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18 AMBULANCE REVENUE and COST REPORT FIRE DISTRICT and SMALL RURAL COMPANY Arizona Department of Health Services Annual Ambulance Financial Report Healthcare Innovations, Inc Reporting Ambulance Service Address: 440 S. Ocotillo City: Benson Zip: Report Fiscal Year From: January 1, 2011 To: Day Year Mo. December 31, 2011 Day / herebyverify thatihave directedthe preparation of the enclosed annual report in accordance with the reporting requirements ofthe State ofarizona. Ihave readthisreport andhereby verify that the information provided is true and correct to the best of my knowledge. This reporthas been prepared using the accrual basis of accounting. Authorized Signature: Print Name and Title: foanji-^ Dale: i/" 2,V -%> 11. James W. Broome, President Phone: Mail to: Arizona Department of Health Services Bureau of Emergency Medical Services Certificate of Necessity and Rates Section 150 North 18th Avenue, Suite 540 Phoenix, AZ Telephone: (602) Fax: (602) /22/04 Pagel MAY BEMSTS -CON &RATES TMFMD33.18

19 AMBULANCE REVENUE AND COST REPORT FIRE DISTRICT and SMALL RURAL COMPANY AMBULANCE SERVICE ENTITY: Healthcare Innovations, Inc FOR THE PERIOD FROM: January TO: December 31, 2011 STATISTICAL SUPPORT DATA (1) SUBSCRIPTION *(2) (3) TRANSPORTS TRANSPORTS (4) Line SERVICE TRANSPORTS UNDER CONTRACT NOT UNDER CONTRACT TOTALS No. DESCRIPTION 1 Number of ALS BillableTransports: 2,351 2,351 2 Number of BLS Billable Transports: Numberof LoadedBillable Miles: 4 Waiting Time (Hrs): 86, Canceled (Non-Billable) Runs: 1,025 AMBULANCE SERVICE ROUTINE OPERATING REVENUE 6 ALS Base Rate Revenue 3,151,495 7 BLS Base Rate Revenue 539,927 8 Mileage Charge Revenue 1,278,970 9 Waiting Charge Revenue 1, Medical Supplies Charge Revenue 80, Nurses Charge Revenue 12 Standby Charge Revenue 42, TOTAL AMBULANCE SERVICE ROUTINE OPERATING REVENUE (Post to Page 3, Line 1) $ 5,095,014 SALARY AND WAGE EXPENSE DETAIL GROSS WAGES: No. of FTEs 14 Management and Officers/Owners 512, Paramedics and lemts Emergency Medical Technician (EMT) 341, Other Personnel 34, Payroll Taxes and Fringe Benefits - All Personnel Total Wages, Taxes & Benefits (Sum Lines 14 through 18; Post to Page 3, Line 10) $ This column reportsonlythose runswhere a contracteddiscountratewas applied. Full-time equivalents (F.T.E.) is the sum of allhoursfor whichemployeeswages were paid during the yeardivided by Page 2 MAY 11 20'2 BEMSTS-CON TMFMD33.19 &RATE:

20 AMBULANCE REVENUE AND COST REPORT FIRE DISTRICT and SMALL RURAL COMPANY AMBULANCE SERVICE ENTITY: Healthcare Innovations, Inc FOR THE PERIOD FROM: January TO: December SCHEDULE OF REVENUES AND EXPENSES Line No, DESCRIPTION Operating Revenues: 1 Total Ambulance Service Operating Revenue (From: Page 2. Line13) $ 5.095,014 Settlement Amounts: 2 AHCCCS 364,101 3 Medicare 1,495, Subscription Service Contractual 6 Other (Champus/Private Insurance) Total (Sum oflines 2 through 6) T 8 Total Operating Revenue (Line 1 minus Line 7) $ 3,097,019 Operating Expenses: 9 BadDebt $ 493, Total Salaries, Wages, and Employee-Related Expenses (From: Page 2, Line 19) 1.785, Professional Services 66, Traveland Entertainment 27,5T3~ 13 Other General Administrative 106, Depreciation 145, Rent/Leasing 9, Building / Station 38, Vehicle Expense 138, Other Operating Expense 33, Cost of MedicalSupplies Charged to Patients 47, Interest 71, Subscription Service Sales Expense 0~ 22 TotalOperating Expense (Sum oflines 9 through 21) 2,965, TotalOperating Incomeor (Loss) (Line 8 minus Line 22) $ 131, Subscription Contract Sales 0 25 Other Operating Revenue 0~ 26 Local Supportive Funding 0~ 27 Other Non-Operating Income (Schedule Attached) 39, Other Non-Operating Expense (Schedule Attached) ~Q~ 29 NET INCOME or (LOSS) Before Income Taxes (Sum of Lines 23 through27, minus Line 28) $ 171,557 Provision for Income Taxes: 30 Federal Income Tax 56, State Income Tax 8, Total Income Tax (Line 30, plus Line 31) $ 65^192~ 33 Ambulance Service Net Income (Loss) (Line 29. minus Une 32) $ 106,365 Page 3 MTtBXKk MAY BEMSTS TMFMD CON &RATE!

21 Healthcare Innovations, Inc January 1, 2011 to December 31, 2011 Other Non-Operating Income Schedule Management Fees Rent Medical Records Interest Income Gain (Loss) on Sale of Property Miscellaneous $18,000 16, (11,486) 15,430 Total $39,743 Healthcare Innovations, Inc January 1, 2011 to December 31, 2011 Other Non-Operating Expense Schedule Total $0 MAY BEMSTS - CON &RATES TMFMD33.21

22 AMBULANCE REVENUE AND COST REPORT FIRE DISTRICT and SMALL RURAL COMPANY AMBULANCE SERVICE ENTITY: Healthcare Innovations, Inc AT: December 31, 2011 BALANCE SHEET ASSETS CURRENT ASSETS 1 Cash and Cash Equivalents $ Accounts Receivable Less: Allowance for Doubtful Accounts (261,040) 4 Inventory 5 Prepaid Expenses 15,124 6 Other Current Assets 7,141 7 TOTAL CURRENT ASSETS $ 486,912 9 PROPERTY & EQUIPMENT 1, Less: Accumulated Depreciation (476,265) 11 OTHER NON CURRENT ASSETS 77, TOTAL ASSETS $ LIABILITIES & EQUITY CURRENT LIABILITIES 13 Accounts Payable $ 1, Current Portion of Notes Payable 114, Current Portion of Long-Term Debt Deferred Subscription Income 17 Accrued Expensesand Other 92, Other CurrentLiabilities TOTAL CURRENT LIABILITIES $ 217, NOTES PAYABLE $ 817, LONG-TERM DEBT, OTHER 23 TOTAL LONG-TERM DEBT $ 817, EQUITY & OTHER CREDITS Paid-in Capital: Common Stock $ Paid-in Capital in Excess of Par Value Contributed Capital Retained Earnings 519,707 Treasury Stock (58,000) Fund Balance TOTAL EQUITY $ 586, TOTAL LIABILITIES & EQUITY $ 1.622,300 Page 4 MAY BEMSTS-CON &RATES TMFMD33.22

23 AMBULANCE REVENUE AND COST REPORT AMBULANCE SERVICE ENTITY: FOR THE PERIOD FROM: January Healthcare Innovations, Inc TO: December 31, 2011 STATEMENT OF CASH FLOWS OPERATING ACTIVITIES: Income (Loss) Before Income Taxes Adjustments to Reconcile Net Income to Net Cash Provided by Operating Activities: Note: an increase in these accounts improves cash flow Depreciation Expense Deferred Income Tax Loss (gain) on Disposal of Property & Equipment (Increase) Decrease in: Accounts Receivable Inventories and Other Current Assets Prepaid Expenses Note: a decrease in these accounts improves cash flow $ 171, ,876 11,486 (3.819) Increase (Decrease) in: Accounts Payable Accrued Expenses Deferred Subscription Income Note: an increase in these accounts improves cash flow (5,933) NET CASH PROVIDED (Used) BY OPERATING ACTIVITIES $ INVESTING ACTIVITIES: Purchases of Property & Equipment (est.) Proceeds from Disposal of Property & Equipment Purchases of Investments Proceeds from Disposal of Investments Loans Made Collection on Loan Other (72.274) 19 NET CASH PROVIDED (Used) BY INVESTING ACTIVITIES $ (72.274) FINANCING ACTIVITIES: New Borrowings: 20 Long-Term 21 Short-Term Debt Reduction: 22 Long-Term and Short-Term (est.) 23 Short-Term ( ) 24 Capital Contributions 25 Purchase of Treasury Stock 26 NET CASH PROVIDED (Used) BY FINANCING ACTIVITIES 27 NET INCREASE (Decrease) IN CASH 28 CASH AT BEGINNING OF YEAR 29 CASH AT END OF YEAR SUPPLEMENTAL DISCLOSURES: Non-cash Investing and Financing Transactions: Interest Paid (Net of Amounts Capitalized) 34 Income Taxes Paid CEIVE MAY $ ( ) $ $ $ 104,164 fare* fp^i i i Jr SaLlufl HUBBI*^ $ $ PageS BEMSTS - CON &RATES TMFMD33.23

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