ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT

Transcription

1 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT July 31,22 Audits of Financial Stateents July 3 1,22 and July 3 1,21

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3 COTETS PAGE Manageent: Discussion and Analysis Independent Auditor's Report Balance Sheets St at eents of Operat i o Stateents of Changes in Fund Balance Stateents of Cash Flows otes to Financial Stateents Independent Auditor's Report on Suppleentary Inforation i- vi SUPPLEMETARY FIACIAL IFORMATIO Schedules of et Patient Service Revenues Schedules of Other Operating Revenues 19 2 Schedules of Operating Expenses: In Total by Departent Salaries by Departent Eployee Benefits by Departent Purchased Services by Departent Supplies and Other Expenses by Departent Schedule of Bonds and Certificates of Indebtedness Schedule of Board of Coissioners REPORT O COMPLIACE AD O ITERAL COTROL OVER FIACIAL REPORTIG BASED O A AUDIT OF FIACIAL STATEMETS PERFORMED I ACCORDACE WITH GOVERMETAUDITIG STADARDS SCHEDULE OF CURRET AUDIT FIDIGS SCHEDULE OF PRIOR AUDIT FIDIGS

4 MAAGEMET: DISCUSSIO AD AALYSIS This section of St. Charles Parish Hospital Service District s (the Hospital) annual financial report presents background inforation and anageent s analysis of the Hospital s financial perforance during the fiscal year that ended July 31, 22. Please read it in conjunction with the financial stateents in this report. Financial Highlights The Hospital s total assets decreased by approxiately $1,288, due to increased estiated uncollectibles and allowances and a decrease in liited assets by Board for construction. During the year, the Hospital s total operating revenues increased $623,927 fro prior year. The Hospital had an increase in operating expenses of $1,69,862. The Hospital reduced long-ter bonds and certificates of indebtedness by $1,79. The Hospital received reiburseent of Uncopensated Care under the State s Medicaid Progra in the aount of $5,296,523. The Hospital had its ajor anaged care provider declare bankruptcy Required Financial Stateents The Basic Financial Stateents of the Hospital report inforation about the Hospital using Governental Accounting Standards Board (GASB) accounting principles. These stateents offer shortter and long-ter financial inforation about its activities. The Balance Sheets include all of the Hospital s assets and liabilities and provide inforation about the nature and aounts of investents in resources (assets) and the obligations to Hospital creditors (liabilities). It also provides the basis for coputing rate of return, evaluating the capital structure of the Hospital and assessing the liquidity and financial flexibility of the Hospital. All of the current year s revenues and expenses are accounted for in the Stateent of Revenue, Expenses and Changes in et Assets. This stateent easures iproveents in the Hospital s operations over the past two years and can be used to deterine whether the Hospital has been able to recover all of its costs through its patient service revenue and other revenue sources. The final required financial stateent is the Stateent of Cash Flows. The priary purpose of this stateent is to provide inforation about the Hospital s cash fro operations, investing and financing activities, and to provide answers to such questions as where did cash coe fro, what was cash used for and what was the change in cash balance during the reporting period. 1

5 MAAGEMET: DISCUSSIO AD AALYSIS Financial Analysis of the Hospital The Balance Sheets and the Stateent of Revenue, Expenses. and Changes in et Asscts rcport inforation about the Ilospital s activities. These hvo stateents report the net assets of the Hospital and changes in the. lncreases or decreases in the Hospital s net assets are one indicator of whether its financial health is iproving or deteriorating. However, other nonfinancial factors such as changes in the health care industry, changes in Medicare and Medicaid regulations, and changes in anaged care contracting should also be considered. et Assets A Suary of the Hospital s Balance Sheet are presented in Table 1 below: TABLE 1 Condensed Balance Sheets (in thousands) 22 July 3 1, 2 1 Dollar Change Percentage ChanPe Total Current Assets Capital Assets - et Other Assets, Including Board-Designated Investents $ 3,841 15, $ 4,175 15, $ (335) (8.1) % (497) (3.17) (456) (84.1 1) Total Assets $ $2.47 $.-1631) Yo Current Liabilities $ 9,68 $ 8,49 $ Yo Long-Ter Debt Outstanding and Other Long-Ter Liabilities 8,56 1,136 (1,576) -- (15.55) Total Liabilities 17,628 18,545 (917) (4.94) Fund Balance 1,49 1 1,862 (371) (1 9.94) Total Liabilities and Fund Balance $ 19,119 $ 2,47 $ (6.31) Yo As can be seen in Table 1, total assets decreased by $1,288,348 to $19,119,75 in fiscal year 22. The fiscal year 21 saw total assets increase by $1 14,787. The change in total net assets results priarily fro non-operating interest expense and operating losses in the current year. 11

6 MAAGEMET: DISCUSSIO AD AALYSIS Suary of Revenue, Expenses and Changes in et Assets TABLE 2 Condensed Stateents of Revenue, Expenses and Changes in et Assets (In Thousands) Years Ended March 3 1, et Patient Service Revenue Other Revenue, et Total Operating Revenue Salaries and Eployee Benefits Supplies and Other Provision for Bad Debts Purchased Services Depreciation and Aortization Eployee Benefits Total Operating Expenses Loss Fro Operations onoperating Incoe Expenses in Excess of Revenues Fund Balance - Beginning of Year Fund Balance - End of Year Sources of Revenue Operating Revenue $ 14, ,244 9,92 5,589 3,61 2,865 1,338 1,126 23,7 1 (2,827) 2,456 (371) $ 1,491 $ 13,855 5,765 19,62 8,63 5,789 2,787 2,645 1, I.462 (1,842) 2, ,399 $ During fiscal year 22, the Hospital derived the ajority of its total revenue fro patient service revenue. Patient service revenue includes revenue fro the Medicare and Medicaid progras and patients, or their third-party payors, who receive care in the Hospital s facilities. Reiburseent for the Medicare and Medicaid progras and the third-party payors is based upon established contracts. The difference between the covered charges and the established contract is recognized as a contractual allowance. Other Operating Revenue is priarily coprised of reiburseent for Uncopensated Care under the State s Medicaid progra

7 MAAGEMET: DISCUSSIO AD AALYSIS Table 3 present the relative percentages of gross charges billed for patient services by payor for the fiscal years ended July 3 1,22 and 21. TABLE 3 Payor Mix by Percentage Year Ended July 3 1, 22 Managed Care Medicare Medicare HMO Medicaid Self-Pay and Other 21% 19% Total Patient Revenues onoperating Incoe The Hospital holds designated and restricted funds in its Balance Sheets that are invested priarily ill oney arket funds. These investents earned $36,946 during the year 22. These earnings were less than earning in prior years due to changes in interest rates and arket conditions of the econoy. Operating and Financial Perforance The following suarizes the Hospital s Stateents of Revenue, Expenses and Changes in et Assets between 22 and 2 1 : Overall activity at the Hospital, as easured by cobined acute patient and psychiatric patient discharges, increased to 1,922 discharges in 22 fro 1,827 discharges in 21. Cobined patient days increased fro 9,625 in 21 to 1,15 in 22. As a result, the average length of stay for acute care patients was 4.4 days and psychiatric patients 6.8 days. Total net patient service revenue increased $497,845 in 22 although the average length of stay for acute care patients reained very near the sae in 22 as copared to 21. The increase in net patient service revenues is directly related to an increase in outpatient revenues during 22. During fiscal year 22, the Hospital s ajor anaged care provider declared bankruptcy. The receivables directly related to services covered by this copany aount to approxiately $1,1, and reain as part of the Hospital s accounts receivable at this tie. Manageent has focused resources on reducing the unbilled and billed balances in all other patient accounts receivable. As a result, days in accounts receivable decreased fro 63 days to 61 days. iv

8 MAAGEMET: DISCUSSIO AD AALYSIS Salaries increased by $1,29,19 fro the prior year. This increase is a direct result of required arket adjustents in salaries for the year to reain copetitive in the industry. Eployee benefits have also increased priarily due to the increased usage of the Hospital s self-insured edical insurance plan. The cost of supplies and aterials was reduced by $I 99,93 1 particularly for patient edical supplies and pharacy drugs. This reduction occurred due to a change in buying groups and taking advantage of available volue discounts. Depreciation expense exceeded the investent of capital back into the Hospital copared to the prior year. Interest expenses decreased by $1 66,195 for the year ended July 3 1, 22 as a direct result of the reduced costs of borrowing onies. Provision for bad debts increased $274,444 over prior year due to the ix of patient accounts receivable. onoperating incoe consists of Ad Valore taxes received for aintenance and operation of the hospital and debt services and interest earnings on funds. onoperating incoe increased fro the prior year due to the fact that the cost to borrow oney was lower in the current year than in the previous year onies. Capital Assets The Hospital s capital assets activities are included in Table 4 below: TABLE 4 Capital Assets (In Thousands) Julv 3 1. Dollar Percentage Change Change Building and Iproveents Equipent Vehicles $ 14,768 $ 14,746 $ 22.1 % 1,68 9, Subtotal 25,743 24, Less Accuulated Depreciation and Aortization 1,93 9,671 1, Land et Property, Plant and Equipent $ $ 15,69 $ (497) (3.17) Yo et property, plant and equipent has decreased, for the year ended July 3 1, 22, as Depreciation and Aortization exceeded the investent of capital back into the Hospital. V

9 MAAGEMET: DISCUSSIO AD AALYSIS Long-Ter Debt At year-end, the Hospital had $12,87, in short-ter and long-ter debt. This has decreased by $1,665, in fiscal year 22, which was the aount of principal payents on outstanding debt for the fiscal year. More detailed inforation about the Hospital s long-ter liabilities is presented in the notes to basic financial stateents. o new long-ter debt was incurred in the current year. Contracting the Hospital s Financial Manager This financial report is designed to provide our citizens, custoers and creditors with a general overview of the Hospital s finances and to deonstrate the Hospital s accountability for the oney it receives. If you have questions bout this report or need additional financial inforation, contact Hospital Adinistration. vi

10 To the Board of Coissioners St. Charles Parish Hospital Service District Luling, Louisiana lndependent Auditor s Report We have audited the accopanying general purpose financial stateents of ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT (Hospital), a coponent unit of the St. Charles Parish Council, as of and for the years ended July 31, 22 and 21, as listed in the table of contents. These general purpose financial stateents are the responsibility of the 1 Iospital s anageent. Our responsibility is to express an opinion on these general purpose financial stateents based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of Aerica, and the standards applicable to financial audits contained in Govevnt Auditi~g Standards, issued by the Coptroller General of the United States. Those standards require that we plan and perfor the audit to obtain reasonable assurance about whether the general purpose financial stateents are free of aterial isstateent. An audit includes exaining, on a test basis, evidence supporting the aounts and disclosures in the general purpose financial stateents. An audit also includes assessing the accounting principles used and significant estiates ade by anageent, as well as evaluating the overall general purpose financial stateent presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the general purpose financial stateents referred to above present fairly, in all aterial respects, the financial position of ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT as of July 3 1,22 and 21, and the results of its operations and its cash flows for the years then ended in confority with accounting principles generally accepted in the United States of Aerica. As discussed in ote A to the general purpose financial stateents, effective August 1, 21, the Hospital adopted Governent Accounting Standards Board (GASB) Stateents o. 34, Basic Financial Stateents - and Manageent s Discussion and Analysis -for State and Local Governents; o. 37, Basic Financial Stateents - and Manageent s Discussion and Analysis - for Stute and Local Governents: Onibus; and o. 3 8, Certain Financial Stateent ote Disclosures. A Professional Accounting Corporation 11 Veterans Meorial Boulevard, Suite 2, Metairie, LA (54) FAX (54) East Boston Street Covington, LA 7433 (985) FAX (985) Address: laporteqlaporte.co Internet Address: Meber of AlCPA Division for CPA Firs-Private Copanies I rdctice Section and SEC Practice Section An Indepcndcntly Owned Meber of the KSM McGladrey etwork

11 The anageent's discussion and analysis on pages i through vi are not a required part of the basic financial stateents but are suppleentary inforation required by accounting principles generally accepted in the United States of Aerica. We have applied certain liited procedures, which consisted principally of inquiries of anageent regarding the ethods of easureent and presentation of the suppleentary inforation. However, we did not audit the inforation and express no opinion on it. In accordance with Governnient Auditing Standards, we have issued our report dated April 15, 23 on our consideration of the Hospital's internal control over financial reporting and our tests of its copliance with certain provisions of laws, regulations, contracts and grants. That report is an integral part of an audit perfored in accordance with Governent Auditing Standards, and should be read in conjunction with this report in considering the results of our audit. A Professional Accounting Corporation April 15,23

12 ST. CHARLES PARISH HOSPITAL SERVICE DlSTRlCT BALACE SHEETS ASSETS July 3 1, CURRET ASSETS Cash and Cash Equivalents Accounts Receivable (et of Estiated Uncollectibles and Allowances of $3,423,68 for 22 and $3,23,677 for 21) Other Receivables Assets Whose Use is Liited Inventory Prepaid Expenses Total Current Assets ASSETS WHOSE USE IS LIMITED By Board for Indenture Reserves By Board for Construction Total Assets Whose Use is Liited Less: Aounts Required to Meet Current Obligations oncurrent Assets Whose Use is Liited PROPERTY, PLAT AD EQUIPMET, ET OTHER ASSETS Goodwill Deposits Total Other Assets $ 57,216 $ 4,298 1, , ,535 1,243, ,726 78,649 69,17 82,546 79,336 3,84,662 4,175,284 I.243, , ,94 1 1,244,4 1,667,667 1, , ,941 15,192,29 15,689,798 85, 85, ,4 85,4 Total Assets $ 19,l 19,75 $ 2,47,423 The accopanying notes are an integral part of these financial stateents.

13 1.862,565 I LIABILITIES AD FUD BALACE Julv CURRET LIABILITIES Current Maturities of Bonds and Certificates of Indebtedness Accounts Payable Estiated Third-party Settleents Accrued Salaries and Benefits Accrued Interest Payable otes Payable Cash Overdraft Other Accrued Expenses 5,29, I, ,49 1,3,39 294,772 74,s ,526 4,142 $ 5,165, 1,598, , , ,14 Total Current Liabilities LOG-TERM LIABILITIES Bonds and Certificates of Indebtedness Estiated Retroactive Adjustents - Third-party Payors otes Payable Total Long-Ter Liabilities 9,68, ,58, 9.37,OOO 75, , ,559,925 IO: 135,646 FUD BALACE 1,491,148 ~ Total Liabilities and Fund Balance $ 19,119,75 $ 2,47,423 3

14 ST. CHARLES PAKlSH HOSPITAL SERVICE DlSTRICT STATEMETS OF OPERATIOS For The Years Ended July 3 1, ET PATIET SERVICE REVEUE OTHER OPERATIG REVEUE Total Revenue OPERATIG EXPESES Salaries and Wages Supplies and Other Provision for Bad Debts Purchased Services Depreciation and Aortization Eployee Benefits Total Expenses Loss fro Operations O-OPERATIG ICOME (EXPESE) Ad Valore Taxes - Maintenance Ad Valore Taxes - Debt Service Interest Expense Interest Incoe Deficiency in et Assets - Services Corporation on-operating Gains, et (EXPESES I EXCESS OF REVEUES) REVEUES I EXCESS OF EXPESES $ 14,352,946 $ 13,855,11 5,89,992 5, ,243,938 19,62,O 1 I 9,92,267 8,63,158 5,589,71 5,789,2 3,61,123 2,786,679 2,864,545 2,644,617 1,338,346 1,23,345 1,125, ,653 23,71, ,46 1,454 (2,827,3 78) (1,84 1,443) 1,662,948 1,75,232 1,549,18 1,474,644 (754,556) (92,751) 36,946 71,696 (38,5 57) (26,142) 2,455,961 2,34,679 $ (371,417) $ 463,236 The accopanying notes are an integral part of these financial stateents. 4

15 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT STATEMETS OF CHAGES I FUD BALACE For The Years Ended July 3 I, BALACE, Beginning of Year (Expenses in Excess of Revenues) Revenues In Excess of Expenses BALACE, End of Year $ 1,862,565 $ 1,399,329 (37 I,4 17) 463,236 $ 1,491,148 $ 1,862,565 The accopanying notes are an integral part of these financial stateents. 5

16 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT STATEMETS OF CASH FLOWS CASH FLOWS FROM OPERATIG ACTIVITIES Kevenue Collected Cash Payents to Eployees and for Eployee-Related Costs Cash Payents for Operating Expenses et Cash Used In Operating Activities CASH FLOWS FROM OCAPITAL FIACIG ACTIVITIES Ad Valore Taxes - Maintenance Ad Valore Taxes - Debt Service et Cash Provided by oncapital Financing Activities CASH FLOWS FROM CAPITAL AD RELATED FIACIG ACTIVITIES Purchase of Property, Plant and Equipent Proceeds fro Issuance of Certificates of Indebtedness Principal Payents on General Obligation Bonds Principal Payents on Certificates of Indebtedness Interest Paid on Debt Obligations Proceeds fro Issuance of otes Payable Principal Payents on otes Payable Proceeds fro Issuance of Capital Lease Obligations Principal Payents Under Capital Lease Obligations et Cash Used in Capital and Related Financing Activities CASH FLOWS FROM IVESTIG ACTIVITIES Interest Incoe Deficiency in et Assets - Services Corporation Cash Withdrawn fro (Invested in) Assets Whose Use is Liited et Cash Provided by (Used in) Investing Activities ET ICREASE I CASH AD CASH EQUIVALETS CASH AD CASH EQUIVALETS - BEGIIG OP YEAR CASH AD CASH EQUIVALETS - ED OF YEAR For The Years Ended Julv I $ 17,75,914 $ 16.56,811 (1,52,171) (8,972,945) (8,195,66) (9,198:89) (54 1,9 1 7) (1,61 1,24) 1,662,948 1,75,232 1,549,18 1,474,644 3,212,128 3,179,876 (84,757) (794,544) 3,5, 4,8, (I, 145,) (1,8,) (4,2,) (2,97,) (792,737) (952,657) 259,59 (54,92) (3,344) 58,48 (3,47) (3,485) (3,3 8,949) (1,328,3) 36,946 71,696 (38,557) (26,142) 423,267 (282,78) 421,656 (23 6,5 24) 52,918 4,298 4,298 $ 57,216 $ 4,298 The accopanying notes are an integral part of these financial stateents. 6

17 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT STATEMETS OF CASH FLOWS (Continued) For The Years Ended Julv RECOCILIATIO OF LOSS FROM OPERATIOS TO ET CASH USED I OPERATIOS Operating Loss Interest Expense Considered Capital Financing Activity Cash Provided by Operating Activities: Depreciation and Aortization Provision for Doubtful Accounts Estiated Retroactive Adjustent - Third-party Payor Changes In: Increase in Accounts Receivable (Increase) Decrease in Inventory lncrease in Prepaid Expenses (Decrease) Increase in Estiated Third Party Payor Settleents Decrease (Increase) in Other Receivables lncrease (Decrease) in Accounts Payable lncrease in Accrued Salaries and Benefits Increase (Decrease) in Cash Overdraft Increase in Other Accrued Expenses et Cash Used In Operating Activities $ (2,827,378) 1,338,346 3,61,123 (2,565,559) (99,479) (3,21) (97,3 46) 27, , ,6 139,526 1,38 $ (541,917) $ (1,84 1,443) 1,23,345 2,786,679 75, (3,3 1,665) 62,98 (54,671) 78,489 (27,535) (1,287,265) 37,866 (3 15,772) 968 $ (1,611,24) The accopanying notes are an integral part of these financial stateents. 7

18 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE A DESCRIPTIO OF REPORTIG ETITY AD SUMMARY OF SIGIFICAT ACCOUTIG POLICIES REPORTIG ETITY ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT (Hospital), a special district and coponent of St. Charles Parish (Parish), was fored for the purpose of operating St. Charles Parish Hospital, a non-profit counity hospital established in The Board of Coissioners is the governing authority for the Hospital and responsible for obtaining voter approval for the levy of tax or debt issuance, but all related Louisiana State Bond Coission approvals ust be obtained through the Parish. ST. CHARLES HOSPITAL SERVICES CORPORATIO (Corporation) is a not-forprofit entity providing clinical services to inates at the parish jail. Although the Corporation is legally separate fro the Hospital, the Corporation is reported as if it were a part of the Hospital due to their having the sae governing body as the Hospital. In accordance with Governental Accounting Standards Board (GASB) Stateent o. 14, the operations of the Corporation, for the year ended July 3 1, 22 and for the period fro its inception of March 21, 21 through July 3 1, 21, have been blended into the Hospital's financial stateents. ACCOUTIG STADARDS The financial stateents of the Hospital have been prepared in confority with Generally Accepted Accounting Principles (GMP) as applied to governental units. The Governental Accounting Standards Board (GASB) is the accepted standard-setting body for establishing governental accounting and financial reporting principles. Pursuant to GASB Stateent o. 2, Accounting and Financial Reporting for Proprietary Funds and Other Governental Entities That Use Propriety Fund Accounting, the Hospital has elected to apply the provisions of all relevant pronounceents of the Financial Accounting Standards Board (FASB), including those issued after oveber 3, 1989 that do not conflict or contradict GASB pronounceents. CASH AD CASH EQIVALETS Cash and cash equivalents include investents in highly liquid debt instruents with aturities of three onths or less, excluding aounts whose use is liited by board designation, other arrangeents under trust agreeents, or with third-party payors. ASSETS WHOSE USE IS LIMITED Assets whose use is liited include assets set aside by the Board of Coissioners for future capital iproveents and future indenture agreeents, over which the Board retains control and ay at its discretion subsequently use for other purposes; assets set aside in accordance with agreeents with third-party payors; and assets held by trustees under indenture agreeents and selfinsurance trust agreeents. IVETORY Inventory is valued at the lower of cost or arket using the first-in, first-out ethod. 8

19 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE A DESCRIPTIO OF REPORTIG ETITY AD SUMMARY OF SIGIFICAT ACCOUTIG POLICIES (Continued) PROPRIETARY FUD ACCOUTIG The Hospital utilizes the proprietary fund ethod of accounting whereby revenue and expenses are recognized on the accrual basis. Substantially all revenues and expenses are subject to accrual. The Corporation also uses the accrual ethod. TVESTMETS Trading securities, if any, which include any security held for near-ter sale, are carried at fair arket value. Gains and losses on trading securities, both realized and unrealized, are included in non-operating incoe. Available-for-sale securities, if any, which include any security for which the Hospital has no iediate plan to sell, but which ay be sold in the future, are carried at fair value. Realized gains and losses, based on the specific identification ethod, are included in non-operating incoe. Unrealized gains and losses are recorded in fund balance. Preius and discounts are aortized and accreted, respectively, to interest incoe using the interest ethod over the period of aturity. Held-to-aturity securities, if any, which include any debt security for which the Hospital has the positive intent and ability to hold until aturity, are carried at historical cost adjusted for aortization of preius and accretion of discounts. Preius and discounts are aortized and accreted, respectively, to interest incoe using the interest ethod over the period to aturity. Interest and dividends on investents in debt and equity securities are included in nonoperating incoe when earned. USE OF ESTIMATES The preparation of financial stateents in confority with generally accepted accounting principles requires anageent to ake estiates and assuptions that affect the reported aounts of assets and liabilities at the date of the financial stateents and the reported aounts of revenues and expenses during the reporting period. Accordingly, actual results could differ fro those estiates. ET PATIET SERVICE REVEUE et patient service revenue is reported at the estiated net realizable aounts fro patients, third-party payors and others for services rendered, including estiated retroactive adjustents under reiburseent agreeents with third-party payors. Retroactive adjustents are accrued on an estiated basis in the period the related services are rendered and adjusted in future periods, as final settleents are deterined. O-DIRECT RESPOSE ADVERTISIG The Hospital expenses advertising costs as incurred. 9

20 1999. I ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE A DESCRIPTIO OF REPORTIG ETITY AD SUMMARY OF SIGIFlCAT ACCOUTIG POLICIES (Continued) RISK MAAGEMET The Hospital is exposed to various risks of loss related to torts; theft of, daage to, and destruction of assets; errors and oissions; injuries to eployees; and natural disasters. The Hospital is a eber of two separate trust funds established by the Louisiana Hospital Association that encopasses self-insurance of (I) Hospital professional liability and coprehensive general liability and (2) Statutory workers copensation. The Hospital continues to carry coercial insurance for all other risks of loss. STATEMETS OF OPERATIOS For purposes of presentation, transactions deeed by anageent to be ongoing, ajor, or central to the provision of health care services are reported as operating revenues and expenses. Peripheral or incidental transactions are reported as other incoe and expense. TRADE RECEIVABLES Trade receivables are carried at original invoice aount less an estiate ade for doubtful receivables based on a review of all outstanding aounts on a onthly basis. Manageent deterines the allowance for doubtful accounts by identifying troubled accounts and by using historical experience applied to an aging of accounts. Trade receivables are written off when deeed uncollectible. Recoveries of trade receivables previously written off are recorded when received. OTE B ET PATIET SERVICE REVEUE The Hospital has agreeents with third-party payors that provide for payents to the Hospital at aounts different fro established rates. A suary of the payent arrangeents with ajor third-party payors follows: Medicare - Inpatient and outpatient acute care services rendered to Medicare progra beneficiaries are paid at prospectively deterined rates. These rates vary according to a patient classification syste that is based on clinical, diagnostic and other factors. Inpatient non-acute services are paid based on a cost reiburseent ethodology. The Hospital is reibursed for cost reibursable ites at a tentative rate with final settleent deterined after subission of annual cost reports by the Hospital and audits thereof by the Medicare fiscal interediary. The Hospital s Medicare cost reports have been audited by the Medicare fiscal interediary through July 3 1, Medicaid - Inpatient care services rendered to Medicaid progra beneficiaries are paid at prospectively deterined rates per day. Certain outpatient services rendered to Medicaid progra beneficiaries are reibursed under a cost reiburseent ethodology. The Hospital is reibursed at a tentative rate with final settleent deterined after subission of annual cost reports by the Hospital and audits thereof by the Medicaid fiscal interediary. The Hospital s Medicaid cost reports have been audited by the Medicaid fiscal interediary through July 3 1 ~ 1

21 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE B ET PATIET SERVICE REVEUE (Continued) The Hospital has entered into payent agreeents with certain coercial insurance carriers, health aintenance organizations and preferred provider organizations. The basis for payent under these agreeents includes prospectively deterined rates per discharge, discounts fro established charges and prospectively deterined daily rates. OTE C COCETRATIOS OF CREDIT FUSK The Hospital grants credit without collateral to its patients, ost of who are residents of St. Charles Parish and are insured under third-party payor agreeents. The ix of receivables fro patients and third-party payors was as follows as of July 3 1, 22 and 21 : Medicare Medicaid Coercial Private Pay Paticnts pjoj 36% 4 1 Yo 16% 13% 24% 17% 24% 29% 1% 1% OTE D CHARITY CARE/HILL-BURTO UCOMPESATED SERVICE AD COMMUITY SERVICE OBLIGATIOS The Hospital does not provide for charity care upon the adission of a patient. lt is only after services have been provided, and a patient clais that he cannot ake payent on his account that the Hospital ay consider forgiveness of the debt under its charity policy. As a result of the Parish receiving a federal Hill-Burton Progra Grant, the Hospital is required to provide a volue of uncopensated services to patients who are unable to pay for their edical care. As of July 31,22, the Hospital had yet to fulfill its requireent for free care. This deficit ust be reduced through providing uncopensated services to indigent patients through its year ended July 31, 23. Additionally, the grant requires the Hospital to provide certain counity services. For the years ended July 3 1, 22 and 21, the Hospital wrote off a cobined $95 1,995 and $494,269, respectively, of free care against gross revenue. OTE E BAK DEPOSITS Cash deposits with financial institutions, which include cash balances whose use is liited or restricted, aounted to $872,95 1 and $1,667,667 as of July 3 1, 22 and 21. These balances were entirely insured or entirely collateralized by securities held by the pledging bank s trust departent in the Hospital s nae. 11

22 ST. CHARLES PARISH HOSPITAL SERVICE DTSTRICT OTES TO FIACIAL STATEMETS OTE F ASSETS WHOSE USE IS LIMITED Assets whose use is liited that are required for obligations classified as current liabilities are reported in current assets. The coposition of assets, whose use is liited at July 3 1, 22 and 21, is set forth in the following table. Investents are stated at fair value. July 3 1, By Board for Construction Cash and Cash Equivalents $ 84 $ 456,941 Under Indenture Agreeents Cash and Cash Equivalents 419, ,96 Certificates of Deposit 823, $ 12244,4 L1,667.6a OTE G PROPERTY, PLAT AD EQUIPMET Major classifications of property, plant and equipent for the years ended July 31, 22 and 21 is suarized below: 22 2 I Building and lproveents Equipent Vehicles $ 14,767,732 $ 14,746,2 1,67,616 9,881, , ,12 25,742,958 24,981,3 I5 Less: Accuulated Depreciation 1,93,346 9,671,114 Total Buildings and Equipent 14,812,612 15,3 1,21 Land 379, ,597 Property, Plant and Equipent, et $, 192,29 S15.68S~J9j3 Depreciation charged to incoe totaled $1,338,346 and $1,23,345 for the years ended July 3 1, 22 and 2 1. Plant and equipent acquisitions are recorded at cost. The Hospital s policy is to record acquisitions over $5,. Depreciation is provided over the estiated useful life of each class of depreciable assets and is coputed on the straight-line ethod. 12

23 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE G PROPERTY, PLAT AD EQUIPMET Maintenance, repairs and inor replaceents and iproveents are expensed as incurred. Major replaceents and iproveents are capitalized at cost. Interest cost incurred on borrowed funds during the period of construction or the outright purchase of capital assets is capitalized as a coponent of the cost of acquiring those assets. Interest earned on these sae borrowed funds offset the interest cost incurred and capitalized. OTE H BODS AD CERTIFICATES OF IDEBTEDESS On oveber 28, 199, the Hospital adopted a resolution issuing $1,47. of General Obligation Bonds, Series 199 A, and $28, of General Obligation Bonds (Taxable), Series 199 B dated Septeber 1, 199, payable fro the pledge of unliited Ad Valore taxes approved by an election held on May 5, 199 for the purpose of expanding the Hospital facilities. The bonds ature in 25. Interest is payable on Septeber I and March 1, each year. The average interest rate is 7.75%. The balance owed on the bonds is $67, at July 3 1, 22, and was $87, at July 3 1,21. On April 22, 1992, the Hospital adopted a resolution issuing $4,925, of General Obligation Bonds, Series 1992 A and $1,2, of General Obligation Bonds (Taxable), Series 1992 B, payable fro the pledge of unliited Ad Valore taxes approved by an election held April 11, 1992 for the purpose of expanding the Hospital facilities. The bonds ature in 27. Interest is payable on Septeber 1 and March I, each year. The average interest rate is 7.1%. The balance owed on the bonds is $3,43, at July 3 1,22, and was $3,89, at July 3 1,21. On January 28, 1998, the Hospital adopted a resolution issuing $2,55, of Certificates of Indebtedness, Series 1999, dated March 1, 1998, payable fro the pledge of liited Ad Valore taxes approved by an election held oveber 15, 1997 for the purpose of constructing and/or iproving hospital facilities and acquiring the necessary equipent and furnishings therefor, and for refunding the outstanding Certificates of Indebtedness, Series The bonds ature in 26. Interest is payable on Septeber 1, and March 1, each year. The average interest rate is 4.6%. The balance owed on the bonds is $1,42, at July 31, 22, and was $1,725, at July 3 1,21. On January 28, 1998, the Hospital adopted a resolution issuing $4,565, of General Obligation Bonds, Series 1998, payable fro the pledge of unliited Ad Valore taxes approved by an election held oveber 15, 1997 for the purpose of constructing and acquiring buildings, achinery and equipent, including both real and personal property, to be used in providing hospital facilities. The bonds ature in 27. Interest is payable on Septeber I, and March I, each year. The average interest rate is 5.125%. The balance owed on the bonds is $2,765, at July 3 1,22, and was $3,25, at July 3 1,

24 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE H BODS AD CERTIFICATES OF IDEBTEDESS (Continued) On January 8,21, the Hospital adopted a resolution issuing $1,, of Certificates of Indebtedness, Series 21, payable fro the pledge of revenues of said District for the purpose of paying the current expenses of the District for the calendar year 21. The interest rate is 6%. The obligation was paid in full as of July 3 1,22. The balance owed on the obligation at July 3 1,21 was $1,,. On January 3 1, 21, the Hospital adopted a resolution issuing $1,7, of Certificates of Indebtedness, Series 21, payable fro the pledge of revenues of said District for the purpose of paying the current expenses of the District for the calendar year 21. The bonds ature in 22. The interest rate is 6%. The obligation was paid in full as of July 3 1, 22. The balance owed on the obligation was $1,7, as of July 3 1,21. On March 28, 21, the Hospital adopted a resolution issuing $8, of Certificates of Indebtedness, Series 21, payable fro the pledge of revenues of said District for the purpose of paying the current expenses of the District for the calendar year 21. The bonds ature in 22. The interest rate is 6%. The obligation was paid in full as of July 3 1, 22. The balance owed on the obligation was $8, as of July 3 1,21. On May 3, 21, the Hospital adopted a resolution issuing $1,3, of Certificates of Indebtedness, Series 21, payable fro the pledge of liited Ad Valore taxes approved by an election held oveber 15, 1997, for the purpose of constructing and aintaining hospital facilities within said District. The bonds ature in March 26. Interest is payable on March 1 and Septeber I, each year. The interest rate is 6%. The balance owed on the bonds is $1,85, at July31,22, andwas$1,3,at July31,21. On January 8, 22, the Hospital adopted a resolution issuing $3,5, of Certificates of Indebtedness, Series 22, payable fro the pledge of revenues of said District for the purpose of paying the current expenses of the District for the calendar year 22. The bonds ature in 23. The interest rate is 4.95%. The balance owed on the obligation is $3,5, at July 3 1,22. Scheduled principal repayents on long-ter debt as of July 3 1,22, are as follows: $ 5,29, 1,9, 2,1, 2,13 5, 1,535, $ 12,87, 14

25 ST. CHAFUES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE I OTES PAYABLE During the year ended July 31, 2, the Hospital borrowed funds for the acquisition of E. Banerjee. M.D., Professional Medical Corporation. The loan originated in the aount of $85,, and is repayable in 36 onthly installents totaling $2,685, per onth including interest at 8.5%. The loan is secured by a proissory note. The balance of the note at July 31, 22 is $1 5,648. The balance outstanding at July 3 1,2 1 was $45,193. During the year ended July 31, 22, the Hospital borrowed funds for the acquisition of equipent. The loan originated in the aount of $259,59, and is repayable in 6 onthly installents totaling $5,245 per onth, including interest at 7.75%. The loan is secured by equipent. The balance of the note at July 3 I, 22 is $234,152. During the year ended July 3 1, 22, the Hospital borrowed funds for the acquisition of coputer equipent under capital lease. The aount of equipent acquired totaled $58,48, and is repayable in 6 onthly installents totaling $1,464 per onth, including interest at 9.8%. The loan is secured by equipent. Aortization charged to incoe totaled $5,841 for the year ending July The balance on the note at July 3 1, 22 is $54,939. Scheduled aturities of these loans, as of July 3 1, 22, are as follows: $ 74,813 64,15 69, ,823 24,339 $ OTE J PESIOS Substantially all eployees of the Hospital are ebers of the Parochial Eployees' Retireent Syste of Louisiana (Syste), a cost sharing, ultiple-eployer public eployee retireent syste, controlled and adinistered by a separate board of trustees. The Syste provides retireent and disability benefits, annual costs of living adjustents, and death benefits to plan ebers and beneficiaries. Benefits are established by state statute. The Parochial Eployees' Retireent Syste of Louisiana issues a publicly available financial report that includes financial inforation and required suppleentary inforation for the Syste. That report ay be obtained by writing to Thoas B. Sis, CFA, Adinistrative Director, P.O. Box 14619, Baton Rouge, LA , or by calling Contributions to the Syste include one-fourth of one percent of the taxes shown to be collectible by the tax rolls of each parish, except Orleans and East Baton Rouge Parishes. All eligible eployees are required by state statute to contribute 9.5% of their salaries to the Syste. In accordance with state statutes, the eployer contributions are deterined by actuarial valuation and are subject to change annually based on the results of the valuation for the prior fiscal year. 15

26 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE J PESIOS (Continued) Retireent contributions totaled $5 17,33 and $425,337 for the years ended July 3 I, 22 and 21, respectively. OTE K ICOME TAXES The Hospital is a governental unit which has registered as a not-for-profit corporation as described in Section 51(c)(3) of the Internal Revenue Code, and is exept fro Federal incoe taxes on related incoe pursuant to Section 51(a) of the Code. OTE L COMMITMETS CAPITAL LEASES The Hospital is lessee of edical equipent under capital lease originally expiring in April, 26. The assets associated with these capital leases are recorded at the lower of the present value of the iniu lease payents or fair value of the asset. The assets are depreciated over the lower of their related lease ters or their estiated productive lives. Depreciation of assets under leases is included in depreciation expense for the years ended July 3 1,22 and 21. OPERATlG LEASES The Hospital also leases, on a onth-to-onth basis, edical and office equipent under operating lease agreeents. Lease expense totaled $1 32,145 and $23,645 for the years ended July 31,22 and 21. PURCHASE AGREEMETS The Hospital entered into a contract with Baxter Healthcare to purchase infusion equipent. The ter of the equipent is three years, through the year ending July 3 1, 23, with an annual purchase coitent of $365 for 23. During the fiscal year ended July 31, 22, the Hospital entered into a long-ter purchase contract with Beckan Coulter for the purchase of equipent and reagents. The ter of the contract is five years, through the year ending July 3 1,27, and it requires the Hospital to purchase annual iniu supplies of $1 1,134. EMPLOYMET COTRACTS The Hospital has an eployent contract with its CEO. The ter of the contract extends through 23. The Hospital is contractually obligated to pay this contract as follows: Year Ended July 3 I, 23 $ 135,48 16

27 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT OTES TO FIACIAL STATEMETS OTE L COMMITMETS (Continued) MAAGEMET COTRACTS The Hospital has a anageent contract with Efficient Manageent Copany. Inc. with ters through May 25 to inanage the Hospital s psychiatric unit. The Hospital is contractually obligated to pay this copany an annual total of at least $12,, but not ore than $52,, as dictated by certain revenue factors. DEFERRED COMPESATIO PLA The Hospital offers to its eployees a deferred copensation plan created in accordance with Internal Revenue Code Section 457. The plan is available to all Hospital eployees and perits the to defer a portion of their salary until future years. The deferred copensation is not available to eployees until terination, retireent, death, or unforeseeable eergency. All aounts of copensation deferred under the plan, all property and rights purchased with those aounts, and all incoe attributable to those aounts, property, or rights are (until paid or ade available to the eployee or other beneficiary) held in trust for the exclusive benefit of the participants and their beneficiaries, and the benefits ay not be diverted to any other use. lt is the opinion of Hospital anageent that the Hospital has no liability for losses under the plan but does have the duty of due care that would be required of an ordinary prudent investor. OTE RECLASSIFICATIOS Certain reclassifications of previously reported aounts have been ade to confor with the 22 presentation. Such reclassifications had no effect on fund balances. 17

28 To the Board of Coissioners The St. Charles Parish Hospital Service District Luling, Louisiana Independent Auditor's Report on Suppleentary Inforation Our report on our audit of the general purpose financial stateents of ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT for the years ended July 3 1,22 and 21 appears on page 1. The audit was ade for the purpose of foring an opinion on the general purpose financial stateents taken as a whole. The suppleentary inforation shown on pages is presented for purposes of additional analysis and is not a required part of the general purpose financial stateents. Such inforation has been subjected to the auditing procedures applied in the audit of the general purpose financial stateents and, in our opinion, is fairly stated in all aterial respects in relation to the general purpose financial stateents taken as a whole. A Professional Accounting Corporation April 15,23

29 ST. CHARLES PARISH HOSPITAL SERVICE DlSTRlCT SCHEDULES OF ET PATIET SERVICE REVEUES For The Years Ended July I PATIET SERVICE REVEUES Laboratory Psychiatric Unit Eergency Roo Pharacy Radiology Operating Roo Routine Med/Surg Abulance CT Scanner ICU Central Supply Inhalation Therapy Rehabilitation Anesthesia MRI EKG Pediatric Corner Dialysis Cardiac Recovery Roo Sae Day Surgery Blood Bank Occupational Therapy Special Procedures Oncology Speech Therapy Work RehabAndustrial Outreach eurology Parish Jail Clinic Pain Manageent Total Less: Contractual Adjustents et Patient Service Revenue $ 4,966,66 3,55,517 3,433,168 2,93 13 I 2,5, ,727 1,612, ,696 1,397, ,5 92, , , , , ,12 174, , ,31 16,689 66,7 56, ,325 23,58 21, ,63 1,74 14,278,794 $ 14,352,946 $ 3,884,25 2, ,54, ,255 1, I,423,1 OS 1, ,111, , , , , ,33 448,45 258, ,1 182, ,764 8,495 46,768 68, , , 36,6 15,286 13,792 1, ,63 1, ,776,3 1 $ 13,855,11 See independent auditor's report on suppleentary inforation. 19

30 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT SCHEDULES OF OTHER OPERATIG REVEUES For The Years Ended July 3 1, OTHER OPERATIG REVEUE Disproportionate Share Revenue Other Cafeteria Sales Rental Incoe $ 5,296,523 $ 5,36, ,91 312,323 12,22 94,295 5,339 52,73 'Total Other Operating Revenue $ 5,89,992 $ 5,764,91 See independent auditor's report on suppleentary inforation. 2

31 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT SCHEDULES OF OPERATIG EXPESES - I TOTAL BY DEPARTMET For The Years Ended July 3 1; URSIG SERVICES MedISurg Intensive Care Unit $ 1,59, ,96 1 1,698,663 $ 945,376 66,638 l,552;1 4 OTHER PROFESSIOAL SERVICES Psychiatric Unit Eergency Roo Surgical Services Laboratory Radiology Pharacy EMS Rehab Services Anesthesia Respiratory Care House Supervisors Hoe Health Dialysis POU Jail Clinic Cardiac Rehab East Bank Clinic IV/Oncology , , , , , , I ,974,323 See independent auditor's report on suppleentary inforation 21

32 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT SCHEDULES OF OPERATlG EXPESES - I TOTAL BY DEPARTMET (Continued) For The Years Ended July 3 1: GEERAL SERVICES Plant Operations Food Senrice Housckeeping Medical Records (Health Inforati on Manag e ent) Aditting Materials M'anageent Quality h4anagenient 853, ,754 49,75 39,55 32,85 247:252 76,48 2,794, , ,72 48, , , A29 81,412 2,5 17:553 FISCAL SERVICES Business Services Data Processing Accounting 51,612 24, , ,348 5, , ,61 84,54 ADM 1l STRATIVE SERVICES Adinistration Professional Developent Huan Resources MarketingFatient Relations Education Volunteer Services 1,854,529 76,77 148,6 8,428 1,52 3,817 2,921,196 1,826, ,967 16,85 15:395 8,327 26,585 2,56, DEPRECIATIO AD AMORTIZATIO PROVISIO FOR BAD DEBTS 18,671,847 1,338,346 3,61,123 17,444,43 1,23, $ 23,71,316 $ 21,461,454 See independent auditor's report on suppleentary inforation 22

33 196,393 I ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT SCHEDULES OF SALARIES BY DEPARTMET For The Years Ended July 3 1 ~ URSIG SERVICES MedJSurg Intensive Care Unit $ 71,34 495;53 $ 69, ,671 1 ~ 1 167,658 OTHER PROFESSIOAL SERVICES Psychiatric Unit Radiology Eergency Roo EMS Laboraton. Surgical Services Rehab Services Anesthesia Respiratory Care House Supervisors Pharacy Hoe Health Dialysis POU Cardiac Rehab IV/Oncology Jail Clinic 1 :25, I : , , , ,945 38:84 245, , ,244 16,58 113,17 95,173 84:295 71,34 17,72 11,81 5,282: ,21 475, ,398 51, :56 43,43 363, , , , ,115 89,632 85, 64,782 17,46 85,27 4:633,27 See independent auditor's report on suppleentary inforation 23

34 ST. CHARLES PARlSH HOSPITAL SERVICE DISTRICT SCHEDULES OF SALARIES BY DEPARTMET (Continued) For The Years Ended July GEERAL SERVICES Aditting Medical Records (Health lnforation Manageent) Housekeeping Food Service Plant Oper a t' ions Materials Managein ent Qualit?l Manageent , ,76 FISCAL SERVICES Business Services Accounting Data Processing 289; , :857 98, , ,583 52,75 ADMIISTRATIVE SERVICES Professional Developent Adinistration Huan Resources Education Volunteer Services Marketing/Patient Relations 37,466 22,6 285, ;742 98,691 7,474 63,723 25,186 21,761-13,5 77, ,638 $ 9,92,267!$ 8,63,158 See independent auditor's report on suppleentary inforation. 24

35 ST. CHARLES PARISH HOSPITAL SERVICE DISTRICT SCHEDULES OF EMPLOYEE BEEFITS BY DEPARTMET FOT The Years Ended July 31, URSIG SERVICES MedISurg Intensive Care Unit $ $ OTHER PROFESSIOAL SERVlCES Psychiatric Unit Radiology Eergency Roo EMS Laboratory Surgical Services Rehab Services Anesthesia Respiratory Care House Supervisors Pharacy Dialysis POU Cardiac Rehab IV/Oncology Jail Clinic I , : , See independent auditor's report on suppleentary inforation. 25