You have been given the Statement of Revenues, Expenses, and Changes in Net Position from Sarasota County Public Hospital for years 2016 and 2015 (Refer to table below). Review the statement and answer the following questions.

SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT

Statements of Revenues, Expenses and Changes in Net Position

Years ended September 30, 2016 and 2015

	2016	2015
operating revenues:
Net patient service revenue, net of provision for bad debtsof $125,863,304 in 2016 and $114,022,502 in 2015 Other revenue	$702,550,286	644,374,041
other revenue	16,881,490	17,431,883
Total operating revenues	719,431,776	661,805,924
operating expenses
salaries, wages and fringe benefits	362,154,492	306,793,080
supplies	148,223,399	132,452,568
purchased services	96,310,316	87,046,147
professional fees	22,366,225	19,435,537
state of florida medical assistance assessment	8,643,786	7,619,198
depreciation and amortization	39,320,638	37,858,112
total operating expenses	677,018,856	591,204,642
operating income	42,412,920	70,601,282
net operating items
Ad valorem tax	46,845,113	44,983,493
interest expense	(14,020,033)	(13,759,733)
INTEREST rate swap receipts, net	733,945	762,916
investment income	19,195,462	11,608,350
unrealized gains and losses on investment net	6,684,182	2,499,399
change in fair value of ineffective interest rate swaps	299,454	4,098,751
other nonoperating income	4,798,957	2,010,096
total nonoperating items	64,537,100	52,203,272
excess of revenues over expenses	106,950,020	122,804,554
other changes in net position:
contributions restricted for capital purposes	1,064,118	3,612,013
increase in net position	108,014,138	126,416,567
net position begining of year	825,899,824	699,483,257
Net position end of year	933,913,962	825,899,824

1. What is the gross patient service revenue for both years? (4)

2. What percentage does the provision for bad debts account for based on the gross patient service revenue? (2) net of prov debts/gross pat rev x100%

3. Compare Sarasota County Hospital Districts bad debt percentage to the AHD national average Make sure to select the correct hospital type for comparison. You may have to go to Saratotas site to determine if it is for profit, not-for profit, multi-hospital, or non-multi hospital.

The AHD data is provided below

HOSPITAL BAD DEBT EXPENSE TRENDS BASED ON OPERATING CRITERIA

For Profit/ Not for Profit	Member of aMultihospitalSystem	Number of Hospitals	Percentage Bad Debt Expense to Net Patient Revenue
For Profit .	NO	181	9.60%
For Profit	Yes	593	13.23%
Not for Profit	NO	862	10.39%

HOSPITAL BAD DEBT EXPENSE TRENDS BASED ON MEDICARE

DISPROPORTIONATE SHARE HOSPITAL (DSH) PARTICIPATION

Hospital Receives Medicare DSH Payment	Number of Hospitals	Percentage Bad Debt Expense to Net Patient Revenue
Yes	2,615	8.90%
No	568	5.36%

HOSPITAL BAD DEBT EXPENSE TRENDS BASED ON PERFORMANCE IN VALUE-BASED PURCHASING

Medicare Value-Based Purchasing Payment Change	Number of Hospitals	Percentage Bad Debt Expense to Net Patient . Revenue
Bonus	1,298	7.92%
No Change	575	7.44%

Penalty

1,310

9.43%

4. How does Sarasota compare to the rest of the country? (5)

5. What could be some reasons for the difference? (5)

6. What percentage of total operating expenses do salaries, wages and fringe benefits account for for each year? (4)

7. Find four areas that represent the biggest differences in line items between the two years under non operating items? What could account for the differences? (10)

8. Sarasotas excess of revenues over expenses was almost 16 million dollars less in 2016 over 2015. Provide two viable, well developed recommendations for Sarasotas administration for ways to reverse this trend. Discuss each recommendation separately. For example: First recommendation is ., Second recommendation is .. Do not co-mingle the recommendations.