4. Given the financial ratio and operating benchmarks below, assess the hospital's performance and provide recommendations to improve financial performance.

Profitability	Hospital	Median	25th	75th	% Difference
Total Margin	3.3%	4.4%	-0.2%	9.7%	-24.1%
Operating Margin	2.9%	3.8%	-0.8%	9.1%	-22.9%
ROA	3.4%	4.5%	1.2%	18.0%	-24.4%
ROE	5.9%	8.4%	-0.1%	10.4%	-29.8%
Liquidity
Days in AR	54.0	56.1	46.8	70.5	-3.7%
Capital Structure
Times Interest Earned	3.84	4.7	0.9	13.1	-17.6%
Equity Financing	54.8%	57.5%	35.2%	79.2%	-4.7%
Turnover
Total Asset Turnover	1.10	1.2	0.8	1.7	-4.3%
Current Asset Turnover	3.50	3.7	2.4	5.1	-4.4%
Fixed Asset Turnover	2.67	2.7	1.9	4.3	-1.8%
Operating Indicators	Hospital	Median	25th	75th	% Difference
Occupancy	56.8%	55.3%	39.0%	68.4%	2.7%
Discharges per bed	34.1	33.0	17.4	47.5	3.3%
Adjusted ALOS	2.8	2.7	2.4	3.0	3.7%
Medicare % Discharges	44.9%	40.3%	30.0%	52.9%	11.4%
Medicaid % Discharges	7.3%	5.7%	1.9%	12.9%	28.1%
Outpatient Revenue %	44.7%	58.4%	44.2%	71.5%	-23.5%
Salaries per Adjusted Discharge	$2,561	$2,382	$1,982	$2,866	7.5%
FTEs per Occupied Bed	4.0	3.7	3.2	4.3	9.3%
Salaries as % of Total Expense	42.7%	39.8%	34.6%	44.7%	7.3%
Deductible ratio	68.2%	62.7%	48.8%	72.0%	8.8%