FORTIS ESCORTS HOSPITAL 2016-2017

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A Project Study Report
On Training Undertaken At
FORTIS ESCORTS HOSPITAL, JAIPUR
“FINANCIAL MANAGEMENT IN HEATHCARE INDUSTRY”
Submitted in Partial Fulfillment for the Award of Degree of
Master of Business Administration
Submitted By:- Submitted To:-
BARKHA SOMANI DR. PREMASHISH ROY
Enroll No.-2016MBXX0263 (HEAD OF DEPARTMEMT)
SANGAM UNIVERSITY
NH-79, Bhilwara Chittor By-pass, Chittor Road, Bhilwara-311001 Phone: 01482-650505, 0789150000-05
Session:2016-2018

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DECLARATION
I hereby declare that the Project report titled “FINANCIAL MANAGEMENT IN
HEATHCARE INDUSTRY” is my original work and has not been published or submitted for
any degree, diploma or other similar titles elsewhere. This has been undertaken for the purpose
of partial fulfillment of MASTER OF BUSINESS ADMINISTRATION at SANGAM
UNIVERSITY
DATE -
BARKHA SOMANI
MBA

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PREFACE
Without practical training, management education is meaningless so long with the theory;
practical training is provided to management students to expose them to the actual working
environment of any organization. Such training provides a framework of knowledge relating to
the concepts and practices of the assigned topics in the organization. The summer training is an
integral part of the course curriculum of Master of Business Administration (M.B.A. 3rd sem). In
this the student is in the position to analyze the integral working of an organization with mature
eyes and understand the dynamics in a much better manner.
This particular project has been conducted at FORTIS ESCORTS HOSPITAL, JAIPUR. In the
first phase of the research project, there is a scenario of health care industry, introduction and
financial working process of hospital are given.
The main objective of the research is to study corporate finance of healthcare.
BARKHA SOMANI
MBA

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ACKNOWLEDGMENT
I express my sincere thanks to my project guide, CA RAVI KHANDELWAL, Designation
FINANCE CONTROLLER, Deptt FINANCE, for guiding me right form the inception till the
successful completion of the project. I sincerely acknowledge him for extending their valuable
guidance, support for literature, critical reviews of project and the report and above all the moral
support he had provided to me with all stages of this project.
I would also like to thank the supporting staff CA HITESH PATNI, CA VISHWABHARTI
SHARMA, MR. VIJAY, MR. AMIT, MRS. RACHNA, MR. BUDHI PRAKASH, MR.
MUKESH and Whole Finance Department, for their help and cooperation throughout our
project.
(Signature of Student)
BARKHA SOMANI

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SCENARIO OF HEALTHCARE SECTOR IN INDIA
Today hospital industry is an important component of the value chain in Indian healthcare
industry rendering services and recognized healthcare delivery segment of the healthcare as
industry which is growing at an annual rate of 14%. The leaders in the Indian healthcare sector
will be in a position to provide world class services at affordable prices. Healthcare will be
accessible to areas that hardly have facilities.
The government has formulated favorable policies to promote health tourism many corporates
hospital are adopting world class service standards to obtain international accreditation such as
JCI accreditation.
Corporate hospitals have come a long in India since their start. People now days when have to
use the services of healthcare unit, look at various parameters before choosing which hospitals
they will get treated or in which hospital they would get their loved ones treated.
According to reports, the corporate hospital sector of the country is all set to take away a
significant share of the tertiary healthcare service business from private healthcare providers.
According to the report of the national commission on macroeconomics and health has estimated
the size of the private of private healthcare sector in India will be worth Rs.156 crore.
Various corporate hospital brands in India in the present time include few of the following below
mentioned names –
1. Fortis escorts hospitals.
2. Apollo hospital group
3. Wockhardt hospitals
4. Max healthcare

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INTRODUCTION
Fortis Healthcare Limited is a chain of super specialty hospitals in India. It has its hospitals in
Delhi, Amritsar, Kolkata, Navi Mumbai, Mohali, Ludhiana, Jaipur, Chennai, Kota, Bengaluru,
Gurgaon, Noida, Faridabad, Mumbai, and Odisha.
Fortis Healthcare is internationally recognized by JCI (Joint Commission International, U.S.A)
and NABH (National Accreditation Board for Hospitals & Healthcare Providers, India) for its
quality of healthcare.
Fortis Healthcare Limited is a leading integrated healthcare delivery service provider in India.
The healthcare verticals of the company primarily comprise hospitals, diagnostics and day care
specialty facilities. Currently, the company operates its healthcare delivery services in India,
Dubai, Mauritius and Sri Lanka with 45 healthcare facilities (including projects under
development), approximately 10,000 potential beds and 314 diagnostic centers.
In a global study of the 30 most technologically advanced hospitals in the world, its flagship, the
Fortis Memorial Research Institute’ (FMRI), was ranked No.2, by ‘topmastersinhealthcare.com,
and placed ahead of many other outstanding medical institutions in the world.
Brand Fortis was established in 1996, by our Founder Chairman Late Dr. Parvinder Singh. Fortis
Healthcare is the country’s ‘fastest’ growing healthcare group. We have grown from first
hospital at Mohali (Chandigarh) which opened in 2001 to over 55 facilities today. These include
the world famous Escorts Heart Institute and the erstwhile Wockhardt facilities.

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BUSINESS FOCUS
 Vision
'to create a world class integrated healthcare delivery system in India, entailing the finest
medical skills combined with compassionate patient care.'
 Value
 Patient Centricity
1. Commit to 'best outcomes and experience' for our patients.
2. Treat patients and their caregivers with compassion, care and understanding.
3. Our patients' needs will come first
 Integrity
1. Be principled, open and honest.
2. Model and live our 'Values'.
3. Demonstrate moral courage to speak up and do the right things.
 Teamwork
1. Proactively support each other and operate as one team.
2. Respect and value people at all levels with different opinions, experiences and
backgrounds.
3. Put organization needs' before department / self interest.
 Ownership
1. Be responsible and take pride in our actions.
2. Take initiative and go beyond the call of duty.
3. Deliver commitment and agreement made.
 Innovation
1. Continuously improve and innovate to exceed expectations.
2. Adopt a 'can-do' attitude.
3. Challenge ourselves to do things differently.

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 Mission
"To be a globally respected healthcare organization known for Clinical Excellence and
Distinctive Patient Care."
 Mergers and Acquisition
Fortis buys 24% in Singapore healthcare giant parkway holding ltd. It is the largest
overseas acquisition by an Indian company in the healthcare space. Buying the entire
23.9% stake held by the TPG capital in Singapore’s parkway holding ltd. for $686
million. Fortis is India’s second largest healthcare provider after Apollo hospitals and
parkway is Asia’s biggest hospital operated by sales. The acquisition would form Asia’s
largest hospital chain with over 10,000 beds across 64 hospitals in six countries.
 Growth and development
 Fortis Healthcare, India was established in 1996 by the promoters of Ranbaxy
Laboratories, among the world's top 10 generic companies, also India's largest pharma
company.
 Fortis Healthcare India hospitals are benchmarked to International standards - achieving
quality.
 The Fortis Healthcare circle of caring is fast expanding, spreading the name of Fortis
Healthcare.
 significantly in the caring approach of our people.
 About Company Logo:
The two hands that fuse seamlessly with a human form, express our reassuring approach
to healthcare.
Green is the color of healing and is symbol of our steadfast focus: to ensure
the health and well-being of those we minister to.
Red is expressive of the dynamic zeal with which we strive to make it a
reality.
Punch line “your caring hospital.”

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 Infrastructure:
The infrastructure facilities of the FEHJ are par excellence, such as:
1. C arm with digital subtraction angiography.
2. Flat panel cath lab
3. Advanced pathological lab
4. Mobile x-ray
5. 64 slice CT scan
6. TMT, ECHO, HOLTER recorder and monitor and ECG to help non-invasive cardiac
investigation.
7. 500Ma image intensifier TV
8. Digital CR reader
9. X-ray
 Location:
The access to the hospital is very easy. The hospital is located on JLN Marg Road, Jaipur.
The address of the hospital is:
Fortis Escorts Hospital, Jaipur
Jawahar Lal Nehru Marg,
Malviya Nagar,
Jaipur – 302017
Rajasthan, India.
Tel: 0141-2547000

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BOARD OF DIRECTORS
Executive chairman
 Mr. Malvinder Mohan Singh
Executive vice chairman
 Mr. Shivinder Mohan Singh
Non-executive independent director
 Dr. Brian William Tempest
Non-executive director
 Mr. Sunil Godhwani
 Harpal singh
 Gurcharan Das
 Preetinder Singh Joshi
 Tejinder singh shergill
Additional Non-executive independent director
 Lynette Joy Hepburn Brown

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Hierarchy of finance department:
ZONAL DIRECTOR
MR. PRATEEM TAMBOLI
FACILITY DIRECTOR
MR. MANAN MUKUL
FINANCE CONTROLLER
CA RAVI KHANDELWAL
MANAGER
CA HITESH PATNI
TEAM LEADER
CA VISHWABHARTI SHARMA

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AWARDS AND ACCOLADES
 Mr Malvinder Mohan Singh, Executive Chairman, Fortis Healthcare, was honoured with
the ‘Entrepreneur of the Year’ award at the APEA 2016.
 Fortis Healthcare received Golden Globe Tigers Award in the ‘Best Patient Safety
Initiative’ category.
 Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute, New Delhi, became the first
Indian doctor to be invited by the USFDA Medical Panel in Washington.
 Fortis Healthcare received the Corporate Live Wire Innovation & Excellence 2015
Award.
 Fortis Hospital, Mohali and the Fortis Hiranandani Hospital, Vashi, were awarded the top
spot at the 16th CII National Awards for Excellence in Energy Management.
 Fortis Hospital, Shalimar Bagh, New Delhi, won the Best Poster Presentation award at
CAHOCON 2015.
 Fortis Escorts Heart Institute’s e-ICU initiative, Critinext, won the prestigious “Asia
Healthcare Excellence Award”.
 Fortis Hiranandani, Vashi, won two Quality Excellence awards for ‘Best Healthcare
Services’ and ‘Dedicated Service’.
 Fortis C-DOC, won the Best Hospital in India for Diabetes Care.
 Fortis Hospital, Noida, and Fortis Hospital, Anandapur, were recognised as Centres of
Excellence in Emergency Medicine.
 Fortis Escorts Heart Institute, New Delhi, won the ICICI Lombard and CNBC India
Healthcare TV 18 Awards 2014-15.
 Fortis won three awards at the 5th Asia Best CSR Practices Awards 2015.
 Fortis Hospital, Mulund and Bengaluru, won the AHPI Award for Nursing Excellence.

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Department Information -
The organizations comparises of the clinical and non- Clinical departments.
Each department has its own operations.
Non- Clinical Departments:
1. Quality Assurance Department:
Headed to maintain and perk up the standards. Quality assurance (QA), the activity of
providing evidence neede to establish quality in work and the activities that require good
quality are been performed effectively. All those planned or systematic actions necessary
to provide enough confidence that a product or service will satisfy the given requirements
for quality.
2. Human Resource Department:
To ensure availability and retention of quality talent to meet organization goals and
objectives. Overall growth and development of employee’s orientation and functional
training. The department looks into matters like attendance and leave management,
appraisal and promotion process, medical benefits, employee welfare programs, payroll
management, grievance handling, medical by laws.
3. Medical Record:
Medical Record Department (MRD) is the custodian of all the discharged/ expired health
record charts. The MRD staff ensures the confidentiality, preservation, storage and
retention of the documents.
The Department deals with record collection, codification, storage, analytical evaluation
and retrieval of records if needed.
4. Pharmacy:
The goal of the pharmacy is to procure and provide medicines and surgical items to the
patients. The pharmacy serves various areas of the hospital like Special Ward, ICUs, OTs
and bio medical. The department services include procurement and providing medicines
to the patients.
The department also deliveries medicines to the wards if needed and gives details to the
billing department at the time of discharge of patients.
5. Housekeeping:
To achieve defect free room with 100% hygiene and cleanliness to maximize patients
satisfaction with minimum cost. The department performs actifities like cleaning,
Providing rooms amenities, pest controlling and waste disposal.

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6. Laundry:
The department delivers spotlessly clean and hygiene linen and uniforms to the users of
different departments. The department maintains record for issued linen, received linen,
new linen and alterations if needed. The department treats infected/ contaminated linen,
treats heat labile linen.
7. Marketing:
The department is responsible for the revenue generation through brand building, retails
sales,cooperate marketing, PR and media Communications and liaison with the
government. Some activities of the department are brand awareness, events management,
cooperate social responsibility, and ensure business & growth in line with organizational
objectives.
8. Finance:
The department provides accurate relevant and timely financial information necessary in
making right business plan and decisions. The finance department looks into business
building insights, areas for lowering cost and improving profitability, updating of bills on
daily basis for IPD Patients. The billing staff has overall responsibility for coordination of
various functions ( Pharmacy, Wards etc.) and daily basis report of admission and
provide the necessary solution to daily problems as deemed proper and reasonable.
9. Information Technology:
The department provide IT values to end users respect to their day to day function. The
department services various departments for IT infrastructure, hardware & network,
antivirus services, internet services.
10. Food & Beverage:
The department provides food and beverages to the esteemed customers and staffs as
well. The department performs daily audits of the store and kitchen areas, take rounds of
the entire services are with and after the services timings, monitoring of services and
sales at various outlets like coffee shops, executive/ doctor’s dining hall.
11. Engineering:
The department manages all the engineering equipment and machines, supervising day to
day hospital maintenance work and ensuring smooth functioning of facilities of hospital.
The department coordinates with various departments medical and non- medical so that
there is no hindrance in day to day work of all facilities. The department is responsible
for managing plant engineering equipment, utilizes, spares and consumables like diesel
generators, plumbing, pipelines, ventilation, air conditioner water treatment plants etc.
12. Patient Welfare Department:

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The departmental goal to make and position the hospital as a “Centre of excellence” by
ensuring customer satisfaction through personalized customer care. The department
manages patients/ attendants expectations as well as keeping the interests of the
organization alive, improves the quality of services for the patients through the feedbacks
given by them, networking within the organization for the benefit of the patient/ attendant
and to ensure the action on the feedback.
13. Bio – Medical Enginering:
The department installs, commission and maintains all the medical equipments in an
efficient and cost effective way and makes technical appraisal and recommendation for
purchase of new equipments. The department provides inputs to commercial department
about new/renewal of contract with equipment supplier including annual
maintenance/comprehensive maintenance contracts.
14. Security:
The department provides proactive, competent services, to protect the life and property of
every individual present in the premises, to prevent any action or situation that might
result in an injury or death when a patient/attendant/visitor/employee are lawfully on the
hospital premises.
15. Research:
The department works on studies related to the hospital and the actives undergoing. The
department maintains protocol report, investigator brushers, informed consent form file,
case report form (CRF) and investigator site file.
Clinical departments
1. Operation theatre:
All type of cardio thoracic and vascular surgeries are performed here. High risk surgeries
are also performed with heart supporting system and advanced perfusion techniques.
2. CSSD:
The department provides clean and sterile supplies which help in reduction of infection
and improving quality of care. The department provides infection control by educating
staff on biomedical waste management, by reviewing surveillance data and identifying
areas of intervention, by identifying patients or staff with communicable/potentially
communicable infections and institute appropriate measures in such cases.
3. Dialysis unit:
It deals with the artificial replacement of the lost kidney function in patient with renal
failure to remove excess water and waste products from the blood.

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4. NICU:
It provides world class tertiary level management of sick babies and children. Specialized
services include pediatric surgery, neurosurgery, physiotherapy and child psychology.
5. Labour Delivery Room (LDR):
The department facilities include obstetrics consultation, investigations, referrals and
opinion from other departments if required.
6. Physiotherapy:
The department provides facilitates such as electrotherapy, diagnostic, manual,
mechanical mobilization therapy, exercise therapy, chest physiotherapy, gynae/obstetrics,
post-operative cardiac surgeries, for neurological disorders and geriatrics.
7. HDU, Triage and ICU:
They provide incentive care and monitoring. Procedures performed include
bronchoscope, central venous line, peripheral line, arterial line, pulmonary artery
catheter, temporary pacemakers, peripheral tracheotomies, PEG placement and chest tube
placement.
8. Cath Lab:
The range of services in this department includes all emergency and electives procedures
across the spectrum of cardiology. CAG, PTCV, BMV, device clouser, EP Studies, RF
ablations, pacemaker implantation, peripheral stenting and may other cardiac procedures
are performed in the cath lab.
9. Dietics:
Dieticians provide an array of patient care services including nutritional assessment,
counseling services and enteral and parenteral feeding recommendations. The food
services department in committed provide all IPD patients with fresh hygienic food.
Menus are planned to take advantage of seasonal food and changing patient preferences.
10. Laboratory:
The department offers a comprehensive menu of more than 300 regular and specialized
tests performed through the state of the are equipment and based on more than 95
technologies.

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Research methodology
1. Primary objective-
To study corporate finance of healthcare.
2. Data collection:
Data has been collected through both primary and secondary approach.
3. Data sources:
The research involved gathering of secondary data as well as primary data.
Secondary data regarding sales figures, promotional expenses and other related expenses
was collected from the company’s own record to analyze the impact on sales due to
running schemes and make cost benefit analysis. Primary data was collected to through
direct interaction with the company’s finance and accounts department.
4. Scope of study:
Both primary and secondary data has been used for the study. Apart from conducting this
research work on the basis of this information, various techniques of financial
management e.g. comparative statement, trend analysis and ratio analysis etc were used
in the present study. To present a board view so far as the purpose of the analysis and to
make it easy to understand the problem concept of a few graphs and tables shall also be
presented in each chapter. The analysis has been compared with actual management
practices of the company under study.
5. Limitations of the study :
 The authenticity of the suggestions and recommendations depend upon the rationality
of the data provided.
 Executives are not ready to part with the information beyond a limit.

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Starting out
An evaluation of hospital finance performance starts with some basic questions:
 How does a hospital get and spend its money?
 Is the hospital in good finance health?
 What type of government policies and regulations affect the hospital’s financial
health?
 What are the market trends and how are these forces shaping the decisions of the
hospital leadership?
These are few of the questions that this guide will explore.

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Key Accounting Principles and Concepts
Measuring Revenues and Expenses with Accrual Accounting :
Key points of accrual accounting include the following:
 Income (revenue) is earned when services are provided. A patient 1. in a bed is
receiving a service.
 Expenses are the costs of providing material and service to the parties 2. that receive
the service, when the service is being provided.
 The timing of when an organization gets paid for the services it 3. renders, or when it
pays for the materials and services it purchases, is irrelevant to the accrual accounting
method. Cash flow is a separate issue for consideration.
 The accurate measurement of profits or losses depends upon the 4. correct matching of
services provided and the costs of providing these services.
Allocation of Revenue (Income)
There are several ways of being paid for patient care. The recognition of revenue depends
upon the payment method. Imaginative payers may come up with new reimbursement
approaches during these turbulent times, but currently there three key methods.
1. Cash basis
2. Per diem
3. Capitation
Realization of Revenue
hospitals or health systems accrue income continuously while the patient is in the hospital.
Measuring income continuously, however, is neither practical nor necessary.
For the case basis, patient revenue in a particular month is the total of the following:
 The full fee for all patients admitted and discharged in the specific ••month; plus
 The prorated portion of total revenue for all patients admitted in a pre••vious month and
discharged this month; plus
 The prorated portion for all patients who are still in the facility past the month’s end.
Cash Accounting
Cash accounting and cash flow are not the same things. Cash accounting is one approach
for recognizing income and expense; cash flow is an analysis of past, present, or
prospective cash activity. Cash flow is a vital indicator of an organization’s financial
performance. Cash accounting is mentioned here only to facilitate an understanding of the
accrual methodology.
Expense Recognition
A number of timing issues arise in recognizing expenses under the accrual method. The
first and easy case involves recognizing the steady flow of invoices for materials and

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services that are to be consumed promptly to provide patient care. Typically, such trans-
actions are recognized as expenses when the invoices are recorded.
Depreciation
Buildings, major equipment, and computers are fixed assets. They last for a relatively long
time and are disposed of when their productivity declines due to advances in technology,
the high cost of repairs, and so forth. To recognize such items as expenses, we allocate their
cost over their estimated useful life and enter that dollar amount on the income statement.
We call this depreciation.

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How Hospitals Are Paid
Reimbursement:
Federal, state, and occasionally local regulatory agencies play a role in the hospital or health
system’s payment. While often negotiated, payment occurs within a structured framework.
For patients who are covered by governmental programs such as Medicare or Medicaid,
government agencies:
Define the medical procedures for which there will be payment.
Assign weights to the procedures to adjust payment for varying factors (for example, acuity
levels).
Establish the mechanism for attaching dollar values to medical procedures.
Payers:
Hospitals receive payments from four chief sources:
 The federal government, which administers the Medicare program through regional
Medicare intermediaries or carriers
 State and local governments, which administer the Medicaid program through approved
carriers
 Private payers, including non-profit Blue Cross Blue Shield and commercial insurance
companies, which offer a wide range of healthcare plans
 Patients and their families, who usually bear part of the cost of health••care services
through deductibles and co-payments, and sometimes, when they have no third-party
insurance, bear the full cost of the services as “self-payers”

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Medicare:
Medicare is a federal program operated by the Centres for Medicare & Medicaid Services
(CMS), a federal agency within the U.S. Department of Health and Human Services.
Established in 1965 through the Social Security Act, Medicare is the national health insurance
program for:
 People age 65 or older
 Some people under age 65 with disabilities
 People with end-stage renal disease (ESRD), which is permanent kidney failure requiring
dialysis or a kidney transplant
Medicaid:
Medicaid is a state-administered program for disabled and low-income individuals and families
who cannot afford to pay for some or all of their medical care.
The Medicaid system is not a carbon copy of the Medicare system. Each state sets its own
guidelines regarding eligibility and coverage subject to federal rules and guidelines. Certain
services must be covered by the states in order to receive federal funds; other services are
optional and are elected by states. States cannot diminish the benefits stipulated by federal
regulation, but they can make changes to the payment schedule and they can adopt per diem
payment. Benefits for Medicaid recipients and Medicaid payments to providers vary from one
state to another.
Health maintenance organization(HMO):
A managed care plan that integrates financing and delivery of a comprehensive set of healthcare
services to an enrolled population. HMOs may contract with, directly employ, or own
participating healthcare providers. Enrollees are usually required to choose from among these
providers and in return have limited copayments. Providers may be paid through capitation,
salary, per diem, or pre-negotiated fee-for-service rates.
Independent practice association(IPA):
An HMO that contracts with individual physicians or small physician groups to provide services
to HMO enrollees at a negotiated per capita or fee-for-service rate. Physicians maintain their
own offices and can contract with other HMOs and see other fee-for-service patients.

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Managedcare organization(MCO):
An organization that offers a health plan that uses managed care arrangements and has a defined
system of selected providers that contract with the plan. Enrollees have a financial incentive to
use participating providers that agree to furnish a broad range of services to them. Providers may
be paid on a pre-negotiated basis.
Physician/hospital organization (PHO):
An organization that contracts with payers on behalf of one or more hospitals and affiliated
physicians. The PHO may also undertake utilization review, credentialing, and quality assurance.
Physicians retain ownership of their own practices, maintain significant business outside the
PHO, and typically continue in their traditional style of practice.
Point-of-service plan (POS):
A managed care plan that combines features of both prepaid and fee-for-service insurance.
Health plan enrollees decide whether to use network or non-network providers at the time care is
needed and usually are charged sizable copayments for selecting the latter.
Preferred provider organization (PPO):
A health plan with a network of providers whose services are available to enrollees at lower cost
than the services of non-network providers. PPO enrollees may self-refer to any network
provider at any time.
Sources of Reimbursement:
Payer Administered By Sources of Money
Medicare Federal government Social Security payroll tax
Participant premiums
Patient deductibles
Patient coinsurance
Medicaid State and localities Federal, state, and local budgets
Commercial insurers, Blue
Cross Blue Shield, HMOs,
preferred providers
Payers Employee and employer premiums
Patient deductible
Patient ci-insurance

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Types of Payment
Per diem payment:
Provides fixed daily payments that do not vary with the level of services used by the patient.
Fee-for-service payment:
Reimburses the provider whatever fee the provider charges on completion of a specific service.
Case-based(MS-DRG) payment:
Pays providers based on patients’ acuity levels.
Capitation:
Pays providers a fixed amount for each person served (“enrollee” or “member”) regardless of the
actual number or nature of services provided.

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Working process of finance department:
 For purchase of any item: mainly there are 3 categories –
 Pharmaceuticals item
 Consignment items
 General items
 Purchase of pharmaceuticals and general item:
1. Need– shortage of product. Such as medicine, tissues, cleaning items, stationary etc.
2. Purchase request (PR)– department who needs items request to the purchase
department.
3. Purchase order - purchase department prepare purchase order document and send it to
the vendor. Purchase order is made in ORACLE in system.
4. Receive orderwith bill – receive order with bill from vendor.
5. Check at gate – security department check items on gate.
6. Prepare goods receiptnote (GRN) – items keep at store where GRN is prepared
by store staff. GRN is made in ORACLE.
7. Validate bill for payment – by GRN no. bill is validated in system.
8. Payment made on due date – payment made through cheque to the vendor.

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 Purchase of item on consignmentbasis: (surgery parts and
equipments )
1. Need– there arise urgent need of item because there required surgery parts and
equipments for patient.
2. Receive order– receive item with bill
3. Goods receiptnote (GRN) – after use of item GRN is prepared by store staff. GRN
is made in ORACLE.
4. Purchase order (PO)– Because PO is the compulsory part of accounting it is
necessary to prepare for making easy validation process.
5. Payment receivedfrom user or patient – who use these items pay for them as
receipt of hospital.
6. Validation of bill – by GRN no. bill is validated in system.
7. Payment made to vendor on due date – payment made through cheque to the
vendor.

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 For receipts of hospital:
 Receipts of indoor patient department (IPD):
IPD patients are those who admit in hospital.
1. Consultancyor receipt(slip) charges –
For IPD patient there are only consultancy charges which applied by hospital.
2. Prepare total bill of patient –
It includes total charges of patient for services which he receive from hospital. Such as
room or bed charges, food charges, medicine charges.
Many times there is discount available which also mentioned in bill.
3. Collectpayment made by patient –
There is government policy for payment made by patient that up to Rs. 199999 they can
submit in cash. Remaining amount they can submit by bank.
 For outdoor patient department (OPD) :
OPD patients are those who coming for check up and not admit in hospital.
Consultancyor receipt(slip) charges:
For OPD patient there are only consultancy charges which applied by hospital.

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 For Third Party Associated (TPA) patient:
TPA patients are those who coming from tie up companies and insurance
companies with their referral letters.
These tie-up and insurance companies are called Third Party Associates.
1. Collectinitial amount for security of full payment –
If patient coming in emergency without referral letter than according to the sop,s of
hospital patient have to pay initial security amount of Rs. 5000.
2. Collectfrom third party who made payment –
when final bill is prepared, TPA department of hospital take approval form TPA
company for payment .
3. Collectother charges -
TPA department of hospital recover reaming amount from patient which will not payable
by TPA company. It may include charges like food and beverages, room and bed charges
etc.
4. Refund initial amount –
At last they refund initial amount of RS. 5000 which they have taken fpr security of
payment purpose.
Here third party associates are insurance companies as well as corporations where
hospital have tie ups. Such as-
1. Necular power corporation ltd.
2. Star health insurance
3. ICICI Lombard health insurance
4. BAJAJ alliance
5. New india assurance
6. ApolloMunich health insurance
7. MAX Bupa health insurance etc.

29. 29
 Payment of tax:
In every organisation Finance department work on payment of taxes. There are many
type of taxes.
A healthcare industry is exempted from many taxes so it have to pay taxes on other than
healthcare services. Such as-
1. Income tax –
It apply on annual total earnings of hospital with rebate and exemptions.
2. Service tax –
Here service tax is charge on other than healthcare services. Such as
1. Business axillary services
2. Cosmetic surgery which is for beauty purpose
3. Consultancy services
4. Cab operator services for staff
5. Food and beverages
3. Tax deducted at sources (TDS) –
Here some types of TDS which payable by hospital:
1. FORM 16 – for those who have fixed salary.
2. FORM 16A – for those who have salary on the basis of share.
3. 194S – 10% TDS on profession.
4. 194I – for rent – 1. Plant and machinery = 2 %
2. Land and building = 10%
4. Work compensationtax –
Work compensation tax is charged on temporary services which we take from outside
the organisation. Such as –
1. Repairing of lights and electricity
2. Paint of oragnisation
3. Repairing of leakages etc.

30. 30
Here service tax and work compensationtax is replacedby goods
and service tax (GST).
5. Goods and service tax –
Healthcare services are exempted from GST. Other than heath care services charged
under it. Such as –
1. Business axillary services
2. Cosmetic surgery which is for beauty purpose
3. Consultancy services
4. Cab operator services for staff
5. Food and beverages
6. Repairing of lights and electricity
7. Paint of organisation
8. Repairing of leakages etc.

31. 31
Payment of other expenses:
It include many type of expenses in a hospital. Such as-
1. Payment of staff salary –
At the month end finance department made cheques for staff salary.
2. Payment of food and beverages –
Facilities for tea and snacks provide by hospital, it is an agreement
between hospital and a particular vendor who supplies food facility, so
finance department need to pay on behalf of hospital for taking services.
3. Payment of using cabs –
It is related to the facility provided by hospital for transportation to the
staff.
4. Provide money for events –
Hospital organise many events for awareness and advertisement.
5. Miscellaneous cashexpenses –
It include petty cash in which many items are purchase.
6. Stationary charges –
It includes stationary like pen, files, printing papers, dairies etc.
7. Audit of financial statements –
When we rendered services like audit from outside the organisation,
Legal charges and consultancy charges are there.

32. 32
Received from agreements for services:
Hospital received rental income from agreements with other vendors. Such
as –
1. Agreement for providing food and beverages:
In it hospital provide place to vendor where vendor operates his services
in hospital for patient and staff. Hospital receive rent from vendor. Here
vendors are – herbs and spices, ammul parlour, tea postand nestle.
2. Agreement for medirent services –
In it medirent is a company who provides equipment on rent like bed,
wheelchair, other necessary items to the patient for home.
Hospital charge rent for place occupied by medirent.
3. Agreement for disposalof bio medical waste –
Hospital made agreement with a vendor who purchase all bio medical
waste and disposeor recycle it.

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Receivedincome from charity –

34. 34
Preparation of financial statements:
Finance department prepare its financial statements. Such as-
Bank ReconciliationStatement-
It is the statement where bank balance and pass book balance is matched by finance
department on weekly basis.
If there is any differences than it auto reconciled in system.
Cashflow –
It is related to cash and bank inflow and outflow of funds.
Mar 16 Mar 15 Mar 14
12 mths 12 mths 12 mths
Net Profit/Loss Before Extraordinary Items And Tax -58.18 -38.53 41.43
Net CashFlow From Operating Activities -693.61 -143.91 -44.67
Net Cash Used In Investing Activities 379.12 293.85 -522.42
Net Cash Used From Financing Activities 317.58 -170.28 483.86
Net Inc/Dec In Cash And Cash Equivalents 3.09 -20.34 -83.23
Cash And Cash Equivalents Begin of Year 6.01 26.45 109.47
Cash And Cash Equivalents End Of Year 9.10 6.12 26.24

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Trading or operating accountProfit and loss account-
Mar
16
Mar 15 Mar 14
12
mths
12 mths 12 mths
INCOME
Revenue From Operations [Gross] 596.67 595.78 354.07
Revenue From Operations [Net] 596.67 595.78 354.07
Other Operating Revenues 14.92 14.86 14.83
Total Operating Revenues 611.59 610.64 368.91
Other Income 147.24 217.91 229.64
Total Revenue 758.83 828.55 598.55
EXPENSES
Operating And Direct Expenses 145.84 148.58 108.22
Changes In Inventories Of FG,WIP And Stock-In Trade -1.29 -1.28 0.11
Employee Benefit Expenses 173.53 182.45 136.04
Finance Costs 62.14 80.63 90.78
Depreciation And Amortisation Expenses 25.42 27.13 17.00
Other Expenses 411.36 429.57 204.96
Total Expenses 817.00 867.08 557.12
Mar
16
Mar 15 Mar 14
12
mths
12 mths 12 mths
Profit/Loss Before Exceptional, ExtraOrdinary Items
And Tax
-58.18 -38.53 41.43
Exceptional Items -15.33 2.65 0.00
Profit/Loss Before Tax -73.51 -35.88 41.43
Tax Expenses-ContinuedOperations
Current Tax 0.00 0.00 17.95
Less: MAT Credit Entitlement 0.00 0.00 0.00
Deferred Tax 0.00 0.20 -0.51
Tax For Earlier Years 0.00 -2.17 0.00
Total Tax Expenses 0.00 -1.97 17.44
Profit/Loss After Tax And Before ExtraOrdinary
Items
-73.51 -33.91 23.99
Profit/Loss From Continuing Operations -73.51 -33.91 23.99
Profit/Loss For The Period -73.51 -33.91 23.99

36. 36
Balance sheet –
Mar '16
Mar '15 Mar '14
12 mths 12 mths 12 mths
Sources Of Funds
TotalShare Capital 463.13 462.81 462.79
Equity Share Capital 463.13 462.81 462.79
Preference Share Capital 0.00 0.00 0.00
Reserves 3,145.14 3,216.70 3,246.80
Networth 3,608.27 3,679.51 3,709.59
Secured Loans 57.05 67.48 134.75
Unsecured Loans 987.49 529.85 1,116.91
Total Debt 1,044.54 597.33 1,251.66
Total Liabilities 4,652.81 4,276.84 4,961.25
Mar '16 Mar '15 Mar '14
12 mths 12 mths 12 mths
Application Of Funds
Gross Block 277.43 284.37 254.28
Less: Accum. Depreciation 105.73 94.25 108.13
Net Block 171.70 190.12 146.15
Capital Work in Progress 177.54 169.00 121.35
Investments 2,635.50 2,411.13 2,795.15
Inventories 5.83 7.24 4.72
Sundry Debtors 102.34 105.06 87.29
Cash and Bank Balance 9.25 6.29 26.29
TotalCurrent Assets 117.42 118.59 118.30
Loans and Advances 1,807.23 2,270.37 1,978.58
TotalCA, Loans & Advances 1,924.65 2,388.96 2,096.88
Current Liabilities 231.52 858.74 181.01
Provisions 25.04 23.62 17.27
TotalCL & Provisions 256.56 882.36 198.28
Net Current Assets 1,668.09 1,506.60 1,898.60
Total Assets 4,652.83 4,276.85 4,961.25
Contingent Liabilities 614.71 548.97 709.59
Book Value (Rs) 77.91 79.50 80.16

37. 37
MY LEARNING EXPERIENCE:-
 About working in the organization
I had a memorable experience from joining the internship programme at FORTIS ESCORTS
HOSPITAL, JAIPUR. In addition to daily work I had great opportunity to meet different people
working over there. Besides, I made a lot of friends during the course of internship. They were
all professional, sincere and taught me patiently. I would never forget our pleasant time. In these
45 days, I have established a good relationship with the employees in the organization. Through
the programme, I broadened my views and improved my communication skills. Besides, I found
that having flexible mind and attitude which is very important in the business world .It was much
different from the study .As part of my study I visited different departments in the organization
to make a detailed study. Finally, I would like to give sincere thanks again to everyone in the
organization who extended their support in training me to complete this programme. I believe
that such experiences and skills are Valuable to my future career.
 About co-operations extendedby management& employees:
The management and the employees at FORTIS ESCORTS HOSPITAL were very co-operative
and helpful. They provided each and every details required by me for the project. The trainers in
each of the department helped me with getting the required information and also explained me
the working of each of the department in details and they also helped me to know how the
theoretical concepts that I have learnt in my academics was useful in implementing with the
practical situations in the organization.
 About what I learnt in their internship training:
It helped me to know the overall functioning of departments in the organization. How the
employees are motivated &trained in the organization towards achieving their goals set by the
organization. It also helped me to know the co-ordination between the different levels in the
organizations, and also helped me to know the leadership skills and also to be as an initiator
during the different situation. It gave me a practical exposure to the various functional areas of
which I only had a theoretical knowledge so far.

38. 38
 About my plan for future:
Through my summer internship programme I had good experience FORTIS ESCORTS
HOSPITAL. This helped me gain self-confidence and improve my skill, through this I would be
able to Implement my skill and knowledge in the organisation where I would be given a chance
to be An employee of the organisation & I build in confidence where I can do my best to the
organization which I am a part of. Now if a job is offered to me by FORTIS ESCORTS
HOSPITAL or any other hospitals I am in a position to handle it and I will take up the offer as an
opportunity to me.

39. 39
Other trainings :
Basic life support – CPR
Prepare letters of invitation and award ceremony of hospital from HR.
Call acquisition work from marketing to doctors for conginential heart surgery seminar.
Work of billing of patient
Table tennis
Other achievements :
Taking part in risk behaviour management seminar
Taking part in group dance in fortis 10th anniversary on 2nd august 2017.

40. 40
CONCLUSION
FORTIS ESCORTSHOSPITAL, JAIPUR is known for rendering the best quality
service in health and educations sector. It is known as one of the leading hospitals
industries especially in India .the quality in service indicates growth and standard
of the organization. The organization’s management is expected to keep vigil to
ensure that the quality in treatment is maintained at appropriate level and the
customers are satisfied at every foot step of the organization Further it is
highlighted that the organization has to be responsible to the changing technical,
Economical and financial scenario. However certain regions need measures to a
greater extent to increase profitability.

41. 41
BIBLOGRAPHY
 www.google.com
 www.wkikipedia.com
 www.who.org
 www.unicef.com
 Fortis finance department.

42. 42

43. 43
Table of content
Chapter no. PARTICULARS Page no.
Acknowledgement 3
Preface 4
1. Introduction Of Banking
a. Introduction of banking………………….
b. History of banking in India………………
c. Banks in India……………………………
d. Fact files of banks in India………………
e. Indian banking industry………………….
6-18
7
8
11
17
18
2. Company’s Profile
a. Introduction to ICICI Bank…………
b. ICICI Bank today……………………
c. Business profile……………………...
d. Board of directors……………………
e. Board committee…………………….
f. Business objective……………………
g. Technology used in ICICI Bank……..
h. Products and services………………...
i. Awards and recognition………………
19-55
21
27
28
29
30
31
32
34
54
3. Research Methodology
a. Objective of study……………………
b. Importance of study………………….
c. Meaning of research…………………
d. Research problem……………………
e. Research design……………………...
f. Data collection method………………
g. Analysisand interpretationof data…..
h. Limitation of study…………………..
56-62
58
58
59
59
60
61
62

44. 44
62
4. Financial Analysis
a. Introduction of the topic……………….
b. Method/Toolsof financial analysis…….
c. Balance sheetof ICICIBank…..
d. ProfitandLoss Accountof ICICI
Bank……………………………..
e. Financial statementanalysis……………
1) Comparative financial
statement……………………….
2) Trendanalysis…………………….
3) Ratioanalysis……………………..
63-92
64
67
73
75
76
76
79
80
5. Findings,SuggestionsAndConclusion………………………. 93-98
6. Bibliography………………………………………… 99-100