advisable to insert another credit 
 
#1 
 
 im 
 
 SUPERINTENDENT'S PETTY CASH BOOK 
 
 column in the Petty Cash Book with the heading "Advance Pay- 
 ments on Account of Salaries and Wages.** 
 
 By having debit and credit entries on the same page, but in 
 separate columns as indicated, there is great economy in space as 
 compared with having separate debit and credit pages, as nearly 
 all of the entries made in the Petty Cash Book are for minor 
 disbursements. 
 
 The disbursements recorded in the Petty Cash Book would be 
 for cashing of time-checks in advance of pay-day, for advances on 
 account of salaries and wages, for miscellaneous petty cash ex- 
 penditures, which, in due course are to be covered by a suitable 
 voucher in favor of the Superintendent to reimburse Petty Cash, 
 and cash returned to the Superintendent's General Cash Account, 
 when more cash than necessary accumulated in the Petty Cash 
 Account. 
 
 The only receipts recorded in the Petty Cash Book would be 
 advances from the Superintendent's General Cash Account and 
 cash received to reimburse Petty Cash for the miscellaneous petty 
 cash expenditures referred to above and pay-roll cash received 
 on pay-day to reimburse Petty Cash Account for time-checks 
 cashed and for advances account salaries and wages paid. 
 
 K at any time the Superintendent had in his cash drawer more 
 cash or checks to the credit of his Petty Cash Account than would 
 be needed in the immediate future, he should deposit a part of 
 this in the bank and debit his General Cash Account and credit 
 his Petty Cash Account accordingly. 
 
 If the Petty Cash Book is balanced at the end of each month 
 this Petty Cash Book can be considered as the Superintendent's 
 Petty Cash Ledger Account, and there will be no necessity of his 
 carrying a Petty Cash Account on his ledger in addition. 
 
 SUPERINTENDENT'S JOURNAL 
 
 As will be seen from the preceding paragraphs many of the 
 entries made in the Superintendent's General Ledger Accounts 
 are posted direct from his Cash Book and Voucher Register. 
 In order, however, to indicate to what ledger accounts other 
 items are debited and credited and to show each month what 
 goes to make up Hospital Earnings (Schedule 1), a Superinten- 
 dent's Journal is kept. Each Journal Entry should be dated. 
 
 At the present time at the Presbyterian Hospital about seven 
 
 
 SUPERINTENDENT'S JOURNAL 
 
 49 
 
 kinds of Journal Entries, as indicated below, are found necessary 
 in the Superintendent's oflBce. Only one of these, the first, is 
 used every month, and by means of this Jomrnal Entry a complete 
 recapitulation of Hospital Earnings is made. The other Journal 
 Entries are used about once a year, except number two, which 
 may be used oftener. Where bills are rendered for Hospital 
 Earnings, as in the case of earnings from Hospital Patients and 
 certain other Hospital Earnings, the information required for 
 Journal Entry 1 is obtained from the Bill Register. In case 
 Hospital Earnings are derived from cash transactions where no 
 bill is rendered and no record of same is made in the Bill Register, 
 the information in regard to such Hospital Earnings required to 
 complete Journal Entry 1 is obtained from the Superintendent's 
 General Cash Book. 
 
 September 30, 1917 
 
 1. 
 
 Bill Account, Dr 
 
 To Superintendent's Account with Treasurer Cr. 
 For Hospital Earnings Accrued during month 
 of as follows: 
 
 From care of Private Room Patients 
 
 From Board of Friends of Patients 
 
 From Care of Semi-Private Patients. 
 
 From Care of Ward Patients 
 
 Private Semi- Ward 
 Room Private Patienia 
 Patients Patients 
 
 From Special Nursing 
 
 From Use of Operating 
 
 Room 
 
 From X-Ray Service 
 
 From Out-Patient Dept. 
 
 From Pharmacy 
 
 *From Ambulance Fees 
 
 •From Telephone and Tele- 
 graph 
 
 *From Bones and Soap Fat Sold 
 
 •From Handling Charges (if any) on General Material 
 
 sold 
 
 *As per Bill Register if Bills were rendered or as per 
 Cash Book if Cash transactions and no bills 
 rendered. 
 From Interest allowed during ... on Supt.'s Cash 
 
 Balances in bank, as per Cash Book 
 
 From Other Miscellaneous Hospital Earnings (enumer- 
 ate) as per Cash Book or Bill Register ... 
 
 Total Hospital Earnings 
 
 as per 
 
 BiU 
 
 Register 
 
 Ias per 
 BiU 
 Register 
 
 :| 
 
 as per 
 Cash Book 
 
m 
 
 SUPERINTENDENT'S JOURNAL 
 
 Sejdemher 30, 1917 
 
 t, BUI Account, Dr ' 
 
 To General Material Account <-r 
 
 Cost price of General Material sold, as per Bill Register, 
 providing a bill was rendered in each case and provid- 
 ing it was not a cash transaction. 
 NoTE.-It would simplify the bookkeeping if General Material is sold only 
 
 for cash. 
 
 Sejftember 80, 1917 
 
 8 Superintendent's Account with Treasurer, Dr. .^ 
 
 ToBillAccount ^ . , **"* 1^ 
 
 For UncoUectible Accounts Receivable charged off during month, as reported 
 
 to Treasurer. (Give details.) 
 
 Sejdember SO, 1917 
 
 4. Bill Account, Dr '.V'^' r, 
 
 To Superintendent's Account with Treasurer. .. .i.r ' " /,^^ 
 
 F:r JZUUA uaclaUned Overpayments by Patient, for -"-^t «- 
 
 dered and not to be rendered, which Overpayments are not hable to he ^»^fj^ 
 
 ttl «.d are the,efore transferred, by authority of the P^P^'-^^'^jlj^^- 
 
 pL and Deficit Account through the Treasurer's books as explained hereafter. 
 
 ^*'''Sl?uLl entry wodd ordinarily be u«=d only .t the cU»e of each fis«d year.) 
 
 September 30. 1917 
 
 5. General Material Account, Dr 
 
 Tn Sunerintendent's Account with Treasurer . . . . Cr ! * V " 
 
 Iir Wus amount of General Material found by inventory to be on 
 hand above that heretofore shown by General Matenal Accomit. 
 
 September 30, 1917 
 
 6. Superintendent's Account with Treasurer, Dr 
 
 To General Material Account Cr 
 
 Loss or depreciation of General Material, as shown by inventory. 
 
 September 30, 1917 
 
 7. Salaries and Wages Account, Dr 
 
 To Superintendent's Account with Treasurer . .Cr. J " \;^ 
 
 For acclulated unclaimed wages which are not likely to »- <=laimed ^d^, 
 
 the^re, transferred to "Surplus and Deficit Account' through the Treasurer s 
 
 n^Vu hv authority of the proper official. (Give details.; , ^ ^^ , 
 
 ^S io»^ entry would ordinarily be used only at the dose of ead. fiscal 
 
 year.) 
 
 SUPERINTENDENT'S GENERAL MATERUL LEDGER ACCOUNT 51 
 
 When Journal Entries Number 3 or 4 are made, proper nota- 
 tions should likewise be made on each of the "Patients Card 
 Ledger Accounts" concerned, in order to complete such records. 
 
 When postings are made from Journal Entries to General 
 Ledger Accounts, proper notations should be made on the Journal 
 to show the pages of the Ledger to which each item is posted and 
 proper reference should be made m each of these ledger accounts 
 to the page of the Journal from which each posting is made. 
 
 SUPERINTENDENT'S GENERAL MATERLiL LEDGER 
 
 ACCOUNT 
 
 In some hospitals certain materials are purchased to be sold 
 later, which are not properly chargeable to current expenses. 
 When such articles are purchased in quantity for resale it will be 
 found advisable to charge same to a General Material Account 
 and when sold, credit th6 cost only of these articles, to the same 
 account. Any amount received to cover handling charges is 
 shown on the Bill Register or Cash Book as Miscellaneous Hos- 
 pital Earnings. The balance on the debit side of this account 
 should at any time represent the cost price of general matenal 
 on hand, as shown on page 56. 
 
 For instance, at many hospitals it is the practice to have a 
 standard style and quaUty of uniform for nurses such as dresses, 
 aprons, bibs, caps, collars and cuffs. The materials used in mak- 
 ing these uniforms are often purchased by the hospital in quantity 
 and resold to nurses at cost price or at cost price plus a small 
 percentage of five or ten per cent, to cover handling charges, etc. 
 At the end of each fiscal year, or oftener if necessary, an in- 
 ventory at cost price should be taken of general material actu- 
 ally on hand. If this inventory shows an excess or a shortage 
 of general material on hand as compared with the amount shown 
 by General Material Account this discrepancy may be corrected 
 by Journal Entries 5 or 6. 
 
 SALE OF SUPPLIES CREDITED TO CURRENT 
 
 EXPENSES 
 
 ■' While the sale by the hospital of supplies not carried in Gen- 
 eral Material Account and which have previously been charged 
 to current expenses should ordinarily be discouraged as an unde- 
 sirable practice, it may at times and under certain circumstances 
 
*r| 
 
 M CREDITS TO CURRENT EXPENSES 
 
 be found expedient to allow doctors or nurses, etc., to purchase 
 from the Hospital certain articles, such as uniform material, rub- 
 ber gloves, thermometers, scissors, etc. If this is permitted the 
 amounts received up to the cost price of such articles should be 
 shown on the Cash Book and under the proper headings on the 
 Voucher Register in red ink as a credit to Current Expenses as 
 shown on Exhibit C and the cash received to cover the cost of 
 articles sold should be deposited in the Superintendent's Voucher 
 Bank Account. The profit, if any, on account of such sales should 
 be shown on the Cash Book as a Miscellaneous Hospital Earning 
 and the cash received on account of profit should be deposited 
 in the Superintendent's General Cash Account. 
 
 When entries are made on the debit side of the Superintendent's 
 General Cash Book to show the amount of cash received on account 
 of the sales referred to, such entry should indicate the cost of the 
 material sold and the amount of profit or handling charges. 
 
 HOW SUPPLIES DONATED MAY BE CHARGED TO 
 CURRENT EXPENSES, IF DESIRED 
 
 In case supplies of such nature as those ordinarily charged to 
 current expenses are donated to the hospital, and if it is desired 
 to show the value of such supplies as a charge against current 
 expenses in order to determine the total expenses involved in 
 caring for patients, the following method may be used. 
 
 The Superintendent may make a voucher in favor of the 
 Treasurer for the amount of the estimated value of the supplies 
 donated, which is entered in the Voucher Register and Cash Book 
 in the usual manner and charged to the proper subdivision of 
 
 current expenses. 
 
 WTien the Treasurer receives this voucher he enters the amount 
 in his Cash Book as a special donation. 
 
 ENTRIES TO BE MADE BY SUPERINTENDENT IN 
 OPENING A NEW SET OF BOOKS 
 
 In case the Superintendent of a hospital or other similar insti- 
 tution is about to adopt this system of accounting and has not 
 already on his books general ledger accounts such as "Bill Ac- 
 count," "Salaries and Wages Account," "General Material Ac- 
 count," "Voucher Account" and "Superintendent's Account with 
 Treasurer," he may open such accounts by making Journal 
 
 ENTRIES BY SUPT. IN OPENING NEW SET OF BOOKS 53 
 
 Entries in about the following form and debiting and crediting 
 his General Ledger Accounts accordingly: 
 
 SepUmber SO, 1917 
 
 Superintendent's Cash Account (Cash Book), Dr 
 
 To Superintendent's Account with Treasurer. . . Cr 
 
 For Cash on Hand September 80. 1917, not including Advance FaymenUby 
 Patients or Overpayments by Patients. 
 
 September SO, 1017 
 
 Superintendent's Cash Account (Cash Book), Dr 
 
 To Bill Account Cr 
 
 Account Advance Payments by Patients on hand September 80, 1917. 
 Account Overpayments by Patients on hand September 80, 1917. 
 
 September SO. 1917 
 
 Superintendent's Cash Account (Cash Book), Dr 
 
 To Salaries and Wages Account Cr 
 
 Account Unpaid or Unclaimed Wages due Sep- 
 tember SO, 1917. 
 
 September SO. 1917 
 
 Bill Account, Dr 
 
 To Superintendent's Account with Treasurer — Cr 
 For Accounts Receivable due September 30, 1917. 
 
 I • • • • 
 
 • • • * • • 
 
 September 80, 1917 
 
 General Material Account, Dr 
 
 To Superintendent's Account with Treasurer. . . Cr 
 For General Material on hand September SO, 1917. 
 
 September 30, 1917 
 
 Superintendent's Account with Treasurer, Dr 
 
 To Voucher Account Or 
 
 For Audited Vouchers Unpaid September 30, 1917. 
 
It 
 
 SUPEBINTENDENTS GENERAL LEDGER ACCOUNTS 
 
 The foUowing examples will illustrate ^He various ^^^^^^ 
 Accounts it has been found necessary to keep - /he Supennten^ 
 ent's office in the Presbyterian Hospital and the manner m 
 which entries to same are posted. When entries are made to 
 TheJlldger Accounts the pages of the books from which they 
 are posted are referred to in each case. 
 
 1. SUPERINTENDENT'S CASH ACCOUNT 
 Sec explanations under heading "Superintendent's Cash Book." page 44. 
 
 «. BILL ACCOUNT 
 
 Dm. 
 
 ♦Total from previous month 
 Amount of Hospital Earn- 
 ings, Schedule 1, accrued 
 during month, as per 
 
 Journal Entry 1 
 
 Cost price (if bills were ren- 
 dered)of General Material 
 gold during month, as per 
 
 Journal Entry 2 
 
 Overpayments by Patients 
 refunded to them during 
 month, as per Cash Book. 
 Accumulated unclaimed 
 Overpayments by Pa- 
 tients transferred to Su- 
 perintendent's Account 
 with Treasurer, as per 
 Journal Entry 4 
 
 Total from previous month. 
 
 Cash received by Superin- 
 tendent during month in 
 payment of bills rendered 
 Patients and including 
 Out-Patient Department, 
 Pharmacy and other Mis- 
 cellaneous receipts ac- 
 count Hospital Earnings 
 and cash received account 
 cost price of General Ma- 
 terial sold (if bills for 
 same were rendered), as 
 
 per Cash Book 
 
 Uncollectible Accounts Re- 
 ceivable charged off dur- 
 ing month, as per Joiur- 
 nal Entry 3 
 
 Total 
 
 Total 
 
 Difference in totals should equal "Accounts Receivable less amount of 
 -Advance Payments" and "Overpayments" by Patients. ,i^ ^ \A 
 
 T^ZuAlmonnt of "Accounts Receivable" at the end of each month, shoiJd 
 e, Jll ^riui^the debit balances, as shown by the Card Ledger Accounts referred 
 to on page 86, if postings have been properly made. 
 
 M 
 
 SUPERINTENDENT'S LEDGER ACCOUNTS 
 
 55 
 
 * t " A^vRtiPe Pavments by Patients" and "Overpayments 
 K p-^^lrJ-TX 1 ^trmorihtl/eaual the sun. of t^credit W- 
 ':I rlwn S Z Card Ledger Accounts, if postings have been p«,perly 
 
 "i^a patient renu^ins in the hospital after the end of '^--f-. "j^^ 
 ance to the credit of such patient's account would represent an Advance 
 
 ""Tri'tient has left the hospital at the end of any month, any balance to the 
 
 -t: £iotr a-rper.:::^^"^- "^^^^^ 
 
 of and the amounts of ^ccoun^ ^^ ^^^^ ^^^ 
 
 and "Overpayments by Patients, as snown "^ "- 
 after these accounts have been baknced for the month. 
 
 "Overoavments by Patients" are payments made by them for services or 
 Uverpaymenis ujr o^snital offers to refund these " overpayments 
 
 . part of the amount »t-f "« *^^^^Va ITtime and will probably 
 :rb:^ri.tt";r b^o^^Knt. . .rindi<.ted on page . to 
 «• Superintendent's Account with Treasurer. 
 
 8. 
 
 SALARIES AND WAGES ACCOUNT 
 
 fTotal from previous month 
 Amount of Pay-Roll vouch- 
 ers registered during 
 month as per Voucher 
 Register 
 
 Cb. 
 
 Dr. 
 
 Total from previous month 
 
 Sakries and Wages paid to 
 employes during the 
 month, as per Cash Book 
 
 Accumulated unclaimed 
 wages transferred to Su- 
 perintendent's Account 
 with Treasurer as per 
 Journal Entry No. 7 
 
 This balance includes the entire last pay-rofl of the month, which fa not usual^ 
 p^d tnta t^^nd or third of the following month, as well as undamied wage. 
 
 "' 'l"rS« tirable for the Superintendent in making ''!» ^ ^^J"- «* 
 the Ld of ^ month as shown on page ,7 to subdivide the credit balance mto 
 
 two subdivisions: . . x\ 
 
 "Unpaid Wages of latest pay-roll (viz. entu* amount) 
 
 I'^^tZTjZ^r^'^^':^^ total-amount ofun^hOmi wage, 
 as shown by the card records referred to on page 31. 
 
 
SUPERINTENDENTS LEDGER ACCOUNTS 
 
 4. GENERAL MATERIAL ACCOUNT 
 
 *TotaI firom previous month 
 
 General Material purchased 
 
 during month, as per 
 
 Voucher Register 
 
 Surplus amount of General 
 Materia] found by inven- 
 tory to be on hand, aa per 
 Journal Entry 5 
 
 Ol 
 
 Total from previous month 
 
 Cost price of General Mate- 
 rial sold for cash during 
 month, as per Cash Book 
 
 Cost price of General Mate- 
 rial sold for which bills 
 were rendered, during 
 month, as per Journal 
 Entry 2 (handling char- 
 ges, if any, having been 
 treated as part of Ho»- 
 pital Earnings) 
 
 Loss or depreciation of 
 General Material, as 
 shown by inventory, as 
 per Journal Entry 6 
 
 Total Total 
 
 * Difference in totals equals "General Material on Hand.' 
 
 «. VOUCHER ACCOUNT 
 
 Db. 
 
 Total from previous month 
 Vouchers (not including Pay- 
 Roil vouchers) paid during 
 month, as per Cash Book. 
 
 Total. 
 
 t Total from previous month 
 
 Amount of vouchers (not 
 
 including Pay-Roll vouch- 
 
 [ ers), registered during 
 
 month, as per Voucher 
 
 Register 
 
 Total 
 
 Difference in totals equals "Audited Voudiers Unpaid.'* 
 6. SUPERINTENDENT'S ACCOUNT WITH TREASURER 
 
 Db. 
 
 •Total from previous month 
 
 Grand Total Current Ex- 
 penses, Schedule 2, dur- 
 ing month, as per Voucher 
 Register 
 
 Capital Expenditures 
 Schedule 3, during month 
 as per Voucher Register. 
 
 Cash remitted to Treasurer 
 during month as per Cash 
 Book, which was part of 
 cash received by Superin- 
 tendent in payment of 
 
 Total from previous month 
 Amount of Hospital Earn- 
 ings, Schedule 1, accrued 
 during month, as per 
 
 Journal Entry 1 
 
 Cash received during month 
 by Superintendent from 
 Treasurer, as per Cash 
 
 Book 
 
 Surplus Amount of General 
 Material found to be on 
 hand, as per Journal En- 
 try 5 
 
 Cb. 
 
 Cb. 
 
 SUPERINTENDENT'S TRIAL BALANCE 
 e. SUPT'S ACCOUNT WITH TREASURER— Confonued 
 
 Db. 
 
 bills rendered patients 
 and including Out-Patient 
 Department, Pharmacy 
 and other Miscellaneous 
 Receipts account Hospi- 
 tal Earnings, and cash 
 received account General 
 Material sold 
 
 Uncollectible Accounts Re- 
 ceivable charged off dur- 
 ing month, as per Journal 
 Entry 3 
 
 Loss or Depreciation of 
 General Material charged 
 off during month, as per 
 Journal Entry 6 
 
 17 
 
 Cb. 
 
 Accumulated unclaimed 
 Overpayments by Pa- 
 tients to be transferred 
 to Surplus and Deficit 
 Account, as per Journal 
 Entry 4 
 
 Accumulated unclaimed 
 wages to be transferred 
 to Surplus and Deficit 
 Account, as per Journal 
 Entry? 
 
 Total 
 
 X OuU ••••••••••••••• 
 
 Difference in totals equals balance shown by "Superintendent's Account 
 with Treasurer" and must agree with balance shown in "Treasurer's Account 
 with Superintendent" on the Treasurer's General Ledger. 
 
 SUPERINTENDENT'S TRIAL BALANCE 
 
 Between the sixth and eighth of each month, after all entries 
 for the previous month to each Ledger Account have been made, 
 totals footed and balance of each account determined, the Super- 
 intendent makes his Trial Balance in the following form by listing 
 the debit and credit balances of these accounts, the totals of which 
 must agree if all entries have been properiy made : 
 
 Cash in hands of Superintendent, including Petty Cash. 
 
 Accounts Receivable (see page 54) 
 
 General Material on Hand 
 
 Balance shown by Superintendent's Account with 
 Treasurer 
 
 Advance Payments by Patients for services to be ren- 
 dered (see page 55) 
 
 Overpayments by Patients for services not rendered 
 and not to be rendered (see page 55) 
 
 Unpaid Wages of latest pay-roll 
 
 Unclaimed Wages of previous pay-rolls 
 
 Audited Vouchers Unpaid 
 
 Totals, which shoiild be equal 
 
 Db. 
 
 « • • * 
 
 Cb. 
 
SUPERINTENDENT'S LEDGER ACCOUNTS 
 
 *At the first of each fiscal year under the headings " BUI Account," "General 
 Material Account," and "Superintendent's Account with Treasurer," the balance 
 shown on the debit side of each account at the end of the previous month should 
 be shown on the debit side only as" Balance at first of Year" instead of "Totals 
 from previous months." 
 
 fAt the first of each fiscal year under headings "Salaries and Wages Account,'* 
 and "Voucher Account." the balance shown on the credit side of each account at 
 the end of the previous month should be shown on the credit side only as "Balance 
 at first of year" instead of "Totals from previous month." 
 
 MONTHLY REPORT OF SUPERINTENDENT TO 
 
 TREASURER 
 
 Between the sixth and eighth of each month the Superintend- 
 ent sends to the Treasurer a report in the form shown on the 
 following page, which is a detailed statement of the "Superin- 
 tendent's Account with Treasurer." 
 
 The balance as shown by this account, if correct, must agree 
 with the balance of the corresponding ledger accoimt on the books 
 of the Treasurer, entitled "Treasurer's Account with Superin- 
 tendent."^ This report of the Superintendent also includes a 
 copy of his Trial Balance. 
 
 SUPERINTENDENT'S MONTHLY STATEMENTS OF 
 REVENUE, EXPENSES, AND STATISTICS 
 
 In order to enable the Superintendent to complete in his office 
 Detailed Statement of Current Revenue (Schedule 1), it is custom- 
 ary for the Treasurer, about the sixth of each month, to for- 
 ward to the Superintendent the information in regard to details 
 of Current Revenue (Schedule 1) (other than Hospital Earnings) 
 during previous month, as shown by the Treasurer's books. 
 
 At the Presbyterian Hospital it is customary to have state- 
 ments showing details of Revenue, Expenses and Statistics called 
 for on Schedules 1 to 6 inclusive, for each month, prepared and 
 ready for inspection by the Executive Committee at its meeting 
 on the second Tuesday of the succeeding month. 
 
 COMPARATIVE MONTH AND TO DATE STATEMENTS 
 
 A book is also kept showing in comparative form the amount 
 of each of the subdivisions of revenue, expenses, and statistics 
 referred to in Schedules 1, 2, 3 and 6 for each month, and for the 
 period from the first of the fiscal year to the end of each month, 
 during the current and previous years. (SeeExhibit 19, page 118.) 
 
 This record is most useful and interesting and shows clearly 
 and exactly how revenue, expenses and statistics, during the 
 current year, compare in detail by months, and up-to-date, with 
 those of previous years and just where any increases or decreases 
 have occurred. It enables the management to promptly locate 
 any extravagances. 
 
 This book also facilitates securing promptly after the close of 
 each fiscal year correct totals for that year of the details called 
 for by the Schedules. 
 
 59 
 
m 
 
 : '. : : : 
 
 • 
 
 U 
 
 • • • . . 
 
 « 
 • 
 • 
 
 • 
 
 • • • • 
 
 • • • • 
 
 • 
 
 Q 
 
 • • • • 
 
 • » • • 
 
 • • • • 
 
 ■ 
 • 
 
 i 
 
 ■5-5 
 
 ? 
 
 
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 C a -o > o a a 
 
 I 
 
 a 
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 I 
 
 I 
 
 TREASURER'S ACCOUNTS 
 
 The following paragraphs describe the various books used in 
 the Treasurer's oflSce of the Presbyterian Hospital and the manner 
 in which entries are made to the accoimts referred to. 
 
 All Donations to the Presbyterian Hospital are paid direct to 
 the Treasurer and are acknowledged by him and put through his 
 accounts and do not appear in the Superintendent's Accoimts. 
 
 TREASURER'S CASH BOOK 
 
 A Cash Book ruled in the ordinary manner is suitable for use 
 in the Treasurer's oflfice, if, as is the case at the Presbyterian Hos- 
 pital, he receives and makes comparatively few payments during 
 the month under this system of accounting. If Unrestricted 
 Donations received are numerous it is advisable for the Treas- 
 urer to keep a record of these in a separate book and enter only 
 the total amount of Unrestricted Donations received during each 
 month in his Cash Book, at the end of such month, or more fre- 
 quently if desired. 
 
 All cash received is entered in detail on the debit side of the 
 Cash Book and must be credited to some (General Ledger accoimt 
 and may, in some cases, as explained later, also be credited to 
 any Income Ledger account concerned. All cash paid out, as 
 shown by the stubs of the Treasurer's Check Book, is entered in 
 detail on the credit side of the Cash Book and must be debited 
 to some General Ledger account and may, in some cases, also be 
 debited to any Income Ledger account concerned. 
 
 All Payments made by the Treasurer are by check. 
 
 Reference is made on the Cash Book to show the page of the 
 General or Income Ledger to which each account is posted. 
 
 It is customary at the Presbyterian Hospital for the purpose 
 of simplifying accounts to pay all expenses of the Treasurer's 
 ofl5ce, which come under the headings "Corporation Expenses" 
 or "Current Expenses from Special Funds for Stated Purposes" 
 (Schedule 2), by voucher through the Superintendent's office. 
 
 All appropriations from Special Funds to meet Current Expenses 
 on account of such Funds are included in the remittances by check 
 made by the Treasurer to the Superintendent described on page 45. 
 
 Taxes and other current expenses than petty current expenses 
 and Capital Expenditures on account of property held as invest- 
 
 61 
 
It TREASURER'S CASH BOOK 
 
 ment and not used for hospital purposes are ordinarily paid direct 
 by check by the Treasurer and debited to the proper income or 
 investment account, but if there is no income from the invest- 
 ment, it may be found preferable to pay current expenses and 
 taxes on such investment by Superintendent's voucher and charge 
 same as a part of Corporation Expenses. 
 
 The total amount of cash on hand at first of month and all 
 cash received during the month as shown on the debit side of the 
 Cash Book, including Donations received, less the total of all cash 
 paid out during the month, as shown on the credit side of Cash Book 
 should at any time equal the amount of Cash in hands of Treasurer. 
 
 As there may not be very many entries on the Treasurer's 
 
 Cash Book during the month, which are to be debited or credited 
 
 to the same accounts, it will probably not be worth while at the 
 
 end of the month to make any further recapitulation of cash 
 
 received or cash paid out, but postings can be made direct from 
 
 the original entries in the Cash Book, with the understanding, 
 
 however, that the total only of all items to be posted to the same 
 
 ledger account may be posted in a lump sum. 
 
 AT THE END OP EACH MONTH 
 
 THE TOTAL AMOUNT OF CASH 
 
 PAID DURING MONTH FOR 
 
 EACH OF THE ACCOUNTS IN- 
 
 CASH PAH) OUT BY TREAS- DICATED MAY BE DEBITED 
 
 URER DURING MONTH MAY RESPECTIVELY DIRECT TO 
 
 CONSIST MOSTLY OF THE THE FOLLOWING GENERAL 
 
 FOLLOWING: . LEDGER ACCOUNTS: 
 
 Cash paid to Superintendent To Treasurer's Account with Superin- 
 tendent. 
 
 Investments Purchased, not including 
 
 Interest Purchased To "Bonds Account," "Mortgages 
 
 Receivable Account," "Stocks Ac- 
 count" or Other Investment Account 
 concerned. 
 
 Interest Purchased To Interest Purchased Account. 
 
 Loans and Notes Receivable made .... To Loans and Notes Receivable Ac- 
 count. 
 
 Loans and Notes Payable paid To Loans and Notes Payable Account. 
 
 Mortgages Payable paid To Mortgages Payable Account. 
 
 Insurance Prepaid To Prepaid Insurance Account. 
 
 Cash paid account taxes or other than 
 petty current expenses on account 
 
 <rf Investments. To Proper Income or Investment 
 
 Account. 
 
 Other Miscellaneous payments To proper account. 
 
 TREASURER'S CASH BOOK 
 
 6S 
 
 ^O ^3 n3 n3 ^3 H^ n3 ^3 n3 ^O 
 
 » 
 
84 
 
 TREASURER'S JOURNAL ENTRIES 
 
 At the Presbyterian Hospital it has not been found necessary 
 for the Treasurer to keep any Cash Account on his General Ledger, 
 as the Cash Book itself answers that purpose. 
 
 TREASURER'S JOURNAL 
 
 As it is necessary for the Treasurer to debit or credit to his 
 General Ledger Accounts or to his Income Ledger Accounts items 
 which are not cash transactions, and which are not posted direct 
 from his Cash Book, it is necessary for him to make use of a Jour- 
 nal, wherein he records for reference first the account to which 
 each item is debited and then the account to which such item is 
 credited, and also notes further information desirable regarding 
 details. 
 
 When postings are made from Journal Entries to General Led- 
 ger Accounts or to Income Ledger Accounts, proper notations 
 should be made on the Journal to show the pages of the ledgers to 
 which each item is posted and proper reference should be made 
 in each of these ledger accounts to the page of the journal from 
 which each posting is made. Samples of such Journal Entries 
 are as follows: 
 
 September 30, 1917 
 
 I. 
 
 Treasurer's Account with Superintendent, Dr 
 
 To Hospital Earnings Account Cr 
 
 Amount of Hospital Earnings, Schedule 1, accrued during month, including 
 monthly earnings of Out-Patient Department, Pharmacy and other Miscellaneous 
 Hospital Earnings, as per Report of Superintendent to Treasurer. 
 
 September 30, 1917 
 
 2. 
 
 Treasurer's Account with Superintendent, Dr 
 
 To Surplus and Deficit Account Cr 
 
 Surplus Amount of General Material found by inventory to be on hand, as 
 per Report of Superintendent to Treasurer. 
 
 Unclaimed Overpayments by Patients, not liable to be claimed, transferred 
 by Superintendent to Treasurer, as per Report of Superintendent to Treasurer. 
 
 Unclaimed Wages, not liable to be claimed, transferred by Superintendent 
 to Treasurer, as per Report of Superintendent to Treasurer. 
 
 September 30, 1917 
 
 8. Surplus and Deficit Account Dr. ... 
 
 To Treasurer's Account with Superintendent. . . Cr 
 
 Grand Total Current Expenses (Schedule 2), during month, as per Voucher 
 Register, as reported by Superintendent. 
 
 TREASURER'S JOURNAL ENTRIES 
 
 65 
 
 - 
 
 And Total Capital Expenditures (Schedule 3), during month, as per Voucher 
 Register (show amount for each account separately), as per report of Superinten- 
 dent to Treasurer. J « J . 
 
 And Superintendent's Uncollectible Accounts Receivable charged off durmg 
 month, as per Report of Superintendent to Treasurer. 
 
 And Loss or Depreciation of General Material charged off. as per Report of 
 Superintendent to Treasurer. 
 
 September 30, 1917 
 
 4. Grand Total Current Revenue for month (Schedule 1) consisting of: 
 
 Hospital Earnings Account Dr 
 
 And Donations, Unrestricted Account. . . .Dr 
 
 And Legacies, Unrestricted Account Dr 
 
 And Income from Investments held in Endowed 
 
 Bed Fund Account Dr 
 
 And Income from Investments held in General En- 
 dowment Fund Account Dr • 
 
 And Income from Investments held in Other Fund 
 
 Accounts (enumerate) Dr 
 
 (The income of which is to be used to meet Operat- 
 ing Expenses (Schedule 2), and is not to be added to 
 the principal.) 
 
 And Income from Unrestricted Investments Ac- 
 count I^' ..... 
 
 And Appropriations from Special Funds to meet 
 
 Current Expenses Account Dr 
 
 (Enumerate each separately.) 
 And any other accounts, composing Grand Total 
 
 Current Revenue for month Dr 
 
 To Surplus and Deficit Account Cr 
 
 For amounts transferred from such accounts to Surplus and Deficit Account. 
 
 September 30. 1917 
 
 6. Sites and Grounds Account Dr 
 
 Or Buildings Account Dr 
 
 Or Furniture and Fixtures Account Dr 
 
 Or Machinery and Tools Account Dr 
 
 Or Apparatus and Instruments Account . .Dr 
 
 Or Ambulances, Live Stock, etc., Account.Dr . . 
 
 Whichever account is concerned. 
 
 To Capital Account (Hospital Properties 
 and Equipment) Cr 
 
 For Capital Expenditures for such accounts during month (Schedule 3), as per 
 Voucher Register, as reported by Superintendent. 
 
 Value of gifts in shape of Hospital Properties and Equipment (Schedule 4), 
 received during month, if capitalized. 
 
 c 
 
 if 
 
 k 
 
If I 
 
 1 11 
 
 M TREASURER'S JOURNAL ENTRIES 
 
 September 30, 1917 
 
 6. Sites and Grounds Account Dr 
 
 Or Buildings Account Dr 
 
 Or Other Hospital Properties and Equipment Ac- 
 counts (Schedule 4) Dr 
 
 To Surplus and Deficit Account Cr 
 
 For profit on sale of such property. (Give details.) 
 
 September 30, 1917 
 
 7. Capital Account (Hospital Properties and Equip- 
 
 ment) Dr 
 
 To Sites and Grounds Account Cr 
 
 Or Buildings Account Cr 
 
 Or Furniture and Fixtures Account Cr 
 
 Or Machinery and Tools Account Cr 
 
 Or Apparatus and Instruments Account Cr 
 
 Or Ambulances, Live Stock, etc.. Account Cr 
 
 Whichever account is concerned. 
 
 For actual net loss or damage account sale, fire or demolition, etc., of Hospitel 
 Properties and Equipment (Schedule 4) during month, if not covered by Reserve 
 for Depreciation. 
 
 If any Reserve for Depreciation has been established covering part of the book 
 value of the property, which has been lost or damaged, it would be preferable to 
 use Journal Entry 22 as regards that part of the actual net loss or damage that 
 is covered by a Reserve for Depreciation. 
 
 September 30, 1917 
 
 8. Bonds Account Dr 
 
 Or Stocks Account Dr 
 
 Or Other Investments Accounts Dr . . . . 
 
 To Surplus and Deficit Account Cr 
 
 For Profit on Bonds, Stocks or Other Investments sold during month as per 
 Income Ledger. (Give details.) See pages 90 and 9«. 
 
 September 30, 1917 
 
 9. Mortgages Receivable Account Dr 
 
 Or Bonds Account Dr . . . . 
 
 Or Stocks Account Dr . 
 
 Or Other Investments Accounts Dr . . . . 
 
 To General Endowment Fund Account. . Cr 
 
 • • • • • • 
 
 Or Other Fund Accounts Cr 
 
 • • • • • • 
 
 Value of "Mortgages Receivable," "Bonds" (not including interest accrued). 
 "Stocks," or "Other Investments" Restricted given to these Reserve Fund Ac- 
 counts during month. (Give full details.) 
 
 M 
 
 TREASURER'S JOURNAL ENTRIES 
 
 «7 
 
 September 30, 1917 
 
 10. Surplus and Defidt Account Dr 
 
 To Mortgages Receivable Account Cr 
 
 Or Bonds Account Cr 
 
 Or Stocks Account Cr 
 
 Or Other Investments Accounts Cr 
 
 Or Loans and Notes Receivable Account . .Cr 
 Whichever account is concerned. 
 Loss or Depreciation charged off during month. 
 
 Loss on sale of Bonds, Stocks or Other Investments during month as per Income 
 Ledger. (Give details.) See pages 91 and 9S. 
 
 September 30, 1017 
 
 11. Pirtly Endowed Bed Fund Dr 
 
 To Endowed Bed Fund Cr 
 
 Amounts transferred to Endowed Bed Fund from Partly Endowed Bed Fund, 
 account completion of such Endowments during month. (Give details.) 
 
 September 30, 1917 
 
 12. Endowed Bed Fund Account Dr 
 
 Or Partly Endowed Bed Fund Account .Dr 
 
 Or General Endowment Fund Account. . Dr 
 
 Or Other Fund Reserve Account Dr 
 
 To Surplus and Deficit Account Cr 
 
 Amount charged off such accounts and credited to Surplus and Deficit Account 
 during month, account liability of Hospital having ceased. (Give details.) 
 
 September 30. 1917 I 
 
 13. Loans and Notes Payable Account Dr 
 
 To Loans and Notes Payable Account Cr 
 
 ' For Loans and Notes Payable renewed during month, by signing of new notes 
 and cancellation of old notes, where it is desired to avoid the necessity of exchanging 
 checks. 
 
 ■'11 
 
 September 30. 1917 
 
 14. Mortgages Receivable Account Dr . .... ...... 
 
 Or Bonds Account Dr 
 
 Or Stocks Account Dr 
 
 Or any Other Investment Account Dr 
 
 To Donations, Unrestricted Account Cr 
 
 Or To Legacies, Unrestricted Account Cr 
 
 For Value of Mortgages Receivable, Bonds, Stocks, or Other Investments 
 unrestricted, not including accrued interest, given to Hospital during month. 
 (Give details.) 
 
68 TREASURER'S JOURNAL ENTRIES 
 
 September 30, 1917 
 
 15. Mortgages Receivable Account Dr 
 
 To Investment Account Concerned. . . Cr 
 
 Value of Mortgages Receivable received during month in full or part payment 
 for property sold. 
 
 September SO, 1917 
 
 16. Surplus and Deficit Account Dr 
 
 To Treasurer's Accounts Receivable Cr 
 
 For Uncollectible Treasurer's Accounts Receivable charged off during month. 
 (Give details.) 
 
 September 30. 1917 
 
 17. Sites and Grounds Account Dr 
 
 Or Buildings Account Dr 
 
 Or Other Hospital Properties and Equipment 
 
 Accounts (Schedule 4) Dr 
 
 To Capital Account (Hospital Properties 
 and Equipment) Cr 
 
 For Appreciation in value of such property. (Give details.) 
 
 September SO, 1917 
 
 18. Treasurer's Accounts Receivable Account. Dr 
 
 To Income from Investments held in any 
 account concerned Cr 
 
 Or To any Reserve Fund Account con- 
 cerned Cr 
 
 Or to any Other Revenue or Income Ac- 
 count (Schedule 1), concerned Cr 
 
 For amounts accrued and due during month and unpaid. (Give details.) 
 
 September 30, 1917 * 
 
 19. Capital Account (Hospital Properties and Equip- 
 
 ment) Dr 
 
 To Surplus and Deficit Account Cr 
 
 For Book Value of "Sites and Grounds," "Buildings," "Furniture and 
 Fixtures," "Machinery and Tools," "Apparatus and Instruments," "Ambu- 
 lances, Live Stock, etc.," or other "Hospital Properties and Equipment," Schedule 
 4, sold during the month, or for amount collected during month from insurance 
 companies for such properties damaged or destroyed by fire, as shown by Treas- 
 urer's Cash Book, and as already posted from the Treasurer's Cash Book direct 
 or by Journal Entry to the credit side of each particular ledger account of the sub- 
 division of "Hospital Properties and Equipment" concerned. 
 
 TREASURER'S JOURNAL ENTRIES 
 Septemher 30, 1917 
 
 20. Capital Account (Hospital Properties and Equip- 
 ment) Dr . • • I 
 
 To Reserve for Depreciation of Hospital 
 
 Properties and Equipment Cr 
 
 For estimated accrued depreciation during the 
 year ending September 30, 1917, as follows: 
 
 69 
 
 (usually at rate of) 
 (from 13^ to 3%) 
 ( " 2 " 5%) 
 ( " 3 " 10%) 
 ( " 3 " 10%) 
 
 Buildings 
 
 Furniture and Fixtures 
 Machinery and Tools 
 Apparatus and Instruments 
 Ambulances, Live Stock, etc. ( " 5 " 10%) 
 
 (of book values) 
 
 September 30, 1917 
 
 21. Reserve for Depreciation of Hospital Properties 
 
 and Equipment Dr 
 
 To Capital Account (Hospital Properties 
 and Equipment) Cr 
 
 For extraordinary repairs or renewals made during month to Buildings, Furni- 
 ture and Fixtures, Machinery and Tools or any other Hospital Properties and 
 Equipment, Schedule 4, which may be chargeable to Reserve for Depreciation 
 and to cover which sufficient Reserve for Depreciation on the property concerned 
 has been established. 
 
 September 30, 1917 
 
 22. Reserve for Depreciation Dr 
 
 To Site and Grounds Account Cr 
 
 Or Buildings Account Cr 
 
 Or Furniture and Fixtures Account Cr 
 
 Or Machinery and Tools Account Cr 
 
 Or Apparatus and Instruments Account. Cr 
 Or Ambulances, Live Stock, etc., Account.Cr 
 Whichever account is concerned. 
 
 For actual net loss or damage account sale, fire or demolition, etc., of Hospital 
 Properties and Equipment (Schedule 4) during month, which is covered by Reserve 
 for Depreciation. (See note under Journal Entry 7.) 
 
 September 30, 1917 
 
 28. Surplus and Deficit Account Dr 
 
 To Capital Account (Hospital Properties and 
 
 Equipment Cr. 
 
 Amount to be credited to "Capital Account" to represent increase of equity 
 of the Hospital in its Properties and Equipment by reduction of Mortgages Payable 
 on Hospital Property, as explained in note concerning" Capital Account "on page 80. 
 
■rr' 
 
 ENTRIES TO BE MADE BY TREASURER IN OPENING 
 
 A NEW SET OF BOOEB 
 
 In case the Treasurer of a hospital or other similar institution 
 is about to adopt this system of accounting and has not already 
 on his books General Ledger Accounts, such as "Bonds Account," 
 "Mortgages Receivable Account," "Stocks Account," "Other 
 Investment Accounts" or other asset ledger accounts showing 
 respectively the various kinds and book values of Bonds, Mort- 
 gages Receivable, Stocks, Other Investments, or other assets on 
 hand, he may open such accounts on his new General Ledger by 
 making suitable entries, to proper accounts to which such assets 
 are debited and credited, as shown for instance by the following 
 sample Journal Entries : 
 
 Se^giemher SO, 1017 
 
 Bonds Account Dr 
 
 To Endowed Bed Fund Cr 
 
 For the foUowing bonds on hand September 30, 1917. if held in Endowed Bed 
 Fund. (Give list of bonds in detail and book value of each, to be inserted in 
 Journal Entry and m "Bonds Account" on ledger.) 
 
 September SO, 1017 
 
 Stocks Account Dr 
 
 To any Special Fund Account Cr 
 
 For the following stocks on hand September SO, 1917. if held in such Specia] 
 Fund. (Give list of stocks in detail and book value of each, to be inserted in Journal 
 Entry and in "Stocks Account" on ledger.) 
 
 September SO, 1917 
 
 Mortgages Receivable Account Dr 
 
 To Surplus and Deficit Account Cr 
 
 For the following Mortgages Receivable on hand September 30, 1917, if un- 
 restricted and not held in any Reserve Fund. (Give list of Mortgages Receivable 
 in detail and book value of each, to be inserted in Journal Entry and in " Mortgages 
 Receivable Account" on ledger.) 
 
 September 30, 1917 
 
 Accounts Receivable Account Dr . • • • • • 
 
 To Surplus and Deficit Account Cr 
 
 For Accounts Receivable due September 30, 1917. (Give details.) 
 
 70 
 
 TREASURER'S JOURNAL ENTRIES 
 
 Tl 
 
 <f 
 
 M 
 
 (* 
 
 <4 
 
 M 
 
 M 
 
 M 
 
 September SO, 1917 
 
 Surplus and Deficit Account Dr 
 
 To General Endowment Fund Account. .Cr 
 
 Or To any other Reserve Fund Account. Cr 
 
 For amount of such Restricted Funds to o£Fset which no Investments or other 
 Assets are held. 
 
 September SO, 1917 
 
 Sites and Grounds Account Dr 
 
 Or Buildings Account Dr 
 
 Or Furniture and Fixtures Account Dr 
 
 Or Machinery and Tools Account Dr 
 
 Or Apparatus and Instruments Account .Dr 
 
 Or Ambulances, Live Stock, etc., Account.Dr .... 
 To Capital Account (Hospital Properties 
 and Equipment) Cr 
 
 For the following Sites and Grounds (Give book values) 
 
 Or Buildings 
 
 Or Furniture and Fixtures 
 
 Or Machinery and Tools 
 
 Or Apparatus and Instruments 
 
 Or Ambulances, Live Stock, etc 
 
 Owned by the Institution September SO, 1917. 
 
 Likewise in opening a new set of books if it is necessary for the 
 Treasurer to open new General Ledger Accounts to show Liabili- 
 ties already existing, such as "Mortgages Payable" or "Loans 
 and Notes Payable,** etc.. Journal Entries showing to what ac- 
 counts such items are debited and credited might be made as 
 follows: 
 
 September SO, 1917 
 
 Surplus and Deficit Account Dr 
 
 To Mortgages Payable Account Cr 
 
 Or To Loans and Notes Payable Account. Cr '. 
 
 For Mortgages Payable, (List in detail) 
 
 Or For Loans or Notes Payable, (List in detail) 
 existing as a liability September 30, 1917. 
 
 In order to open the "Treasurer's Account with Superintend- 
 ent*' the following journal Entry would be made: 
 
 September SO, 1917 
 
 Treasurer's Account with Superintendent. .Dr 
 
 To Surplus and Deficit Account Cr 
 
 For Cash advanced to Superintendent September SO, 1917. 
 
 • • ■ • 
 
TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 In the Treasurer's office General Ledger Accounts are kept 
 with the Superintendent; also for Hospital Earnings and for each 
 of the other subdivisions shown under the general heading of 
 Other Revenue or Income on Schedule 1, and for each of the 
 headings shown on Schedule 4, except those shown in the Super- 
 intendent's Trial Balance heretofore mentioned. 
 
 It will be found convenient at large hospitals to have the 
 Treasurer's General Ledger in loose leaf form, with lock, as in 
 that style of ledger, accounts can be at all times kept in the order 
 desired and when new accounts are opened the new ledger sheet 
 can be inserted in its proper place. Considerable time and labor 
 will thus be saved in posting, or in referring to the different ac- 
 counts when desired and the ledger wiU not be unnecessarily 
 
 large or heavy. 
 
 If a loose leaf Treasurer's General Ledger is used, for the same 
 reasons it will also be found convenient to have a loose leaf Treas- 
 urer's Income Ledger, referred to on page 87, and to include this 
 Income Ledger in the same binder in which the Treasurer's General 
 Ledger Accoimts are bound. 
 
 The following illustrations will show how entries are made to 
 these General Ledger Accounts: 
 
 1. TREASURER'S CASH ACCOUNT 
 See explanations under heading "Treasurer's Cash Book," page 64. 
 
 2. TREASURER'S ACCOUNT WITH SUPERINTENDENT 
 
 Db. 
 
 Total from previous month 
 Amount of Hospital Earn- 
 ings, Schedule 1, accrued 
 during month, as shown 
 by Report of Superin- 
 tendent to Treasurer as 
 
 per Journal Entry 1 
 
 Cash paid to Superintend- 
 ent during month, as per 
 Treasurer's Cash Book. . 
 
 Cr. 
 
 §Total from previous month 
 Grand Total Current Ex- 
 penses, Schedule 2, dur- 
 ing month, as per Vouch- 
 er Register, as reported 
 by Superintendent and 
 as per Journal Entry 8. . 
 Total Capital Expenditures 
 Schedule 3, during month 
 as per Voucher Register, 
 
 78 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 78 
 
 «. TREASURER'S ACCOUNT WITH SUPERINTENDENT-^onfonucd 
 
 Ob. 
 
 Surplus Amount of General 
 Material found to be on 
 hand during month, as 
 per Report of Superinten- 
 dent to Treasurer, as per 
 Journal Entry 2 
 
 Unclaimed overpayments 
 by Patients as per Report 
 of Superintendent to 
 Treasurer, credited to 
 Surplus and Deficit Ac- 
 count, as per Journal En- 
 try 2 
 
 Unclaimed Wages, as per 
 Report of Superintendent 
 to Treasurer, credited to 
 Surplus and Deficit Ac- 
 count, as per Journal 
 Entry 2 
 
 Gb. 
 
 Total 
 
 as reported by Superin- 
 tendent, as per Journal 
 
 Entry S 
 
 Cash received by Treasurer 
 from Superintendent dur- 
 ing month, as per Treas- 
 urer's Cash Book 
 
 Uncollectible Accounts Re- 
 ceivable charged oflf dur- 
 ing month, as per Report 
 of Superintendent to 
 Treasurer, as per Journal 
 
 Entry 3 
 
 Loss OP Depreciation of 
 General Material charged 
 off during month, as per 
 Report of Superintendent 
 to Treasurer, as per 
 Journal Entry 3 
 
 v*l 
 
 Total 
 
 Difference in totals equals balance shown by "Treasurer's Account with 
 Superintendent," and must agree with balance shown by "Superintendent's 
 Account with Treasurer" on the Superintendent's General Ledger. 
 
 S. HOSPITAL EARNINGS ACCOUNT 
 
 Dr. 
 
 Total from previous month 
 Amount of Hospital Earn- 
 ings, Schedule 1, trans- 
 ferred to Surplus and 
 Deficit Account, as per 
 Journal Entry 4 
 
 Total from previous month 
 Amount of Hospital Earn- 
 ings, Schedule 1, includ- 
 ing monthly earnings of 
 Out-Patient Department, 
 Pharmacy and other 
 Miscellaneous Hospital 
 Earnings accrued during 
 month, as per Report of 
 Superintendent to Treas- 
 urer, as per Journal En- 
 try 1 
 
 Total 
 
 Total 
 
 This account will balance monthly. 
 
74 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 4. DONATIONS, UNRESTRICTED ACCOUNT 
 
 Db. 
 
 Total from previous month 
 Amount of Unrestricted 
 Donations transferred to 
 Surplus and Deficit Ac- 
 
 Cb. 
 
 Total from previous month 
 Amount of Unrestricted Do- 
 nations received during 
 month, as per Treasurer's 
 Cash Book 
 
 count* as per Journal En* 
 try 4 Value of "Mortgages Re- 
 ceivable" or "Bonds" or 
 
 "Stocks," or "Other In- 
 vestments" unrestricted 
 given to Hospital during 
 month, as per Journal 
 Entry 14 
 
 Total 
 
 This account will balance monthly. 
 
 Ledger Accounts of "Legacies, Unrestricted Account" may be treated m the 
 same manner as "Donations, Unrestricted Account." 
 
 5. INCOME FROM INVESTMENTS HELD IN GENERAL 
 
 ENDOWMENT FUND 
 
 Total. 
 
 Db. 
 
 Total from previous month 
 Taxes or other than petty 
 current expenses, if any, 
 charged directly against 
 income from this invest- 
 ment, as per Treasurer's 
 
 Cb. 
 
 Total from previous month 
 Cash received during month 
 account Income from In- 
 vestments held in this ac- 
 count, as per Treasurer's 
 Cash Book 
 
 Cash Book Amount of Income from In- 
 
 Net Income during month 
 from Investments held in 
 this account transferred 
 to Surplus and Deficit 
 Account, as per Journal 
 Entry 4 
 
 Total 
 
 vestments held in this 
 Account accrued and due 
 during month and unpaid 
 and transferred to "Ac- 
 counts Receivable," as 
 per Journal Entry 18 ... . 
 
 Total 
 
 This account will balance monthly. 
 The General Ledger Accounts "Income from Investments held in Endowed 
 Bed Fund Account" or "Income from Investments held in any other Fund Ac- 
 count" (Income only of which is to be used to meet Current Expenses, and is not 
 to be added to the principal) or "Income from Unrestricted Investments Account** 
 or Other Miscellaneous Revenue Accounts should be treated in a similar manner 
 to some of those described above. 
 
 The amount of monthly Income from Investments held in 
 Endowed Bed Fund, General Endowment Fund or any other 
 Fund, the income only of which is to be used to meet Current 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 7^ 
 
 Expenses, is also shown by the Treasurer's Income Ledger Ac- 
 counts of such funds, as described on pages 95 and 96, and should 
 agree with amounts of Income from Investments held in such 
 Funds, as shown on the respective General Ledger Accounts. 
 
 6. SITES AND GROUNDS ACCOUNT 
 
 •Total from previous month Total from previous month 
 
 Capital Expenditures on this Sites and Grounds sold dur- 
 
 account during month, as ing month, as per Treas- 
 
 per Voucher Register, as urer's Cash Book 
 
 reported by Superintend- Depreciation or Loss 
 
 ent, as per Journal En- charged oflf during month, 
 
 ^y ^ and credited to this ac- 
 
 Value of Sites and Grounds count, as per Journal En- 
 given to Hospital during try 7 
 
 month, if capitalized, as 
 
 per Journal Entry 5 
 
 For Appreciation in value 
 of Sites and Grounds, as 
 per Journal Entry 17 
 
 For Profit on Sale of Sites 
 and Grounds, as per Jour- 
 nal Entry 6 
 
 Total .— — : Total .... .. 
 
 Diflference in totals equals value of "Sites and Grounds," as shown on Books 
 and on Balance Sheet. 
 
 7. BUILDINGS ACCOUNT 
 
 !>»• Cb. 
 
 ♦Total from previous month Total from previous month 
 
 Capital Expenditures on this Buildings sold during 
 
 account during month, as month, as per Treasurer's 
 
 perVoucherRegister,asre- Cash Book 
 
 ported by Superintendent, Cash received during month 
 
 as per Journal Entry 5 from Insurance Com- 
 
 Value of Buildings given to panics in settlement of fire 
 
 Hospital during month, if loss, as per Treasurer's 
 
 capitalized, as per Journal Cash Book 
 
 E°t^y5 .. Actual Net Loss or Damage 
 
 For Appreciation in value of caused by sale, fire or de- . 
 
 BuUdings, as per Journal molition, charged off dur- 
 
 ^°*^17 ing month and credited 
 
 For Profit on Sale of Build- to this account, as per 
 
 ings, as per Journal Entry Journal Entry 7 or 22 
 
 6 
 
 Total Total 
 
 Difference in totals equals value of "Buildings," as shown on Books and on 
 Balance Sheet. 
 
76 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 Note— The Ledger Accounts "Furniture and Fixtures Account," "Machinery 
 and Tools Account," "Apparatus and Instruments Account," "Ambulances, Live 
 Stock, etc.. Account" or any other accounts belonging to Hospital Properties and 
 Equipment (Schedule 4), should be worded in manner similar to " Sites and Grounds 
 Account," and "Buildings Account," as shown above. 
 
 Db. 
 
 *Total from previous month 
 
 Mortgages Receivable pur- 
 chased during month, not 
 including accrued interest 
 (enumerate), as per Treas- 
 urer's Cash Book 
 
 Value of Mortgages Receiv- 
 able unrestricted given to 
 Hospital during month 
 (enumerate), as per Jour- 
 nal Entry 14 
 
 Value of Mortgages Receiv- 
 able restricted given to 
 Hospital during month 
 (enumerate), as per Jour- 
 nal Entry 9 
 
 Value of Mortgages Receiv- 
 able received during 
 month in full or part pay- 
 ment for property sold, as 
 per Journal Entry 15 ... . 
 
 Total 
 
 8. MORTGAGES RECEIVABLE ACCOUNT 
 
 Cb. 
 
 Total from previous month 
 Mortgages receivable sold 
 or paid off during month 
 (enumerate), as per Treas- 
 urer's Cash Book 
 
 Loss or Depreciation charged 
 off during month and 
 credited to this account, 
 as per Journal Entry 10. . . 
 
 Total. 
 
 as shown on 
 
 Difference in totals equals amount of "Mortgages Receivable,' 
 Books and on Balance Sheet. 
 
 "Loans and Notes Receivable " made or paid off are treated in a General Ledger 
 Account in the same manner as Mortgages Receivable purchased or paid off. 
 
 Dr. 
 
 •Total from previous month 
 Bonds purchased during 
 month, not including ac- 
 crued interest (enumer- 
 ate), as per Treasurer's 
 
 Cash Book 
 
 Value of Bonds unrestricted, 
 not including accrued in- 
 terest, given to Hospital 
 during month (enumer- 
 ate), as per Journal Entry 
 14 
 
 ». BONDS ACCOUNT 
 
 Total from previous month 
 
 Bonds sold during month 
 (enumerate), as per Treas- 
 urer's Cash Book 
 
 Lessor Depreciation charged 
 off during month credited 
 to this account, as per 
 Journal Entry 10 
 
 Loss on sale of Bonds during 
 month, as per Journal 
 Entry 10 
 
 Cb. 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 77 
 
 9. BONDS ACCOUNT— Con/mwei 
 Db. Cb. 
 
 Value of Bonds restricted, 
 not including accrued in- 
 terest, given to Hospital 
 during month (enumer- 
 ate), as per Journal Entry 
 9 
 
 Profit on bonds sold during 
 month, as per Journal En- 
 try 8 
 
 Total Total 
 
 Difference in totals equals amount of '* Bonds," as shown on Books and on 
 Balance Sheet. 
 
 Note — ^The Ledger Account of "Stocks Account" (Schedule 4), should be 
 worded in a manner similar to "Bonds Account," as shown above. 
 
 For Other Miscellaneous Investments it will be found advisable 
 to keep a separate General Ledger Account in each case, to which 
 capital expenditures on account of such investments should be 
 debited and capital receipts credited. 
 
 For instance, if the investment were in the form of an unoccu- 
 pied dwelling house, not producing any revenue, the General 
 Ledger Account for same might be treated in the following manner: 
 
 i 
 
 10. DWELLING HOUSE, 
 
 Db. 
 
 Value of property, unre- 
 stricted given to Hospital 
 during month, as per 
 
 Journal Entry 14 
 
 Cost of Additions and Bet- 
 terments during month as 
 per Treasurer's Cash Book 
 
 Taxes and other than petty 
 current expenses during 
 month, which may be 
 charged to this Account 
 (if there is no income 
 from this investment), as 
 per Treasurer's Cash Book 
 
 Profit on property sold dur- 
 ing month, as per Journal 
 Entry 8 
 
 Total 
 
 UNFURNISHED, AND LOT, 900 EAST 70th ST., 
 N. Y. 
 
 Cb. 
 
 Loss or Depreciation charged 
 off during month, as per 
 Journal Entry 10 
 
 Cash received during month 
 
 in full or part payment 
 account sale of this prop- 
 
 erty, as per Treasurer's 
 
 Value of Mortgages Re- 
 ceivable received during 
 month in full or part pay- 
 ment account sale of this 
 property, as i>er Journal 
 
 Entry 15 
 
 Loss on property sold dur- 
 ing month, as per Journal 
 
 Entry 10 
 
 Total 
 
78 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 If all of this property is sold the totals as shown above should 
 agree. If a part only or none of this property is sold, the balance 
 on the debit side of this account will show the book value of the 
 remaining property at any time. 
 
 11. TREASURER'S ACCOUNTS RECEIVABLE ACCOUNT 
 
 Db. 
 
 •Total from previous month 
 Amounts accrued and due 
 
 during month and unpaid. 
 
 as per Journal Entry 18. . 
 
 Total. 
 
 Total from previous month 
 Cash received during month 
 account Treasurer's Ac- 
 counts Receivable, as per 
 Treasurer's Cash Book. . . 
 Uncollectible Treasurer's 
 Accounts Receivable 
 charged off during month, 
 as per Journal Entry 16. . 
 
 Total 
 
 Cb* 
 
 Difference in totals equals '* Treasurer's Accounts Receivable," as shown on 
 Books and on Balance Sheet 
 
 12. INTEREST PURCHASED ACCOUNT 
 
 •Total from previous month 
 Accrued Interest Purchased 
 during month when Mort- 
 gages Receivable. Bonds, 
 etc.. are purchased, as per 
 Treasurer's Cash Book . . . 
 Total 
 
 Gb. 
 
 Total from previous month 
 Cash received account In- 
 terest Purchased collected, 
 as per Treasurer's Cash 
 Book 
 
 Total. 
 
 Difference in totals equals "Interest Purchased," as shown on Books and on 
 Balance Sheet 
 
 IS. PREPAID INSURANCE ACCOUNT 
 
 Db. 
 
 •Total from previous month 
 
 Insurance prepaid during 
 
 month, as per Treasurer's 
 
 Cash Book 
 
 Cb. 
 
 Total. 
 
 Total from previous month 
 Cash received from Super- 
 intendent during month 
 to pay for Insurance 
 charged to Current Ex- 
 penses, which had pre- 
 viously been prepaid, as 
 per Treasurer's Cash Book 
 Total 
 
 Difference in totals equals ** Prepaid Insurance,** as shown on Books and on 
 Balance Sheet 
 
 TREASURER*S GENERAL LEDGER ACCOUNTS 
 
 79 
 
 APPORTIONING INSURANCE CHARGES 
 
 When large bills for insurance of various kinds are rendered they should, when 
 approved, be paid direct by Treasurer's check. Amounts so paid should be 
 entered on the credit side of the Treasurer's Cash Book and should be debited to 
 Prepaid Insurance Account. 
 
 The Treasurer should keep in his office and also furnish to the Superintendent 
 a statement showing how much of any prepaid insurance is properly chargeable 
 each month to current expenses, so that each month the Superintendent can 
 make a voucher in favor of the Treasurer for such an amount accordingly and 
 thus include the proper charge in current expenses. When the Treasurer receives 
 the Superintendent's voucher check he debits his cash account and credits Pre- 
 paid Insurance Account accordingly. If original bills for certain kinds of insur- 
 ance are very small it may be thought best to pay these direct by voucher through 
 the Superintendent's office and not apportion the charges over a series of months 
 during which the insurance is in effect. 
 
 14. CAPITAL ACCOUNT (HOSPITAL PROPERTIES AND 
 
 EQUIPMENT) 
 Db. 
 
 Actual Net Loss or Damage 
 
 Cb. 
 
 account sale, fire or demo- 
 lition, charged off Hos- 
 pital Properties and 
 Equipment. Schedule 4. 
 during month and cred- 
 ited to proper accounts 
 on Treasurer's General 
 Ledger, as per Journal 
 
 Entry 7 
 
 Book Value of "Sites 
 and Grounds," "Build- 
 ings,** "Furniture and 
 Fixtures." "Machinery 
 and Tools,** "Apparatus 
 and Instruments." "Am- 
 bulances. Live Stock, 
 etc.," or other "Hospital 
 Properties and Equip- 
 ment" Schedule 4, sold 
 during the month, or for 
 amount collected during 
 month from insurance 
 companies for such prop- 
 erties damaged or de- 
 stroyed by fire, as per 
 Journal Entry 19 
 
 Total 
 
 §Total from previous month 
 
 Capital Expenditures 
 Schedule 3, during month, 
 as per Voucher Register, 
 as reported by Superin- 
 tendent, as per Journal 
 Entry 5 
 
 Value of gifts in shape of 
 "Hospital Properties and 
 Equipment, " Schedule 4, 
 given to Hospital during 
 month, if capitalized, and 
 debited to proper account 
 on Treasurer's General 
 Ledger, as per Journal 
 Entry 5 
 
 Appreciation in value of 
 "Sites and Grounds," 
 "Buildings," or other 
 Hospital Properties and 
 Equipment as per Jour- 
 nal Entry 17 
 
 Amount to be credited to 
 " Capital Account" to rep- 
 resent increase of equity 
 of the Hospital in its Pro- 
 perties and Equipment by 
 reduction of Mortgages 
 Payable Account, as per 
 Journal Entry 23 
 
 Total 
 
 i 
 
 Difference in totals equals "Capital Account** (Hospital Properties and Equip- 
 ment), as shown on Books and on Balance Sheet 
 
ii 
 
 80 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 Note— "Capital Account " ("HospiUl Properties and Equip- 
 ment") may be considered as practically a subdivision of "Sur- 
 plus and Deficit Account" The balance standing to the credit 
 of "Capital Account" is really a part of the surplus of the 
 hospital. 
 
 "Capital Account," which represents the book value of the 
 hospitaPs equity in its working plant, plus "Reserve for Depre- 
 ciation of Hospital Properties and Equipment," if any such 
 account is established, plus bonds outstanding or mortgages 
 payable on Hospital Property, if any, should equal the total 
 book value of the assets of the hospital, which compose its work- 
 ing plant or Hospital Properties and Equipment, Schedule 4, 
 such as "Sites and Grounds," "Buildings," "Furniture and Fix- 
 tures," "Machinery and Tools," "Apparatus and Instruments," 
 and "Ambulance, Live Stock, etc." 
 
 By keeping this "Capital Account" (Hospital Properties 
 and Equipment) out of "Surplus and Deficit Account" as 
 here indicated, the amount of the deficit, if any, up to the 
 amount of the Reserve Fund Accounts, as shown by the "Sur- 
 plus and Deficit Account," will represent the exact amount 
 which the Reserve Funds of the Hospital have been encroached 
 upon. 
 
 The amount of surplus, if any, as shown by the "Surplus and 
 Deficit Account," will represent the amount of surplus, which 
 the hospital may have to its credit, not including the equity the 
 hospital may have in its working plant or Hospital Properties 
 and Equipment. 
 
 If a mortgage payable on Hospital Property is fully or partly 
 paid oflF the money paid should be entered on the credit side of the 
 Treasurer's Cash Book and should be debited to "Mortgages Pay- 
 able Account." 
 
 The equity of the Hospital in its Properties and Equipment is 
 increased by the amount of such payment and reduction in "Mort- 
 gages Payable Account" and in order that Capital Account may 
 represent this equity Journal Entry No. 23 should be made and 
 "Surplus and Deficit Account" should be debited and "Capital 
 Account" should be credited accordingly. 
 
 Conversely, if a mortgage payable on Hospital Property is 
 created the money received should be entered on the debit side of 
 the Treasurer's Cash Book and should be credited to "Mortgages 
 Payable Account." In order that Capital Account may then 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 81 
 
 represent the decreased equity of the Hospital in its Properties and 
 Equipment, a Journal Entry, the reverse of No. 23, should be 
 made, whereby "Capital Account" may be debited and "Surplus 
 and Deficit Account" may be credited accordingly. 
 
 RESERVE FOR DEPRECIATION OF HOSPITAL PROP- 
 ERTIES AND EQUIPMENT 
 
 In case it is desired to establish a "Reserve for Depreciation of 
 Hospital Properties and Equipment" (without disturbing the cost 
 values and without reducing book values below the values at 
 which such properties may be insured) to show the estimated 
 amount of depreciation or deferred up-keep on "Buildings," 
 "Furniture and Fixtures," "Machinery and Tools," or on other 
 Hospital Properties and Equipment, Schedule 4, the amounts of 
 this estimated depreciation mdy at the end of each fiscal year be 
 debited to "Capital Account" and credited to "Reserve for 
 Depreciation of Hospital Properties and Equipment" by a journal 
 entry similar to No. 20. 
 
 This "Reserve for Depreciation" would practically be a sub- 
 division of "Surplus and Deficit Account" and the balance on 
 the credit side of this account would represent a part of the surplus 
 of the hospital. 
 
 In case there is actual net loss or damage caused by sale, 
 fire, or by demoKtion, etc., not covered by insurance, to any 
 of the subdivisions of Hospital Properties and Equipment, 
 Schedule 4, and if it is desired to charge such part of this net 
 loss or damage as may be covered by the "Reserve for Depre- 
 ciation" to such Depreciation Account this may be done by 
 Journal Entry 22. 
 
 In case extraordinary repairs or renewals are made to any 
 of the subdivisions of Hospital Properties and Equipment, 
 Schedule 4, and if it is desired to charge such part of such 
 expenditures as may be covered by the Reserve for Depre- 
 ciation, to such Depreciation Account this may be done by 
 Journal Entry 21. 
 
 If a Fund for Depreciation of Hospital Properties and 
 Equipment, as outlined above, is estabhshed, one-twelfth of the 
 estimated amount of yearly depreciation of Hospital Properties 
 and Equipment might very properly be added to the actual 
 monthly Operating Expenses, Schedule 2, in order to ascertain 
 
81 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 the full cost of running the Hospital and to figure the full cost 
 per patient per day (not including Corporation Expenses or Special 
 Fund Expenses). 
 
 W. RESERVE FOR DEPRECIATION OP HOSPITAL PROPERTIES AND 
 
 EQUIPMENT 
 
 Db. Cb. 
 
 For actual net loss or dam- Balance Estimated Depre- 
 
 age by sale, fire or demoli- ciation from previous year 
 
 tion, etc., charged oflF Buildings Account 
 
 Hospital Properties and Furniture and Fixtures Ac- 
 Equipment referred to count 
 
 during month, as per Jour- Machinery and Tools Ac- 
 
 nal Entry 22 count 
 
 Buildings Apparatus and Instruments 
 
 Furniture and Fixtures Account 
 
 Machinery and Tools Ambulances, Live Stock, 
 
 Apparatus and Instruments etc^ Account 
 
 Ambulances, Live Stock, etc 
 
 Total Total 
 
 For extraordinary repairs or Estimated depreciation ac- 
 
 renewals made during crued during year ending 
 
 month charged to Depre- as per Journal En- 
 
 ciation Account, as per try No. 20 
 
 Journal Entry No. 21 Buildings Account 
 
 Buildings Furniture and Fixtures Ac- 
 Furniture' and Fixtures count 
 
 Machinery and Tools Machinery and Tools Ac- 
 Apparatus and Instruments count 
 
 Ambulances, Live Stock, etc Apparatus and^Instruments 
 
 Total ."^T^TT Account 
 
 Ambulances, Live Stock, 
 
 ^^^^^ Total 
 
 Total Totol 
 
 The above "Reserve for Depreciation" will cease to exist unless there remains 
 a balance on the credit side, which represents the amount of this "Reserve for 
 Depreciation of Hospital Properties and Equipment," as shown on the Books and 
 on the Balance Sheet. 
 
 16. ENDOWED BED FUND ACCOUNT 
 
 Db. Cb. 
 
 Total from previous month § Total from previous month 
 
 Amount charged off En- Cash received to fully En- 
 dowed Bed Fund during dow Beds during month, 
 month and credited to as per Treasurer's Cash 
 Surplus and Deficit Ac- Book 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 8S 
 
 1«. ENDOWED BED FUND ACCOUNT— Continued 
 
 Db. 
 
 count, liability of Hospital Amounts transferred from 
 
 having ceased, as per "Partly Endowed Bed 
 
 Joumal Entry 12 Fund" during month, 
 
 account completion of 
 ' such endowments as per 
 
 Joumal Entry 11 
 
 Total Total 
 
 Ck. 
 
 Difference in totals equals "Endowed Bed Fund," as shown on Books and on 
 Balance Sheet. 
 
 Note — ^When beds are endowed at the Presbyterian Hospital it is the practice 
 to credit such endowments to "Endowed Bed Fund Account" and to keep the 
 amounts received invested in income bearing securities, as long as anynominor 
 has the right to name i>atients to occupy such beds. 
 
 I In case, however, the right to name patients to occupy a bed should lapse, 
 either by expiry of the term of the endowment or by death of ^the nominor without 
 having appointed in writing a successor, the liability of the hospital, as regards that 
 particular endowment, is considered to have ceased and the endowment is there- 
 after treated as unrestricted and is credited as per Joumal Entry No. 12 to " Surplus 
 and Deficit Account," if such action is approved by the Board of Managers. A 
 Suitable entry is also made on the Treasurer's Endowed Bed Ledger Accounts as 
 described on pages 99 and 100. 
 
 17. PARTLY ENDOWED BED FUND ACCOUNT 
 Db. 
 
 Total from previous month 
 
 Cb. 
 
 § Total from previous month 
 Cash received account Part- 
 ly Endowed Bed Fund 
 during month, as per 
 Treasurer's Cash Book. . . 
 
 • • • • 
 
 Amounts Transferred to 
 Endowed Bed Fund, dur- 
 ing month, account en- 
 dowments completed, as 
 per Joumal Entry 11 
 
 Amounts charged off partly 
 Endowed Bed Fund dur- 
 ing month, and credited 
 to Surplus and Deficit 
 Account account liability 
 of Hospital having ceased, 
 as per Joumal Entry 12 
 
 Total Total. 
 
 Difference in totals equals "Partly Endowed Bed Fund," as shown on Books 
 and on Balance Sheet. 
 
 Note — ^Instalments received to partly endow beds are subject at any time to 
 transfer to "Endowed Bed Fund Account" upon completion of such endowments. 
 There is usually no liability on the part of the Hospital to fumish free treatment 
 on such beds until they are fully endowed. No investments are therefore assigned 
 to offset amounts standing to credit of "Partly Endowed Bed Fund Account** 
 «nd no income from this Account is therefore shown in Schedule 1. 
 
 M 
 
 f 
 
 r 
 
84 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 18. GENERAL ENDOWMENT FUND ACCOUNT 
 
 § Total from previous month 
 
 Cash received during month 
 
 for this Account, as per 
 
 Treasurer's Cash Book. . . 
 
 Value of Investments given 
 
 . to Hospital during month, 
 
 for this Account as per 
 
 Journal Entry 9 
 
 Cb. 
 
 State in detail purposes and conditions of this Fund, as for instance, "Principal 
 to be invested and income only to be used for meeting Operating Expenses" 
 (Schedule 2). 
 
 Db. 
 
 Total from previous month 
 
 Amount charged off this 
 accoimt during month 
 and credited to Surplus 
 and Deficit Account, lia- 
 bility of Hospital having 
 ceased, as per Journal En- 
 try 12 
 
 Total 
 
 Cb. 
 
 Total 
 
 .. Difference in totals equals "General Endowment Fund," as shown on Books 
 and on Balance Sheet. 
 
 19. X. Y. Z. VISITING NURSING FUND ACCOUNT 
 
 State in detail purposes and conditions of this Fund, as for instance. Principal 
 
 to be used for all expenses in connection with work of Visiting Nurses. 
 
 Db. 
 
 Total from previous month §TotaI from previous month . 
 
 Appropriation during Donations received during 
 
 month, for expenses month, for this Fund, as 
 
 chargeable to this Fund, as per Treasurer's Cash Book 
 
 reported by Superintend- 
 ent, as per Journal Entry 4 
 
 Total Total 
 
 Difference in totals equals the amount of this Fund, as shown on Books and 
 on Balance Sheet. 
 
 «0. A. B. C. PATHOLOGICAL DEPARTMENT FUND ACCOUNT 
 
 State m detail purposes and conditions of this Fund, as for instance, "Principal 
 or Income may be used for subscriptions to Periodicals, or for Purchase of Apparatus 
 or Instruments for the Pathological Department." 
 Db. 
 
 Total from previous month 
 Appropriation during 
 month for expenses 
 chargeable to this Fund, 
 as reported by Superin- 
 tendent, as per Journal 
 Entry 4 
 
 §Total from previous month 
 
 Donations received during 
 month for this Fund, as 
 per Treasurer's Cash Book 
 
 Cash received during month, 
 account Income from in- 
 vestments held in this 
 Fund, as per Treasurer's 
 Cash Book 
 
 Amount of Income from In- 
 vestments held in this 
 
 Cb. 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 85 
 
 «0. A. B. C. PATHOLOGICAL DEPT. FUND ACCOUNT— Confonti«f 
 
 Db. 
 
 Total. 
 
 Account accrued and due 
 during month and unpaid 
 and transferred to "Ac- 
 counts Receivable," as 
 per Journal Entry 18 ... . 
 Value of Investments given 
 to Hospital during month, 
 for this Fund as per Jour- 
 nal Entry 9 
 
 Total 
 
 Cb. 
 
 Difference in totals equals the amount of this Fund, as shown on Books and 
 on Balance Sheet. 
 
 Note— The general Ledger Accounts, "Endowed Bed Fund," "General En- 
 dowment Fund" or other similar Funds, the income from investments held in 
 which is to be used only to meet current expenses and is not to be added to the 
 principal, are intended to show only the increase or decrease of the principal of 
 such Capital Funds. 
 
 The investments assigned to each of such Funds and monthly income from 
 same is shown by an Income Ledger Account, as described on pages 95 and 96 
 and also in separate General Ledger Accounts referred to on page 74. 
 
 There are other General Ledger Accounts such as "X. Y. Z. Visiting Nursing 
 Fund," "A. B. C. Pathological Department Fund" or other similar Fund Accounts 
 in which the income from investments held in these funds as it falls due, is to be 
 added to and becomes a part of the principal. 
 
 Donations towards the principal of such Funds and income from investments 
 which may be held in such Funds, are therefore both credited to such General Led- 
 ger Fund Accounts and it is not necessary in such cases to keep additional General 
 Ledger Accounts to show the income only from such Funds. Income Ledger 
 Accounts, however, as described on pages 95 and 96 are kept where necessary to 
 show a list of investments assigned to such f imds and the monthly income from same. 
 
 «1. LOANS AND NOTES PAYABLE ACCOUNT 
 Db. 
 
 Cb. 
 
 Total from previous month 
 Loans paid during month, as 
 per Treasurer's Cash Book 
 Loans paid during month 
 by renewal, by signing of 
 new notes, and cancella- 
 tion of old notes, as per 
 Journal Entry 13 
 
 Total. 
 
 §Total from previous month 
 Cash received during month 
 account Loans incurred, as 
 per Treasurer's Cash Book 
 Loans renewed during 
 month by signing of new 
 notes and cancellation of 
 old notes, as per Journal 
 Entry 13 
 
 Total 
 
 Difference in totals equals "Loans and Notes Payable*" as shown on Books 
 and on Balance Sheet. 
 
 Note — "Mortgages Payable Account" may be treated in the same manner 
 as "Loans and Notes Payable Account." 
 
89 
 
 TREASURER'S GENERAL LEDGER ACCOUNTS 
 
 TREASURER'S INCOME LEDGER ACCOUNTS 
 
 87 
 
 «. SURPLUS 
 Dr. 
 
 tTotal from previous month . . . 
 Grand Total Current Ex- 
 penses. Schedule 2, during 
 month, as per Voucher 
 Register, as reported by 
 Superintendent, as per 
 
 Journal Entry 3 
 
 Total Capital Expenditures, 
 Schedule S, during month, 
 as per Voucher Register, 
 as reported by Superin- 
 tendent, as per Journal 
 
 Entry 3 
 
 Uncollectible Superintend- 
 ent's Accounts Receiv- 
 able charged o£F during 
 month, as reported by 
 Superintendent, as per 
 
 Journal Entry 3 
 
 Uncollectible Treasurer's 
 Accounts Receivable 
 charged off during month, 
 
 as per Journal Entry 16 
 
 Loss or Depreciation of 
 General Material charged 
 off during month, as re- 
 ported by Superintendent, 
 
 as per Journal Entry 3 
 
 Loss or Depreciation 
 charged off Investment 
 Accounts or Current Asset 
 Accounts, Schedule 4, 
 during month, as per 
 
 Journal Entry 10 
 
 Amount to be credited to 
 "Capital Account " to rep- 
 resent increase of equity 
 of the Hospital in its Pro- 
 perties and Equipment 
 by reduction of Mortgages 
 Payable Account, as per 
 Journal Entry 23 
 
 Total. 
 
 AND DEFICIT ACCOUNT 
 
 fTotal from previous month 
 Grand Total Current Revenue, 
 Schedule 1, during month, 
 as per Journal Entry 4 . . . 
 Profit on Bonds, Stocks or 
 other Investments sold 
 during month, as per 
 Income Ledger, as per 
 
 Journal Entry 8 
 
 Profit on sale of "Sites and 
 Grounds," "Buildings " or 
 other Hospital Properties 
 and Equipment, as per 
 
 Journal Entry 6 
 
 Amount charged off En- 
 dowed Bed Fimd, Partly 
 Endowed Bed Fund, or 
 Other Funds during 
 month, account liability 
 of Hospital having ceased, 
 as per Journal Entry 12. . . 
 Surplus amount of General 
 Material found to be on 
 hand during month as re- 
 ported by Superintendent, 
 as per Journal Entry 2. . . . 
 Unclaimed Overpayments 
 by Patients, as per Jour- 
 nal Entry 2 
 
 Unclaimed Wages, as per 
 
 Journal Entry 2 , 
 
 Book Value of "Sites 
 and Grounds," " Buildings," 
 "Furniture and Fixtures," 
 ** Machinery and Tools," 
 "Apparatus and Instru- 
 ments," " Ambulances, 
 Live Stock, etc." or other 
 "Hospital Properties and 
 Equipment," Schedule 4, 
 sold during the month or for 
 amount collected during 
 month from Insurance Com- 
 panies for such properties 
 damaged or destroyed by 
 fire, as per Journal Entry 19 . . 
 
 Total 
 
 Cb. 
 
 Difference in totals equals ''Surplus or Deficit" to date, as shown on Books and 
 on Balance Sheet. 
 
 "Deficit to date," if any, up to the amount of Reserve Fund Accounts will 
 represent the amount Reserve Fund Accounts, if any, have been encroached upon. 
 
 "Surplus to date," if any, will represent the amount of surplus, which the 
 Hospital has to its credit, not including the value of any of its plant, which goes 
 to make up "Hospital Properties and Equipment." 
 
 *At the first of each fiscal year, under the headings in the Treasurer's General 
 Ledger of any of the accounts referred to on the debit side of the Balance Sheet 
 (Schedule 4), the balance shown on the debit side of each account at the end of the 
 previous month should be shown on the debit side only as "Balance at first of 
 year," instead of "Total from previous month." 
 
 §At the first of each fiscal year under the headings in the Treasurer's General 
 Ledger of "Treasurer's Account with Superintendent," and any of the accounts 
 referred to on the credit side of the Balance Sheet (Schedule 4), the balance shown 
 on the credit side of each account at the end of the previous month should be shown 
 on the credit side only as "Balance at first of year" instead of "Total from previous 
 month." 
 
 t At the first of each fiscal year, under the heading in the Treasurer's General 
 Ledger "Surplus and Deficit Account," the amount of the "Surplus" or "Deficit 
 to date" at the end of the previous month is the amount which should be shown 
 on the credit side of the account, if a Surplus, or on the debit side of the account 
 if a Deficit, as "Balance at first of Year," instead of "Total from previous month." 
 
 TREASURER'S TRIAL BAKAJ^CE 
 
 The Treasurer's Trial Balance at the end of any month or year 
 is simply a transcript of the Balance Sheet (Schedule 4), in which, 
 opposite each of the headings shown is entered the balance as 
 shown by each account on the Treasurer's General Ledger at the 
 end of such month and in lieu of the balance shown by Treasurer's 
 Account with Superintendent such additional information from 
 the Superintendent's Trial Balance, as is needed to complete the 
 Balance Sheet. Opposite the word "Deficit" on the debit side, 
 or opposite the word "Surplus" on the credit side of the trial 
 balance must be entered "Deficit to date" or "Surplus to date," 
 as the case may be, as shown by the "Surplus and Deficit" ledger 
 account. The final totals must then agree. 
 
 TREASURER'S INCOME LEDGER ACCOUNTS 
 
 In addition to the "General Ledger Accounts" referred to in 
 the preceding pages, the Treasurer should also keep separate 
 Income Ledger Accounts with each kind of Bonds, Stocks, other 
 Investments owned or Loan or Mortgage Receivable or Payable, 
 
 I 
 
 '^ 
 
 'f 
 
88 
 
 TREASURER'S INCOME LEDGER ACCOUNTS 
 
 SO as to show plainly the amount of the principal and income 
 or expenses on accomit of each. 
 
 In order to show what securities or other investments are 
 assigned to each Fund and the monthly income from same, sepa- 
 rate Income Ledger Accounts should be kept for each of these 
 Fund accounts. The income as it accrues is posted to such ac- 
 counts from the Treasurer's Cash Book, if paid, or by Journal 
 Entry, if not paid, as indicated in the sample of such an account 
 on pages 95 and 96. 
 
 These Income I^edger Accounts do not form any part of the 
 Treasurer's Balance Sheet and should not be confused with the 
 General Ledger Accounts. 
 
 The following illustrations will show how entries are made to 
 such accounts: 
 
 TREASURER'S INCOME LEDGER ACCOUNTS 
 
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TREASURER'S INCOME LEDGER ACCOUNTS 
 
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 T3 
 
 QQ 
 
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 8 
 
 PROVISION FOR AMORTIZATION OR ACCUMULATION 
 
 ON BONDS 
 
 In Hospital Accounting it will not often be thought worth 
 while to go into what might be called the technical refinements 
 of accounting and to consider such matters as amortization and 
 accumulation on bonds for the reasons that comparatively few 
 hospitals own enough bonds, the book value of which is so different 
 from the par value, as to make worth while the extra accoimting 
 involved. There would not seem to be much practical necessity, 
 therefore, for financial officers of the ordmary hospital to consider 
 such matters and, to avoid what seems to be unnecessary complica- 
 tions in hospital accounting, no reference has been made to any 
 periodical allowances for amortization and accumulation in the 
 entries referring to bonds or interest thereon on the books of the 
 Treasurer referred to in this volume. 
 
 As a matter of information, however, for those who may not 
 understand what is meant by taking care of amortization and 
 Accumulation on bonds the following brief explanation is offered. 
 
 AMORTIZATION 
 
 Bonds which are well secured or which bear a high rate of 
 interest command a better price than those issued on a less 
 favorable basis and are usually sold at a premium where both 
 features are present. As the amount payable to the bond-holder 
 at the maturity of the bond is the par value it may be desired to 
 adopt some method to write off the premium paid, when bonds of 
 a market value much above par are purchased by or are given to 
 the hospital. 
 
 From published tables it is easy to ascertain the amount of 
 amortization or accumulation on bonds bearing different rates of 
 interest and having certain fixed dates of maturity. 
 
 The method of writing off the premium would be to treat the 
 interest received as being in part true interest and in part a return 
 of capital invested and divide it accordingly, properly crediting 
 that part of the cash received which is applicable to the principal. 
 For instance, if the market rate of interest is 4J^% a $1000 bond 
 
 97 
 
 ij 
 
 I 
 
 », 
 ii I 
 
 I 
 
 !| 
 
 
08 
 
 ACCUMULATION 
 
 ^eanng 6% interest payable semi-annually, redeemable at par 
 in four years, will command a premium of about $54.40. An 
 investor on a 4^% basis would therefore pay $1054.40 for the 
 bond and receive $60.00 a year nominal interest and $1000 prin- 
 cipal at the end of four years. 
 
 rQn m •^^ T"^ ""^ *^^ ^* '^^ '°^°*^" *^^ >'^^^«*or ^« <Jivide the 
 $30.00 into two parts, $23.70 net income at say 4^% on the book 
 
 value and $6.30 return of original investment. This amount 
 representing return of original investment would be credited to 
 Bonds Accomit' on the Treasurer's General Ledger and would 
 be credited to reduce the book value of the particular bond con- 
 cemed on the Treasurer's Income Ledger. At the end of the six 
 months the book value of the investment wiU be $1048.10. This 
 woud continue, making the proper allowance for amortization, 
 until the bond was reduced to par at maturity. 
 
 ACCUMULATION 
 
 Bonck which do not bear a high rate of interest or are not well 
 secured do not command as high a price as those issued on a more 
 favorable basis and where both features are present the bonds are 
 usually sold at a discount. As the amount payable to the bond- 
 holder at matunty of the bond is the par value, it may be desired 
 to adopt some method to periodically credit the accumulation. 
 Ihe accumulation or discount, therefore, is properly divided in 
 proportion to the number of years the bond is to run. The annual 
 proportion of the discount is added to the true interest and the 
 l^^'t «>f 'derfd net income on the bond. For instance, if a 
 $1000 bond beanng 3% interest payable semi-annuaUy, redeem- 
 able at par m four years, seUs on a 4^% interest basis it will seU 
 at a discount of about $54.40, the investor paying $945.60 for the 
 bond, receiving $30.00 a year nominal interest and $1000 principal 
 at the end of four years. 
 
 *i r^tn ^^ l""^ ""^ *^^ ^* ^'^ '^^'^^^^ *^^ '°^^«*0'- ^M add to the 
 $15.00 cash mterest at 3%, $6.30 accumulation. This amount 
 
 representmg accumulation would be debited to Bonds Account 
 
 on the Treasurer's General Ledger and would be debited to in- 
 
 crease the book value of the particular bond concerned on the 
 
 Treasurer s Income Ledger. The book value of the investment 
 
 JTo^^on 1** "" ""^^ ^^ *^^ ^"* ^^^ °^^^^^«' th«^^««^' will be 
 $951.90. This practice wiU continue until the bond is increased 
 to par at maturity. 
 
 TBEASURER'S ENDOWED BED LEDGER ACCOUNTS 99 
 
 The advantages claimed for Amortization and Accumulation 
 are that if bonds are purchased at a premium or a discount 
 the par value is shown on the books at maturity, thus making the 
 book value more nearly represent actual value and obviating the 
 necessity of showing the loss or profit on redeeming securities if 
 handled otherwise and spreading the premium or discount over 
 the number of years the bonds are held. 
 
 TREASURER'S ENDOWED BED LEDGER ACCOUNTS 
 
 At the Presbyterian Hospital the Treasurer keeps in a separate 
 Ledger from those referred to heretofore an Endowed Bed Ledger 
 Account with each organization which, or each individual who, 
 fully endows a bed or makes payments on account toward such 
 endowments. 
 
 At the head of each account detailed information is given in 
 regard to the name of the Organization or Individual endowing 
 the bed, and whether in perpetuity or for one life, ete., the name 
 the bed is to bear, if any and in whose memory the bed is endowed, 
 its certificate number and any other information pertinent. 
 
 This record also shows the name and address of the OflScer of 
 any Organization or the Individual having the right to nominate 
 patients to use such bed. In case of transfer of the right to nomi- 
 nate patients by death of the nominor, or otherwise, the name and 
 address of his or her successor is recorded as long as any such 
 nominor exists at whose request the Hospital is obligated to fur- 
 nish free treatment to patients. 
 
 If no nominor exists having the right to name patients to use 
 an endowed bed the liability of the Hospital ceases and at the 
 Presbyterian Hospital it is then customary, with approval of the 
 Board of Managers, in each case, to charge off the amount of such 
 endowment from Endowed Bed Fund Account at the end of the 
 fiscal year, as per Journal Entry 12. 
 The following illustration will show how entries are made: 
 
 In Cass ▲ Bed is Fullt Endowed 
 
 Dm, 
 
 Cb. 
 
 Cash received by Treasurer, 
 as per his Cash Book, or 
 amount transferred from 
 Partly Endowed Bed 
 Fund account completion 
 of such endowment, as per 
 Journal Entry 11 
 
 
 
100 TBEASURER'S ENDOWED BED LEDGER ACCOUNTS 
 Im Case a Bed is Endowkd in Pabi Patmknts 
 
 Db. 
 
 Cb. 
 
 Total from previous month .... . . 
 
 Cash received by Treasm^r 
 during month, partial 
 payment on account, as 
 per his Cash Book 
 
 ^CABMABmEABMMmEimOWmAJ^UABmTJOTEoeFTrALnABCEABm 
 
 Db, 
 
 Amount charg^ off account Total of such endowment ^^ 
 
 habdity of Hospital hav- 
 
 ing ceased, as per Journal 
 
 Entry 12 
 
 This account will then bahince. 
 
THE PRESBYTERIAN HOSPITAL in the City of New York 
 Statistics of Patients for Month of 
 
 Hospitd Wards mad Private Rooms 
 
 Patients in Hospital First or Month : 
 In Medical Wards, 
 In Surgical Wards, 
 In Private Rooms, 
 Total 
 Patients Abmitteo During Month : 
 To Medical Wards, 
 To Surgical Wards, 
 To Private Rooms. 
 Total 
 Total Patients Treated in "Hospital Warbs 
 
 AND Private Rooms During Month : 
 Patients Discharged During Month : 
 Cured 
 Improved 
 Unimproved 
 
 Transferred to other institutions 
 Died 
 Total 
 Patients in Hospital End of Month : 
 In Medical Wards, 
 In Surgical Wards, 
 In Private Rooms. 
 Total 
 
 Total Patient Days 
 Treatment : 
 Percentage : 
 Average Patients 
 PER Day: 
 
 Free Ward 
 
 Endowed Brd 
 
 Average Days per Patient in Hospital 
 
 Daily Average Cost per Private Room Patient 
 
 Daily Average Cost per Ward Patient 
 
 Out-Patient Department 
 
 Former Patients Treated, who have not been 
 treated in any previous month of present 
 fiscal year, 
 
 Former Patients Treated, who have been treated 
 m some previous month of present fiscal yt-ar. 
 
 Patients Treated, who were transferred from 
 other departments of O. P D. 
 
 New Patients Treated, 
 
 Total Patients Treated, 
 
 Visits Made. 
 
 Average Visits per day, 
 
 Average Visits per Patient. 
 
 Average Cost per Visit. 
 
 Patients Receiving Surgical Dressings. 
 
 Prescriptions Filled, 
 
 Ambulance 
 
 Ambulance Calls during month. 
 
 Average Calls per day. 
 
 Average Cost per Ambulance Call. 
 
 Patients Treated by Ambulance Surgeon in 
 Emergency Ward and .Transferred. 
 
 Patients Treated by Ambulance Surgeon and' 
 left at place of call or transferred direct to I 
 other Institutions or to their homes. 
 
 Summary 
 
 Total Patients Treated at the Hospital during 
 
 month in all departments. 
 Average Patients per day in all departments, 
 Daily Average Number of Employes Boarded in 
 
 Hospital, 
 Daily Cost per capita for Provisions for all 
 
 persons supported, 
 
 Social Service Department 
 
 Former Cases Cared for. who have not been 
 cared for in any previous month of present 
 fiscal year, 
 
 Former Cases Cared for, who have been cared 
 for m, some previous month of present fiscal 
 year, 
 
 New Cases Cared for. 
 Total Cases Cared for. 
 Visits to Homes for Social Service, 
 Visits to Homes of Patients for Nursing Care 
 Visits to Ward Patients needing Social Service 
 Care, 
 
 Visits Made at Social Service Office, 
 
 Total Visits, 
 
 Former Cases Given Material Relief, who have 
 
 not received such relief in any previous month 
 
 of present fiscal year, 
 Former Cases Given Material Relief who have 
 
 received such relief in some previous month 
 
 of present fiscal year. 
 New Cases Given Material Relief, 
 Total Cases given Material Relfef, 
 Cases referred to Organizations for Material 
 
 Relief or Employment, 
 Patients sent to Convalescent Homes and 
 
 Sanatoria, 
 
 Patients sent to Hospitals, Homes forlncurablei 
 
 and Aged, 
 Patients sent to Fresh Air Homes. 
 
 EXHIBIT 1 s ze 8i^» x lo^» 
 
 iThis Form should have faintly-ruled horizontal lines i„ addition Thev ha H 
 
 addition. They have been omitted here for the sake of clearness 
 
FORMS USED IN COMPUTING STATISTICS CONCERN- 
 ING NUMBERS OF PATIENTS TREATED, DAYS 
 TREATMENT, VISITS, ETC., REFERRED TO IN 
 SCHEDULE 6, ON PAGES 11, 12 AND 13 
 
 It is thought that the following description and illustrations 
 of forms used by the Presbyterian Hospital in New York to 
 show and to compute certain statistics concerning patients cared 
 for in its Hospital and in its Out-Patient and Social Service De- 
 partments may be of interest to hospital officials. ^ ^ _ 
 
 The use of such forms has simplified and minimized the labor 
 of securing the results desired. It might, of course, be desirable 
 to modify some of the details shown to better smt particular re- 
 quirements of certain institutions, but it is thought that the meth- 
 ods described could be used advantageously by many hospitals. 
 
 At the Presbyterian Hospital such a statement as is illustrated 
 by "Exhibit 1 " is made up at the first of each month, and such a 
 statement as is illustrated by "Schedule 6" is maxie up at the 
 first of each fiscal year, to show the information caUed for thereon 
 concerning patients cared for, etc., during the previous month or 
 
 The other forms described below are used in obtaining the 
 information required to complete "Exhibit 1," and some addi- 
 tional information of interest connected more or less closely 
 therewith. 
 
 HOSPITAL PATIENTS STATISTICS 
 
 "Exhibit 2," is printed the same on both sides, and a separate 
 page is used for the Medical Wards, for the Surgical Wards, and 
 for the Private Rooms in the Hospital. On these forms the 
 Superintendent's clerk enters each day the information called 
 for by the headings. At the end of each month the totals of each 
 column are obtained and are entered in the proper places on 
 
 "Exhibit 1." 
 
 "Exhibit 3," a card entitled "Pedigree of Patient." is printed 
 
 101 
 
 
 if 
 
102 
 
 PEDIGREE CARDS 
 
 differently on each side. On one side the information caUed for 
 IS filled in by the clerk in the Superintendent's oflSce and on the 
 
 ail I0M-«.I7 
 
 Pm^wr—^fPmtlmnt 
 
 n 
 
 M4ftt 
 
 ski t °'- — 2^ 
 
 WiOOWCO 
 
 In th« a S 
 
 Httmt N«ma 
 
 TMri 
 
 Jml. 
 
 Oceupatieii 
 Praviout Hoa^ul TrMimcnT 
 
 R«l%i«n 
 
 Uothw't Maiden Nama 
 Nama 
 
 Birth^ae* 
 
 BinKptoM 
 
 Naaraai Ktlatiwa ta ■*«« 
 
 Addraai 
 
 Nam* 
 
 Addraas 
 
 Raladen 
 
 Kacommandad lo Hospiui ky 
 
 81.. 6« , 4- i»rtot.<l dlff.>.«tly m .«eh »ld. 
 
 Adnw'itwl to f marganey Ward 
 iiili lill 
 
 JLJL 
 
 TiaatmaiM 
 
 Padigwa tifcan by 
 
 -"^■^o* T*«i»« rtMa^M ynn wwitc on thi. aioc 
 
 — 5tf>^ Iff yyifrf.. 
 
 other side the diagnosis, etc., is filled in by the examining physi- 
 cian for each patient admitted to the Hospital. These pedigree 
 
 M. S. 
 
 ADMISSION 
 
 Data 
 
 TiMia 
 
 OISCHAROC 
 
 A.^ U. 
 
 Diagmnia 
 
 Waau to 
 
 ' ''^^ ^'"'"•«« t»i« ».♦»«« 1^ f „ j [| 
 
 I* auliiact for t faatwm m tha hou>ii^. 
 
 Otlia>Bad fcy 
 
 M. 
 
 BffllBTT "[ 
 
 Hoapttat Ny . 
 
 ''"''^'^■^^''■'UKSm 
 
 caids are kept on file in the Superintendent's oflSce for future 
 feference. 
 
Statistics of Patients in 
 
 
 
 
 
 
 
 
 
 
 
 Dur 
 
 ing 
 
 
 
 
 
 191 
 
 
 
 ''t 
 
 w 
 
 
 
 MALE PATIENTS | 
 
 FEMALE PATIENTS 1 
 
 
 
 PATIENT DAYS TREATMENT 
 
 
 
 
 
 
 DISCHARGED 
 
 
 DISCHAROED 
 
 TOTAL 
 PATIENTS 
 
 PATIENTS 
 REMAINING 
 
 GENERAL 
 
 1 f 
 
 ENDOWED BED 
 
 -'I 
 
 
 Total Days 
 Treatment ol 
 Dischart^ed 
 
 
 
 Date 
 
 Adm. 
 
 C. 
 
 1. 
 
 U. T. 
 
 D. 
 
 Total 
 
 Adm. 
 
 C. 
 
 1. 
 
 V. 
 
 T. 
 
 D. 
 
 Total 
 
 Adm. 
 
 Dis- 
 charged 
 
 Re- 
 jected 
 
 Male 
 
 Female 
 
 Total 
 
 Remain- 
 ing 
 
 Adm. 
 
 Total 
 
 Remain 
 Ing 
 
 Adm. 
 
 Total 
 
 GRAND 
 TOTAL 
 
 Patients 
 
 . 
 
 
 1 
 
 2 
 
 3 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 - 
 
 
 
 7 
 
 8 
 
 ■ 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 9 
 
 to 
 
 11 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 12 
 13 
 14 
 
 1 K 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 17 
 
 1 IX 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 lO 
 
 1 ^^ 
 20 
 
 9 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 C I 
 
 i ^^ 
 
 li tA 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1 fcl 
 
 25 
 26 
 27 
 
 
 
 
 
 £ 
 
 XE 
 
 ■£!!. 
 
 
 an 
 
 le 
 
 IQl 
 
 i 
 
 _e: 
 
 v> 
 
 in* 
 
 ^d 
 
 IBM 
 
 i 01 
 
 X be 
 
 th 
 
 Jidos 
 
 
 
 
 
 
 
 
 « 
 
 28 
 
 30 
 31 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ■^ ' ■■ 
 
 Total 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I 
 
 
 |oty 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 1 
 
 
 
 
 
 
 * 
 
 
 
 
 
 
 
 1 
 
1! 
 
 BEDSIDE CARDS 
 
 103 
 
 "Exhibit 4," a card entitled "Bedside Card" is printed differ- 
 ently on each side, as shown. This card remains with the history 
 of the patient, whUe the patient is in the Hospital, and when the 
 
 ■ KOSlOe CAMD 
 
 ■Mtf. 
 
 Ok. 
 
 II"'—"' 
 
 ■t.fmci 
 
 nftyMtlBB 
 
 T" "■* *^ 
 
 TIti ■■ ■ "■ "^ 
 
 T 
 
 JEABS- 
 
 MlltTf TO 
 
 ■cttwrrifjo 
 
 piltP— Ti> to .... 
 
 rtr '"**■ 
 
 E XHIBIT 
 
 NtCII*WH» 
 
 raoH 
 
 
 JJL. 
 
 A Blae S** X 3* 
 
 | yinted difffttftntly OTl e^Ctl ii<^f 
 
 ji. 
 
 Ji. 
 
 n 
 
 ir — *"•"■ 
 
 JMMttJUJUEB&a 
 
 patient U discharged the entries called for on the card aj* ««m- 
 Jleted by the House Physician or Surgeon, and the card ,s promptly 
 sent to the Superintendent's office. 
 
 KXHTBIT 4 f*"^^* ****' 
 
 ClIA* 
 
 CMTAMIMTM CLUa 
 
 raii>«*v MMMi 
 
 1mm* huum ■immmu* 
 
 •KOaMMV •■••• 
 
 fw4X0« «» •«• 
 
 From these bedside cards sent to his office daily, the Super- 
 intendent's derk obtains the information needed to complete the 
 pedigree cards, m regards discharged patiente. and to insert on 
 
 H 
 
 I 
 
104 
 
 NURSE'S REPORT OF ADMISSIONS AND DISCHARGES 
 
 form referred to a^ "Exhibit 2" the information called for regard- 
 mg number of patients discharged and number of days treatment 
 of discharged patients. 
 
 When this information has been thus recorded, these bedside 
 cards are sent to the history room, where they are used as name 
 mdex cards of the history file. 
 
 In case a patient is examined for admission to the Hospital 
 and IS rejected the results of such examination and cause of rejec- 
 tion are noted on a history form and such histories are filed in a 
 rejected patient's history file for future reference after the number 
 of patients rejected each day has been noted on Exhibit 2. 
 
 By properly sorting these pedigree and bedside cards the 
 Supenntendent's clerk learns how many male or female patients 
 have been admitted to, or discharged from the Medical or Surgi- 
 cal Wards or Private Rooms of the Hospital, and thereby ob- 
 tains the information necessaiy to complete the daily entries on 
 "Exhibits 2." 
 
 "Exhibit 5" illustrates a form on which the head nurse of 
 each Ward or group of Private Rooms reports daily to the Super- 
 intendent's office the names of patients admitted to, or discharged 
 from, and the number of patients remaining in such section of the 
 Hospital for the twenty-four hours ending at midnight. These 
 reports of nurses are used to check receipt of bedside cards of 
 discharged patients. Exhibit 4, to verify the figures entered on 
 Exhibit 2 " and to check the Census Book referred to below. 
 
 Census of Patients Book 
 
 At the Presbyterian Hospital it has been found desirable to 
 keep in the Superintendent's office a "Census of Patients" book 
 made of leather with space assigned for each ward or group of 
 private rooms about as indicated on "Exhibit 6." 
 
 The numbers (or letters) shown in the center columns refer 
 to beds (or private rooms). When a patient is admitted to the 
 Hospital a smaU card J^'^ x 2%^ is made out bearing the name of 
 the patient and is inserted in the census book on the proper page 
 to indicate that a bed or room in that section of the Hospital is 
 occupied by the patient named. 
 
 Blue cards are used to indicate endowed bed ward patients 
 and white cards to indicate other ward patients. Buff cards are 
 used to indicate private room patients. 
 
NURSE'S DAILY REPORT OF 
 PATIENTS ADMITTED AND DISCHARGED 
 
 This Report must be filled out by the Nurse in charge of each Ward or 
 group of Private Rooms and must be delivered to the Superintendent s Office 
 
 not later than eight A. M. . ,, . j 
 
 Give names In full of all admitted and discharged. 
 
 12:00 Midnight 
 
 191 
 
 Ward Number - 
 
 Private Room Group 
 
 Patients remaining as shown by last report 
 
 Admitted Since 
 
 Discharged Since 
 
 EXHIBIT_5_sllze 5Jy" X 8Jf"_ 
 
 Number of Patients remaining 
 
 Nurse 
 

 ^« 
 
 <^ 
 
 <» 
 
 
 III 
 
 +-" — r- r "> 
 
 O 
 
 I— 
 
 lO 
 
 10 
 
 en 
 
 a> 
 
 10 
 
 T 
 
 
 T 
 
 o 
 
 C 
 tdCA 
 
 O 
 OO 
 
 W 
 
 ^^K 
 
 I I 
 
 Cii 
 
 10 
 
 I 10 I H 
 
 lO 
 
 lO 
 
 lO 
 
 o o 
 fl> M 
 
 I W 
 
 <g I 
 
 ^ 
 
 \ 
 
 VI 
 
 I I 
 
 09 
 
 I Ok 
 
 >V 
 
 ^^ 
 
 _i 
 
 o> 
 
 ■■■■Mlaii^aN 
 
 o> 
 
 ^ I '_ j 
 
 mmm 
 
 t 
 
 0E> 
 
 10 
 
 o^ 
 
 j I • _l ] I .1 1 I- 
 
 I 
 
 Ci> 
 
 I H- 
 
 1 I g 
 
 I 1^ 
 
 
 ^ I 
 
 10 
 
 I M 
 
 T 
 
 
 o 
 
 I g 
 
 m 
 
 margin for binding 
 
 ■iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii'ili'lA 
 
CENSUS OF PATIENTS BOOK 
 
 lOS 
 
 K a page of the census book has, as shown on "Exhibit 6," 
 spaces for holding thirty small cards and if the normal capacity 
 of the ward referred to is only twenty-four beds, it has been 
 found desirable to attach a small seal or paster, as indicated 
 opposite number twenty-five, to show that if cards bearing names 
 of patients are inserted opposite any of the numbers higher than 
 twenty-four it means that such patients are temporarily occupy- 
 ing extra beds or cots in such ward. 
 
 Thus by a glance at any page of the census book it is possible 
 to see quickly just how many beds are occupied or available in 
 that section of the Hospital. The Superintendent's clerk also uses 
 the census book to check the nurses' daily reports, Exhibit 5 and 
 the figures he inserts on Exhibit 2, to show the number of patients 
 remaining each day in the different branches of the service. 
 
 While a leather census book such as that described, made to 
 order, is much more expensive in first cost than certain kinds of 
 ready made patent card indices that might answer the purpose, 
 it is thought that the book in the long run will be found most 
 satisfactory and convenient and can be more easily handled. It 
 should last for ten years unless it becomes obsolete sooner on ac- 
 count of radical changes in, or enlargements of the hospital. 
 
 When the small ^^ x 2^" cards bearing the patient's name 
 are inserted in the census book it has been found desirable to note 
 the date of admission on the right end of the card if the patient 
 is able to pay for treatment and on the left end of the card if 
 it is thought that the patient is not or may not be able to pay for 
 
 treatment. 
 
 By this plan the Superintendent, or his clerk, can see by a 
 glance at the census book which patients are free and which are 
 pay; but if doctors, nurses or patients happen to see this census 
 book they cannot tell which are free or pay patients and it is not 
 desirable that they should have this information. 
 
 On the back of the small cards referred to the Superintendent's 
 clerk sometimes makes notations in regard to promises to pay or 
 other information concerning patients whose payments may be 
 doubtful, as these memoranda may be useful later in collecting 
 
 bills. 
 
 Clothes Cards 
 
 When patients are admitted to the Hospital it is customary 
 for the nurse to make a list of their clothing as well as of any valu- 
 
 )i 
 
lit 
 
 106 
 
 CLOTHES CARDS 
 
 ables to be cared for, on white cards provided for that purpose 
 called "Clothes Cards" as shown by "Exhibit 7," for female 
 
 MTt •MHTTtO 
 
 CLOTHING LIST 
 
 (•Mft Oa »THCII tlM tMT or *«TIClU TMCM Ttt O'nCf ) 
 
 ChemiM 
 
 Coat 
 
 Collar 
 
 Conet 
 
 C!!>rMt CoTtr 
 
 Drawers 
 
 Gloves 
 
 Handkerchiefs 
 
 Hat 
 
 Nightgown 
 
 Petticoat 
 
 ihoes 
 
 Skirt (dress) 
 
 Stockings 
 
 Undervest 
 
 Waist 
 
 luglgf ijg^ 
 
 IWMkr 
 
 •actiitl liViflly 
 
 Date taken to bake room Received in mortuary by 
 
 Received from the ffesb/terian HospJtih in the Cjty oJ New Vork, in good conditten, th« 
 articles mentioned above. 
 
 gXHTBTT 7 m\m» ^' y Z' 
 
 Date 
 
 jUMMjIM 
 
 ZMHB 
 mmLm 
 
 m- uay twn naii v iuhmm wwiTiwa ow TMta c^ma ^a 
 
 ■ ■ II III . — »»jt«m*— i 
 
 LIST OF ARTICLES TAKCN TO OFriCC 
 
 
 • 
 
 
 
 
 
 
 
 
 EXHTl 
 
 JIT 7 reverse elde 
 
 
 
 
 
 
 
 
 Dollars 
 
 
 I 
 
 
 Brought to office by 
 
 Received in office by Date 
 
 Received from the Presbyterian Hospital in the City of New York in good condition 
 \ aiticles mentioned above, and 
 « articles mentioned on other side 
 
 
 «0C<l(M " ' "" ' 
 
 Date ; 
 
 «V> V«C INK OMVr WHIN WftlTINO ON THIS CANB "m 
 
 patients, and on bufiF cards as shown by "Exhibit 8" for male 
 patients. 
 
 CLOTHES CARDS 
 
 107 
 
 The clothes cards are kept on ffle m the fupennl^ndent s 
 office and when a patient is to leave the Hospital his clothe^ and 
 valuables are returned to him and he is asked to sign receipts for 
 them in the places provided therefor on the clothes card. 
 
 Date Uken to bake room 
 
 Received in mortuary by 
 
 Uken to bake room ■ 
 
 J e ' ceived Irom the Presbyterian Hospital in the City oi New Vork, tn good condition, the 
 articles »i^«?AniKJ above. innrrBTT ft alBa 6* » 4*^ 
 
 ' trrr 
 
 J ; fr^r*^^ Ainttn^^^ *^ *^*^^ ■^^^ 
 
 n,.. ff^^^^«^ ff lrt f t r— ^^*v>»riifr 11 (to of KTMMt 7 
 
 i g BS-M-^IJi 
 
 ^ .„ .>.M ».., Y WHf OT I TII IB O H THin rM O.^: 
 
 ua>jau 
 
 iisai 
 
 When a clothes card is made out it has been found convenient to 
 stamp by a rubber stamp the letters c. c. on the fax* of the smaU 
 y.' X iW card used in the Census Book for the patient con- 
 cerned to indicate that the nurse has taken the patient's clothes 
 to the proper store room, and the patient's valuables if any. to 
 the Superintendent's office, and that a clothes card has been made 
 out and filed in the Superintendent's office. This c. c. also re- 
 minds the clerk in the Superintendent's office to see that when 
 the patient is discharged his clothes and valuables are returned 
 and are properly receipted for on the clothes card by the patient. 
 Receipts for clothes or valuables are given to patients only 
 when requested by them and the surrender of such receipt are 
 requested when clothing or valuables are returned to the patient 
 When patients are discharged from the Hospital, or die, the 
 Superintendent's clerk takes the small cards bearing these patients 
 names from the census book and makes a notation on each card 
 as to whether the patient is cured, improved, ummproved or 
 has died, and the number of the Ward or Private Room tfom which 
 the patient came. 
 
 i' 
 
108 
 
 CX)ST PER PATIENT PER DAY 
 
 n 
 
 These small cards are then sent to the infonnation clerk at 
 the front entrance of the Hospital, who corrects her list showing 
 names and locations of patients in the Hospital accordingly and 
 notes the condition in which the patient left, so that she can 
 reply properly to further inquu-ies. 
 
 These small cards are then returned to the Superintendent's 
 clerk, who uses them to remind him to see that the accounts of 
 all discharged patients are promptly written up, if this has not 
 already been done, and in the case of endowed bed patients to 
 notify the owners of the endowed bed that the patient who had 
 occupied such bed had left the Hospital. When the small cards 
 have served these purposes they are thrown away. 
 
 Pay and Free Ward Patient Days Treatment 
 
 The number of pay ward patient days treatment referred to 
 on "Exhibit 1" is obtained by dividing the total amount earned 
 from board and attendance of pay ward patients during the 
 month, as shown by the Bill Register (described on page 35), 
 by the full rate per day charged for pay ward patients (at present 
 $2.00 at the Presbyterian Hospital). 
 
 The number of free ward patient days treatment is obtained 
 by subtracting the pay ward patient days treatment plus the 
 endowed bed patient days treatment from the total ward patient 
 days treatment shown by "Exhibits 2." 
 
 Cost per Patient per Day 
 
 The average cost per patient per day and per visit referred to 
 on "Exhibit 1" are figured as described on the opposite page, but 
 it would ordmarily hardly seem worth while to figure these of tener 
 than twice a year. 
 
 The labor involved in such computations is considerable and 
 average costs per day for a period of less than six months might 
 give misleading results due to monthly fluctuations in current 
 expenses for certain special causes and also because at times 
 expenses properly chargeable to one month may not be charged 
 in the accounts until a subsequent month. 
 
 OUT-PATIENT DEPARTMENT STATISTICS 
 
 In order to obtain the information called for on Exhibit 1 as 
 regards patients treated in the Out-Patient Department and 
 also as regards patients treated in each of the different Clinics of 
 the Out-Patient Department (which includes the Emergency 
 Ward) the forms described below have proved very satisfactory. 
 
* 
 
 WATEMENT SHOWING MKTHOD OF FIGURING "CO^ PEK PATIENT PER DAY" AT THE PRESBYTERIAN HOSPITAL 
 STATEMENT SHOWir^U ^^ ^^^ ^^^ ^^^^^^ ^ ^^^ ^^^ ^^^.^ Corpomlion Eipe».e.) 
 
 Administration Expenees. 
 
 Professional Care of Patients: 
 
 Supt. of Nurses, Assistants and Instructors. 
 
 Nurses. 
 
 Special Nurses 
 
 Orderlies 
 
 Ward Employees 
 
 Equipment for Nurses 
 
 Medical and Surgical Supplies 
 
 Dispensary, Matron 
 
 Dispensary 
 
 Emergency Ward 
 
 Visiting and Home Nursing 
 
 X Ray Service 
 
 Ambulance 
 
 Pathological Department 
 
 Housekeeping 
 
 Kitchen. 
 
 Laundry. 
 
 General House and Property Expenses. 
 
 Total Operating Expenses ,••:•.:•■ 
 
 Total Patient Days' Treatment and visits. 
 Cost per Patient per Day 
 
 Total 
 
 100% 
 118,113.56 
 
 100% 
 3,978.96 
 
 6,879.05 
 
 WW'o 
 17,149.00 
 
 101. 1':,; ■ 
 
 5,465.70 
 
 1,980.95 
 
 100*;, 
 
 2,347.11 
 
 100% 
 18,712.93 
 
 100% 
 600.00 
 
 100%, 
 8,768.83 
 
 100% 
 3,865.58 
 
 100'; 
 
 9,461.42 
 
 100% 
 1,122.58 
 
 1(K)% 
 6,135.99 
 
 '70 
 
 6,585.85 
 
 '70 
 31,407.06 
 
 100% 
 8,473.82 
 
 1009;, 
 7,142.22 
 
 100% 
 
 Steward's Department | ^'^'^JJ^^ 
 
 100% 
 
 29,045.27 
 
 $253,306.59 
 
 Ward 
 
 Patients 
 
 82% 
 $14,853.12 
 
 82% 
 3,262.75 
 
 actual cost 
 4,782.10 
 
 actujil co-;t 
 3,408.00 
 
 actual cost 
 4,238.87 
 
 actual cost 
 1,633.45 
 
 87L'/Hr, 
 2,047.15 
 
 92'"" 
 17,215!90 
 
 23% 
 138.00 
 
 '^% 
 
 392.90 
 
 22 5/10%, 
 1,380.60 
 
 84% 
 6,532.11 
 
 88 5/10% 
 27,795.25 
 
 6,948.53 
 
 85 5/10% 
 6,106.60 
 
 54,177.98 
 
 25,559.84 
 
 $179,473.15 
 74.013 
 
 Cost per Ward 
 
 Patient per 
 
 Day 
 
 $ .20 
 
 .044 
 
 .065 
 
 .046 
 
 .057 
 
 .022 
 
 .028 
 
 .233 
 
 .002 
 
 .005 
 .019 
 
 .075 
 .376 
 .094 
 .082 
 .732 
 .345 
 
 Private Room 
 Patients 
 
 Cost Per Pri- 
 vate Room Par 
 tient per day 
 
 $1,811.36 
 
 10% 
 397.89 
 
 actual cost 
 2,096.95 
 
 actual cost 
 13.741.00 
 
 actual cost 
 1,226.83 
 
 actual cost 
 347.50 
 
 5 
 
 130.50 
 
 1,497.03 
 
 12!oO 
 
 $2.42 5/10 
 
 6% 
 56.13 
 
 8% 
 526.87 
 
 0% 
 2,826.64 
 
 15^; 
 1,271.07 
 
 ^^% 
 642.80 
 
 i.r; 
 
 9,910.60 
 
 0% 
 1,452.26 
 
 37,947.43 
 6,383 
 
 $ .284 
 
 .062 
 
 .329 
 
 2.153 
 
 .192 
 
 .054 
 
 .02 
 
 .234 
 
 .002 
 
 .009 
 
 .083 
 
 .443 
 
 .199 
 
 .10 
 
 1.552 
 
 .229 
 
 Dispensary 
 
 ^^0 
 
 $905.68 
 
 
 198.95 
 
 2 8/10% 
 65.25 
 
 75% 
 450.00 
 
 100% 
 8,768.83 
 
 $5.94 5/10 
 
 20% 
 224.52 
 
 8% 
 626.87 
 
 1% 
 314.07 
 
 1% 
 84.74 
 
 2% 
 142.84 
 
 1% 
 660.71 
 
 5% 
 1,452.26 
 
 $13,794.72 
 86,172 
 $0.16 
 
 Emergency 
 Ward 
 
 3% 
 $543.40 
 
 3% 
 119.37 
 
 ••••■• 
 
 4 4/10% 
 104.21 
 
 100% 
 3,865.58 
 
 Visiting and 
 Home Nursing 
 
 40% 
 449.03 
 77 5/10% 
 4,755,39 
 
 1% 
 314.07 
 
 1% 
 84.74 
 
 3% 
 214.27 
 
 1% 
 660.71 
 
 1 5/10% 
 435.68 
 
 $11,546.45 
 
 29,305 
 $0.39 4/10 
 
 ...••• 
 
 100% 
 9,461.42 
 
 5/10% 
 157.03 
 
 1% 
 84.74 
 
 5/10% 
 
 35.71 
 
 1% 
 660.71 
 
 5/10% 
 145.23 
 
 $10,544.84 
 
 13,790 
 $0.76 5/10 
 
 Method op 
 The method in use at The Presbyterian Hospital of figuring the 
 
 The salaries of Operating Rc c^Nur^ and Open^ting Roe.. Or derUes are distributed in proportion to the numbers of Private Roo. Su^ea. Patients and Ward Surgical PatienU 
 
 *'^*^' *' FiQURiNQ Cost of Different Branches op the Service. p^tipnts or Patients visited in their 
 
 total cost of caring for Ward, Private. Room, D/spensa^, Emei^ency Wa^^^^^^^^^^^ Other 
 
 s employed exclusively in, and aU suphes and repaira directly XsSnts may consider most fair 
 3 are prorated in such proportion as the ^X^^^ttiVe^^ Expenses, Pro- 
 
 change from time to time In ^eter^iimng the relati^^ Home Nursing, 
 
 :penses, nu. u.c.uuing the amounts directly chargeab^ to D^^^^^ faT^rrvTcrmodified by wfll-known facts. For 
 
 'atients is based upon the number of days treatment furnished m^^e^^^^^ preparation of it costs very much 
 
 essional care than necessary if he were located in ^^warji, also that h^^^^^^ service is based upon the relative cubic 
 
 ''thlnTh^roVihe wa-id patient, the distribution of the cost of General House and Property Expenses among the different branches 
 
 f^i^iXc^re oFPairenis, Housekeeping, Kitchen, and other expenses, not including the amounts dixectjy W faT^r^; "modified by-weil-known facts.^For 
 
 the percentage charged to Ward Patients and to Private Room Patients j« ^— 
 instance, the fact that a private room patient requires more professional 
 
 S»Xnte of those parts of the buildings occupied by each of the five services mentioned. 
 
OUT-PATIENT DEPARTMENT STATISTICS 
 
 109 
 
 As new patients come for the first time to the Out-Patient 
 Department for treatment they are given as they enter a small 
 
 round piece of cardboard I A inches 
 in diameter, bearing a sequence num- 
 ber, as shown herewith, so that in the 
 order of their arrival they may be ex- 
 amined by the Chief of Clinic or his 
 Assistant for assignment to the proper 
 
 Clinic. 
 
 When the Chief of Clinic has ques- 
 tioned and made a provisional diag- 
 nosis of a new patient he notes on a 
 small piece of paper the number of the 
 room in which the clinic is held to which the patient is assigned. 
 The patient then takes this paper to the admitting clerk who 
 gives the patient an Identification Card printed on both sides, as 
 shown by "Exhibit 9." This card conforms with the require- 
 
 II 
 
 THE PRESBYTERIAN HOSPITAL 
 
 OUT PATIENT DEPARTMENT 
 Madison Avenue and 70th Strkkt 
 
 NAME — ^O^ 
 
 „.. EXHIBIT 9 el«e^^"x^^^^^^^^^^^ 
 
 Surgical Patients, 9 to 10 A.M. 
 Medical Patients, 1.30 to 2.30 P.M. 
 
 C0VER> 
 
 o ST 
 
 O ^ 
 
 > » 
 r IL 
 
 r ST 
 
 3 o 
 
 1 0» 
 
 Z Ob 
 
 ments of the New York State Board of Charities. If a patient 
 loses this Identification Card it has been found desirable to make 
 an extra charge of ten cents for a new card, so as to make patients 
 careful of their cards. 
 
 The Clerk also makes out a Name Index Card of such patient, 
 for the Out-Patient Department history file, as shown by "Exhi- 
 bit 10," printed on one side only. 
 
 The clerk also gives the new patient a small cardboard sequence 
 
 if 
 
110 
 
 OUT-PATIENT DEPARTMENT STATISTICS 
 
 letter showing the room number of the clinic to which he b as- 
 signed and the sequence in which he is to receive treatment. 
 
 Penalty for False Representations. 
 
 Section 296, Chapter 56, Consolidated Lawt. 
 
 "Any person who obtains medical or surgi- 
 cal treatment on false representations from any 
 dispensary licensed under the provisions of this 
 act, shall be guilty of a misdemeanor, and on 
 conviction thereof shall be punished by a fine of 
 not less than ten dollars and not more than 
 two hundred and fifty dollars." 
 
 (Imprisonment until fine be paid may be im- 
 posed. Code Crim. Pro., Sec. 718.) 
 
 223-1311^17 
 
 EXHtBIf 9 >#Ttrge mlAm 
 
 When the new patient is examined in the clinic his history 
 is made out. This history is kept on file in the Out-Patient De- 
 
 •MM ■#. 
 
 
 vciUM •eew^ATiow •MrM»k*«« 
 
 
 MOMTMt »*IHWT*M 
 
 
 MAkS WMirC ••NCkC 0A-WB 
 9*mtAM •UkCll MAM»lte 
 
 wtoowa* 
 
 SfPAHATSO 
 
 
 DEPARTMENT 
 
 
 EXHIBIT 10 tflM 5" X 3* 
 
 
 ff*-""-^" 
 
 
 partment unless the patient is transferred to a ward in the Hos- 
 pital, in which case the history follows him. 
 
 After his first visit, when a patient returns to the Out-Patient 
 Department with his Identification Card, Exhibit 9, he calls at 
 the clerk's office and receives a small cardboard sequence number 
 
 OUT-PATIENT DEPARTMENT STATISTICS 
 
 111 
 
 showing the room number of the clinic to which he is assigned 
 and the sequence, as indicated by the number, in which he is to 
 
 receive treatment. The clerk also sends the history of the patient 
 to the clinic to which the patient is assigned. 
 
 It has been found desirable to give patients coming to the 
 Out-Patient Department for the first time cardboard sequence 
 letters and on subsequent visits to give them cardboard sequence 
 numbers, so that if the doctor in charge of the clinic should so 
 desire, those who have been to the Out-Patient Department before 
 may have preference in the order of their treatment, and also to 
 facilitate counting the new patients and checking the numbers of 
 new patients treated, as posted from the histories to "Exhibit 11. " 
 
 The reason why at times it may be desirable to give preference 
 to former patients is because ordinarily it requires more time and 
 care to examine a patient and make out his history for the first 
 time than at subsequent vi^ts. Therefore, if the patients, who 
 have been examined and treated before are given attention first 
 the aggregate delays to patients will probably be minimized. 
 
 Cardboard sequence numbers and letters for the same clinic 
 have a distinctive color different from the colors used for any other 
 clinic and those not already distributed to patients each day are 
 kept arranged in proper order in a wooden holder made of a block 
 of wood bored with holes about one and one half inches in diameter 
 
 as shown. Thus by a glance at the number or letter next in order 
 the clerk can see just how many patients have visited any clinic 
 that day up to that time. 
 
 1| 
 
lit 
 
 OUT-PATIENT DEPARTMENT STATISTICS 
 
 These pieces of cardboard have a one-eighth-inch hole punched 
 in the center so that if desired they can be placed on a spike 
 holder or strung together on a string. 
 
 By means of the sequence numbers and letters distributed to 
 patients each session the clerk determines the figures entered 
 daily on "Exhibits 11 " to show the number of visits to each clinic 
 and the number of new patients for such cHnic, and the total 
 visits made by all patients to be entered on "Exhibit 13." 
 
 The cardboard sequence numbers or letters given to patients 
 each day are left by the patients in the clinic room, in which they 
 are treated and are returned with the histories to the clerk after 
 the session is over. 
 
 These sequence numbers and letters are then sorted and put 
 back in the proper holders in numerical or alphabetical order 
 ready for use again at the next session. 
 
 Missing numbers or letters are replaced by stamping with rub- 
 ber stamps the proper numbers or letters on the small round cards, 
 of which reserve stocks are kept on hand and can be obtained 
 from some of the large manufacturers of such cards. 
 
 A form as illustrated by "Exhibit 11" is used each month for 
 each different clinic, and on this form the clerk records daily the 
 information called for. The date of each visit of a patient is 
 recorded by a rubber stamp on the history of such patient by the 
 clerk before the history is sent to the clinic which is treating such 
 patient. At the close of each session of the Out-Patient Depart- 
 ment the history of each patient who has visited a clinic is returned 
 to the clerk. From the dates on these histories the clerk secures 
 the information to record the patient in the proper column on 
 Exhibit 11. The first visit which any patient makes in each month, 
 which is the fijst date for such month appearing on his history, 
 is the only time he is recorded as a patient treated in the first, 
 second, or fourth columns of Exhibit 11, as the case may be. 
 
 The same patient should only be recorded once in any one 
 month in the third column of Exhibit 11, in case he is transferred 
 from another clinic of the Out-Patient Department. Thus when 
 the first four columns are totaled at the end of each month, the 
 totals show the actual number of patients treated in such clinic 
 during the month classified as shown by the headings. 
 
 At the end of each month the totals for each clinic, as shown 
 on Exhibits 11, are transferred, summarized and totaled on "Exhi- 
 bit 12" and the figures to be set opposite corresponding headings 
 
Patients Treated Di 
 
 iring Month of 
 
 101 
 
 
 
 Clinic. Out Patient Dent. 
 
 
 
 
 " — -wf" 
 
 
 Date 
 
 Former Patients treated, 
 
 who have not been treated 
 
 in any previous month 
 
 of i>reseat fiscal year 
 
 Former Patients treated. 
 
 who have been treated 
 
 in some previous month 
 
 of present fiscal year 
 
 Patients treated 
 who were transferred 
 
 from other depart- 
 - meats of 0. P. D. 
 
 New 
 Patients 
 Treated 
 
 Total 
 Patients 
 Treated 
 
 Visits 
 Made 
 
 Surgical 
 
 Dressings 
 
 Made 
 
 t 
 
 
 
 
 
 
 
 
 
 2 
 
 
 
 
 
 
 
 
 
 3 
 
 
 
 
 
 
 
 
 
 4 
 
 
 
 
 
 
 
 
 
 5 
 
 
 
 
 
 
 
 
 
 6 
 
 
 
 
 
 
 
 
 
 7 
 
 
 
 
 
 
 
 
 
 8 
 
 
 
 
 
 
 
 
 
 9 
 
 
 
 
 
 
 
 
 
 10 
 
 
 
 
 
 
 
 
 
 11 
 
 
 
 
 
 
 
 
 
 12 
 
 
 
 
 
 
 
 vr 
 
 
 13 
 
 
 
 
 
 
 
 
 
 14 
 
 
 
 
 
 
 
 
 
 15 
 
 
 
 
 
 
 
 
 
 16 
 
 
 
 
 
 
 
 
 
 17 
 
 
 
 
 
 
 
 
 
 18 
 
 
 
 
 
 
 
 
 
 19 
 
 
 
 
 
 
 
 
 
 20 
 
 
 
 
 
 
 
 
 
 21 
 
 
 
 
 
 
 
 
 
 22 
 
 
 
 , 
 
 
 
 
 
 
 23 
 
 
 
 
 
 
 
 
 
 24 
 
 
 
 
 
 
 
 
 
 28 
 
 
 
 
 
 
 
 
 — — — — ^ — 
 
 26 
 
 
 
 
 
 
 
 
 27 
 
 EX 
 
 JIBIT 11 size 1 
 
 0" X 8" 
 
 
 
 
 
 2S 
 
 
 
 
 
 
 
 . 
 
 29 
 
 
 
 
 
 
 
 
 
 30 
 
 
 
 
 
 
 
 
 
 31 
 
 
 
 
 
 
 
 
 
 Total 
 
 
 
 
 
 
 
 
 
 nY{« per 
 Day 
 
 
 
 
 
 
 
 
 1 Number of days Clinic was ooen Av^ffffo visits ner oatient — 
 
 
 Record same patient only once In any one of first four columns. 
 
 
 
 
 
 
 
 
 
 
K 
 
 Summary of Patients Treated in Out Patient Department during Month of — 
 
 .191^ 
 
 NAMES OF CLINICS 
 
 Former Patients 
 
 treated who have not 
 
 been treated in any 
 
 pre^rioua month of 
 
 present fiscal year 
 
 Male 
 
 Pmle. 
 
 Total 
 
 Former Patients 
 
 treated who have been 
 
 treated in some 
 
 prerioos month of 
 
 present fiscal year 
 
 Male 
 
 Pmle. 
 
 Total 
 
 Patients 
 
 transferred 
 
 from other 
 
 departments of 
 
 O. P. D. 
 
 Male E^le. 
 
 Total 
 
 New Patients 
 Tpeated 
 
 Male 
 
 E mi III 
 
 Total 
 
 Average per day 
 
 Number of Pays 
 
 X P. 
 
 Nnirifccr of iPases 
 
 Fmle. 
 
 12 8:.ze 
 
 Total Patients 
 Treated 
 
 Total Male E^mle. 
 
 Total 
 
 Visits 
 Made 
 
 Surgical 
 
 Dressings 
 
 Made 
 
 Rejec :ed 
 
 D. was 
 
 open 
 
 10 
 
 X 8 
 
 i.veraje Visits per 'atient 
 
 Pres<:ripti< 
 
 ns Fillei 
 
 Casb Receipts 
 
Out Patient Department Month of. 
 
 .191. 
 
 DaU 
 
 mJULm 
 
 
 JUJL 
 
 11 
 
 ■JUBLa 
 
 
 
 1&. 
 
 14. 
 
 17 
 
 18 
 
 19 
 
 dflUlBi 
 
 21 
 
 22 
 
 23 
 
 24 
 
 25 
 
 26 
 
 27 
 28 
 29 
 30 
 31 
 
 ToUl 
 
 | | y f . p er 
 
 Day 
 
 Visits Made by all 
 Patients 
 
 Free 
 
 Pay 
 
 Total 
 
 Visits Made 
 
 by Follow-up 
 
 Patients 
 
 Medical 
 
 Surgical 
 
 Patients 
 
 admitted to Wards 
 
 from O.P.D. 
 
 Medical 
 
 Surgical 
 
 
 •57 S 
 
 O 1X4 
 
 xn '^ 
 
 a 
 a; 
 
 ■•-* 
 
 CO 
 
 Pi4 
 
 o 
 
 '57 
 OS 
 
 E C H IBIT J 5 t?li^^ 
 
 LP" X & 
 
i 
 
 .: 
 
 OUT-PATIENT DEPARTMENT STATISTICS 
 
 113 
 
 for the Out-Patient Department on Exhibit 1 are thus obtained. 
 
 The object of having the subdivisions "Former Patients 
 Treated, who have not been treated in any previous month of 
 present fiscal year" and "Former Patients treated, who have been 
 treated in some previous month of present fiscal year" is so 
 that if it is desired to find out how many different patients have 
 actually been treated in any particular clinic during a period of 
 months or a year this information can be accurately obtained by 
 adding the monthly figures during such period showing "Former 
 Patients treated, who have not been treated during any previous 
 month of present fiscal year," "Patients treated who were trans- 
 ferred from other departments of the Out-Patients Department" 
 and " New Patients Treated." Only by using these classifications 
 is it practicable to determine accurately the actual number of 
 different patients treated in the Out-Patient Department during 
 a series of months or during a year. By new patients is meant 
 patients who have not been treated previously by the Out-Patient 
 Department or Hospital. 
 
 On "Exhibit 13" the clerk records daily the information called 
 for by the headings. 
 
 The colored sequence numbers and letters distributed for each 
 clinic show the total number of visits made to such clinic each day 
 and by adding these totals the total number of visits made by all 
 patients is determined. A satisfactory way of counting how many 
 of these visits are free visits has been for the clerk to use a small 
 inexpensive mechanical counter or tallying register. Every -time 
 a visit is made for which the patient is unable to pay the nominal 
 fee charged, the clerk presses the lever of the tallying register so 
 that by looking at the register at the end of the session the total 
 number of free visits is ascertained. 
 
 By deducting the number of free visits from the total visits 
 made the number of pay visits is found. 
 
 Visits Made by "Follow Up" Patients 
 
 When a ward patient, whom it is desired to "follow up" leaves 
 the Hospital he is given a white card, if a medical case, and a 
 salmon colored card, if a surgical case, as illustrated on "Exhibit 
 14." These cards, printed differently on each side, bear the name 
 and history number of the patient and on the front or back of 
 the card is shown the time at which he should return to the Out- 
 Patient Department for further examination or treatment. 
 
114 
 
 VISITS MADE BY "FOLLOW UP" PATIENTS 
 
 SOCIAL SERVICE DEPARTMENT STATISTICS 
 
 115 
 
 Wheo a follow up patient comes to the Out-Patient Depart- 
 ment he is given a cardboard follow up sequence number, as 
 
 NfliiMi 
 
 No. 
 
 Pl«as« eoiiM to tho Out Fationt Dopartmenlt, 
 Madison Ave. and 70th St., at 9 A. M. on 
 
 If you change yoor Mldrem, pl«aM Mnd new aildrtM to 
 
 The Piresbyterian Hospital Record Room 
 41 East 70th St.. New York City. 
 
 SXEXBIT 14 slie 5" X 3* 
 pvlBtad difreroBtlj an aaeli Mda 
 
 ALWAYS BRING THIS CARD 
 
 I 
 
 DATK or NIXT RCTUaN 
 
 IXBIBIT 14 
 
 ^avarsa* side 
 
 shown herewith, to indicate the order in which he is to be examined. 
 The clerk also secures the patient's history from the History 
 Room and sends it to the room where follow up patients are 
 received. 
 
 If follow up medical cases are examined during the same hours 
 as follow up surgical cases it would be desirable to have sequence 
 numbers for the former of a different color than for the latter, so 
 
 as to determine each day by the colored sequence numbers dis- 
 tributed how many medical and how many surgical foUow up 
 patients had made visits. If the med- 
 ical cases are examined at different 
 hours than the surgical cases one set 
 of follow up sequence numbers is suf- 
 ficient. 
 
 In case a follow up patient needs 
 treatment in the clinic the clerk gives 
 him a colored sequence number to in- 
 dicate the room in which the clinic, to 
 which he has been assigned, is held and 
 the order of his treatment. 
 
 The number of visits made by follow up patients is entered 
 
 daily on Exhibit 13. 
 
 The number of patients admitted to the medical or surgical 
 wards of the Hospital from the Out-Patient Department is entered 
 
 daily on Exhibit 13. 
 
 The amount of cash receipts, number of prescriptions filled 
 and number of patients rejected are entered daily on Exhibit 13. 
 The cash received in the Out-Patient Department is turned in 
 daily to the Superintendent's office. 
 
 SOCIAL SERVICE DEPARTMENT STATISTICS 
 
 For the purpose of obtaining the statistics concerning cases 
 cared for by the Social Service Department caUed for on Exhibit 
 1 a form illustrated by "Exhibit 15," printed differently on each 
 
 side IS used. 
 
 One of these forms is used each month for each subdivision 
 of the Social Service Department and the information in regard 
 to the cases cared for by such subdivision is filled in daily under 
 the proper headings by the nurse or person in charge. 
 
 It should be noted that the same case is only recorded once 
 in any of the first three columns as a case cared for in any month 
 (viz., the first time it is cared for in such month), so that the totals 
 will represent the actual number of different cases cared for during 
 the month under the classification shown. 
 
 The total numbers of "Former Cases Cared for, who have 
 not been cared for in any previous month of the present fiscal 
 
116 
 
 SOCIAL SERVICE DEPABTMENT STATISTICS 
 
 year" plus the total numbers of "New Cases Cared for/' as shown 
 by the monthly reports for a period of months or for a year would 
 show the actual total number of "Cases cared for" during such 
 period of months or year. 
 
 At the Presbyterian Hospital at the present time one of these 
 forms, Exhibit 15, is kept by each of the following: 
 
 Head of Social Service Department, Hospital Ward and Out- 
 Patient Department Social Service Nurse, Tuberculosis Nurse, 
 Dietitian, Follow-up Medical Nurse, Follow-up Surgical Nurse, 
 and by the Visiting Pupil Nurse in each of three districts in which 
 visiting nursing is done. 
 
 At the end of each month the totals of each report are reca- 
 pitulated on the same form and the grand total figures for all sub- 
 divisions are thus obtained to be entered on Exhibit 1 under the 
 heading Social Service Department. 
 
 On the reverse side of Exhibit 15 it has been found useful to 
 provide a form on which nurses can enter daily their expenses 
 and disbursements under classifications shown. 
 
 At the end of each month, the total receipts, expenses, and 
 disbursements of each nurse are recapitulated on the same form 
 and the grand total receipts, expenses, and disbursements of all 
 the Social Service Department nurses are thus obtained. 
 
 Visiting Pupil Nurses, who make visits to homes of patients 
 for nursing care, and the Hospital Ward and Out-Patient Depart- 
 ment Social Service Nurses each use a form, as shown by "Exhibit 
 16," on which is recorded the name and address of each patient 
 visited during the month. On this form is entered daily a record 
 of visits made to patients named, so that at the end of the month 
 the number of visits made to each patient is shown and also the 
 total visits made each day during the month in such department 
 or subdivision. 
 
 The first time a patient is visited each month, as shown on 
 Exhibit 16, is the only time such patient is counted in one of the 
 first three columns of Exhibit 15 as a "Case Cared for" during 
 such month. If there is any doubt as to whether it is a "Former 
 Case Cared for, who has not been cared for in any previous month 
 of present fiscal year" or a "Former Case Cared for, who has been 
 cared for in some previous month of present fiscal year" or a 
 "New Case Cared for" this question is settled by reference to 
 name index cards or histories of cases cared for. Two kinds of 
 name index cards are kept in the same file. One of these is a 
 
Social Service Department, cases cared for During Month of. 
 
 _I91_ 
 
 Date 
 
 Former Cases Cared for, who have not beeij 
 
 cared for in any previous month ©■ 
 
 * present fiscal year. 1 
 
 Former Cases Cared for, who have beeJ 
 
 eared for in some previous iiM»nth oil 
 
 • present fiscal year. | 
 
 o 
 
 t 
 
 • 
 
 Total Cases Cared for. | 
 
 • 
 
 o 
 
 > 
 
 CO 
 1 
 
 3i 
 
 O 
 V 
 
 a 
 
 o 
 
 a 
 
 o 
 
 • mm 
 
 > 
 
 Visits to Homes of Patients for H 
 Nursing Care. | 
 
 Visits to Ward Patients needingi 
 Social Service Care.' | 
 
 6 
 O 
 
 > 
 
 •3 
 
 U 
 
 es 
 4; 
 
 a 
 
 (fl 
 
 Total Visits. 1 
 
 Former Cases Given Material Relief, wh<* 
 * have not received such relief in any| 
 previous month of present fiscal year. 
 
 Former Cases Given Material Relief, who 
 « have received such relief in some pre- 
 vious month of present fiscal year 
 
 OS 
 
 1 
 
 a 
 > 
 
 6 
 
 4> 
 (fl 
 
 U 
 
 • 
 
 13 
 
 0(S 
 
 *-» 
 
 C 
 
 > 
 
 •*• 
 
 o 
 
 U 
 
 •— • 
 cs 
 
 Cases Referred to Organizations for Material 
 Relief or Employment. 
 
 _ 
 
 Patients sent to Convalescent Homes and| 
 Sanitoria 1 
 
 Patients sent to Hospitals, Homes for 
 Incurables and Aged 
 
 i 
 
 a 
 
 < . 
 
 16 
 
 u 
 O 
 
 *•* 
 
 o 
 4; 
 tn 
 
 « 
 
 ♦J 
 
 C 
 4; 
 
 
 1 
 2 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4 
 t 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 6 
 7 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 8 
 f 
 
 
 
 
 
 
 
 
 
 
 • 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 11 
 
 12 
 13 
 14 
 15 
 
 
 
 
 
 
 
 
 
 
 
 =■ 
 
 
 
 
 
 
 
 
 16 
 17 
 IS 
 19 
 
 20 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 21 
 22 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 2J 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 24 
 
 
 
 
 
 
 
 
 
 
 , 
 
 
 
 
 
 
 
 
 
 
 25 
 
 26 
 
 27 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 EXH 
 
 BT' 
 
 * v 
 
 S B1 
 
 ze 
 
 B** : 
 
 : JIO 
 
 * P 
 
 •Inted ( 
 
 llfferc 
 
 ntl 
 
 r 
 
 1 6f 
 
 ch 
 
 lidq 
 
 
 2R 
 
 
 
 ikA- 
 
 
 : — su 
 
 
 
 
 
 
 
 
 
 
 
 
 
 f- 
 
 29 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ' 
 
 30 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 31 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Total 
 Avera|< 
 per Da) 
 
 
 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Days Social Sarvice De|lt. wai opeit 
 
 Record lainc cue ooly once in columas loarked 
 
 ■Dept 
 
 Nunc or S. S. Worker. 
 
Expenses During Month of. 
 
 _19t 
 
Social Service Department Visits to Patients, etc., During Month of. 
 
 .Dept. 
 
 19 
 
 ::; )i!e:ip!!"'« """"ir-j 
 
SOCIAL SERVICE DEPARTMENT STATISTICS 
 
 117 
 
 buff colored "Slight Service Card" as shown by "Exhibit 17," 
 which is printed diflFerently on each side. On this card is recorded 
 any slight services rendered and the dates. 
 
 NAMK 
 
 HOSPITAt NO. 
 
 AODRRSt 
 
 pnoMT niOHT •itPCNSAiiy no. 
 
 
 •ACK Lcrr 
 
 
 rLOON 
 
 NOVIO TO 
 
 mONT niOHT OATK 
 
 
 •ACK LCn 
 
 
 rLOon 
 
 MALC 
 
 WMITB RKUOiON 
 
 rSMAk* 
 
 •LACK AQI 
 
 MMOLf 
 
 OCCUPATION WAOIS •IRTMPLACK 
 
 MARHICO 
 
 wid6wi» 
 
 EXHIBIT 17 sl«e 5" x 3" 
 
 »ivonccD 
 
 ICrAHATtO 
 
 printed differently on eaoh side 
 
 • M>t-IT 
 
 
 Referred by 
 
 
 Referred for 
 
 
 Service rendered 
 
 
 
 EXHIBIT 17 reverse aide 
 
 Oiignotit 
 
 *' 
 
 The other name index card of a history of a case cared for is 
 a white index card, as shown by "Exhibit 18," which is used to 
 show reference to the Social Service History number and the name 
 and address of each case that has received continuous care or 
 more than slight services. On the histories are recorded the dates 
 and nature of continuous care or services rendered. 
 
lis 
 
 COMPARATIVE STATISTICAL FIGURES 
 
 Ji the history applies to the same person for whom a slight 
 service card had previously been made out it is customary to 
 
 ■uhnamc 
 
 MAN'S wmmr nams 
 
 WOMAN'S NAMC 
 
 MirOfK MAIHIIA4M 
 
 WOMAN'S rmar nam« 
 
 MCMBSRS or HOUSKMOLO 
 
 KEIBlf 18 9im9 5* z 3* 
 
 transfer the information on the slight service card to the history 
 and then destroy the slight service card, so as to have only one 
 name index card in the name index file for the same case. 
 
 CoMPARATivi: Statistical Figures fob a Period op Months 
 
 OR Year 
 
 In order to have statistical figures in such form that results 
 for a series of months or a year can be readily obtained and com- 
 pared with other months or years over a period of four or five 
 years, a form, as illustrated by "Exhibit 19," has been found very 
 satisfactory and useful. 
 
 The headings at the top of the form can be filled in to suit the 
 statistical information desired. By adding the monthly amount 
 for each month to the amount shown in the "To Date" column 
 opposite the previous month, the amount to date, or from the first 
 of the fiscal year to the end of the month concerned, is obtained. 
 A similar form, ruled with dollars and cents columns, may 
 be used where comparative month and to date figures are desired 
 which represent receipts or expenditures, etc. This is the form 
 of "Comparative Month and To Date Statement" referred to on 
 page 59. 
 
P A T I E N TS ADUITTEP 
 
 ^ A T I E N TS nTSCHARGED 
 
 Ma e 
 
 Month 
 
 
 17. 
 18. 
 
 Mofgo ■ 
 
 De4 
 
 17- 
 
 18. 
 
 9- 
 
 Jati 
 
 l€. 
 
 19- 
 
 20. 
 
 '21 
 
 ie_ 
 
 19- 
 
 Ma 
 
 18. 
 
 19- 
 
 ie_ 
 
 19. 
 APf21. 
 
 18 - 
 
 19- 
 u 20 
 
 JunI 
 
 18. 
 
 19. 
 »0. 
 
 ii. 
 
 Jul! 
 
 18 — 
 
 19- 
 
 !0_ 
 
 18. 
 19. 
 20 
 
 Ayg?: 
 
 18. 
 19- 
 
 Sipg? 
 
 le. 
 19- 
 
 T.t|S: 
 
 Mtdlcal Wards 
 
 Pea ale 
 
 To DATC II MOHTH 
 
 Tctal 
 
 To Date I Momth 
 
 To Path | Mouth 
 
 Mele 
 
 
 Ti)tal 
 
 Month 
 
 To DATS 
 
 private Roome 
 
 GRAND TOTAL 
 
 "E 
 
 e 
 
 Fen ale 
 
 Month 
 
 ^ 
 
 To J>ATE B Month 
 
 Je I 1 
 
 To Date | Month 
 
 Tptal 
 
 To Date 
 
 Cured 
 
 To Datb 
 
 Month 
 
 : 
 
 To Date 
 
 ■I 
 
 Month 
 
 To Date 
 
 j^ii^^^^^^^^TTT^nsferT^ d^ Die 
 
 Died 
 
 Month 
 
 To Date 
 
 
 
 ;; 
 
 XHIBIT 
 
 :: 
 
 l2_SiSEllli 
 
 :m 
 
 ^m 
 
 Month 
 
 ^"T'-^B 1 *'°''^*' 
 
 ; 
 
 =— + — r 
 
 ^^ 
 
 H — I — I 
 
COMPARATIVE STATISTICAL FIGURES 
 
 110 
 
 The use of such forms greatly facilitates obtaining promptly 
 at the close of each fiscal year the figures showing the various 
 subdivisions of revenue, expenses, and statistics required for the 
 
 annual report. 
 
 It has been found convenient to keep the forms shown by 
 Exhibits 1, 2, 11, 12, 13, and 15 filed in suitable Post or Spring 
 Back Binders in which they can be easily inserted or from which 
 they can be readily removed. 
 
 t .<! I 
 
r 
 
 •4ilr^\ 
 
 )li:iHi>iiii*P^ 
 
 Thome 
 
 Hospital accounting 
 
 c-o 
 
 r 
 
 1946 
 
 ^ ^^^ 
 
 ^^^ Ia/H- 
 
 ^Qy'O 
 
 Jl/^'// '^' 
 
 >^ 
 
 
 r 
 
 MAR 1 1 1994 
 
 f^Woavl 
 
END OF 
 TITLE