The FPA Financial Statement and Description

Each item is numbered to correspond with the explanation below in a blank FPA Statement.

  1. Fund Number - The fund number is comprised of eight digits. The eight-digit number refers to an income fund statement, which covers the activity of a particular participant or group who use one income account to report their activities.
  2. Fund Name - This is either the name of the participant (i.e. Dr. Smith) or a group (i.e. Radiology Associates) or a department (i.e. Rehabilitation Medicine).
  3. Date - The date of statement preparation.
  4. Cumulative - The period, which the statement represents, is cumulative from the first day of the calendar year to the end of the quarter. For example, the first quarter's statement may read "1/1/11 - 3/31/11," and the second quarter's statement may read "1/1/11 - 6/30/11."
  5. Non-FPA: Hospital Transfers – CARTS – This revenue represents funds transferred from the Hospital.
  6. Non-FPA: School Transfers – CARTS – This revenue represents funds transferred from the School of Medicine.
  7. FPA Patient Revenue - from Practice - These receipts represent fees collected from patients seen at Mount Sinai or affiliated institution. (See sub-code 3051 in your fund ledger report.)
  8. FPA Patient Revenue - from Other Activities - This represents receipts for income from professional activities such as fees for patients seen off campus.
  9. Total FPA Patient Revenue - This total is represented in line 7 and 8, by definition: "income defined as fees and unrestricted monetary donations, for patient-related activities, wherever performed, consultations or any other activity performed on campus or at an institution affiliated with the school, must be deposited either in the Professional Service Plan on the Department Fund". All fees for professional services received from Faculty Practice Associate participants will be deposited in their respective income fund for each participant or group.
  10. Departmental Growth Fund - The various percent of total receipts are accrued for use at the discretion of the department. Some department may not assess.
  11. School Equalization Fund - 5 percent of total receipts are accrued for use at the discretion of the Dean.
  12. Indirect Overhead Expenses - 5.2 percent of the Indirect Overhead Expense covers the following items:
    • Space utilization charge
    • FPA Administrative and Financial Services
    • Malpractice Insurance coverage relating to FPA Practice activities
    • Use of institutional support services
  13. Growth Fund - .75 percent Growth Fund is intended to provide funding for the FPA Compliance Program.
  14. Renovation Reserve Fund - .25 percent Renovation Reserve Fund is intended to provide funding for updating practice facilities within rules laid down by the Executive Council and FPA participants may apply for support. Funds are allocated by the FPA Executive Council.
  15. Direct Overhead Expense - Direct overhead expenses are expenses incurred by participants in their practices, such as secretarial and administrative salaries, fringe benefits, supplies, telephone and answering services, billing services, etc. These expenses are accounted for in a direct overhead account (0265-xxxx). Overhead expenses are determined in one of three ways:
    1. If an FPA participant or group has one income fund number and one direct overhead expense account, the total in the direct overhead expense account is included in line 15. The percentage is derived by dividing the amount on line 15 by the amount on line 7 (Gross receipts)
    2. If FPA participants or group share a direct overhead account, the amount on line 15 is determined as follows. Let's say three individuals share in one direct overhead account and the total in that account is $10,000. The individuals receipts for the three participants are as follows:
      • Dr. X. $50,000
      • Dr. Y 30,000
      • Dr. Z 20,000
        Total $100,000
    3. The percentage of direct overhead to be applied to each participant's account is $10,000 divided by $100,000 or 10 percent. Overhead for each individual would then be:
      • Dr. X. $50,000 (50,000 x 10 percent)
      • Dr. Y 30,000 (30,000 x 10 percent)
      • Dr. Z 20,000 (20,000 x 10 percent)
        Total $10,000
    4. The third method is, by special agreement, among FPA participants involved, to charge a flat fee or overhead percentage to the gross receipts.
  16. Total FPA Taxes & DOE - Line 16 is the total of lines 10, 11, 12, 13, 14, and 15.
  17. Total Revenue After Taxes and DOE - The total patient revenue (line 9) less the total taxes and DOE (line 16).
  18. Expenses - Expenses are defined as allowable charges or disbursements that are made against Adjusted Gross Income.
  19. Salary – Faculty - This amount represents a portion of a faculty member's base salary on which fringe benefits are paid or calculated. An approved personnel action from (PSM 100) is required to implement the salary charged to the practice income.
  20. Salary – Non Faculty - This amount represents a portion of a non-faculty member's base salary on which fringe benefits are paid or calculated.
  21. Fringe Benefits - This represents the fringe benefits related to the above salaries, which are charged at a composite rate (varies) to the practice income funds.
  22. Salary Reimbursement - Reimbursements to Mount Sinai from outside institution for salary cost of physicians providing service. Balance is typically a negative amount or contra.
  23. FPA Supplement – This represents the amount of compensation supplemental to the base salary for clinical work.
  24. Non FPA Supplement – This represents the amount of compensation supplemental to the base salary for non-clinical work.
  25. Bonus - This amount represents Faculty Bonus, which approved by department Chair and Dean.
  26. Space - This space costs are allocated to the FPA in the annual administrative Service Agreement: All debt service (principal and interest) on buildings, institutional safety, security, housekeeping, and utilities. The cost of alterations/renovations to the space will follow the Renovation Reserve Fund policy.
  27. Malpractice Insurance - This malpractice cost are allocated to the FPA under an existing agreement with the Medical Center, FOJP Service Corporation insures clinical practice activities of all full-time clinical faculty, participating in the FPA.
  28. Consulting & Outside Services – This represents the cost of consultants and/or other outside services allocated to the account.
  29. Travel – The total cost of travel expenses allocated to the account.
  30. Capital / Principal – This represents the cost of capital and principal expenses.
  31. Administrative Costs – This amount represents the cost of all administrative functions allocated to the account.
  32. All Other Research, Clinical & Instructional – All other costs generated by the physician during their time doing research, teaching, or clinical work.
  33. FPA Surcharge Adjustment - This FPA Surcharge Adjustment costs are adjustment to overhead after allocation of charges for space and Malpractice.
  34. Disability Insurance - This represents charges to the practice income fund for cost of additional disability insurance over the amount provided through institutional program up to a premium limit to $10,000 per annum effective January 1, 2007. Payments are processed through the accounts payable department by check requests payable directly to the insurance company or reimbursed to the participant. All participants must elect to consider these premium payments either taxable on non-taxable. In the event that the decision is made to tax the Disability Insurance Premiums, all taxable payments will be included in the participant's W-2 form. The election forms are available on the FPA Accounting web site.
  35. Miscellaneous / Other – All other costs not described in lines 19 through 34.
  36. Total Expenses - The amount on this line is the total expenses or the sum of lines 19 through 34.
  37. Net Results - The amount on this line is the Total Revenue After Taxes & DOE less the Total Expenses or line 17 minus line 36.
  38. Beginning Balance 01/01/11 – This represents the opening balance remaining in the account from the previous year.
  39. Fund Balance as of 01/31/11 – This represents the balance in the fund before any funds are distributed to the department or elsewhere.
  40. Department Allocation – This is the amount of funds transferred to or from the department.
  41. Closing Balance as of 01/31/11 – This is the final balance in the account at the end of a month.