Mercy Health Quarterly Financial Report. As of and for the three months ended December 31, 2018 and 2017
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1 Mercylit Quarterly Financial Report As of and for the three months ended December 31, 2018 and 2017 Contents: - Consolidated Financial Statements (Unaudited) - Management Discussion & Analysis
2 Consolidated Balance Sheets (Unaudited) December 31 June (In Thousands) Assets Current assets: Cash and cash equivalents 357,538 $ $ 481,881 Accounts receivable, net 785, ,824 Inventories 123, ,945 Short term investments 34,686 34,686 Other current assets 207, ,467 Total current assets 1,507,981 1,491,803 Investments 2,300,741 2,399,438 Property and equipment, net 3,037,976 3,005,229 Other assets 619, ,828 Total assets $ 7,466,189 $ 7,507,298 Liabilities and net assets Current liabilities: Current maturities of long-term obligations $ 15,290 $ 18,811 Accounts payable 235, ,512 Accrued payroll and related liabilities 463, ,828 Accrued liabilities and other 274, ,256 Total current liabilities 988, ,407 Insurance reserves and other liabilities 461, ,312 Pension liabilities 298, ,479 Long-term obligations, less current maturities 1,707,566 1,706,492 Total liabilities 3,456,244 3,445,690 Net assets: Unrestricted 3,900,436 3,956,780 Restricted 109, ,828 Total net assets 4,009,944 4,061,608 Total liabilities and net assets $ 7,466,189 $ 7,507,298 Page 1
3 Consolidated Statements of Operations (Unaudited) Six Months Ended December 31 (In Thousands) Operating revenues: Net patient service revenues $ 2,961,878 $ 2,807,810 Capitation revenues 116, ,468 Other operating revenues 150, ,900 Total operating revenues 3,228,339 3,077,178 Operating expenses: Salaries and benefits 1,867,059 1,802,088 Supplies and other 1,122,508 1,031,917 Medical claims expense 41,297 42,798 Interest 25,588 20,294 Depreciation and amortization 147, ,808 Total operating expenses 3,204,125 3,050,905 Operating income 24,214 26,273 Nonoperating (losses) gains: Investment returns, net (72,149) 99,713 Realized and unrealized (losses) gains on interest rate swaps, net (6,734) 1,167 Other, net (1,910) 130 Total nonoperating (losses) gains, net (80,793) 101,010 Excess of revenues over expenses (56,579) 127,283 Other changes in unrestricted net assets: Net assets released from restrictions for property acquisitions 1,020 1,933 Other (785) 1,767 Increase in unrestricted net assets $ (56,344) $ 130,983 Page 2
4 Consolidated Statements of Changes in Net Assets (Unaudited) Six Months Ended December 31 (In Thousands) Increase in unrestricted net assets $ (56,344) $ 130,983 Restricted net assets: Pledges, bequests, and gifts for specific purposes 12,045 18,394 Investment returns, net (519) 1,369 Net assets released from restrictions (1,020) (8,288) Other (5,826) 143 Increase in restricted net assets 4,680 11,618 Increase in net assets (51,664) 142,601 Net assets at beginning of period 4,061,608 3,817,709 Net assets at end of period $ 4,009,944 $ 3,960,310 Page 3
5 Consolidated Statements of Cash Flows (Unaudited) Six Months Ended December 31 (In Thousands) Operating activities Change in net assets $ (51,664) $ 142,601 Adjustments to reconcile change in net assets to net cash provided by operating activities: Pledges, bequests, and gifts for specific purposes (12,045) (18,394) Unrealized losses (gains) on interest rate swap 3,522 (5,635) Depreciation and amortization 147, ,808 Provision for uncollectible receivables 286, ,972 Changes in assets and liabilities: Accounts receivable (347,122) (331,561) Investments classified as trading 63,292 (181,587) Inventories and other current assets (57,920) (84,865) Accounts payable (43,942) (8,239) Accrued liabilities and other 84,070 71,875 Insurance reserves and other liabilities (1,172) (4,483) Net cash provided by operating activities 71,219 8,492 Investing activities Additions to property and equipment, net (180,420) (162,994) Net change in notes receivable and other assets (8,662) 8,965 Net change in alternative investments (16,078) (31,663) Business acquisitions (15,990) Net cash used in investing activities (205,160) (201,682) Financing activities Proceeds from issuance of long-term debt, net of original 252, ,652 issue discount and financing costs Principal payments on long-term obligations (255,148) (113,142) Pledges, bequests, and gifts for specific purposes 12,045 18,394 Net cash provided by financing activities 9, ,904 Net decrease in cash and cash equivalents (124,343) 10,714 Cash and cash equivalents at beginning of period 481, ,451 Cash and cash equivalents at end of period $ 357,538 $ 534,165 Page 4
6 MANAGEMENT S DISCUSSION AND ANALYSIS OF FINANCIAL RESULTS ($ in thousands) INTRODUCTION For the six months ended December 31, 2018, Mercy's net operating income was $24.2 million, compared to prior year operating income of $26.3 million. The operating margin percentage for this period was 0.8%, compared to prior year of 0.9%. Six months ended December 31 EBIDA $ 197,476 $ 200,375 EBIDA margin 6.1% 6.5% Operating income $ 24,214 $ 26,273 Operating income margin 0.8% 0.9% Net income $ (56,579) $ 127,283 Net income margin -1.8% 4.1% December June Days cash on hand Days in AR Days cash on hand decreased from days at June 30, 2018 to days at December 31, Days in accounts receivable of 48.8 at December 31, 2018 increased from the June 30, 2018 days in accounts receivable of OPERATING REVENUES Operating revenues increased 5% from the prior year, due primarily to an increase in net patient service revenue as a result of higher volumes, as inpatient volumes, outpatient volumes and clinic visits are up compared to prior year. Total discharge volume was above prior year by 3.2%; acute discharge volume was also above prior year, by 3.1%. Acute length of stay was 4.4, unchanged from prior year. Clinic visits, Surgeries, and Outpatient visits were up 12.4%, 4.4%, and 5% respectively from prior year. ED visits were down from prior year. KEY STATISTICS Six months ended December 31 Total discharges 98,408 95,375 Acute discharges 89,014 86,330 Total patient days 450, ,019 Acute patient days 389, ,829 Acute length of stay Outpatient visits 1,896,614 1,806,036 Surgeries 92,918 88,975 Emergency room visits 367, ,536 Clinic Visits 3,561,877 3,168,921 Page 5
7 OPERATING EXPENSES Operating expenses increased 5.0% from the prior year, primarily in supplies and other expense and salaries and benefits expense. The increase in salaries and benefits expense from the prior year is due to an increase in the number of FTEs (related primarily to volume growth but also impacted by acquisitions), wage increases, additional use of overtime, and retention incentives. The increase in supplies and other expense is due to the impact of growth related to volume increases and acquisitions, as well as higher medical supply and drug costs as a result of higher acuity/change in case mix. Key expense indicators include: salaries and benefits as a percentage of revenue, which at 60.7% was favorable to the prior year of 61.4%, and medical supplies and drug costs as a percentage of revenue of 21.5%, which was higher compared to the prior year of 20.0%. Six months ended December 31 Salary & benefit expense/adcmi $ 4,052 $ 4,211 Salary & benefits as % of patient revenue 60.7% 61.4% Med supplies & drugs as % of patient revenue 21.5% 20.0% Manageable operating exp as % of patient revenue 98.5% 98.0% In support of its mission, Mercy provides care to patients who personally bear a significant financial burden relative to their health care services. The table below reflects the costs of such services that are not reimbursed or are reimbursed at less than cost. Six months ended December 31 Cost of charity care $ 64,805 $ 52,753 Unpaid cost of Medicaid 68,673 70,135 Cost of bad debt 89,602 83,199 Total $ 223,080 $ 206,087 Total as % of operating expenses 7.0% 6.8% NON-OPERATING RESULTS Non-operating results for the six months ended December 31, 2018 are primarily related to investment returns. Mercy realized a loss of 3.04% on our investments, fiscal year-to-date, which was better than the policy benchmark loss of 3.82% for the same period. Page 6
8 LIQUIDITY* (In thousands) December 31, 2018 Accessible Daily Cash and Cash Equivalents $ 357,538 Money Market Funds 28,831 Subtotal Daily Liquidity 386,369 Accessible Within One Week Publically Traded Fixed Income Securities & Funds 203,153 Publically Traded Equity Securities & Funds 402,779 Other Publically Traded Funds 119,365 Subtotal Liquidity Within One Week 725,297 TOTAL DAILY AND WEEKLY LIQUIDITY 1,111,666 Accessible Monthly Fixed Income Securities & Funds 96,781 Equity Securities & Funds 65,700 Other Commingled Funds 25,155 Subtotal Monthly Liquidity 187,636 Accessible Greater than One Month Funds, vehicles, investments 1,022,745 TOTAL LONGER TERM LIQUIDITY 1,210,381 Other Sources of Liquidity 364 Day Line of Credit 120,000 Drawn Portion of Line - Net Available Line 120,000 TOTAL $ 2,442,047 *Liquidity schedule based on total Mercy Investment Fund value at December 31, 2018 (excluding foundation assets), inclusive of accruals and pending trades. Page 7
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