Riverside Memorial Hospital Balance Sheets (December 31, 2010 and 2011) in thousands 2010 2011 Cash and equivalents $ 3,095 2,263 Short-term investments 2,000 4,000 Accrued expenses 5,421 5,650 Notes payable 6,237 2,975 Total current liabilities 16,803 13,332 Long-term debt 33,055 30,582 Net assets (equity) 98,792 107,364 Total liabilities and net assets 148,650 151,278 Riverside Memorial Hospital Statements of Operations (Years Ended December 31, 2010 and 2011) in thousands 2010 2011 Net patient service revenue $ 95,398 106,495 Premium revenue 4,622 5,232 Other revenue 6,014 3,644 Total revenues 106,034 115,371 Expenses: Nursing services 56,752 58,285 Dietary services 4,718 5,424 General services 11,655 13,198 Administrative services 11,585 11,427 Employee health and welfare 10,705 10,250 Provision for bad debts 3,469 3,328 Insurance expense 1,204 1,320 Depreciation 4,025 4,130 Interest expense 1,521 1,542 Total expenses 105,634 108,904 Operating income 400 6,467 Nonoperating income 1,995 2,105 Net income 2,395 8,572 Additional case details: Riverside Memorial Hospital has experienced the following cash flows for the 2011 financial period (in thousands): o Cash flows from operating activities: $11,196 o Cash flows from investing activities: ($6,293) o Cash flows from financing activities: ($5,735) The nursing department is requesting additional funding (estimated $10,000) for additional, hospital-based continuing education programs. The Womens Center expansion project is estimated to cost roughly $1,000,000, and will require 4 years for build-out. Due to the Patient Protection and Affordable Care Act (PPACA) of 2010, Medicare recoupments due to HCAHPS survey responses have consistently resulted in a reduction of patient service revenue and are estimated to increase by 1.5% annually for the next 3 years. As a new, up-and-coming healthcare administrator, excited about graduating and landing a position of such great responsibility right out of college, you are eager to create and discuss an analysis of Riversides financial position and the proposed states of each requested/required service expansion request. Case Analysis your job as the administrator is to provide a financial condition analysis of Riverside Memorial, given the information above. Specifically, please be sure to address the following questions in your response: 1. What is the overall financial position of Riverside Memorial Hospital, to-date? Are there any key-indicator benchmarks that can be used to support your claim? If so, what are they and where did they come from? 2. In addition to the information provided in the case, what other types of information would you request in order to thoroughly analyze the hospitals financial position to-date? 3. Do you recommend the funding of the nursing continuing education request? If so, how should the request be funded/financed? If no, then what financial information will you use to explain to the Director of Nursing for the hospital? 4. Do you recommend the funding of the Womens Center expansion project? How should this large project be financed? 5. For each of the above items, what additional information would you specifically request knowledge of, prior to a solid decision on each objective? Explain why this information is needed thoroughly.