EXHIBIT 4.16a FINANCIAL RATIOS FOR ALL U.S. HOSPITALS BY BED SIZE Optum & CMS Median Ratio' Desired Beds 400+ Beds Position 200-299 300-399 Ratio Hospital Industry 1-99 Beds 100-199 BedsBeds Liquidity ratios 2.04 1.39 Current ratio 1.84 Quick ratio Acid test ratio Days in accounts receivable 1 88 0.20 102 1.52 1.65 0.35 47 Days cash on hand Average payment period, days 56 53 52 Revene, expense, and profitability ratios Operating revenue per adjusted discharge Operating cxpense por adjusted discharge $7A48 $7,197 $7,086 $6,494 $6,407 $6112 38% $6,766 $6,260 3896 $7,517 $7,399 Salary and benefit expense as a percentage 3896 of operating expense 0 04 0.05 004 0 09 Operating margin 002 0.03 0.04 Nonocerating revenue Return on total assets Return on net assets 0.07 0.05 0.17 0.05 0.05 0.08 0.09 Activity ratios Total asset turnover ratio Net fixed assets turnover ratio Age of plant ratio 0.99 2.11 11 .97 1.07 1.06 2.17 10.41 2.04 10.93 2.03 10.31 10.12 11.19 Capital structure ratios 0.18 0.58 3.47 3.51 0.31 0.42 0.47 364 3 50 Long-term debt to net assets ratio Net assets to total assets ratio Times interest earned ratio Debt service coverage ratio 0.54 3.78 3.18 0.38 0.52 4.43 6.36 0.59 0.48 5.13 4.24 Al ratio values, except br quick, acid test, and salary and benefit expense as a percentage of ope rating expense ratios were obtained from Optum Insight, 2013 Amarac of Hospital inanciafl and Operoting indicators, 201 1/2010 medien value data. The quick, acid te st and salary and benefit expense asa percentage of operating ex perse ratios were obiained from 2010 CMS cost report data These are true up to a certain point. For example, in genetal the higher the better for the current ratio, but after a certain point, the arganiation might be better off investing some of the excess