Major Medical Center Statements of Operations

Year ended December $3120212020$

$($In Thousands$)$

Operating Revenue

Net patient service revenue

Other revenue

Net assets released from restrictions

Total Operating Revenue

Operating Expenses

Salaries and wages

Employee benefits

Supplies and expenses

Depreciation and amortization

Research $2,457$ Interest $4,456$

Total Operating Expenses

Operating Income

Net assets released from restrictions used for capital acquisitions Increase in net assets without donor restrictions

$$418,556$ $ $2,429139$ $ $2,568$

$$402,92113,3564,708$ $$420,985$

$$369,51213,8502,863$ $$386,225$

$$196,45344,860117,83818,8562,2145,253$ $$385,474$ $ $751146$ $ $897$

Net Assets

$$207,14144,456137,50522,541$

See accompanying notes.

Major Medical Center Statements of Changes in Net Assets

Without Donor Restrictions

$$37,117$

$ $897$

$$

$$

$$ $ $897$ $$38,014$

$ $2,568$

With Donor Restrictions

$$4,155$

$$7,253$

$252$

$(2,863)$

$(146)$ $$4,496$ $$8,651$

$$5,421$

Net Assets at December $31,2019$

Increase in net assets without donor restrictions Restricted contributions, grants, and other

receipts

Investment income restricted for specific purposes

Net assets released from restrictions for: Operating expenses

Capital asset acquisitions

Change in net assets

Net Assets at December $31,2020$

Increase in net assets without donor restrictions Restricted contributions, grants, and other receipts

$4$

Investment income restricted for specific purposes

$$

$169$

Net assets released from restrictions for: Operating expenses

Capital asset acquisitions

$$

$ $2,568$ $$40,582$

$(4,708)(139)$

$ $743$ $$8,262$

Change in net assets

Net Assets on December $31,2021$

See accompanying notes.

Operating Activities

Major Medical Center Statements of Cash Flows

Year Ended December $31$

$2021$

$($In Thousands$)$

Operating income

Change in net assets restricted to purpose or time

Adjustments to reconcile change in net assets to cash provided by operations:

Depreciation and amortization

Investment income earned on assets limited as to use Changes in operating assets and liabilities:

$($Increase$)$ decrease in receivables for patient care

$($Increase$)$ decrease in due from third$-$party reimbursement programs Increase in accounts payable and accrued expenses and accrued salaries and related liabilities

Net effect of increases and decreases in other assets and liabilities Cash provided by operations

Investing Activities

Acquisitions of property, plant, and equipment, net

Less amounts provided by restricted funds Increase in investments

Cash used in investing activities

Financing Activities

Net payment from $($to$)$ affiliates Increase in deferred financing costs

Repayments of long$-$term debt

Deposits into sinking fund, as required by mortgage loan agreement Increase in compensating balances for standby letters of credit $($Increase$)$ decrease in pledges receivable

Cash used in financing activities

Net $($decrease$)$ increase in cash and cash equivalents

$ $2,429743$

$ $3,172$

$22,541(774)$

$(2,105)(8,413)$

$9,6542,286$

$ $26,361$

$$(10,043)$

$139(618)$ $$(10,522)$

$ $126(1,323)$

$(13,326)(303)(1,923)(30)$ $$(16,779)$

$ $(940)$

$2020$

$ $7514,496$

$ $5,247$

$18,856(698)$

$7,5894,500$

$1,412(8,707)$

$ $28,199$

$$(12,998)$

$146(70)$ $$(12,922)$

$ $(1,773)(9,510)$

$(3,190)$ $$(14,473)$

$ $8045$

Cash and cash equivalents at be$1.(5$ point

ginning of year Cash and cash equivalents at end of year

See accompanying notes.

Notes to Financial Statements

$1.$ Organization and Summary of Significant Accounting Policies

Organization

$9,005$ $ $8,065$

$8,201$ $ $9,005$

Major Medical Center $($the $$Medical Center$)$ is a not$-$for$-$profit corporation. The Medical Center provides health care and related services. The accompanying financial statements do not include the accounts of the Research Foundation, a not$-$for$-$profit corporation that solicits funds and awards grants to the Medical Center for research purposes, nor for Hospital Support, Inc., which provides certain support services.

Net Assets Restricted by Donors

Net assets restricted by donors are those whose use by the Medical Center has been limited by donors to a specific time period$--$either temporarily or in perpetuity$--$or purpose. When a donor restriction expires $($i$.$e$.,$ when a stipulated time restriction ends or purpose restriction is accomplished$),$ net assets with donor restrictions are reclassified as net assets without donor restrictions and reported in the statements of operations as net assets released from restrictions. Donor$-$restricted contributions whose restrictions are met within the same year as received are reflected as contributions with donor restrictions and net assets released from restrictions in the accompanying financial statements.

Receivables for Patient Care

Patient accounts receivable from third$-$party programs for which the Medical Center receives payment under reimbursement formulas or negotiated rates are stated at the estimated net amounts receivable from such payers, which are generally less than the established charges of the Medical Center.