Brooks Health System, FL (FL)

Transcription

1 Brooks Health System, FL (FL) 1City of Jacksonville, Florida, Health Care Facilities Revenue Bonds (Brooks Rehabilitation), Series, $55,095,000, Dated: September 1, 2 Jacksonville Health Facilities Authority Health Care Facilities Revenue Bonds (Brooks Health System), Series 2007, $95,000,000, Dated: December 7, 2007 Historical Utilization Brooks Rehabilitation Hospital Patient Days 47,655 Discharges 3,091 Average Length of Stay 15.5 Average Daily Census Percentage of Occupancy 83.2% Outpatient Units of Service 941,957 Patient Visits 279,472 Units of Service per Visit 3.37 Brooks Skilled Nursing Facility (Facility opened in July 2013) Patient Days 33,069 Discharges 1,220 Average Length of Stay Average Daily Census Percentage of Occupancy 91% Brooks Home Care Admissions 4,661 Medicare Episodes 6,337 Final Case Mix Weight 1.10 Selected Financial Information Consolidated Statement of Operations of Brooks Health System (000's) Unrestricted revenues, gains and other support: Net patient service revenue $141,892 Contract service revenue $14,457 Investment Income, net $17,277 Other $5,980 Total unrestricted revenues, gains and other support $179,606 Expenses: Salaries, wages and benefits $110,875 Supplies $4,087 Depreciation and amortization $7,814 Leases and rentals $3,650 Interest $7,616 Professional fees $2,433 Insurance $920 Purchased services $7,449 Provision for bad debts $1,196 Impairment charge assets & goodwill $0 Other $23,370 Total Expenses $169,410 Operating Income $10,196 Other gains (losses) ($18,369) Excess of revenues over expenses ($8,173)

2 Consolidated Balance Sheet of Brooks Health System (000's) Assets Current Assets: Cash and cash equivalents $5,222 Patient receivables, net of allowance for doubtful accounts $18,994 Other current assets $5,831 Total current assets $30,047 Investments $273,397 Assets limited as to use: $56,082 Property and equipment, net $121,066 Land held for development $22,042 Other investments $5,604 Other assets, net $2,197 Goodwill $25,515 Intangible assets, net $11,370 Total Assets $547,320 Liabilities and Net Assets Current liabilities: Line of credit $42,205 Current portion of long term debt $4,742 Accounts payable and accrued expenses $25,925 Third party Payor settlements $1,133 Other current liabilities $1,312 Total current liabilities $75,317 Long term debt, net of current portion $226,116 Other Liabilities $13,359 Total Liabilities $314,792 Net assets: Unrestricted $230,968 Temporarily restricted $1,560 Total Net Assets $232,528 Total Liabilities and Net Assets $547,320 Key Financial Ratios Debt Service Coverage Ratio Excess of revenues over expenses ($8,173,231) Depreciation and amortization $7,813,629 Interest $7,616,297 Net unrealized (gains) losses on investments $18,432,366 Ineffective change in interest rate swap ($1,114,138) Income available for debt service $24,574,923 Historical and actual annual debt service $11,884,074 Historical and actual annual debt service coverage 2.07x Maximum annual debt service $16,509,527 Maximum annual debt service coverage 1.49x Liquidity Unrestricted Cash, Cash Equivalents and Investments $280,571,239 Operating Expense Per Day (excluding depreciation and amortization) $442,731 Days Cash on Hand x

3 Capitalization Total debt $230,858,386 Unrestricted net assets 230,967,399 Total capitalization 461,827,800 Debt (net of current maturities) 48.96% to total capitalization Management's Discussion and Analysis See attached

4 MANAGEMENT DISCUSSION AND ANALYSIS ANNUAL REPORT The following discussion and analysis should be read in conjunction with the Financial Statements and related Notes, and the disclosure of Selected Financial Information. Results of Operations Fiscal year versus fiscal year Net patient service revenue increased 16% due to the acquisition of AmeriCare Home Therapy, Inc. (AmeriCare), a home health agency, on August 1, along with the continued ramp up of new facilities. Hospital patient days increased from 2014 to by 1% with the average daily census increasing from to and the percentage of occupancy increasing from 82.5% to 83.2%. Outpatient visits increased 6% from 264,000 in 2014 to 279,000 in. Total new admissions in Home Health increased by 39% from 2014 to. Medicare episodes increased by 80% from The significant increase in Home Health statistics is attributed to the acquisition of AmeriCare. The Skilled Nursing Facility patient days increased 16% to 33,069 in. The average daily census increased 16% from 74.9 in 2014 to 91 in. The Assisted Living and Greenhouse resident days increased 63% from 16,210 in 2014 to 26,426 in. Brooks Halifax Rehab Management patient days increased to 9,749 in from 8,175 in Total expenses increased 15% in as compared to Salaries and benefits increased 17% due to increased wage and benefit costs and additional full time equivalent employees as a result of continuing ramp up in the new facilities and the acquisition of AmeriCare. Interest costs were up 6% primarily due to the issuance of new long term debt issued midway through. Brooks Management and Board of Directors, measures operating income excluding elective community program expenses, interest expense, and investment portfolio results. Operating income on this basis increased by approximately $1.5 million to approximately $10.2 million in from $8.7 million in 2014, (see attached modified income statement) Non operating Revenue/(expenses), net of community benefit, decreased by 13.4 million primarily as a result of investment activity. During, net community benefit expenses increased by approximately $3.4 million. Balance Sheets Fiscal year versus fiscal year Total assets increased approximately $61 million from 2014 to. The increase reflects the acquisition of AmeriCare, increase in funds held by trustee related to the bond issues, and new construction projects. Current assets increased 1.9 million primarily as a result of increased patient receivables in the Home Health Division. Increase in non current assets of $38 million, is primarily a result of an increase of funds held by trustees, related to the bond issue and intangible assets related to the acquisition of AmeriCare. Total liabilities increased by $69 million primarily as a result of the issuance of the bonds and recording deferred payments related to the AmeriCare acquisition. Net assets decreased $7.8 million primarily as a result of the impact of unrealized losses offsetting operating gains.

5 Selected Financial Information Combined Statement of Operations of Brooks Health System (000's) 2014 Net patient service revenue $ 141,892 $ 121,998 Contract Service Revenue 14,457 13,238 Investment Income 17,277 14,640 Other 5,980 6,163 Total Operating Revenue 179, ,039 Salaries, wages, and benefits 110,875 94,669 Supplies 4,087 3,484 Depreciation and amortization 7,814 7,780 Leases and rentals 3,650 3,250 Interest 7,616 7,191 Professional Fees 2,433 1,503 Bad Debt 1, Insurance Purchased Services 7,449 7,393 Other 23,370 20,389 Total Operating Expenses 169, ,325 Operating Income 10,196 8,714 Community programs (6,769) (3,324) Unrealized loss on investments (17,318) (10,808) Other income 5,718 15,638 Revenue in excess of expenses $ (8,173) $ 10,220

6 Combined Balance Sheet of Brooks Health System (000's) 2014 Assets Cash and cash equivalents $ 5,222 $ 6,237 Patient Receivables 20,489 14,471 Less allowance for doubtful accounts (1,495) (792) Net Patient Receivables 18,994 13,679 Other current assets 5,831 8,208 Total Current Assets 30,047 28,124 Investments 273, ,469 Assets limited as to use: Funds held by trustee 54,130 31,107 Board designated funds 1,952 1,943 Total assets limited as to use 56,082 33,050 Property and equipment, net 121, ,870 Land held for development 22,042 16,817 Other investments 5,604 5,219 Other asets, net 2,197 1,331 Goodwill 25,515 10,417 Other intangibles, net 11,370 6,686 Liabilities and Net Assets Total Assets $ 547,320 $ 485,983 Lines of credit $ 42,205 $ 33,725 Current portion long term debt 4,742 4,120 Accounts payable & accrued expenses 25,925 20,817 Third party settlements 1,133 1,054 Other current liabilities 1, Total current liabilities 75,317 60,413 Long-term debt, excluding current maturities 226, ,951 Other liabilities 13,359 8,329 Total Liabilities 314, ,693 Net assets: Unrestricted 230, ,017 Temporarily restricted 1,561 1,273 Net Assets 232, ,290 Total Liabilities and Net Assets $ 547,320 $ 485,983

7 HISTORICAL UTILIZATION The table below sets forth certain inpatient (Hospital) and outpatient utilization statistics for the twelve months ended December 31, and Inpatient Patient Days 47,655 47,297 Admissions 3,091 3,161 Percentage of Occupancy 83.2% 82.5% Average Length of Stay Average Daily Census Outpatient Units of Service 941, ,733 Patient Visits 279, ,404 Units of Service Per Visit Home Health (c.) New Admissions 4,661 3,360 Medicare Episodes 6,337 3,515 Final Case Mix Weight Skilled Nursing Patient Days 33,069 28,507 Average Daily Census Percentage of Occupancy (b) 91% 78%

8 KEY FINANCIAL RATIOS DEBT SERVICE COVERAGE 2014 Revenue in excess of expenses $ (8,173,231) $ 10,220,334 Depreciation and amortization 7,813,629 7,779,998 Interest 7,616,297 7,191,218 Net Unrealized gain/loss on Investments 18,432,366 14,035,730 Bond Swap Valuation gain/loss (1,114,138) (3,227,924) Income available for debt service $ 24,574,923 $ 35,999,356 Historical Actual annual debt service* $ 11,884,074 $ 11,500,430 Historical Actual annual debt service coverage Maximum annual debt service** $ 16,509,527 $ 14,602,927 Maximum annual debt service coverage *includes interest and principal on long-term debt and notes payable. **Maximum annual debt service of long term debt. LIQUIDITY 2014 Unrestricted Cash, Cash equivalents, and Investments $ 280,571,239 $ 286,649,893 Operating expense Per Day (excluding depreciation and amortization) $ 442,731 $ 382,316 Days Cash on Hand CAPITALIZATION 2014 Total Debt* $ 226,116,433 $ 176,950,923 Unrestricted Net Assets 230,967, ,017,446 Total Capitalization 457,083, ,968,369 Debt (net of current maturities) to total capitalization 49.5% 42.5% *Total debt for purposes of this table includes long-term debt, excluding notes payables. Total long-term debt excludes other longterm liabilities Source: Brooks Management

9 BRO KS"' Rehabilitation April 29, 2016 RE: Officers Certificate for Genesis Health, Inc. d!b/a Brooks Rehabilitation Relating to the Annual Fi11ancial Filing Infonnation I hereby certify that the Historical Utilization, Selected Financial Information, Key Financial Ratios and Management Discussion and Analysis filed.on April 29, 2016 constitute the mm1ial financial infotmation reqnired by the Continuing Disclosure Agteement. I futther certify thatthe information corhplies with the Continuing Dis'closure Agreement and the Rule as required. DAC shall be. e11titled to l'ely on this cel'lificate. If you 11ave fl!rther questions about this matter please do not hesitate to call. Sincerely, tltf ~ Chief Executive Officer Univ.ersity Blvd, South Jacksonville, Florida 322! 6 (904) !.~tooksHehab.org