Final Budget. Teton County Hospital District

Transcription

1 FY 7/1/17-6/30/18 Teton County Hospital District 625 E. Broadway, PO Box 428 Jackson, WY Teton County Budget Hearing Information Location: St. John's Medical Center Board Room Date: 7/20/2017 Time: 4:00 p.m. Budget Prepared by: Alisa Lane S-A BUDGET MESSAGE W.S (d) Teton County Hospital District does business as St. John s Medical Center (the Medical Center). The Final budget for the fiscal year (FY) ending June 30, 2018 was developed with critical input from Department Managers, the Finance Team, the Finance Committee, and The Board of Trustees. Several key assumptions were made to arrive at the basis for the budget. These assumptions include a 3.5% average price increase (historically, the Medical Center has aimed for a rate increase at or below the national hospital services Consumer Price Index which is 5.4% as of April 2017), a 1.5% inpatient volume decrease, a 2% outpatient volume increase, and a Living Center average daily census of 47 residents per day. S-B RESERVE DESCRIPTION Our Reserve Fund is a Rainy Day Fund that is defined as follows: The district may accumulate retained earnings in any enterprise or intergovernmental service fund or accumulate a fund surplus in any other fund. With respect to the general fund the accumulated fund balance may be used to meet any legal obligation of the district or to: Provide cash to finance expenditures from the beginning of the budget year until general property taxes and other revenues are collected or Provide a reserve to meet emergency expenditures. S-C The largest increase in the upcoming budgets is salaries. As the healthcare environment has become more complex, additional resources have become necessary to successfully navigate the arena. In addition, Jackson has a high cost of living which includes expensive housing. Most of the increase in this line item is due to annualizing the FY 2017 market adjustment raises. These raises were done with input from an outside consulting firm in order to make unbiased adjustments. Another part of the increase is due to annualizing new patient centered positions (such as the clinical care coordinator, patient safety officer, and patient access manager), and improving access to care (by hiring a general surgeon and internal medicine physician to replace retiring physicians, and increasing outpatient hours in high volume departments). Unfortunately not all of the necessary resources are available in our location which has caused the need for travelers. Although the market adjustments and robust recruiting has reduced turnover, we included in the FY 2018 budget a premium for travelers. Consistent with an increase in employee compensation is an increase in employee benefits (FICA and pension as a percentage of salaries). The cost of employee health insurance is also projected to increase due to additional employees and the rise in the cost of healthcare. The proposed FY 2018 operating budget provides for an overall increase in net assets of $4.8 million, which will be applied to existing capital needs, including debt service and equipment expenditures. This figure reflects a projected operating gain of $23,000 which is netted with a projected non-operating revenue amount of $4.8 million. The non-operating revenue includes district tax revenue, interest, other income and contributions. Contributions are expected to be lower than last year because the St. John s Hospital Foundation underwrote most of our FY 2017 patient and family lobby remodel which should be complete by the end of FY Expenditures related to this project are included in the Capital Outlay section of the attached budget. It is important to realize that due to the relatively small size of the Medical Center and community population, this budget is highly sensitive to small changes in revenue, volume, payor mix, collections, and expenses. Thus the proposed budget, as presented today, is based on the current assumptions outlined in the first paragraph. Names of Board Members Michael Tennican, Chair Barbara Herz, Vice Chair C. Scott Gibson, Treasurer Elizabeth Masek, Secretary Joe Albright Bruce Hayse, MD Cynthia Hogan Date of End Does the district have regular office hours of Term exceeding 20 hours per week? yes 11/1/18 If Yes, enter 11/1/18 Address of office: PO Box /1/20 City, State, Zip: Jackson, WY /1/18 Phone Number: /1/18 Hours Open: Office Hours 8 a.m. - 5 p.m. Mon-Fri / Emergency 24 hr/day, 7 days/week 11/1/20 11/1/20 Where are the minutes of your board meeting available for public review? How and where are the notices of meeting posted for the public? Website and local newspaper. Where are the public meetings held? The Hospital Board Room

2 FINAL BUDGET SUMMARY OVERVIEW S-1 Total Budgeted Expenditures $105,610,991 $114,175,900 $129,137,870 $125,502,999 S-2 Total Principal to Pay on Debt $935,000 $910,000 $165,000 $165,000 S-3 Total Change to Restricted Funds -$1 $1,651 $3,633 $3,633 S-4 Total General Fund and Forecasted Revenues Available $166,843,030 $176,658,798 $187,778,136 $189,831,275 S-5 Amount requested from County Commissioners $4,159,240 $4,065,771 $4,297,577 $4,297,577 S-6 Additional Funding Needed : $0 $0 REVENUE SUMMARY S-7 Operating Revenues $103,398,186 $105,495,140 $111,660,658 $113,713,797 S-8 Tax levy (From the County Treasurer) $4,159,240 $4,065,771 $4,297,577 $4,297,577 S-9 Government Support $0 $0 $0 $0 S-10 Grants $1,229,946 $752,273 $708,193 $708,193 S-11 Other County Support (Not from Co. Treas.) $0 $0 $0 $0 S-12 Miscellaneous $721,873 $1,879,431 $947,257 $947,257 S-13 Other Forecasted Revenue $389,757 $0 $0 $0 S-14 Total Revenue $109,899,001 $112,192,615 $117,613,685 $119,666,824 FY 7/1/17-6/30/18 Teton County Hospital District EXPENDITURE SUMMARY S-15 Capital Outlay $5,856,096 $8,164,000 $14,711,529 $10,648,616 S-16 Interest and Fees On Debt $1,258,809 $1,236,637 $1,222,125 $1,301,935 S-17 Administration $22,704,375 $24,424,415 $27,099,818 $27,702,919 S-18 Operations $54,855,515 $57,794,070 $62,396,823 $61,712,131 S-19 Indirect Costs $20,936,196 $22,556,778 $23,707,576 $24,137,398 S-20 Total Expenditures $105,610,991 $114,175,900 $129,137,870 $125,502,999 DEBT SUMMARY S-21 Principal Paid on Debt $935,000 $910,000 $165,000 $165,000 CASH AND INVESTMENTS S-22 TOTAL GENERAL FUNDS $56,944,029 $64,466,183 $70,164,451 $70,164,451 Summary of Reserve Funds S-23 Beginning Balance in Reserve Accounts S-24 a. Depreciation Reserve $0 $0 $0 $0 S-25 b. Other Reserve $955 $0 $0 $0 S-26 c. Emergency Reserve (Cash) $2,004,707 $2,005,661 $2,007,312 $2,007,312 S-27 Amount to be added Total Reserves (a+b+c) $2,005,662 $2,005,661 $2,007,312 $2,007,312 S-28 a. Depreciation Reserve $0 $0 $0 $0 S-29 b. Other Reserve -$955 $0 $0 $0 S-30 c. Emergency Reserve (Cash) $954 $1,651 $3,633 $3,633 Total to be added (a+b+c) -$1 $1,651 $3,633 $3,633 S-31 Subtotal $2,005,661 $2,007,312 $2,010,945 $2,010,945 S-32 Less Total to be spent $0 $0 $0 $0 S-33 TOTAL RESERVES AT END OF FISCAL YEAR $2,005,661 $2,007,312 $2,010,945 $2,010,945 End of Summary Budget Officer / District Official (if not same as "Submitted by") Date adopted by Special District 7/20/2017 DISTRICT ADDRESS: 625 E. Broadway, PO Box 428 Jackson, WY PREPARED BY: Alisa Lane DISTRICT PHONE: Prepared in compliance with the Uniform Municipal Fiscal Procedures Act (W.S through 124) as it applies. 3/27/17 Form approved by Wyoming Department of Audit, Public Funds Division

3 Teton County Hospital District NAME OF DISTRICT/BOARD PROPERTY TAXES AND ASSESSMENTS R-1 Property Taxes and Assessments Received R-1.1 Tax Levy (From the County Treasurer) $4,159,240 $4,065,771 $4,297,577 $4,297,577 R-1.2 Other County Support FORECASTED REVENUE R-2 Revenues from Other Governments R-2.1 State Aid R-2.2 Additional County Aid (non-treasurer) R-2.3 City (or Town) Aid R-2.4 R-2.5 Total Government Support $0 $0 $0 $0 R-3 Operating Revenues R-3.1 Customer Charges $100,545,456 $102,625,498 $108,175,244 $110,228,382 R-3.2 R-3.3 Sales of Goods or Services Other Assessments $2,852,730 $2,869,642 $3,485,415 $3,485,415 R-3.4 Total Operating Revenues $103,398,186 $105,495,140 $111,660,658 $113,713,797 R-4 Grants R-4.1 Direct Federal Grants $415,650 $33,561 $8,758 $8,758 R-4.2 Federal Grants thru State Agencies R-4.3 Grants from State Agencies $814,296 $718,712 $699,435 $699,435 R-4.4 Total Grants $1,229,946 $752,273 $708,193 $708,193 R-5 Miscellaneous Revenue R-5.1 Interest $475,956 $276,225 $297,257 $297,257 R-5.2 Other: Specify Contributions $245,917 $1,603,206 $650,000 $650,000 R-5.3 R-5.4 Other: Additional Total Miscellaneous $721,873 $1,879,431 $947,257 $947,257 R-5.5 Total Forecasted Revenue $105,350,005 $108,126,844 $113,316,108 $115,369,247 R-6 Other Forecasted Revenue R-6.1 a. Other past due-as estimated by Co. Treas. R-6.2 b. Other forecasted revenue (specify): R-6.3 R-6.4 R-6.5 See Additional Details $389,757 R-6.6 Total Other Forecasted Revenue (a+b) with additional details $389,757 $0 $0 $0

4 NAME OF DISTRICT/BOARD CAPITAL OUTLAY BUDGET E-1 E-1.1 Real Property $600,262 $3,260,000 E-1.2 Vehicles $0 $66,245 E-1.3 Office Equipment $2,034,504 $2,550,555 $2,712,439 $3,030,137 E-1.4 E-1.5 Milward, Lobby, Living Ce $3,221,330 $2,287,200 $11,999,089 $7,618,479 E-1.6 E-1.7 Capital Outlay E-1.8 TOTAL CAPITAL OUTLAY $5,856,096 $8,164,000 $14,711,529 $10,648,616 E-2 E-3 E-4 ADMINISTRATION BUDGET E-2.1 Administrator $718,504 $662,150 $878,578 $852,988 E-2.2 Secretary E-2.3 Clerical $5,853,400 $6,816,471 $8,209,122 $9,043,781 E-2.4 E-2.5 Support staff, including lau $4,846,750 $5,410,142 $5,790,949 $5,622,201 E-2.6 E-2.7 E-3.1 E-3.2 E-3.3 E-3.4 E-3.5 E-3.6 Travel Mileage E-4.1 Legal $387,534 $373,121 $300,095 $300,095 E-4.2 Accounting/Auditing E-4.3 E-4.4 Collection fees, bank card $4,565,310 $4,472,761 $4,628,389 $4,624,669 E-4.5 E-4.6 E-5 Other Administrative Expenses E-5.1 Office Supplies $1,290,655 $1,295,108 $1,343,717 $1,343,717 E-5.2 Office equipment, rent & repair $1,637,225 $1,902,283 $2,181,604 $2,201,104 E-5.3 Education $866,305 $860,685 $1,113,325 $1,218,825 E-5.4 Registrations E-5.5 E-5.6 Utilities, freight, security, s $1,802,226 $1,934,616 $1,903,637 $1,903,637 E-5.7 Other, Recruiting, dues & $736,466 $697,078 $750,402 $591,902 E-5.8 Personnel Services Board Expenses Contractual Services E-6 TOTAL ADMINISTRATION $22,704,375 $24,424,415 $27,099,818 $27,702,919

5 OPERATIONS BUDGET E-7 E-7.1 Wages--Operations $29,760,552 $32,118,369 $35,052,038 $34,295,697 E-7.2 Service Contracts E-7.3 E-7.4 E-7.5 E-7.6 E-8 Travel E-8.1 E-8.2 E-8.3 E-8.4 Mileage E-8.5 E-9 E-9.1 Operating supplies (List) Patient Supplies $14,929,142 $15,242,071 $16,673,990 $16,643,784 E-9.2 E-9.3 E-9.4 E-9.5 E-10 E-10.1 Program Services (List) Physician Fees $4,671,295 $4,824,143 $4,886,767 $4,896,767 E-10.2 Rehabilitation, Reference $2,747,432 $3,055,932 $3,065,257 $3,065,256 E-10.3 E-10.4 E-10.5 E-11 Contractual Arrangements (List) E-11.1 E-11.2 E-11.3 E-11.4 E-11.5 E-12 Other operations (Specify) E-12.1 Rent/Repair/Maintenance $2,256,178 $2,156,175 $2,262,321 $2,304,173 E-12.2 Loss on Investments $350,392 $130,204 $163,080 $163,080 E-12.3 Community Programs $140,524 $267,176 $293,370 $343,374 E-12.4 E-12.5 Personnel Services E-13 TOTAL OPERATIONS $54,855,515 $57,794,070 $62,396,823 $61,712,131

6 INDIRECT COSTS BUDGET E-14 Insurance E-14.1 Liability $1,196,887 $1,680,634 $1,713,393 $1,513,393 E-14.2 Buildings and vehicles $179,632 $239,885 $230,626 $230,626 E-14.3 Equipment E-14.4 E-14.5 E-14.6 E-14.7 E-15 Indirect payroll costs: E-15.1 FICA (Social Security) taxes $2,668,822 $2,864,492 $3,117,208 $3,287,548 E-15.2 Workers Compensation $388,049 $468,066 $500,000 $500,000 E-15.3 Unemployment Taxes $37,857 $48,000 $40,000 $40,000 E-15.4 Retirement $1,252,124 $1,340,150 $1,509,899 $1,500,438 E-15.5 Health Insurance $8,035,717 $8,531,454 $9,100,000 $9,205,786 E-15.6 E-15.7 LTD, Life Insurance, Emp $534,533 $525,322 $657,480 $659,422 E-15.8 E-15.9 E-16 Depreciation Expenses $6,642,575 $6,858,775 $6,838,969 $7,200,185 E-17 TOTAL INDIRECT COSTS $20,936,196 $22,556,778 $23,707,576 $24,137,398 DEBT SERVICE BUDGET D-1 Debt Service D-1.1 Principal $935,000 $910,000 $165,000 $165,000 D-1.2 Interest $1,258,809 $1,236,637 $1,222,125 $1,301,935 D-1.3 Fees D-2 TOTAL DEBT SERVICE $2,193,809 $2,146,637 $1,387,125 $1,466,935

7 NAME OF DISTRICT/BOARD GENERAL FUNDS C-1 Balances at Beginning of Fiscal Year C-1.1 General Fund Checking Account Balance $44,865,680 $46,175,663 $51,615,359 $51,615,359 C-1.2 Savings and Investments Account Balance $11,908,525 $18,088,178 $18,016,101 $18,016,101 C-1.3 C-1.4 General Fund CD Balance All Other Funds $169,824 $202,342 $532,992 $532,992 C-1.5 Reserves (From Below) $2,005,661 $2,007,312 $2,010,945 $2,010,945 C-1.6 Total Cash and Investments on Hand $58,949,690 $66,473,495 $72,175,396 $72,175,396 C-2 General Fund Reductions: C-2.1 a. Unpaid bills at FYE C-2.2 b. Reserves $2,005,661 $2,007,312 $2,010,945 $2,010,945 C-2.3 Total Deductions (a+b) $2,005,661 $2,007,312 $2,010,945 $2,010,945 C-2.4 Non-Restricted Funds Available $56,944,029 $64,466,183 $70,164,451 $70,164,451 DEPRECIATION RESERVE (CAPITAL OUTLAY - REPLACEMENT) C-3 C-3.1 Beginning Balance in Reserve Account (end of previous year) $0 $0 $0 C-3.2 C-3.3 Amount to be added to the reserve $0 C-3.4 C-3.5 SUB-TOTAL $0 $0 $0 $0 C-3.6 C-3.7 Identify the amount to be spent from "Reserve for Capital Outlay" a. C-3.8 b. C-3.9 c. C-3.10 C-3.11 TOTAL CAPITAL OUTLAY (a+b+c) $0 $0 $0 $0 C-3.12 Balance to be retained in Depreciation Reserve Account $0 $0 $0 $0 OTHER RESTRICTED FUND BALANCES - RESERVE (LEGALLY ENFORCED) C-4 C-4.1 Beginning Balance in Reserve Account (end of previous year) $955 $0 $0 C-4.2 C-4.3 Amount to be added to the reserve -$955 C-4.4 C-4.5 SUB-TOTAL $0 $0 $0 $0 C-4.6 C-4.7 Identify the amount and project to be spent from "Other a. C-4.8 b. C-4.9 c. C-4.10 C-4.11 TOTAL OTHER RESERVE OUTLAY (a+b+c) $0 $0 $0 $0 C-4.12 Balance to be retained in Other Reserve Account $0 $0 $0 $0 ASSIGNED FUND BALANCE (EMERGENCY RESERVE - NOT COMMITTED) C-5 C-5.1 Beginning Balance in Reserve Account (end of previous year) $2,004,707 $2,005,661 $2,007,312 $2,007,312 C-5.2 C-5.3 Amount to be added to the reserve $954 $1,651 $3,633 $3,633 C-5.4 C-5.5 SUB-TOTAL $2,005,661 $2,007,312 $2,010,945 $2,010,945 C-5.6 C-5.7 C-5.8 Amount to be spent from Emergency Reserve (Cash) Balance to be retained in Assigned Fund Balance $2,005,661 $2,007,312 $2,010,945 $2,010,945 C-5.9 TOTAL TO BE SPENT $0 $0 $0 $0