ISA 570 · Healthcare

Going Concern Checklist for Healthcare

Tailored going concern assessment for healthcare entities. Covers industry-specific indicators including funding dependency, regulatory compliance, staffing capacity, and medical liability exposure.

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Going Concern
Checklist.

Session
0xB78C
FY End
not set
Currency
engagement.conf
indicators.list
README.md
01// engagement_context— ISA 570.3
02entity_name=
03fy_end=
04expected_auth_date=
05entity_type=
06initial_engagement=
07currency=
08// indicators— ISA 570.A2–A7 (0/21 selected)
No indicatorsscore: 0awaiting selection0/21 indicators
highfinNet liability or net current liability position
highfinFixed-term borrowings approaching maturity without realistic refinancing prospects
highfinLoan covenant breaches or indications that financial support may be withdrawn
highfinSubstantial operating losses or significant deterioration in the value of assets
mediumfinArrears or discontinuance of dividends
mediumfinInability to pay creditors on due dates
mediumfinAdverse key financial ratios
mediumfinNegative operating cash flows indicated by historical or prospective financial statements
highopeManagement intentions to liquidate the entity or cease operations
highopeLoss of key management or personnel without replacement
highopeLoss of a major market, franchise, licence, or principal supplier
mediumopeLabour difficulties or shortages of important supplies
mediumopeFundamental changes in market or technology that the entity cannot adapt to
lowopeDependence on the success of a particular project
highothLegal proceedings or regulatory action that may result in claims the entity cannot meet
highothChanges in law or regulation expected to adversely affect the entity
mediumothNon-compliance with capital or other statutory requirements
mediumothCatastrophic loss of a major asset
lowothExcessive dependence on short-term borrowings to fund long-term assets
mediumothBusiness interruption from cyber attacks or IT system failure
mediumothExposure to climate-related physical or transition risks threatening the business model
15// events_conditions_rationale— ISA 570.10–11 · independent identification
16auditor.identification=
17management.own_list=
Events & conditions · independent identification (ISA 570.10–11)
20// management_assessment— ISA 570.12–15 · evaluate management's assessment
21period_end=must be ≥12m from FS date
22method=
23key_assumptions=
24data_reliability=
Management's assessment · period + method + data reliability
27// management_plans— ISA 570.16 · feasibility + intent & ability
No plans documented. Add management's plans (asset sale, refinancing, equity raise, cost reduction, etc.) with per-plan feasibility assessment.
Management's plans · feasibility (intent AND ability)
35// cash_flow_stress_test— ISA 570.16(c) · runway scenarios
Enter monthly burn rate to run cash flow stress test.
Cash flow stress test · runway scenarios
45// sensitivity_analysis— what-if additional indicators
Select indicators to run sensitivity.
Sensitivity · what-if indicator escalation
50// risk_heat_map— category × severity
Select indicators to generate heat map.
Risk heat map · category × severity
55// material_uncertainty— ISA 570.18–20 · three-step determination
56basis_appropriate=
is GC basis of accounting appropriate?
57uncertainty_level=
58reasoning=
59stand_back_assessment=
Material uncertainty · three-step determination + stand-back
62// disclosure_adequacy— ISA 570.19 · financial statement note
Going concern basis of accounting is appropriate based on audit evidence obtainedISA 570.19
Material uncertainty (if any) is adequately disclosed in the financial statementsISA 570.20
Principal events or conditions giving rise to doubt are specifically describedISA 570.20(a)
Management’s plans to address the uncertainty are disclosedISA 570.20(b)
Financial statements include explicit statement that material uncertainty existsISA 570.21
Auditor’s report includes ‘Material Uncertainty Related to Going Concern’ sectionISA 570.22
If disclosure is inadequate, a qualified or adverse opinion is consideredISA 570.23
Written representations obtained on going concern assessment completenessISA 580.10(e)
70proposed_disclosure_text=
Disclosure adequacy · ISA 570.19 + proposed text
75// audit_report_decision— ISA 570.21–24 · report form
76report_decision=
77rationale=
tcwg_communication (ISA 570.25)
78
79key_points_communicated=
Audit report decision + TCWG communication
85// isa_570_revised_readiness— effective Dec 2026 · 2024 revisions
Enhanced risk assessment for going concern events and conditions
Structured identification process for events and conditions, applied regardless of initial risk assessment.
Evaluate management’s intent AND ability to execute mitigating plans
Both intent and ability must be separately assessed and documented.
Mandatory going concern section in all auditor’s reports
A dedicated GC section is required even when no material uncertainty exists.
Explicit stand-back assessment at the end of audit fieldwork
Stand back and consider all evidence obtained that is relevant to going concern before forming a conclusion.
Enhanced transparency about going concern work in auditor’s report
Greater detail about procedures performed and conclusions reached.
Professional skepticism documented at each stage, not just in conclusions
Evidence of skeptical questioning of management assumptions must appear throughout working papers.
ISA 570 (Revised) 2024 readiness checklist
awaiting selection·0/21 indicators · score 0private
01weighted_score
total
02assessment_level
level
03indicators
selected
04high_severity
count
CONTEXTUAL INTELLIGENCE — 1 warning
ISA 570.10
No indicators identified. ISA 570.10 still requires documentation that going concern was considered. Ensure working papers record the basis for this nil conclusion, including the information sources reviewed.
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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.

Frequently asked questions

What are the key going concern risk factors for 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).
What should auditors consider when assessing going concern for healthcare?
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.
What is the ISA 570 going concern assessment period?
The going concern assessment must cover at least 12 months from the date the financial statements are expected to be authorised for issue, not from the balance sheet date. This distinction matters: for entities with a long time between year-end and signing, the assessment period may extend significantly into the future.

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