CVPM Flashcards
Uniform Comercial Code (applies to the sale of goods)
What does UCC stand for in relation to contract law?
Offer
Acceptance
Consideration
Subjective elements are-an intent to contract and the meeting of the minds.
What are the three objective elements of a contract?
Adhesion contract
A contract that is written by the dominant party with no realistic opportunity to negotiate.
4 esental components to the law of negleance
1- Had a duty to prevent an injury from occurring.
2 - Violated that duty by failing to act in accordance with the standard of care expected of other DVMs under the same or similar circumstances.
3 – Showing that a connection existed between the DVMs conduct or lack of conduct and the resulting injury (doctrine of proximate cause).
4 – Proving that the actual damage or harm occurred.
Altering or destroying medical records
Spoilation
Criminal Law
Defines the boundaries of the relationship between the individual and society. Acts that are harmful to people and to the fabric of ordinary society.
Civil Law
Law pertaining to the relationships among individuals within society.
2 major subdivisions of Civil Law
Contract law and tort law
Tort Law
Subdivision of cival law pertaining to duties toward other people. Example: Law of negleance
Substantive Law
Set of rights and duties to which a person must adhere in today’s society.
Procedural Law
The rules and procedures for conducting a lawsuit.
What is an AHT on the state veterinary board.
Animal Health Technician
National Board Exam
What does NBE stand for?
What does CCT stand for?
Clinical Competency Test
Financial Accounting Standards Board
What does FASB stand for?
Everything of value owned by the company.
Assets
Money that is owed or debit
Liabilities
Equity (worth of the business)
Assets (everything of value owned by the company) minus liability (debts and money the practice owes)=
Cash flow statement
Report showing the sources of the practices incoming cash and the uses for that cash.
A detailed list of all accounts used in the normal course of business.
Chart of accounts
Balance Sheet
A statement of financial condition of the practice listing assets, liabilities and owners equity at a specific point in time.
MACRS
Modified accelerated cost recovery system. Where depreciation is more recognized in the first few years.
EBITDA
Earnings before intrest taxes depreciation and amortization.
What is a G & A expense?
General and administrative expense. Examples: janitorial, accounting, dues and subscriptions, maintenance and repair.
Gross profit margin
What is the difference between the cost of a product and the revenue it generates?
Net profit margin
What calculation divides the profit of the business by revenue generated.
Average transaction charge
Practice revenue divided by # of Practice transactions
- Product consolidation
- Order quantities that make sense
- Measure and increase compliance
- Doctor and staff product education
4 ways to maximize inventory turnover
Per se rule & Rule of reason
The two rules the courts use when making a ruling regarding antitrust
What is the DEA?
Drug Enforcement Agency
Primary federal law enforcement agency responsible for combating the abuse of controlled substances.
DEA 222 form
What form is used to order controlled drugs?
Copies 1 & 2 to the supplier
Copy 3 stays with clinic
Copy 2 is sent to the DEA by the supplier
DEA 106 form
What form is used to report theft or loss of a controlled drug?
2 questions permissible to ask a new hire regarding controlled substances?
Within the past 5 years have you been convicted of a felony or a misdemeanor in the last 2 or currently charged?
In the past 3 years have you knowingly used narcotics?
Controlled substance act 1970
Regulates distribution and dispensing of controlled substances
CSA
What schedule drugs have the highest potential for abuse and lowest acceptable medical use?
Schedule 1
Adulterated drug
Drugs that contain unsanitary components, differ in strength from official compendium. Think Triz-Baytril-Dex. Illegal to dispense.
Misbranded drug
A drug which the labeling is false or misleading or missing required rx information
What is a legend drug?
A prescription drug
FDA form 1932
What form is used for reporting adverse drug events
Awareness
Behavioral expectations
Consequences
Decision confirmed
Employee involved
Follow up
Corrective Action Formula (ABCDEF)
HMO Health Maintenance Organization
Patients visit physicians and facilities within the “network” usually it is required for the patient to be referred to a specialist by their primary care provider.
PPO- Preferred Provider Organization
A blend of fee for service and HMOs. They don’t require a referral from a primary care provider to visit a specialist although they do have a network of preferred providers and it’s more costly to go outside that network.
Similar to HMOs but patients are not required to get referrals from their primary care provider to see a specialist.
POS Point Of Service Plan
HSA
Health Savings Account
A Health Savings Account owned by you to be used to pay for medical services. To be used with high deductible plans.
FSA
Flexible Spending Account
Owned by your employer. Used to pay for a variety of health services.
SIMPLE IRA Plan
Retirement plan established by employers to allow employees to make pre taxed contributions. Employers must match.
What is a 401K?
Retirement plan established by employers to allow employees to contribute pre taxed dollars. Employers are not required to match. Required administrators and can be costly.
SEP
Simple Employee Pension Plan.
Similar to profit sharing. Funded by tax deductible employer contributions. Employees cannot contribute.
Drive times
What is the best way to identify your practices trade area?
Autonomy
Mastery
Purpose
Three elements must exist for intrinsic motion
ADA Act of 1990
Americans with Disabilities Act- no covered entity shall discriminate against a qualified individual because of disability.
EEOC
Equal Employment Opportunity Commission
Responsibile for enforcement of the ADA at state and federal levels.
Hostile work environment
Exists when conduct based on a protected class by anyone in the work place has the purpose or effect of creating a hostile intimidating or offensive work environment.
What is Quid Pro Quo
Occurs when a supervisor conditions the granting of employment benefits upon the receipt of sexual favors from a subordinate. Or punishment for refusal of the sexual favors.
FLSA
Fair Labor Standards Act
Law regulating the way in which employees are paid. i.e. minimum wage, OT, child labor, equal pay ect.
Undue hardship?
An employment accommodation would be substantially costly, disruptive, or would alter the operation of the business.
Mental Health Parity Act (MHPA) of 1996
Provided that large, employer-sponsored (group) health plans and their insurers cannot impose annual or lifetime dollar limits on mental health benefits that are less favorable than any such limits imposed on physical health benefits.
ERISA
Employee Retirement Income Security Act of 1974 (ERISA)
A federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans.
COBRA stands for Consolidated Omnibus Budget Reconciliation Act. This is the federal law that provides many workers with the right to continue coverage in a group health plan. This federal law applies to employers with 20 or more employees, including self-insured employers.
COBRA
Income Statement
Another name for profit and loss
Expansion
Prosperity
Contraction
Recession
The 4 stages of the business cycle
Examples of personnel expenses
Wages, payroll tax & benefits
Occupancy expense examples
Rent, utilities, property tax, repairs and maintenance
Variable expenses (Cost of Goods Sold COGS)
Pharmacy inventory, OTC, laboratory fees
Fixed administrative expense examples
Business license, advertising, equipment rental, interest expenses
Pro forma statement
Financial statements including income statement, cash flow statement and balance sheet based on projections inthe future.
Net Present Value
NPV is the difference between the present value of cash inflows and the present value of cash outflows over a period of time.
IRR Internal Rate of Return
The annual rate of growth that an investment is expected to generate.
What is debt financing
Borrowing money from a bank as a loan to finance something.
Equity financing
Financing obtained by venture capitalists, veterinary groups or veterinary practices.
Flash report
Illustrates a basic summary of data for the entire practice. Overall summary of practice preformance that is usually reviewed monthly.
common sized
An expense as a percentage of revenue.
A practice should aim for what percentage in AR (amounts receivable)?
Should not exceed 1% of gross income
Gross income
Income before taxes are taken out
Net income
After tax (what is left in the net after tax) Think of it like a tax strainer
Direct expense/cost
Cost directly related to patient care and can be traced back to a patient or client. Example: Drugs, supplies and food.
An indirect cost/expense
Associated with patient care but cannot directly be traced back to a patient or client.
Example: uniforms, holding inventory costs
Fixed expense
Expense that doesn’t change regardless of volume. Example: rent, building insurance and utilities.
Gross income
The amount of income received before taxes and expenses are paid
It must be multiplied by 100. Example costs of medical supplies $68,828.93 divided by $1,000,000 (income) = 0.07 × 100 = 7%
To express a percentage in a math equation
4.8%
Average yearly price increase on COGS and general and administrative expenses.
Balance Sheet
Statement of financial condition of the practice.
Profit and Loss (also known as the income statement)
Report matching revenue to expenses between two select dates (usually a month)
Basic accounting equation
Assets = Liabilities + Owners Equity
1400 with 60% known to cross species
How many known zoonotic disseases are there?
Veterinarians are responsible for educating clients on zoonotic diseases? True or false
True
Reservoir
A place where an infectious organism survives and replicates?
A host
When discussing zoonotic diseases what offers an organism an environment for maintenance but is not required for survival?
FUTA federal unemployment tax
Which payroll tax is paid by the employer and only the first $7000
26
How many payroll per year with biweekly payroll?
52
How many payrolls per year with weekly payroll?
24
How many payroll per month with bimonthly?
5-10 days
Monthly financial reports should be generated and analyzed within ___ business days following month end?
10-12%
According to the AVMA what is the average net profit of a general practice in a given year?
What are forms 941 & 940
Quarterly payroll tax
Yearly Quarterly payroll tax
ROI Return on investment.
The measure of a company’s ability to use its assets to generate value for a company.
ROI=Net operating income ÷ Average Operating assets × 100
How to calculate ROI
An incidental or fringe benefit
Perk
DCAP
Dependent Care Assistance Program.
Companies contribute to the cost to care for dependents (children or elders) only 25% can be provided for the practice owners.
Intrinsic value
The deemed asset worth derived by the practice owner, including how the equipment generates value for the practice.
AKA a measurement of what an asset is worth.
Net book value
Asset (equipment) cost less accumulated depreciation since the purchase date.
Employee stock ownership plan
ESOP
Profits
Bottom line is also known as
Revenue
Top line=
Veterinary salaries
Management salaries
Perquisite
Return on owner’s investment in the practice
Equitable distribution of remaining profits among owners
Five tiers practice owner/s compensation
Define the culture.
Align behaviors with the desired culture.
Commit to the change.
Support the shift.
Grow the team.
Five key steps in making a culture change within apractice.
Gross Profit Margin
The difference between the cost of a product and the revenue it generates is called what
13%
If your end of year revenue for the practice was $2,400,000 and your profit was $312,000 what is your Net Profit Margin percent?
Direct Expenses are usually more controllable because they relate directly to specific income production.
Which expenses are considered more controllable, Direct Expense or Indirect Expense?
Current Liabilities
An organization’s debts or other obligations which must be discharged within a short time (usually within the earnings cycle, or one year) are called what?
If thepracticecurrently has $94,250 of cash on hand and the annual operating expenses of thepracticeare $1,677,000, how many days cash balance do you have and is that a healthy number for thepractice?
14.6 days. As a general rule, it is a good businesspracticeto keep 20 to 30 days’ worth of cash on hand to ensure liquidity issues do not arise
8-20%
How much are average inventory holding costs?
In ABC ordering what are A products
A products are the top 20% of your products that generate 80% of your use and sales
What is JIT?
Just in time ordering
Commodity
Product that is interchangeable with another product of the same type. The price is a function of supply and demand.
Indemnity insurance
System of health insurance in which the insurance carrier reimburses the insured individual for medical expenses after care has been provided. (Most pet insurance)
NFC Near field communication.
Tap to pay.
Money Factor
Term used in leasing that is similar to but not the same as interest. It determines how much you will pay in finance charges over the life of the lease.
1 year from filling the position or 2 if you think the applicant may be over 40.
What are the federal retention laws for applicant documents such as resumes?
On payroll
US citizen
Paid minimum wage
Covered under workers comp
What are 4 elements required for a working interview
1-2% annually
What is a reasonable training budget?
Location of 1st aid, eye wash and exits
Location of PPE and proper use
Location of mandatory posters
Location of hospital safety manual
Copies of all applicable OSHA safety standards
New employees must have immediate knowledge of what 5 safety standards?
Lack of positive feedback
Lack of training
Not being included in the bigger picture
What 3 reasons do employees leave?
Engage and empower
Recognize and reward
SOPs
Shared purpose
Name 4 elements of enhancing employee productivity
Prepare
Present info with a twist
End with a bang
Ask compelling questions
What are 4 elements of virtual training
70% on the job training
20% mentoring
10% lectures and courses
70/20/10 development
Apt cards
Confirm 24 hours a head
Have established protocols
3 ways to avoid apt problems
S-Specific
M-Measurable
A-Agreed
R-Realistic
T-Timebound
What is a SMART goal
Section 125 plans
Medical plan that enables employees to make payments for premiums pretaxed.
FSA
Which is owned by the employer an HSA or FSA?
50
How many full time employees can a business have before its required to offer health insurance?
222 form is used
Copy 1 stays with Lending DVM
Copy 2 is sent to the DEA
Copy 3 stays with borrowing DVM
Process for lending a controlled drug
Descriptive ethics
The study of ethical views of veterinarians regarding behavior and attitudes. Essentially right and wrong.
Official ethics
Involve the creation of official ethical standards adopted by professional organizations and imposed on its members.
Administrative ethics
Involve actions by administrative government body that regulate veterinary practice activities. License revocation can result if any civil or criminal violations of those actions occur.
Normative Ethics
The search for correct principles of good and bad, right and wrong, justice and injustice.
Practice Act
Coded regulations describes what licensed employees can and cannot do & acceptable medical standards.
Unjust enrichment
A law created to avoid one party benefitting from the expense of emergency care. Owner receives ER care at the veterinarians expense.
When you are prevented from acting on what is right
Ethics Exhaustion
What is the most common bacteria found in dog and cat bites
Pasteurella
Hazards + Vulnerability = Risks
What is the risk assessment equation
Ask
Affirm
Assess
Act
What are the 4 As to rise above moral distress?
Employers
Who pays FUTA tax?
COBRA
What is not required on a labor law poster?
PVME principles of veterinary medical ethics
By the AVMA
What entity requires DVMs to protect the personal privacy of clients and patients?
14-15 year olds
Who can only work 3 hours per day on school days and 8 hours on non school days and never before 7am?
Depends on the agreement with the practice.
When is it acceptable for a departing member of the clinic to take client lists and information with them when they leave?
Tax prep
Valuation
Large financial issues
What 3 financial issues are outsourced in most practices?
COGS cost of goods sold.
Products used to produce a service or Products sold to clients.
Income Statement
What is another name for the Profit and Loss statement?
Profit and Loss
What is another name for the Income Statement?
Accrual
What type of accounting is more accurate? Accrual or Cash?
Federal Income Contribution Act (funds social security and medicare)
What is FICA?
Both
Who pays FICA? Employer, employee or both?
$600
A contractor that makes more than $____ gets a 1099
Assets=Owners Equity + Liability
What is the basic accounting equation?
1.5%
AR should be no higher than ___% of gross revenue
FDCPA Fair Debit Collection Practices Act
Which act regulates collection procedures for past due amounts?
The amount of times accounts receivable is turned into cash?
What is accounts receivable turnover?
Credit sales ÷ Average accounts receivable = Accounts receivable turnover
What is the formula for accounts receivable?
Higher because it indicates AR being turned into cash more often.
Is it better to have a higher or lower accounts receivable turnover?
- Determining the desired results
- Analysis of the financial statements
- Normalizing the revenue and expenses
- Budgeting revenue
- Budgeting expenses
- Combining budgeted revenue and expenses and making adjustments
What are the 6 stages of budgeting?
Key driver
Patient volume is considered a ____ ____ of revenue growth.
The last 3 years average growth rate
A simple method of creating an expense budget is to add what to the base expense figure?
5%
What percentage of gross revenue is lost to embezzlement in small businesses annually?
Consistency
Compassion
Customer service
Convenience
Competence
Cost
What are the 6 Cs of client relationship management
Recall
Reappointment
Reminder
3 components of client retention
70-75% in 3 years
Retention goal
20% of what is spoken
30% of what they read
Percentage of information clients retain
Five times
How many times does a recommendation need to be made before a client purchases
5000
How many appointments should a DVM see on average per year?
10
Optimal visits per client per year?
1000
How many current clients should each DVM have?
39-40% This seems unrealistic
According to the text we should be aiming for what % net income?
6:1
What is the ideal ratio of new to lost clients?
8-10%
What is the industry revenue benchmark for vaccines?
Encourage
Align
Solve
End
What does EASE in regards to the onboarding process stand for?
1-2%
What percentage of annual revenue should be spent on training?
Compliance standards of care
Recommendation
Acceptance
Follow through
What is the CRAFT formula for compliance?
1 – The tort of outrageous conduct.
2 – The right not to have one’s sensibilities shocked.
I am sure we all agree that performing a necropsy without the owner’s consent is unethical but it is also a high risk liability. The risks of liability center on causes of action. Define those two causes of action
Operating demands
Inventory control is defined as the process whereby the need to maintain sufficient inventory to meet ______ ______ is weighed against the monetary cost of carrying inventory.
Products are available when needed
Controlled drugs are properly maintained
Clients can conveniently obtain refills
Fees are adjusted regularly
List at least 4 inventory control goals
25-35%
What percentage of cost accounts for combined ordering and holding costs?
Perpetual
When items are received and immediately added to the inventory record, and items sold are immediately subtracted from the inventory record, its called a __________ inventory system.
The difference between the price of a product to the client and the cost of that product to the clinic.
Define gross profit on a product
Reduced waste
Better organization and tracking
What are the two main benefits of using a central supply inventory system?
- Create spreadsheet and calculate annual usage volume
- Calculate cumulative annual usage volume
- Calculate cumulative percentage and annual volume
- Calculate annual usage distribution
- Group items into classes ABC
5 basic steps to ABC inventory
Tighter
The higher the inventory turnover ratio, the _____ the inventory control.
EOQ
What mathematical formula that recognizes three specific costs including unit cost, ordering costs, holding costs allows calculation of inventory ordering?
Margin pricing method
Regarding markup and margin pricing structures which is a useful strategy to use where there are large ranges in the end resulting in priced based on the size of the patient?
Drugs used to treat chronic conditions
Which category of drugs is likely to have a higher mark up; competitive drugs or drugs used to treat a chronic condition?
False. Clients do not have a complete understanding or appreciation of costs associated with dispensing medications.
Itemizing various fees potentially associated with dispensing medication (labeling, dispensing minimum) on the invoice helps improve perceived value of medication. True or false?
Poor legibility that can lead to patient care mistakes and confusion.
What is the most significant drawback to written medical records?
Lockout
Electronic medical records should have an automatic _____ ______ time frame after back up has been completed and any entries following will be added as an addendum.
Lack of complete patient or client identification
Lack of tentative DX
Lack of prognosis
Lack of treatment specified
Illegible entry
Alterations
Three examples of board violations regarding medical records
Name of medication
Strength
Dose given
Route of administration
Medication documentation must include what?
Date of entry
Initials of staff making entries
Complete SOAP
Authorization forms signed
Missed charges
Recheck and recall
Compliance with medical standards
Medical service compliance
Elements that should be included in the auditing of medical records
True
In reference to disease transmission, fleas and ticks are considered vectors? True or false
Staff training
Referrals
Through medical records
Informed consent
Continuing education
What are 5 strategies to reducing the potential for malpractice suits?
Mitigation
Preparation
Response
Recovery
4 priorities of general emergency management
Prioritizing inventory time investment
Applying Pareto’s 80/20 rule to inventory helps in
The receiver and documenter and tracker
To maintain tight inventory controls the inventory purchaser should always be a separate individual from
Tax act of 2003
Significantly increased the amount of eligible property that can be written off the first year (an additional deduction of 50% on the remaining balance of equipment that is above $139000) the remainder of purchases can also be depreciated on a straight table.
1%
Practices should plan to invest around ___ of gross revenue replacing or acquiring new equipment yearly
Negotiation
Mediation
Arbitration
What are 3 alternatives to a lawsuit?
T-truth teamwork transparency
E- empathy
A- apology
M- management
AVMAs PLIT acronym to discussing medical errors
Duplication of drugs is minimized
What is an ancillary benefit of a ration based inventory system?
Pharmacy licensing/DEA fees
What is NOT a hidden ordering cost associated with inventory?
Every year on Dec 31
How often do vet licenses need to be renewed?
The accounts, amount owed and the due date
What two pieces of information are shown on an accounts payable report?
The job is protected by the civil rights act because it constitutes unlawful sex discrimination
Protection of a pregnant workers job
Employer has to examine docs but not necessarily copy. Must be kept 3 years from date of hire or 1 year after termination whichever is longer
Weird I9 facts
Proforma statements- based on projections of the future
Statements, balance sheets, cash flow Statements are all examples of what?
Use OSHA form 300 if there are 11 or more employees
What is the correct scenario when reporting a work place injury
Using the assumptive technique. Assume the animal owner wants best in care and offer the next steps.
The most effective method of marketing a service to a client is
Employers control or right of control,over manner in which working to be preformed and the results of that work.
What is themost important factor under the 20 factor common law test
