NATHALIA
DISTRICT HOSPITAL
ANNUAL FINANCIAL
AND
PERFORMANCE REPORT
2009-10
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 1
NATHALIA DISTRICT HOSPITAL
VISION
To provide our Community with quality health
services in a pleasant, caring and safe
environment.
PUBLICATIONS
The following publication is a public document
and may be obtained by contacting the Chief
Executive Officer at the address listed above Annual Report 2009/2010 of the Nathalia District
Hospital.
MISSION
The Vision of Nathalia District Hospital is to be
an effective and creative provider of a caring and
quality focused health care service.
STATEMENT OF OBJECTIVES
Nathalia District Hospital is committed to:
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Maintaining Leadership and Management
strategies to comply with all relevant
standards and statutory requirements
Encouraging an environment which
promotes personal and professional
development
Responding to the needs of an everchanging environment within our community
Ensuring the Continuum of Care by
maintaining and improving services in a safe
and caring environment
Continuing to build on Community
awareness and support through the process
of consultation and planning
CONTACT DETAILS
Nathalia District Hospital
36-44 McDonell Street
Nathalia Victoria 3638
Telephone:
Facsimile:
Email:
Website:
03 58669444
03 58662042
nathalia@humehealth.org.au
www.nathalia.humehealth.com.au
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 2
In accordance with the Financial Management
Act 1994, I am pleased to present the Report of
Operations for Nathalia District Hospital for the
year ended 30 June 2010.
Nathalia District Hospital reports on its annual
performance in two separate documents. This
Annual Financial and Performance Report fulfills
the statutory reporting requirements to
Government by way of an Annual Report and the
Quality of Care Report reports on quality, risk
management and performance improvement
matters. Both documents are presented to the
Annual General Meeting and then distributed to
the community.
BOARD OF MANAGEMENT
CHAIR REPORT
friends in the Harbison Centre. To me, that’s all
that anyone involved in improving the service can
wish to hear and be part of.
Despite the turmoil of the shift, the usual round of
accreditation and inspection has continued. I’m
pleased to once again report on and thank staff
for the high results gained. The community has
come to expect us to be leaders in providing our
services in the Acute and Aged Care sections.
The new Medical Clinic has also been given high
praise for a fledgling business. Well done to
everyone.
As satisfying as the new building and services
mix is, we can’t sit back and just let it all move
past us however. The challenges of attracting
staff remain, as does the job of providing a
relevant and responsive service for our
community.
What a privilege and pleasure to be able to
present this report following our move to the new
site. This is the most significant of many
important achievements during my time as a
Board of Management member.
I hope we remain up to the task.
I have great pleasure in commending this report
to you.
To Leigh Giffard, Tim Elrington, Kris Andrews,
Peter Poon, John Drenen, the respective staff
teams at the Hospital, Hume Health, GV Health,
Nathalia Medical Clinic, the Board, and
everyone who worked so tirelessly, I offer
“Congratulations”, and “Thanks” from the
community.
ALAN SAGE
CHAIR
BOARD OF MANAGEMENT
Yours sincerely,
We thought the move would be challenging. I
don’t think we really suspected how much late
night, early morning and “days off” work was
needed to achieve the smooth shift. The way it
was executed and the settled feeling of the new
place so soon after was a tribute to the planning
and skill of our devoted team.
The new arrangements weren’t without some
downsides and difficulties. I thank everyone for
the way these were handled and the quick move
forward.
After a few months in the new Nursing Home, a
long-term resident and friend took me aside and
said emphatically, “I love it here!”. A few weeks
later, another resident and past Board member
celebrated his 80th birthday with his family and
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 3
RELEVANT MINSTER
Nathalia District Hospital is established under the
Health Services Act 1988. the responsible
Minister during the reporting period is the Hon.
Daniel Andrews MP, Minister for Health.
OBJECTIVES FUNCTIONS, POWERS AND
DUTIES
Objectives, Function, Powers and Duties of
Nathalia District Hospital are described in
Operational Practices and By-Laws of the
organization.
seen in Emergency, with 13% patients admitted
to our Hospital and 12% transferred to Goulburn
Valley Health as our primary referral hospital.
Statistically 64% of patients presenting were
seen by a Medical Officer within 10 minutes of
arrival. Considering there is no resident medical
officer and most presentations are after hours,
this figure is an excellent result.
Acute Care
Dr Poon and Dr Drenen have continued to
provide a dedicated service to Nathalia District
Hospital and the local community. Over the last
year we have been fortunate to continue the
service provided by Dr Wann and attract Dr
Huang to the medical team.
NATURE AND RANGE OF SERVICES
PROVIDED
Nathalia District Hospital continues to operate
under the Department of Health Small Rural
Health Services funding model. This model gives
the hospital flexibility to tailor services to meet
the changing needs of our community. These
programs are reviewed annually in consultation
with our community.
The Hospital services the residents of Nathalia
and District, which encompasses the small
townships and districts of Waaia, Barmah,
Picola, Kotupna, Bearii and Yalca. It provides a
24 hour emergency service with a medical
practitioner on call, and a range of services
within the acute care unit to cater for adults and
children. Outpatient services are conducted in
Radiology, Pathology, Physiotherapy, Speech
Pathology, Occupational Therapy, Dietetics, and
Generalist Counselling. Community Health staff
and District Nurses provide a wide range of
health promotion and domiciliary programs to our
community.
Discharge Planning processes are continually
monitored and reviewed to ensure our patients
receive the best available care to optimize their
health outcomes. Regular discharge planning
meetings identify appropriate referrals for
individual patients to get them well and home as
soon as possible. In 2009-2010 only 3 patients
were readmitted within 28 days of their previous
presentation.
Palliative Care
Our new Palliative Care Suite has been fitted out
using the very generous donations received from
our building fund. The area has a kitchenette,
fold out bed and its own garden; this allows
families to stay with their loved ones during an
acute episode or terminal stages of a patient’s
illness if the patient chooses a Hospital
admission. The District Nursing Service provides
the majority of palliative care services to clients
in their own home, with support from the Hume
Region Palliative Care Service.
Nathalia Medical Clinic
Residential Aged Care
Nathalia District Hospital commenced
management of the Nathalia Medical Clinic on 1st
March 2010. A practice manager has been
appointed to ensure the administration of the
practice runs smoothly. In addition a practice
nurse has been appointed to support the doctors
in their day to day work. The Nathalia Medical
Clinic successfully passed AGPAL accreditation
in June 2010.
Our residential aged care bed numbers were
expanded in November 2009 to 20 beds. The
brand new state of the art nursing home has all
single room accommodation for our residents
together with specialized support equipment
such as overhead tracking for lifting residents,
piped oxygen and data cabling to every room.
Emergency Department
The Hospital runs an Emergency Department
which operates twenty-four hours a day seven
days a week. Following the redevelopment of the
hospital, facilities have been extended and our
emergency department has grown to a three bed
unit. In the year 2009/2010, 193 patients were
Banawah continues to move with the times, and
is doing the majority of its residential
documentation on computer using the
Management Advantage Program.
Immediately after the relocation to McDonell
Street, the Aged Care Standards and
Accreditation Agency paid a support visit to our
residents and families to check on their progress.
Thank you to our residents and families who took
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 4
the time to speak with the assessors during their
visit. During the year we received one spot visit
to monitor the care we provide to our residents
and all visits had positive results.
Our Music Therapy and Massage Programs
continue to encourage resident’s sensory
awareness. Resident’s enjoy playing the musical
instruments purchased for the music therapy
program, having a massage and being involved
in the sensory therapy sound and light program.
The Resident Activity Program has been
reviewed and is currently undergoing some
changes. An activities coordinator has been
appointed who identifies suitable for each
resident. Every resident will have an activity
profile developed in conjunction with them and
their family. An individual program will be
recommended to ensure that the residents all get
to participate in activities of their choice.
Following on from the Sensory Therapy project
last year, all residents are given the opportunity
to participate in sensory therapy. Activities staff
are looking forward to having a designated
Activity Room in the new facility.
Throughout the year there have been varied
speakers and presentations at the resident
meetings and morning teas. Residents and
families are encouraged to participate in the daily
activities of the Nursing Home. A monthly
residents meeting is held and with the support of
family, volunteers and staff, areas identified for
improvement or any current issues are
discussed. Regular family morning teas and a
resident newsletter keep everyone informed
about changes that may affect them.
anaphylaxis management) and school health
programs.
Our Strength Training Program has been highly
successful and is suitable for people of all ages,
even those with chronic health problems.
Participating in regular Strength Training has
enabled participants to do physical activities
more easily in a supported environment. These
programs have run all year on Monday and
Thursdays.
Our District Nurse team has continued to deliver
high care to both our people community and
hospital in the home patients. This vital service
supports people to remain in their homes and
have much needed care provided by trained and
caring staff. This service operates seven days a
week.
EARLY INTERVENTION in CHRONIC
DISEASE (EIiCD) INITIATIVE
In early January 2009 five healthcare
organisations within Moira Shire lodged a joint
funding submission for the EIiCD initiatives being
offered across the state.
This partnership included:
 Cobram District Health
 Nathalia District Hospital
 Numurkah District Health Service
 Moira Healthcare Alliance
 Yarrawonga District Health Service
This submission was successful and these
organisations are now developing and delivering
EIiCD services from each site.
What is EIiCD?
We sincerely thank the volunteers who assist our
residents throughout the year. They continue to
provide much needed support and
companionship to our residents. The community
is reminded of the display of items in the foyer for
sale with proceeds funding the activities
program.
Community Health
Our Community Health Team have provided a
wide range of health promotion and health
prevention programs across all ages. Programs
run in 2009/2010include:
Women's Health clinics including pap tests /
cervical screening
Health screening for local businesses and a
presence at the local Nathalia Show and the
Easter Bushman’s Bash
Programs to assist clients to manage chronic
conditions (includes Asthma, Diabetes, QUIT,
EIiCD focuses upon community based early
intervention services for people with chronic
diseases. The initiative invests in both
Community Health Services and Primary Care
Partnerships.
The following principles underpin the initiative:
 Health care is person-centred care
 Consumers are active partners in the
management of their chronic disease
 Consumers have increased choice and
control
 The right care is provided at the right
place and the right time
 Good health is proactively promoted
 Population subgroups of greatest need
are targeted
 A whole of service system response is
developed
There is a shift towards early intervention, via
prevention, and self management principles for
clients with one or multiple chronic conditions.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 5
Rather than waiting for signs and symptoms to
become evident, or for an acute episode of
illness, learning about ways to understand,
accept and manage a condition/s is the goal of
early intervention services.
completing their medication endorsement and
Certificate III students in Aged Care
Staff across these organisations, (generally allied
health practitioners), have undergone training
with Health Coaching Australia. Health Coaching
is a practice in which health practitioners guide
clients to change health behavior and provides
techniques to assist them to follow through with
different treatment and lifestyle
recommendations, so that clients can achieve
better health outcomes.
All health services are working together in a
coordinated approach, endeavoring to provide
the same range of services, but perhaps from a
slightly different perspective. Practitioners will
ask you to become involved in decisions
concerning your health and management, giving
some ownership to those who have to live with
this condition/s.
In addition we have four trainees undertaking
Certificate IV in Health (Nursing) and continue to
support the upskill to Registered Nurse Division 1
through a partnership with Charles Sturt
University.
Community Involvement
Nathalia District Hospital was fortunate to have
had two community representatives involved in
the capital redevelopment program, Mr William
Kelly who took ownership of the arts program,
and Mrs Bev Pell as a community representative.
The open day several weeks before the move
was well attended by our community, with over
600 people taking the opportunity to look over
the new building before we moved in.
Allied Health
Nathalia District Hospital has been fortunate to
be able to provide a wide range of allied health
services to enhance our care. The following
Allied Health Services have been provided in
2009/2010 through the Department of Health
Small Rural health Service funding initiative:
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During 2009/10 two of our Registered Nurses
Division 1 successfully participated in the
Department of Health Advanced Practice
Certificate to assist the organization to manage
patient presentations in Emergency Department
when there is no doctor on call.
The official opening of the new Nathalia District
Hospital took place on the 5th February 2010,
when the Honorable Daniel Andrew opened the
new hospital in front of residents of our nursing
home, their families and more than 300
community members.
Physiotherapy
Dietetics
Speech Pathology
Occupational Therapy
Generalist Counseling
Volunteers
Support Services
The organization has been well supported in
2009/10 by a dedicated team of environmental
service, catering and maintenance staff
Education
Nathalia District Hospital has supported ongoing
professional development for many of its staff
over the 2009/2010 financial year.
Volunteers play a valuable role at Nathalia
District Hospital and help with a wide range of
programs. Banawah is fortunate to have an
active group of dedicated ladies who offer their
time and expertise to support our residents and
bring “home” into Banawah. The Planned
Activities Program relies on its volunteers to
support participants on numerous adventures to
make a difference to their lives. Regular
volunteer education were held during the year as
well as a thank you day to recognise the valuable
contribution they make to our organisation.
The organisation has taken work experience
students and VCAL students from Nathalia
Secondary College and St Mary of the Angel’s
Secondary College. It also has two students
complete their community service for the Duke of
Edinburgh Award.
Staff have mentored Registered Nurses Division
1 and 2 students, Medical students and taken
placement of Registered Nurses Division 2
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 6
GOVERNING BOARD
Administrative Support
The Board of Management is responsible for the
overall management and direction of the Hospital
and Nursing Home, and meetings are held on the
last Thursday of each month.
Administrator: Mr. Tim Elrington, Cert Bus, GDB
IR, AFCHSE, Cert IV Quality
Director of Medical Services
Dr. Bruce Warton, RFD, MBBS, BHA, Grad Dip
Health & Medical Law, DTM&H, AFCHSE, CHE,
FRCSEd, FRCOG, FRANZCOG, FRACMA
OFFICE BEARERS
President:
Mr. Alan Sage
Director of Finance & Corporate Services
Mr. Shaun Eldridge; B.Bus (Acc) M.B.A, C.P.A.
Senior Vice President:
Mr. Trevor Andrews (until March 2010)
Visiting Medical Officers
Junior Vice President:
Ms. Sue Logie
Dr. Peter Poon
B Med. Sc., MB.BS
Treasurer:
Mr. David Vaughan
Dr. John Drenen
MB.BS, Dip RACOG
Dr. Kyi Wann
MB.BS
OTHER MEMBERS:
Dr Jian Xuan Huang
MB.BS
Mr. Kevin Pell
Mrs Merrin Prictor
Mrs Bernadette Brooks
Mr David McKenzie
Executive Staff
Goulburn Valley Health’s Chief Executive Officer
fulfills the role of Chief Executive Officer of
Nathalia District Hospital and in that capacity is
responsible to the Board of Management for
administration of our Hospital. The Director of
Nursing is responsible for the day to day
operations of the Hospital with the support of the
Associate Director of Nursing.
Chief Executive Officer
Ms. Kerryn Healy, B Bus, CPA, AFCHSE, CHE,
FHFM
Director of Nursing/Manager
Mrs. Leigh Giffard, RN, RM, BN, Grad Dip
Advanced Nursing (Management), Master of
Health Service Management, MRCNA
Associate Director of Nursing
Mrs. Kristine Andrews; RN, BaHSc (Nursing),
Grad Dip Rural Health, Master of Rural Health,
MRCNA
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 7
ORGANISATIONAL CHART
Board of Management
Nathalia District Hospital & Banawah
Nursing Home
Director of
Medical
Services
Chief Executive Officer
Visiting Medical
Officers
Director of Nursing/Manager
Quality Coordinator
CLINICAL SERVICES
COMMUNITY HEALTH
SERVICES
Administrator
HOSPITALITY
SERVICES
NURSE UNIT
MANAGER
Emergency
Acute Care
Palliative Care
Radiology
Pathology
Residential Aged Care
Resident Lifestyle
ACFI Documentation
Community Health Coordinator
District Nurses
Diabetes Clinic
Planned Activity Group
Volunteer Coordination
Home & Community Care
Allied Health
Counselling Services
Visiting Services
Administrative Support
Health Information
Management
Stores
Catering
Cleaning
Laundry
Maintenance
Independent Living Units
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 8
QUALITY OF CARE REPORT
Welcome to Nathalia District Hospital’s eighth
Quality of Care Report. This report aims to
provide practical information about how we
monitor the quality and safety of the care and
services we provide to our community as well as
complying with the mandatory reporting
requirements set down by the Department of
Human Services.
We would like to highlight and share with you
areas of improvement and success. This report
will be distributed at our annual general meeting
and will be available in the foyer of the hospital
and on the Nathalia District Hospital website after
that. We would appreciate constructive feedback
to enable us to improve and expand into the
future.
HEALTH SERVICE GOVERNANCE
Our Board of Management developed their
strategic plan for the next three years in July
2009. The plan has 6 key achievement areas
identified:
 Service delivery
 Human resources
 Transition to the new facility
 Relationships and partnerships
 Sustainability and compliance
 Technology
71% of the strategic directions have
had strategies commenced to
implement the recommendation
The Patient Care Review Committee comprises
of a representative from our Community,
Medical, Nursing and Administration
representatives and all members of the Board of
Management. The Committee meets bi-monthly
and its function is to monitor the overall quality,
effectiveness, appropriateness and use of
services rendered to customers. Patient Care
Review Committee reviews policies, procedures
and relevant issues that impact upon patient care
and monitors health promotion, health education
and oversees the quality and risk management
systems.
One of the roles of the Patient Care Review
Committee is that of Medication Advisory. The
committee monitors compliance with drugs,
poisons and controlled substances used within
the organisation, and evaluates medication
incidents to ensure medication safety.
The other role of Patient Care Review Committee
is that of a Cultural Diversity Committee. It
ensures culturally appropriate care is delivered
by recognising and responding to cultural
diversity in our community.
CONSUMER PARTICIPATION
Nathalia District Hospital values feedback from
consumers as a means to identify areas for
improvement as identified by the consumers of
our service. Feedback is sought through
satisfaction surveys, comments, suggestions,
complaints and focus groups. Consumers have
excellent knowledge and experience of their own
health in regards to how their condition affects
them, how they cope and feel, whilst still relying
on clinical expertise for treatment, healthcare
planning and education.
A community representative sits on the Patient
Care Review Committee of the Board of
Management which meets second monthly. We
have been fortunate to have two community
representatives on our relocation planning
committee who have provided valuable feedback
about the appropriateness of the building.
During the 2009 Australia Council on Healthcare
Standards organization wide survey, the
organization received a Moderate Achievement
rating for seeking input from consumers, carers
and community in planning, delivering and
evaluating the health service.
Wave 17 of the Victorian Patient
Satisfaction Monitor showed 100% of
consumers were happy with their
involvement in care decisions.
recommendation
DEALING WITH COMPLAINTS
Nathalia District Hospital has a policy of open
disclosure when dealing with complaints under
the guidelines of the Australian Quality and
Safety Council. Every complaint is taken
seriously and dealt with as soon as possible.
Complaints may be verbal or written and may be
made anonymously. The Quality Coordinator
oversees our complaints process. Complaints
are a measure for us to improve our service
provision and in this respect are always
welcomed.
Nathalia District Hospital received 9
complaints during 2009/2010, five of
these related to patient care. All
complaints were addresses within 7
days.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 9
RISK MANAGEMENT
AUSTRALIAN COUNCIL ON HEALTHCARE
STANDARDS
Nathalia District Hospital has a comprehensive
Quality and Risk Management Program to
manage quality and safety across the
organisation. The program identifies both clinical
and non clinical risks and provides strategies to
manage the safety of people, the protection of
buildings, contents and other physical assets and
the protection of our financial assets. Potential
risks to our organisation are identified and
monitored and the strategies to effectively reduce
the risk to the organisation are clarified.
The Australian Council on Healthcare Standards
Periodic Review was conducted in September
2009 in which the 14 mandatory criteria were
reviewed. The results were excellent, with 11
Moderate Achievements and 3 Extensive
Achievement ratings being received. This
ensured our accreditation status for the next two
years.
Key performance indicators are in place to assist
management to monitor all identified risks; these
are reported to the Board of Management, staff
and residents monthly. An additional risks added
to our Risk Register was legibility of
documentation and asbestos management has
been removed since the hospital has relocated to
the Greenfield site.
Monitoring of the accreditation for HACC service
standards is now being undertaken by the
Australian Council on Healthcare Standards.
Nathalia District Hospital District Nursing Service
was accredited in September 2009 with a perfect
20/20 score.
SENTINEL AND LIMITED ADVERSE
OCCURENCES
CLINICAL PERFORMANCE INDICATORS
Nathalia District Hospital participates in the
Sentinel Events and Limited Adverse Occurrence
Screening programs which are reported to the
Department of Health. Sentinel events are
serious events that may result in adverse patient
outcomes. We are pleased to report that no
Sentinel Events have occurred at Nathalia
District Hospital in 2009/2010.
Our local medical officers are involved in the
peer review process of the Limited Adverse
Occurrence Screening (LAOS) program. The
information is collected through a review of
patient care and outcomes and is used to identify
opportunities to improve the quality and safety of
care and promote best practice. Their
participation is ongoing.
ACCREDITATION PROCESSES
AGED CARE STANDARDS AND
ACCREDITATION AGENTY
The Aged Care Standards and Accreditation
Agency conducted an accreditation survey of
Banawah in June 2009. In October, Banawah
received an unannounced support visit and in
December a scheduled support visit from the
Agency. At each visit our nursing home was
found compliant in all 44 standards.
HOME AND COMMUNITY CARE NATIONAL
SERVICE STANDARDS
Clinical indicators are measures of the outcomes
of patient/resident care. By measuring specific
outcomes we are able to monitor and assess the
effectiveness of the care we provide, thus
identifying areas of excellence and areas for
potential improvement.
As a means of maintaining best practice
standards, Nathalia District Hospital is a member
of the Quality Management Network. This is a
group of E-sized hospitals that meet on a
quarterly basis to evaluate the quality of care we
provide. This group has grown over the past five
years and now consists of eight member
hospitals.
As a result of the benchmarking
partnership it was identified that
clients may fall from a low blood
sugar level, so all patients who fall
now have the blood sugar level
checked.
MEDICATION SAFETY
All nursing staff are required to demonstrate
competency in safe medication administration
annually. Medication safety is monitored
continuously through our hazard identification
reporting system. The aim of this program is to
reduce both medication errors and medication
signing omissions.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 10
The Quality Coordinator evaluates each
medication error and looks at the effect the error
had on the patient’s well being. This is reported
back to staff at the monthly quality meetings and
to Medical Officers through Patient Care Review
Committee.
24 medication incidents were reported
in the 2009/2010 period with the
majority of the errors being wrong
dose or wrong strength.
FALLS PREVENTION
The Falls Prevention Program remains effective
in both the nursing home, the hospital and the
client’s own home. The focus of our program is to
reduce the number of falls which occur and
reduce the severity of injury occurring in the
event that a client falls.
Monitoring of the program has seen a change in
focus to measure the number of clinical
interventions required as a result of a fall. This
would include suturing of lacerations, wound care
and x-rays. Falls sustained in our nursing home
are 50% less than the State average.
INFECTION CONTROL
Nathalia District Hospital has a well established
Infection Control Program. All employees use
standard and additional infection control
precautions in line with the National Health and
Medical Research Council recommendations.
The infection control program reviews all
episodes of infection, whether patients are
admitted with an infection or acquired it whilst in
hospital. All results are reported to the
Department of Health through the VICNISS
program. All staff, residents and volunteers
complete education in the areas of waste
disposal and hand hygiene.
HAND HYGIENE
The Hand Hygiene Program remains a vital link
to the prevention of spread of infection at
Nathalia District Hospital. Audit results have
been excellent with compliance rates over 80%.
Hand hygiene compliance is audited every 4
months and results reported to the Department of
Health.
CLEANING
Two staff have completed the external cleaning
auditor course as funded by the Department of
Health in late 2009. In compliance with the new
hospital cleaning standards monthly audits
commenced in January 2010.
47 falls were recorded in 2009/2010,
with 27.7% of those falls resulting in a
skin tear for the patient. There were
no fractures or serious injuries
sustained.
PRESSURE ULCER PREVALENCE
Both patients and residents are monitored for
pressure ulcer development through the
Pressure Ulcer Point Prevalence (PUPPS)
Program. This is a state wide clinical indicator
which is reported to the Department of Health on
a quarterly basis.
Staff are trained in early recognition of pressure
ulcers and are provided with the knowledge to
implement early preventative measures. All beds
are fitted with special pressure mattresses and
staff have the additional option to fit an electric
pressure relieving mattress to beds if they
assess the client as high risk.
No Stage 3 or 4 pressure ulcers have
occurred at Nathalia District Hospital
in 2009/2010. Our pressure ulcer
prevalence rate remains under the
State average.
Average score for at internal cleaning
audit for January – June 2010 was
90.9% and external audit 98%.
OCCUPATIONAL HEALTH AND SAFETY
The health and safety of our staff, residents,
patients and visitors is paramount in our
organization and we work diligently towards
creating and maintaining a safe environment for
everyone.
Occupational Health and Safety is supported by
an appropriate incident and hazard identification
system in a ‘No Blame’ environment and
implementation of quality risk management
strategies in such areas as manual handling and
fire safety education.
Our staff also complete training in the Hume
Region supported program to address
occupational violence in the workplace.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 11
WORKFORCE DATA
SUMMARY OF FINANCIAL RESULTS FOR
THE YEAR
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 12
SIGNIFICANT CHANGES IN FINANCIAL POSITION
OPERATIONAL & BUDGETARY OBJECTIVES
FACTORS AFFECTING THE ACHIEVEMENT OF OPERATIONAL OBJECTIVES
EVENTS SUBSEQUENT TO BALANCE DATE
CONSULTANCIES
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 13
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 14
COMPLIANCE WITH OCCUPATIONAL HEALTH AND SAFETY MATTERS
Two visits by Worksafe Victoria in 2009/10 did not identify any issues of concern.
There were 10 work injuries recorded for 2009/2010 with 3 days time lost.
SUMMARY OF THE BUILDING ACT 1993
Nathalia District Hospital has a plan in place to ensure compliance with the provisions of the Building Act
1993.
During 2009-2010 the following have been undertaken:
Nathalia District Hospital Redevelopment Project
Demolition of the old Nathalia District Hospital in Elizabeth Street, Nathalia
Assessment
Fire Safety Certificates of Compliance were supplied to the Department of Human Services for the
following sites:
36-44 McDonell Street, Nathalia 3638
Occupancy Permits and Certificates of Final Inspection
An occupancy permit was issued by Brian Sherwell and Associates on 24 November 2009 for the Nathalia
District Hospital Redevelopment at 36-44 McDonell Street Nathalia 3638. The Occupancy Permit number
was 1009/003523.
Essential Safety Measures
FREEDOM OF INFORMATION ACT 1982
There were no formal requests for information were received by Nathalia District Hospital under the above
Act during 2009/2010.
WHISTLEBLOWERS PROTECTION ACT 2001
Nathalia District Hospital has established a reporting framework for whistleblower disclosures and has
instituted written procedures for handling them. There were no protected disclosures under the Act during
2009/2010.
NATIONAL COMPETITION POLICY
The Hospital complied with all government policies regarding competitive neutrality in regard to tender
applications.
VICTORIAN INDUSTRY PARTICIPATION POLICY
Nathalia District Hospital abides by the principles of the Victorian Industry Participation Policy.
In 2009-2010 the following project commenced:
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 15
.
.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 16
In compliance with the requirements of the Standing Directions of the Minister for Finance details in
respect of the items listed below have been retained by Nathalia District Hospital and are available to the
relevant Minister, Members of Parliament and the public on request
(a) Declarations of pecuniary interests has been completed;
(b) Details of shares held by senior officers as nominee or held beneficially;
(c) Details of publications produced by the
Department about the activities of the Health
Service
and where they can be obtained.
(d) Details of changes in prices, fees, charges, rates and levies charged by the Health Service;
(e) Details of any major external reviews carried
out on the Health Service;
(f) Details of major research and development activities undertaken by the Health Service
that are
not otherwise covered either in the
Report of Operations or in a document that
contains
the
financial statements and Report of Operations.
(g) Details of overseas visits undertaken
including a summary of the objectives and
outcomes of each visit;
(h) Details of major promotional public relations and marketing activities undertaken to develop
community awareness of Nathalia
District Hospital and its services;
(i) Details of assessments and measures
undertaken to improve occupational
health and
safety of Nathalia District Hospital
employees;
(j) General statement on industrial relations
within Nathalia District Hospital and details of
time lost
through industrial accidents and disputes; and
(k) A list of major committees sponsored by
Nathalia District Hospital the purpose of each
committee and the extent to which the
purposes have been achieved.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 17
ATTESTATION OF DATA INTEGRITY
I, Kerryn Margaret Healy certify that Nathalia District Hospital has put in place appropriate internal
controls and processes to ensure that reported data reasonably reflects actual performance.
Nathalia District Hospital has critically reviewed these controls and processes during the year.
Kerryn Margaret Healy
CHIEF EXECUTIVE OFFICER
June 2010
ATTESTATION OF COMPLIANCE WITH AUSTRALIAN/NEW ZEALAND RISK MANAGEMENT
STANDARD
I, Kerryn Margaret Healy certify that Nathalia District Hospital has risk management processes in
place consistent with the Australian/New Zealand Risk Management Standard and an internal
control system is in place that enables the executives to understand, manage and satisfactorily
control risk exposures. The audit committee verifies this assurance and that the risk profile of
Nathalia District Hospital has been critically reviewed within the last 12 months.
Kerryn Margaret Healy
CHIEF EXECUTIVE OFFICER
June 2010
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 18
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 19
DISCLOSURE INDEX
The annual report of Nathalia District Hospital is prepared in accordance with all relevant Victorian
legislation. This index has been prepared to facilitate identification of the Department's compliance
with statutory disclosure requirements.
Legislation
Requirement
Page Reference
Ministerial Directions
Report of Operations
Charter and purpose
FRD 22B
Manner of establishment and the relevant Ministers
FRD 22B
Objectives, functions, powers and duties
FRD 22B
Nature and range of services provided
Management and structure
FRD 22B
Organisational structure
Financial and other information
FRD 10
Disclosure index
FRD 11
Disclosure of ex-gratia payments
FRD 21A
Responsible person and executive officer disclosures
FRD 22B
Application and operation of Freedom of Information Act 1982
FRD 22B
Application and operation of Whistleblowers Protection Act 2001
FRD 22B
Compliance with building and maintenance provisions of Building Act 1993
FRD 22B
Details of consultancies over $100,000
FRD 22B
Details of consultancies under $100,000
FRD 22B
Major changes or factors affecting performance
FRD 22B
Occupational health and safety
FRD 22B
Operational and budgetary objectives and performance against objectives
FRD 22B
Significant changes in financial position during the year
FRD 22B
Statement of availability of other information
FRD 22B
Statement of merit and equity
FRD 22B
Statement on National Competition Policy
FRD 22B
Subsequent events
FRD 22B
Summary of the financial results for the year
FRD 22B
Workforce Data Disclosures
FRD 25
Victorian Industry Participation Policy disclosures
SD 4.2(j)
Report of Operations, Responsible Body Declaration
SD 4.5.5
Attestation on Compliance with Australian/New Zealand Risk Management Standard
Financial Statements
Financial statements required under Part 7 of the FMA
SD 4.2(a)
SD 4.2(b)
SD 4.2(b)
SD 4.2(b)
SD 4.2(b)
SD 4.2(c)
SD 4.2(c)
SD 4.2(d)
Compliance with Australian accounting standards and other authoritative pronouncements
Comprehensive Operating Statement
Balance Sheet
Statement of Changes in Equity
Cash Flow Statement
Accountable officer’s declaration
Compliance with Ministerial Directions
Rounding of amounts
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 20
Legislation
Requirement
Page Reference
Legislation
Freedom of Information Act 1982
Whistleblowers Protection Act 2001
Victorian Industry Participation Policy Act 2003
Building Act 1993
Financial Management Act 1994
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 21
Nathalia District Hospital
Board member's, accountable officer's and chief
finance & accounting officer's declaration
We certify that the attached financial statements for
Nathalia District Hospital have been prepared in accordance
with Standing Direction 4.2 of the Financial Management
Act
1994,
applicable
Financial
Reporting
Directions,
Australian Accounting Standards, Australian Accounting
Interpretations and other mandatory professional reporting
requirements.
We further state that, in our opinion, the information set out
in the Comprehensive Operating Statement, Balance Sheet,
Statement of Changes in Equity, Cash Flow Statement and
notes to and forming part of the financial statements,
presents fairly the financial transactions during the year
ended 30 June 2010 and the financial position of Nathalia
District Hospital at 30 June 2010.
We are not aware of any circumstance which would render
any particulars included in the financial statements to be
misleading or inaccurate.
Alan Edward Sage
Kerryn Margaret Healy
Shaun Andrew Eldridge
Board Chair
Chief Executive Officer
Director Finance &
Nathalia
Shepparton
Corporate Services
Shepparton
June 2010
June 2010
June 2010
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 22
AUDITOR GENERAL REPORT
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 23
AUDITOR GENERAL REPORT
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 24
OPERATING STATEMENT
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 25
BALANCE SHEET
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 26
STATEMENT OF CHANGES IN EQUITY
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 27
CASH FLOW STATEMENT
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 28
Goulburn Valley Health
Notes to the Financial Statements
30 June 2010
Note 1: Statement of Significant Accounting Policies
(a)
Statement of compliance
These financial statements are a general purpose financial report which have been prepared in
accordance with the Financial Management Act 1994 and applicable Australian Accounting
Standards (AASs) and Australian Accounting Interpretations and other mandatory requirements.
AASs include Australian equivalents to International Financial Reporting Standards.
The financial statements also complies with relevant Financial Reporting Directions (FRDs) issued
by the Department of Treasury and Finance, and relevant Standing Directions (SDs) authorised by
the Minister for Finance.
The Health Service is a not-for profit entity and therefore applies the additional Aus paragraphs
applicable to "not-for-profit" Health Services under the AAS's.
(b)
Basis of accounting preparation and measurement
The accounting policies set out below have been applied in preparing the financial statements for
the year ended 30 June 2010, and the comparative information presented in these financial
statements for the year ended 30 June 2009.
Accounting policies are selected and applied in a manner which ensures that the resulting financial
information satisfies the concepts of relevance and reliability, thereby ensuring that the substance
of the underlying transactions or other events is reported.
The going concern basis was used to prepare the financial statements.
The financial statements, except for cash flow information, have been prepared using the accrual
basis of accounting. Under the accrual basis, items are recognised as assets, liabilities, equity,
income or expenses when they satisfy the definitions and recognition criteria for those items, that
is they are recognised in the reporting period to which they relate, regardless of when cash is
received or paid.
The financial statements are prepared in accordance with the historical cost convention, except for
the revaluation of certain non-financial assets and financial instruments, as noted. Particularly,
exceptions to the historical cost convention include:



Non-current physical assets, which subsequent to acquisition, are measured at valuation and
are re-assessed with sufficient regularity to ensure that the carrying amounts do not
materially differ from their fair values;
Derivative financial instruments, managed investment schemes, certain debt securities, and
investment properties after initial recognition, which are measured at fair value through profit
and loss; and
Available-for-sale investments which are measured at fair value with movements reflected in
equity until the asset is derecognised.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 29
Goulburn Valley Health
Notes to the Financial Statements
30 June 2010
In the application of AASs management is required to make judgments, estimates and assumptions
about carrying values of assets and liabilities that are not readily apparent from other sources. The
estimates and associated assumptions are based on historical experience and various other factors
that are believed to be reasonable under the circumstances, the results of which form the basis of
making the judgments. Actual results may differ from
these estimates.
The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to
accounting estimates are recognised in the period in which the estimate is revised if the revision
affects only that period or in the period of the revision, and future periods if the revision affects
both current and future periods.
(c)
Reporting Entity
The financial statement includes all the controlled activities of Goulburn Valley Health.
Its principle address is:
Graham Street
Shepparton
Victoria 3630.
All amounts shown in the financial statements are expressed to the nearest $1,000 <if total
assets, or revenue, or expenses are less than $10 million, amounts must be rounded off to
the nearest dollar> unless otherwise stated.
(e)
Functional and Presentation Currency
The presentation currency of Goulburn Valley Health is the Australian dollar, which has also
been identified as the functional currency of the Health Service.
(f)
Change in Accounting Policies
Where there has been a change in Accounting Policy,
disclose: (a) the nature of the change in accounting policy;
(b) the amount of each item/class of item affected by the change in policy; and
(c) the reason for the change in policy.
When it is impractical to implement a change in policy, disclose:
(d) the reason for not for not implementing the change in policy; and
(e) the nature of adjustments that would have been in made if the change in accounting
policy had been implemented.
When comparative amounts are reclassified,
disclose: (a) the nature of the classification;
(b) the amount of each item or class of items that is reclassified; and
(c) the reason for the classification.
When it is impracticable to reclassify comparative amounts, disclose:
(d) the reason for not reclassifying the amounts; and
(e) the nature of the adjustments that would have been made if the amounts had been
reclassified.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 30
ABC Health
Service Notes to
the Financial
Statements 30
June 2010
(h)
Principles of Consolidation
The assets, liabilities, incomes and expenses of all controlled entities of
Goulburn Valley Health have been included at the values shown in their audited
Annual Financial statements. Subsidiaries are entities controlled by Goulburn
Valley Health control exists when Goulburn Valley Health has the power to
govern the financial and operating policies of an entity so as to obtain benefits
from its activities. In assessing control, potential voting rights that presently are
exercisable are taken into account. Any inter-entity transactions have been
eliminated on consolidation. The consolidated financial statements include the
audited financial statements of the controlled entities listed in note 30.
(i)
Cash and Cash Equivalents
Cash and cash equivalents comprise cash on hand and cash at bank, deposits
at call and highly liqUid investments with an original maturity of 3 months or
less, which are readily convertible to known amounts of cash and are subject to
insignificant risk of changes in value.
For the cash flow statement presentation purposes, cash and cash equivalents
includes bank overdrafts, which are included as current interest bearing liabilities in
the balance sheet.
(j)
Receiveables
Trade debtors are carried at nominal amounts due and are due for settlement within
30 days from the date of recognition. Collectability of debts is reviewed on an
ongoing basis, and debts which are known to be uncollectible are written off. A
provision for doubtful debts is recognised when there is objective evidence that an
impairment loss has occured. Bad debts are written off when identified.
Receivables are recognised initially at fair value and subsequently measured
at amortised cost, using the effective interest method, less any accumulated
impairment.
(k)
Inventories
Inventories include goods and other property held either for sale, consumption
or for distribution at no or nominal cost in the ordinary course of business
operations. It includes land held for sale and excludes depreciable assets.
Inventories held for distribution are measured at cost, adjusted for any loss of
service potential. All other inventories, including land held for sale, are measured
at the lower of cost and net realisable value.
The bases used in assessing loss of service potential for inventories held for
distribution include current replacement cost and technical or functional
obsolescence. Technical obsolescence occurs when an item still functions for
some or all of the tasks it was originally acquired to do, but no longer matches
existing technologies. Functional obsolescence occurs when an item no longer
functions the way it did when it was first acquired.
Cost is assigned to land for sale (undeveloped, under development and
developed) and to other high value, low volume inventory items on a specific
identification of cost basis (identify classes).
Cost for all other inventory is measured on the basis of weighted
average cost. Inventories acquired for no cost or nominal
considerations are measured at current replacement cost at the date
of acquisition.
Cost of Goods Sold
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 31
Costs of goods sold are recognised when the sale of an item occurs by
transferring the cost or value of the item/s from inventories.
(l)
Investment and Other Financial Assets
Other financial assets are recognised and derecognised on trade date where
purchase or sale of an investment is under a contract whose terms require
delivery of the investment within the timeframe established by the market
concerned, and are initially measured at fair value, net of transaction costs.
Goulburn Valley Health classifies its other financial assets between current
and noncurrent assets based on the purpose for which the assets were
acquired. Management determines the classification of its other financial
assets at initial recognition.
Goulburn Valley Health assesses at each balance sheet date whether a
financial asset or group of financial assets is impaired.
All financial assets, except those measured at fair value through profit and loss
are subject to annual review for impairment.
Financial assets at fair value through profit or loss
Financial assets held for trading purposes are classified as current assets and
are stated at fair value, with any resultant gain or loss recognised in profit or
loss. The net gain or loss recognised in profit or loss incorporates any dividend
or interest earned on the financial asset. Fair value is determined in the
manner described in Note 23.
(omit if not applicable)
(If a Health Service has reclassified any financial assets from this category into
loans and receivables category in accordance with AASB 2008-10, that fact
may be disclosed in this section of the policy note. Health Services should
discuss any proposed reclassifications with their VAGO representative at an
early stage as any change is dependent upon satisfying certain restrictive
conditions in the accounting standard).
Loans and receiveables
Trade receivables, loans and other receivables are recorded at amortised cost,
using the effective interest method, less impairment. Term deposits with maturity
greater than three months are also measured at amortised cost, using the effective
interest method, less impairment.
The effective interest method is a method of calculating the amortised cost of a
financial asset and of allocating interest income over the relevant period. The effective
interest rate is the rate that exactly discounts estimated future cash receipts through
the expected life of the financial asset, or, where appropriate, a shorter period.
(omit if not applicable)
Held-to-maturity investments
Where the Health Service has the positive intent and ability to hold investments to
maturity, they are measured at amortised cost less impairment losses.
(omit if not applicable)
Available-for-sale
financial assets
Other financial assets held by the Health Service are classified as being availablefor-sale and are measured at fair value. Gains and losses arising from changes in fair
value are recognised directly in equity until the investment is disposed of or is
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 32
determined to be impaired, at which time the cumulative gain or loss previously
recognised in equity is included in profit or loss for the period. Fair value is
determined in the manner described in Note 23.
(omit if not applicable)
(m) Intangible Assets
Intangible assets represent identifiable non-monetary assets without physical
substance such as patents, trademarks, and computer software and development
costs (where applicable).
Intangible assets are initially recognised at cost. Subsequently, intangible assets
with finite useful lives are carried at cost less accumulated amortisation and
accumulated impairment losses. Costs incurred subsequent to initial acquisition
are capitalised when it is expected that additional future economic benefits will flow
to the Health Service.
Amortisation is allocated to intangible assets with finite useful lives on a systematic
(typically straight-line) basis over the asset's useful life. Amortisation begins when the
asset is available for use, that is, when it is in the location and condition necessary
for it to be capable of operating in the manner intended by management. The
amortisation period and the amortisation method for an intangible asset with a finite
useful life are reviewed at least at the end of each annual reporting period. In
addition, an assessment is made at each reporting date to determine whether there
are indicators that the intangible asset concerned is impaired. If so, the assets
concerned are tested as to whether their carrying value exceeds their recoverable
amount.
Intangible assets with indefinite useful lives are not amortised, but are tested for
impairment annually or whenever there is an indication that the asset may be
impaired. The useful lives of intangible assets that are not being amortised are
reviewed each period to determine whether events and circumstances continue to
support an indefinite useful life assessment for that asset. In addition, the entity tests
all intangible assets with indefinite useful lives for impairment by comparing the
recoverable amount for each asset with its carrying amount:
 annually, and
 whenever there is an indication that the intangible asset may be impaired.
Any excess of the carrying amount over the recoverable amount is recognised as
an impairment loss. (Impairment losses may be reversed. See page 39 of these
gUidelines for further guidance).
Intangible assets with finite useful lives are amortised over a 10-15 year period
(2009: 1015 years).
(n)
Property, Plant and Equipment
Crown Land is measured at fair value with regard to the property's highest and
best use after due consideration is made for any legal or constructive
restrictions imposed on the asset, public announcements or commitments
made in relation to the intended use of the
asset. Theoretical opportunities that may be available in relation to the asset(s) are not
taken into account until it is virtually certain that any restrictions will no longer apply.
Land and Buildings are recognised initially at cost and subsequently measured
at fair value less accumulated depreciation and impairment.
Land Under Declared Roads acquired subsequent to 1 July 2008 is measured
at fair value. Land under declared roads acquired on, or after 1 July 2008 is
measured initially at cost of acquisition and subsequently at fair value. (Please
refer to AASB 1051 Land Under Roads and FRD 118B Land Under Declared
Roads for further details).
[Note for Health Services who have adopted the option in AASB 1051 to not
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 33
recognise land under roads acquired on or after 1 July 2008, and who are now
required to recognise this asset due to the State's new policy to recognise all land
under roads must recognise and represent this as a change in accounting policy,
including presenting a third balance sheet. AASB 1051 Land Under Roads provides
the option to recognise or not recognise land under roads acquired prior to 1 July
2008. The methodology applied to determine initial cost is based on discounted site
values for relevant municipal areas applied to land area under the arterial road
network, including related reservations. The disclosure requirements of AASB 108:
Accounting Policies, Changes in Accounting Estimates and Errors for change in
accounting policy is required to be disclosed}.
Plant, Equipment and Vehicles are recognised initially at cost and
subsequently measured at fair value less accumulated depreciation and
impairment. Depreciated historical cost is generally a reasonable proxy for
depreciated replacement cost because of the short lives of the assets
concerned.
Cultural, Collections, Heritage Assets and Other Non-Current
Physical Assets that the State intends to preserve because of their
unique historical, cultural or environmental attributes are measured at the
cost of replacing the asset less, where applicable, accumulated
depreciation calculated on the basis of such cost to reflect the already
consumed or expired future economic benefits of the asset.
Restrictive nature of cultural and heritage assets, Crown land and
infrastructure assets during the reporting period, the Health Service
may hold cultural assets, heritage assets, Crown land and infrastructure
assets.
Such assets are deemed worthy of preservation because of the social rather
than financial benefits they provide to the community. The nature of these
assets means that there are certain limitations and restrictions imposed on
their use and/or disposal.
(0)
Revaluations of Non-current Physical Assets
Non-current physical assets are measured at fair value and are revalued in
accordance with FRD 103D Non-current physical assets. This revaluation
process normally occurs at least every five years, based upon the asset's
Government Purpose Classification, but may occur more frequently if fair value
assessments indicate material changes in values. Independent valuers are used to
conduct these scheduled revaluations and any interim revaluations are determined
in accordance with the requirements of the FRDs. Revaluation increments or
decrements arise from differences between an asset's carrying value and fair value.
Revaluation increments are credited directly to the asset revaluation surplus, except
that, to the extent that an increment reverses a revaluation decrement in respect of
that same class
of asset previously recognised as an expense in net result, the increment is
recognised as income in the net result.
Revaluation decrements are recognised immediately as expenses in the net result,
except that, to the extent that a credit balance exists in the asset revaluation
surplus in respect of the same class of assets, they are debited directly to the
asset revaluation surplus.
Revaluation increases and revaluation decreases relating to individual assets within
an asset class are offset against one another within that class but are not offset in
respect of assets in different classes.
Revaluation surplus are normally not transferred to accumulated funds on
derecognition of the relevant asset.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 34
In accordance with FRD 103D, <ABC Health Service's> non-current physical
assets were assessed to determine whether revaluation of the non-current
physical assets was required.
(p)
Investment Property
Investment properties represent properties held to earn rentals or for capital
appreciation or both. Investment properties exclude properties held to meet
service delivery objectives of the State of Victoria.
Investment properties are initially recognised at cost. Costs incurred
subsequent to initial acquisition are capitalised when it is probable that future
economic benefits in excess of the originally assessed performance of the
asset will flow to the Health Service.
Subsequent to initial recognition at cost, investment properties are revalued to
fair value, determined annually by independent valuers. Changes in the fair
value are recognised as income or expenses in the period that they arise.
Investment properties are not depreciated.
Rental revenue from leasing of investment properties is recognised in the
Comprehensive Operating Statement in the periods in which it is receivable on
a straight line basis over the lease term.
(q)
Non Current Assets Classified as Held for Sale
Non-current assets (including disposal groups) classified as held for sale are
measured at the lower of carrying amount and fair value less costs to sell, and
are not subject to depreciation.
Non-current assets and disposal groups and related liabilities are treated as
current and are classified as held for sale if their carrying amount will be
recovered through a sale transaction rather than through continuing use. This
condition is regarded as met only when the sale is highly probable and the
asset's sale (or disposal group) is expected to be completed within 12 months
from the date of classification.
(r)
Depreciation
Assets with a cost in excess of $1,000 (2008-09 and 2009-10) are capitalised and
depreciation has been provided on depreciable assets so as to allocate their cost or
valuation over their estimated useful lives. Depreciation is generally calculated on a
straight line basis, at a rate that allocates the asset value, less any estimated residual
value over its estimated useful life. Estimates of the remaining useful lives and
depreciation method for all assets are reviewed at least annually. This
depreciation charge is not funded by the Department of Health.
Depreciation is provided on property, plant and equipment, including freehold
bUildings, but excluding land and investment properties. Depreciation begins when
the asset is available for use, which is when it is in the location and condition
necessary for it to be capable of operating in a manner intended by management.
The following table indicates the expected useful lives of non current assets
on which the depreciation charges are based.
As part of the Buildings valuation, building values were componentised and each
component assessed for its useful life which is represented above.
(Note: should the health service change the useful lives arising from 2008-09
revaluations, a note will need to be included to explain the change in Note
l(at) with a reference to Note 33. Correction of error.)
(s)
Net gain/(Loss) on Non-Financial Assets
Net gain/(loss) on non-financial assets includes realised and unrealised gains and
losses from revaluations, impairments and disposals of all physical assets and
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 35
intangible assets.
Disposal of Non-Financial Assets
Any gain or loss on the sale of non-financial assets is recognised at the date
that control of the asset is passed to the buyer and is determined after deducting
from the proceeds the carrying value of the asset at that time.
Impairment of Non-Financial Assets
Apart from intangible assets with indefinite useful lives, all other assets are
assessed annually for indications of impairment, except for (delete items if not
applicable to the Health Service):
 inventories;
 financial assets;
 investment properties that are measured at fair value;
 non-current physical assets held for sale; and

assets arising from construction contracts.
If there is an indication of impairment, the assets concerned are tested as to whether
their carrying value exceeds their possible recoverable amount. Where an asset's
carrying value exceeds its recoverable amount, the difference is written-off as an
expense except to the extent that the write-down can be debited to an asset
revaluation surplus amount applicable to that same class of asset.
It is deemed that, in the event of the loss of an asset, the future economic
benefits arising from the use of the asset will be replaced unless a specific
decision to the contrary has been made. The recoverable amount for most
assets is measured at the higher of depreciated replacement cost and fair value
less costs to sell. Recoverable amount for assets held primarily to generate net
cash inflows is measured at the higher of the present value of future cash flows
expected to be obtained from the asset and fair value less costs to sell.
(t)
Net Gain/(Loss) on Financial Instrument
Net gain/(loss) on financial instruments includes realised and unrealised gains
and losses from revaluations of financial instruments that are designated at fair
value through profit or loss or held-for-trading, impairment and reversal of
impairment for financial instruments at amortised cost, and disposals of financial
assets.
Revaluations of Financial Instrument at Fair Value
The revaluation gain/(loss) on financial instruments at fair value excludes
dividends or interest earned on financial assets.
Impairment of Financial Assets
Financial Assets have been assessed for impairment in accordance with Australian
Accounting Standards. Where a financial asset's fair value at balance date has
reduced by 20 per cent or more than its cost price; or where its fair value has been
less than its cost price for a period of 12 or more months, the financial instrument is
treated as impaired.
In order to determine an appropriate fair value as at 30 June 2010 for its portfolio of
financial assets, <ABC Health Service> obtained a valuation based on the best
available advice using an estimated [insert appropriate valuation method] through a
reputable financial institution. This value was compared against valuation
methodologies provided by the issuer as at 30 June 2010. These methodologies were
critiqued and considered to be consistent with standard market valuation techniques.
Prices obtained from both sources were compared and were generally consistent
with the full portfolio. The above valuation process was used to quantify the level of
impairment on the portfolio of financial assets as at year end.
(u)
Payables
These amounts consist predominantly of liabilities for goods and services.
Payables are initially recognised at fair value, and then subsequently carried at
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 36
amortised cost and represent liabilities for goods and services provided to the
Health Service prior to the end of the financial year that are unpaid, and arise
when the Health Service becomes obliged to make future payments in respect of
the purchase of these goods and services.
The normal credit terms are usually Nett 30 days.
(v)
Provisions
Provisions are recognised when the Health Service has a present obligation, the
future sacrifice of economic benefits is probable, and the amount of the
provision can be measured reliably.
The amount recognised as a provision is the best estimate of the consideration
required to settle the present obligation at reporting date, taking into account the
risks and uncertainties surrounding the obligation. Where a provision is
measured using the cash flows estimated to settle the present obligation, its
carrying amount is the present value of those cash flows.
(w) Interest Bearing Liabilities
Interest bearing liabilities in the Balance Sheet are recognised at fair value upon
initial recognition. Subsequent to initial recognition, interest bearing liabilities are
measured at amortised cost with any difference between the initial recognised
amount and the redemption value being recognised in profit and loss over the
period of the interest bearing liability using the effective interest method. Fair
value is determined in the manner described in Note 23.
(x)
Goods and Services Tax
Income, expenses and assets are recognised net of the amount of associated
GST, unless the GST incurred is not recoverable from the taxation authority. In
this case it is recognised as part of the cost of acquisition of the asset or as part
of the expense.
Receivables and payables are stated inclusive of the amount of GST
receivable or payable. The net amount of GST recoverable from, or payable
to, the taxation authority is included with other receivables or payables in the
balance sheet.
Cash flows are presented on a gross basis. The GST components of cash
flows arising from investing or financing activities which are recoverable from,
or payable to the taxation authority, are presented as an operating cash flow.
Commitments and contingent assets and liabilities are presented on a gross
basis.
(y)
Employee Benefits
Wages and Salaries, Annual Leave, Sick Leave and Accrued Days off
Liabilities for wages and salaries, including non-monetary benefits, annual
leave accumulating sick leave and accrued days off which are expected to
be settled within 12 months of the reporting date are recognised in the
provision for employee benefits in respect of employee's services up to the
reporting date, and are classified as current liabilities and measured at their
nominal values.
Those liabilities that the Health Service are not expected to be settled within 12
months are recognised in the provision for employee benefits as current
liabilities, measured at present value of the amounts expected to be paid when
the liabilities are settled using the remuneration rate expected to apply at the
time of settlement.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 37
Long Service Leave
The liability for long service leave (LSL) is recognised in the provision
for employee benefits.
Current Liability - unconditional LSL (representing 10 or more years
of continuous service) is disclosed in the notes to the financial
statements as a current liability even where the <ABC Health Service>
does not expect to settle the liability within 12 months because it will not
have the unconditional right to defer the settlement of the entitlement
should an employee take leave within 12 months.
The components of this current LSL liability are measured at:
 present value - component that Goulburn Valley Health does not expect to
settle within 12 months; and
 nominal value - component that Goulburn Valley Health expects to settle
within 12
months.
Non-Current Liability - conditional LSL (representing less than 10
years of continuous service) is disclosed as a non-current liability. There
is an unconditional right to defer the settlement of the entitlement until the
employee has completed the requisite years of service. Conditional LSL
is required to be measured at present value.
Consideration is given to expected future wage and salary levels, experience of
employee departures and periods of service. Expected future payments are
discounted using interest rates of Commonwealth Government guaranteed
securities in Australia.
Superannuation
Defined contribution plans
Contributions to defined contribution superannuation plans are expensed when
incurred.
Defined benefit plans
The amount charged to the Comprehensive Operating Statement in respect of defined
benefit superannuation plans represents the contributions made by the Health
Service to the superannuation plans in respect of the services of current Health
Service staff. Superannuation contributions are made to the plans based on the
relevant rules of each plan.
Employees of Goulburn Valley Health are entitled to receive superannuation
benefits and Goulburn Valley Health contributes to both the defined benefit and
defined contribution plans. The defined benefit plan(s) provide benefits based
on years of service and final average salary.
The name and details of the major employee superannuation funds and
contributions made by Goulburn Valley Health are as follows:
Fund
Contributions Paid or Payable for
the year
2010
2009
$'000
$'000
Defined benefit plans:
State Superannuation Fund - revised and new
Other
Defined contribution plans:
VicSuper
Other
Total
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 38
Goulburn Valley Health does not recognise any unfunded defined benefit liability
in respect of the superannuation plans because the entity has no legal or
constructive obligation to pay future benefits relating to its employees; its only
obligation is to pay superannuation contributions as they fall due. The Department
of Treasury and Finance administers and discloses the State's defined benefit
liabilities in its financial statements.
Termination Benefits
Termination benefits are payable when employment is terminated before the
normal retirement date or when an employee accepts voluntary redundancy in
exchange for these benefits.
Liabilities for termination benefits are recognised when a detailed plan for the
termination
has been developed and a valid expectation has been raised with those
employees affected that the terminations will be carried out. The liabilities for
termination benefits are recognised in other creditors unless the amount or timing
of the payments is uncertain, in which case they are recognised as a provision.
On-Costs
Employee benefit on-costs, such as payroll tax, workers compensation,
superannuation are recognised separately from provisions for employee
benefits.
(z)
Finance Costs
Finance costs are recognised as expenses in the period in which they are
incurred.
Finance costs include:
- interest on bank overdrafts and short-term and long-term
borrowings;
- amortisation of discounts or premiums relating to
borrowings;
amortisation of ancillary costs incurred in connection with the
arrangement of borrowings; and
finance charges in respect of finance leases recognised in accordance
with AASB 117 Leases.
(aa) Residential Aged Care Service
(Where the Residential Aged Care Service is an integral segment of the Health
Service, not separately incorporated)11
The XXX Residential Aged Care Service operations are an integral part of Goulburn
Valley Health and shares its resources. An apportionment of land and bUildings has
been made based on floor space. The results of the two operations have been
segregated based on actual revenue earned and expenditure incurred by each
operation in Note 2b to the financial statements.
The XXX Residential Aged Care has a separate Committee of
Management and is substantially funded from Commonwealth bed-day
subsidies.
(ab) Joint Ventures
Interests in jointly controlled assets are accounted for by recognising in Goulburn
Valley Health financial statements, its share of assets, liabilities and any revenue and
expenses of such joint ventures. Details of the joint venture are set out in note 27.
(ac) Intersegment Transactions
Transactions between segments within Goulburn Valley Health have been
eliminated to reflect the extent of Goulburn Valley Health operations as a group.
(ad) Leases
Leases are classified at their inception as either operating or finance leases
based on the economic substance of the agreement so as to reflect the risks
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 39
and rewards incidental to ownership.
Leases of property, plant and equipment are classified as finance leases
whenever the terms of the lease transfer substantially all the risks and rewards
of ownership to the lessee. All other leases are classified as operating leases.
Finance Leases
Entity as lessor
The Health Service does not hold any finance lease arrangements with
other parties.
Entity as lessee
Finance leases are recognised as assets and liabilities at amounts equal to the
fair value of the lease property or, if lower, the present value of the minimum
lease payment, each determined at the inception of the lease. The lease asset
is depreciated over the shorter of the estimated useful life of the asset or the
term of the lease. Minimum lease payments are apportioned between reduction
of the outstanding lease liability, and the periodic finance expense which is
calculated using the interest rate implicit in the lease, and charged directly to the
Comprehensive Operating Statement.
Operating Leases
Rental income from operating lease is recognised on a straight-line basis over the
term of the relevant lease.
Operating lease payments, including any contingent rentals, are recognised as an
expense in the Comprehensive Operating Statement on a straight line basis over the
lease term, except where another systematic basis is more representative of the
time pattern of the benefits derived from the use of the leased asset.
All incentives for the agreement of a new or renewed operating lease are
recognised as an integral part of the net consideration agreed for the use of
the leased asset, irrespective of the incentive's nature or form or the timing of
payments.
In the event that lease incentives are received by the lessee to enter into
operating leases, such incentives are recognised as a liability. The aggregate
benefits of incentives are recognised as a reduction of rental expense on a
straight-line basis, except where another systematic basis is more
representative of the time pattern in which economic benefits from the leased
asset is diminished.
Leasehold Improvements
The cost of leasehold improvements are capitalised as an asset and
depreciated over the remaining term of the lease or the estimated useful life of
the improvements, whichever is the shorter.
Income is recognised in accordance with AASB 118 Revenue and is
recognised as to the extent it is earned. Unearned income at reporting date
is reported as income received in advance.
(ae) Income Recognition
Amounts disclosed as revenue are, where applicable, net of returns, allowances
and duties and taxes.
Government Grants and other transfers of income (other than
contributions by owners)
Grants are recognised as income when the Health Service gains control of the
underlying assets in accordance with AASB 1004 Contributions. For reciprocal
grants, <ABC Health Service> is deemed to have assumed control when the
performance has occurred under the grant. For non-reciprocal grants, <ABC
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 40
Health Service> is deemed to have assumed control when the grant is received
or receivable. Conditional grants may be reciprocal or nonreciprocal depending on
the terms of the grant.
Indirect Contributions from the Department of Health
Insurance is recognised as revenue following advice from the Department of
Health.
Long Service Leave (LSL) - Revenue is recognised upon finalisation of
movements in LSL liability in line with the arrangements set out in the
Metropolitan Health and Aged Care Services Division Hospital Circular 14/2009.
Patient and Resident Fees
Patient fees are recognised as revenue at the time invoices are raised.
Private Practice Fees
Private practice fees are recognised as revenue at the time invoices are raised.
Donations and Other Bequests
Donations and bequests are recognised as revenue when received. If donations
are for a special purpose, they may be appropriated to a reserve, such as the
specific restricted purpose reserve.
Dividend Revenue
Dividend revenue is recognised on a receivable basis.
Interest Revenue
Interest revenue is recognised on a time proportionate basis that takes in
account the effective yield of the financial asset.
Sale of investments
The profit/loss on the sale of investments is recognised when the investment is
realised.
Goulburn Valley Health operates on a fund accounting basis and maintains three
funds:
Operating, Specific Purpose and Capital Funds. Goulburn Valley Health Capital
and Specific Purpose Funds include unspent capital donations and receipts from
fund-raising activities conducted solely in respect of these funds.
(ag) Services Supported By Health Services Agreement and Services
Supported By Hospital and Community Initiatives
Activities classified as Services Supported by Health Services Agreement (HSA)
are substantially funded by the Department of Health and includes Residential
Aged Care Services (RACS) and are also funded from other sources such as
the Commonwealth, patients and residents, while Services Supported by
Hospital and Community Initiatives (Non HSA) are funded by the Health
Service's own activities or local initiatives and/or the Commonwealth.
(ah) Resources Provided and Received Free of Charge or for
Nominal Consideration
Resources provided or received free of charge or for nominal consideration are
recognised at their fair value when the transferee obtains control over them,
irrespective of whether restrictions or conditions are imposed over the use of the
contributions, unless received from another Health Service or agency as a
consequence of a restructuring of administrative arrangements. In the latter case,
such transfer will be recognised at carrying value. Contributions in the form of
services are only recognised when a fair value can be reliably determined and the
services would have been purchased if not donated.
(ai) Amalgamations and Mergers
Assets and liabilities of the acquired (amalgamated) Health Services are taken
up at book value at date of acquisition (amalgamation). Crown assets acquired
remain the property of the Crown, however they are reported as assets of the
Health Service, because effective control passes to the entity along with a
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 41
substantial benefit. (This note only applies for the first year of integration.)
(aj)
Property, Plant & Equipment Revaluation Surplus
The asset revaluation surplus is used to record increments and
decrements on the revaluation of non-current physical assets.
(ak)
Financial Asset Available-for-Sale Revaluation Surplus
The available-for-sale revaluation surplus arises on the revaluation of availablefor-sale financial assets. Where a revalued financial asset is sold that portion of
the reserve which relates to that financial asset is effectively realised, and is
recognised in the Comprehensive Operating Statement. Where a revalued
financial asset is impaired that portion of the reserve which relates to that financial
asset is recognised in the Comprehensive Operating
Statement.
(am) General Reserves
(Details of the nature and purpose of any such reserves.
(an) Specific Restricted Purpose Reserve
A specific restricted purpose reserve is established where the Health Service
has possession or title to the funds but has no discretion to amend or vary the
restriction and/or condition underlying the funds received.
(ao) Contributed Capital
Consistent with Australian Accounting Interpretation 1038 Contributions by
Owners Made to Wholly-Owned Public Sector Entities and FRD 119 Contributions
by Owners, appropriations for additions to the net asset base have been
designated as contributed capital. Other transfers that are in the nature of
contributions or distributions that have been designated as contributed capital are
also treated as contributed capital.
(ap) Commitments
Commitments are not recognised on the Balance Sheet. Commitments are
disclosed at their nominal value and are inclusive of the GST payable.
(aq) Contingent assets and contingent liabilities
Contingent assets and contingent liabilities are not recognised in the Balance
Sheet, but are disclosed by way of note and, if quantifiable, are measured at
nominal value. Contingent assets and contingent liabilities are presented inclusive
of GST receivable or payable respectively.
(ar) Net Result Before Capital & Specific Items
The subtotal entitled 'Net result Before Capital & Specific Items' is included in the
Comprehensive Operating Statement to enhance the understanding of the
financial performance of <ABC Health Service>. This subtotal reports the result
excluding items such as capital grants, assets received or provided free of
charge, depreciation, and items of an unusual nature and amount such as
specific revenues and expenses. The exclusion of these items are made to
enhance matching of income and expenses so as to facilitate the comparability
and consistency of results between years and Victorian Public Health Services.
The 'Net result Before Capital & Specific Items' is used by the management of
<ABC Health Service>, the Department of Health and the Victorian Government
to measure the ongoing performance of Health Services in operating hospital
services.
Capital and specific items, which are excluded from this sub-total, comprise:
Capital purpose income, which comprises all tied grants, donations and
bequests received for the purpose of acquiring non-current assets, such as
capital works, plant and equipment or intangible assets. It also includes
donations of plant and equipment (refer Note 1 (t». Consequently the
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 42
recognition of revenue as capital purpose income is based on the intention of
the provider of the revenue at the time the revenue is provided .
Specific income/expense, comprises the following items, where material:










Voluntary departure packages
Write-down of inventories
Non-current asset revaluation increments/decrements
Diminution/impairment of investments
Restructuring of operations (disaggregation/aggregation of Health
Services)
Litigation settlements
Non-current assets lost or found
Forgiveness of loans
Reversals of provisions
Voluntary changes in accounting policies (which are not required by
an accounting standard or other authoritative pronouncement of the
Australian Accounting Standards Board)
Impairment of financial and non-financial assets, includes all impairment losses
(and reversal of previous impairment losses), which have been recognised in
accordance with Note 1 (p) and (q)
Depreciation and amortisation, as described in Note 1 (k) and (0)
Assets provided or received free of charge, as described in Note 1 (t)
Expenditure using capital purpose income, comprises expenditure which
either falls below the asset capitalisation threshold (Note 1 (j) and (k), or
doesn't meet asset recognition criteria and therefore does not result in the
recognition of an asset in the balance sheet, where funding for that
expenditure is from capital purpose income
(as) Category Groups
The <ABC Health Service> has used the following category groups for reporting
purposes for the current and previous financial years.
Admitted Patient Services (Admitted Patients) comprises all
recurrent health revenue/expenditure on admitted patient services,
where services are delivered in public hospitals, or free standing day
hospital facilities, or alcohol and drug treatment units or hospitals
specialising in dental services, hearing and ophthalmic aids.
Mental Health Services (Mental Health) comprises all recurrent health
revenue/expenditure on specialised mental Health Services (child and
adolescent, general and adult, community and forensic) managed or
funded by the state or territory health administrations, and includes:
Admitted patient services (including forensic mental health), outpatient
services, emergency department services (where it is possible to separate
emergency department mental Health Services), community-based
services, residential and ambulatory services.
Outpatient Services (Outpatients) comprises all recurrent health
revenue/expenditure on public hospital type outpatient services, where
services are delivered in public hospital outpatient clinics, or free standing
day hospital facilities, or rehabilitation facilities, or alcohol and drug
treatment units, or outpatient clinics specialising in ophthalmic aids or
palliative care.
Emergency Department Services (EDS) comprises all recurrent health
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 43
revenue/expenditure on emergency department services that are
available free of charge to public patients.
Aged Care comprises revenue/expenditure form Home and
Community Care (HACC) programs, Allied Health, Aged Care
Assessment and support services.
Primary Health comprises revenue/expenditure for Community Health
Services including health promotion and counselling, physiotherapy,
speech therapy, podiatry and occupational therapy.
Off Campus, Ambulatory Services (Ambulatory) comprises all recurrent
health revenue/expenditure on public hospital type services including
palliative care facilities and rehabilitation facilities, as well as services
provided under the following agreements: Services that are provided or
received by hospitals (or area health services) but are delivered/received
outside a hospital campus, services which have moved from a hospital to a
community setting since June 1998, services which fall within the agreed
scope of inclusions under the new system, which have been delivered
within hospital's i.e. in rural/remote areas.
Residential Aged Care including Mental Health (RAC incl. Mental
Health) referred to in the past as psychogeriatric residential services,
comprises those Commonwealth-licensed residential aged care
services in receipt of supplementary funding from DH under the mental
health program. It excludes all other residential services funded under
the mental health program, such as mental health funded community
care units (CCUs) and secure extended care units (SECs).
Other Services excluded from Australian Health Care Agreement
(AHCA) (Other) comprises revenue/expenditure for services not
separately classified above, including: Public Health Services including
Laboratory testing, Blood Borne Viruses / Sexually Transmitted
Infections clinical services, Kooris liaison officers, immunisation and
screening services,
Drugs services including drug withdrawal, counselling and the needle and
syringe program, Dental Health services including general and specialist
dental care, school dental services and clinical education, Disability services
including aids and equipment and flexible support packages to people with a
disability, Community Care programs including sexual assault support, early
parenting services, parenting assessment and skills development, and various
support services. Health and Community Initiatives also falls in this category
group.
(at) Accounting error
Where there has been an accounting error, disclose the nature of the error
with a reference to the Note 33.
(omit if not applicable)
(au) New accounting Standards and Interpretations
Certain new Australian accounting standards and interpretations have been
published that are not mandatory for the 30 June 2010 reporting period. As
at 30 June 2010, the following standards and interpretations had been
issued but were not mandatory for the reporting period ending 30 June 2010.
<ABC Health Service> has not and does not intend to adopt these standards
early.
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 44
Nathalia District Hospital
36-44 McDonnel St
Nathalia, VIC 3638
Nathalia District Hospital
Annual Financial and Performance Report 2009-2010 45