You are the administrator of Riverside Memorial Hospital, a 100-bed not-for-profit facility in the southwest United States. It is January of 2021 and your hospital board members are expecting a report regarding the next 3-5 years of the facility (short-term strategic plan), which hopefully includes a large facility expansion project of the Womens Center wing of the hospital, among other growth initiatives. Below are the hospitals financial statements from the past two years: Riverside Memorial Hospital Balance Sheets (December 31, 2019 and 2020) in thousands 2019 2020 Cash and equivalents $ 3,095 2,263 Short-term investments 2,000 4,000 A/R 20,738 21,840 Inventories 2,982 3,177 Total current assets 28,982 31,280 Gross property and equipment 140,865 145,158 Less accumulated depreciation 21,030 25,160 Net property and equipment 119,835 119,998 Total assets 148,650 151,278 A/P 5,145 4,707 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 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 2019 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.

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.