Kit Carson County Health Service District Rooted in excellence. Growing in trust.

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1 Rooted in excellence. Growing in trust. FINANCIAL STATEMENT SUMMARY Income Statement Summary Kit Carson County Health Service District (KCCHSD) had a net loss of $4,041 for the month and a net profit of $463,835 YTD. KCCHSD had YTD budgeted income of $30,413. The budget is set up in to twelve equal months rather than volume based. The District should expect to see revenue decline in correlation to volume decline throughout the coming months. KCCHSD s Net Operating Income was a loss of $5,236 for the month and a profit of $449,937 YTD. YTD Budgeted Net Operating Income was $131,217. Revenue: Gross Patient Revenue was $2,109,608 for the month and $13,417,333 YTD compared to the budget of $2,034,730 and $12,208,377. Again, the District will continue to see volume decreases that will cause decreased revenue in the coming months. Net Patient revenue was $1,234,458 for the month and $7,967,250 YTD compared to the budget of $1,377,081 and $7,952,586. The District continues reviewing contractual and doubtful account allowances calculations quarterly to ensure accuracy throughout the year. Additional allowance has been accrued to aid in the offset of the imminent Medicaid write-offs and overall AR clean-up. Expense: Operating Expense Less Depreciation at $1,150,589 was under budget for the month by $34,042. YTD Operating expense less depreciation was under budget by $128,553. Non-Operating Income (Expense): Non-Operating Income was $1,195 compared to the budget expense of $16,801. YTD the income is $13,898. Kit Carson County Health Service District th Street Burlington, CO Phone

2 Rooted in excellence. Growing in trust. Notes District is under budget YTD on all categories with the exception of Purchased Service and Education. o Purchased services is over budget by $129,870 26% over budget Imaging budget is not sufficient for the current purchased maintenance Home Health and Hospice is utilizing their EMR vendor for billing recovery this cost was not factored in the budget Transcription services were not factored in the budget Nursing MCG subscription was not factored in the budget o Education is over budget by $2,260 9%. Education expense will be analyzed and brought to the board meeting in August for review. Other expense was over budget in June but remains under budget YTD. The district incurred extraordinary expenses related to prior obligations in June. Professional fees are over budget by $34,041 for the month and over budget YTD. The main contributor to June is the increase in ED coverage costs. The District needs to be mindful that the Provider Fee payment received monthly will decline beginning in July by $18,284 per month leaving a total deficit for the remainder of the year at $91,420. The payment is subject to change again in August so the total deficit figure is based on the payment beginning in July and could vary. Medicaid inpatient reimbursement will decline per a CDHPE and Medicaid announcement. Once CMS approves this change, all claims beginning July 1, 2018 will be adjusted to reflect the new rate. The reduction will be $ per day. Kit Carson County Health Service District th Street Burlington, CO Phone

3 Rooted in excellence. Growing in trust. Days Cash on Hand KCCHSD Days Cash on Hand is 152 in June compared to 148 as of May. The District currently continues to see an increase. KCCHSD s Bond Covenants require 60 Days Cash. Note: Days Cash on Hand is calculated on a YTD basis consistent with the bond covenant calculation. Gross Days in AR Gross Days in AR for the District in June were 94.6 compared to 96.4 as of May and as of December The District has increased full time staff and added per diem temporary staff to help reduce aging, limit write offs, and clean up AR report. The AR balance continues to decline. Note: Gross Days in AR are calculated using a 6 month average for daily revenue Kit Carson County Health Service District th Street Burlington, CO Phone

4 Rooted in excellence. Growing in trust. Volume Inpatient volume decreased in June from May. June volume is much lower than the same month in previous years. Outpatient volume for June saw a decrease from May. The month volume is comparative to prior years. Kit Carson County Health Service District th Street Burlington, CO Phone

5 Rooted in excellence. Growing in trust. Debt Service Ratio Debt Service Ratio for June is at 2.17 which is a decrease from May at The bond covenant requires the district to have a debt service ratio of Debt Service Coverage Ratio Net Income 463,835 Interest exp 362,255 Dep Exp 557,228 Revenue Available for Debt Service 1,383,317 MRI 60,774 CT 48,690 Bonds 529,450 Annual Debt Service 638,914 Debt Service Coverage Ratio 2.17 **YTD Figures in accordance with bond convenants Kit Carson County Health Service District th Street Burlington, CO Phone

6 Financial Statements for

7 KIT CARSON COUNTY HEALTH SERVICE DISTRICT STATEMENT OF CHANGES IN CASH FLOW Year-to-Date Beginning Cash 4,750,083 Income From Operations: Net Operating Income (Loss) $449,937 Noncash Expenses and Revenues Included in Income: Depreciation 557,228 Changes in Operating Assets and Liabilities: Patient Receivables (15,574) Cost Report and Settlements 475,755 Inventories (11,544) Prepaid Expenses 35,550 Other Receivables 0 Accounts Payable and Accrued Expense (849,341) Nonoperating Revenues, Net 364,078 Cash Flows from Investing Activities: Investment Income 12,075 Change in Restricted Funds (3,125) Cash Flows from Financing Activities: Property Tax Receivable 496,447 Interest Expense (362,255) Change in Long Term Debt 0 Change in Fixed Assets (225,682) Change in Restricted Cash 187,157 Ending Cash $5,860,790

8 KIT CARSON COUNTY HEALTH SERVICE DISTRICT COMPARATIVE BALANCE SHEET Increase/ UNRESTRICTED FUNDS - ASSETS: 6/30/ /31/2017 (Decrease) CURRENT ASSETS: Cash: $ 5,860,790 $ 4,750,083 $ 1,110,706 Receivables: Patient $ 7,370,472 $ 6,284,250 1,086,222 Less: Allowances for Bad Debts $ (2,136,173) $ (1,763,566) (372,608) Less: Contractual Allowances $ (3,131,135) $ (2,433,094) (698,041) Net Patient Receivables 2,103,164 2,087,590 15,574 Medicare / Medicaid / Cost Report $ 190,049 $ 665,805 (475,755) Property Tax Receivable $ 83,262 $ 579,709 (496,447) Other Receivables $ 29,372 $ 29,372 - Total Receivables 2,405,848 3,362,476 (956,628) Other Current Assets: Inventories $ 473,245 $ 461,700 11,544 Prepaid Expense $ 177,539 $ 213,088 (35,550) Total Other Current Assets 650, ,789 (24,005) Total Current Assets 8,917,421 4,037, ,073 OTHER ASSETS: Property, Plant and Equipment $ 23,298,387 $ 23,072, ,682 Less: Accumulated Depreciation $ (16,160,482) $ (15,603,254) (557,228) Net Property Plant and Equipment 7,137,905 7,469,452 (331,546) Bond Funds $ 1,644,390 $ 1,831,547 (187,157) Restricted Fund Assets $ 1,016,951 $ 1,013,826 3,125 Total Other Assets 9,799,246 10,314,825 (515,579) TOTAL ASSETS $ 18,716,667 $ 19,102,173 $ (385,506)

9 KIT CARSON COUNTY HEALTH SERVICE DISTRICT COMPARATIVE BALANCE SHEET Increase/ LIABILITIES AND FUND BALANCE: 6/30/ /31/2017 (Decrease) CURRENT LIABILITIES: Accounts Payable and Accrued Expenses $ 598,600 $ 611,994 $ (13,394) Leases Payable - Current 109, ,561 (89,093) Bonds Payable - current - 360,000 (360,000) Vacation Payable 182, ,804 (28,859) Salary & Salary Deductions Payable 134, ,825 (52,881) Interest Payable 352, ,163 (12,150) Deferred Income County Tax 292, ,926 (292,963) Medicare / Medicaid / Cost Report Total Current Liabilities 1,670,932 2,520,271 (849,341) LONG TERM LIABILITIES: Leases 318, ,432 0 Bonds Payable 10,430,000 10,430,000 0 Total Long Term Debt 10,748,432 10,748,432 0 Total Liabilities 12,419,363 13,268,702 (849,341) FUND BALANCE: Operating Fund 5,833,469 8,086,309 (2,252,840) Revenues over Expenses 463,835 (2,252,840) 2,716,675 Total Fund Balance 6,297,304 5,833, ,835 TOTAL LIABILITIES AND FUND BALANCE $ 18,716,667 $ 19,102,173 $ (385,506)

10 KIT CARSON COUNTY HEALTH SERVICE DISTRICT COMBINED INCOME STATEMENT Month YTD Actual Budget Actual OPERATING REVENUE: Actual Budget Actual $ 2,109,608 $ 2,034,730 1,776,002 Patient Revenue, Gross $ 13,417,333 12,208,377 $ 11,082,271 $ (852,664) $ (657,648) (538,313) Less: Contractual Adjustments $ (4,953,872) (3,945,889) $ (3,518,989) 1,256,944 1,377,081 1,237,689 Patient Revenue, Net of Contractual Adjustments 8,463,460 8,262,488 7,563,282 $ (22,485) $ (51,650) (89,017) Less: Provision for Uncollectable Accounts $ (496,211) (309,902) $ (281,730) 1,234,458 1,325,431 1,148,672 Patient Revenue, Net 7,967,250 7,952,586 7,281,553 $ 3,809 $ 3,103 3,120 Other Operating Revenue $ 19,146 18,618 $ 23,423 1,238,268 1,328,534 1,151,792 NET OPERATING REVENUE 7,986,396 7,971,204 7,304,976 59% 65% 65% 59% 65% 66% OPERATING EXPENSE: $ 708,212 $ 757, ,614 Salary and Benefits $ 4,488,197 4,544,054 $ 4,872,229 $ 91,290 $ 117, ,612 Supplies, Drugs and Food $ 597, ,169 $ 716,545 $ 109,078 $ 75, ,095 Professional Fees $ 477, ,224 $ 493,348 $ 115,316 $ 84,272 86,480 Purchased Service $ 635, ,631 $ 511,648 $ 2,711 $ 9,746 14,606 Repair and Maintenance $ 23,254 58,476 $ 63,267 $ 11,438 $ 12,282 19,671 Insurance $ 68,630 73,692 $ 73,051 $ 18,763 $ 26,628 26,535 Utilities $ 147, ,768 $ 157,137 $ 1,304 $ 4,236 21,820 Travel and Education $ 27,678 25,418 $ 88,140 $ 11,539 $ 14,731 20,645 Lease $ 81,861 88,388 $ 88,866 $ 5,805 $ 9,488 7,753 Dues, Books and Subscriptions $ 41,425 56,928 $ 50,471 $ 440 $ 1,493 3,308 Advertising $ 3,142 8,959 $ 8,959 $ 74,692 $ 71,680 63,302 Other $ 387, ,078 $ 440,834 1,150,589 1,184,631 1,384,441 Total Operating Expense Less Depreciation 6,979,231 7,107,784 7,564,496 87, ,903 (232,650) EBIDA 1,007, ,420 (259,521) $ 92,915 $ 122, ,248 Depreciation $ 557, ,202 $ 732,202 (5,236) 21,870 (354,898) NET OPERATING INCOME 449, ,217 (991,723) NON-OPERATING INCOME (EXPENSE) $ (60,403) $ (63,443) (63,859) Interest (Expense) $ (362,255) (380,660) $ (380,660) $ 1,922 $ 1,340 2,742 Interest Income $ 12,075 8,040 $ 8,040 $ 48,827 $ 40,080 40,080 Tax Revenue $ 292, ,481 $ 240,481 $ 35 $ 110 4,202 Donations and Grants $ 3, $ 277 $ 10,813 $ 5,112 5,661 Other Non-Operating Income/(Loss) $ 67,411 30,673 $ 30,673 1,195 (16,801) (11,174) Total 13,898 (100,805) (101,190) $ (4,041) $ 5,069 (366,072) NET INCOME $ 463,835 30,413 $ (1,092,913)