Clark Memorial Hospital

Transcription

1 Clark Memorial Hospital Jeffersonville, Indiana (Unaudited) Financial Statements December, 2012

2 Table of Contents Financial Statements Page # a. Statistical Report b. Inpatient Utilization By Payor 7 c. Outpatient Utilization by Payor 8 d. Balance Sheet 9 e. Schedule of Revenues and Expenses 10 f. Schedule of Net Patient Service Revenue 11 g. Statement of Changes in Fund Balance 13 h. Statement of Cash Flows 14 i. Accounts Receivable Aging Analysis 16

3 STATISTICAL REPORT YEAR TO DATE DECEMBER 2012 % Change Same % Change Favorable Actuall Period This Yearl Actual Budget (Unfavorable) Budget Last Year Last Year ACUTE CARE: Patient Days YTD 51,788 57,465 (5,677) (10) 55,864 (7) Month 4,394 4,873 (479) (10) 4,394 Discharges YTD 13,869 14,735 (866) (6) 13,994 (1 ) Month 1,119 1,249 (130) (10) 1,156 (3) ALOS YTD (5) 4.0 (8) Month % of Occupancy YTD (7.5) (10) 74.3 (8) Month (7.5) (10) 68.8 Average Daily Census YTD (15.5) (10) (8) Month (15.5) (10) BEHAVIORAL MEDICINE: Patient Days YTD 3,883 3, , Month (17) (5) Discharges YTD (60) (14) Month (15) (37) 31 (16) ALOS YTD (0.5) Month (1.7) % of Occupancy YTD Month (2.7) (5) Average Daily Census YTD Month (0.6) (6)

4 STATISTICAL REPORT YEAR TO DATE DECEMBER 2012 % Change Same % Change Favorable Actual! Period This Yearl Actual Budget (Unfavorable} Budget last Year Last Year NURSERY: Patient Oays YTO 3,435 3,673 (238) (6) 3,522 (2) Month (51 ) (16) 286 (9) Oischarges YTO 1,546 1,670 (124) (7) 1,587 (3) Month (27) (19) 135 (15) Births YTO 1,535 1,621 (86) (5) 1,561 (2) Month (22) (16) 125 (8) ALOS YTO Month (0.1 ) % of Occupancy YTO (4.3) (6) 64.3 (3) Month (11.0) (16) 61.5 (9) Average Oaily Census YTO (0.6) (6) 9.6 (2) Month (1.7) (17) 9.2 (9) - 2-

5 STATISTICAL REPORT YEAR TO DATE DECEMBER 2012 % Change Same % Change Favorable Actual/ Period This Year/ Actual Budget {Unfavorable} Budget last Year Last Year INPATIENT STATISTICS: Emergency Room Visits YTO 7,956 7, , Month laboratory Tests YTO 1,296,547 1,362,347 (65,800) (5) 1,325,055 (2) Month 112, ,529 (961) (1 ) 108,433 4 Radiology Procedures YTO 13,581 14,001 (420) (3) 15,630 (13) Month 1,315 1, , CT Scans YTO 4,292 4, ,518 (5) Month (6) Ultrasound YTO 2,686 2,907 (221) (8) 2,947 (9) Month (28) (11 ) 270 (18) MRI Procedures YTO 1,890 1, , Month (3) Surgery Procedures Main OR YTO 2,324 2,543 (219) (9) 2,451 (5) Month (46) (21 ) 181 (5) Endoscopy YTO 1,565 1, ,478 6 Month (6) Outpatient Surgery Ctr YTO (56) (38) 172 (47) Month 1 12 (11 ) (92) 16 (94) Cardiac Cath YTO 1,149 1, , Month (6) (7) 111 (27) Case Mix Index: AI! Payor Sources YTO Month Medicare YTO Month

6 STATISTICAL REPORT YEAR TO DATE DECEMBER 2012 % Change Same % Change Favorable Actual! Period This Year! Actual Budget {Unfavorable} Budget Last Year Last Year OUTPATIENT STATISTICS: Emergency Room Visits YTD 37,870 38,186 (316) (1) 36,783 3 Month 3,176 3,243 (67) (2) 3,031 5 laboratory Tests YTD 737, ,791 (13,881) (2) 728,339 1 Month 55,602 62,649 (7,047) (11 ) 58,513 (5) Radiology Procedures YTD 39,332 38, ,564 (1 ) Month 3,331 3, ,119 7 Radiology Procedures - HS YTD 6,466 6,467 (1 ) 6,454 Month (20) (4) 534 (1 ) CT Scans YTD 19,502 16,166 3, ,386 1 Month 1,569 1, ,581 (1 ) CT Scans - HS YTD 1,648 2,064 (416) (20) 1,952 (16) Month (51 ) (29) 137 (9) Ultrasound YTD 11,172 11,273 (101 ) (1 ) 11,538 (3) Month (67) (7) 975 (9) Ultrasound - HS YTD 1,554 1,784 (230) (13) 1,759 (12) Month (31 ) (20) 151 (19) MRI Procedures YTD 3,532 3, , Month MRI Procedures - HS YTD 1,181 1,364 (183) (13) 1,319 (10) Month (43) (38) 90 (21 ) Women's Imaging Ctr YTD 14,199 13, ,459 (2) Month 1,269 1, ,311 (3) Women's Imaging Ctr - HS YTD 6,425 6, ,430 Month (14) - 4-

7 STATISTICAL REPORT YEAR TO DATE DECEMBER 2012 % Change Same % Change Favorable Actuall Period This Year! Actual Budget {Unfavorable} Budget Last Year last Year Surgery Procedures Main OR YTD 3,601 3, , Month Endoscopy YTD 1,897 1, , Month Outpatient Surgery Ctr YTD (3) 1,403 (39) Month (27) (33) 118 (53) Lithotripsy YTD Month (4) (10) 40 (10) Pain Management YTD 2,108 1, , Month Observation Bed Days YTD 3,070 3,381 (311 ) (9) 3,385 (9) Month Cardiac Cath YTD (42) (6) 663 (1) Month (23) (38) 52 (29) Adjusted Patient Days YTD 101, ,220 (4,332) (4) 105,980 (4) Month 8,436 9,029 (593) (7) 8,411 Net Charge per Adjusted Pt. Day YTD 1,800 1, , Month 2,241 1, , Expenses per Adjusted Pt Day YTD 1,811 1,673 (138) 8 1,690 7 Month 1,780 1,668 (112) 7 1,651 8 Margin per Adjusted Pt. Day YTD (11 ) (126) (247) 96 Month 461 (120) (156) 396 Net Charge per Discharge YTD 7,029 6, , Month 8,212 5,984 2, , Expense per Discharge YTD 6,357 6,093 (264) 4 6,347 Month 6,013 6, (1 ) 5,

8 STATISTICAL REPORT YEAR TO DATE DECEMBER 2012 % Change Same % Change Favorable Actual! Period This Yearl Actual Budget (U nfavorabie) Budget Last Year Last Year Operating Margin per Oischarge YTO 672 (58) 730 1,259 (729) 192 Month 2,199 (116) 2,315 1,996 (624) 452 Net Income % of Net Revenue YTO (0.57) (5.33) (16.00) 96 Month (6.02) (10.76) 291 Paid FTE's per Adj Occupied Bed YTO (7) 4.10 (5) Month (5) Worked FTE's per Adj Occupied YTO (12) 3.61 (3) Bed Month (7) Personnel ExpenselTotal Operating YTO 36.09% 42.54% 6.45% (15) 36.57% (1) Revenue Month 29.87% 42.00% 12.13% (29) 37.74% (21 ) OT Hours YTO 41,594 38,461 (3,133) 8 45,360 (8) Month 3,787 3,205 (582) 18 2, OT Expense YTO 1,327,757 1,159,200 (168,557) 15 1,335,352 (1 ) Month 122,401 96,600 (25,801 ) 27 88, Agency Expense YTO 123,037 96,752 (26,285) 27 91, Month 4,910 8,079 3,169 (39) 6,341 (23) -6-

9 STATISTICAL REPORT inpatient UTILIZATION BY PAYOR %of Days Month of December %of %of % of % of Dollars ALOS Cases Days Dollars ALOS Year to Date December % of % of % of % of % of % of % of Cases,~~--,D::.ca""Yc.::s_.:::D-",o;.;.:lIa::;.r,,-s...;Ac..:L=.O=-S=--.:::C.::;:as::..;e::.;:s,-- _-=D:..;:a:.<.y,,-s--=D::.;o::;;lI:::a:.,:rsc--:-A.:::L:.::O:..::S,---,C::..;a::.:s:.:::e=--.s Acute Inpatient: Medicare ", Medicaid Total Government ,; Blue Cross Commercial :d, ); Humana Total Managed Care { ;:--:1""'9-=.3--2=-=5::-c. 5 =----=2-=.7c----: 2 =5-=.7; Self-pay \ Other Total Other :: 'i" ---:;1c;:;5-=.3--4:.-:.7:;-----;:;:3--:.1--,1;-:::;7-=.8: Total Behavioral Medicine: Medicare Total { " Hi: ====================== -7 -

10 STATISTICAL REPORT OUTPATIENT UTILIZATION BY PAYOR Month of December Budget %of % of Dollars Dollars Year to Date December 2011 % of Dollars Outpatient: Medicare Medicaid Total Government Blue Cross Commercial Humana T otai Managed Care Self-pay Other Total Other Total

11 Clark. Memorial Hospital Balance Sheet (in thousands) ASSETS LIABILITIES AND FUND BALANCE December 31, December 31, December 31, December 31, Current assets: Current liabilities: Cash and cash equivalents $ 6,316 $ 1,333 Current portion of long term debt $ 4,924 $ 3,640 Cash with Fiscal Agent Republic Investment 1,026 Equity Index Fund 1,364 1,502 Accounts payable 6,116 7,273 7,703 3,878 Accrued expenses 21,074 17,945 Receivables: Hospital assessment fee payable 139 Patient accounts, less estimated doubtful accounts and allowances Estimated liability for excess (2012-$60,461, 2011-$69,909) 15,333 16,124 third-party payments 1,859 1,537 Hospital assessment fee receivable 2,860 Total current liabilities 34,112 30,395 Other 36,478 29,343 Long Term Debt Debt ,415 46,330 54,671 45,467 Unamortized Loss on Refunding (368) (390) Mortgage Note Payable 791 1,013 Inventories 1,073 1,059 Republic Bond Payable 1,252 1,521 Prepaid expenses 1,273 1,438 Your Community Bond Payable 3,040 3,385 Long Term Debt 1,181 1,799 Total current assets 64,720 51,842 Workmans Comp Payable Deferred Compensation Payable Assets whose use is limited: Bonds ,906 3,921 Total Long Term Debt 50,704 54,147 Funds held by trustee: Debt Service Reserve Funds 4,201 4,201 Total Liabilities 84,816 84,542 8,107 8,122 Property and equipment 221, ,954 Less accumulated depreciation 140, ,116 81,594 87,838 Deferred financing costs Other assets Investment in SIRH 1,830 1,566 Investment in CPG (25,851) (18,178) Investment in CORF Investment in Cardiac Cath 2,014 2,025 Fund Balance 48,543 49,608 $ 133,359 $ 134,150 $ 133,359 $ 134,150-9-

12 SCHEDULE OF REVENUE AND EXPENSES (in thousands) Year to Date One Month Ended December 31,2012 December 31, 2011 December 31,2012 December 31, 2011 Actual Budget % Actual % Actual Budget Actual % Net patient service revenues: Inpatient $ 108,102 $ 98,931 9 $ 84, $ 10,111 $ 8, $ 4, Outpatient 72,505 62, , ,555 5, , Behavioral Medicine 2, , , , ,901 13, , Provision for Bad Debts 31,739 33,539 5 (26) 16 4, , , , ,582 11, , Other Operating Revenues 5, , (31) 210 (10) Total Operating Revenues 157, , , ,772 11, , Personnel 56,796 57, , ,009 4,830 (4) 3,918 (28) Benefits 13,324 13, , , , Supplies 24,867 30, , ,073 2, , Purchased Services 19,057 20, ,491 (3) 1,793 1,684 (6) 1,620 (11 ) Professional Fees 2,217 2,121 (5) 2, (11) Other Expenses 5,448 7, , (8) 510 (38) Depreciation 10,558 10,207 (3) 10,090 (5) (11) 826 (12) Interest Expense 2,961 3, , (252) 186 Hospital Assessment Fee N/A N/A 984 N/A N/A Operating Expenses: 152,821 (6) 137,571 (11) 12,693 (4) (15) Operating Income(Loss) before Equity in Earnings of Uncombined Entities, and IGT 4,549 (8,100) 156 (29,299) 116 4,079 (705) 679 (6,645) 161 Equity in Earnings of Uncombined Joint Ventures (7,251) (6,205) (17) 210 3,553 (1,676) (489) (243) 6, Inter-Governmental Transfer 1,462 5,367 (73) 5,367 (73) 1, Operating Income (1,240) (8,938) 86 (23,722) 95 3,865 (747) 618 (442) 974 Non-Operating Gains(Losses) Investment Income (7) 248 (20) nm Non-Operating Gains(losses) (23) (100) (20) (15) (2) (100) (2) (17) 228 (23) nm Excess of Revenues and Gains over Expenses $ (1,065) $ (8,725) $ 3, $ (379) 1,

13 SCHEDULE OF NET PATIENT SERVICE REVENUE (in thousands) Year to Date One Month Ended December 31,2012 December 31,2011 December 31,2012 December 31,2011 Actual Budget Actual % Actual Budget % Actual % Gross Acute Inpatient Revenue $ 220,471 $ 243,013 (9) $ 229,134 (4) $ 19,310 $ 20,875 (7) $ 18,753 3 Deductions: Contractual Allowances: Medicare 72,687 81, ,178 (10) 6,013 7, ,165 (2) Medicaid 1,557 24, ,098 (94) 588 2, ,650 (84) Blue Cross 14,411 15, ,024 (10) 1,638 1,304 (26) 1,959 (16) Humana 9,502 8,683 (9) 9,832 (3) ,352 (55) Other 11,274 10,124 (11 ) 10, ,251 (40) Uncompensated Care: Charity 1,810 2, , (583) (1,123) Other Deductions 1,128 1, ,167 (3) (82) , , ,711 (22) 9,199 12, ,467 (36) Net Acute Inpatient Revenue $ 108,102 $ 98,931 9 $ 84, $ 10,111 $ 8, $ 4, Deductions as % Gross Revenue 51.0% 59.3% % (19) 47.6% 59.7% % Outpatient Revenue $ 183,231 $ 181,131 $ 180,559 $ 15,334 $ 15,363 $ 15,263 Contractual Allowances: Medicare 45,122 42,291 (7) 42, ,366 3, ,894 (14) Medicaid 17,278 21, ,026 (22) 1,294 1, ,257 (43) Blue Cross 20,946 23, ,851 (8) 1,928 1, ,014 (4) Humana 10,814 12, ,908 (16) 1,013 1, ,403 (28) Other 10,947 10,221 (7) 12,141 (10) ,199 (61 ) Uncompensated Care: Charity 3,467 5, ,322 4 (1,432) (1,490) Other Deductions 2,152 2,043 (5) 2,357 (9) (18) 110, , ,493 (7) 6,779 10, ,040 (39) Net Outpatient Revenue $ 72,505 $ 62, $ 62, $ 8,555 $ 5, $ 4, Deductions as % Gross Revenue 60.4% 65.3% % (8) 44.2% 65.3% %

14 SCHEDULE OF NET PATIENT SERVICE REVENUE (in thousands) Year to Date One Month Ended December 31, 2012 December 31,2011 December 31,2012 December 31,2011 Actual Budget % Actual % Actual Budget % Actual % Behavioral Medicine Revenue $ 4,516 $ 3, $ 4, $ 360 $ $ Deductions: Contractual Allowances: Medicare 1,295 1,054 (23) 1, (2) 168 (43) Medicaid (36) (52) Blue Cross (118) (40) Humana 85 (100) (100) Other (65) 50 (74) Uncompensated Care: Charity 32 5 (540) 6 (433) Other Deductions (380) (33) 100 1,736 1,311 (32) 1, (9) 214 (42) Net Behavioral Medicine Revenue $ 2,780 $ 2,617 6 $ 2, $ 235 $ 233 $ Deductions as % Gross Revenue 38.4% 33.4% (15) 39.8% (3) 34.7% 33.0% (5) 72.3% Total Gross Revenue $ 408,218 $ 428,072 (5) $ 413,736 (1 ) $ 35,004 $ 36,586 (4) $ 34,312 2 Total Net Patient Service Revenue $ 183,387 $ 164, $ 148, $ 13, $ 8, Total Deductions % Gross Revenue 55.1% 61.6% % (14) 46.0% 61.8% % (26)

15 Clark Memorial Hospital Statement of Changes in Fund Balance (in thousands) Year to Date December 31, ---=2:-='0-=-12=--- --::-20~1~1-- Balance, beginning of period $ 49,608 $ 73,102 Excess of revenues over expenses (1,065) (23,494) Baiance, end of period $ 48,543 $ 49,

16 Clark Memorial Hospital Statement of Cash Flows (in thousands) Year to Date ~~~De~c~embe~r~3~1~,~~_ Year to Date December 31, Cash flows from operating activities: Cash flows from investing activities: Excess of revenues and gains over expenses Adjustments to reconcile excess of revenues and gains over expenses to net cash provided by operating activities and nonoperating gains: $ (1,065) $ (23,494) Purchase of Property and Equipment Cash with Fiscal Agent Transfers (To)1 From other restricted reserves Net cash used in investing activities and nonoperating gains $ (4,302) $ (8,194) (163) 15 2,133 (4,287) (6,224) Amortization and Depreciation Provision for doubtful accounts Equity in (Earnings) Loss in Uncombined Entity Cash Contributions From Uncombined Entity Transfers from Foundation Other Changes in operating assets and liabilities: Patient accounts and other receivables Hospital assessment fee receivable Inventories Prepaid expenses Accounts payable Accrued expenses Hospital assessment fee payable Estimated liability for excess third-party payments 10,558 31,739 7, (38,083) (2,860) (14) 165 (1,157) 3, ,090 43,142 (210) (32,360) (75) 391 3,183 3, Cash flows from financing activities: Payments on Current Portion Long Term Debt Payments on Current Portion Long Term Lease Other Draw/(Payments) on Line of Credit Net cash used in financing activities Increase in cash, cash equivalents and funded depreciation Cash, cash equivalents and funded depreciation at beginning of period (3,286) (4,797) (708) 152 1, (2,086) (5,053) 3,825 (6,372) 3,878 10,250 Net cash provided by operating activities $ 10,198 4,905 Cash, cash equivalents and funded depreciation at end of perioc -14-

17 Clark Memorial Hospital Statement of Cash Flows (in thousands) For Month Ended For Month Ended December 31, December 31, Cash flows from operating activities: Cash flows from investing activities: Excess of revenues and gains over expenses $ 3,879 $ (381) Purchase of Property and Equipment $ (631) $ (568) Cash with Fiscal Agent Adjustments to reconcile excass of revenues and gains over Transfers (To)! From other restricted reserves (3) 12 expenses to net cash provided by operating activities and nonoperating gains: Net cash used in investing activities and nonoperating gains (634) (556) Cash flows from financing activities: Amortization and Depreciation Provision for doubtful accounts 2,319 4,409 Payments on Current Portion Long Term Debt (266) (149) Equity in (Earnings) Loss in Uncombined Entity 1,675 (6,203) Payments on Current Portion Long Term Lease Cash Contributions From Uncombined Entity Other (51) Transfers from Foundation Draw!(Payments) on Line of Credit (27) (300) Other 15 2 Net cash used in financing activities (293) (499) Changes in operating assets and liabilities: Patient accounts and other receivables (8,066) (155) Hospital assessment fee receivable (2,500) Inventories (13) (89) Increase in cash, cash equivalents and funded depreciation (1,254) (1,287) Prepaid expenses Cash, cash equivalents and funded depreciation at beginning of period 8,957 5,165 Accounts payable 795 2,315 Accrued expenses 374 (1,334) Hospital assessment fee payable 63 Estimated liability for excess third-party payments Net cash provided by operating activities $ (327) $ (232) Cash, cash equivalents and funded depreciation at end of perioc $ 7,703 $ 3,

18 ACCOUNTS RECEIVABLE December 31,2012 Days Medicare Medicaid Pending Medicaid Blue Cross Humana Other Ins. Contract Unsecured Balance after Insurance Total December Receivables Computed Net Daxs Total November Receivables Computed Net Daxs Change in Accounts Receivable Over 181 $ 8,949,185 $ 596, , ,138 38,159 28, ,113 1,699,216 $ , , , ,525 1, , ,440,558 26,194 2,065, , ,127 53,315 32,774 8, ,088 1,304, ,749 66,639 11,118 17,125 12,446 92,203 $ 2,342,785 $ 3,387 1,034,726 19, ,869 70, ,803 67, ,153 99, ,388 76, ,496 1,453,359 $ 1,598,315 1,273,572 1,510,271 2,002,487 1,838,908 2,073,585 22,167, , , , ,678 56,650 28, ,173 $ 18,171,811 5,030,126 3,910,656 3,173,558 2,448,020 2,804,243 28,336,136 $ 16,546,301 5,923,523 3,504,033 3,034,253 3,132,106 2,675,535 29,412,970 $1,625,510 (893,397) 406, ,305 (684,086) 128,708 p,076,834) Prior month Inc!(Dec) 10,221,422 8,939,704 1,281,718 7,313,744 29,681 7,444,932 37,304 (131,188) (7,623) 3,232,916 2,950, ,858 1,857,320 1,510, ,028 5,011,220 1,791,230 5,554,024 1,775,504 (542,804) 15,726 32,465,089 33,863,938 (1,398,849) 1,951,928 2,152,965 (201,038) 63,874,550 54,228,721 (354,171) Inhouse 3,515,710 2,661, ,863 Discharged - Not Final Billed 0-4 Days 3,777,725 2,428,778 1,348,947 Discharged ~ Not Final Billed> than Four Days 3,284,752 3,663,304 (378,552) Total Accounts Receivable 74,452,737 72,982,549 1,470,088 Less: Cardiac Cath Receivables 3,352,008 11,907,651 (8,555,643) Allowance for Doubtful Accounts 34,063,653 48% 34,046,740 56% 16,913 Reserve for Contractual Allowances and Discounts 21,703,683 31% 19,398,075 32% 2,305,606 Net Accounts Receivable $15,333, $7,630, $7,703,210 Reconciliation of Allowance Account Provision For Bankruptcy Bad Debts Writeoff Amount Charged Off (Hosel Amount Charged Off (Cath) Net Accounts Receivable Goals Ending Balance In Reserve $20,991,008 Month $20,991,008 Average DailX Net Revenue Current Year Month Prior Four Months December 31,2011 $ 46,325,696 December , ,380 January 2012 $ 3,384,179 $ (276,006) February ,146,910 (478,227) March ,328,249 (167,045) April ,794,204 (10,176) May ,270,633 (269,306) June ,259, ,948 July ,892,695 (58,638) August ,523,729 (57,729) September ,414,320 (88,979) October ,559,441 (231,197) November ,866,445 (178,784) December ,318,579 (203,719) Balance in Reserve at November 30, ,738,505 p,077,858l (2,818,161) (1,905,651) (2,249,655) (4,940,350) (3,372,004) (5,903,288) (5,032,981) (3,474,557) (2,209,839) (5,220,337) (3,810,297) (4,060,993) $ ~44,998, 1131 $ 49, ,305 1,963,046 $ 2,075,424 $ 46,595,708 $ 47,408,295 $ 48,320,382 $ 46,154,040 $ 44,855,667 $ 41,153,448 $ 39,954,524 $ 38,945,967 $ 38,061,469 $ 38,169,376 $ 34,046,740 $ 34,063,653 34,063,653 January February March April May June July August September October November December , , , , , , , , , , , , , , , , , , , , , , , ,854 ~ Due to Medicare Rural Floor sel1lement and Hospital Assessment Fee settlement impact on June results, the computed amounts have normalized to remove the Rural Floor sel1lement, but to include monthly amounts for the Hospital Assessment Fee. 16 ~