Format of Hospital Internal Audit Report

XXXX Hospital Management Audit Investigation

XXXX hospital co., ltd.:

According to the internal audit management regulations of the group company, we conducted an on-site audit on the operation and management of XXXX Hospital Co., Ltd. (hereinafter referred to as XX Hospital) on.

Audit scope: this audit starts with your company's balance sheet, income statement and relevant materials related to economic responsibility, focusing on the rationality, compliance and authenticity of the internal control system of XX Hospital after the restructuring; The effectiveness of management system construction and management; Abide by relevant laws and regulations and the Articles of Association; Senior management's performance of fiduciary responsibilities and the rationality of new employee salary distribution.

Audit objectives: improve the management level of XX hospital, standardize the management behavior of the hospital, straighten out the investment relationship, improve the corporate governance structure, and minimize the management risk of XX hospital.

Audit method: Our audit is based on internal auditing standards. In the audit process, we combined the actual situation of XX Hospital and implemented the audit procedures that we thought necessary, including checking accounting records, listening to reports from relevant personnel of XX Hospital, investigating the formulation and implementation of the internal control system of XX Hospital, reviewing accounting books and statements, and extending the audit period.

Audit responsibility: Petroleum hospitals are responsible for the authenticity, integrity and legality of accounting statements, contracts, account books, agreements and other related materials. Our responsibility is to express audit opinions on the legality and appropriateness of these accounting statements, related materials and management actions.

Limitations of audit: We only conducted on-site audit on XX Hospital in this audit. Due to the limitation of professional factors and objective conditions, it is impossible to review and check the drug purchase price of XX Hospital, and it is impossible to express opinions on it.

The audit situation is now reported as follows:

I. Basic information

1, ownership structure

2. Changes in rights and interests

3. Organizational structure and business model

Second, the financial situation

According to the relevant information provided by xx Hospital, the authenticity of assets, liabilities and operating performance of xx Hospital is as follows:

1 and xx hospital assets

Up to now, the book value and actual value of the capital structure, profit and loss of xx Hospital after audit adjustment are as follows (see "Main Audit Adjustment Items" at the end of this chapter for details of audit adjustment items):

The total book assets of xx Hospital are 265,438+0,278,025.08 yuan, which is reduced by 382,780.90 yuan after audit, and the total assets confirmed by audit are 20,895,757.38 yuan; The total book liabilities are 7,236,205.58 yuan (including normal current accounts of internal units), which is increased by 974,868.96 yuan after audit, and the total liabilities confirmed by audit are 8,265,438+065,438+0074.54 yuan.

The book equity capital is 65,438+03,658,525.40 yuan, and the audited equity capital is 65,438+0,364,274.86 yuan, and the audited equity capital is 65,438+0,267,7544.64 yuan.

Of the total assets, fixed assets 14757804.72 yuan, accounting for 70.62% of the total assets, accounts receivable 1062 195.63 yuan, accounting for 5.08% of the total assets, long-term investment of 789,282.00 yuan, accounting for 3.77% of the total assets, and inventory of 8000.

Of the total liabilities, accounts payable is 57765 12.70 yuan, accounting for 70.35% of the total liabilities, accounts received in advance are 68 1002. 16 yuan, accounting for 8.29% of the total liabilities, and long-term loans are 1000000 yuan, accounting for/. Excluding XXX 265,438+080,000 yuan and its capital occupation, long-term loan of 65,438+000,000 yuan and working capital of-928,408.85 yuan, the working capital is insufficient under the condition of income growth. According to the audit and verification analysis, first, the book profit is higher than the actual profit, and there are false profits; Secondly, the investment growth is too fast; Third, distribute dividends in the case of potential losses.

2. Operating efficiency of 2.xx hospital

(1) Operating Benefit of XX Hospital in 2005

The main income in 2005 was12228171.79 yuan, of which medical income was 8,238,783.77 yuan, and the composition of medical income was as follows:

Outpatient treatment income 1352554.82 yuan, accounting for11.06% of the main income; Medical examination income 142324 1.50 yuan, accounting for11.64% of the main income; Hospitalization income is 4674392.23 yuan, accounting for 38.22% of the main income; Drug income is 3989388.02 yuan, accounting for 32.63% of the main income; The management fee income of the cooperative medical department is 697,405.80 yuan, accounting for 5.7% of the main business income, and other income is 395,598.42 yuan, accounting for 0.75% of the main business income. Audit and verify that the above income conforms to the principle of revenue recognition and is true and accurate.

Audit adjustment of main business cost in xx hospital in 2005;

Investment income-impairment reserve for long-term investment is 864,094.52 yuan.

Medical expenses-depreciation expense137,000.00 yuan.

Medical expenses-repair expense is 46,872.25 yuan.

Management expenses-bad debt loss of 85,353.04 yuan.

Management expenses-tax loss 10762 1.7 1.

The above audit adjusted the profit and loss in 2005 to 124094 1.52 yuan.

(2) Operation of xx Hospital from October to August in 2006/KLOC-0.

From June to August, 2006, Xx Hospital realized the main business income of 8,650,425.99 yuan, including outpatient treatment income of 805,865,438+00.67 yuan, accounting for 9.365,438+0% of the main business income; Physical examination income 1083658.00 yuan, accounting for12.53% of the main income; Hospitalization income is 3408647.59 yuan, accounting for 39.4438+0% of the main income; The drug income is 268,5381.17 yuan, accounting for 31.04% of the main income; The management fee income of the cooperative medical department is 457,969.73 yuan, accounting for 5.29% of the main business income, and other income is 22,865,438+088.83 yuan, accounting for 2.42% of the main business income.

The recognition principle of the above-mentioned income items is to complete the medical treatment, and at the same time receive the price or obtain the credentials for collecting the price. After auditing and verification, revenue recognition basically follows the requirements of accounting standards.

Audit adjustment of main business cost in xx hospital in 2006;

Medical expenses-depreciation expense 123333.34 yuan.

According to the communication with some employees of xx Hospital during the on-site audit, as of August 3, 2006, some maintenance, procurement and internal matters of this year and previous years have not been handed over to the financial department for accounting treatment. Due to the lack of relevant information and limited audit scope, we did not consider these factors affecting profits, so we drew the attention of the board of directors, board of supervisors and management authorities of xx Hospital.

Audited list of adjusted net profit

Unit: RMB yuan

year

In 2005

August 3, 20061

net profit

1606 19 1.50

555899.57

Audit adjustment

- 124094 1.52

- 123333.34

Adjusted net profit

365249.98

432566.23

3. Dividend distribution in 3.xx Hospital

After auditing, the profit in 2004 was 65,438+0,520,308.65,438+0.4 yuan, the retained income was 65,438+0,520,30.5438+0 yuan, and the rest was distributed to shareholders.

Main adjustment items of audit:

(1) Fixed assets increased by 2197,000.00 yuan, accumulated depreciation increased by 260,333.34 yuan, construction in progress decreased by/kloc-0 1370000.00 yuan, undistributed profit was adjusted by-260,333.34 yuan, and accounts payable increased by 827,000 yuan.

. . . . . .

In 2005, the final accounts of five maintenance projects were completed, and the invoices were kept by the project managers of xx Hospital, but they were not paid into the financial accounts.

The above adjustments mainly follow the principle of materiality, which does not mean that all the factors that need to be adjusted have been reflected in the audit adjustment. I hope the management will pay due attention to the adjustment items not listed in the audit.

Third, business evaluation.

According to the provisions of the Dean's Business Contract in 2005 formulated by the board of directors, the annual salary system and the method of exceeding the quota are implemented for the incentive of President xxx's business performance in 2005. According to this method, the performance appraisal of XXX is realized: the annual salary is 66,000.00 yuan, and the excess index reward is16061965,438 yuan. If the assessment index is exceeded by 22,665,438+0,965,438+0.50 yuan, the bonus will be accrued by stages. If it exceeds 100000.00 yuan, the reward will be 10000.00 yuan, and the bonus will be calculated as 100000.00 yuan.

According to the analysis of profit index after audit adjustment, there are five factors that affect accounting profit and loss during President xxx's tenure, namely, poor management of xxxx investment center and poor investment decision of xx hospital. President xxx's responsibility before taking office is not considered, and the other four factors are caused by Comrade xxx during his tenure. According to the Accounting Law and the articles of association of XX Hospital, Comrade xxx bears the main responsibility, and the actual profit index after removing the above factors is 1229344.

During his tenure, Comrade xxx failed to take effective measures to reduce losses and investment risks as much as possible, resulting in a sharp decline in this part of income. The depreciation of major fixed assets investment lags behind, and some small investments are not recorded in time. Comrade xxx has leadership responsibility and management responsibility for this.

In 2005, the staff of xx Hospital was 10 1 person, and the salary paid to the staff was 3 1526 14.36 yuan, and the per capita salary was 3 1526. 14 yuan. Total wages account for 30% of expenses, which is the most sensitive factor affecting profits. It is based on the salary and bonus in the financial accounts. We selected six departments, including internal medicine, clinical laboratory, hand anesthesia, obstetrics and gynecology, radiology and pediatrics, to check the collection and distribution of bonuses from 2005 to August 3, 2006. After verification, there are the following problems in bonus management of secondary departments:

1, the bonus distribution method was made by ourselves and failed to pass the hospital approval or filing.

2. Some departments paid extra bonuses and got them back, but failed to use them for special purposes, which reflected the effective incentives for employees. For example, the internal medicine bonus is 3450.00 yuan, which is used to pay for its personnel or matters alone.

3. The bonus management in some departments is not strict, and the accounts are handed over or recorded incompletely when the staff changes jobs. For example, as of August 3 1 bonus balance was 2992.90 yuan, the bonus balance of obstetrics and gynecology was 1.6 1.00 yuan, and the bonus balance of radiology was 1.9465438 yuan, with no relevant records.

4. The bonus distribution and balance records of bonus managers in various departments are imperfect and lack continuity.

5.xx Hospital implements a separate reward policy for department directors, and there is no clear regulation on whether to redistribute department bonuses. The heads of all departments are basically involved in the distribution of departmental bonuses.

6. The salary management in 6.xx Hospital is not systematic and overall, and there is no standardized performance appraisal and salary management method and mechanism.

This bonus management method has certain risks in the security and integrity of cash; The bonus distribution model weakens the positive correlation between bonus expenditure and performance incentive in xx hospital to some extent. There is a big gap between total wages and employees' sense of identity and satisfaction with the unit.

Fourth, the internal situation

Verb (abbreviation of verb) main investment conditions

1, investment in medical special equipment

In 2005, XX Hospital purchased 65,438+04 items of special medical equipment with an investment of 65,438+065,438+076,000.00 yuan. The specific projects are as follows:

List of medical equipment investment projects in 2006

device name

Quantity (unit)

Amount (yuan)

comment

Computer fetal monitor

1

33000.00

Breast scanner, therapeutic instrument

2

8500.00

Multi-parameter monitor

three

84000.00

Fully automatic biochemical analyzer

1

400500.00

Desktop electronic sphygmomanometer

1

20500.00

Medical high concentration Q3 generator

1

70000.00

Beam device, buckywall stand, etc.

1

1 13000.00

catch up with

Medical imaging workstation

1

30000.00

Digital electroencephalograph

1

19900.00

Anesthesia machine

1

233000.00

Developing machine

1

29000.00

Milai 20 16 microtomes

1

3 1000.00

Infant incubator, jaundice tester, etc.

four

38600.00

Trace element analyzer

1

65000.00

Left over from 2004

total

20

1 176000.00

From June, 5438 to August, 2006, special medical equipment was invested for 6 times, with an investment of 893,900.00 yuan, including Yum! Automatic Digital Color Doppler Ultrasound Instrument 1 set! Infant incubator, with an investment of 65,438+00400.00 yuan, Lenovo multimedia workbench with an investment of 35,000.00 yuan, and a pathological image analysis system.

Extended audit project: argon-helium knife center invested by individuals such as XX Hospital. The investment of XX Hospital is 65,438+0,965,438+0,6470.52 yuan, and the investment is gradually recovered with the income of the center and dividends are paid. According to the investment plan of petroleum hospital, the high-tech tumor treatment is carried out in an all-round way with argon-helium knife as the leading factor, so that the tumor center goal can be realized. On average, more than 30 people will be hospitalized every day, with a monthly income of 300 thousand, and more than 3 argon-helium knife operations will be performed every week. The actual situation is that since its establishment in May 2002, the center has earned 438,000 yuan in 2003, 300,000 yuan in 2004, 63,000 yuan in 2005 and 22,000 yuan in 2006, which seriously deviates from the investment plan. Considering the current operating effect, the service life of electronic products (5 years) stipulated by the state and the emergence of new technologies, the future recoverable amount of this investment is very risky. It is hoped that XX Hospital will adopt active business strategy or timely.

2, maintenance projects

In 2005, the building maintenance and decoration project of XX Hospital 19, including canteen decoration, house maintenance, physical examination center decoration, water supply emergency repair, pediatric ward decoration of outpatient building, etc., with a total investment of 205,655.09 yuan. From June, 5438 to August, 2006, four projects including canteen maintenance, roof maintenance, obstetrics and gynecology decoration, and waterproofing of outpatient building and administrative building were completed, with an investment of 163655.05 yuan. According to the relevant provisions of the Accounting Standards for Business Enterprises-Fixed Assets, the above-mentioned items are included in expense accounting as part of income and expenditure, and some items are not accounted for because invoices and related materials did not arrive in finance in time, which affected the authenticity of profits and losses.

3, inpatient building decoration engineering

From July 26, 2004 to the end of 2004, XX Hospital renovated the lobby on the first floor and the wards on the third and sixth floors of the inpatient building in the form of contracting. This project is undertaken by Baoji Lin Wei Wuxing Decoration Co., Ltd. The project cost budget is 924,295 yuan, the contract period is 60 days, and the actual project cost is 1.37 million yuan. The main body of the project ended at the end of June 2004.

There is no tender for this project, incomplete information on project completion acceptance, incomplete final accounts, no bill of quantities, no project change visa, and no additional supplementary contract for the project. The acceptance is carried out by the personnel of each department in pieces, and there are no subsequent rectification measures, acceptance reports and other materials. Only part of the final accounts of the project (the cost is 408,496.82 yuan) and a settlement agreement for the renovation project of the inpatient building of XX Hospital with a total final account cost of 1 370,000.00 yuan recognized by both parties are seen.

After the project was completed at the end of 2004, it reached the expected usable state and met the conditions for capital transfer. So far, it has been under construction. Depreciation expense should be accrued for 20 months.

4. Vehicle purchase items

On February 6, 2006, I bought a Jianghuai Ruifeng HFC647A light commercial vehicle, with a value of 154800.00 yuan, various license plates and accessories costs of 7 1 1.00 yuan, and vehicle purchase tax of 13300.00 yuan. On February 8, 2006, the vehicle completed the license plate and household registration procedures, which met the conditions for capital transfer. On July 3, 2006, XX Hospital was actually included in the fixed assets accounting, and the transfer time of funds was delayed by 6 months.

In the audit of vehicle property rights, it was found that the brand of XX hospital was Shaanxi C23629, and the owner of the minibus was YYY Co., Ltd., which was found to belong to YYY Co., Ltd., and the company temporarily stopped working during the restructuring of XX hospital, and has not changed so far.

5. Investment in intangible assets

From August 2005 to August 2006, intangible assets increased by 365,438+0,4, with a total investment of 78,355.00 yuan. Among them, the medical examination management system is 2400.00 yuan, the medical insurance management software system is 72 100.00 yuan, the medical examination software is 750.00 yuan, and the obstetrics and gynecology management software is 3 105.00 yuan.

The development of medical insurance management software has no project development plan, final accounts and acceptance data.

Tax treatment of intransitive verbs

According to the relevant provisions of the tax law, during the first three years after the restructuring of XX Hospital, its important taxes are business tax, business tax surcharge, enterprise income tax, property tax and urban land use tax, but the tax exemption policy is not implemented for the related taxes involved in its non-medical income. The non-medical income of the hospital is mainly the income from house leasing business, and the management fee and royalties are paid by the liaison office.

From 2003 to 2005, the hospital failed to pay the taxable income on time, including business tax of 65,438+07,803.00 yuan, property tax of 30,967.20 yuan, urban land use tax of 65,438+000.00 yuan, urban maintenance and construction tax of 65,438+0246.22 yuan, and education. The total tax payment is 50935.35 yuan.

In 2005, the tax audit did not find out the tax-related amount of business tax of 38,357.32 yuan.

In 2003, personal income tax on salaries and salaries of XXX was withheld and remitted 1 1685.35 yuan, and in 2004, personal income tax on salaries and salaries of XXX and other employees was withheld and remitted 45,385.85 yuan. The above taxes are paid by XX Hospital on behalf of individuals.

In 2005 and 2006, there were no official invoices for the payment of external doctors' labor fees and asset use fees, and personal income tax was not withheld and remitted.

The expenditure on advertising and business promotion in 2005 was 245,380.40 yuan, and in 2006 it was 65,438+065,438+006,5438+008.00 yuan. The information of advertising expenditure items is incomplete, and there is no advertising release time, media and advertising samples.

After the 3-year tax exemption expires, the taxes payable by XX Hospital include business tax, value-added tax, enterprise income tax, vehicle and vessel tax, property tax, urban land use tax, urban maintenance and construction tax, education surcharge, personal income tax, water conservancy construction fund and stamp duty. By then, the tax involved will be as much as 1 1, and the annual tax payment will account for about 8% of the main income. The profit-income ratio in 2005 and 2006 was 8.87%, which was basically the same as the tax rate/income ratio. Considering unconventional taxation and the emergence of special matters in business, the future tax burden may be higher than estimated. In the audit, it was found that a large number of tax-related businesses and matters were not perfect in financial treatment and did not meet the tax requirements, and they would face greater tax risks in the future.

Seven. contract management

Audit spot-checked 18 copies of materials procurement, engineering construction, property management, loans and guarantees in XX Hospital in 2005 and 2006.

The problems existing in the terms of the contract mainly include:

1, missing key attribute information of purchased goods. For example, "brand, trademark, model and specification, manufacturer and delivery time" are not specified in the equipment purchase contract No.2006002.

2, quality requirements, technical standards do not meet. In the spot-checked contracts, most of the contract quality requirements and technical standards were not implemented according to the requirements of national standards and industry standards, and the quality guarantee period of some infrastructure projects and equipment was unclear.

3. Some contracts lack acceptance standards and methods, and some contract acceptance methods and standards are not operable. There are many vague words in the contract, such as "the equipment runs well and the site acceptance is qualified" and non-operational statement clauses.

4. The definition of liability for breach of contract is not clear. Failing to agree on the way of liability for breach of contract according to the standards of payment of liquidated damages, compensation, refund, redoing and price reduction. The clause is basically expressed as "the responsibility of the breaching party shall be negotiated by both parties".

5. The settlement of contract disputes is single and not binding. Basically, it is settled by both parties through consultation.

6. Some large medical equipment only have commercial contracts and lack technical agreements.

7. A few format contracts and format clauses do not require the other party to explain the format clauses and sign supplementary agreements.

8. The terms of the contract are not standardized, and the statement is not signed according to the professional terms of the contract.

There are the following problems in the performance of the contract: first, it is not performed in time according to the relevant terms; Second, the installation and construction have exceeded the time limit agreed in the contract; Third, the acceptance of equipment or goods is not standardized; Fourth, the follow-up management of problems in contract performance is not strict; Fifth, breach of contract and disputes are not implemented according to the terms of liability for breach of contract, and performance lacks seriousness. Sixth, the terms of individual economic contracts can not reflect the principle of equality and mutual benefit, and the responsibilities and rights are asymmetric.

Eight. Creditor's rights and debts

1, creditor's rights receivable

As of August 3, 2006, the accounts receivable of XX Hospital was 28023 15.59 yuan.

Bad debt losses of other receivables for more than three years:

. . .

Bad debt losses of accounts receivable for more than three years:

. . .

The above factors are audited and adjusted to 1738729.56 yuan, and the actual creditor's rights after adjustment are 1063586.03 yuan.

As of August 3, 2006, the top five debtors and their debts:

The municipal medical insurance premium is 42 16 16.57 yuan, which is a designated medical insurance unit, with normal settlement and no bad debt risk.

Physical examination XXXX Co., Ltd. is RMB 286,780.20, which is a major shareholder and related party of XX Hospital, with normal business credit and no bad debt risk.

XX city heating center 4 1402.36 yuan, staff physical examination fee, long-term business relationship, rolling settlement, low risk of bad debts.

XXXX Petroleum Equipment Manufacturing Company is RMB 29 100.00 Yuan, and the employee's medical examination fee is within 1 year, so there is basically no bad debt insurance.

XXX's personal loan is 20426. 13 yuan, which belongs to the reserve fund borrowed in advance during his tenure. The audit investigation shows that individual employees in XX Hospital borrowed money on their behalf, which was not reflected in the personal provident fund account, and the creditor-debtor relationship with the hospital was not cleared when they left the company, so there was a certain risk of bad debts.

2. Debt payable

As of August 3, 2006, the accounts payable were 6 1 yuan. 36638.68668666667

Unpaid or unpaid debts payable for more than three years:

. . .

The creditor's rights payable after audit adjustment is 75435 19.06 yuan, which is 808242.25 yuan higher than the book.

As of August 3, 2006, the top 10 creditors and their claims:

Wanfang Medical Station of XXX Pharmaceutical Company is RMB 265,438+027,706.57.

The balance of medical equipment purchase of XXXX Trading Co., Ltd. is RMB 400,000.00.

The drug purchase amount of XX Pharmaceutical Distribution Company is 2 1 1659.00 yuan.

The amount of drugs purchased by XX Medicine and Medicinal Materials Company is 147 106.75 yuan.

The purchase price of drugs in Zhongshan Drug Station of XX Pharmaceutical Corporation is 103264.90 yuan.

The medical expenses of argon-helium knife center are 55734.37 yuan.

XXX deposit is 50000.00 yuan.

The purchase price of medical equipment of XXXX Medical Products Co., Ltd. is RMB 37,633.90.

After the audit, the accounts payable business transactions and matters are true, and no fictitious units are found to be used to transfer funds or adjust profits.

Nine. Construction and implementation of internal control system

1, the system is imperfect and there are rules to follow.

2. The project construction lacks relevant procedures and necessary formalities.

3. Poor management of investment projects

4. The procedures related to expenses are not perfect.

5. Weak legal concept.

6. The management of monetary funds is not standardized.

7. Improper financial handling of sensitive payment items.

X. Audit observations and recommendations

In view of the above problems, we put forward the following audit opinions and suggestions:

XXXX hospital audit team

165438+20061October 30