CHFA study plan

Reconstruct the core financial statements (balance sheet, statement of operations, statement of changes in net assets, statement of cash flows) from a trial balance without notes, and label each line with its statement classification.

Distinguish net asset classifications (with and without donor restrictions) and explain how restricted contributions, releases from restriction, and investment returns are reported.

Apply revenue recognition rules to patient service revenue, including implicit price concessions, charity care vs. bad debt, and the net patient service revenue presentation.

Compute and interpret at least six healthcare-specific statement relationships (days in accounts receivable, operating margin, net asset composition) from a single constructed example.

Trace lease, bond, and debt issuance transactions through journal entries to the statement of operations and cash flow statement.

Explain the purpose and limits of an independent audit, the auditor's report language, and how management's assertions map to audit procedures.

Map internal control components (control environment, risk assessment, control activities, information and communication, monitoring) onto a hospital revenue cycle, naming one control per component.

Identify fraud risk indicators and segregation-of-duties failures in a small finance department and propose a compensating control for each.

Classify costs by behavior (fixed, variable, step-variable, semivariable) using a healthcare department example and separate mixed costs with the high-low method.

Build a contribution margin income statement for a service line and compute break-even volume and break-even revenue in both fee-for-service and capitated settings.

Allocate overhead to service lines using direct, step-down, and activity-based methods, and explain how the choice changes reported line profitability.

Compute and interpret standard cost variances (price and quantity) for labor and supplies, and state whether each variance is favorable or unfavorable in plain language.

Assemble a full operating budget for a hypothetical facility: volume assumptions, revenue net of contractual allowances, flexible and step-fixed expense budgets, and resulting margin.

Convert a static budget to a flexible budget and compute volume and rate variances for revenue and expense.

Construct a cash budget and a capital budget request, and explain how depreciation and capital purchases affect cash versus accrual results.

Defend each major budget assumption in writing and state which two assumptions carry the most downside risk.

Build a 12-month rolling forecast using driver-based volume, payer mix, and rate assumptions, and roll it forward one month to demonstrate the mechanics.

Compute and interpret the core ratio set: liquidity, days cash on hand, capital structure and debt service coverage, profitability, and asset efficiency.

Benchmark your hypothetical facility against plausible peer ranges and flag the three ratios that would draw the most scrutiny.

Explain the DuPont decomposition of return on equity and apply it to show which driver moves margin most.

Evaluate a capital project using net present value, internal rate of return, payback, and profitability index, and reconcile cases where the methods rank projects differently.

Estimate a project's relevant cash flows, including working capital, tax effects, and depreciation shields, while excluding sunk and allocated costs.

Compute a weighted average cost of capital for a not-for-profit health system and explain how debt capacity and credit rating constrain the capital plan.

Perform sensitivity and scenario analysis on the discount rate and volume assumptions, and state the break-even discount rate.

Trace a claim from registration through coding, charge capture, adjudication, and payment, naming the failure point each denial reason points to.

Compute net patient revenue from gross charges by applying contractual allowances, denials, and collection rates, and explain the difference between gross and net reimbursement.

Compare fee-for-service, capitation, bundled, and shared-savings arrangements and quantify how each shifts financial risk between payer and provider.

Model the effect of a payer mix shift on net revenue and margin, and identify which payer contract terms most affect downside exposure.

Complete two full-length timed practice exams under exam conditions and log every missed question by domain and root cause.

Re-teach your five weakest concepts from scratch in writing, without consulting notes, and verify each against a source.

Drill the ratio, variance, and capital budgeting formulas from memory until you can produce them in under 60 seconds each.

Build a one-page personal formula and concept sheet and rehearse it until you can reconstruct it from memory.