Indicators
Check all indicators that apply to the entity. Severity levels reflect their weight under ISA 570.A2. Expand any indicator to see the working paper guidance and likely review challenge.
ISA 570 Going Concern Reference Card — free PDF
All 19 ISA 570 indicators with severity ratings, review challenges, and auditor response guidance. One page for your planning folder. Plus one practical audit insight per week.
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Going Concern Assessment: Healthcare
Healthcare entities face going concern risks that intertwine financial sustainability with regulatory compliance and clinical capacity. For publicly funded healthcare organisations, funding is politically determined and can change with government priorities. For private healthcare, patient volumes and payer mix drive viability. In both cases, staffing shortages, regulatory sanctions, and medical liability claims can rapidly escalate into going concern situations.
Key risk factors: Healthcare
Key healthcare going concern indicators include: government funding reductions or changes in reimbursement formulae, regulatory sanctions or loss of accreditation, inability to recruit and retain clinical staff at sustainable cost levels, medical malpractice claims that exceed insurance coverage, declining patient volumes or unfavourable payer mix shifts, and capital expenditure requirements for ageing facilities or mandatory technology upgrades (e.g. electronic health records).
Funding dependency — for publicly funded entities, assess the security and duration of government funding commitments. Annual funding cycles create inherent uncertainty if commitments don't extend 12 months beyond the signing date.
Regulatory compliance — loss of accreditation or a regulatory enforcement action can prevent the entity from operating. Assess the status of any regulatory findings, inspection results, or improvement notices.
Staffing capacity — healthcare entities cannot operate without qualified clinical staff. Assess vacancy rates, agency staff dependency (which is typically more expensive), and the entity's ability to attract permanent staff.
Medical liability and insurance — assess the adequacy of professional indemnity insurance and the status of any claims that could exceed coverage. Uninsured or underinsured claims can be catastrophic.
Patient volume and referral patterns — for entities dependent on referrals (specialist clinics, diagnostic centres), a loss of referring relationships can significantly reduce revenue.
Capital expenditure requirements — healthcare facilities have mandatory maintenance and technology requirements. If the entity cannot fund necessary upgrades, regulatory closure is a possibility.
ISA 570.9 — The auditor shall evaluate management's assessment of the entity's ability to continue as a going concern.
ISA 570.A2 — Events or conditions that may cast significant doubt include financial, operating, and other indicators.
ISA 570.16 — If events or conditions have been identified, the auditor shall obtain sufficient appropriate audit evidence about whether a material uncertainty exists.