Calculate the following ratios and discuss their importance for the year ended 12.31.18. Please consider using Net Patient Service Revenue as Kaleidas Net Sales as needed when applying some of the ratio calculations.

3. Debt to Equity
4. Return on Assets
5. Return on Equity
6. Days of Accounts Receivable
7. Net Margin
8. Net Working Capital
9. Times Interest Earned
10. Asset Turnover
11. Quick Ratio

KALEIDA HEALTH Consolidated Balance Sheets December 31, 2018 and 2017 (Dollars in thousands) 2018 2017 $ 61,731 168,709 37,385 213,383 Assets Current assets: Cash and cash equivalents Investments (notes 6 and 7) Accounts receivable: Patient, less estimated allowance for doubtful accounts of $35,852 in 2018 and $31,004 in 2017 Other (note 10) Grants receivable Estimated third-party payor receivables (note 4) Inventories Prepaid expenses and other current assets Total current assets Assets limited as to use (notes 5, 6, 7, and 10): Designated under debt agreements Designated under self-insurance programs Board designated and donor restricted Other 298,229 44,635 13,287 19,934 46,219 17,989 251,977 34,213 16,243 14,120 42,379 28,284 637,984 670,733 39,830 89,862 123,322 2,568 255,582 40,892 101,174 142,864 2,006 286,936 Property and equipment, less accumulated depreciation and amortization (note 9) Other (note 10) Total assets 767,635 54,472 755,078 69,796 $ 1,748,422 1,749,794 IOS) 2018 2017 175,665 70,292 Liabilities and Net Assets Current liabilities: Accounts payable and other accrued expenses Accrued payroll and related expenses Construction costs payable Estimated third-party payor settlements (note 4) Current portion of long-term debt (note 11) Line of credit (note 11) Other current liabilities Total current liabilities Long-term debt, less current portion (note 11) Estimated self-insurance reserves (note 5) Asset retirement obligations (note 14) Pension and postretirement obligations (note 13) Other long-term liabilities (note 4) 149,355 68,144 11,269 22,598 36,546 10,000 9,786 22,203 41,210 42,054 9,744 361,168 399,827 158,293 8,066 319,436 3,585 307,698 407,291 155,410 11,185 359,876 3,241 889,207 937,003 1,250,375 1,244,701 Total liabilities Commitments (notes 9 and 12) Net assets: Without donor restrictions: Available for operations Provision for future benefit costs (note 13) Total without donor restrictions Total with donor restrictions Total net assets Total liabilities and net assets 740,425 (381,845) 358,580 726,265 (355,337) 370,928 127,119 498,047 1,748,422 146,513 505,093 $ 1,749,794 2018 2017 1,621,831 19,937 1,601,894 1,802,654 23,316 1,779,338 61,405 12,811 1,853,554 55,875 8,693 1,666,462 Operating revenue: Patient service revenue, net of contractual allowances and discounts (notes 3 and 4) Less provision for bad debts Net patient service revenue Other operating revenue (notes 6 and 15) Net assets released from donor restrictions for operations Total operating revenue Operating expenses: Salaries and benefits Purchased services and other Medical and nonmedical supplies Depreciation and amortization Interest Total operating expenses Income from operations Other income: Investment (loss) income (note 6) Net realized (losses) gains on sales of investments (note 6) Net change in unrealized (losses) gains on investments (note 6) Loss on impairment and disposal of assets (note 9) Total other (losses) income, net (Deficiency) excess of revenue over expenses, before effect of affiliation, net 1,015,900 381,196 350,612 77,088 18,681 922,538 325,327 311,052 66,433 13,797 1,843,477 1,639,147 27,315 10,077 (18,057) (5,650) (6,824) 22,779 2,863 8,520 (12,198) 21,964 (30,531) (20,454) 49,279 Years ended December 31, 2018 and 2017 (Dollars in thousands) 2018 2017 (20,454) 49,279 41,584 (20,454) 90,863 26,508 (50,212) 12,588 16,721 3,746 6,397 (103) 12,348 73,706 Changes in net assets without donor restrictions: (Deficiency) excess of revenue over expenses, before effect of affiliation Effect of affiliation (note 18) (Deficiency) excess of revenues over expenses, after effect of affiliation Pension and postretirement related changes other than net periodic cost (note 13) Contributions for capital acquisitions Net assets released from restrictions for capital expenditures Other, net Increase in net assets without donor restrictions Changes in net assets with donor restrictions: Contributions, bequests, and grants Restricted investment income Effect of affiliation (note 17) Net change in unrealized (losses) gains on investments Net assets released from restrictions for operations Net assets released from restrictions for capital expenditures Effect of affiliation (note 17) (Decrease) increase in net assets with donor restrictions Change in net assets Net assets, beginning of year Net assets, end of year 8,892 6,284 (15,362) (12,811) (6,397) 5,823 9,342 20,218 6,259 (8,693) (16,721) 24,214 40,442 (19,394) (7,046) 114,148 390,945 505,093 498,047 $ 505,093 KALEIDA HEALTH Consolidated Statements of Cash Flows Years ended December 31, 2018 and 2017 (Dollars in thousands) 2018 2017 S (7,046) 114,148 77,088 540 (1,639) (8,236) 19,772 19,598 (634) 23,316 (26,508) 66,433 (86,016) 12,198 785 (23,334) (2,415) (20,850) (14,779) (12,205) 19,937 50,212 (69,568) (5,814) (3,966) 25,805 (395) 5,377 (14.405) 33,285 (76,455) 332 (21,858) 41,907 2.921 (6,615) 19,661 64,007 Operating activities: Change in net assets Adjustments to reconcile change in net assets to net cash provided by operating activities: Depreciation and amortization Effect of affiliation Loss on impairment and disposal of assets Accretion expense Restricted contributions and bequests Restricted grants Change in interests in other investments Net change in unrealized gains on investments Net realized gains and losses on investments Provision for bad debts Pension and postretirement related changes other than net periodic cost Change in operating assets and liabilities: Patient accounts receivable Estimated third-party payor receivables Other receivables, inventories, and prepaid expenses Accounts payable, accrued expenses, accrued payroll, and construction costs payable Estimated third-party payor settlements Other assets Other liabilities Net cash provided by operating activities Investing activities: Additions to property and equipment, net of change in capital acquisitions included in accounts payable Purchases of investments Proceeds from sales of investments Change in cash restricted for use Capital contributions to joint venture Net cash provided by (used in) investing activities Financing activities: Principal payments on debt and capital lease obligations Proceeds from restricted contributions and bequests Proceeds from line of credit Proceeds from restricted grants Proceeds from long-term debt Payments for deferred financing fees Net cash provided by financing activities Net increase (decrease) in cash and cash equivalents Cash and cash equivalents, beginning of year Cash and cash equivalents, end of year Supplemental disclosures on cash flow activities: Capital lease obligations Interest paid Capital acquisitions included in accounts payable (64,832) (349, 100) 398,826 2,136 (4.626) (17,596) (159,805) (168,066) 188,005 (439) (140,305) (36,131) 1.639 32,054 11,192 3,620 23,334 10,000 5,000 26,581 (635) 67.900 (97) 8,657 24,346 37.385 61.731 (8,398) 45.783 37,385 S $ 33,333 19.909 4,350 49,872 17,377 12,967