Chairman Heather O Donnell, JD, LLM and Directors Quin R. Golden; Edward L. Michael; and Carmen Velasquez (4)

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1 Minutes of the meeting of the Finance Committee of the Board of Directors of the Cook County Health and Hospitals System held Friday, August 24, 2012 at the hour of 9:00 A.M., at 1900 W. Polk Street, in the Second Floor Conference Room, Chicago, Illinois. I. Attendance/Call to Order Chairman O Donnell called the meeting to order. Present: Chairman Heather O Donnell, JD, LLM and Directors Quin R. Golden; Edward L. Michael; and Carmen Velasquez (4) Board Chairman David Carvalho (ex-officio) and Director Hon. Jerry Butler Absent: Director Jorge Ramirez (1) Additional attendees and/or presenters were: Gina Besenhofer System Director of Supply Chain Management John Cookinham System Chief Financial Officer LaVerne Hall Cook County Office of Contract Compliance Helen Haynes System Associate General Counsel Dorothy Loving System Executive Director of Finance Ram Raju, MD, MBA, FACS, FACHE Chief Executive Officer Elizabeth Reidy System General Counsel Tanda Russell System Interim Chief Nursing Officer Deborah Santana Secretary to the Board II. Public Speakers Chairman O Donnell asked the Secretary to call upon the registered speakers. The Secretary called upon the following registered public speakers: 1. George Blakemore Concerned Citizen 2. Lonnell Saffold Director of Institutional Services, SEIU Local 1 Board Chairman Carvalho noted that when issues are brought forth during the provision of public testimony that ought to be addressed, the usual practice is that someone in the administration provides a response as soon as the matter has been investigated or reviewed. During his testimony, Mr. Saffold described an issue in which he alleged that a current vendor has been non-compliant with its contractual obligations. Mr. Saffold testified at the August 9 th Board Meeting on the same issue; Board Chairman Carvalho inquired whether the administration had completed their review of the matter. Elizabeth Reidy, System General Counsel, responded that the administration is aware of the matter and they are addressing it; a response will be provided when review of the matter is completed 1. III. Action Items A. Minutes of the Finance Committee Meeting, June 22, 2012 Director Golden, seconded by Director Michael, moved to accept the minutes of the Finance Committee Meeting of June 22, THE MOTION CARRIED UNANIMOUSLY. Page 1 of 95

2 Finance Committee Meeting Minutes Friday, August 24, 2012 Page 2 III. Action Items (continued) B. Contracts and Procurement Items (Attachment #1) Gina Besenhofer, System Director of Supply Chain Management, presented the requests for the Committee s consideration. The Committee reviewed and discussed the requests. With regard to the suggestions made at the August 9 th Board Meeting for possible revisions to the transmittal template, in order to include additional information and data, Ms. Besenhofer stated that a small committee will be set up to work on this matter; she anticipates that the work should be completed in time for the October meeting. During the Committee s review of the requests, discussion took place regarding nurse staffing, in relation to request number 1 (request for commercial nurse agency services). Tanda Russell, System Interim Chief Nursing Officer provided further information. She stated that there were a significant number of retirements in December of last year; the administration was unable at that time to fully staff the nursing units, so some of the nursing units were closed as a result. As new employees have been hired, the administration has also supplemented with agency personnel, especially in hard-to-fill specialty positions. Ms. Russell stated that recruiting efforts continue, but it has been challenging. In January, seventy-seven (77) critical nursing positions were identified; recruiting and hiring for those positions is now being concluded. She added that the System is losing approximately two (2) nursing staff every week, so those positions will need to be filled, as well. With regard to the reason for the contract increase, Ms. Russell stated that the contract increase is directly tied to the vacancy rate. With regard to request number 4, Director Michael noted that this is a revenue generating contract; however, he inquired whether there was a cost to the System associated with the contract. Ms. Besenhofer responded affirmatively; she stated that, depending on the type of the request, it could be $3.00 or $5.00 per record. Director Velasquez, seconded by Director Michael, moved the approval of request numbers 1 through 4, under the Contracts and Procurement Items. THE MOTION CARRIED UNANIMOUSLY. LaVerne Hall, Director of the Cook County Office of Contract Compliance, provided a report (Attachment #2) regarding the review by Contract Compliance of the four contractual requests. The Committee reviewed the information. C. Supplemental Contracts and Procurement Items There were no Supplemental Contracts and Procurement Items for the Committee to consider. D. Approval of Transfer of Funds requests There were no Transfer of Funds requests for the Committee to consider. E. Any items listed under Sections III and IV Page 2 of 95

3 Finance Committee Meeting Minutes Friday, August 24, 2012 Page 3 IV. Recommendations, Discussion/Information Items A. Notification of Emergency Purchases (Attachment #3) The Secretary indicated that a Notification of Emergency Purchase was received that morning. Electronic copies of this Notification will be sent to the Committee Members following this meeting, and will be included in the record. B. Financial Reports through June July 2012 (Attachment #4) Dorothy Loving, System Executive Director of Finance, presented the Financial Reports through July The Committee reviewed and discussed the information. Director Michael, seconded by Director Golden, moved to accept the Financial Reports through July THE MOTION CARRIED UNANIMOUSLY. C. Introduction of CCHHS FY2013 Preliminary Budget (Attachment #5) Chairman O Donnell indicated that the Committee will review and discuss the budget materials at this time; the CCHHS FY2013 Preliminary Budget is expected to be considered for approval at the System Board Meeting on September 5 th. Public hearings will be held on the Preliminary Budget by the Finance Committee. Dates, times and locations of the public hearings are as follows: Tuesday, August 28, 2012 at 7:30 A.M. Thursday, August 30, 2012 at 6:00 P.M W. Polk Street, 2 nd Floor Conference Room Chicago, Illinois 1900 W. Polk Street, 2 nd Floor Conference Room Chicago, Illinois Tuesday, September 4, 2012 at 9:00 A.M. 118 North Clark Street, Room 567 Cook County Building Chicago, Illinois In addition to providing a mechanism on the System s website allowing the public to view the budget materials and register in advance to provide testimony at a public hearing, the System s website will also provide a mechanism for the public to electronically provide their testimony directly to the Board, via the Secretary. This mechanism will provide a convenient method for those members of the public who cannot attend a hearing to share their comments on the Preliminary Budget with the System Board. Dr. Ram Raju, Chief Executive Officer, and John Cookinham, System Chief Financial Officer, introduced the CCHHS FY2013 Preliminary Budget and related materials. Dr. Raju provided an overview of the materials. The Committee reviewed and discussed the information. The Committee discussed the subject of the Section 1115 Medicaid Waiver. Dr. Raju noted that this budget begins December 1; a decision or approval of the Waiver by the Centers for Medicare and Medicaid Services (CMS) could take place prior to or after December 1, which affects the projected revenue estimates for the budget. Page 3 of 95

4 Finance Committee Meeting Minutes Friday, August 24, 2012 Page 4 IV. Recommendations, Discussion/Information Items C. Introduction of CCHHS FY2013 Preliminary Budget (continued) The Committee discussed the following subjects: payer mix; expedited hiring process for Section 1115 Medicaid Waiver positions; chargeback of expenses associated with the Waiver population; and budgeting for expenses related to productivity, communication and tracking of patients within the Waiver population. Board Chairman Carvalho provided an overview of the process used last year in budgeting and funding vacant positions. A large number of vacant positions were funded at twenty percent (20%); at the time, it was thought to be an easier process and would provide more flexibility in filling vacancies, rather than using the process of taking a smaller pool and reclassifying a position in order to transform that vacancy into a different vacancy. He stated that, now that the System has a better rapport with County processes, it was determined that the System would budget for the positions that are needed, with 100% funding. If a need arises, staff can process a reclassification to get a job title closer to what is needed. Following the Committee s discussion, Chairman O Donnell requested that the Committee receive regular updates at each meeting on the implementation schedule and timeline for critical projects that impact the budget; these projects include the Section 1115 Medicaid Waiver; the implementation of the GHX contract management/electronic data exchange system in Supply Chain Management; and Meaningful Use 2. Board Chairman Carvalho reminded the Committee members that at the August 9 th Board Meeting, a request was made for an update to be provided to the Finance Committee sometime in the near future on Information Technology operations and impact of the Shared Services amendment that was approved by the Cook County Board during their FY2012 Budget deliberations 3. Additionally, Chairman O Donnell requested that a Board/Committee Education presentation with an overview on the subject of how the County is financed be provided at a Finance Committee Meeting in the near future 4. V. Adjourn As the agenda was exhausted, Chairman O Donnell declared the meeting ADJOURNED. Respectfully submitted, Finance Committee of the Board of Directors of the Cook County Health and Hospitals System Attest: XXXXXXXXXXXXXXXXXXXX Heather O Donnell, JD, LLM, Chairman XXXXXXXXXXXXXXXXXXXX Deborah Santana, Secretary Page 4 of 95

5 Finance Committee Meeting Minutes Friday, August 24, 2012 Page 5 1 Follow-up: Response re: testimony provided by Mr. Lonnell Saffold (Reidy) Page 1 2 Follow-up: New standing item for Finance Committee Meetings - Updates on the implementation schedule and timeline for the following projects: Page 4 Section 1115 Medicaid Waiver GHX contract management/electronic data exchange system implementation (Supply Chain Management) Meaningful Use 3 Follow-up: Future Finance Committee item - Update on Information Technology operations and Shared Services budget amendment (Hota, Hart) Page 4 4 Follow-up: Future Finance Committee Education item - overview on the subject of how the County is financed (Cookinham) Page 1 Page 5 of 95

6 Cook County Health and Hospitals System Finance Committee Meeting Minutes August 24, 2012 ATTACHMENT #1 Page 6 of 95

7 COOK COUNTY HEALTH AND HOSPITALS SYSTEM ITEM III(B) AUGUST 24, 2012 FINANCE COMMITTEE MEETING CONTRACTS AND PROCUREMENT ITEMS Request # Vendor Service or Product Fiscal Impact Increase Contract Affiliate / System Begins on Page # 1 L.M.R. Nursing Services, Inc. Service commercial nurse agency $600, SHCC 2 Execute Contracts 2 GE Medical Systems Product monitoring systems $1,105, PHCC, SHCC 3 3 Simplex Grinnell LP 4 Discovery Health Record Solutions Service testing of secondary fire suppression system, fire pumps and fire extinguishers, and monitoring of fire alarm system $196, SHCC 4 Revenue Service third party record copy generating: services $324, System 5 Page 7 of 95

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17 Cook County Health and Hospitals System Finance Committee Meeting Minutes August 24, 2012 ATTACHMENT #2 Page 17 of 95

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19 Cook County Health and Hospitals System Finance Committee Meeting Minutes August 24, 2012 ATTACHMENT #3 Page 19 of 95

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22 Cook County Health and Hospitals System Finance Committee Meeting Minutes August 24, 2012 ATTACHMENT #4 Page 22 of 95

23 Cook County Health and Hospitals System Financial Statements Year To Date July 31, As of August 17, 2012 Page 23 of 95

24 Index Page 1. Mission Statement Attestation Statement Management Discussion and Analysis Combining Balance Sheet Assets Combining Balance Sheet Liabilities and Net Assets Combining Income Statement Comparative Income Statements: Cook County Health Facilities (Consolidated) Stroger Hospital ACHN (Clinics) Oak Forest Health Center Provident Hospital Bureau of Health Dept. of Public Health Cermak Disclosure Checklist Page 24 of 95

25 COOK COUNTY HEALTH & HOSPITALS SYSTEM MISSION STATEMENT The Cook County Health and Hospitals System will deliver integrated health services with dignity and respect regardless of a patient's ability to pay; and, Foster partnerships with other health providers and communities to enhance the health of the public; and, Advocate for policies, which promote and protect the physical, mental and social well being of the people of Cook County. 3 Page 25 of 95

26 Board of Directors Cook County Health and Hospitals System The accompanying financial statements of Cook County Health and Hospitals System and the related Management's Discussion and Analysis for the month ended July 31, 2012 have been prepared by Management who is responsible for their presentation and disclosure. The statements have not been compiled, reviewed or audited by independent accountants. CCHHS maintains an internal control structure designed to provide reasonable assurance that assets are safeguarded and that transactions are properly executed, recorded and summarized to produce reliable records and reports, To the best of Management's knowledge and belief the statements were prepared in conformity with generally accepted accounting principles and governmental accounting standards using the accrual basis of accounting and are based on recorded transactions and Management's best estimates and judgment. John Cookinham, Chief Financial Officer Dorothy M. Loving, Executive Director of Finance 4 Page 26 of 95

27 MANAGEMENT S DISCUSSION AND ANALYSIS INTRODUCTION This discussion and analysis provides the readers of the monthly unaudited financial statements of the Cook County Health and Hospital System (CCHHS) with an overview of the financial activities for the month ended July 31, This discussion focuses on the significant financial issues and major financial activities during the current month. It should be read in conjunction with the accompanying financial statements of the CCHHS. The CCHHS includes the following entities: John H. Stroger Jr. Hospital (JSH), Oak Forest Health Center (OFC) Provident Hospital (PHCC), the Department of Public Health (DPH), the Ambulatory and Community Health Network (ACHN), the Bureau of Health Services (BHS), CORE Center (for reporting purposes part of Stroger Hospital), and Cermak Health Services (CHS). Collectively, these entities provide primary, intermediate, acute, and tertiary medical care to patients, without regard to their ability to pay. The Bureau of Health Services oversees the operational, planning, and policy activities of the CCHHS. The CCHHS is included in the reporting entity of the Cook County, Illinois, as an enterprise fund. As an enterprise fund, the CCHHS financial statements are prepared using proprietary fund accounting that focuses on the determination of changes in net assets, financial position, and cash flows in a manner similar to private sector businesses. The financial statements are prepared on an accrual basis of accounting, which recognizes revenue when earned and expenses when incurred. In 2008 the Cook County Health and Hospital System Board was created by the Cook County Board of Commissioners to provide independent oversight of health care operations, and in 2010 the Cook County Board of Commissioners voted to make the Cook County Health and Hospital System Board permanent. In 2010 the Cook County Health and Hospital System Board and the Cook County Board of Commissioners approved Vision 2015 Strategic Plan, which outlines, over five years, restructuring CCHHS to deliver the best possible care for the vulnerable population of Cook County within the constraints of dollar resources available to the health system. This plan seeks to better allocate resources. FINANCIAL HIGHLIGHTS (IN THOUSANDS) The Cook County Health and Hospitals System finished the eight months with overall revenue of $561,778 and overall expenses was $617,174. Net Patient revenue for the eight months was $360, Page 27 of 95

28 Net Patient revenue consists of all charges including automated contractual allowances and bad debt adjustments. Write-off of Bad Debt is a CCHHS Board approved policy. Other revenue was $4,358. Other revenue consists primarily of parking revenue. Patient Accounts Receivable BEPA System Only General As compared to November 30, 2011, Total Patient Accounts Receivable at the end of July-2012 remained the same at 154 days. The 7 day increase in this figure, as compared to June-2012 figure, is due largely to the one-time or first-time occurrence of the following factors: Movement of accounts with undeliverable addresses to the collection agency; Correction of pharmacy charging issues; and Transition of patients previously covered under the LOL program to the Carelink program. Days of Revenue Outstanding measures the average number of days charges remain in accounts receivable after service has been rendered before collection activities have been completed, including charity care and bad debt write-offs. Days of Revenue Outstanding is measured in charges, not cash collections. Days of Revenue Outstanding is a useful tool to measure collection efforts over time (i.e., whether this number is growing or decreasing). This number will be large due to the large number of Self-Pay patients CCHHS services and the processes CCHHS must complete before patient accounts are collected or written-off to bad debt. These processes include, but are not limited to, the following: Making an effort to attain third-party insurance coverage; Processing charity care applications; Sending three (3) monthly statements before accounts are turned over to collections; Placing accounts bi-monthly with the collection agency; and Permitting patients to pay their account balances over time (time payment). Total billed accounts grew by $4.797M (1.4%) as compared to the November-2011 balance, but fell by $10.662M (2.9%) as compared to the prior month s balance. The decrease in this balance continues the six (6) month trend of this figure s decline. This indicates an increasing number of accounts are completing the collection process. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS on the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs will not result in actual cash collections. 6 Page 28 of 95

29 Inpatient Accounts Receivable BEPA System Only Discharged Not Final Billed Inpatient discharged but not final billed accounts at the end of July-2012 decreased by $6.058M (28.6%) as compared the November 30, 2011 balance. This amount is greater than the previous month s balance by $1.591M (11.8%) as well. This indicates that less inpatient accounts are moving to a Billed status. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims on the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Billed Inpatient Accounts Billed inpatient accounts at the end of July-2012 increased by $2.264M (1.2%). This amount is less than the previous month s balance by $3.320M (1.7%). This decrease also decreased CCHHS days in revenue outstanding. The decrease in this number indicates more accounts had the collection process completed than in the previous month and that accounts are being removed from active accounts receivable. CCHHS collection process includes charity care and bad debt write-offs. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays on a per-diem and Medicare pays on the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs will not result in actual cash collections. Outpatient Accounts Receivable BEPA System Only Unbilled Outpatient Accounts The balance of unbilled outpatient accounts increased by $2.954M (13.2%) by the end of July-2012, as compared to the level of unbilled accounts as of November 30, This month s balance increased by $3.805M (17.7%). Fewer outpatient accounts are moving to a Billed status, as compared to the November-2011, and there was a growth in the outpatient unbilled accounts during the month of July The reduction of internal bill-holds from 20 days to 6 days will tend to cause a decline in the unbilled accounts receivable. The change in this figure does not translate dollar-for-dollar into actual cash receipts due to Medicaid s and Medicare s reimbursement configuration. Billed Outpatient Accounts 7 Page 29 of 95

30 The billed outpatient accounts receivable at the end of July-2012 rose by $2.533M (1.6%) over the balance as of November 30, This figure is smaller than the previous month s balance by $7.342M (4.3%). The reduction in this figure, as compared to the prior month s balance, indicates a greater number of Out-Patient accounts had their collection and write-off related activities completed. The reduction of internal bill-holds from 20 days to 6 days will tend to cause a growth in the billed accounts receivable. The change in this figure does not translate dollar-for-dollar into actual cash receipts due to Medicaid and Medicare s reimbursement configuration and to charity care and bad debt write-offs. Carelink Program Activities (Charity Care) The volume and dollar amounts written-off to charity care are as follows: Cumulative Number of Accounts Through July Cumulative Value of Accounts Through July Number of Accounts for July-2012 Value of Accounts for July In-Patient 435 $4.447M 3,191 $31.553M Out-Patient 27,579 $19.828M 270,961 $ M Operating Expenses at the end of eight months was $ M broken down as follows: Salaries and Wages - $ M Benefits - $95.305M Supplies - $65.388M Purchased Services, Rental, and Other - $89.302M Depreciation - $22.422M Utilities - $6.580M Insurance - $20.953M Nonoperating Revenue was $ M. The largest portions of this are attributed to sales tax in the amount of $82.352M and property tax in the amount of $53.285M. Sales tax revenues are recognized by CCHHS when earned; this occurs when the underlying sales transactions occur. The amount recorded as Due from State of Illinois - 8 Page 30 of 95

31 Sales Tax represents the amounts earned by CCHHS, however, the cash is not yet received from the state. There is a 3 months lag from the time of the underlying sales transaction to the receipt of funds. Taxes collected for the Health to date have been fully credited to the Health Fund except as mentioned in the previous paragraph. OVERVIEW OF THE FINANCIAL STATEMENTS This discussion and analysis are intended to serve as an introduction to the CCHHS financial statements. CCHHS basic monthly unaudited financial statements are comprised of fund financial statements. A fund is a grouping of related accounts that is used to maintain control over resources that have been segregated for specific activities or objectives. The CCHHS, like other state and local governments, uses fund accounting to ensure and demonstrate compliance with finance-related legal requirements. 9 Page 31 of 95

32 Accounts Receivable Comparison Cook County Health and Hospitals System Fiscal /31/2011 1/31/2012 2/29/2012 3/31/2012 4/30/2012 5/31/2012 6/30/2012 7/31/2012 BEPA BEPA BEPA BEPA BEPA BEPA BEPA BEPA Inpatient In-house $ 12,795,759 $ 13,552,149 $ 13,699,833 $ 12,386,360 $ 11,460,620 $ 12,386,158 $ 12,595,474 $ 13,109,329 Discharged Not Final Billed $ 16,039,995 $ 12,807,580 $ 10,298,697 $ 10,149,285 $ 10,894,292 $ 19,230,544 $ 13,539,019 $ 15,130,320 Billed $ 215,372,796 $ 226,684,055 $ 246,676,173 $ 236,363,473 $ 216,274,438 $ 206,340,779 $ 198,499,226 $ 195,179,479 Total Inpatient Asccounts Receivable $ 244,208,550 $ 253,043,784 $ 270,674,703 $ 258,899,118 $ 238,629,350 $ 237,957,481 $ 224,633,718 $ 223,419,128 Outpatient Unbilled $ 22,386,168 $ 23,355,905 $ 21,675,531 $ 21,471,442 $ 19,298,121 $ 20,461,556 $ 21,498,581 $ 25,303,209 Billed $ 172,222,206 $ 179,257,581 $ 192,949,670 $ 193,000,920 $ 200,806,195 $ 180,113,280 $ 171,174,814 $ 163,832,993 Total Outpatient Accounts Receivable $ 194,608,374 $ 202,613,486 $ 214,625,201 $ 214,472,362 $ 220,104,316 $ 200,574,836 $ 192,673,395 $ 189,136,202 Combined Inpatient and Outpatient A/R Unbilled $ 51,221,922 $ 49,715,634 $ 45,674,061 $ 44,007,087 $ 41,653,033 $ 52,078,258 $ 47,633,074 $ 53,542,858 Billed $ 387,595,001 $ 405,941,636 $ 439,625,843 $ 429,364,393 $ 417,080,633 $ 386,454,059 $ 369,674,040 $ 359,012,472 Total IP and OP Accounts Receivable $ 438,816,924 $ 455,657,270 $ 485,299,904 $ 473,371,480 $ 458,733,666 $ 438,532,317 $ 417,307,113 $ 412,555,330 Average Daily Revenue $ 2,566,742 $ 2,582,261 $ 2,748,845 $ 2,729,286 $ 2,971,025 $ 2,749,921 $ 2,842,621 $ 2,675,907 Days of Revenue Outstanding Page 32 of 95 10

33 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) (In Thousands) July 31, 2012 ASSETS CURRENT ASSETS: Cash and cash equivalents: Stroger Hospital ACHN (Clinics) Total Stroger & ACHN O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Intra-Activity Eliminations Grand Total Cash in banks 1, , , ,543 Cash held by Cook Co Treas 477, ,315 76, , , ,579 (782,855) Due from working cash fund 60,083 34,607 94,691 94,691 (94,691) Total cash & cash equivalent 538,708 34, ,316 76, , , ,580 (877,545) 1,543 Property taxes receivable: Tax levy - current year 18,547 22,041 40,587 3,483 3,335 1,888 49,293 5,379 54,672 Tax levy - prior year 20,814 23,675 44,488 3,991 3,957 2,044 54,480 5,956 60,436 Total property taxes rec 39,361 45,715 85,076 7,474 7,292 3, ,774 11, ,108 Receivables: Patient AR-net of allowances 123, , , , ,076 Third-party settlements Other receivables Due from State - sales taxes 7,977 8,788 16,765 2,363 3, ,742 3,232 6,619 33,593 Interacct (payable)receivabl (144,832) (144,832) 10,424 (27,587) 166,432 4,438 (2) (4,436) Total receivables (13,045) 8,794 (4,251) 12,887 (9,683) 167, ,151 3,394 2, ,730 Inventories 2,331 2, ,812 4, ,154 TOTAL CURRENT ASSETS 567,354 89, ,472 96, , ,130 1,042, ,308 3,021 (877,545) 293,534 CAPITAL ASSETS: Depreciable assets - net 367,997 6, ,608 25,806 20,104 15, ,375 2, ,342 TOTAL ASSETS 935,351 95,729 1,031, , , ,987 1,479, ,490 3,806 (877,545) 732,877 Page of 95

34 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) (In Thousands) July 31, 2012 LIABILITIES & NET POSITION CURRENT LIABILITIES: Stroger Hospital ACHN (Clinics) Total Stroger & ACHN O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Intra-Activity Eliminations Grand Total Due to Cook County Treasurer 144, , , ,075 30,532 (877,545) 2,062 Accounts payable 15, , ,383 9,444 28, ,561 Accrued salaries, wages, & other liabilities 2, , , ,010 Compensated absences 25,580 3,019 28,599 2,143 3,717 3,544 38,002 1,175 2,575 41,752 Deferred revenues 48,546 48,546 10,848 9,472 68,866 68,866 Third-party settlements 1,652 1,652 1,652 1,652 Due to others TOTAL CURRENT LIABILITIES 93, , ,824 14,041 15, , ,808 1,938 33,715 (877,545) 147,915 LONG-TERM LIABILITIES: Reserve-tax objection suits 4,254 2,540 6,795 1,016 1, ,364 1,081 10,446 TOTAL LIABILITIES 98, , ,619 15,057 17, , ,172 3,019 33,715 (877,545) 158,360 NET ASSETS: Investment in capital assets 367,997 6, ,608 25,806 20,104 15, ,375 2, ,342 Beginning balance 489,337 (146,210) 343,127 88,235 92,516 (459,880) 63, ,245 (13,095) 168,148 Bond depreciation 15, ,428 1,920 1,642 2,179 22, ,422 Excess revenue (expenses) (36,035) 84,333 48,298 (8,252) 6,872 (89,506) (42,588) 4,900 (17,707) (55,396) Ending balance 837,162 (54,701) 782, , ,134 (531,350) 479, ,471 (29,908) 574,516 TOTAL LIABILITIES & NET ASSETS 935,351 95,729 1,031, , , ,987 1,479, ,490 3,806 (877,545) 732,877 Page of 95

35 Cook County Health Facilities Combining Income Statement of General Funds (Unaudited) (In Thousands) July 31, 2012 Stroger Hospital ACHN (Clinics) Total Stroger & ACHN O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Grand Total REVENUE: Net patient service revenue 238,378 88, ,557 3,378 30, , ,377 Other revenue 2, , , ,358 Total Revenue: 240,924 88, ,767 3,693 30, , ,735 OPERATING EXPENSES: Salaries and wages 198,273 24, ,985 13,377 21,980 26, ,659 8,191 24, ,225 Employee benefits 58,210 8,043 66,253 4,704 6,725 8,402 86,085 2,369 6,852 95,305 Supplies 23,216 18,630 41,846 1,057 1,423 18,244 62, ,781 65,388 Purchased svs, rental & other 35,914 2,938 38,851 1,798 7,364 39,541 87, ,031 89,302 Depreciation 15, ,428 1,920 1,642 2,179 22, ,422 Utilities 3, ,942 1, , ,580 Insurance expense 12,154 1,481 13,635 1,539 1,916 1,634 18, ,628 20,953 TOTAL OPERATING EXPENSES 347,493 56, ,941 25,488 41,896 96, ,284 12,111 36, ,174 GAIN (LOSS) FROM OPERATIONS (106,569) 32,395 (74,174) (21,794) (11,276) (96,960) (204,204) (11,460) (36,776) (252,439) NONOPERATING REVENUE: Property taxes 17,996 21,699 39,695 3,346 3,159 1,854 48,055 5,229 53,285 Cigarette taxes 9,047 5,399 14,446 2,160 2, ,907 2,297 22,205 Sales taxes 19,556 21,543 41,099 5,794 9,435 1,873 58,202 7,923 16,227 82,352 Interest income Retirement plan contribution 23,927 3,296 27,224 2,242 2,776 3,201 35, ,841 39,194 TOTAL NONOPERATING REVENUE 70,534 51, ,472 13,542 18,147 7, ,616 16,359 19, ,043 NET INCOME (LOSS) (36,035) 84,333 48,298 (8,252) 6,872 (89,506) (42,588) 4,900 (17,707) (55,396) Page of 95

36 Cook County Health Facilities Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue 339,082 21, ,377 Other revenue 3, ,358 Total Revenue 342,937 21, ,735 OPERATING EXPENSES: Salaries and wages 274,398 42, ,225 Employee benefits 83,419 11,886 95,305 Supplies 58,115 7,272 65,388 Purchased svs, rental & other 76,949 12,353 89,302 Depreciation 19,508 2,914 22,422 Utilities 5, ,580 Insurance expense 18,691 2,262 20,953 TOTAL OPERATING EXPENSES 536,868 80, ,174 GAIN (LOSS) FROM OPERATIONS (193,931) (58,508) (252,439) NONOPERATING REVENUE: Property taxes 46,368 6,917 53,285 Cigarette taxes 9,967 12,238 22,205 Sales taxes 73,531 8,821 82,352 Interest income Retirement plan contribution 34,294 4,899 39,194 TOTAL NONOPERATING REVENUE 164,167 32, ,043 NET INCOME (LOSS) (29,764) (25,632) (55,396) 14 Page 36 of 95

37 Stroger Hospital Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue 219,565 18, ,378 Other revenue 2, ,546 Total Revenue 221,880 19, ,924 OPERATING EXPENSES: Salaries and wages 171,268 27, ,273 Employee benefits 50,868 7,342 58,210 Supplies 21,141 2,075 23,216 Purchased svs, rental & other 29,509 6,404 35,914 Depreciation 13,880 1,983 15,863 Utilities 3, ,864 Insurance expense 10,768 1,386 12,154 TOTAL OPERATING EXPENSES 300,846 46, ,493 GAIN (LOSS) FROM OPERATIONS (78,967) (27,603) (106,569) NONOPERATING REVENUE: Property taxes 15,644 2,352 17,996 Cigarette taxes 4,061 4,986 9,047 Sales taxes 17,461 2,095 19,556 Interest income Retirement plan contribution 20,936 2,991 23,927 TOTAL NONOPERATING REVENUE 58,109 12,425 70,534 NET INCOME (LOSS) (20,857) (15,178) (36,035) 15 Page 37 of 95

38 ACHN (Clinics) Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue 78,555 9,624 88,179 Other revenue Total Revenue 79,175 9,669 88,844 OPERATING EXPENSES: Salaries and wages 21,372 3,341 24,713 Employee benefits 7,026 1,017 8,043 Supplies 16,545 2,086 18,630 Purchased svs, rental & other 2, ,938 Depreciation Utilities Insurance expense 1, ,481 TOTAL OPERATING EXPENSES 49,555 6,894 56,448 GAIN (LOSS) FROM OPERATIONS 29,620 2,776 32,395 NONOPERATING REVENUE: Property taxes 18,924 2,775 21,699 Cigarette taxes 2,423 2,976 5,399 Sales taxes 19,236 2,308 21,543 Retirement plan contribution 2, ,296 TOTAL NONOPERATING REVENUE 43,467 8,471 51,938 NET INCOME (LOSS) 73,087 11,246 84, Page 38 of 95

39 Oak Forest Health Center Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue 3,738 (360) 3,378 Other revenue Total Revenue 4,006 (313) 3,693 OPERATING EXPENSES: Salaries and wages 11,669 1,708 13,377 Employee benefits 4, ,704 Supplies 1, ,057 Purchased svs, rental & other 1, ,798 Depreciation 1, ,920 Utilities ,093 Insurance expense 1, ,539 TOTAL OPERATING EXPENSES 22,545 2,943 25,488 GAIN (LOSS) FROM OPERATIONS (18,539) (3,255) (21,794) NONOPERATING REVENUE: Property taxes 2, ,346 Cigarette taxes 969 1,190 2,160 Sales taxes 5, ,794 Interest income Retirement plan contribution 1, ,242 TOTAL NONOPERATING REVENUE 11,008 2,535 13,542 NET INCOME (LOSS) (7,531) (721) (8,252) 17 Page 39 of 95

40 Provident Hospital Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue 37,224 (6,782) 30,443 Other revenue Total Revenue 37,346 (6,726) 30,620 OPERATING EXPENSES: Salaries and wages 18,991 2,989 21,980 Employee benefits 5, ,725 Supplies 1, ,423 Purchased svs, rental & other 6, ,364 Depreciation 1, ,642 Utilities Insurance expense 1, ,916 TOTAL OPERATING EXPENSES 36,916 4,980 41,896 GAIN (LOSS) FROM OPERATIONS 431 (11,707) (11,276) NONOPERATING REVENUE: Property taxes 2, ,159 Cigarette taxes 1,246 1,530 2,777 Sales taxes 8,425 1,011 9,435 Interest income Retirement plan contribution 2, ,776 TOTAL NONOPERATING REVENUE 14,832 3,315 18,147 NET INCOME (LOSS) 15,263 (8,391) 6, Page 40 of 95

41 Bureau of Health Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 22,825 3,492 26,317 Employee benefits 7,368 1,034 8,402 Supplies 17, ,244 Purchased svs, rental & other 34,872 4,669 39,541 Depreciation 1, ,179 Utilities Insurance expense 1, ,634 TOTAL OPERATING EXPENSES 86,543 10,416 96,960 GAIN (LOSS) FROM OPERATIONS (86,543) (10,416) (96,960) NONOPERATING REVENUE: Property taxes 1, ,854 Cigarette taxes Sales taxes 1, ,873 Retirement plan contribution 2, ,201 TOTAL NONOPERATING REVENUE 6,326 1,128 7,454 NET INCOME (LOSS) (80,217) (9,289) (89,506) 19 Page 41 of 95

42 Dept of Public Health Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue 0 0 Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 7, ,191 Employee benefits 2, ,369 Supplies Purchased svs, rental & other Depreciation Utilities Insurance expense TOTAL OPERATING EXPENSES 10,635 1,476 12,111 GAIN (LOSS) FROM OPERATIONS (10,107) (1,352) (11,460) NONOPERATING REVENUE: Property taxes 4, ,229 Cigarette taxes 1,031 1,266 2,297 Sales taxes 7, ,923 Retirement plan contribution TOTAL NONOPERATING REVENUE 13,450 2,910 16,359 NET INCOME (LOSS) 3,342 1,557 4, Page 42 of 95

43 Cermak Comparative Income Statement of General Funds (Unaudited) (In Thousands) Year to Date July 31, 2012 June 30, 2012 Inc (Dec) July 31, 2012 REVENUE: Net patient service revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 21,004 3,372 24,375 Employee benefits 6, ,852 Supplies 449 2,332 2,781 Depreciation Insurance expense 1, ,628 TOTAL OPERATING EXPENSES 29,828 6,950 36,779 GAIN (LOSS) FROM OPERATIONS (29,825) (6,950) (36,776) NONOPERATING REVENUE: Sales taxes 14,489 1,738 16,227 Retirement plan contribution 2, ,841 TOTAL NONOPERATING REVENUE 16,975 2,093 19,068 NET INCOME (LOSS) (12,850) (4,857) (17,707) 21 Page 43 of 95

44 OBJECTIVE: COOK COUNTY HEALTH AND HOSPITALS SYSTEM FINANCIAL STATEMENT DISCLOSURE CHECKLIST Fiscal Year 2012 The object of this checklist is to help determine if the form and contents of the financial statements are in conformity with the accounting standards applicable to financial statement basis of accounting. DISCLOSURE PRINCIPLES: Note: Management can comply with a disclosure principle by making disclosure in body of financial statements or in the notes accompanying the financial statements. In a compilation engagement, management's election to omit substantially all disclosures applies to all disclosure principles in GAAP financial statements. Yes, N/A, No? If no, state reason (immaterial, estimated, etc.) FINANCIAL STATEMENT REFERENCES: 1. Do the financial statements reference footnotes (MD&A) or selected information? Yes GENERAL DISCLOSURES: A. Estimates: 1. General disclosure about use of estimates (MD&A)? Yes 2. Disclosure of possible changes in estimates? Yes B. Vulnerabilities do to concentrations in following areas disclosed?: 1. Customers? Yes 2. Suppliers? Yes 3. Lenders? Yes 4. Products? Yes 5. Supply of materials, labor or supplies? Yes 6. Location of assets in geographic area? Yes C. Related parties (FASB 57): 1. Known common control and economic dependency disclosure? Yes 2. Known transactions with related parties disclosed? Yes OTHER DISCLOSURE AREAS TO BE CONSIDERED: 1. Method of consolidations? Yes 2. Accounting changes including changes in GAAP and in estimates? Yes 3. Business combinations? Yes 4. Discontinues operations? Yes 5. Going concern? Yes COMMENTS: Completed by Reviewed by Date Date 22 Page 44 of 95

45 Cook County Health and Hospitals System Financial Operations and Statistical Reports (Non GAAP) For the Month Ended July 31, Page 45 of 95

46 Index Page 1. Actual vs. Budget Cash Receipts Actual vs. Budget Expenses per Adjusted Patient Days Payer Mix Utilization Factors Case Mix Page 46 of 95

47 Cash Report as of 7/31/2012 Cumulative Cash Report as of 7/31/2012 ***Final Cash Report *** For the Month July-2012 Cumulative Cash Summary Through July-2012 Actual Budget Variance Actual Budget Variance SHCC SHCC Medicare $ 9,799,326 $ 4,744,794 $ 5,054,532 Medicare $ 42,480,486 $ 37,346,120 $ 5,134,366 Medicaid 10,156,127 14,955,870 (4,799,743) Medicaid 78,399, ,124,896 (48,725,419) Other 2,498,605 3,048,915 (550,310) Other 12,838,278 23,997,915 (11,159,637) Physician Billing 666,586 1,407,200 (740,614) Physician Billing 2,765,597 7,317,440 (4,551,843) Medicaid UPL Adjustment - 1,850,746 (1,850,746) Medicaid UPL Adjustment - 12,716,417 (12,716,417) Medicaid Retroactive Payment Medicaid Retroactive Payment 39,632,769 10,000,000 29,632,769 Vendor Payments From Revenue Vendor Payments From Revenue Pharmacy Billing Pharmacy Billing (845,624) - (845,624) Collection Agency (2,677) - (2,677) Collection Agency (23,227) - (23,227) Revenue Enhancement Revenue Enhancement (432,633) - (432,633) Physician Billing Physician Billing (14,923) - (14,923) Physician Contract Payments Physician Contract Payments 145, ,640 Physician Contract Revenues 7,540-7,540 Physician Contract Revenues 485, ,553 Totals $ 23,125,507 $ 26,007,525 $ (2,882,018) Totals $ 175,431,393 $ 218,502,788 $ (43,071,395) Actual Budget Variance Actual Budget Variance PHCC PHCC Medicare $ 151,231 $ 396,442 $ (245,211) Medicare $ 1,798,394 $ 3,120,383 $ (1,321,989) Medicaid 437, ,028 (453,995) Medicaid 3,267,913 7,573,738 (4,305,825) Other 62, ,996 (214,199) Other 734,558 2,180,227 (1,445,669) Physician Billing 64, ,800 (221,176) Physician Billing 320,893 1,486,160 (1,165,267) Medicaid UPL Adjustment Medicaid UPL Adjustment Medicaid Retroactive Payment Medicaid Retroactive Payment 4,396,528-4,396,528 Vendor Payments From Revenue - Vendor Payments From Revenue Pharmacy Billing Pharmacy Billing (21,612) - (21,612) Collection Agency Collection Agency (104,023) - (104,023) Revenue Enhancement Revenue Enhancement Physician Billing Physician Billing Physician Contract Payments Physician Contract Payments Physician Contract Revenues Physician Contract Revenues Totals $ 715,685 $ 1,850,266 $ (1,134,581) Totals $ 10,392,652 $ 14,360,508 $ (3,967,856) Actual Budget Variance Actual Budget Variance OFHC OFHC Medicare $ (53,091) $ 63,179 $ (116,270) Medicare $ 7,118 $ 497,280 $ (490,162) Medicaid 200, ,858 (311,873) Medicaid 2,192,124 4,359,294 (2,167,170) Other 21, ,646 (119,804) Other 460,164 1,114,888 (654,724) Physician Billing 32, ,000 (74,443) Physician Billing 118, ,400 (437,571) Medicaid UPL Adjustment Medicaid UPL Adjustment Medicaid Retroactive Payment Medicaid Retroactive Payment 2,906,137-2,906,137 Vendor Payments From Revenue Vendor Payments From Revenue Pharmacy Billing Pharmacy Billing (3,908) - (3,908) Collection Agency Collection Agency Revenue Enhancement Revenue Enhancement Physician Billing Physician Billing Physician Contract Payments Physician Contract Payments Physician Contract Revenues Physician Contract Revenues Totals $ 202,293 $ 824,683 $ (622,390) Totals $ 5,680,464 $ 6,527,862 $ (847,398) Actual Budget Variance Actual Budget Variance SYSTEM SYSTEM Medicare 9,897,466 $ 5,204,415 $ 4,693,051 Medicare $ 44,285,998 $ 40,963,783 $ 3,322,215 Medicaid 10,794,145 16,359,756 (5,565,611) Medicaid 83,859, ,057,928 (55,198,414) Other 2,583,244 3,467,557 (884,313) Other 14,033,000 27,293,030 (13,260,030) Physician Billing 763,767 1,800,000 (1,036,233) Physician Billing 3,205,320 9,360,000 (6,154,680) Medicaid UPL Adjustment - 1,850,746 (1,850,746) Medicaid UPL Adjustment - 12,716,417 (12,716,417) Medicaid Retroactive Payment Medicaid Retroactive Payment 46,935,434 10,000,000 36,935,434 Vendor Payments From Revenue Vendor Payments From Revenue Pharmacy Billing Pharmacy Billing (871,144) - (871,144) Collection Agency (2,677) - (2,677) Collection Agency (127,250) - (127,250) Revenue Enhancement Revenue Enhancement (432,633) - (432,633) Physician Billing Physician Billing (14,923) - (14,923) Physician Contract Payments Physician Contract Payments 145, ,640 Physician Contract Revenues 7,540-7,540 Physician Contract Revenues 485, ,553 Meaningful Use Meaningful Use 3,893,227-3,893,227 DSH 12,567,309 11,666, ,642 DSH 100,538,471 93,333,336 7,205,135 Retro-Active DSH Retro-Active DSH 15,000,000-15,000,000 BIPA BIPA - - Medicaid Malpractice Retro Medicaid Malpractice Retro Totals $ 36,610,794 $ 40,349,141 $ (3,738,347) Totals $ 310,936,206 $ 332,724,494 (21,788,288) OFHC had negative Medicare revenue for the month due to a Medicare RAC audit. The Medicaid fee-for-service revenue through the IGT covers the period beginning week ended 06/20/ /11/2012. Vendor Payments From Revenue are payments out of revenue posted by the County Comptroller. Pharmacy Billing and Revenue Enhancement payments are reductions to Medicaid revenue. Collection Agency payments are reductions to Self-Pay (Other) revenue. Physician Billing payments include refunds processed by CCHHS. Included in the "Revenue Enhancement" total is a payment to the state for supplemental workers hired to help clear the Medicaid backlog. The Upper Payment Limit Revision is spread over 11 months, beginning Jan-2012, as it is not known in which month this payment will be received. The "Medicaid Retroactive Payment" was budgeted all at SHCC. Please see the notes re: the FY2012 budget, located on the final budget tab. Page 47 of 95 3 Cash Sum Final

48 CCHHS Cumulative Net Patient Fee Cash Receipts Through July-2012 Medicaid $82,555,737 59% Medicare $44,285,998 31% Page 48 of 95 Commercial Self-Pay $8,527,853 $5,377,897 6% 4% - The receipts on this graph are net of any payments out of revenue. 4

49 CCHHS All Net Cash Receipts Cumulative Total Through July-2012 Meaninful Use $3,893,227 1% Medicaid Retro- Active Payment $46,935,434 15% DSH $100,538,471 32% Retro-Active DSH $15,000,000 5% Medicare $44,285,998 14% Medicaid $82,555,737 27% Self-Pay $5,377,897 2% Commercial $8,527,853 3% Page 49 of 95 - The receipts on this graph are net of any payments out of revenue. 5

50 Cook County Health Facilities System Expenses per Adjusted Patient Days Budget and Actual (Non-GAAP Budget Basis) With Temporary Budget Numbers As of July 31, 2012 Institution Actual Budget Variance Stroger $ 3,340 $ 3, % Provident $ 3,503 $ 3, % 6 Page 50 of 95

51 CCHHS IP, OP, And Combined Payer Mix For July-2012 (Based Upon Charges) Assumes 30% Of Accounts Accepted By Vendor Successfully Converted To Medicaid 9.8% 38.9% 2.5% 3.2% 30.3% 12.6% 1.8% 0.7% 0.1% 0.5% 9.4% 18.2% 1.0% 1.9% 37.6% % 0.7% 0.7% 0.1% 9.6% 27.3% 1.7% 2.5% 34.4% 22.4% 1.2% 0.3% 0.7% 0.1% Medicare Medicaid Medicaid- Pending Commercial Self-Pay Charity Cermak Public Health In-Patient Out-Patient Combined Institutional Page 51 of 95 - The data in this graph is based upon charges. - Other includes Grants, Risk Management, and Workman's Compensation % Other

52 Cumlative CCHHS IP, OP, And Combined Payer Mix Through July-2012 (Based Upon Charges) Assumes 30% Of Accounts Accepted By Eligibility Vendor Successfully Converted To Medicaid 11.0% 42.6% 0.3% 3.1% 30.8% 10.7% 0.9% 0.4% 0.2% 0.4% 0..8% % 8.7% 19.6% 2.7% 37.6% 0.6% 0.5% 0.1% 9.7% 29.2% 0.6% 2.9% 34.8% 21.3% 0.7% 0.2% 0.5% 0.1% Medicare Medicaid Medicaid- Pending Commercial Self-Pay Charity Cermak Public Health In-Patient Out-Patient Combined Institutional Page 52 of 95 - The data in this graph is based upon charges. - Other includes Grants, Risk Management, and Workman's Compensation % Other

53 IP And OP Cumulative Combined Payer Mix Comparison (Based Upon Charges) Cook County Health And Hospitals System Prior 13 Months Ending July-2012 Assumes 30% of Accounts Accepted By Eligibility Vendor Successfully Converted To Medicaid 100% 90% 80% 70% 60.0% 58.8% 58.2% 57.9% 57.6% 56.6% 56.3% 56.1% 58.1% 56.5% 57.1% 57.4% 57.6% 60% 50% 40% 3.2% 3.1% 3.1% 3.1% 3.2% 2.9% 3.1% 3.3% 3.4% 3.0% 3.0% 3.0% 2.9% 30% 20% 26.3% 27.7% 28.3% 28.6% 28.8% 31.1% 30.0% 30.0% 28.0% 29.6% 30.2% 29.9% 29.8% 10% 0% 10.4% 10.3% 10.4% 10.4% 10.4% 9.3% 10.6% 10.6% 10.5% 10.8% 9.7% 9.7% 9.7% Medicare Medicaid Commercial Self-Pay Page 53 of 95 9

54 CCHHS Utilization Factors Assumes 30% of Accounts Accepted by Eligibility Vendor Successfully Converted to Medicaid July-2012 Stroger Hospital Admissions Provident Hospital Oak Forest Specialty Health Center System Total Payer Type Actual Budget Variance Actual Budget Variance Actual Budget Variance Actual Budget Variance Medicare (78) (5) (83) Medicaid (374) (32) (406) Medicaid-Pending Commercial (15) 3 4 (1) (16) Self-Pay 1, (17) , Charity Cermak Grants Institutional Public Health Workmens' Compensation Total Admissions 2,003 2,009 (6) (31) ,143 2,180 (37) Stroger Hospital Patient Days Provident Hospital Oak Forest Specialty Health Center System Total Payer Type Actual Budget Variance Actual Budget Variance Actual Budget Variance Actual Budget Variance Medicare 833 1,084 (251) (75) ,229 (326) Medicaid 2,383 4,111 (1,728) (135) ,473 4,336 (1,863) Medicaid-Pending 1,037-1, ,059-1,059 Commercial (69) 7 24 (17) (86) Self-Pay 4,394 4, (75) ,623 4, Charity Cermak Grants Institutional Public Health Workmens' Compensation Total Patient Days 9,523 9,804 (281) (210) ,011 10,502 (491) Stroger Hospital Adjusted Patient Days Provident Hospital Oak Forest Specialty Health Center System Total Payer Type Actual Budget Variance Actual Budget Variance Actual Budget Variance Actual Budget Variance Medicare 1,901 2,118 (217) (189) ,208 2,614 (406) Medicaid 5,519 8,033 (2,514) (336) ,953 8,803 (2,850) Medicaid-Pending 2,366-2, ,463-2,463 Commercial (43) (51) (94) Self-Pay 10,027 8,323 1,704 1,005 1,041 (36) ,032 9,364 1,668 Charity ,286-1,286 Cermak Grants Institutional Public Health Workmens' Compensation Total Adjusted Patient Days 21,812 19,158 2,654 2,181 2,389 (208) ,993 21,547 2,446 Stroger Hospital Average Length of Stay Provident Hospital Oak Forest Specialty Health Center - Acute Oak Forest Specialty Health Center - Rehabilitation Payer Type Actual Budget Variance Actual Budget Variance Actual Budget Variance Actual Budget Variance Medicare (0.9) Medicaid (0.1) Medicaid-Pending Commercial (2.0) Self-Pay (0.4) (0.7) Charity (1.5) (0.1) Grants Cermak (1.2) Institutional (1.0) Public Health Workmens' Compensation Overall Average LOS (0.4) (0.7) The primary insurance has been used to determine "Payer Type". Page 54 of 95 -"Medicaid-Pending" assumes 30% of the Self-Pay accounts accepted by the eligibility vendor will be successfully converted to Medicaid accounts. 10