Accounting Question

PART 1-Job Descriptions

Review each job description for the executive staff at CCH (linked below). Your first task is to adapt the job description of each team member to detail the essential job duties with respect to risk management. Use the provided job descriptions as a starting point for your work. Then add specific risk responsibilities for each person using the COSO framework as a guide.

Only 5 from each position need to be addressed for specific risks.

PART 2-Financial/Operational Risk

This is the first step in developing a risk assessment and management policy. In developing your policy, consideration of risk appetite is critical. Identify the areas of financial and operational risk at CCH. Prepare a policy on how each area of risk should be handled (i.e., assume the risk, mitigate the risk, or transfer the risk).

Prepare a table with the risks that you have identified, level of risk, strategy, and justification for choosing the strategy. You are encouraged to use the balance sheet and income statement as a starting point, but keep in mind there are items not listed on the financials that can also be at risk. For example, the reputation of the company, HIPAA, or key employees. Below is a suggested format but feel free to add additional columns as needed.

Risk Area – Cash

Level of Risk – Low

Strategy (Assume, Mitigate, Transfer) – Assume cash consists of bank deposits federally insured

Risk Area – Vehicles

Level of Risk – Medium

Strategy (Assume, Mitigate, Transfer) – Assume physical damage, transfer liability risk

City Community Hospital
Job Description
Job Title: President/CEO
Department: Administration
Reports To: Board of Directors
Revised Date:
SUMMARY
The CEO will render full-time, professional services to City Community Hospital in the capacity of Chief
Executive Officer of the medical center, including all related organizations (collectively, the “Hospital”).
The CEO will faithfully, industriously and to the best of his/her ability, perform all duties that may be
required by virtue of the position as CEO and all duties set forth in the Hospital’s governing laws,
regulations, contracts and bylaws and in policy statements of the Board of Directors, to implement the
strategic goals and objectives of the Hospital. The CEO will be committed to providing inspiring and
effective leadership while administering, directing and coordinating all activities of the Hospital toward
the fulfillment of the Hospital’s values, mission, strategy, and the achievement of its annual goals and
objectives. The CEO will model, promote and ensure that the Hospital’s Mission, Vision and Core
Values are evident and present in the provision of health care at CCH.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following functions. Nothing in
this job description restricts CCH’s ability to assign, reassign or eliminate functions, duties and
responsibilities of this job at any time.
1. Board Administration and Support – The CEO supports the operations and administration of the
Salida Hospital District Board of Directors by maintaining continual, open and effective
communication with the Board members and the Medical Staff. The CEO will ensure that
comprehensive orientation and continuing education opportunities are available to the Board. The
CEO will facilitate relationships between the Board, legal counsel, and accounting and audit
organizations, will manage the use of legal counsel for operational matters, and, in conjunction with
the VP of Finance, will manage the engagement of accounting and audit organizations of operational
matters.
a. RISK2. Medical staff Liaison – CEO facilitates relationships between the physicians and CCH as well as the
relationships between physician practices. CEO leads the efforts to support our physicians through
recruiting, continuing education opportunities, medical staff and physician referral compliance education
and implementation, and medical staff development. The CEO recognizes the ongoing strength and
success of the Hospital relies heavily on the strength and success of our medical staff and engages them
accordingly. The CEO participates in issues surrounding ethics and quality.
a. RISK3. Community and Public Relations – Through exceptional communication and interpersonal skills,
the CEO assures that the Hospital and its mission, programs, and essential services are consistently
presented in a strong, positive image to relevant stakeholders, including patients, physicians,
employees, benefactors and taxpayers. As the ‘face’ of CCH, the CEO will be actively involved in the
community through service organization membership, speaking engagements, community forums,
educational offerings and other opportunities to communicate CCH’s Mission.
A. RISK-
B. Compliance – The CEO will ensure the Hospital complies with local, state and federal laws and
regulations as they apply to operations of the Hospital.
a. RISKC. Strategic Planning – The CEO stays current with general trade and industry conditions and their
potential impact on the Hospital’s policies and operations and, in collaboration with the Board of
Directors, develops the short-term and long-term strategic plan for the Hospital and its offered
services. The CEO ensures the strategic plan is articulated both internally and externally, and
effectively delegates key activities to ensure timely execution of the strategic plan initiatives.
a. RISKD. Delivery of Healthcare Services – CEO has overall responsibility for the design, marketing,
promotion, delivery, risk management and quality of all Hospital healthcare programs and services
provided to our community. The CEO ensures that policies and practices effectively support sound
and safe patient care, and that the delivery of healthcare services provides the highest level of a
positive experience to the patient.
a. RISK7. Financial Management – CEO recommends yearly budget for Board approval and ensures prudent
management of the Hospital’s resources within those budget guidelines according to current laws and
regulations. The CEO conducts or oversees the negotiation of professional, consultant and service
contracts. The CEO ensures that appropriate internal and management controls are established and
maintained.
a. RISK
8. Human Resource Management – The CEO organizes function of the Hospital through appropriate
delegation, and establishes a formal means of accountability for those assigned duties. The CEO ensures
effective management of the human resources of the Hospital according to current, authorized personnel
policies and procedures that fully conform to current laws and regulations. He/she completes annual
evaluations for direct reports in a timely and effective manner.
a. RISK9. Facilities Management – The CEO oversees the preservation of the asset value of CCH’s capital
investments, oversees the management of construction and facility rehabilitation activities, and ensures
disaster and emergency preparedness activities are appropriately planned, exercised, and documented.
a. RISK10. Fundraising – CEO sits on the CCH Foundation Board and oversees fundraising planning and
implementation through direct supervision of the Foundation Director. The CEO will play an instrumental
fundraising role which includes identifying resource requirements, and in developing and cultivating
relationships that will support and enhance fundraising efforts. The CEO will provide oversight of the
Foundation Director’s functions which include researching funding sources, establishing strategies to
approach grantors, donors and benefactors, submitting proposals and administrating fundraising records
and documentation.
a. RISK
OTHER DUTIES
The Board of Directors may assign other duties as necessary.
SUPERVISORY RESPONSIBILITIES
The CEO leads the Executive Team and directly supervises the Vice President of Nursing, Vice President
of Financial Services, Vice President of Ancillary Services and Vice President of Human Resources.
Directly supervises the Marketing/Recruiting Director, the Quality Director, the Risk Manager, the
Laboratory Medical Director and Laboratory Manager, the Facilities Manager and the Foundation
Director. The CEO carries out supervisory responsibilities in accordance with the organization’s policies
and applicable laws.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential
functions.
EDUCATION and/or EXPERIENCE
Masters degree (e. g., Healthcare Administration, Business Administration, Public Administration);
graduate of an accredited university with a degree in Management or related field; five years directly
related experience with community healthcare facilities of similar size and structure (e.g., independent
hospital, rural community hospital, Critical Access Hospital) preferred.
LANGUAGE SKILLS
Superior communication skills to successfully represent the Hospital in the community, with patients,
families and the medical staff; at state and national level boards and organizations and in the media.
Ability to read, analyze, and interpret business periodicals, professional journals, technical procedures, or
governmental regulations. Ability to write reports, business correspondence and procedure manuals.
MATHEMATICAL SKILLS
Able to amass all relevant information to complete a careful assessment of investments and strategies in
the organization; able to build a strong business case to advocate for the betterment of CCH; is objective
and capable of ‘de-emotionalizing analyses and corrections
CERTIFICATES, LICENSES, REGISTRATIONS
None required. Membership as a Fellow in American College of Healthcare Executives desired.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions. While performing the duties of this
job, the employee is regularly required to talk and hear. The employee is occasionally required to sit,
stand, walk, and reach with hands and arms. Specific vision abilities required by this job include close
vision to be able to read and prepare documentation, and ability to adjust focus required for computer
input.
WORK ENVIRONMENT
The CEO works in a face-paced environment, with a high level of activity and frequent interruptions and
multiple competing demands. Work continues beyond normal office hours. The CEO regularly rounds in
patient care areas as well as non-patient care areas and may be exposed to infections and contagious
diseases. Some travel is an expectation as the CEO will often serve on state level boards and associations
as a representative of CCH.
HAZARDS to which this position may be exposed are listed below. No expected interaction with
hazardous chemicals or materials except in an emergency situation.
CONFIDENTIALITY
Maintains patient, employee, and hospital confidentiality at all times, discussing patient, employee, or
hospital business only with appropriate parties who have a bona fide need to know; and communicating
only the minimum amount of information necessary with respect to protected health information (PHI) as
identified by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
City Community Hospital
Job Description
Job Title: Chief Financial Officer
Department: Administration
Reports To: Chief Executive Officer
Revised Date:
SUMMARY
To oversee the financial operations of the organization including the billing function. The CFO
will model, promote and ensure that the Hospital’s Mission, Vision and Core Values are evident and
present in the provision of health care at CCH.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following functions. Nothing in
this job description restricts CCH’s ability to assign, reassign or eliminate functions, duties and
responsibilities of this job at any time.
1. Responsible for all financial accounting and reporting, procedures and internal controls of the
Department
a. RISK2. Overall supervision of Payroll, Purchasing, Accounts Receivable, Accounts Payable, MIS
and General Accounting functions of the Finance Department.
a. RISK
3. Responsible for the recruitment, supervision, training, and evaluation of the Finance
Department staff which also includes the billing department
a. RISK4. Responsible for the center’s relationship with federal and state tax authorities and
government regulators (BPHC, regional office, etc.)
a. RISK5. Ensure all insurance coverage’s including director’s and officer’s, malpractice, general
property, etc. are in place each year.
a. RISK6. Fiscal management of all city, state, and federal grants.
a. RISK7. Develop, supervise, and coordinate all efforts to attain maximum third-party reimbursement
including capitated arrangements.
a. RISK8. Supervise the preparation of all regulatory reports (i.e. FSR, UDS, Medicare, Medicaid, IRS
Form 990, state tax returns, etc.)
a. RISK-
9. Attend the finance committee meeting of the health center’s Board of Directors and present
the current fiscal situation. Also, attend the meetings of and report to Board of Directors at
the request of the Chief Executive Officer or board members.
a. RISK10. Preparation of annual organization budget as well as individual grant budgets; coordinate all
department budgets; work with all department heads throughout the year to insure that
expenditures adhere to legal and budgetary requirements.
a. RISKAct in behalf of the Chief Executive Officer in his/her absence and upon request All
other duties as assigned by the Chief Executive Officer
OTHER DUTIES
The Board of Directors or CEO may assign other duties as necessary.
QUALIFICATIONS
Should have knowledge and experience in health care finance, including third party
reimbursement mechanisms and Federal guidelines regarding budget and financing.
Supervisory experience a must Experience with automated accounting and billing systems
Computer literate
EDUCATION and/or EXPERIENCE
Undergraduate degree from an accredited college or university in accounting or finance, MBA or
CPA preferred but not required. Certified Public Accountant preferred but not required
LANGUAGE SKILLS
Superior communication skills to successfully represent the Hospital in the community, with patients,
families and the medical staff; at state and national level boards and organizations and in the media.
Ability to read, analyze, and interpret business periodicals, professional journals, technical procedures, or
governmental regulations. Ability to write reports, business correspondence and procedure manuals.
MATHEMATICAL SKILLS
Able to amass all relevant information to complete a careful assessment of investments and strategies in
the organization; able to build a strong business case to advocate for the betterment of CCH; is objective
and capable of ‘de-emotionalizing’ analyses and corrections
CERTIFICATES, LICENSES, REGISTRATIONS
None required.
Membership as a Fellow in American College of Healthcare Executives desired.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions. While performing the duties of this
job, the employee is regularly required to talk and hear. The employee is occasionally required to sit,
stand, walk, and reach with hands and arms. Specific vision abilities required by this job include close
vision to be able to read and prepare documentation, and ability to adjust focus required for computer
input.
WORK ENVIRONMENT
The CEO works in a face-paced environment, with a high level of activity and frequent interruptions and
multiple competing demands. Work continues beyond normal office hours. The CEO regularly rounds in
patient care areas as well as non-patient care areas and may be exposed to infections and contagious
diseases. Some travel is an expectation as the CEO will often serve on state level boards and associations
as a representative of CCH.
HAZARDS to which this position may be exposed are listed below. No expected interaction with
hazardous chemicals or materials except in an emergency situation.
CONFIDENTIALITY
Maintains patient, employee, and hospital confidentiality at all times, discussing patient, employee, or
hospital business only with appropriate parties who have a bona fide need to know; and communicating
only the minimum amount of information necessary with respect to protected health information (PHI) as
identified by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
City Community Hospital
Job Description
Job Title: Chief Risk Officer
Department: Administration
Reports To: Chief Executive Officer
Revised Date:
SUMMARY
Responsible for and has the authority to make all decisions on risk management issues that directly
impact the strategic direction of the company. Sets the strategic risk management vision and is charged
with delivering that strategy to the company using exceptional leadership skills, network of internal and
external alliances and highly developed business skills. Possesses an intimate knowledge of internal
business processes and the organization’s industry. Exhibits business process knowledge, possesses a
broad based operational perspective and provides solutions for non-insurance related business risk issues.
Recognized risk leader, who is a dynamic, proactive and decisive person. Adapts well to and initiates
change in the organization. Seeks ways to optimize risks in the organization as a competitive business
advantage. Key traits for the individual in this position are: highly developed communications, team
player, change agent, strategic and creative, excellent project management skills and the ability to drive
performance from all areas within their company. The CRO will model, promote and ensure that the
Hospital’s Mission, Vision and Core Values are evident and present in the provision of health care at
CCH.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following functions. Nothing in
this job description restricts CCH’s ability to assign, reassign or eliminate functions, duties and
responsibilities of this job at any time.
1. Create an integrated risk framework for the entire organization
2. Assess risk throughout the organization
a. RISK3. Quantify risk limits
a. RISK4. Develop plans to mitigate risks.
a. RISK5. Advise on directing capital to projects based on risk
a. RISK6. Assist functional managers in obtaining risk mitigation funding
a. RISK7. Monitor the progress of risk mitigation activities.
a. RISK8. Create and disseminate risk measurements and reports
a. RISK9. Communicate to key stakeholders regarding the risk profile of the business
a. RISK-
10. Oversee insurance. Decide upon the types and specifics of the various insurance policies that the
organization should buy. This includes being the contact person for the insurance providers.
a. RISK11. Recommend insurance alternatives. Recommend any alternative insurance features that are not
currently being used, or suggest using insurance products that are entirely new to the company.
a. RISK12. Manage claims. Supervise the filing of insurance claims, monitor their progress with insurers, and
verify that payments have been received.
a. RISK13. Conduct due diligence. Investigate the risks inherent in a target company that may be acquired, as
well as the state of its risk management practices.
a. RISKOTHER DUTIES
The Board of Directors or CEO may assign other duties as necessary.
QUALIFICATIONS
The candidate chief risk officer should have a master’s degree in business administration, or equivalent
business experience and 10+ years of progressively responsible experience for a major company or
division of a large corporation. Should have experience in partnering with an executive team, and have a
high level of written and oral communication skills, as well as a strong knowledge of processes..
EDUCATION and/or EXPERIENCE
Masters degree (e. g., Healthcare Administration, Business Administration, Public Administration);
graduate of an accredited university with a degree in Management or related field; five years directly
related experience with community healthcare facilities of similar size and structure (e.g., independent
hospital, rural community hospital, Critical Access Hospital) preferred.
LANGUAGE SKILLS
Superior communication skills to successfully represent the Hospital in the community, with patients,
families and the medical staff; at state and national level boards and organizations and in the media.
Ability to read, analyze, and interpret business periodicals, professional journals, technical procedures, or
governmental regulations. Ability to write reports, business correspondence and procedure manuals.
MATHEMATICAL SKILLS
Able to amass all relevant information to complete a careful assessment of investments and strategies in
the organization; able to build a strong business case to advocate for the betterment of CCH; is objective
and capable of ‘de-emotionalizing’ analyses and corrections
CERTIFICATES, LICENSES, REGISTRATIONS
None required. Membership as a Fellow in American College of Healthcare Executives desired.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions. While performing the duties of this
job, the employee is regularly required to talk and hear. The employee is occasionally required to sit,
stand, walk, and reach with hands and arms. Specific vision abilities required by this job include close
vision to be able to read and prepare documentation, and ability to adjust focus required for computer
input.
WORK ENVIRONMENT
The CEO works in a face-paced environment, with a high level of activity and frequent interruptions and
multiple competing demands. Work continues beyond normal office hours. The CEO regularly rounds in
patient care areas as well as non-patient care areas and may be exposed to infections and contagious
diseases. Some travel is an expectation as the CEO will often serve on state level boards and associations
as a representative of CCH.
HAZARDS to which this position may be exposed are listed below. No expected interaction with
hazardous chemicals or materials except in an emergency situation.
CONFIDENTIALITY
Maintains patient, employee, and hospital confidentiality at all times, discussing patient, employee, or
hospital business only with appropriate parties who have a bona fide need to know; and communicating
only the minimum amount of information necessary with respect to protected health information (PHI) as
identified by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
1
2
3
4
5
6
7
8
9
10
Risk Area
Level of Risk
Ex. Accounts Recievable
Medium
Strategy
Assume Initial Risk. Individuals may need time to gather money
by transferring funds to different accounts. Transfer on risk
accounts 90 days past due to third party as collection efforts
may be difficult.