Worksheet G-1
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FORM CMS-2552-10
INSTRUCTIONS AS PUBLISHED IN CMS PUB. 15-II, , REV 1
MEDICAL UNIVERSITY OF SOUTH CAROLINA - CHARLESTON, SC
Cost report status - As Submitted
[Record Code 741780 - 2010]
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| STATEMENT OF CHANGES IN FUND BALANCES | Provider CCN: 420004 | PERIOD: FROM 07/01/2021 TO 06/30/2022 |
WORKSHEET G-1 | |||||||
| GENERAL FUND | SPECIFIC PURPOSE FUND | ENDOWMENT FUND | PLANT FUND | |||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |||
| 1 | Fund balances at beginning of period | ### | 1 | |||||||
| 2 | Net income (loss) (from Worksheet G-3, line 29) | ### | 2 | |||||||
| 3 | Total (sum of line 1 and line 2) | ### | 3 | |||||||
| 4 | Additions (credit adjustments) (specify) | 4 | ||||||||
| 5 | 5 | |||||||||
| 6 | 6 | |||||||||
| 7 | 7 | |||||||||
| 8 | 8 | |||||||||
| 9 | 9 | |||||||||
| 10 | Total additions (sum of lines 4 through 9) | 10 | ||||||||
| 11 | Subtotal (line 3 plus line 10) | ### | 11 | |||||||
| 12 | Deductions (debit adjustments) (specify) | 12 | ||||||||
| 13 | 13 | |||||||||
| 14 | 14 | |||||||||
| 15 | 15 | |||||||||
| 16 | 16 | |||||||||
| 17 | 17 | |||||||||
| 18 | Total deductions (sum of lines 12 through 17) | 18 | ||||||||
| 19 | Fund balance at end of period per balance sheet (line 11 minus line 18) | ### | 19 | |||||||
| FORM CMS-2552-10 (10/2012) (INSTRUCTIONS FOR THIS WORKSHEET ARE PUBLISHED IN CMS PUB. 15-II, SECTION 4040) | ||||||||||
| 10-12 | Rev. 3 | |||||||||