ANALYSIS OF THE IMPLEMENTATION OF ENVIRONMENTAL COSTS CASE STUDY AT BANJARMASIN ISLAMIC HOSPITAL

: This study aims to uncover waste management activities and environmental costs of environmental cost reporting at the Islamic Hospital of Banjarmasin. This researcher uses a qualitative paradigm with a case study design. The research scope is the Unit of Environmental Health Sanitation with the accounting process of environmental management, hospital waste management's data focus, and expenditures for waste costs. Primary data were collected through in-depth interviews and observations; secondary data, through documentation. The results revealed that environmental management accounting systems in 2019 and 2020 found hidden environmental costs from waste management cost reports in the Financial Statements. For example, the environmental cost report applied to the SKL Unit revealed Rp 677,646,500 and Rp 459,521,600 not presented as an environmental cost in 2019 and 2020. The implementation of environmental cost accounting through environmental cost reporting at the Islamic Hospital of Banjarmasin revealed that special reports in environmental management accounting could be used as information by the management of the Islamic Hospital of Banjarmasin in planning and controlling environmental responsibility activities. The study results also revealed that the environmental cost report facilitated the direction of the Islamic Hospital of Banjarmasin in making decisions related to environmental costs and provided information for stakeholders that the hospital had been responsible for maintaining environmental health.


INTRODUCTION
A hospital is a health service institution that provides complete individual health services, providing inpatient, outpatient and emergency services.Regulation of the Minister of Health of the Republic of Indonesia Number 7 of 2019 concerning Hospital Environmental Health Articles 1b and 1c, states that hospital environmental health aims to protect hospital human resources, patients, visitors and the community around the hospital from environmental risk factors and create a home environmentally friendly sick (www.healthenvironment.com, 2019).
Law Number 32 of 2009 concerning Environmental Protection and Management in Article 2 also regulates that environmental protection and management is carried out based on participatory principles and local wisdom.This means that the law states that we are ordered to maintain, protect and care for the surrounding environment, including hospitals as health service institutions.As the population grows, the need for health services continues to increase.The existence of a hospital (RS) is very important to provide health services to the community.Based on data from the Ministry of Health of the Republic of Indonesia in 2020, the number of hospitals in Indonesia from 2015-2019 increased by 13.52%.In 2015 the number of hospitals was 2,488, increasing to 2,877 in 2019.The number of hospitals in Indonesia as of 2019 consisted of 2,344 General Hospitals (RSU) and 533 Special Hospitals (RSK).The South Kalimantan Province region as one of the provinces in Indonesia has 45 hospitals spread across several city districts.A total of 11 hospitals or around 24.4% are in Banjarmasin City which will certainly have an impact on the amount of waste produced (https://pusdatin.kemkes.go.id, 2020).
Hospital waste is all waste produced from hospital activities in the form of solid, liquid, paste (gel) or gas which can contain infectious pathogenic microorganisms, toxic chemicals that can affect human health (Indrawati and Rini, 2018).One One type of hospital waste is medical waste.It is very important for medical waste to be managed properly, this is because medical waste is included in the category of hazardous and toxic waste.Some medical waste is included in the hazardous waste category and some is included in the infectious category.There are still many hazardous medical wastes in the form of chemical waste, pharmaceutical waste, heavy metals, genotoxic waste and pressurized containers that have not been managed properly.Meanwhile, infectious waste is waste that can be a source of disease spread to staff, patients, visitors or the community around the hospital environment.Infectious waste usually consists of patient body tissue, syringes, blood, bandages, other cultures that are thought to be contaminated by the patient's disease.
Activities arising from environmental management will give rise to environmental costs.As with other business activities, the responsibility imposed on hospitals for environmental problems, such as waste management activities resulting from operational activities, of course incurs environmental costs.According to Ikhsan (2009), environmental costs are impacts, both monetary and non-monetary, that must be borne as a result of activities that affect environmental quality.Meanwhile, according to Hansen and Mowen (2017), environmental costs can be called environmental quality costs.Environmental costs are costs that occur because the quality of the environment is poor or poor environmental quality may occur.Thus, environmental costs relate to the creation, detection, improvement, and prevention of environmental degradation.
Hospital environmental costs are costs that arise due to hospital operational activities which can reduce the quality of the surrounding environment, namely hospital waste.The efforts made are not only expressed in the form of activities, but are also implemented in the accounting system so that they can be implemented in a sustainable manner (Swastyakso and Widodo (2016).Meanwhile, according to Anam and Ramlah (2020), environmental cost reports are very important for environmental cost management for every company that produces hazardous waste, especially in a hospital environment, also provides benefits such as good environmental cost management, more accurate charging, minimizing environmental costs, and hospitals gain more trust from stakeholders.
The background regarding the phenomenon of the importance of waste management and environmental costs arising from the waste management process as well as the high amount of costs incurred by the Banjarmasin Islamic Hospital to manage hospital waste motivates research on environmental costs with the title "Analysis of the Implementation of Environmental Costs in Case Studies in Islamic Hospitals Banjarmasin".

Environmental Ethics Theory
One theoretical view regarding environmental ethics is the theory of ecocentrism.Ecocentrism theory offers an increasingly adequate understanding of the environment.Moral concern is expanded to include the entire ecological community, both living and non-living.Ecocentrism is increasingly expanded in deep ecology and ecosophy, which greatly arouses human understanding of the interests of the entire ecological community.Deep ecology demands a new ethic that is not centered on humans, but is centered on the whole of life with efforts to overcome environmental problems (Ernawan, 2007).

Stakeholder Theory
Stakeholders are all parties, internal and external, who can influence or be influenced by the company either directly or indirectly.The success of a company's business is determined by company management which is successful in fostering relationships between the company and its stakeholders.Stakeholder theory states that companies have a responsibility to stakeholders, by carrying out social disclosures (Hadi, 2011).

Environment
According to ISO 14001, the environment is the surrounding conditions in which an organization operates, including air, water, land, natural resources, flora, fauna, humans and their interactions.The environment in Indonesia is often called the living environment.Regulations for implementing the environment are contained in Law of the Republic of Indonesia number 32 of 2009 concerning Environmental Protection and Management.
According to Law number 32 of 2009 concerning Environmental Protection and Management, the definition of the environment is the unity of space with all objects, forces, conditions and living creatures, including humans and their behavior, which influence the continuity of life and the welfare of humans and other living creatures.Environmental impact is any change that occurs in the environment, whether detrimental or beneficial, which is wholly or partly caused by the environment and the organization.
Some excerpts from the contents of Law number 32 of 2009 on the environment include: a.The living environment is the unity of space with all objects, conditions and living things.1. Know from the start the impact of an activity 2. Implement and enforce controls 3. Involved in the decision making process

Environmental Management Accounting
Environmental management accounting is a sub-system of environmental accounting that explains a number of issues regarding the issue of quantifying a company's business impacts into a number of monetary units.Environmental management accounting can also be used as a benchmark for environmental performance.The USEPA (1995) definition explains environmental management accounting as a "process of identifying, collecting and analyzing information about costs and performance to assist organizational decision making" (Ikhsan, 2009).

Environmental Costs
Environmental costs are impacts, both monetary and non-monetary, that occur as a result of company activities that affect environmental quality.Environmental costs basically relate to the costs of products, processes, systems or facilities important for better management decision making.The goal of cost acquisition is how to reduce environmental costs, increase income and improve environmental performance by paying attention to the current situation, the future and potential management costs (Ikhsan, 2009).

Identify Environmental Costs
Environmental cost quality is an industry standard technique for evaluating trends in full costs in guaranteeing each end product and customizing services beyond customer desires (Ikhsan, 2009).Identification of environmental costs can be classified into 4 categories (Hansen Mowen, 2017) Source.Hansen and Mowen, 2017 Environmental Cost Report Hansen and Mowen (2017), stated that environmental cost reports are information related to the relative distribution of environmental costs which is useful for improving and controlling environmental performance.A good environmental costs report provides a breakdown of environmental costs by category.Reporting environmental costs by category will provide important information for companies, namely information regarding the impact of environmental costs which provides information regarding the company's profitability and information regarding the relative amounts and costs spent for each category.
According to Hansen and Mowen (2017), environmental cost reporting is important if an organization is serious about improving its environmental performance and controlling its environmental costs.A good first step is a report that provides a breakdown of environmental costs by category.Reporting environmental costs by category provides 2 important results: 1.The impact of environmental costs on company profitability, and 2. The relative amount spent on each category.An illustrative example of an environmental cost report at Thamus Corporation can be seen in Table 2 below: It can be concluded based on the definition above, hospitals provide several types of services including medical services, medical support services, care services, rehabilitation services, prevention and improvement of health, as places for medical education and/or training, as places for research and development of science and technology in the health sector, general administration and finance, as well as to avoid risks and health problems as intended, so it is necessary to organize a hospital environmental health in accordance with health requirements (http://bprs.kemkes.go.id, 2009).

Hospital Waste
According to Government Regulation (PP) no. 12 of 1995, waste is leftover material from an activity and/or production process.Meanwhile, hospital waste according to the Republic of Indonesia Minister of Health Regulation Number 7 of 2019 concerning Hospital Environmental Health is all waste produced from hospital activities in solid, liquid and gas form (RI Minister of Health Regulation, 2019).

Characteristics of Hospital Waste
Hospital waste is all waste produced by hospital activities and other supporting activities.When compared with the activities of other agencies, it can be said that the types of hospital waste can be categorized as complex.In general, hospital waste is divided into two large groups, namely medical and non-medical waste, both solid and liquid (Permenkes RI, 2019).

The Effect of Hospital Waste on the Environment and Health
The influence of hospital waste on environmental quality and health can cause various problems such as (Silfa, 2013): 1) Comfort and aesthetic disturbances, in the form of color originating from sediment, solutions, phenol odor, eutrophication and taste from organic chemicals.2) Property damage can be caused by dissolved salts (corrosive, rust), muddy water and so on which can reduce the quality of buildings around the hospital.3) Disturbance/damage to plants and animals can be caused by viruses, nitrate compounds, chemicals, pesticides, certain nutrient metals and phosphorus.4) Disturbances to human health can be caused by various types of bacteria, viruses, chemical compounds, pesticides, and metals such as Hg, Pb, and Cd which come from dentistry.5) Genetic and reproductive disorders.
Although the mechanism of interference is not fully known with certainty, several compounds 6) can cause disruption or damage to genetics and the human reproductive system, for example pesticides, radioactive materials.
Based on RI Minister of Health Regulation No. 7 of 2019 also states that waste management officers must use personal protective equipment consisting of hats/helmets, masks, eye protection, long clothing, industrial aprons, boots and special gloves.The influence of hospital waste on environmental quality and health can cause various problems (Permenkes RI No. 7, 2019: 1) Comfort and aesthetic disturbances, in the form of colors originating from sediments, solutions, phenol odors, eutrophication and tastes from organic chemicals, which cause environmental aesthetics to become unsightly 2) Property damage can be caused by dissolved salts (corrosive and rust), muddy water and so on which can reduce the quality of buildings around the hospital.3) Disturbance/damage to plants and animals can be caused by viruses, nitrate compounds, chemicals, pesticides, certain nutrient metals and phosphorus.4) Disturbances to human health can be caused by bacteria, viruses, chemical compounds, pesticides, and heavy metals such as Hg, Pb, and Cd which come from dentistry.5) Genetic and reproductive disorders 6) Poor hospital waste management will become a good place for disease vectors such as flies and mice 7) Work accidents to workers or the public due to spilled syringes or other sharp objects 8) The incidence of dengue fever is increasing because the disease vector lives and reproduces in used cans or standing water 9) The process of decomposing waste by microorganisms will produce certain gases that cause a foul smell 10) The presence of flying dust particles will interfere with breathing, causing air pollution which causes disease germs to contaminate medical equipment and hospital food.11) If unsanitary hospital waste is burned, the smoke will disrupt breathing, vision and reduce air quality.

RESEARCH METHOD
This research is a qualitative descriptive study.
According to Bungin (2017), descriptive research is research that describes, summarizes various conditions, various situations or various variables that arise in society which are problems, then draws them to the surface as a characteristic or description of the conditions of certain situations or variables.Qualitative type descriptive research is where data is expressed in the form of words or sentences as well as descriptions.
The research paradigm uses an alternative approach.The qualitative research design used is a case study approach.The qualitative descriptive format of case studies does not have characteristics like water (spreading on the surface), but focuses on a particular unit of various phenomena.The descriptive qualitative case study format is exploratory research and plays a very important role in creating understanding and is more appropriate when used to research problems that require in-depth study (Bungin, 2017).

Method of collecting data
Data collection is the initial activity carried out by researchers in the field.Researchers begin conducting research with observations or interviews.According to Bungin (2017), an important issue in data collection that must be considered is "how it can be ensured or believed that the sample determined is representative".In collecting data, researchers must be sure that the data obtained can strengthen the research results.The primary data collection method used in this research is: 1) Interview: According to Bungin (2017), an interview is often referred to as an interview, which means obtaining information for research purposes by conducting questions and answers face to face between the interviewer and the respondent.In this research, interviews as a data collection tool were carried out using the in-depth interview method, namely interviews with informants in depth to gather information about data related to waste management and costs incurred by the SKL Unit of Banjarmasin Islamic Hospital.

2) Observation
Observation is a data collection method used to collect research data through observation and sensing (Bungin, 2017).In this research, the researcher used unstructured observation, that is, observation was carried out without using an observation guide, that is, there was no need to understand theoretically the research object first.Data collected using unstructured observation includes direct observations related to waste management at the Banjarmasin Islamic Hospital.

3) Documentation
Secondary data collection was carried out by means of manual documentation in the SKL Unit environmental cost expenditure data archive.

Research Instrument
According to Bungin (2017) states that the qualitative research instrument is the researcher himself so that the reliability, validity of measurements and measuring tools.Reliability and validity are aimed at the feasibility and credibility of the researcher.Measurements and measuring tools in qualitative research are respondents and a list of questions in interviews.Bungin (2017) also stated that the research instrument is the researcher himself so he does not need a lot of tools.In this research, the researcher will be the research instrument, namely so that the results of the interview can be recorded properly and the researcher has evidence of having conducted interviews with respondents, supporting instruments are needed in the form of a recording device and photo camera, in this case the researcher uses a cellphone.

Research subject
The research subjects are informants, that is, they provide information regarding the required data.Research information in qualitative research is related to the steps taken by researchers so that data or information can be obtained (Bungin, 2017).Research subjects consist of parties involved in the research.
Determining informants can be done by researchers if the researcher understands the general research problem and also understands the anatomy of the community where the research is carried out (Bungin, 2017).In this research, researchers used a purposive procedure technique.According to Bungin (2017), purposive procedures are one of the most common strategies for determining informants in qualitative research, namely determining the group of participants who become informants according to selected criteria that are relevant to a particular research problem.An example of using this procedure is using a Key Informant.

General Description of Accounting and Financial Reporting Activities at Banjarmasin Islamic Hospital
The development of hospital dynamics, the very rapid development of medical technology, changes in payment pattern policies from fee for service to pre-payment and demands for quality health services require that hospitals can always provide evidence of high performance accountability to stakeholders so that resource management is needed effectively.transparent, effective and efficient in accordance with the principles of good corporate governance.As a form of accountability for the management of managed resources, hospitals must create financial management guidelines to ensure the level of soundness and reliability of financial reports prepared by the Muhammadiyah and Aisyiyah Health Business Charities.One effort to increase accountability in hospital financial management is by creating comprehensive guidelines and standards.For this reason, the Muhammadiyah Central Leadership Community Health Development Council (MPKU) collaborated with the UMY MMR Team to prepare Hospital Financial Management Guidelines, namely Guidebook 6 concerning Accounting Policies and Hospital Financial Reports.
The aim of preparing this guidebook is that it can be used as a reference and implemented well by the Banjarmasin Islamic Hospital in financial management, so that the financial management pattern at the Banjarmasin Islamic Hospital can be managed by applying the principles of healthy, standardized, productive practices and reporting can be done.consolidated down to the central level by the associations.
Financial reports must disclose all components that are material enough to influence management evaluations or decisions.Financial reports must be clear and understandable, based on accounting policies.The accounting policies at Banjarmasin Islamic Hospital are: 1) Policy on cash and cash equivalents 2) Policy on trade receivables 3) Policy on other receivables 4) Policy on down payments 5) Inventory policy 6) Corporate tax/income installment policy 7) Fee policy is paid in advance 8) Income policy that will still be accepted 9) Fixed asset policy 10) Deferred load policy 11) Fixed asset policy under construction 12) Inventory policies don't work 13) Security deposit policy 14) Current liability policy 15) Long-term liability policy 16) Equity policy 17) Deferred and current tax policies 18) Income policy 19) Expense policy 20) The financial reports of the Banjarmasin Islamic Hospital consist of business results reports, balance sheets, changes in equity reports, cash flow reports, explanatory notes to financial reports.
Structurally, the owner is Muhammadiyah.For financial reporting, it continues to the owner through the central representative of the Muhammadiyah Regional Leadership (PWM) and the representative of the Muhammadiyah Regional Leadership is the Daily Executive Board (BPH).Description of operational waste at the Banjarmasin Islamic Hospital.Results of in-depth interviews with the Head of the Environmental Health Sanitation Unit at the Banjarmasin Islamic Hospital as Key Informant 1 regarding operational waste produced by the Banjarmasin Islamic Hospital.Following are some excerpts from the interview: "The waste produced at this Islamic hospital is solid waste and liquid waste.Well, solid waste is in solid form while liquid waste is in liquid form.There is solid waste, both medical and nonmedical."Medical solid waste comes from medical activities, for example infectious waste,

"... sharps and needle waste comes from all medical activities in the hospital" (Key Informant 1).
"...pharmaceutical waste means waste from medicines that are no longer used, for example expired medicines and it could also be that the medicine has been opened in packaging so it is contaminated and can no longer be used, so it is waste" (Key Informant 1).

"... chemical waste is from the use of chemicals in medical and laboratory procedures, heavy metal means waste from metals used in chemical management from laboratories for medical purposes" (Key Informant 1). "... for liquid waste, some are included in the infectious waste category, such as blood waste originating from laboratory activities or pathology waste, surgical activities, delivery rooms that are in contact with patients that contain bacteria or viruses" (Key Informant 1).
"…it could also be liquid waste from water used for washing hands, water from bathrooms, water from laundry such as cloth from the hospital environment such as curtains, bolster pillowcases, bed sheets and others."Liquid waste can also damage the environment because it contains soap and substances that are not good for the environment" (Key Informant 1).
"…liquid waste needs to be handled specifically because it can cause an unpleasant odor and quickly spread disease, especially if it is not treated first, it can endanger the surrounding community."At the Islamic Hospital there is a Waste Water Treatment Plant or IPAL facility to neutralize liquid waste" (Key Informant 1).
Based on the results of in-depth interviews with the Head of the Environmental Health Sanitation Unit as Key Informant 1, the waste generated from operational activities of Banjarmasin Islamic Hospital is: 1.
Medical and non-medical solid waste.Medical solid waste is waste generated from medical activities.Examples of medical solid waste are: 2.
Non-medical solid waste is a type of waste generated from hospital services.Nonmedical solid waste includes organic waste and non-organic waste.For example, leaves, paper, plastic waste, rice wrappers or leftover food from visitors or kitchen activities.

3.
Liquid waste is liquid waste that is included in the infectious waste category, such as blood waste originating from laboratory activities or pathology waste, surgical activities, delivery rooms that are in contact with patients that contain bacteria or viruses.Liquid waste which is included in the domestic waste category comes from household waste such as from washing curtains, bolster pillowcases, bed sheets, used washing water.hands and water from the bathroom containing soap.Liquid waste needs special handling because it can cause an unpleasant odor and quickly spread disease, especially if it is not treated first, it can endanger the surrounding community.
According to the Republic of Indonesia Minister of Health Regulation no.7 of 2019 explains that hospital waste is all waste produced from hospital activities in solid, liquid and gas form.Results of in-depth interviews with cleaning staff at the Banjarmasin Islamic Hospital as supporting informant 8 regarding solid waste management.The following are excerpts from the interview: "There has never been any special housekeeping training for hospitals, taught only from the SKL unit" (supporting informant 8) "…here we work in 3 shifts, namely morning, afternoon and evening shifts."For our duties here we clean the hospital environment, for example cleaning patient rooms, rooms, gardens, pools and collecting waste" (supporting informant 8)

"...the waste location varies according to the type. Medical waste is yellow and non-medical waste is black" (supporting informant 8)
Results of observations and interviews with employee staff at Banjarmasin Islamic Hospital as supporting informants 7. The following are excerpts from the interview: "I have worked as a nurse assistant for 17 years, my daily job is to maintain patient hygiene" (supporting informant 7) "...there is, usually it's pampers waste, used sanitary napkins from patients after giving birth" (supporting informant 7) "...it is differentiated, there are special places, for example the waste used by patients after giving birth is placed in the yellow bag infectious waste area, if there is no blood it is just put in the normal rubbish bin" (supporting informant 7) "...no, because it's guaranteed, because the waste is differentiated according to the type of waste" (supporting informant 7) "...there is, when you want to get accreditation, you are always reminded to separate the waste" (supporting informant 7) The results of an in-depth interview with an official doctor who works at the Banjarmasin Islamic Hospital as a supporting informant 3. The following are excerpts from the interview: "There is no SOP related to waste management.I know that yellow bags are for medical waste and black bags are for non-medical waste.It is very important for there to be an SOP related to waste management because so far there have been none" (supporting informant 3).This is also in line with the results of an in-depth interview with a Head of the Nursing Team working at the Banjarmasin Islamic Hospital as a supporting informant 4.Here are some excerpts from the interview: "Regarding waste management, especially waste products, both medical solid waste and non-medical solid waste, it is usually communicated to us from the SKL Unit, but the SOP itself has never been seen displayed in hospitals or posted.In my opinion, the SOP regarding waste products from activities in the hospital is very important, because I have found visitors throwing non-medical waste into the medical waste bin, we often remind them.Usually there are also doctors who throw away things incorrectly, for example throwing away handscoons to brokers."I hope that there will be some kind of banner related to the SOP posted so that it can be seen by many people" (supporting informant 4) "This was coordinated by the SKL unit with us (supporting informant 4)" "I once took part in training related to liquid waste such as blood dripping, so I used a tool called a skillkit, even though the tool was complete with procedures for using and handling it, but at the time of the incident here, there was blood dripping in the patient's room, instead the cleaners were called" (supporting informant 4) Based on the results of observations, interviews and documentation related to the medical solid waste management process at the Banjarmasin Islamic Hospital, it is in accordance with applicable regulations, namely the Republic of Indonesia Minister of Health Regulation Number 7 of 2019 concerning hospital environmental health which explains that every hospital must manage and supervise medical waste starting from collection., transportation and destruction must undergo certification from the competent authority However, non-medical solid waste is still not optimal because it is not in accordance with the Republic of Indonesia Minister of Health Regulation Number 7 of 2019 concerning hospital environmental health.This is proven by several findings, namely: 1) For the container stage, there are several trash cans for non-medical waste containing black bags that don't have lids and are left open, even though based on Minister of Health Regulation Number 7 of 2019 Chapter III, it is stated that damaged trash cans must be replaced with trash cans that meet the requirements.2) For the storage stage at the TPS, it was also found that not all domestic solid waste was wrapped in black plastic bags but was scattered at the bottom of the TPS floor because based on Minister of Health Regulation Number 7 3) In 2019, CHAPTER III explained that domestic solid waste that had been placed in TPS was guaranteed to remain wrapped in black plastic bags and the contents were prohibited from being disassembled.4) And for sorting efforts, it was also found that there were organic solid waste and inorganic solid waste that were not sorted in accordance with Minister of Health Regulation Number 7 of 2019 CHAPTER III which explains that sorting is carried out by separating organic and inorganic waste types.
Meanwhile, for liquid waste there are also several findings such as: There is careless withholding of information regarding environmental costs that is misplaced on indirect costs rather than directly on the processes or products that create the costs.This practice can create problems if a manager does not know where to look for the necessary cost information so that it can obscure fixed costs that are difficult to reduce and variable costs that can be reduced or prevented by environmental management (Ikhsan, 2009).According to Ikhsan (2009) also explains that some costs are included in the gray zone or may be classified as some that are environmental and some that are not.Among the types of environmental costs that are potentially hidden from managers, such as direct labor costs related to the environment and administrative costs, are piled on general and hidden costs, such as monitoring, reporting and training costs related to environmental management.
Identify environmental costs in the operational costs report for the SKL Unit at Banjarmasin Islamic Hospital Environmental cost report in the environmental cost report at the SKL Unit of Banjarmasin Islamic Hospital The results of the interview with the Head of Finance as Key Informant 2, below are excerpts from the interview: "The environmental costs incurred by the SKL unit have so far been included in the asset maintenance expenses group, in the financial reports they are in the SHU report.So so far there has never been a special report for environmental costs" (Key Informant 2).
The environmental cost report applied for 2019 and 2020 as an internal report at the SKL Unit of Banjarmasin Islamic Hospital based on Hansen and Mowen's (2017) environmental cost theory is expressed as follows:  Based on the results of interviews with the Head of the Environmental Health Sanitation Unit and the Head of Finance at the Banjarmasin Islamic Hospital, the increase in costs was due to the Banjarmasin Islamic Hospital receiving Covid patients during the 2020 pandemic so that the waste produced from the Covid room, whether medical or non-medical waste, was treated.as covid waste.Furthermore, there are costs incurred for prevention and detection activities.It was recorded that the total costs incurred for prevention activities were IDR 470,130,500 in 2019 and IDR 465,290,600 in 2020.Meanwhile, detection activities amounted to IDR 34,761,000 for 2019 and IDR 20,992,000 for 2020.Finally, the recorded external failure costs incurred were nil due to the absence of activities or events that could be categorized as external failures.
Relative Distribution of Environmental Costs at the Banjarmasin Islamic Hospital Based on Islamic Hospital environmental cost report data Banjarmasin which researchers have previously made, a comparison of the relative distribution between the environmental costs of the Banjarmasin Islamic Hospital in 2019 and 2020 can be made.The definition of relative distribution is a percentage number that explains the amount of data in a particular group.Comparisons will be made according to cost activities.The following is a table that presents the relative distribution of environmental costs at the Banjarmasin Islamic Hospital: 3) Internal failure costs with a relative distribution ratio are 56.79% of total environmental costs.The costs incurred for internal failure costs were IDR 663,439,000.4) External failure costs with a relative distribution ratio of 0% of total environmental costs.There are no costs incurred for these two costs.5) Internal failure costs with a relative distribution ratio are 63.66% of total environmental costs.The costs incurred for internal failure costs amounted to IDR 851,842,900.-.
6) External failure costs with a relative distribution ratio of 0% of total environmental costs.There are no costs incurred for these two costs.
Based on this information, it is hoped that it can reduce the impact of environmental damage (waste).This is in line with the application of the expanded theory of ecocentrism in deep ecology which demands a new ethic that is not centered on humans, but is centered on the whole of life with efforts to overcome environmental problems and the importance of harmony between the surrounding environment and the activities of an agency in this research, namely hospitals. .

Implications of Research Results
Based on the results of this research, the following theoretical and practical implications can be stated: 1) Theoretically, hospitals as institutions or institutions operating in the health sector have a fairly large and significant role in protecting the environment.If medical waste produced by hospitals is not managed properly, it can result in a polluted environment.In its activities, every hospital produces waste which is classified as hazardous waste, especially medical waste.
It cannot be denied that hospitals really need to implement good environmental management.Environmental management accounting is predominantly related to providing information for internal decision making.The application of environmental costs according to Hansen and Mowen's theory is based on 4 categories of activity costs, namely, prevention costs, detection costs, internal failure costs, external failure costs, which can be applied in agencies.Hospitals, especially the Banjarmasin Islamic Hospital.2) Practically, the results of this research are used as input for hospital agencies that reporting environmental costs can provide an overview of the costs incurred as a result of environmental management activities so that the information conveyed, especially expenditures in the SKL unit of Banjarmasin Islamic Hospital, can be clearly seen for convenience.in the managerial decision making process at Banjarmasin Islamic Hospital.

Research Limitations
This research was carried out in accordance with ethical research considerations, however, in its implementation there were limitations, namely: 1.The financial report for the Banjarmasin Islamic Hospital cannot be presented in this research because the report is internal and confidential.So researchers can only present details of the environmental costs at the Banjarmasin Islamic Hospital.2. The focus of the research data is only 2019 and 2020, and waste management data in 2021 during the Covid-19 pandemic has not been included.

CONCLUSIONS
Based on the results of the research and analysis that researchers have carried out, several conclusions have been drawn as follows: 1. Waste management activities as a form of environmental responsibility carried out by the management of the Banjarmasin Islamic Hospital in the form of non-medical solid waste are still not optimally carried out, likewise liquid waste management in terms of Waste Water Management Installation (IPAL) equipment does not meet the predetermined requirements, namely it does not have Special medical wastewater treatment plant with an anaerobic aerobic biofilter system but only domestic wastewater treatment plant.2. Environmental costs arising from waste management activities in the financial reports of the Banjarmasin Islamic Hospital found that there were environmental costs P-ISSN: 2338 -1205 E-ISSN: 2985 -461X Padlah Riyadi

Table 4
Supporting Informants