xt7kh12v6014_265 https://exploreuk.uky.edu/dips/xt7kh12v6014/data/mets.xml https://exploreuk.uky.edu/dips/xt7kh12v6014/data/2008ms006.dao.xml Benham Coal Mines. (Benham, Ky.) 151.0 Cubic feet 302 Boxes The Benham Coal Company records (151 cubic feet, 302 Boxes; dated 1911-1973) focus primarily on the early years of Benham Coal through the 1940s, including office files, Employee Benefits Association records, files on accidents and safety, and photographs. archival material English University of Kentucky This digital resource may be freely searched and displayed.  Permission must be received for subsequent distribution in print or electronically.  Physical rights are retained by the owning repository.  Copyright is retained in accordance with U. S. copyright laws.  For information about permissions to reproduce or publish, contact the Special Collections Research Center. Benham Coal Company Records African American coal miners--Kentucky--Harlan County Coal miners--Kentucky--Harlan County Coal mines and mining--Appalachian Region Coal mines and mining--Appalachian Region--History. Coal mines and mining--Kentucky--Benham--History Company towns--Kentucky--Benham General Correspondence text General Correspondence 2015 https://exploreuk.uky.edu/dips/xt7kh12v6014/data/2008ms006/2008ms006_27/2008ms006_27_17/21509/21509.pdf 1944 1944 1944 section false xt7kh12v6014_265 xt7kh12v6014 ACCOUNTING DEPARTMENT
DEPARTMENT ,, _ _ , -,
m ucu %1¤c¤¤s;r ‘+o¤“ Fool Nwvos c»ucAG0.1LLu January 9, 1ONh
OR WORKS , ' ' '
??@nhFv·¤, ?;ra¤*i¤vc¥'fj
FcRMR. J. C. Pallcré, Qufifor
on FILE no. °
I have recoxoly voroivod Frmw the American
Mining Congress an aoetdod Oroar D-EW coverinv fha
wocoisvvv nrooedvwv For okfvitiro mPtor5als evo suv-
oiier for carrying on operations ai wines.
I &ssuwF vow have racoivod & corv of this
amended order, ¤nd if fhore Q#@ &¤¤ diffororcos from
yovr owovious procodure, ploaso woke Sife i%at our
ropov%s, etc. are in accordance with this amevdcd
J. B. Parka?
¤~ — Mr. C. J. Camwkoll - Steel Ui?l
Uo. “. E, ¤¤l%r¤¤%F — Coal Tires
Vv, VQTS Ve1¤ow — Oro Hives
; A
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i · A A
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i ¤n T Q A

 J- B. Parker. Auditor, January 17, 1944.
We sro attaching hereto Form EPB-·2.585, Transportation
System Requirammihs, for the qusrtur umding Juno 50, 1914, thrse d
oowiss of which sro to bo forn·;:.;~dsd to tho nar Production Board,
U Washington, D. C., and one copy for your filo.
Hsrotofors the cor miles shown undor "Oporsting Stutisticxs" I
have been furnished from your office. _
d Yours truly, _
l By........................_,............._....
Encls. Works Auditor. o

 J. B. Parker, Auditor,
‘ January 19, 1944.
We are at caching hereto letter dutaed Jexmery 18th, addressed  
to the Mining Division, wor Production Bofrd, Wessbington, D. C., list-
ing items of minor capitnl additions as provided for under Preference
Rating Order N0. P-56, as amended December 24, 1943.
We one permlttezd to apply by letter for the dollar value quota
for tin fir et end second quarters of 1944. This lettwr sluimld be for-
warded to émsxhinggtou. to reahh tom by January 24, 1944.
Youre truly, or `
A` B&;................_..,.__,________
1 encl. €· Works Al1d1tQI‘•
CC — Mr. 0.5. Williams, ‘ li

DE TME ,_., .   _,.. __,1 .‘ V
g::&E;KSNT ‘:a'lSCO1lSlE b‘b€€]. Coal LXZLIIGS cI—ucA<;c>, u..1.., .29DI‘LI&I’§[ 5, 1944
MRMK J. C. Ballard
  . .._-.
Dear Sir:
Since early au ust lQe5 when hr. G. E. Rose
.. . . .. J . . 2 2 .
established the steel Division rriority Control at the
Steel Jorks, ve have been receiving copies of your
purchase orders and requisitions for material.
These have been.pre;ared under the supervision
of your otorekeeper, nr. C. S. Williams, and I believe
that at this tire it would be in order to advise you
that nr. Uillians has been doing an exceptionally good
job in endeavoring to comply with all regulations per-
taining to the material which has been purchased. his
ability to interpret correctly the various regulations,
which have been issued, has nade our position in reviewing
your purchases merely a matter of checking.
I wish you would express to nr. Williams our
aytreciation of his good work and hope that he will con-
tinue his efforts in this most difficult problem.
Yours very truly,
ii. (1// ih;T·   {rrd \   r   ’ 1 _»
caczrc J,.  “ it c _ 1»<,.._.,...,-— I.//’

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 Form HP-16-2-10-44. -7500 Sets
. . . —·· .
·¤~·Si<·¤ -—-—---»-»·--·----— ¤»*i1i’~i-Qmtm -»~Y·-— - --—----—-·—-—---——-·--»--—-·—------·—·—·-·---~——--——··»~~·--—---·V·-----~---—-- Highway Contact No .........................,....,......4.....
District N0 -----··-·--—·· 7 ---—-—-»··v----» Cmmtv »·-—-i·--»----»--»- Harlan, -»------··-·—------—-   -···-----~---·------·»--· Account No. ............... ZQEQ ................................
Name of Allotment or
...................................__._.._._,_,,_,_   ......_....__..._.._ . ..,.... Project No.   .....   ........   ..........»......... Revolving Account ....... E quipmgnt .............
C Date .........A...................   ...................................
I. ,~i Harvester c
Ft9fn3’D1Onal C , J Departmental Requisition N0.3g.Q ...................
‘<·»< rx
Benham, kentucky. District nequisitiolii   ....   ......
Invitation N0. ........................................................
You are hereby awarded the contract described below in accordance with the Request No-  
bid submitted by you on ...........................i...... . _rr_,o...   ....,.   ..............................................   .........
. ‘ D , . · .
Ship to Department of Highways care .....   ........ 1 .......   .........     ..........  
------·-—--—·-----··-·--···-—--——----·---—--—---—-----·—--—-—------—---—-—---··- Somerset-) ·-·v- Keri-*&u@»l&y·-; --·--·------·-—--——-
umass oruenwnse moicirreo, Au. peices ARE F. o. o. oesrnmraou Amo
i>ne»=·A¤¤ suippino ann. Musr BE sem TO consiomze
ouAN·r11·v 1 umm- r oescnnpriow l PUR**{g*é i Amounr
5 1
·   Rental for plot of land at Eenham, Ky Har an l
i 00, on which land Xx the Department has e cted g
. I I a Maintenance Garage for use in that Coun y,  
{ i toget   wlth storage of stone, guard pea \ ;
i   and zlincldental material. For nerlod from l-l-1-—U·l· {
|to Zi-51-U5, At the rate of at 12.00 per year. 1
l A
§AMOUNT OF CONTPAGT NOT TC EXCEED. ........ U .........   12,00
iln accepting this Purchase Contract, cell ng; for
`payment in advance for the period speclfl d, it is
iagreed that should the Department of High aye be
lforced to vacate before the end of the pe lcd epec .-·
’ Ifled, refund will be made of the rental p d for t` e
period the space was not occupied by the epartmen .
_.__-n.l_l_..Jll__----.--.._l__.._____.__-_ .__._._____%l____
Purchaser's Symbol: DP(Code Nc. lO.50’l,,-»_  
TERMS: ·*»·TotalAm¤unt{__‘ ` ____` _A
 .-t_   / V \
imponmur msraucrions TO coN·rnAc·roRs ' . `-
" B§}}X5{L$§¤52°»‘$‘é‘qu‘L1t"F§?°¤§i?l%t5’¥§Fm'°§iiYé?” "‘° (signed) __.__ ¢/   ,.__   ________,___________,,__,
2. Submit invoices on Standard Invoice forms in accord- (Dir€°t°r_DivlSi°“ or Purchases and Pub rc Properties)
ance with instructions contained thereon.
3. Contract number_must appear on each invoice, on all Approved (JS to availability of funds:
· packages and delivery tickets and any correspondence
pertaining thereto.
I Posted to Records of l O
Division of Accounts

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` ‘ ,' STANDARD INVDICE Your Invoice No ..........»... . ..................~.».
I ¤,"’ Division 0 - 4-29-4
  DEPARTMENT ...»...i.,   EEE...i,,,..i.. , ,.... Institutionr .........__.....» E Q,\A1I?E§.X1§ Eooi...................... h“’°‘°° Date ················»··· Q ···················‘·
L t- t Wh- h Purchase Order or
ngigiégga? ......,. if ....,»....,,.e4...._oi.... Qw?4IHrL¤nd.,..Ky.» ....................,,..............i.ii.._....e.,.................,..e...,.. <§:¤¤*r=;<=t Ng  ------ 6-·aHm`»—-§5§ ---— {
· V opy rom urc ase r er or on Fac
I Name and Address of Vendor .......     .................eor..e..rro....o......... Account Nc_ ____ Y_Q§jQ _____________________________
Be mmm W Copy from Purchase Order or Contract
] 1 ’ I
-  Amount R Code ! Amount   Voucher  
y I i 1 gmounlt of
,_ Hcllm l‘3.11C8
y   } Q Liquidation S ............,....,,..,......_.........
Quantity { Unit I DESCRIPTION Unit Price . Amount Eiigxa
· I iiigntel for plot of lend at Benhem, Ky.,Horl n
I E County, on which lend the Department has
i erected e Mezlntenance Garage for use in the i
F Miounty, together with storage of stone, gu ·d [
  ipoet and incidental materiel. For period |
3 I from 4-1-44 to 5-31-45. At the rate cf Q
E i$l2.00 per year.  
i gAl.;0UN'£' UF COH'I'¥ZA<€'l‘ HUT TO EDCCEED . . . . . . . .   $12.00
i i I
3 ` 1
I ¥In accepting this Purchase CC;.trzxct, callin 2
_   `for payment in advance for the period speci led,  
  lit is agreed that should the Department of
Q @H1;;hwnys be forced to vacate before the end of the
  Iporiod specified, refund will be made of th I
  crentel p~~1d for the period the space was no
I ioccupicd by the UB urtment. i Q
I g P I
  iPurchcser'¤ Symb 1: DP(Code No. 10.50) l } \
    ` L
; I I
TOTAL AMOUNT I $13, gg i
I hereby certify that the commodities specified above have been Discount ‘·`·‘‘‘*‘···‘·‘···’*··*···························································
furnished to the Commonwealth of Kentucky; that the quality and Net Amount
prices conform to the proposal and purchase order or contract; and Ch _ ````````i`````````````'i``````````i````````i````````````````````'`````''````
that payment, in whole or in part, has not been received.   I -
Ch k ii tn
signed i...i.... ¥§§@53T.Q€?.¥%.9§?§l_.H§4T_Y_=_i9tl;&;_F.__99g _____,______,_.____ Reggivtingwéeport No ...............»......».»»....»..............................
%,./,22 . . , -· . . .
By ______,__ _ ____ ’__\,5;__·___§;{{g___}_» ____ §;_;_‘_( _____ {___;j¥ __________________________________________ Extensions and Additions Checked ........_._i....____,__,___,......
O works Audi tor.

 as HPSR . -
’ P‘§·¥%3‘i WGS E ` .
_ . ~
    HAV   .
QEEA1;.1 J rsisi
1. Invoices must be submitted in duplicate on this form; retain the third copy for
your files.
2. Render invoice immediately upon completing shipment of all items ordered.
Payment will be withheld until order is completely filled. Discount period will
be computed from date of final delivery or date of invoice, whichever is later.
3. Use a separate invoice for each purchase order or contract.
4. Be sure to insert the purchase order or contract number and the account num-
ber in the spaces provided.
5. Vendor’s certiiication must be signed on all copies.

 \ .
A \
U. S. Department of Labor
ChilQrcn's Euro n April 15, lQ@¥
Washington, D. G. (Suocrscdincvm;ngrcnjgmpr_ig;
_ strlctions on this snbicct
To: Executive officers of Stats agcncics administering maternal
. and chilc hcnlth (including cmcrgcncy mptornity and infcnt—
cars) ond cricolcd childrcn's programs under thc provisions
of the Social Sccnrity Act.
From: Chief, Children': Bureau, United Stmtcs Dcpnrtmont of Labor.
Subject: Purchase of bospitrl l/ cars nndcr programs for maternal and
:· child health Qinclliirg cmcrgcncy maternity and infant
cars) and cripylci children.
Y ¢
<€f`£`@ctlV{2 Jgly lj lQLLU,}
The Cbildrcm‘s Eurcau believes it to Li a icsiroblc policy for
Stats agcxciss uicinistering matcrnpl gud ehilc-nsplth {including emcrgcncy
metsruity and infnnt~cprcF ono crjpplgo chilnr;n’c programs to purclvsc in-
pcticnt or oot—p¤tic1t Losyitcl cars oi ratc: based upon thc calculation of
rtinz`:n1.rszawblc costs per oz»ttL-cnt   or in~;;¤·ti_rznt   or i~cimb.,sz·scblc
costs per out—paticnt visit, nc outlinci in this mcxorcnium.
It is bclicvcd by tho Chilircn‘s Burcsu cnc by bcspitwl ndministr¤—
tors and accountants conferring witn tEc Chilir;n's Enrcnn on this subject
trot thc procsoirss outlined here will result in tn? rst bllSXH?it of rctco
of poymcrt for hospital cnr: thqt can be considered rcgsonpblc by both thc
ggblic agencies and thc hospitcls conccrnod.
Stct; agcncics should ccmplctc sgrccmcnts with porticipgting
honoitnls wlcrctv thc hospitcl rirscc tl) to prrvids ccrc for patients when
nospitvl cor; was anthcriuci nrdcr t1;sc trogrsms oriinarily in rooms with
two TT morc bgis, but who; mgiicnllv iriicatco cr vhcn no othcr occocmodrtions
l orc rrsilablc. ¤s‘’ in rcors with cnc Lol? [Q) to accept pcymqnt for all services
oroviizi, cud, irrcspcctivc of thc tgnc of room occnpisc, nt thc roto of
§~cg;1‘11»;`n.t r,·.dC[>t·5d by   Q*irai‘·i .·=g:·;;;_c;r; rnd   that ‘c¢g;:n.;·nt misc;   thc Stsiio
céticy will be consictrcd full purport for xll scrviccs crovi&c@ and thot tbr
hispitsl will ncccgt no goym nt from the pgtignts or tbrir families for such
‘ scrviccs.
l/ Ecspitmlc, for tht pnrposc of this strtcmrnt, are dofincd to incluic
maternity homo:.

 · I
-3- ,.
In—paticmt hospital care.
In—patisnt hospital care purch~s;d with Federal 0r m¤tching funds for
maternal and child—hcnlth (including cmcrgcncy maternity and imfant—carc) cr
crippled childr@n's services under plans approved by the Childrcn‘s Bureau
shall be at an inclusive per diem rate; 1.c., the rate shall cover all serv-
ices provided the patient by the hospital. The per diem rptc 0f payment
shall not exceed the “reimburSnble cogt per pgtiant day" calculated by each
hospital in accordance with the method outlined in this memorandum. The
calculation of the "reimbursable cost per pztient dgy“ takes into c0nsidcr2—
tion all expenditures by the hospital thrt are regarded as related to the
. care of in—paticnts. Therefore, the per diem rate 0f payment as approved by
the State agency for each hospital shall cover all i;~paticnt hospital care
provided patients under these programs, including the use of delivery or
operating rooms, drugs and casts, laboratory, X—r2y, anesthesia, physical—
therapy and all other services rendered by individuals who receive any
remuneration (salaries, fees, commissions, Or maintenance) from the hospital
for such services. .
when a hospital has made no expenditures during the accounting year for
certain materials or services, such as appliances fcr crippled children,
blood purchased from donors, anesthesia, X—ray, special nursing, services Of
a physical therapist, etc., it should list such items in the space provided
. under item C 0f the st¤t@ment submitted to the State agency, so that the
State agency may make arrangements, when necessary, for purchasing such
materials 0r services directly from independent vendors.
The "reimbursable cost of in—pqtient service per patient day" entered in
item E S will bc, for most hospitals, 85 percent of the average per diem cost
as calculated for all patient days (exclusive 0f newb0rn—infant days) in the
hospital. However, hospitals with more than YO percent of their patient dvys
in rooms with two or more beds may request a higher rrts of payment than
85 percent, in accordance with the procedure described in items E and F 0f
the Statement 0f Total Expenses. Hospitals with YO percent 0r less 0f their
patient days (exclusive 0f n©wb0rn—imfnnt days) in rooms with two 0r more
beds may receive a maximum 0f 85 pcrccnt of the evervgc per diem cost as A
Out—paticnt hcspitrl gggg.
It is recommended that for the fiscal year beginning July l, 19UU, that
agencies purchase 0ut-patient care at the "reimbursable cost per 0ut—puti¤nt
visit" as shown in item G 5. This rgccmmendstion is n0~ made fox the first
time because methods for purchase 0f 0ut~p2ti@nt care have not been com-
sidcrcd in previous memoranda 0n this subject. Experience with the method
recommended or other methods is needed to dctcrminc the most satisfrctory
way 0f purchasing 0ut—paticnt care.

i, -5l
Gcnercl instructions.
’ Each hospital in which care is to be authorized and paid for from funds
for maternal and child health (including emergency maternity and infnnt—c¤rc}
or crippled children'; services should be rcquirrd by thc Stats agency to
provide ovcry l2 months a statsmcnt of thc total cxpsnscs cnc the calcula-
tion of reimbursable cost pcr pgticnt Qay and reimbursable cost psr out-
patient visit for the hospitgl's most rcccnt accounting ycar. This stato-
mcnt should bc bcscd upon the amount of total expenses ns ccrtificd to by a
public accountant 2/ who is not an cmploysc of thc hospital. A form of
certification suitgblc for this purpose is included in this memorandum.
l. Whcn rwtcs for thc purchase of hospital care have
bccn cstcblishad by lpw ani thsss laws apply to thc purchase
4 of ccrc from funds, Federal or matching, under mgtcrnal and
Child—h©olth {including gngrgqncy maternity and inf2Ht—C&TG)
or crippled chil&ren's progrrms, stctcm nts of operating
cxpcnsc nccd not be required for hospitals participating in
thcsc programs.
2. lf a hospital has fcwcr thcn 25 availsblc beds or is
paid less than $500 &uring c year for hosfitrl carc from funds
for maternal and child—hcalth (including emergency mztcrnity
and infnnt—curcl or crippled chilircn's services, Fcicral or
matching, it may sibmit Q statement of total cxpsnscs and
calculation of rcimburswblc cost por pstiunt day as prcvionsly
indicated, or it may `cg paid fror; tliesc, funds on tlié 'b8.SiS of
an inclusive per diem rctc cstablisicd ty the Stats agency for
such hospitals.
5. If an oificcr of thc hospital csrtifics that the
hospital could not obtain thc ccrvic»s of a public accountant
to mnkc an audit on thc basis of ~nich ,·.. thc accountont could
ccrtify to thc total amount of cxpcnscs (itci A), then a
stctcmcnt of toicl cxocnscc ani cplculation of rsimbursnblc
2,/ A public accountant   usuyzlly hold to be 2 person: °'(.;~,> Y'.'liO . . .
holds himself out to thc public in any manner es one skilled in thc knowledge,
science and prmcticc of accounting, and rs Qualified ano ready to Tcmdcf PTO-
fcssional scrvicc therein vs a public accountant for compensation; or (bl Who
maintains on office for the trnnsrction of business ns A public cccountant;
or (cl who offers to pro occtivc clients to perform for coxpcnsztion, or who
docs perform on behalf of clients for ccnpcnsation, nrofcssioncl scrviccs that
invnlvc or require on cucit, examination, verification, investigation or
l rcvicw of financial trcnsvctions vnd ccccuntinr récoris; or (o) Who pT$p?T€5
or certifies for clients rxports on vucits or cxnminctions ci books or records
of account, bclcnce shccts, and othcr fincncinl, accounting and rclntcd
schciulcs, cxnibits, stctsmcnts, or reports ~hich cr; to bc used for publica-
tion or for crciit purposes or crc to be filed with n court of law or equity
or with any other governmental agency, or for any othcr purpose; or (cl Who,
in general or as rn incident t; such ~crk, rsnicrs profcssionvl dsgistancc to
clicnts for compensation in rny or all mrtters rglrting to accounting proccdurc
and to thc rccoriing, presentation, and ccrtificvtion of financial facts or

s -M~ ` .
cost per patient day and per out—patient visit may be pre—
pared by the hospital, certified by an officer of the hospital,
and sworn to before a notary public. A form of certification V
and affidavit suitable for this purpose is included in this
memorandum. _
U. Statements need not be required from hospitals operated
by agencies of the Federal Government since payments by State
agencies to such hospitals are at the uniform inclusive rete paid
by Federal agencies in purchasing care in such hospitals.
5. Statements of operating expenses for hospitals operetsd
by city, county, or State governments need not be certified by a
public accountant if signed by an officer or the superintendent
of the hospital and sworn to before a notary public.
6. In those States uber; hospital accounts are audited and
certified by eccountants ewplcyed by State agencies authorized by
State law or regulation to perform these functions, certification
of the hospital statements of operating expenses by the executive
officer of such State agency will be acceptable.
lf the statement received from any hospital appears to establish en ex-
cessive cost per patient dey as compared with costs per patient day for serv-
ices of comparable quality in other hospitals in the State, the State agency
should establish a maximum rete to be paid under these programs, e rate that
shell be reasonable in view of the average per diem costs in hospitals
throughout the State.
Copies of the statements of total expenses end calculation of reimburs-
able cost per patient dey from each hospital are to be submitted by the State
agency to the Children's Bureau as a part of the plans for services for
maternal and child—heslth (including emergency maternity and infant care)
end crippled children. when a statement is received by the State agency for
a new hospital accounting year, copies of this statement should bei`orwarded
to the Children's Bureau to replace the statements previously submitted.
4 It is the responsibility of each State agency to review request necessary
adjustment, and accept the hospital statements and calculations of reimbursable
costs per patient day and per out—patient visit.
when a hospital subnits a new or 2 revised statement of operating cx-
pense and calculation of per diem cost, and a new rate of payment is adopted
by the State eeency, the new rate shgll be effective as of the dgte it is
adopted_py_t§p_§;;te_pgency for all admissions to the hospital after such
date of adoption.
where maternal and child—health (including emergency maternity and infant-
care) and crippled children‘s services are administered by separate State
agencies, the cooperation of the two agencies in obtaining stntements of
operating expense from the hospitals used in both programs and in developing
policies within the State for the purchase of hospital care under these
programs will expedite the edministration of both programs.

· ) Statement
·. ` Page l of Y
For the accounting year ended . ~ A l9U____
by___ hospital, · ` address.
For hospitals cooperating with official State agencies ad-
ministering programs for maternal and child health (including
emergency maternity and infant care) and for crippled children.
A. Total amount of expenses per books l/ ................
B. Less the following items if included in item A. Q/t
l. Research expense and medical education .......
2. Cost of gift shops, lunch counters, etc ....... _______
3. Cost of guest meals or meals paid for by employees .
M. Cost of telephone and telegraph charges~paid for
by patients, guests or employees ......... _____
5. Cost of drugs or supplies that are purchased by
individuals not admitted as in—patients or out-
patients ..................... _
6. Provision for depreciation of buildings and equip-
ment .......................
Y. Bad debts or provision therefor ...........
S. Estimated value of donated or voluntary services . .
9. Interest expense .,...,............ __
lO.. Real estate taxes and income taxes .........
ll. Rent expense ....................
l2. Other (specify) V
l]. Total of items B l to B l2 . .......... ‘ ....... ‘ .
C. Total amount of operating expenses applicable to in—patient and
out—patient services (item A minus item B l§). .‘ .........
List here material or services not provided by the hospital, such as appliances l
for crippled children, blood for transfusion, anesthesia, X—ray, special nursing,
services of physical therapists, etc.
l/ The amount to be entered should be as follows:
Ij;Reporting on the—~ Amount To Be Entered
' (a) Accrual basis (al Total expenses
(b) Cash basis (bl Total cash disbursements
(c) Modified cash basis (c) Total cash disbursements after giving
effect to adjustments. V
Do not include in the total amount (item A) expenditures for land, buildings, and l
permanent improvements and equipment, whether replacements or additions.
Q/ If the "total amount of expenses" as shown on the statement prepared and
. certified to by a public accountant does not include any of the items listed under
item B, then no entries would be made for item B, and entries would be made only
for items A and C. '

Statement , '
Page 2 of Y *
D. Operating expenses for calculating reimbursable costs. §/ B/
‘ ln—patient Out—patient
Total service service
(1) (2) (5) (A)
l. Administration .............
2. Dietary . ...... . ........... ____
5. Laundry ................
M. Housekeeping ..............
5. Heat, light, power and water ......
6. Maintenance and repairs ........
7. Motor service .............
8. Medical and surgical service ...... __
9. Nursing service and nursing education .
lO. Medical records and library ......
ll. Social service ....,........ ___
12. X-my 5/ 6/ .............. __
15- Laboratories j/   ...........
lh. Pharmacy ................
l5- Physical therapy _@/ ..........
lo. Other special services 7/ .......
(Specify) _
l/. Total .................
(Equal to item C) 1
;/ A hospital having a total of 25 available beds or fewer (b.l complement)
may elect to submit a statement of operating expenses in accordance with the
classification per books of the hospital in lieu of item D. These hospitals should
also complete items A, B, and G.
E/ The manual entitled "Hospital Accounting and Sgatistics", umich can be ob—
tained from the American Hospital Association, lS E. Division St., Chicago, lll.,
gives more detailed instructions on expenses to be included under each of the head-
ings listed under item D, and a method for allocating in—patient and out—patient
operating expenses. If a hospital is unable to segregate in-patient and out¥
patient expenses by this or a comparable method, it may obtain the amount to be
entered in item D l/, col. H, an estimate of the cost of out—patient operating ex-
pense, by multiplying the number of visits in item G 2 by $l.50. Item D l/, col. },
l will be item D 1/, col. 2, minus item D l7, col. U.
Maintenance of student nurses and of members of religious orders who serve in
the hospital may be included in the appropriate items under item D.
5/ lf the hospital acts as the billing and collection agency for individuals
not employed by the hospital but who are providing service in these departments,
the amounts so collected and paid to these individuals is not to be included in
the statement of operating expenses.
§/ lf the following information is known, please make entries here: