A comprehensive paper will be dueSunday of weeksevenof the course. The topic is based upon an actual case study of two small hospitals located in central Washingtonstate. The final project report should consist of a comprehensive report (~ 8-10 pages plus any spreadsheets and other addenda and other supporting documents, as warranted). You may follow the Modern Language AssociationMLAor American Psychological Association,APAstyle guide for your Paper. This will serve as an outstanding learning opportunity.

Course Project

Purpose:

The purpose of this Course Project is:

• To provide the student with a real life learning experience relating to the challenges of healthcare evolution following the Affordable Care Act and Hospital Value-Based Purchasing legislation;
• To provide the student with an opportunity to fully research and evaluate financials, demographics and clinical information relating to Safety-Nethospital providers;
• To provide the student with an opportunity for critical thinking alternative solutions and recommendations for corrective action based upon their research and evaluation of the Case;
• To provide the student a learning experience evaluating options for aregional population-based health delivery network
• To provide the student to design a meaningful format for a Strategic Business Plan.

Overview:

Today, many hospitals are closing and downsizing as a result of lacking financial resources due to continued tightening of federal and state reimbursement, lacking of financial resources to upgrade needed technology, market competition and the on-going efforts of large systems to consolidate facilities. The hospitals that do survive these challenges must redesign their organizational structure and develop new and needed alternatives to ensure they continue their mission of meeting the health care requirements within their respective communities. It is even more difficult for smaller and somewhat isolated communities because physicians often choose an urban environment with sophisticated technology not affordable in smaller community hospitals. The Project detail is as follows:

Klickitat County is located in the State of Washington and has a population of 20,318 according to the County is in south central Washington State and its southern border is the State of Oregon. It consists of 1,904 square miles. There is an average of 10 people per square mile, and basically two centers of population hubs; and 19.1% of the population residents at below federal poverty guidelines. The comparative Washington state average is 12.9%. It consists of an extremely rural, isolated, socioeconomically deprived population base. According to the US Census Bureau, any area under 7 people per square mile is considered Frontier Land.

The County population centers consist of Goldendale in the eastern/central and White Salmon to the southern/western demographics. The communities are approximately 40 miles apart with few people living between. Goldendale has a population base of 3,407 residents and a decrease of 9.4% over the past ten year census period. It is designated as the County Seat and local government. White Salmon is located on the Columbia River Gorge and has a population base of 2,193 residents and a 1.4% increase in population over the past ten years.

Healthcare services for the population are provided by two small district hospitals that are owned and operated by the individual municipalities. Both hospitals are extremely under-utilized and therefore, the taxpayers provide a major annualized financial subsidy to ensure services are available for the residents. Skyline Hospital located in White Salmon, Washington serves the western townships of the County; while, Klickitat Valley Hospital serves the central and eastern regions. The comparative Mission Statements and other details are published at the following websites:

www.kvhealth.net(Links to an external site.)

www.skylinehospital.com(Links to an external site.)

Both communities want to retain services within their respective communities, but it is becoming increasingly difficult because of lacking of resources. Neither community appears willing to consolidate the hospitals and share resources in efforts to maintain basic healthcare services and reduce costs to the taxpayers. They both want autonomy and control of their respective healthcare system. Both facilities are considered the largest localized employer within the community and serve as an economic resource. The County is considered a Federal Medical Underserved Area which basically means there are not enough healthcare professionals to appropriately meet the needs of the population.

There is a larger hospital located in northern Oregon that is capable of receiving more traumatic cases and provides additional Obstetrical Services for the entire County as neither hospital appears to be able to appropriately finance obstetricians for this service. Realize the hospitals are forty miles apart and basically have their individualized service areas and market. Each hospital is designated as a Critical Access Hospital and basically provide appropriate services for such designation.

The following information compares basic demographic information for each facility.

Comparative Demographics	Skyline Hospital	Klickitat Hospital
Licensed Beds	32	25
Number of Admissions Acute (Current Year)	295	199
Number of Admissions Skilled Nursing (Current Yr.)	76	52
Days of Care Acute (Current Year)	753	616
Days of Care Skilled Nursing (Current Year)	1,014	1,175
Average Daily Census Acute	2.0	1.7
Average Daily Census Skilled Nursing	2.8	3.2
Average Daily Census Total Facility	4.8	4.9
Average Available Daily Beds	25	17
% of Occupancy (All Beds)	15.1%	19.6%
Taxpayer Subsidy (Annualized)	$506,716	$1,455,016
Bad Debts (Annualized)	$1,246,579	$1,486,504
Full-Time Equivalent Employees (1 Emp=40Hrs)	109.24	167.35
Net Operating Revenue	$15,380,655	$18,929,514
Operating Expenses	$17,129,538	$20,553,613
Operating Margin (Loss)	$ (984,862)	$ (904,009)

Klickitat County Health Care Consolidation Coalition

This hypothetical Coalition consists of business and civic leaders residing in Klickitat County who believe there must be a change within the healthcare services so that tax subsidies are reduced and a new delivery system will evolve based on serving the entire population through HVBP throughout the County. There are several concepts which this group is evaluating. Examples include:

1. Closing one facility and only have one hospital serving the entire population of the County.
2. Merge the hospitals and form a new corporation and name structure and re-deploy services so that financial solvency may be retained. Some consolidation and reduction in services would take place. Mergers could be considered with a larger regional trauma center.
3. Close one hospital and maintain it as an urgent care center with supporting ancillary services.
4. Leave the situation as is and wait for one facility to realize they can no longer survive in the manner they are operating.
5. Other alternatives as reasonable and realistic for this population density and isolation level.

As you begin developing this project, yourstrategic goals would basically be determining which one of the five examples above would be most appropriate to reduce tax subsidy and yet maintain adequate and appropriate healthcare delivery services for the residents of Klickitat County. You will need to carefully complete an analysis for each facility's financial statements, business ratios, utilization, staffing FTEs (full-time equivalent employees) and quality measurements. SWOT and Root Cause Analysis may be beneficial for this project. Realize, the information provided is based upon a real situation that currently exists in this County. However, there is no Klickitat County Health Care Consolidation Coalition at this time. This is now a period to seriously evaluate the transition from traditional localized services to regional healthcare delivery.

You will be required to finalize a minimum 8-10 page report on your conclusions (plus any addenda, etc.). Be specific about your data search, using appropriate references to verify how you arrived at your recommendations. Use excel grids and graphs as appropriatein reaching your conclusions.This final document must be prepared in an extremely professional manner. There is no right or wrong answer: it is based strictly on the opinion and research completed by you, the author. This case represents today'shealthcare finance issues at its best!! (Worst?)Use the innovative and creative learning skills you have acquired and design thinking and project management concepts to assess this situation and formalize a realistic and reasonable conclusion.

There is significant financial and statistical information available through the Hospital Data Reports for the State of Washington.http://www.doh.wa.gov/DataandStatisticalReports/(Links to an external site.)Just open the site under hospital data and drill down to the above two facilities. There is also an excellent site that can be located for theKlickitat County Public Health Department. Also, each hospital has its own website that details its specific facility. There are several other sites available to obtain information. It is important to evaluate the quality indicators acquired through Medicare Compare Hospitals.

Example of Planning Process that should be included in your report:

The planning process used to develop the strategic plan is comprised of two major phases a strategic planning phase and an implementation / measurement phase.

Phase 1 Strategic Planning Assess the current situation, develop long-term goals, and select the strategies that will advance the organization towards its vision.

Here is an excellent overview of the strategic planning process:click here(Links to an external site.).

Phase 2 Implementation Planning / Measurement Determine the specific actions or tactics, along with their resources and timing, to implement the plan. Regularly measure performance against established metrics and milestones to ensure the strategic plan is successfully implemented.

EDIT Klickitat County Public Hospital District #1 H-0 VOLUME: Hospital Admissions Hospital Patient Days FYE 12/31/2014 Info Page 199 616 Payer CC Detail 192 627 638 52 1,175 59 1,182 399 ATC Admissions ATC Patient Days 0 0 0 0 0 Newborn Admissions Newborn Patient Days 0 0 SNF/Swing Admissions SNF/Swing Patient Days 0 OPERATING EXPENSES: Salaries Employee Benefits Professional Fees Supplies Purch Srv - Utilities Purch Srv - Other Depreciation Leases/Rentals Insurance Licenses & Taxes Interest Ins, Lic. & Taxes, and Interest Other Direct Expense Total Other Direct Expense Total Expenses FS-3 9,037,184 2,215,161 2,141,770 1,337,436 308,507 2,890,608 1,230,871 309,185 225,614 15,275 332,078 572,967 509,924 1,082,891 20,553,613 CC Detail 9,037,184 2,215,161 2,141,770 1,337,436 308,507 2,890,608 1,230,871 309,185 DEDUCTIONS: Bad Debt Contractuals Charity Care Other Deductions Total Other Deductions SS-8 1,486,504 12,941,011 600,884 203,524 15,231,922 FS-3 1,486,504 12,941,011 600,884 203,524 15,231,923 CHARITY CARE FIXED ASSET ENDING BALANCES: Land Land Improvements Buildings Fixed Equip - Bldg Serv Fixed Equip - Other Equipment (Moveable) Leasehold Improvements Construction In Progress Total Accum Depre Ending Balance 1,230,871 309,185 225,617 15,275 332,078 572,971 0 0 600,884 FS-3 820,090 0 CC-DETAIL 820,090 0 FS-3 3,913,577 30,147,860 34,061,437 CC-DETAIL 3,913,577 30,147,860 34,061,437 PATIENT SERVICE REVENUE: IP Revenue OP Revenue Gross Revenue 2,215,160 Deductions From Revenue Support Sched. # Of Patients Inpatient Outpatient OTHER REVENUES: Other Revenue Tax Revenue 0 1,082,887 1,082,887 20,553,610 Support Sched. FS-1 203,707 1,368,080 16,059,470 0 0 5,577,782 0 1,332,746 24,541,786 SS-4 203,707 1,368,081 16,059,470 0 0 5,692,033 0 1,332,746 24,656,038 13,739,587 13,739,587 PAYER INFO 3,913,577 30,147,860 34,061,437 Page 1 of 21 TRANSMITTAL AND CERTIFICATION HOSPITAL'S YEAR END REPORT TO The Department of Health Office of Hospital and Patient Data P.O. Box 47814 Olympia, Washington 98504-7814 Name of Hospital: License Number: Street Address: Mailing Address: City and Zip Code: FROM Klickitat County Public Hospital District #1 H-008 310 310 Goldendale CERTIFICATION OF OFFICER OF HOSPITAL I HEREBY CERTIFY that I have examined the accompanying Hospital Year End Report as specified by the Department of Health for the fiscal year ended 12/31/2014. To the best of my knowledge and belief, they are true and correct statements prepared from the books and records of the Hospital in accordance with applicable instructions. x Signature of Chief Executive Officer Name/Title: Date: x Signature of Chair of Governing Board Name/Title: Date: Page 2 of 21 HOSPITAL INFORMATION 1 Fiscal Year Ended: 12/31/2014 License Number: H-8 2 Hospital Name Klickitat County Public Hospital District #1 3 County Klickitat 4 Executive Officer Leslie Hiebert 5 Financial Officer Jamie Eldred 6 Chair of Gov Brd Jim Daniel 7 Telephone # 5097734022 8 Facsimile # 5097734714 9 TYPE OF ORGANIZATION HAVING CONTROL (check one only) Governmental Not For Profit For Profit State Church Op. Individual County Other Partnership City/County X Corporation Hosp. Dist. 10 ACTUAL UTILIZATION Admissions Intensive, Semi-Intensive, Acute & Psych 199 616 52 1,175 0 0 0 0 Skilled Nursing Facility / Swing Chemical Dependency / ATC 11 Number of Births 12 # of Beds Available Beds Intensive Care Patient Days # of Beds Available 0 Skilled Nursing Semi -Intensive Care 10 Swing Beds Beds 0 7 Acute - Medical / Surg 0 Chemical Dependency 0 Acute - Pediatrics 0 Other (Excl Nursery) 0 Acute - Obstetrical 0 Total Beds Available 17 Acute - Rehabilitation 0 (Excluding Nursery) Psychiatric 0 Total Beds Licensed 25 Nursery - Bassinets 0 13 Skilled Nursing Ancillary Revenue : 0 15. PAYOR UNITS OF SERVICE AND REVENUE Page 3 of 21 Hospital Name: Klickitat County Public Hospital District #1 YE-A FYE: 12/31/2014 HOSPITAL ONLY Units of Service PAYOR Admissions Pat. Days Revenue OP Visits Inpatient Outpatient Total Medicare 128 449 0 2,418,413 12,657,957 15,076,370 Medicaid 33 106 0 685,138 7,731,529 8,416,667 All Other 31 72 0 440,013 9,758,374 10,198,387 Total 192 627 0 3,543,564 30,147,860 33,691,424 SNF / SWING ONLY Units of Service PAYOR Admissions Pat. Days Revenue OP Visits Inpatient Outpatient Total Medicare 42 358 0 164,106 0 164,106 Medicaid 5 516 0 155,405 0 155,405 All Other 12 308 0 50,502 0 50,502 Total 59 1,182 0 370,013 0 370,013 CHEMICAL DEPENDENCY/ATC ONLY Units of Service PAYOR Admissions Pat. Days Revenue OP Visits Inpatient Outpatient Total Medicare 0 0 0 0 0 0 Medicaid 0 0 0 0 0 0 All Other 0 0 0 0 0 0 Total 0 0 0 0 0 0 16. Hospital Based Physicians - Professional Component Revenue : 0 Expense : 0 SUPPORTING SCHEDULES Hospital: Klickitat County Public Hospital District #1 1 Page 4 of 21 FYE: 12/31/2014 SS-2 EMPLOYEE BENEFITS 2 Fica Taxes 637,801 3 Unemployment Compensation 3,555 4 Workers Compensation 92,030 5 Group Health Insurance 1,340,727 6 Group Life Insurance 18,096 7 Pension & Retirement 117,834 8 Other Employee Benefits 5,117 9 Other Employee Benefits 0 10 TOTAL EMPLOYEE BENEFITS 11 2,215,160 SS-3 RENTAL AND LEASE EXPENSE 12 Rental & Lease Expense - Buildings 0 13 Rental & Lease Expense - Equipment 309,185 14 TOTAL RENTAL & LEASE EXPENSE 309,185 15 SS-5 INSURANCE EXPENSE 16 INSURANCE 17 Hospital & Professional Malpractice Insurance 18 Other Insurance 46,218 19 TOTAL INSURANCE 20 225,617 LICENSE AND TAXES 21 License Fees 14,137 22 Taxes (other than Income) 1,138 23 Other 0 24 TOTAL LICENSE AND TAXES 25 179,399 15,275 SS-6 INTEREST EXPENSE 26 Interest Expense - Working Capital 0 27 Interest Expense - Other 332,078 28 TOTAL INTEREST EXPENSE 332,078 SS-4 DEPRECIATION EXPENSE Page 5 of 21 Hospital: Klickitat County Public Hospital District #1 FYE: 12/31/2014 FIXED ASSETS Beginning Ending Balance 1 Land Additions Balance 0 0 203,707 0 0 1,368,081 16,059,470 0 0 16,059,470 4 Fixed Equipment-Bldg Serv 0 0 0 0 5 Fixed Equipment-Other 0 0 0 0 5,480,822 697,741 486,530 5,692,033 7 Equipment-Minor 0 0 0 0 8 Leasehold Improvements 0 0 0 0 143,687 1,457,419 268,360 1,332,746 23,052,060 2,155,160 754,890 24,656,038 2 Land Improvements 3 Buildings 6 Equip-Major Moveable 9 Construction-in-process 10 TOTAL 1,368,081 Retirements Err:509 ACCUMULATED DEPRECIATION Beginning Total Balance Provision Ending Retirements Balance 11 Land 12 Land Improvements 762,078 90,377 0 852,455 8,110,280 648,475 0 8,758,755 14 Fixed Equipment-Bldg Serv 0 0 0 0 15 Fixed Equipment-Other 0 0 0 0 4,048,887 492,020 412,530 4,128,376 17 Equipment-Minor 0 0 0 0 18 Leasehold Improvements 0 0 0 0 19 Construction-in-process 0 0 0 0 12,921,245 1,230,871 412,530 13,739,587 13 Buildings 16 Equip-Major Moveable 20 TOTAL S-8 DEDUCTIONS FROM REVENUE Hospital: Klickitat County Public Hospital District #1 ACCT: 1 Page 6 of 21 FYE: 12/31/2014 Item: Provision for Bad Debt 2 1,486,504 Contractual Adjustments 3 5810 Medicare 7,159,939 4 5820 Medicaid 3,140,094 5 5830 Workers Compensation 6 5840 Other Government Programs 0 7 5850 Negotiated Rates 0 8 5860 Other 9 16,424 2,624,555 Total Contractual Adjustments 12,941,011 10 11 12 Charity Care Number of Charity Care Patients 0 13 14 5900 Inpatient Charity Care Provided 15 5910 Outpatient Charity Care Provided 0 600,884 16 17 18 Total Charity Care 600,884 19 20 5970 Administrative Adjustments 0 5980 Other Deductions (specify) 203,524 21 22 23 TOTAL DEDUCTIONS FROM REVENUE 24 Explanations 15,231,922 BALANCE SHEET (Pg 1) HOSPITAL: Klickitat County Public Hospital District #1 FYE: 12/31/2014 FYE: 12/31/2013 ASSETS 1 CURRENT ASSETS: 2 Cash 3,547,223 2,281,123 3 Marketable Securities 0 0 4 Accounts Receivable 4,546,093 4,921,238 5 Less-Estimated Uncollectable & Allowances 2,263,133 2,460,515 6 Receivables From Third Party Payors 846,905 814,626 7 Pledges And Other Receivables 151,256 291,256 8 Due From Restricted Funds 9 Inventory 10 Prepaid Expenses 11 Current Portion Of Funds Held In Trust 12 TOTAL CURRENT ASSETS 0 0 170,277 211,649 158,457 63,800 0 0 7,157,078 6,123,176 686,997 399,708 13 14 BOARD DESIGNATED ASSETS: 15 Cash 16 Marketable Securities 17 Other Assets 18 TOTAL BOARD DESIGNATED ASSETS: 0 0 608,954 188,614 1,295,951 588,322 203,707 203,707 1,368,080 1,368,081 19 20 PROPERTY, PLANT AND EQUIPMENT: 21 Land 22 Land Improvements 23 Buildings 16,059,470 16,059,470 24 Fixed Equipment - Building Service 0 0 25 Fixed Equipment - Other 0 0 5,577,782 5,480,822 27 Leasehold Improvements 0 0 28 Construction In Progress 1,332,746 143,687 29 TOTAL 24,541,786 23,255,767 30 Less Accumulated Depreciation 13,739,587 12,921,246 31 NET PROPERTY, PLANT & EQUIPMENT 10,802,198 10,334,521 34 Investments In Property, Plant & Equipment 0 0 35 Less - Accumulated Depreciation 0 0 36 Other Investments 0 0 37 Other Assets 0 0 38 TOTAL INVESTMENTS & OTHER ASSETS 0 0 41 Goodwill 0 0 42 Unamortized Loan Costs 0 0 43 Preopening And Other Organization Costs 0 0 44 Other Intangible Assets 0 0 45 TOTAL INTANGIBLE ASSETS 0 0 19,255,227 17,046,020 26 Equipment 32 33 INVESTMENTS AND OTHER ASSETS: 39 40 INTANGIBLE ASSETS: 46 TOTAL ASSETS ** Rounding is $1 BALANCE SHEET (Pg 2) HOSPITAL: Klickitat County Public Hospital District #1 FYE: 12/31/2014 FYE: 12/31/2013 LIABILITIES AND FUND BALANCES-UNRESTRICTED 1 CURRENT LIABILITIES 2 Notes and Loans Payable 3 Accounts Payable 4 Accrued Compensation and Related Liabilities 5 Other Accrued Expenses 6 Advances from Third Party Payors 7 Payables to Third Party Payors 194,473 205,863 1,016,262 644,535 888,046 387,807 29,412 503,635 0 0 1,298,474 770,260 8 Due to Restricted Funds 0 0 9 Income Taxes Payable 0 0 62,049 0 872,530 839,536 4,361,245 3,351,635 15 Deferred Income Taxes 0 0 16 Deferred Third Party Revenue 0 0 17 Other Deferred Credits 0 0 18 TOTAL DEFERRED CREDITS 0 0 21 Mortgage Payable 0 7,132,456 22 Construction Loans-Interim Financing 0 0 23 Notes Payable 0 104,789 23,487 0 8,003,391 0 186,111 294,159 0 0 8,212,989 7,531,404 872,530 839,536 7,340,459 6,691,868 7,553,523 6,485,751 0 0 0 0 0 0 0 516,766 0 0 10 Other Current Liabilities 11 Current Maturities of Long Term Debt 12 TOTAL CURRENT LIABILITIES 13 14 DEFERRED CREDITS: 19 20 LONG TERM DEBT 24 Capitalized Lease Obligations 25 Bonds Payable 26 Notes and Loans Payable to Parent 27 Noncurrent Liabilities 28 TOTAL 29 Less Current Maturities of Long Term Debt 30 TOTAL LONG TERM DEBT 31 32 TOTAL FUND BALANCE 33 34 EQUITY (INVESTOR OWNED) 35 Preferred Stock 36 37 Common Stock 38 39 Additional Paid In Stock 40 41 Retained Earnings (Capital Account for Partnership 42 (or Sole Proprietorship) 43 44 Less Treasury Stock 45 TOTAL EQUITY 46 TOTAL LIABILITIES AND FUND BALANCE OR EQUITY 7,553,523 7,002,517 19,255,227 17,046,020 ** Rounding is $1 INCOME STATEMENT - UNRESTRICTED FUND HOSPITAL: Klickitat County Public Hospital District #1 FYE: 12/31/2014 1 FYE: 12/31/2013 OPERATING REVENUE: 2 Inpatient Revenue 3,913,577 3,547,574 3 Outpatient Revenue 30,147,860 26,581,277 4 TOTAL PATIENT SERVICES REVENUE 34,061,437 30,128,851 7 Provision for Bad Debts 1,486,504 1,886,976 8 Contractual Adjustments 12,941,011 10,070,366 9 Charity and Uncompensated Care 600,884 813,435 10 Other Adjustments and Allowances 203,524 (124,218) 11 TOTAL DEDUCTIONS FROM REVENUE 15,231,923 12,646,559 12 NET PATIENT SERVICE REVENUE 18,829,514 17,482,292 820,090 666,581 0 0 820,090 666,581 19,649,604 18,148,873 21 Salaries and Wages 9,037,184 8,961,843 22 Employee Benefits 2,215,161 2,397,721 23 Professional Fees 2,141,770 1,484,495 24 Supplies 1,337,436 1,298,723 308,507 283,552 26 Purchased Services - Other 2,890,608 2,321,071 27 Depreciation 1,230,871 1,174,232 28 Rentals and Leases 309,185 285,774 29 Insurance 225,614 243,804 15,275 124,082 31 Interest 332,078 351,053 32 Other Direct Expenses 509,924 406,231 20,553,613 19,332,580 (904,009) (1,183,706) 1,455,016 1,700,472 551,007 516,766 41 EXTRAORDINARY ITEM 0 0 42 FEDERAL INCOME TAX 0 0 551,007 516,766 5 6 DEDUCTIONS FROM REVENUE: 13 14 OTHER OPERATING REVENUE 15 Other Operating Revenue 16 Tax Revenues 17 TOTAL OTHER OPERATING REVENUE 18 TOTAL OPERATING REVENUE 19 20 25 Purchased Services - Utilities 30 License and Taxes 34 TOTAL OPERATING EXPENSES 35 NET OPERATING REVENUE OPERATING EXPENSES 36 37 NON-OPERATING REVENUE-NET OF EXPENSES 38 39 NET REVENUE BEFORE ITEMS LISTED BELOW 40 43 44 NET REVENUE OR (EXPENSE) 45 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 3 Unit Description 4 Units of Measure 6010 6030 6070 6100 6120 Intensive Semi Acute Alternative Physical Care ICU Care Birthing Ctr Rehab Patient Days Patient Days Patient Days Patient Days Patient Days 0 0 616 0 0 0.00 0.00 22.78 0.00 0.00 6 Salaries & Wages 0 0 1,295,009 0 0 7 Employee Benefits 0 0 306,079 0 0 8 Professional Fees 0 0 1,016,015 0 0 9 Supplies 0 0 86,203 0 0 10 Purch Srv - Utilities 0 0 4,176 0 0 11 Purch Srv - Other 0 0 101,078 0 0 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 39,934 0 0 14 Other Direct Expenses 0 0 32,674 0 0 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 0 2,881,168 0 0 18 Cost Allocations 0 0 1,343,207 0 0 19 Inpatient Revenue 0 0 1,932,474 0 0 20 Outpatient Revenue 21 Total Patient Revenue 0 0 0 0 1,640,826 3,573,300 0 0 0 0 22 Plant Square Feet 0 0 4,438 0 0 23 Dietary Meals 0 0 6,297 0 0 24 Housekeeping Hours 0 0 5,164 0 0 5 Full Time Equivalents 17 Tax Revenue Cost Allocation Statistics 25 Laundry Dry Pounds 26 Nursing FTE's 0 0 1,881 0 0 0.00 0.00 7.67 0.00 0.00 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 6170 6200 6210 6330 6400 Skilled Swing Hospice - Other Daily Nursery Nursing Beds Inpatient Services Newborn Days Patient Days Patient Days Patient Days Patient Days 2 Account Name 3 Unit Description 4 Units of Measure 0 0 399 441 22 0.00 0.00 0.00 0.58 0.00 6 Salaries & Wages 0 0 0 35,596 11,656 7 Employee Benefits 0 0 0 0 0 8 Professional Fees 0 0 0 0 0 9 Supplies 0 0 0 15,806 0 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 0 0 8,769 0 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 0 4,133 0 14 Other Direct Expenses 0 0 0 6,764 0 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 0 0 71,068 11,656 18 Cost Allocations 0 0 0 27,362 (47,222) 19 Inpatient Revenue 0 0 0 0 0 20 Outpatient Revenue 0 0 0 216,551 9,143 21 Total Patient Revenue 0 0 0 216,551 9,143 22 Plant Square Feet 0 0 0 0 26,056 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 0 0 0 0 5 Full Time Equivalents 17 Tax Revenue Cost Allocation Statistics 25 Laundry Dry Pounds 26 Nursing FTE's 0 0 185 0 0 0.00 0.00 0.00 0.20 0.00 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 3 Unit Description 4 Units of Measure 7030 7040 Recovery Room Anesthesia Recovery Min Anesthia Min 7050 7060 7070 Central Intravenous Services Therapy Laboratory Bill. Tests 0 0 0.00 2.00 0.00 0.00 8.76 6 Salaries & Wages 0 247,398 0 0 535,143 7 Employee Benefits 0 50,216 0 0 105,223 8 Professional Fees 0 0 0 0 12,077 9 Supplies 0 9,091 0 0 373,447 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 0 0 0 158,032 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 0 0 28,307 14 Other Direct Expenses 0 10,278 0 0 17,742 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 316,983 0 0 1,229,972 18 Cost Allocations 0 79,873 (995) 0 531,820 19 Inpatient Revenue 0 13,670 0 0 444,261 20 Outpatient Revenue 0 278,928 0 0 4,272,311 21 Total Patient Revenue 0 292,598 0 0 4,716,572 22 Plant Square Feet 0 0 518 0 1,604 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 0 0 0 0 5 Full Time Equivalents 65,526 17 Tax Revenue Cost Allocation Statistics 25 Laundry Dry Pounds 26 Nursing FTE's 0 20 559 0 147 0.00 0.00 0.00 0.00 0.00 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 3 Unit Description 4 Units of Measure 7130 7140 7150 7160 7170 CT Radiology- Radiology- Nuclear Scanning Diagnostic Therapeutic Medicine HECT Unit RVU RVU RVU Pharmacy 1,499 5,766 0 0 0.00 10.95 0.00 0.00 0.46 69,414 555,675 0 0 18,421 0 124,144 0 0 1,889 107,569 162,458 0 0 0 12,797 16,016 0 0 156,047 1,118 3,935 0 0 0 97,907 87,096 0 0 136,590 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 0 0 9,166 282 3,969 0 0 748 0 0 0 0 0 289,086 953,292 0 0 322,861 18 Cost Allocations 261,052 392,102 0 0 169,028 19 Inpatient Revenue 223,242 247,284 0 0 638,925 20 Outpatient Revenue 3,331,523 3,385,629 0 0 1,046,886 21 Total Patient Revenue 3,554,765 3,632,913 0 0 1,685,811 575 2,979 0 0 213 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 0 0 0 0 5 Full Time Equivalents 6 Salaries & Wages 7 Employee Benefits 8 Professional Fees 9 Supplies 10 Purch Srv - Utilities 11 Purch Srv - Other 14 Other Direct Expenses 15 Recoveries 16 Adjusted Direct Expenses 17 Tax Revenue Cost Allocation Statistics 22 Plant Square Feet 25 Laundry Dry Pounds 26 Nursing FTE's 20 391 0 0 68 0.00 0.00 0.00 0.00 0.00 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 3 Unit Description 4 Units of Measure 7200 7220 7230 7240 7250 Physical Psychiatric Emergency Therapy Day Care Room Ambulance Stay Treatments Visits Visits Occasions Outpatients Short 14,954 0 4,413 0 0 2.16 0.00 16.58 0.00 0.00 6 Salaries & Wages 58,877 0 1,041,479 0 0 7 Employee Benefits 26,631 0 215,391 0 0 0 0 584,142 0 0 9,112 0 64,908 66,201 0 0 0 373 4,302 0 307,660 0 10,105 1,004,832 0 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 18,539 557 0 62 0 10,346 23,540 0 0 0 0 0 0 402,342 0 1,945,283 1,099,432 0 138,445 0 806,610 338,736 0 93,787 0 54,445 1,834 0 969,720 0 7,333,529 2,133,208 0 1,063,506 0 7,387,974 2,135,042 0 1,352 0 2,909 2,450 0 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 0 0 0 0 5 Full Time Equivalents 8 Professional Fees 9 Supplies 10 Purch Srv - Utilities 11 Purch Srv - Other 14 Other Direct Expenses 15 Recoveries 16 Adjusted Direct Expenses 17 Tax Revenue 18 Cost Allocations 19 Inpatient Revenue 20 Outpatient Revenue 21 Total Patient Revenue Cost Allocation Statistics 22 Plant Square Feet 25 Laundry Dry Pounds 209 0 278 736 0 26 Nursing FTE's 0.00 0.00 6.89 0.00 0.00 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 3 Unit Description 4 Units of Measure 7320 7330 7340 7350 7380 Speech Recreational Electro- Observation Free Standing Therapy Therapy myography Unit Clinics Treatments Treatments Procedures Hours Visits 0 0 0 8,156 0 0.00 0.00 0.00 0.00 0.00 6 Salaries & Wages 0 0 0 0 0 7 Employee Benefits 0 0 0 0 0 8 Professional Fees 0 0 0 0 0 9 Supplies 0 0 0 0 0 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 0 0 0 0 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 0 0 0 14 Other Direct Expenses 0 0 0 0 0 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 0 0 0 0 18 Cost Allocations 0 0 0 (788) 378,854 19 Inpatient Revenue 0 0 0 0 0 20 Outpatient Revenue 0 0 0 0 0 21 Total Patient Revenue 0 0 0 0 0 22 Plant Square Feet 0 0 0 410 0 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 0 0 0 27,592 5 Full Time Equivalents 17 Tax Revenue Cost Allocation Statistics 25 Laundry Dry Pounds 26 Nursing FTE's 0 0 0 0 68 0.00 0.00 0.00 0.00 0.00 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 7410 7420 7430 7490 8200 Organ Outpatient Other Research/ Lithotripsy Acquisitions Chemical Dep. Ancillary Education Treatments Acquisitions Visits 2 Account Name 3 Unit Description 4 Units of Measure 0 0 0 0.00 0.00 0.00 0.00 0.80 6 Salaries & Wages 0 0 0 0 70,330 7 Employee Benefits 0 0 0 0 15,771 8 Professional Fees 0 0 0 0 0 9 Supplies 0 0 0 0 2,839 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 0 0 23,328 9,403 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 0 0 0 14 Other Direct Expenses 0 0 0 0 1,657 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 0 0 23,328 100,000 18 Cost Allocations 0 0 0 8,085 19 Inpatient Revenue 0 0 0 0 x 20 Outpatient Revenue 0 0 0 60,558 x 21 Total Patient Revenue 0 0 0 60,558 x 22 Plant Square Feet 0 0 0 0 0 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 0 0 0 0 5 Full Time Equivalents 17 Tax Revenue Cost Allocation Statistics 25 Laundry Dry Pounds 26 Nursing FTE's 0 0 0 0 0.00 0.00 0.00 0.00 0 x YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 8330 8350 8360 8370 Laundry & Social Central Cafeteria Linen Service Transport. Equiv. Meals Pds. Proc. 2 Account Name 3 Unit Description 4 Units of Measure 8420 Purchasing 0 0 0.00 0.00 0.00 0.00 1.04 6 Salaries & Wages 0 0 0 0 41,886 7 Employee Benefits 0 0 0 0 14,308 8 Professional Fees 0 0 0 0 0 9 Supplies 0 0 0 0 3,742 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 0 0 0 0 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 0 0 0 0 14 Other Direct Expenses 0 0 0 0 92 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 0 0 0 60,028 5 Full Time Equivalents 17 Tax Revenue 18 Cost Allocations 19 Inpatient Revenue x x x x x 20 Outpatient Revenue x x x x x 21 Total Patient Revenue x x x x x Cost Allocation Statistics 22 Plant Square Feet 23 Dietary Meals 24 Housekeeping Hours x 502 0 0 0 967 0 0 0 0 x 0 0 71 x 25 Laundry Dry Pounds x x 26 Nursing FTE's x x 0 x 0 x x x YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 8470 8480 8490 8510 Communica- Data Other General tion Processing Services 8530 Patient Accounting Accounts 3 Unit Description 4 Units of Measure 5 Full Time Equivalents 0.00 6.23 0.00 2.15 9.95 6 Salaries & Wages 0 191,626 0 100,348 349,965 7 Employee Benefits 0 51,216 0 25,376 126,307 8 Professional Fees 0 0 0 0 0 9 Supplies 0 10,636 0 4,009 9,226 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 167,472 0 70,732 105,060 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 9 0 1,821 1,837 14 Other Direct Expenses 0 35,962 0 3,104 21,558 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 456,921 0 205,391 613,953 17 Tax Revenue 18 Cost Allocations 19 Inpatient Revenue x x x x x 20 Outpatient Revenue x x x x x 21 Total Patient Revenue x x x x x Cost Allocation Statistics 22 Plant Square Feet 0 352 0 387 0 23 Dietary Meals x 0 0 x 0 24 Housekeeping Hours x 0 0 x 0 25 Laundry Dry Pounds x 26 Nursing FTE's x 0 x 63,980 x x x 0 x YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 8610 8620 8630 8640 8650 Hospital Employee Public Management Admin Health Relations Engineering Personnel 3 Unit Description 4 Units of Measure 5 Full Time Equivalents 6.94 0.00 0.00 0.00 0.00 6 Salaries & Wages 686,909 0 0 0 0 7 Employee Benefits 224,440 0 0 0 0 0 0 0 0 0 38,155 0 0 0 0 0 0 0 0 0 107,819 0 0 0 0 1,221,555 0 0 0 0 10,037 0 0 0 0 762,081 0 0 0 0 0 0 0 0 0 3,050,996 0 0 0 0 8 Professional Fees 9 Supplies 10 Purch Srv - Utilities 11 Purch Srv - Other 12 Depreciation 13 Leases/Rentals 14 Other Direct Expenses 15 Recoveries 16 Adjusted Direct Expenses 17 Tax Revenue 18 Cost Allocations 19 Inpatient Revenue x x x x x 20 Outpatient Revenue x x x x x 21 Total Patient Revenue x x x x x Cost Allocation Statistics 22 Plant Square Feet 2,211 0 0 0 23 Dietary Meals x x x x 24 Housekeeping Hours x x x x 0 0 x 25 Laundry Dry Pounds x x x x x 26 Nursing FTE's x x x x x YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 8680 8690 8700 8710 8720 Medical Medical Medical Utilization Nursing Library Records Staff Management Admin 3 Unit Description 4 Units of Measure 5 Full Time Equivalents 0.00 5.93 0.00 0.00 0.00 6 Salaries & Wages 0 207,568 0 0 0 7 Employee Benefits 0 71,893 0 0 0 8 Professional Fees 0 0 0 0 0 9 Supplies 0 3,083 0 0 0 10 Purch Srv - Utilities 0 0 0 0 0 11 Purch Srv - Other 0 20,250 0 0 0 12 Depreciation 0 0 0 0 0 13 Leases/Rentals 0 1,691 0 0 0 14 Other Direct Expenses 0 5,329 0 0 0 15 Recoveries 0 0 0 0 0 16 Adjusted Direct Expenses 0 309,815 0 0 0 17 Tax Revenue 18 Cost Allocations 19 Inpatient Revenue x x x x x 20 Outpatient Revenue x x x x x 21 Total Patient Revenue x x x x x Cost Allocation Statistics 22 Plant Square Feet 0 408 0 0 0 23 Dietary Meals 0 0 0 0 0 24 Housekeeping Hours 0 117 44 0 0 25 Laundry Dry Pounds 26 Nursing FTE's 0 0 0 0 0 YEAR END REPORT COST CENTER SUMMARY HOSPITAL NAME: Klickitat County Public Hospital District #1 1 Account Number 2 Account Name 8770 8790 8830-8900 Comm. Health Other Unassigned Education Admin Srvcs Other Direct 3 Unit Description 4 Units of Measure 5 Full Time Equivalents 0.00 0.00 6 Salaries & Wages 0 0 7 Employee Benefits 0 0 8 Professional Fees 0 0 9 Supplies 0 0 10 Purch Srv - Utilities 0 0 11 Purch Srv - Other 0 0 12 Depreciation 0 0 13 Leases/Rentals 0 0 14 Other Direct Expenses 0 0 0 15 Recoveries 0 0 820,090 16 Adjusted Direct Expenses 0 0 -820,090 17 Tax Revenue 18 Cost Allocations 19 Inpatient Revenue x x 20 Outpatient Revenue x x 21 Total Patient Revenue x x Cost Allocation Statistics 22 Plant Square Feet 0 0 23 Dietary Meals x 24 Housekeeping Hours x 25 Laundry Dry Pounds x 26 Nursing FTE's x ST CENTER SUMMARY PAGE 10 OF 21 FYE: 12/31/2014 6140 6150 Psychiatric Chemical Care Dependency Patient Days Patient Days 0 0 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0.00 PORT COST CENTER SUMMARY PAGE 11 OF 21 FYE: 12/31/2014 7010 7020 Labor And Surgical Delivery Services Procedures Operating Min. 0 906 0.00 9.74 0 679,175 0 95,993 0 19,036 0 66,826 0 0 0 111,657 0 0 0 0 0 34,519 0 0 0 1,007,206 0 260,846 0 53,207 0 1,109,313 0 1,162,520 0 4,399 0 0 0 0 0 701 0.00 3.88 PORT COST CENTER SUMMARY PAGE 12 OF 21 FYE: 12/31/2014 7110 7120 Electro- Magnetic Res diagnosis Imaging Bill. Tests MRI RVU 0 356 0.00 0.01 0 15,231 0 0 0 21,919 0 0 0 280 0 2,386 0 0 0 187,810 0 154 0 0 0 227,779 0 95,813 0 21,918 0 863,348 0 885,266 0 18 0 0 0 0 0 0 0.00 0.00 PORT COST CENTER SUMMARY PAGE 13 OF 21 FYE: 12/31/2014 7180 7190 Respiratory Therapy Dialysis Treatments Hours 1,915 0 1.10 0.00 83,734 0 18,510 0 0 0 2,053 0 0 0 4,676 0 0 0 0 0 315 0 0 0 109,289 0 37,693 0 135,288 0 156,611 0 291,899 0 398 0 0 0 0 0 0 0 0.00 0.00 PORT COST CENTER SUMMARY PAGE 14 OF 21 FYE: 12/31/2014 7260 7310 Occupational Clinics Therapy Visits Treatments 16,174 1,654 24.29 0.00 1,607,567 0 419,087 0 218,554 0 122,005 0 12,305 0 28,152 57,459 9,316 0 2,934 0 62,708 0 0 0 2,482,627 57,459 634,927 18,179 0 53,242 2,645,927 65,728 2,645,927 118,970 7,193 0 0 0 0 0 2,724 0 2.92 0.00 PORT COST CENTER SUMMARY PAGE 15 OF 21 FYE: 12/31/2014 7390 7400 Air Home Care Transport Services Occasions Visits 0 3,032 0.00 9.35 0 363,983 0 99,472 0 0 0 19,671 0 6,554 0 155,535 0 0 0 0 0 16,173 0 0 0 661,389 0 167,672 0 0 0 628,121 0 628,121 0 0 0 0 0 0 0 104 0.00 6.89 PORT COST CENTER SUMMARY PAGE 16 OF 21 FYE: 12/31/2014 8310 8320 Printing & Duplication Dietary Patient Meals 28,620 0.00 5.56 0 192,266 0 72,181 0 0 0 143,838 0 0 0 482 0 0 0 0 0 5,639 0 0 0 414,407 x x x x x x 0 1,127 x x x x x x x x PORT COST CENTER SUMMARY PAGE 17 OF 21 FYE: 12/31/2014 8430 8460 Plant Housekeeping Gross Sq Ft 47,000 7.75 7.81 228,573 229,111 69,291 60,081 0 0 50,032 45,840 275,090 373 70,260 41,541 0 0 488 0 26,804 183 0 0 720,538 377,128 x x x x x x 11,472 591 x x 0 x x x x x PORT COST CENTER SUMMARY PAGE 18 OF 21 FYE: 12/31/2014 8560 8590 Other Admitting Fiscal Services 4.42 0.00 120,244 0 21,662 0 0 0 5,853 0 0 0 2,325 0 0 0 1,921 0 208 0 0 0 152,214 0 x x x x x x 0 0 0 0 0 0 0 x 0 x PORT COST CENTER SUMMARY PAGE 19 OF 21 FYE: 12/31/2014 8660 8670 Auxiliary Chaplaincy Groups Services 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 x x x x x x 0 0 0 0 0 0 0 x 0 x PORT COST CENTER SUMMARY PAGE 20 OF 21 FYE: 12/31/2014 8730 8740 Nursing Float Inservice Personnel Education 0.00 0.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 x x x x x x 0 0 0 0 0 0 0 0 PORT COST CENTER SUMMARY PAGE 21 OF 21 FYE: 12/31/2014 Grand Total 167.35 9,037,184 2,215,161 2,141,770 1,337,436 308,507 2,890,608 1,230,871 309,185 1,082,887 (820,090) 19,733,520 0 3,913,577 30,147,860 34,061,437 73,529 6,297 32,988 72,071 28.44 EDIT Klickitat County Public Hospital District #1 H-0 VOLUME: Hospital Admissions Hospital Patient Days FYE 12/31/2013 Info Page 198 521 Payer CC Detail 202 525 521 71 1,427 71 1,427 563 ATC Admissions ATC Patient Days 0 0 0 0 0 Newborn Admissions Newborn Patient Days 0 0 SNF/Swing Admissions SNF/Swing Patient Days 0 OPERATING EXPENSES: Salaries Employee Benefits Professional Fees Supplies Purch Srv - Utilities Purch Srv - Other Depreciation Leases/Rentals Insurance Licenses & Taxes Interest Ins, Lic. & Taxes, and Interest Other Direct Expense Total Other Direct Expense Total Expenses FS-3 8,961,843 2,397,721 1,484,495 1,298,723 283,552 2,321,071 1,174,232 285,774 243,804 124,082 351,053 718,939 406,231 1,125,169 19,332,580 CC Detail 8,961,843 2,397,721 1,484,495 1,298,723 283,552 2,321,071 1,174,232 285,774 DEDUCTIONS: Bad Debt Contractuals Charity Care Other Deductions Total Other Deductions SS-8 1,886,976 10,070,366 813,435 (124,218) 12,646,559 FS-3 1,886,976 10,070,366 813,435 (124,218) 12,646,559 CHARITY CARE FIXED ASSET ENDING BALANCES: Land Land Improvements Buildings Fixed Equip - Bldg Serv Fixed Equip - Other Equipment (Moveable) Leasehold Improvements Construction In Progress Total 1,174,462 285,774 243,804 124,082 351,053 718,939 0 0 813,435 FS-3 CC-DETAIL 666,581 0 0 0 FS-3 3,547,574 26,581,277 30,128,851 CC-DETAIL 3,547,574 26,581,277 30,128,851 PATIENT SERVICE REVENUE: IP Revenue OP Revenue Gross Revenue 2,397,721 Deductions From Revenue Support Sched. # Of Patients Inpatient Outpatient OTHER REVENUES: Other Revenue Tax Revenue 302,412 822,756 1,125,168 19,332,579 Support Sched. FS-1 203,707 1,368,081 16,059,470 0 0 5,480,822 0 143,687 23,255,767 SS-4 203,707 1,368,081 16,059,470 0 0 5,480,823 0 143,686 23,255,766 PAYER INFO 0 0 0 BALANCE SHEET HOSPITAL: Skyline Hospital ASSETS 1 CURRENT ASSETS: 2 Cash 3 Marketable Securities 4 Accounts Receivable 5 Less-Estimated Uncollectable & Allowances 6 Receivables From Third Party Payors 7 Pledges And Other Receivables 8 Due From Restricted Funds 9 Inventory 10 Prepaid Expenses 11 Current Portion Of Funds Held In Trust 12 TOTAL CURRENT ASSETS 13 14 BOARD DESIGNATED ASSETS: 15 Cash 16 Marketable Securities 17 Other Assets 18 TOTAL BOARD DESIGNATED ASSETS: 19 20 PROPERTY, PLANT AND EQUIPMENT: 21 Land 22 Land Improvements 23 Buildings 24 Fixed Equipment - Building Service 25 Fixed Equipment - Other 26 Equipment 27 Leasehold Improvements 28 Construction In Progress 29 TOTAL 30 Less Accumulated Depreciation 31 NET PROPERTY, PLANT & EQUIPMENT 32 33 INVESTMENTS AND OTHER ASSETS: 34 Investments In Property, Plant & Equipment 35 Less - Accumulated Depreciation 36 Other Investments 37 Other Assets 38 TOTAL INVESTMENTS & OTHER ASSETS 39 40 INTANGIBLE ASSETS: 41 Goodwill 42 Unamortized Loan Costs 43 Preopening And Other Organization Costs 44 Other Intangible Assets 45 TOTAL INTANGIBLE ASSETS 46 TOTAL ASSETS FS-1 BALANCE SHEET (Pg 2) HOSPITAL: Skyline Hospital LIABILITIES AND FUND BALANCES-UNRESTRICTED 1 CURRENT LIABILITIES 2 Notes and Loans Payable 3 Accounts Payable 4 Accrued Compensation and Related Liabilities 5 Other Accrued Expenses 6 Advances from Third Party Payors 7 Payables to Third Party Payors 8 Due to Restricted Funds 9 Income Taxes Payable 10 Other Current Liabilities 11 Current Maturities of Long Term Debt 12 TOTAL CURRENT LIABILITIES 13 14 15 Deferred Income Taxes 16 Deferred Third Party Revenue DEFERRED CREDITS: 17 Other Deferred Credits 18 TOTAL DEFERRED CREDITS 19 20 LONG TERM DEBT 21 Mortgage Payable 22 Construction Loans-Interim Financing 23 Notes Payable 24 Capitalized Lease Obligations 25 Bonds Payable 26 Notes and Loans Payable to Parent 27 Noncurrent Liabilities 28 TOTAL 29 Less Current Maturities of Long Term Debt 30 TOTAL LONG TERM DEBT 31 32 TOTAL FUND BALANCE 33 34 EQUITY (INVESTOR OWNED) 35 Preferred Stock 36 37 Common Stock 38 39 Additional Paid In Stock 40 41 Retained Earnings (Capital Account for Partnership 42 (or Sole Proprietorship) 43 44 Less Treasury Stock 45 TOTAL EQUITY 46 TOTAL LIABILITIES AND FUND BALANCE OR EQUITY INCOME STATEMENT - UNRESTRICTED FUND HOSPITAL: Skyline Hospital 1 OPERATING REVENUE: 2 Inpatient Revenue 3 Outpatient Revenue 4 TOTAL PATIENT SERVICES REVENUE 5 6 DEDUCTIONS FROM REVENUE: 7 Provision for Bad Debts 8 Contractual Adjustments 9 Charity and Uncompensated Care 10 Other Adjustments and Allowances 11 TOTAL DEDUCTIONS FROM REVENUE 12 NET PATIENT SERVICE REVENUE 13 14 OTHER OPERATING REVENUE 15 Other Operating Revenue 16 Tax Revenues 17 TOTAL OTHER OPERATING REVENUE 18 TOTAL OPERATING REVENUE 19 20 OPERATING EXPENSES 21 Salaries and Wages 22 Employee Benefits 23 Professional Fees 24 Supplies 25 Purchased Services - Utilities 26 Purchased Services - Other 27 Depreciation 28 Rentals and Leases 29 Insurance 30 License and Taxes 31 Interest 32 Other Direct Expenses 34 TOTAL OPERATING EXPENSES 35 NET OPERATING REVENUE 36 37 NON-OPERATING REVENUE-NET OF EXPENSES 38 39 NET REVENUE BEFORE ITEMS LISTED BELOW 40 41 EXTRAORDINARY ITEM 42 FEDERAL INCOME TAX 43 44 NET REVENUE OR (EXPENSE) FYE: 12/31/2014 Variance FYE: 12/31/2013 SETS T ASSETS: 4,213,548 4,511,564 0 0 9,310,467 16,721,115 0 0 0 545,423 (7,088,667) (13,913,378) 0 0 166,937 147,179 140,383 150,818 0 0 6,767,212 8,162,721 1,363,978 1,506,270 0 0 0 0 1,363,978 1,506,270 291,246 291,246 304,123 304,123 15,968,405 15,948,787 0 0 526,002 524,954 5,226,599 6,365,273 0 0 17,415 47,957 0 23,482,340 (10,386,454) 9,528,534 11,947,335 13,953,806 (298,016) 0 (7,410,648) 0 (545,423) 6,824,711 0 19,758 (10,435) 0 (1,395,509) NATED ASSETS: (142,292) 0 0 (142,292) T AND EQUIPMENT: 0 0 19,618 0 1,048 (1,138,674) 0 (30,542) (23,482,340) (19,914,988) (2,006,471) ND OTHER ASSETS: 0 0 0 0 0 0 435,638 0 435,638 0 0 0 0 0 0 0 0 0 0 0 20,514,163 23,622,797 0 0 0 435,638 435,638 LE ASSETS: 0 (0) 0 0 (0) (3,108,634) HEET (Pg 2) FYE: 12/31/2014 Variance FYE: 12/31/2013 ALANCES-UNRESTRICTED LIABILITIES 0 0 360,612 938,410 817,122 845,648 0 0 0 0 0 0 0 0 0 0 0 774,988 0 0 1,177,734 2,559,046 0 0 0 0 0 (577,798) (28,526) 0 0 0 0 0 (774,988) 0 (1,381,312) D CREDITS: 0 0 87,954 87,954 87,954 0 87,954 0 0 0 0 0 0 63,580 503,831 961,122 15,475,000 15,755,000 0 0 87,954 89,951 15,978,831 16,869,653 0 0 15,978,831 16,869,653 0 0 (63,580) (457,291) (280,000) 0 (1,997) (890,822) 0 (890,822) 3,269,644 4,194,098 (924,454) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3,269,644 4,194,098 20,514,163 23,622,797 0 (924,454) (3,108,634) ERM DEBT ESTOR OWNED) RESTRICTED FUND FYE: 12/31/2014 FYE: 12/31/2013 Variance G REVENUE: (283,090) (667,618) (950,708) 5,859,272 6,142,362 18,451,910 19,119,528 24,311,182 25,261,890 1,246,579 2,229,896 7,236,350 6,180,356 167,995 221,149 279,603 1,426,853 8,930,527 10,058,254 15,380,655 15,203,636 257,306 423,546 506,716 967,986 764,021 1,391,532 16,144,676 16,595,168 7,516,470 8,166,322 1,674,552 2,149,083 1,236,264 959,371 1,241,386 1,121,545 222,015 258,516 1,761,111 2,306,140 1,860,943 2,018,869 39,312 49,464 116,240 181,478 353,489 121,075 1,034,994 1,065,515 426,251 241,486 17,129,538 18,638,864 (984,862) (2,043,696) (649,852) (474,531) 276,893 119,841 (36,501) (545,029) (157,926) (10,152) (65,238) 232,414 (30,521) 184,765 (1,509,326) 1,058,834 60,409 105,283 (44,874) FROM REVENUE: (983,317) 1,055,994 (53,154) (1,147,250) (1,127,727) 177,019 ATING REVENUE (166,240) (461,270) (627,511) (450,492) G EXPENSES (924,453) (1,938,413) 1,013,960 0 0 0 0 0 0 (924,453) (1,938,413) 1,013,960