Healthcare Budget Project. Please see attached instructions

BUSI 523 BUDGET PROJECT GRADING RUBRIC Criteria Part 1: Financial Statement Analysis Part 1: Financial Statement Analysis Part 2: Budget Analysis Part 3: Monthly Cash Budget Part 4: Long-term Debt Financial Analysis Points Possible 0 to 20 points Financial statements are downloaded into Microsoft Excel, and include a horizontal analysis, with ratios included. 0 to 20 points Memo clearly outlines the financial strengths and weaknesses of the company, and clearly outlines the maximum loan amount to be authorized. 0 to 20 points A revenue and expense budget is developed for each PCS center, each line is labeled correctly as a fixed or variable expense, the basis for allocation is explained, and questions are answered thoroughly and correctly. 0 to 15 points Aging analysis is correctly and properly used to estimate cash inflows. Implications are clearly, correctly, and articulately explained. 0 to 15 points Part 5: Surgery Questions are clearly, correctly, thoroughly, and articulately answered. 0 to 15 points Part 6: Hospital Discounts Questions are clearly, correctly, thoroughly, and articulately answered. 0 to 15 points Part 7: Medicaid Expansion Part 8: New Primary Care Practices Instructor's Comments: Points Earned Questions are clearly, correctly, thoroughly, and articulately answered. 0 to 15 points Questions are clearly, correctly, thoroughly, and articulately answered. 0 to 15 points Questions are clearly, correctly, thoroughly, and articulately answered. Total /150 BUSI 523 BUDGET PROPOSAL INSTRUCTIONS Instructions: Complete each part of the following Case Study. You will need to use Microsoft Word and Excel. Tables referenced in the case study are located in the Excel file labeled \"Case Study Tables\". Label your written responses by part number. For example, your memo for Part 1 must be labeled Part 1 as a level 1 heading, then proceed with your memo, and then a new level 1 heading Part 2, followed by answers to those questions. A title page must be included in your submission. Financial Management Part 1 Financial Statement Analysis The loan committee of a major bank needs a financial assessment. Analyze the financial statement for (your instructor will provide the company name). Download the financial statements into Microsoft Excel and then use horizontal statement analysis as well as financial ratios to assess the organization's liquidity, profitability, financial efficiency (turnover), and capital/debt structure. Based on your assessment, present a 2-4-page memo that describes the financial strengths and weaknesses of the organization as of their most recent year-end. Your memo must indicate the maximum loan amount that should be authorized. Part 2 Budget Analysis Table 1 includes PCS's proposed budget for 2018. Using this as a basis, develop a revenue and expenses budget for each PCS center. Note that professional reading fees and laboratory expenses are variable costs that need to be allocated based on the type of visit. Generally, an occupational health visit (Categories 8 and 9 on Tables 2 and 3) including all physicals has reading and laboratory costs 1.4 times what a general medical visit incurs (Category 1, 2, or 3). For each line item in the budget, indicate whether the item is a fixed or variable expense and the basis of allocation or assignment for the budget for each center. Each center is expected to generate approximately the same profit margin. Given your analysis, will it? Should management change its expectations regarding average revenue per visit by center? Part 3 Monthly Cash Budget Table 4 includes the 2018 budget for Jasper Gardens Nursing Home. For your monthly cash budget, assume that one-twelfth of cash expenses and revenues are Page 1 of 6 BUSI 523 incurred per month. Use the following aging analysis to estimate cash inflows. What are the management implications of this analysis? Page 2 of 6 BUSI 523 Table III.4 Aging Analysis Percent of Bills Paid in Cash Within days of Billing Days Medicare Medicaid Commercial Insurance Private Insurance Self-Pay VA 30 or less 31-60 61-90 91-120 121-150 5 0 20 25 30 25 40 25 5 25 25 30 40 25 25 30 30 15 25 30 20 10 10 10 0 45 15 0 10 5 Assume that Accounts Receivable - Net as of December 31, 2017, are the same percentage as anticipated revenue to be earned during 2018. Part 4 Webster HospitalLong-Term Debt Financial Analysis OHA has indicated that we should maintain a debt to asset ratio no higher than 40 percent. Given this, how much additional long-term debt could have been added in 2017? We would use this additional debt to finance new construction, renovations, and the acquisition of technology. To finance this additional long-term debt we would use bonds. As such, we need to assess our credit worthiness. The following are the select median values for specific financial ratios for hospitals that received \"below investment grade (BBB)\" and \"high investment grade (AA)\" bond ratings. Assess and report Webster's position with recommendations. Are Webster's bonds more likely to be rated as AA or BBB? Why? Table III.5 Comparison of Financial Ratios by Bond Rating Bond Grade Days Cash on Hand Days in Accounts Receivables Days in Current Liabilities Cash to Debt (%) Total Margin-% AA BBB 194 58.0 62.3 153.9 4.1 53.6 47.7 64.7 37.9 (0.3) Page 3 of 6 BUSI 523 Salaries and benefit costs as Page 4 of 6 BUSI 523 % of Total Revenue 49.9 56.3 Average Age of Plant (years) Capital Expenditures as % of Depreciation Expense 9.5 13.4 169.9 76.2 Our annual interest cost of long-term borrowing would be 3.0 percent if our bonds were rated \"high grade\" and 7.5 percent if rated \"below investment grade.\" Assume that tenyear bonds are used to finance this additional debt. What would be the annual principal and interest payment for this amount? Can Webster Hospital afford this increased annual expense? Note that for every $100,000 borrowed over ten years, our monthly payments would be $989 at 3.5 percent or $1,136 at 6.5 percent. Part 5 Surgery for Middleboro As you are aware, Medical Associates has achieved its targeted utilization and financial projections for ambulatory surgery in Jasper. It is now time to consider a similar service at our offices in Middleboro. The physical facilities needed for ambulatory surgery will cost $450,000. Our cost of capital is 4 percent and the hurdle rate is 6 percent. The anticipated salvage value of these new fixed assets will be $150,000 after five years. To do this we will need to recruit two new general surgeons for our Jasper office, thereby freeing our Middleboro general surgeons to work in this new ambulatory surgical facility. We anticipate opening no earlier than January 2, 2016 Based on operational estimates, we anticipate that this project's annual operational revenue will exceed its operational expenses (R-E) for each of the first five years in accordance with the following schedule. Note that the operational expenses include all direct costs including salaries and benefits. Table III.6 Fiscal Implications of New Ambulatory Surgery Service R-E ($) Year 01 Year 02 Year 03 Year 04 20,000 40,000 60,000 100,000 Median Cases per Day (M-F) 9.0 10.0 12.5 12.5 Page 5 of 6 BUSI 523 Year 05 140,000 14.0 We estimate that this unit, employing the standard RVU system used in hospitals, will generate 1.1 surgical procedures per case. Assess the financial implication. Should we do this? Why? Part 6 Hospital Discounts A coalition of key area employers has approached MCH or WH demanding an additional 10 percent discount per patient day for all of their employees admitted to the hospital. If not offered, they will change their health insurance to favor the one hospital in Middleboro with the lowest prices. What would be the implications of such a change? Structure the analysis that would be undertaken to respond to this demand. Part 7 Medicaid Expansion The state legislature and governor have just rejected additional Federal funding for Medicaid expansion. Assess the financial impact of this decision on MCH or WH. Part 8 New Primary Care Practices in Jasper Determine the costs to MCH of establishing two new primary care practices in Jasper. The analysis should include estimates of all costs (recruitment, compensation arrangements, facility, staffing, information technology, etc.) and assess the advantages and disadvantages of leasing or purchasing building space. Submit this assignment by 11:59 p.m. (ET) on Friday of Module/Week 7. Page 6 of 6 Table 1.5 Hillsboro County Health Insurance Profile 2016-2017 (Special Study by Chamber of Commerce, Percent o Percent of Coverage All Residents Covered by own Not employment covered Covered by based any time employment insurance during the based (self year insurance employed) Covered by Covered by Medicare Medicaid and and private private insurance insurance 19.3 55.1 28.6 2.8 7.5 32.7 25.6 14.9 13.6 0.0 50.6 70.5 76.6 78.8 0.0 12.4 8.3 5.6 0.0 0.0 1.0 1.5 1.5 0.7 0.0 0.2 0.1 0.2 0.2 0.0 28.3 22.8 13.2 9.3 7.3 43.4 64.1 79.5 8.2 23.6 30.5 39.4 0.00 0.00 0.00 0.00 8.1 15.4 7.5 5.7 Employer size, workers aged 18-64 Fewer than 25 employees 25-99 employees 100-499 employees 500-999 employees 1,000+ employees Household income Less than $25,000 $25,000 to $49,999 $50,000 to $74,999 $75,000 or more NOTE: Percentages may exceed 100% depending on changes during the year of study and multiple coverage. er of Commerce, Percent of Total) verage. Covered by Medicare and Medicaid 2.1 0.2 0 0.3 0.3 0.0 0.00 0.00 0.00 0.00 Table 1.9 HIV and AIDS in Capital City and Hillsboro County, 2007-2017 2017 2012 AIDS cases Rate per 100,000 Population, All Ages Hillsboro County 6.9 7.2 Capital City 8.4 9.3 2007 7.8 11.2 Statewide 12.5 13.4 14.5 AIDS cases Rate per 100,000 Population, Adults and Adolescents Hillsboro County 7.0 7.4 8.2 Capital City 8.5 9.6 11.5 Statewide AIDS case rates Hillsboro County Male Female Capital City Male Female Statewide Male Female AIDS cases Hillsboro County White Black Hispanic Other Capital City White Black Hispanic Other Statewide White Black Hispanic 15.2 16.0 18.3 Adults and Adolescents, Rates per 100,000 by Sex 20.9 6.3 23.5 7.9 17.2 5.4 22.9 7.7 24.0 7.7 21.3 7.9 22.9 26.3 30.1 7.7 6.7 6.7 Distribution of Persons Estimated to be Living with AIDS (%) 70.9 18.8 4.4 5.9 71.2 19.3 4.4 5.1 67.3 20.3 6.2 6.2 48.2 35.7 13.4 2.7 40.3 40.7 16.7 2.3 35.5 44.5 17.3 2.7 34.1 42.7 20.9 30.2 44 23.2 28.4 44.3 25.2 Other HIV 2.3 2.6 Age-Adjusted Death Rate per 100,000 for HIV Hillsboro County 1.1 1.2 Capital City 3.8 3.2 Statewide HIV 4.2 4.6 2.1 1.1 3.2 4.8 Estimated Rate per 100,000 for Persons Living with HIV Infections (not AIDS) Hillsboro County 22.7 21.3 24.3 Capital City 34.5 36.7 39.5 Statewide HIV2017 51.7 48.3 50.2 Rates per 100,000 of New HIV Infections in Adults and Adolescents Males Females Total Hillsboro County Whites Blacks Hispanics Capital City Whites Blacks Hispanics Statewide Whites Blacks Hispanics 10.5 80.7 31.2 2.2 21.7 6.3 7.1 51.9 19.2 13.5 112.4 47.5 4.1 50.9 13.0 9.1 82.7 30.7 19.6 115.7 3.9 55.7 11.5 83.7 43.8 14.4 29.3 Table 2.2 Service Area Utilization by Town and Division for Calendar Years Ending December 31 Boalsburg Carterville Harris City Division Jasper Middleboro Mifflenville Minortown Service Home Care RN visits LPN visits HHA visits PT visits OT visits ST visits Social worker visits 1,702 330 422 150 56 10 26 2,004 356 82 26 59 13 24 3,404 676 823 301 107 18 47 3,220 666 863 605 101 20 51 16,071 3,264 4,904 1,547 490 91 230 3,794 725 967 335 100 21 53 3,020 445 106 18 71 11 38 RN inhome hours LPN inhome hours 73 794 54 290 154 1,241 194 1,448 798 7,109 150 1,571 61 293 PCA inhome hours HHA inhome hours Other inhome hours 957 844 10 1,487 1,513 1,741 1,291 9,479 7,658 6 64 2,155 2,040 0 1,315 1,729 43 1,835 1,517 21 18 7 38 23 56 11 34 44 190 198 101 131 16 12 72 0 0 246 653 0 114 0 12 0 Private Duty 39 Community Health Ante/postpartum visits Child health visits Senior Health Clinic attendees by HCHHA Office Location Seen at Middleboro office Seen at Jasper office 15 0 12 0 Stateville Total 820 200 263 92 30 5 18 34,035 6,662 8,430 3,074 1,014 189 487 50 419 1,534 13,165 376 426 8 19,345 17,018 191 23 30 476 456 45 8 923 254 Table 2.3 Services to Patients, Calendar Years Ending December 31 Division/Program 2017 2016 Home Care 1,596 1,582 Unduplicated client census RN home visits 34,035 35,463 LPN home visits 6,662 5,678 Home health aide visits 8,430 8,230 PT visits 3,074 2,647 OT visits 1,014 993 ST visits 189 165 SW visits 487 472 Total visits 53,891 53,648 2015 2014 2013 1,578 35,867 5,980 8,356 2,630 897 174 434 54,338 1,498 36,304 4,823 8,856 2,240 899 178 445 53,745 1,499 37,192 4,725 8,923 2,430 903 156 342 54,671 Private Duty Unduplicated client census RN inhome hours LPN inhome hours Personal care attendant inhome hours HHA inhome hours Other inhome hours Total hours 260 1,534 13,165 19,345 17,018 212 51,274 225 1,267 12,564 16,745 11,788 180 42,544 145 1,050 9,160 14,290 8,304 210 33,014 Community Health Ante/postpartum visits Child health visits Prenatal class enrollees Children seen, Middleboro Children seen, Jasper 476 456 139 901 301 512 502 140 740 222 500 656 123 634 305 499 450 130 812 317 412 496 112 845 328 High Blood Pressure Program People screened MD referrals 7,456 398 6,867 423 7,234 307 7,124 456 6,838 512 Senior Health Clinics Clients seen, Middleboro Clients seen, Jasper 923 254 902 243 920 289 934 389 978 412 Table 2.6 Statement of Revenue and Expenses for Calendar Year Ending December 31 2017 2016 Home Care Division 6,736,375 6,322,329 Less allowances for bad debt 85,240 88,340 Less contractual allowances 2,049,283 1,737,912 Net revenue 4,601,852 4,496,077 Private Duty Division 3,165,221 2,843,959 Less allowances for bad debt 65,340 45,230 Less contractual allowances 18,469 12,669 Net revenue 3,081,412 2,786,060 Community Health Division Support from state and towns 208,750 240,000 United Appeal 20,000 20,000 Other 1,935 1,257 Net revenue 230,685 261,257 Total net operational revenue 7,913,949 7,543,394 Expenses Divisional Salaries and wages 4,186,227 4,086,160 Fringe benefits 1,255,868 1,022,548 Travel 725,388 701,383 Supplies 453,778 398,202 Equipment 152,430 122,494 Total divisional 6,773,691 6,330,787 Administrative Salaries and wages 360,233 340,229 Fringe benefits 102,339 98,334 Supplies 157,910 158,705 Equipment 45,929 42,393 Insurance 56,729 54,202 Interest 54,894 53,890 MaintenanceMiddleboro 138,595 79,303 RentJasper office 40,500 40,500 Computer services 84,253 80,150 Travel 18,356 18,430 Heat/lightMiddleboro 11,488 10,004 Legal/audit 55,088 44,411 Printing and postage 15,540 13,450 Telecommunications 21,364 19,560 Staff development 10,060 7,010 Board expenses 10,150 10,445 Publications and memberships 10,700 10,500 Depreciation expense 38,240 39,440 Total administrative 1,232,368 1,120,956 Total expenses 8,006,059 7,451,743 Gain (or loss) from operations 92,110 91,651 Other Income 202,445 245,300 110,335 336,951 Gain (or loss) 2015 5,936,445 72,450 1,365,999 4,497,996 1,893,345 24,550 8,738 1,860,057 240,000 60,000 1,458 301,458 6,659,511 3,604,595 1,021,445 604,387 258,304 82,394 5,571,125 335,110 96,990 140,680 34,220 45,043 53,004 78,380 40,500 73,229 13,450 7,545 28,340 12,000 18,334 7,500 6,342 8,550 44,350 1,043,567 6,614,692 44,819 295,606 340,425 Table 2.7 Balance Sheet as of December 31 2017 2016 2015 Current assets Cash Accounts receivable (net) Prepaid insurance Inventory Total current assets 708,339 1,430,404 8,650 19,299 2,166,692 474,519 1,152,383 17,340 19,345 1,663,587 378,495 904,871 14,230 14,236 1,311,832 Property and equipment Gross, property & equipment (Less accumulated depreciation) Net property and equipment 2,328,440 603,559 1,724,881 2,255,606 565,319 1,690,287 2,153,284 525,879 1,627,405 Other assets Investments (at market) 7,951,190 8,403,134 7,456,012 11,842,763 11,757,008 10,395,249 Liabilities and net assets Current liabilities Accounts payable Accrued items Current portion of longterm debt Total current liabilities 487,220 284,570 68,244 840,034 433,291 255,683 69,262 758,236 415,073 306,492 70,385 791,950 Noncurrent Liabilities Loan payable 448,292 472,445 492,558 1,288,326 1,230,681 1,284,508 6,917,307 3,024,604 612,526 6,961,213 3,062,923 502,191 5,423,731 3,521,770 165,240 Total net assets 10,554,437 10,526,327 9,110,741 Liabilities + net assets 11,842,763 11,757,008 10,395,249 Total assets Total liabilities Net assets Donorrestricted fund Investment fund (at market) Working capital fund Table 3.1 PCS Utilization Report Alpha Alpha Beta Beta Alpha Beta Total Visits Private Visits Occupational Health Visits Private Visits Occupational Health Visits Gross Charges ($) Gross Charges ($) January 909 302 185 192 230 78,450 94,040 February 1,030 402 170 207 251 87,650 102,272 March 1,039 449 165 204 221 92,425 93,092 April 1,100 481 190 187 242 101,925 96,844 May 988 480 103 167 238 82,660 92,876 June 1,067 493 150 195 229 94,625 94,168 July 1,195 460 252 219 264 112,940 107,748 August 1,276 503 260 217 296 120,075 116,812 September 1,031 406 165 209 251 87,050 102,552 October 1,048 403 233 205 207 101,635 89,144 November 905 329 225 168 183 90,625 76,956 December 799 325 230 119 125 91,225 53,160 12,387 5,033 2,328 2,289 2,737 January 894 312 180 202 200 72,228 75,038 February 990 398 166 214 212 79,732 79,526 March 1,048 440 173 217 218 86,095 81,413 April 1,102 486 176 203 237 92,154 84,592 May 999 476 115 163 245 79,069 81,872 June 978 478 132 133 235 82,622 75,752 July 1,031 455 204 117 255 93,925 78,948 August 1,276 501 251 269 255 108,564 97,036 2017 Total 1,141,285 1,119,664 2016 September 970 396 160 202 212 78,324 78,098 October 1,056 447 203 199 207 92,778 76,466 November 1,005 423 254 178 150 99,867 59,432 December 1,000 405 240 190 165 94,995 64,685 Total 12,349 5,217 2,254 2,287 2,591 January 876 303 170 213 190 66,842 73,912 February 938 365 169 200 204 73,720 75,800 March 993 402 190 205 196 81,928 74,420 April 963 406 156 194 207 75,924 75,806 May 1,001 426 155 175 245 78,014 82,950 June 986 453 145 143 245 79,192 78,982 July 1,027 451 184 127 265 86,374 81,998 August 1,259 493 271 227 268 107,692 95,148 909 312 203 189 205 74,138 74,686 October 1,057 449 213 178 217 91,656 76,322 November 974 425 207 164 178 87,780 64,836 1,060,353 932,858 2015 September December 1,012 401 231 193 187 89,604 Total 11,995 4,886 2,294 2,208 2,607 January 866 313 160 200 193 62,917 60,235 February 887 375 153 145 214 68,415 58,115 March 978 397 187 189 205 76,933 61,332 April 954 376 159 205 214 69,604 64,895 May 1,035 445 193 165 232 83,245 63,885 June 1,047 463 193 160 231 85,207 63,125 992,864 70,682 925,542 2013 July 968 421 195 107 245 80,989 59,866 1,212 504 241 207 260 98,316 74,091 September October November 986 990 974 323 409 400 200 198 212 188 156 145 275 227 217 71,207 80,221 81,760 74,869 61,893 58,700 December 960 394 223 156 187 83,086 54,093 11,857 4,820 2,314 2,023 2,700 August Total A PP 941,900 755,099 B OH PP OH 220 140 140 140 140 292 189.7579758 This is a "work area" - please do 292 184.39029126 not include in table. 292 178.55341675 292 180.69909091 125 220 140 292 177.66801619 125 220 140 292 176.93814433 125 220 140 292 184.67615063 125 220 140 292 185.64811912 125 220 140 292 183.90106693 125 220 140 292 182.04103053 125 220 140 292 185.17237569 125 220 140 292 180.70713392 125 220 125 220 125 220 125 292 182.52595463 119 195 119 255 164.72706935 119 195 119 255 160.86666667 119 195 119 255 159.83587786 119 195 119 255 160.38656987 119 195 119 255 161.1021021 119 195 119 255 161.93660532 119 195 119 255 167.67507274 119 195 119 255 161.12852665 119 195 119 255 161.25979381 119 119 119 195 195 195 119 119 119 255 160.26893939 255 158.50646766 255 159.68 161.40667261 114 114 114 114 190 190 190 190 114 114 114 114 114 114 114 114 190 190 190 190 190 190 190 190 124 124 124 124 124 124 124 124 124 124 124 124 250 160.67808219 250 159.40298507 250 157.45015106 250 157.55970924 250 160.8031968 250 160.4198783 250 163.94547225 250 161.11199365 250 163.72277228 250 158.91958373 250 156.6899384 250 158.38537549 159.93380575 109 109 109 109 109 109 109 109 109 109 109 109 180 180 180 180 180 180 180 180 180 180 180 180 113 113 113 113 113 113 113 113 113 113 113 113 195 142.20785219 195 142.64937993 195 141.37525562 195 140.98427673 195 142.15458937 195 141.67335244 195 145.51136364 195 142.25 195 148.15010142 195 143.54949495 195 144.20944559 195 142.89479167 143.12212195 Total Gross Charges ($) 172,490 189,922 185,517 198,769 175,536 188,793 220,688 236,887 189,602 190,779 167,581 144,385 2,260,949 147,266 159,258 167,508 176,746 160,941 158,374 172,873 205,600 156,422 169,244 159,299 159,680 1,993,211 140,754 149,520 156,348 151,730 160,964 158,174 168,372 202,840 148,824 167,978 152,616 160,286 1,918,406 123,152 126,530 138,265 134,499 147,130 148,332 140,855 172,407 146,076 142,114 140,460 137,179 1,696,999 work area" - please do Table 3.5 Revenue Generation by Physician, Center, Day of Week, September 1-November 29, 2017 RECORD DATE MD/ARNP DAY CTR REVENUE $ VISITS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Sept 1 Sept 2 Sept 3 Sept 4 Sept 5 Sept 6 Sept 8 Sept 9 Sept 10 Sept 11 Sept 12 Sept 13 Sept 15 Sept 16 Sept 17 Sept 18 Sept 19 Sept 20 Sept 22 Sept 23 Sept 24 Sept 25 Sept 26 Sept 27 Sept 29 Sept 30 Oct 1 Oct 2 Oct 3 Oct 4 Oct 6 Oct 7 Oct 8 Oct 9 Oct 10 Oct 11 Oct 13 Oct 14 Oct 15 Oct 16 Oct 17 Oct 18 Oct 20 Holiday 1 3 3 1 11 1 1 3 3 4 11 1 1 3 3 4 11 1 1 3 3 4 11 1 1 3 3 5 11 1 1 3 3 4 11 1 1 3 3 5 11 1 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3,156 3,788 3,956 3,059 3,076 3,044 3,657 4,366 4,381 3,547 3,148 3,008 3,005 3,976 3,740 3,547 3,005 3,259 3,051 3,906 3,856 3,944 3,452 3,056 3,067 3,010 2,840 3,049 1,599 6,559 3,769 3,276 3,806 3,051 3,028 5,278 4,650 3,920 2,534 4,020 3,699 4,460 17 21 23 24 19 22 34 20 25 38 16 23 18 21 19 30 20 32 22 18 22 24 20 20 23 23 18 20 10 42 21 20 20 18 20 33 28 20 14 28 24 36 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 Oct 21 Oct 22 Oct 23 Oct 24 Oct 25 Oct 27 Oct 28 Oct 29 Oct 30 Oct 31 Nov 1 Nov 3 Nov 4 Nov 5 Nov 6 Nov 7 Nov 8 Nov 10 Nov 11 Nov 12 Nov 13 Nov 14 Nov 15 Nov 17 Nov 18 Nov 19 Nov 20 Nov 21 Nov 22 Nov 24 Nov 25 Nov 26 Nov 27 Nov 28 Nov 29 Sept 1 Sept 2 Sept 3 Sept 4 Sept 5 Sept 6 Sept 8 Sept 9 Sept 10 Sept 11 Sept 12 1 3 3 4 11 1 1 3 3 4 11 1 1 3 3 5 11 1 1 3 3 4 13 1 1 3 3 5 11 1 1 3 Holiday 9 11 Holiday 2 6 6 7 13 2 2 6 6 7 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2 4,739 4,230 3,288 3,805 3,397 5,520 4,367 3,650 3,090 3,001 1,145 5,350 2,768 3,587 4,879 2,757 1,036 5,567 2,586 5,980 4,771 2,061 2,212 5,789 3,879 5,879 4,244 2,959 2,055 4,789 4,444 5,546 28 22 19 25 22 39 28 20 18 20 10 35 15 21 26 19 10 31 17 32 24 14 22 35 23 31 24 17 15 30 25 32 4,007 2,335 30 16 5,157 4,286 4,367 4,156 1,956 6,648 5,978 4,934 2,166 4,305 25 14 16 17 10 30 29 20 12 16 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 Sept 13 Sept 15 Sept 16 Sept 17 Sept 18 Sept 19 Sept 20 Sept 22 Sept 23 Sept 24 Sept 25 Sept 26 Sept 27 Sept 29 Sept 30 Oct 1 Oct 2 Oct 3 Oct 4 Oct 6 Oct 7 Oct 8 Oct 9 Oct 10 Oct 11 Oct 13 Oct 14 Oct 15 Oct 16 Oct 17 Oct 18 Oct 20 Oct 21 Oct 22 Oct 23 Oct 24 Oct 25 Oct 27 Oct 28 Oct 29 Oct 30 Oct 31 Nov 1 Nov 3 Nov 4 Nov 5 13 2 2 6 7 8 13 2 2 6 8 8 12 2 2 5 5 8 13 2 2 5 5 6 13 2 2 5 5 6 13 2 2 5 5 6 12 2 2 5 5 6 13 2 2 6 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 1,510 6,250 4,850 3,956 4,707 3,958 1,941 5,790 4,415 3,083 3,546 4,026 1,850 4,890 3,827 4,080 3,080 2,044 830 4,560 4,050 4,069 3,827 1,566 1,209 4,038 4,740 3,567 5,035 3,077 1,518 5,734 3,657 3,256 3,070 3,058 1,656 5,020 4,640 2,748 2,978 2,007 1,205 3,557 4,047 3,344 9 28 20 18 20 18 10 28 20 14 16 16 12 24 18 18 15 9 4 20 20 20 18 11 6 19 20 17 18 15 8 22 19 20 13 12 8 22 20 15 14 9 6 17 15 18 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 Nov 6 Nov 7 Nov 8 Nov 10 Nov 11 Nov 12 Nov 13 Nov 14 Nov 15 Nov 17 Nov 18 Nov 19 Nov 20 Nov 21 Nov 22 Nov 24 Nov 25 Nov 26 Nov 27 Nov 28 Nov 29 6 8 13 2 2 6 6 8 13 2 2 6 6 7 13 2 2 6 Holiday 9 13 CODES For Table 3-5 MD/ARNP 1 B. Casey 2 M. Welby 3 S. Tobias 4 J. Smooth 5 R. Hottle 6 L. Cytesmath 7 C. Withers 8 L. Jones 9 M. Foxx 10 M. Meyers 11 C. Withers, ARNP 12 J. Jones, ARNP 13 G Mattox, ARNP Revenue = Total gross billed charges Visits = Number of paying patients 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 1 2 3 4 5 6 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 Day Monday Tuesday Wednesday Thursday Friday Saturday 4,289 3,756 1,034 4,420 4,510 3,089 3,837 4,730 1,856 4,298 3,587 2,689 4,856 3,962 1,091 5,029 2,538 2,177 20 14 4 30 16 16 15 17 10 21 12 13 22 14 10 24 12 12 2,002 1,053 8 5 Center Alpha Beta Table 3.6 Statement of Operations 2017 2016 2015 2014 2013 2,246,188 179,695 2,066,493 18,520 2,085,013 1,993,211 159,457 1,833,754 22,463 1,856,217 1,918,406 153,472 1,764,934 22,252 1,787,186 1,696,999 135,760 1,561,239 23,595 1,584,834 1,690,252 135,220 1,555,032 23,684 1,578,716 1,131,608 392,301 18,330 3,000 1,267 21,556 1,529 4,100 28,100 44,870 12,830 8,450 61,450 18,437 10,122 23,955 78,500 3,167 10,315 18,925 72,556 8,437 1,973,805 1,001,556 310,482 17,339 3,400 845 31,443 1,270 4,100 24,100 45,292 12,256 8,450 58,220 29,348 9,450 23,425 78,750 2,966 7,495 16,800 70,449 5,629 1,763,065 982,450 294,735 10,494 3,856 342 34,256 948 4,100 24,100 42,550 8,156 8,450 57,354 28,420 9,014 23,302 58,900 1,529 6,519 13,560 70,383 4,303 1,687,721 839,229 243,376 10,056 3,003 659 35,378 805 1,800 18,560 44,691 3,440 7,850 58,556 28,556 3,588 23,884 58,900 2,349 2,550 13,720 68,363 3,494 1,472,807 838,226 234,703 9,562 2,340 589 25,398 355 1,800 24,100 39,254 2,440 7,850 28,340 28,360 2,013 24,885 58,900 3,620 2,044 13,900 79,262 3,102 1,431,043 Income (loss) before taxes 111,208 93,152 99,465 112,027 147,673 Federal and state taxes Income (loss) after taxes 44,483 66,725 37,261 55,891 39,786 59,679 44,811 67,216 59,069 88,604 Revenue Patient services, gross Contractual alllowances Patient revenue, net Other revenue Total revenue Expenses Salaries and wages Staff benefits Administrative expenses Advertising Collection fees Computer support Consultants Equipment leases Insurance Laboratory Laundry and housekeeping Legal/audit Medical supplies Office supplies Printing and postage Professional fees Rent Repairs and maintenance Telephone Utilities Depreciation Bad debt expenses Total expenses Table 3.7 Balance Sheet for Fiscal Year Ending December 31 2017 2016 2015 2014 2013 Assets Current Cash, operating Accounts receivable Inventory Prepaid expenses Total current assets 153,449 139,385 3,339 3,078 299,251 163,035 134,450 4,125 4,565 306,175 86,999 131,560 5,233 4,021 227,813 76,223 130,455 28,734 5,688 241,100 84,550 168,455 30,335 8,944 292,284 Investments 368,825 341,010 405,903 353,628 314,040 Property and equipment Equipment and leasehold improvements, gross Less accumulated depreciation Equipment and leasehold improvements, net Total assets Liabilities and net assets 1,197,602 645,239 552,363 1,220,439 1,125,046 572,683 552,363 1,199,548 1,054,597 502,234 552,363 1,186,079 984,214 431,851 552,363 1,147,091 915,851 363,488 552,363 1,158,687 49,668 29,000 2,134 80,802 13,534 27,387 945 41,866 13,796 30,100 823 44,719 10,455 45,662 1,126 57,243 77,454 23,145 569 101,168 0 80,802 84,770 126,636 124,339 169,058 132,506 189,749 167,393 268,561 Common stock note1 Authorized and issued 720,000 720,000 720,000 720,000 720,000 Cumulative operating (deficit) or gain after taxes 371,637 352,912 297,021 237,342 170,126 Dividends payable Net assets 48,000 1,139,637 1,072,912 1,017,021 957,342 890,126 Net assets and liabilities 1,220,439 1,199,548 1,186,079 1,147,091 1,158,687 Current liabilities Accounts payable Accrued expenses Accrued payroll taxes Total current liabilities Long-term liabilities Notes payable Total liabilities Net assets NOTE: 1. Common stock: $12 par, 60,000 authorized and issued. Table 4.1 Webster Hospital Medical Staff Information, 2017 Name Office Age Specialty Patient Days Discharges Department of MedicineActive Staff General and Family Practice A. Able 1 A. Adelson 1 A. Downs 1 B. Dawes 1 B. Lamb 1 C. Franklin 2 C. Newton 2 D. Dodger 3 E. Best 3 E. Devishson 3 E. Doogle 3 F. Walczek 5 F. Evans 4 G. Liu 6 H. Megg 7 J. Child 4 J. Kim 4 J. Lopez 1 K. Blood 1 K. Justin 2 M. Heart 1 B. Easter 1 C. Fisher 2 D. Hamilton 2 I. Kelly 8 29 33 34 34 37 48 44 37 35 31 36 38 39 29 36 43 32 40 50 57 43 68 60 55 69 Family Practice* Family Practice* Family Practice* Family Practice* Family Practice* Family Practice Family Practice Family Practice* Family Practice* Family Practice* Family Practice* Family Practice Family Practice Family Practice Family Practice Family Practice Family Practice Family Practice Family Practice Family Practice Family Practice General Practice General Practice General Practice General Practice 504 601 678 590 603 323 476 415 340 186 357 300 197 287 454 244 456 478 534 539 478 547 416 345 38 115 125 152 146 149 66 96 91 84 43 82 64 45 50 100 55 91 103 109 114 101 102 92 77 7 I. Lasker 68 General Practice 135 24 Internal Medicine: General J. Morgan 1 8 35 Internal Medicine 590 121 K. Organs 1 54 Internal Medicine 398 86 Pediatrics D. White H. Wall N. Green 1 1 1 34 37 35 Pediatrics* Pediatrics* Pediatrics* 162 45 80 45 18 28 X. Hirsh 1 39 Pediatrics* 40 15 W. Snipes 3 45 Cardiology 546 105 Other: Medicine A. Zook J. Hogan 1 1 57 50 Endocrinology ENT 129 365 24 70 P. Taff 1 43 ENT 356 66 65 243 10 41 Cardiology Department of MedicineConsulting Staff J. Washington 3 43 Internal Medicine C. Eisenhower 9 50 Cardiology S. Truman L. Coolidge W. G. Chan W. Tafy V. Kennedy T. Johnson C. Nixon M. Polk S. Warren T. Werner 9 3 3 9 3 9 9 3 9 9 Others 9 43 44 37 57 64 47 54 40 50 53 Rheumatology ENT Pediatrics Oncology ENT Cardiology Internal Medicine OB/GYN Pulmonary Medicine Pulmonary Medicine 334 143 132 356 140 176 160 112 655 503 62 31 25 50 26 32 24 20 113 90 168 32 Department of Surgery General and Orthopedic S. Saw 1 C. Blade 1 R. Runner 1 31 50 37 General* General* Orthopedic 759 671 766 155 142 155 D. Dolittle 1 46 Orthopedic 792 164 D. Felix 1 47 Urology 403 77 OB/GYN B. Shaw D. Kirby E. Munson F. Zebra G. Martinez 1 1 1 1 1 40 43 44 41 47 OB/GYN* OB/GYN OB/GYN* OB/GYN* OB/GYN* 415 403 403 602 621 90 92 95 129 143 M. Lewis 1 49 OB/GYN* 678 137 SurgeryConsulting Staff M. Merrill 9 W. Pierce 9 F. Stevensen 3 J. Tyler 3 P. Miller 3 J. McKinley 3 M. Dawes 10 S. Strimpf 10 S. Skier 9 W. Hockey 9 S. Fremont 9 M. Fremont 9 D. Davids 9 K. Nioxon 9 G. Grant 9 L. Goldwater 3 W. Miller 3 D. Garfield 9 K. McGovern 9 47 51 61 63 68 65 56 54 54 47 45 45 50 63 50 44 47 43 53 General General General General General General General General Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic Thoraracic Thoraracic 48 153 100 140 45 32 116 124 216 106 95 96 54 20 22 20 27 59 105 8 27 19 26 7 5 20 22 D. Chest 50 Thoraracic 145 Other 9 Department of Pathology and RadiologyActive Staff 41 20 18 16 10 3 4 3 5 9 16 20 J. Ericksen H. Holland W. Jippel D. Yip M. Stern 1 1 1 1 1 48 62 46 43 44 Radiology Radiology Radiology Pathology Pathology M. Lincoln 1 34 Pathology Department of Pathology and RadiologyConsulting Staff M. Currie 9 58 Radiology D. Douglas 9 43 Radiology W. Lewis 9 40 Radiology D. Slide 9 55 Pathology F. Fillerautz 9 44 Pathology G. Gathews 9 47 Pathology Department of AnesthesiologyActive Staff N. Needle 1 38 Anesthesiology S. Westerman 1 42 Anesthesiology N. Chamerblin 1 44 Anesthesiology S. Pak 1 54 Anesthesiology D. Sleep 9 61 Anesthesiology M. Halo 9 50 Anesthesiology J. Jones 9 46 Anesthesiology D. Dinckens 9 41 Anesthesiology Department of Emergency MedicineActive Staff E. Abelson 1 44 Emergency M. Gasp 1 51 Emergency I. Hurt 1 42 Emergency A. Lincoln 1 34 Emergency H. Calson 1 40 Emergency W. Hiller 1 47 Emergency S. Sams 1 45 Emergency G. Bodansky 1 50 Emergency Department of Emergency MedicineConsulting Staff J. Whitey 9 47 Emergency J. Sallowash 9 51 Emergency R. Ritco 9 41 Emergency TBD 9 Emergency NOTES * = Medical practice owned by Webster Health System, Inc. Office Location: 1 = Middleboro; 2 = Mifflenville; 3 = Jasper; 4 = Harris City; 5 = Statesville; 6 = Carterville; 7 = Boalsburg; 8 = Minortown; 9 = Capital City; Table 4.2 Hospital Inpatient Occupancy by Service, 2017-2011 Hospital Service 2017 2016 2015 2014 2013 2012 2011 Pediatrics Beds Patient days Occupancy 2 450 61.6% 2 645 88.4% 3 706 64.5% 4 804 55.1% 4 903 61.8% 4 998 68.4% 6 1,212 55.3% Beds Patient days Occupancy Medical Surgical I Beds Patient days Occupancy Medical Surgical II Beds Patient days Occupancy Medical Surgical III Beds Patient days Occupancy Orthopedic Beds Patient days Occupancy ICU Beds Patient days Occupancy 20 5,470 74.9% 20 4,956 67.9% 14 4,106 80.4% 14 3,845 75.2% 14 3,455 67.6% 11 2,840 70.7% 10 2,740 75.1% 20 5,270 72.2% 20 6,047 82.8% 22 6,070 75.6% 20 5,578 76.4% 20 6,129 84.0% 18 4,996 76.0% 20 5,582 76.5% 20 5,442 74.5% 20 5,163 70.7% 23 5,890 70.2% 21 5,830 76.1% 21 5,770 75.3% 24 6,556 74.8% 21 5,979 78.0% 20 5,067 69.4% 20 6,089 83.4% 20 5,378 73.7% 20 5,503 75.4% 20 5,586 76.5% 21 5,767 75.2% 20 5,830 79.9% 0 0 0.0% 0 0 0.0% 4 955 65.4% 7 1845 72.2% 8 2140 73.3% 12 3324 75.9% 13 3824 80.6% 13 2,956 62.3% 13 2,802 59.1% 12 2,655 60.6% 12 2,282 52.1% 11 1,981 49.3% 10 1,810 49.6% 10 1,567 42.9% 95 24,655 71.1% 95 25,702 74.1% 98 25,760 72.0% 98 25,687 71.8% 98 25,964 72.6% 100 26,291 72.0% 100 26,734 73.2% Maternity Total Hospital Beds Patient days Occupancy Table 4.3 Detailed Utilization Statistics, 2017 and 2016 2017 Discharges Patient Inpatient Days Surgery January 412 2,133 103 February March 387 507 1,894 2,060 104 112 Outpatient Surgery Births ED Visits ED Admits OPV 407 124 1,798 215 6,962 105 1,676 200 6,072 124 1,803 234 7,245 367 427 April 499 1,978 107 419 136 1,830 220 7,520 May 409 2,178 105 434 121 1,795 218 7,029 June 2,056 2,157 1,867 2,245 1,956 2,059 2,072 24,655 101 102 90 114 116 103 99 1,256 495 412 390 408 417 426 403 5,005 123 115 127 139 136 134 126 1,510 1,798 July August September October November December Total 389 353 375 435 423 494 412 5,095 212 219 230 200 213 223 200 2,584 6,998 7,126 6,349 7,836 7,354 6,926 6,559 83,976 January February March April May June July August September October November December Total 312 433 446 400 445 412 408 407 405 434 490 541 5,133 2,056 117 104 116 137 132 113 105 95 134 120 116 109 1,398 405 401 417 423 422 395 366 382 410 412 418 419 4,870 121 200 196 199 190 201 200 206 212 209 214 204 188 2,419 6,956 1,823 1,880 1,748 1,850 1,880 1,675 21,556 2016 1,928 2,186 2,001 1,978 1,905 2,156 2,169 2,190 2,101 2,067 2,265 25,002 NOTES: ED Visits = Total emergency department visits ED Admits = ED visits that led to an inpatient admission OPV = Outpatient visits, excludes ED visits 108 110 124 108 118 114 113 118 137 122 106 1,399 1,662 1,640 1,658 1,640 1,720 1,710 1,720 1,820 1,748 1,743 1,734 1,656 20,451 5,728 6,689 7,387 7,704 7,005 6,129 5,946 7,558 7,054 7,067 6,126 81,349 * WEBSTER HOSPITAL TABLE 44 REVISED 5/18/18 STATEMENT OF REVENUE AND EXPENSE ($) FOR CALENDAR YEARS ENDING DECEMBER 31 2017 2016 2015 REVENUE PATIENT SERVICES REVENUE TOT Inpatient Outpatient 290,117,301 288,362,045 105,718,744 109,577,577 184,398,557 178,784,468 287,223,124 116,919,656 170,303,468 50,744,997 103,017,173 153,762,170 136,355,131 53,667,342 102,048,162 155,715,504 132,646,541 55,341,870 99,758,617 155,100,487 132,122,637 108,330 88,453 72,290 136,463,461 132,734,994 132,194,927 43,245,232 30,898,223 24,836,292 24,638,272 1,865,693 5,320,108 251,799 131,055,619 40,384,554 30,556,393 22,405,239 24,003,292 1,813,907 5,891,202 299,874 125,354,461 38,345,292 30,573,990 23,450,202 24,595,281 1,936,889 5,412,404 225,665 124,539,723 NET INCOME FROM OPERATIONS 5,407,842 7,380,533 7,655,204 NONOPERATING REVENUE Unrestricted Gifts and Bequests Income from Investments Miscellaneous NonPatient Revenue TOTAL 198,233 3,059,282 1,118,332 4,375,847 147,841 2,517,304 500,300 3,165,175 596,053 3,045,222 720,754 4,362,029 NONOPERATING EXPENSES Net NonOperating Income 2,554,293 1,821,554 2,007,343 1,157,832 1,245,422 3,116,607 PROFIT or (LOSS) 7,229,396 8,538,365 10,771,811 Allowances and Uncollectables Inpatient Allowances and Uncollectables Outpatient Total NET SERVICE REVENUE Other Operating Revenue TOTAL OPERATING REVENUE EXPENSE OPERATING EXPENSES Patient Care Services Other Professional Services General Services Fiscal and Admin Services Interest Depreciation Community Education and Outreach TOTAL OPERATING EXPENSES 10,771,811 WEBSTER HOSPITAL TABLE 4-5 Revised 5/18/18 BALANCE SHEET ($) AS OF DECEMBER 31 2017 2016 2015 Cash Short Term Investments Accounts Receivables - Gross Allowances for Uncollectables Accounts Receivables - Net Due from Third Party Payers Inventories Prepaid Expenses 3,005,494 3,035,445 33,458,282 18,563,987 14,894,295 607,255 4,866,345 153,702 2,324,303 2,224,383 34,292,554 19,393,554 14,899,000 443,420 4,995,395 176,872 2,439,495 893,247 36,595,230 19,937,554 16,657,676 103,450 5,394,129 162,508 TOTAL CURRENT ASSETS 26,562,536 25,063,373 25,650,505 NON-CURRENT ASSETS Property, Plant and Equipment - Gross Less Accumulated Depreciation Property, Plant and Equipment - Net Other Investments 107,353,474 67,334,262 40,019,212 14,997,675 104,393,556 62,014,154 42,379,402 14,349,292 100,384,345 56,122,952 44,261,393 8,530,204 TOTAL ASSETS 81,579,423 81,792,067 78,442,102 Accounts Payable Accrued Salaries and Wages Accrued Interest Other Accrued Expenses Due to Third Party Vendors Long Term Debt Due Within One Year 5,334,675 767,056 107,342 279,474 705,613 2,158,337 5,539,564 828,349 72,204 261,584 702,461 1,345,965 5,420,787 792,414 70,245 270,654 582,491 945,229 TOTAL CURRENT LIABILITIES 9,352,497 8,750,127 8,081,820 Long Term Debt 20,456,294 28,500,704 34,357,411 TOTAL LIABILITIES 29,808,791 37,250,831 42,439,231 Restricted Unrestricted 6,128,484 45,642,148 6,034,292 38,506,944 6,203,445 29,799,426 TOTAL NET ASSETS 51,770,632 44,541,236 36,002,871 CURRENT ASSETS CURRENT LIABILITIES NET ASSETS Table 5.1 Medical Staff Information as of December 2017 Name Notes Office Age Specialty Family Practice: Active Staff F. Player G. Banero J. Apple S. Fistru S. Mix 5 8 6 7 2 70 55 59 58 64 General Practice General Practice General Practice General Practice General Practice 235 319 174 260 130 Family Practice: Consulting Staff C. Berrnally D. Mathews H. Cavenero H. Wang J. Yates N. Chamerberlin S. Mathews 3 3 3 3 3 3 3 38 45 55 40 44 47 42 General Practice* General Practice* General Practice* General Practice General Practice General Practice General Practice 101 48 57 79 51 118 18 Internal Medicine A. Barton B. Crush C. Douglas D. Justin D. Meow D. Michael E. Frost F. Grist G. Filly G. Hurt H. Hippster J. Justin J. Vogel K. Kessler L. Lesko L. Nask M. Horse M. Mast M. Master N. Nostrom O. Ogg P. Xiao P. Trip Q. Quinn S. Jessey S. Knach S. Steel S. Stocapy T. Beata T. Cushing T. Davis T. Figher T. King 1 3 1 1 1 4 3 3 1 8 1 4 5 1 1 5 1 2 1 2 2 2 6 6 7 8 3 3 3 3 3 3 3 45 63 41 67 60 45 41 50 58 55 56 59 55 34 38 56 68 41 40 57 39 50 52 63 60 67 50 57 60 62 58 54 63 Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine* Internal Medicine Internal Medicine Internal Medicine Internal Medicine* Internal Medicine Internal Medicine* Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine* Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine* Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine 812 380 800 310 280 250 490 140 240 172 250 84 103 658 560 203 544 877 472 112 572 126 263 156 177 63 416 150 80 87 203 306 64 Pediatrics MA MA MA MA MA MA 2017 Patient Days A. Sloan 1 54 Pediatrics* 56 B. Bickford G. Gavin M Miller M. Bill N. Otter O. Pushy P. Kettel P. Quester Q. Reaper R. Samuels S. St. James T. Turtle U. Unvey V. Vesh W. Warren W. Washed 1 1 3 3 3 1 3 3 1 1 1 1 3 1 1 3 50 44 40 59 37 50 57 40 59 47 40 58 56 52 56 64 Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics Pediatrics* Pediatrics Pediatrics* Pediatrics* Pediatrics 92 44 103 52 105 120 70 280 81 114 120 240 234 92 84 48 Allergy and Immunology S. Sleek T. Gustave T. Hampshire 1 1 3 49 53 58 Allergy/Immunology Allergy/Immunology Allergy/Immunology 448 207 204 Cardiology D. Eastman G. Hurst J. Dufresne T. Underwood U. Victem 1 1 3 1 1 56 60 60 46 41 Cardiology* Cardiology* Cardiology Cardiology Cardiology* 384 234 180 652 471 1 1 2 2 1 1 60 55 59 64 49 44 Gastroenterology Gastroenterology Gastroenterology Gastroenterology Gastroenterology Gastroenterology Psychiatry A. Actor B. Banana 1 1 42 50 Psychiatry Psychiatry 480 432 F. Jilley I. Stanzl S. Zeus 1 2 2 39 61 40 Psychiatry Psychiatry Psychiatry 360 86 272 Other: Medicine C. Tunsteb M. White M. Whittier V. Weckenson W. Xerox X. Yalper B. Divan M. Schoen S. Hatcher T. Kwok 1 1 1 1 1 1 1 1 1 1 60 63 44 44 42 57 44 39 53 32 ENT ENT ENT ENT ENT ENT Oncology/Hemo Oncology/Hemo* Oncology/Hemo* Oncology/Hemo 80 68 353 470 497 170 440 401 459 150 Gastroenterology T. Amas T. Eisher T. Tiger T. Wingate Y. Zaller Z. Autumn MA MA MA MA MA MA MA MA MA MA MA 120 128 58 86 1,270 748 C. Carp F. Fish 3 3 54 49 ENT ENT Surgery: Orthopedic D. Jones G. Hooper 1 1 57 50 Orthopedic Orthopedic 1,376 1,253 K. Amberson K. Matthews K. Questrom L. Rex M. Dillon M. Stanley 1 1 1 1 1 1 55 45 39 57 64 49 Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic Orthopedic 1,540 1,721 1,401 1,703 1,420 1,507 1 1 1 1 1 1 1 1 1 1 40 57 39 58 50 45 49 62 59 57 General General* General General* General* General General General General* General* 1,200 1,245 734 1,300 586 870 416 601 1,246 980 1 1 1 1 1 1 1 1 33 51 65 45 57 56 55 59 OB/GYN OB/GYN OB/GYN* OB/GYN OB/GYN OB/GYN* OB/GYN OB/GYN* 650 290 480 720 336 236 186 280 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 45 56 50 43 59 42 58 55 60 60 66 47 51 44 47 46 45 51 Neuro Urology Neuro Urology Neuro Plastic Plastic Thoracic Thoracic General General Thoracic Vascular Bariatric Vascular Eye Urology Urology 329 450 334 578 444 332 101 921 844 640 225 340 310 380 340 300 650 850 Surgery: General B. Hersh C. Isherum D. Jackson F. Limpey G. Munson H. Never I. O'Connell J. Putter J. Timas J. Victor MA MA MA MA MA MA MA 300 280 Surgery: OB/GYN D. Dustin E. Eberle F. Fraser G. Gost J. Kim I. Japen K. Lights M. Nester Surgery: Other B. Bernal C. Eason D. Crow D. Fixer F. Seimer G. Tho H. Yee J. Underside J. Warren J. Yellow J. Zetias L. Clock L. David L. Fession L. Frederick M. Blue M. Mold N. Nerve MA MA MA MA Department of Medicine: Consulting Staff W. Pokorny 9 B. Rubble 3 F. Feada 9 F. Flint 9 H. Ruth 9 J. Klock MA 3 K. Kipstein MA 3 L. Gomez 9 L. Mustard MA 3 M. McVoy 9 O. Maeer MA 3 P. Carles 9 S. Ange 9 S. Lott 9 S. Malone 9 S. Parish 9 V. Vitter 9 51 54 63 56 42 49 50 44 39 37 42 60 48 50 55 48 57 Psychiatry Oncology Hematology Oncology Gastroenterologyenter OB/GYN Cardiology Allergy OB/GYN Psychiatry Cardiology Pulmonary Medicine Endocrinology Hematology Allergy Dermatology Hematology 14 32 32 54 65 130 201 26 223 32 133 28 84 112 31 16 102 Department of Surgery: Consulting Staff A. Hamp 9 A. Steve MA 3 C. Finn MA 3 F. Mike 9 J. Wingate 9 L. Picture MA 3 L. Richard 9 N. New 9 S. Lee MA 3 48 47 49 60 50 47 45 58 40 General Thoracic Thoracic Ortho Pediatric Orthopedic Orthopedic Orthopedic Orthopedic 45 80 39 28 30 76 19 24 56 Department of Pathology: Active Staff A. Mixture 1 B. Nerverto 1 C. Leatros 1 D. Mushroom 1 D. Pathos 1 E. Fisher 1 F. Mautz 1 G. Wingate 1 61 56 47 42 56 54 64 63 Pathology Pathology Pathology Pathology Pathology Pathology Pathology Pathology Department of Radiology: Active Staff A. Picture 1 B. Quadic 1 C. Roetgen 1 D. Sunshine 1 M. Ray 1 K. Hines 1 W. Hines 1 L. Jinks 1 P. Patel 1 R. Ricker 1 R. El-Amin 1 R. Trippe 1 E. Tracer 1 56 45 61 40 45 50 39 45 52 34 44 49 49 Radiology Radiology Radiology Radiology Radiology Radiology Radiology Radiology Radiology Radiology Radiology Radiology Radiology Department of Anesthesiology: Active Staff A. Aaron B. Carter B. Dexter B. Harrington B. Nelson 1 1 1 1 1 38 62 66 63 60 Anesthesiology Anesthesiology Anesthesiology Anesthesiology Anesthesiology B. Thomas C. Fisher D. Gass E. Lister F. Mask 1 1 1 1 1 64 54 48 61 59 Anesthesiology Anesthesiology Anesthesiology Anesthesiology Anesthesiology Department of Emergency Medicine: Active Staff R. Romanikova 1 S. Hines 1 B. Casey 1 J. Smooth 1 G. Goodspeed 1 L. Jinks 1 M. Gotlike 1 J. Ishabi 1 L. Cytesmith 1 M. Welby 1 R. Hotlick 1 S. Tobias 1 29 60 44 54 70 45 52 43 60 56 58 51 Emergency Emergency Emergency Emergency Emergency Emergency Emergency Emergency Emergency Emergency Emergency Emergency Department of Hospital Medicine A. Palmer B. Carlos C. Frost F. Drudge M. Gupta M. Shine S. Ruderbacker V. Martinez W. Lewis 32 40 39 35 40 43 56 44 50 Hospitalist Hospitalist Hospitalist Hospitalist Hospitalist Hospitalist Hospitalist Hospitalist Hospitalist 1 1 1 1 1 1 1 1 1 NOTES: MA = Medical Associates Office Location: 1 = Middleboro; 2 = Mifflenville: 3 = Jasper 4 = Harris City; 5 = Statesville: 6 = Carterville; 7 = Boalsburg 8 = Minortown; 9 = Capital City; 10 = Other * = Medical practice owned by Medical Practice Subsidiary (MPS) Inc. Table 5.2 Hospital Inpatient Occupancy by Service, 2011-2017 Hospital Service 2017 2016 2015 2014 2013 2012 2011 Beds Patient days 12 2,249 14 2,245 16 2,224 18 2,270 18 2,546 18 3,260 18 3,150 Occupancy 51.3% 43.9% 38.1% 34.6% 38.8% 49.6% 47.9% Beds Patient days 26 4,372 28 4,423 28 4,134 29 5,045 29 6,023 29 6,007 29 6,045 Occupancy 46.1% 43.3% 40.5% 47.7% 56.9% 56.8% 57.1% Beds 50 Patient days 13,756 50 13,505 50 13,333 50 13,340 50 12,103 50 12,400 50 12,547 75.4% 74.0% 73.1% 73.1% 66.3% 67.9% 68.8% 50 50 50 50 50 50 50 13,604 13,503 12,056 12,440 10,378 10,501 75.9% 74.5% 74.0% 66.1% 68.2% 56.9% 57.5% Beds 44 Patient days 10,054 50 10,450 53 11,004 55 11,856 55 11,420 53 11,890 53 11,945 62.6% 57.3% 56.9% 59.1% 56.9% 61.5% 61.7% Beds Patient days 40 9,850 40 9,893 45 9,833 50 10,956 50 11,584 50 12,282 50 12,470 Occupancy 67.5% 67.8% 59.9% 60.0% 63.5% 67.3% 68.3% Beds Patient days 18 4,644 18 4,847 18 4,856 18 4,934 18 4,926 20 5,102 20 5,008 Occupancy 70.7% 73.8% 73.9% 75.1% 75.0% 69.9% 68.6% Beds 240 Patient days 58,770 250 58,967 260 58,887 270 60,457 270 61,042 270 61,319 270 61,666 Occupancy 67.1% 65.5% 62.9% 62.2% 62.8% 63.1% 63.4% Pediatrics Maternity Medical Surgical I Occupancy Medical Surgical II Beds Patient days 13,845 Occupancy Medical Surgical III Occupancy Medical Surgical IV ICU/CCU Total Hospital Table 5.3 Detailed Utilization Statistics for 2017 and 2016 2017 Discharges Patient Inpatient Days Surgery January 890 4,959 201 Outpatient Surgery Births ER Visits ER Admits OPV 362 98 2,134 272 9,558 February 823 4,655 209 350 84 1,883 238 8,973 March 934 5,098 190 372 101 2,090 268 9,495 112 2,063 254 9,088 109 2,110 283 9,265 2,203 260 253 250 275 245 249 240 3,087 8,857 9,436 9,356 9,030 9,234 9,345 8,245 109,882 270 265 289 365 310 270 280 263 289 240 279 288 3,408 8,951 April May June 956 923 5,124 5,170 193 197 348 394 July August September October November December Total 1,025 897 862 898 893 863 766 10,730 5,768 4,535 4,425 4,978 4,990 4,923 4,145 58,770 185 170 165 187 198 193 170 2,258 345 325 303 365 323 395 302 4,184 108 99 101 109 114 104 109 1,248 January February March April May June July August September October November December Total 882 837 893 967 980 1,005 823 812 934 954 848 703 10,638 4,703 191 190 207 215 199 204 187 160 188 193 196 178 2,308 390 331 387 367 346 361 302 296 379 384 382 312 4,237 109 2,083 2,068 2,205 2,003 2,209 2,027 25,078 2016 4,780 5,149 5,547 5,320 5,756 3,701 4,301 5,734 5,134 4,775 4,067 58,967 NOTES: ED Visits = Total emergency department visits ED Admits = ED visits that lead to an inpatient admission OPV = Outpatient Visits, excludes ED visits 110 113 109 110 111 103 102 116 111 103 113 1,310 2,167 2,107 2,278 2,678 2,398 2,351 2,278 2,056 2,556 2,044 2,196 2,286 27,395 8,094 9,092 9,234 9,245 9,345 9,832 9,257 9,934 10,109 9,887 8,750 111,730 * TABLE 5-4 Revised 5/18/18 MIDDLEBORO COMMUNITY HOSPITAL STATEMENT OF REVENUE AND EXPENSE ($) FOR CALENDAR YEARS ENDING DECEMBER 31 2017 2016 2015 REVENUE PATIENT SERVICES REVENUE- TOTAL Inpatient Outpatient 658,351,925 312,565,340 345,786,585 650,578,354 315,343,506 335,234,848 650,829,412 322,465,856 328,363,556 Allowances and Uncollectables - Inpatient Allowances and Uncollectables - Outpatient Total 200,564,989 203,464,546 404,029,535 190,282,353 200,343,595 390,625,948 185,374,561 196,294,375 381,668,936 254,322,390 259,952,406 269,160,476 154,229 288,354 372,343 254,476,619 260,240,760 269,532,819 80,373,449 69,363,454 40,383,464 40,228,343 3,956,433 14,378,565 542,383 78,354,002 68,394,262 42,393,446 45,383,557 3,825,354 15,340,272 599,454 77,343,526 68,001,200 44,627,308 50,526,303 3,800,240 16,340,229 535,495 249,226,091 254,290,347 261,174,301 NET INCOME FROM OPERATIONS 5,250,528 5,950,413 8,358,518 NONOPERATING REVENUE Unrestricted Gifts and Bequests Income from Investments Miscellaneous Non-Patient Revenue TOTAL 76,342 1,978,564 118,453 2,173,359 48,331 2,018,334 49,510 2,116,175 26,051 2,933,162 157,394 3,116,607 NONOPERATING EXPENSES Net Non-Operating Income 1,553,675 619,684 1,444,303 671,872 1,324,556 1,792,051 NET SERVICE REVENUE Other Operating Revenue TOTAL OPERATING REVENUE EXPENSE OPERATING EXPENSES Patient Care Services Other Professional Services General Services Fiscal and Admin Services Interest Depreciation Community Education and Outreach TOTAL OPERATING EXPENSES PROFIT or (LOSS) 5,870,212 6,622,285 11,475,125 TABLE 5-5 REVISED 5/18/18 MIDDLEBORO COMMUNITY HOSPITAL BALANCE SHEET ($) AS OF DECEMBER 31, 2017 2016 2015 Cash Short Term Investments Accounts Receivables - Gross Allowances for Uncollectables Accounts Receivables - Net Due from Third Party Payers Inventories Prepaid Expenses TOTAL CURRENT ASSETS 16,008,364 6,546,791 72,564,867 28,453,998 44,110,869 378,559 2,663,265 89,020 69,796,868 16,343,949 3,283,445 71,540,304 29,474,665 42,065,639 349,228 2,995,394 72,343 65,109,998 10,438,282 3,029,393 70,283,443 29,117,273 41,166,170 103,450 2,235,119 69,372 57,041,786 NON-CURRENT ASSETS Property, Plant and Equipment - Gross Less Accumulated Depreciation Property, Plant and Equipment - Net Other Investments 354,783,292 176,453,887 178,329,405 39,997,354 354,282,404 171,133,779 183,148,625 39,105,569 360,283,443 165,242,577 195,040,866 34,674,187 TOTAL ASSETS 288,123,627 287,364,192 286,756,839 Accounts Payable Accrued Salaries and Wages Accrued Interest Other Accrued Expenses Due to Third Party Vendors Long Term Debt Due Within One Year TOTAL CURRENT LIABILITIES 16,342,575 10,453,274 134,569 1,393,253 1,205,494 5,142,939 34,672,104 15,369,594 8,259,669 156,304 1,657,330 1,723,657 4,920,338 32,086,892 16,002,347 7,345,002 700,585 1,435,020 582,491 4,823,293 30,888,738 Long Term Debt 67,540,223 75,330,404 82,374,337 TOTAL LIABILITIES 102,212,327 107,417,296 113,263,075 Restricted Unrestricted TOTAL NET ASSETS 6,128,484 179,782,816 185,911,300 6,034,292 174,006,796 180,041,088 6,203,445 167,215,358 173,418,803 288,123,627 287,458,384 286,681,878 CURRENT ASSETS CURRENT LIABILITIES NET ASSETS NET ASSETS +LIABILITIES Table 6.1 Physicians Affiliated with Medical Associates as of December 31, 2017 Name Specialty Age Office Active Consulting Autumn Gastroenterology 44 Middleboro MCH CCG Barton Internal medicine 45 Middleboro MCH CCG Coolidge ENT 44 Jasper CGS OMC, WH Douglas Internal medicine 41 Middleboro MCH CCG Dustin OB/GYN 33 Middleboro MCH CCG Eason Urology 56 Middleboro MCH CCG Finn Surgery 47 Jasper CCG MCH Fixer Urology 43 Middleboro MCH CCG Frost Internal medicine 41 Jasper MCH CGS Goldwater Orthopedic surgery 44 Jasper CGS WH, OMC Gost OB/GYN 45 Middleboro MCH CCG Hersh General surgery 40 Middleboro MCH CCG Jackson General surgery 39 Middleboro MCH CCG Kessler Internal medicine 34 Middleboro MCH CCG Kipstein Cardiology 50 Jasper CGS MCH Klock OB/GYN 49 Jasper CGS MCH Lee Orthopedic surgery 40 Jasper CGS MCH Lesko Internal medicine 38 Middleboro MCH CCG Maeer Cardiology 42 Jasper CGS MGH Master Internal medicine 40 Middleboro MCH CCG Chan Pediatrics 37 Jasper CGS MCH Mustard OB/GYN 39 Jasper CGS MCH Never General surgery 45 Middleboro MCH CCG O'Connell General surgery 49 Middleboro MCH CCG Otter Pediatrics 37 Jasper CGS MCH Picture Orthopedic surgery 47 Jasper CGS MCH Polk OB/GYN 40 Jasper OMC WH Putter General surgery 62 Middleboro MCH CCG Qestrom Orthopedic surgery 39 Middleboro MCH CCG Quester Pediatrics 40 Jasper MCH CGS Reeper Pediatrics 59 Middleboro MCH CCG Samuels Pediatrics 47 Middleboro MCH CCG St. James Pediatrics 40 Middleboro MCH CCG Stanley Orthopedic surgery 49 Middleboro MCH CCG Steve Orthopedic surgery 47 Jasper CGS MCH Underwood Cardiology 46 Middleboro MCH CCG Unvey 56 Jasper MCH CGS Washington Internal medicine 43 Jasper CCG WH Weckensen ENT 44 Middleboro MCH CCG Xerox 42 Middleboro MCH CCG Pediatrics ENT NOTES: Active = Active medical staff privileges by hospital Consulting = Consulting medical staff privileges by hospital MCH = Middleboro Community Hospital WH = Webster Hospital CCG = Capital City General OMC= Osteopathic Medical Center, Capital City Table 6.2 Utilization StatisticsMiddleboro Office Name 2017 APPTS P-Days Specialty DIS 2016 APPTS P-Days DIS 2015 APPTS P-Days DIS Department of Primary Care S. St. James Pediatrics R. Samuels Pediatrics Q. Reeper Pediatrics G. Gost OB/GYN D. Dustin OB/GYN Z. Autumn Gastroenterology W. Xerox ENT V. Weckensen ENT T. Underwood Cardiology D. Fixer Urology C. Eason Urology M. Master Internal medicine L. Lesko Internal medicine K. Kessler* Internal medicine C. Douglas Internal medicine A. Barton Internal medicine Subtotals 5,521 5,167 5,234 4,319 4,625 2,789 2,845 2,945 4,456 2,403 1,645 3,623 4,034 4,256 4,340 4,206 62,408 120 45 114 29 99 25 720 177 650 193 755 156 504 131 483 104 677 133 578 143 457 101 492 102 560 102 712 161 820 210 850 177 8,591 1,989 5,432 5,234 5,134 4,138 4,456 2,705 2,840 2,834 4,178 2,202 1,470 4,263 4,083 2,033 4,256 4,256 59,514 135 123 102 734 645 745 512 477 606 598 459 501 525 204 834 654 7,854 40 30 24 164 187 144 134 99 105 142 101 102 98 45 187 152 1,754 5,234 5,005 4,687 4,023 4,044 2,656 3,405 2,341 4,277 2,005 1,034 2,330 4,405 0 4,456 4,124 54,026 178 126 98 793 696 801 529 490 545 612 499 535 555 0 902 756 8,115 59 32 32 170 190 131 143 105 109 157 101 135 99 0 167 165 1,795 Department of Surgery H. Never General J. Putter General L. O'Connell General D. Jackson General B. Hersh General M. Stanley Orthopedic K. Qestrom Orthopedic Subtotals 2,546 912 1,456 1,843 1,245 1,766 1,799 11,567 870 630 416 792 1,200 1,544 1,433 6,885 215 126 104 167 267 279 220 1,378 2,206 1,112 1,045 1,678 1,045 1,862 1,566 10,514 830 720 418 722 1,103 1,647 1,153 6,593 204 160 103 134 245 298 208 1,352 2,345 1,345 867 1,767 1,956 2,645 2,675 13,600 854 779 436 812 1,223 1,767 1,254 7,125 207 199 109 99 265 202 267 1,348 73,975 15,476 3,367 70,028 14,447 3,106 67,626 15,240 3,143 Total NOTES: APPTS = Appointments P-Days - Patient days (all hospitals) DIS = Discharges (all hospitals) * = Hired July 1, 2013 Table 6.3 Utilization StatisticsJasper Office 2017 2015 P-Days DIS APPTS P-Days DIS Department of Primary Care Pediatrics W. G. Chan 4,604 Pediatrics U. Unvey 4,767 Pediatrics N. Otter 4,523 Pediatrics P. Quester 4,033 OB/GYN M. Polk 3,651 OB/GYN J. Klock 3,749 OB/GYN L. Mustard 4,317 J. Washington Internal medicine 3,745 Internal medicine E. Frost* 4,980 L. Coolidge** ENT 3,369 Cardiology K. Kipstein 4,126 Cardiology O. Maeer 4,682 Subtotals 50,546 212 234 206 312 650 607 908 712 700 345 612 698 6,196 78 66 51 75 140 135 245 156 176 123 145 167 1,557 3,324 4,654 4,045 3,978 3,612 3,256 4,450 2,867 3,156 3,278 3,682 4,356 44,658 276 267 224 356 984 1,115 1,102 505 646 806 700 512 7,493 90 4,125 69 4,209 57 4,509 76 3,956 202 3,487 256 3,356 315 4,245 101 2,456 120 2,077 323 1,433 156 3,933 102 4,631 1,867 42,417 303 291 205 334 982 1,138 1,298 536 495 345 596 878 7,401 90 81 45 79 215 267 335 146 103 143 133 175 1,812 Department of Surgery General C. Finn Orthpedic A. Steve Orthpedic S. Lee Orthpedic L. Picture L. Goldwater Orthpedic Subtotals 1,587 1,266 2,156 1,920 2,877 9,806 806 612 885 957 1,134 4,394 165 134 231 245 278 1,053 1,601 1,534 1,935 1,756 2,645 9,471 1,206 733 893 1,234 1,376 5,442 245 167 287 298 325 1,322 830 723 1,104 1,556 1,589 5,802 203 154 303 366 387 1,413 Total 60,352 10,590 2,610 54,129 12,935 3,189 49,789 13,203 3,225 Name APPTS 2016 Specialty NOTES: APPTS = Appointments P-Days = Patient days (all hospitals) DIS = Discharges (all hospitals) * = Hired March 1, 2012 ** = Hired, July 1, 2012 APPTS P-Days 700 793 1,689 2,156 2,034 7,372 DIS Table 6.7 Statement of Revenue and Expense for Calendar Years Ending December 31 2017 2016 2015 Patient services revenue 46,732,370 Allowances 8,206,111 Bad debt 760,040 41,961,328 7,658,241 519,476 39,295,973 5,720,365 498,207 Net patient services revenue 37,766,219 33,783,611 33,077,401 8,070 3,026 7,456 Total operating revenue 37,774,289 33,786,637 33,084,857 14,552,361 15,681,186 3,548,975 1,739,871 185,523 1,841,231 14,088,994 13,425,397 2,243,109 1,610,224 179,058 1,997,170 13,455,329 13,327,203 2,125,242 1,428,305 174,894 2,361,678 Total operating expenses 37,549,147 33,543,952 32,872,651 225,142 242,685 212,206 85,554 92,220 80,638 139,588 150,465 131,568 Revenue Other operating revenue Expenses Physician compensation Other professional services General services Fiscal services Interest Depreciation Pretax income (loss) Taxes Profit (loss) Table 6.8 Balance Sheet as of December 31 2017 2016 2015 Cash and marketable securities 3,563,292 2,867,340 3,763,193 Accounts receivablegross Allowances for uncollectables Accounts receivablenet 8,929,737 -927,353 8,002,384 7,423,188 -689,303 6,733,885 7,334,868 -612,039 6,722,829 556,247 739,864 254,352 13,116,139 634,929 443,988 797,665 11,477,807 1,012,745 515,200 342,389 12,356,356 47,159,223 -19,084,473 28,074,750 47,112,343 -17,243,242 29,869,101 45,182,334 -15,246,072 29,936,262 1,917,234 2,120,940 2,087,230 Total assets 43,108,123 43,467,848 44,379,848 Accounts payable Accrued salaries and wages Accrued interest Other accrued expenses Accrued vacation days Due to third-party vendors Long-term debt due within one year Total current liabilities 2,143,485 837,240 180,238 137,450 92,867 198,335 952,189 4,541,804 1,882,494 801,282 200,345 154,203 90,124 100,000 874,230 4,102,678 1,701,905 735,240 210,876 150,239 84,236 81,564 912,572 3,876,632 Long-term debt 5,229,449 6,167,888 7,456,399 Total liabilities 9,771,253 10,270,566 11,333,031 Net assets 33,336,870 33,197,282 33,046,817 Total liabilities and net assets 43,108,123 43,467,848 44,379,848 Assets Current assets Due from third-party payers Inventory Prepaid expenses Total current assets Noncurrent assets Property, plant, and equipmentgross Less accumulated depreciation Property, plant, and equipmentnet Other investments Liabilities Current liabilities Table 7.6 Balance Sheet as of December 31 2017 2016 2015 2014 Assets Current Cash, operating 3,989,694 3,623,583 3,056,894 2,745,020 Cash, restricted 396,844 382,374 295,750 340,163 Patient trust cash 22,919 24,900 23,491 21,403 Total cash 4,409,457 4,030,857 3,376,135 3,106,586 Accounts receivable-net 2,083,242 2,156,393 2,134,265 1,990,237 Inventory 36,404 30,340 22,360 19,372 Prepaid expenses 50,494 45,202 37,345 39,202 Total current assets 6,579,597 6,262,792 5,570,105 5,155,397 Plant, property, and equipment (PPE) Building, land, and improvements 814,300 795,756 690,202 680,272 Fixed and leasehold fixed equipment 156,303 155,302 155,506 180,383 Furniture and other equipment 1,082,011 995,292 990,385 994,283 Automobile 7,227 14,454 21,681 28,908 Total 2,059,841 1,960,804 1,857,774 1,883,846 Less accumulated depreciation 1,246,294 1,041,511 836,217 625,723 Net PPE 813,547 919,293 1,021,557 1,258,123 Security deposits 11,565 9,450 10,474 12,570 7,404,709 7,191,535 6,602,136 6,426,090 Accounts payable 1,847,294 1,945,292 1,638,294 1,400,230 Accrued expenses 635,640 685,205 690,283 695,304 Patient trust liability 22,919 24,900 23,491 21,403 Accrued interest 9,371 9,145 8,628 8,120 Total current liabilities 2,515,224 2,664,542 2,360,696 2,125,057 Deferred lease obligations 2,541,464 2,734,820 3,028,349 3,450,203 Due to (from) Medicaid (198,872) (106,392) (154,292) (254,981) Notes payable 874,260 550,393 525,404 503,282 Line of credit 651,026 655,230 230,450 201,494 Total long-term liabilities 3,867,878 3,834,051 3,629,911 3,899,998 6,383,102 6,498,593 5,990,607 6,025,055 897,725 692,942 611,529 401,035 7,280,827 7,191,535 6,602,136 6,426,090 Other assets Total assets Liabilities and net assets Current liabilities Long-term liabilities Total liabilities Net assets-owners equity Liabilities + net assets Table 8.4 Statement of Revenue and Expenses as of December 31 2017 2016 2015 2,421,165 2,553,000 2,870,525 8,450 37,566 21,705 194,204 103,440 8,450 35,688 24,340 212,440 90,450 8,200 33,903 27,393 215,383 85,303 215,400 121,000 45,000 55,000 68,445 15,787 118,407 234,040 83,817 56,818 85,000 357,202 200,000 110,000 45,000 55,000 50,000 15,000 94,818 212,494 85,000 72,404 85,000 325,493 200,000 110,000 45,000 55,000 50,000 12,450 56,282 0 85,000 86,249 85,000 365,292 40,000 2,175 1,863,456 30,000 0 1,751,577 0 0 1,520,455 Food services Campgrounds Tanning facilities 6,219 1,250 450 2,430 5,740 1,433 560 3,145 5,952 1,340 0 3,767 Overhead recovery1 Othermisc. Subtotal noncounty tax revenue Total revenue 100,113 204 1,974,122 4,395,287 125,000 612 1,888,067 4,441,067 150,300 120 1,681,934 4,552,459 262,969 73,631 18,540 24,660 260,314 77,286 21,500 24,302 256,408 71,063 20,340 12,560 Revenue County appropriation/tax levy Federal grants CDC environmental health tracking EPAasthma Oral health Rural healthcare development Rural poverty and homelessness State grants County health department development EMS assistance EMS preparedness HIV control and prevention Immunization Lead control program Medicaid oral health Primary healthcaredemo STD control and prevention Tobacco use WIC administration WIC services Private foundations Breast cancer awareness Obesity control and prevention Subtotal external grants and contracts Licenses and permits Special fees and fines Expenses Office of the director Salaries and wages Benefits Supplies Equipment Utilities2 Marketing and promotion Staff development Misc. Grants to local agencies Subtotal Administrative services division Salaries and wages Benefits Supplies Equipment 2,422 4,000 500 2,366 4,800 393,888 2,200 4,000 4,000 596 6,800 400,998 2,030 5,000 4,000 856 6,800 379,057 523,420 157,026 84,284 4,803 500,200 155,062 94,563 5,234 553,487 171,580 99,363 4,109 Utilities2 Marketing and promotion Staff development Misc. Grants to local agencies Subtotal Environmental health division Salaries and wages Benefits Supplies Equipment 28,383 450 1,000 200 0 799,566 26,440 500 1,500 140 0 783,639 28,304 500 2,000 167 0 859,510 452,320 135,696 6,579 1,039 456,675 141,569 6,500 2,546 446,905 138,541 5,356 2,946 Utilities2 Marketing and promotion Staff development Misc.lab contracts Misc. Grants to local agencies Subtotal Community health and health promotion Salaries and wages Benefits Supplies Equipment 37,669 3,825 500 4,375 243 0 642,246 36,122 4,024 4,000 3,760 201 0 655,397 35,476 6,034 4,000 3,700 103 0 643,061 765,744 222,066 98,161 39,445 762,971 236,521 103,453 23,450 735,923 228,136 117,506 12,404 Utilities2 Marketing and promotion Staff development Misc. Grants to local agencies Subtotal Personal health and health protection Salaries and wages Benefits Supplies Equipment 22,341 4,512 355 456 124,565 1,277,645 23,460 5,500 5,000 402 135,400 1,296,157 24,354 5,500 5,000 450 150,220 1,279,493 765,957 237,447 103,288 23,693 780,156 241,848 110,393 12,000 847,233 262,642 114,506 4,500 Utilities2 Marketing and promotion 34,552 2,300 34,595 2,500 30,282 2,500 Excess revenue3 Staff development Misc. Grants to local agencies Subtotal 1,800 356 112,445 1,281,838 4,800 221 118,340 1,304,853 4,800 498 124,303 1,391,264