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6 EMSA Comparison of Budget to Actual 6/30/11 June 30, 2011 Actual for June 30, 2010 Eastern Western EMSA % Eastern Western EMSA Division Division Total Change Division Division Total Net patient service revenue: Ambulance revenue $ 66,300,000 72,800, ,100, % 64,771,500 71,100, ,871,500 Utility bill revenue 4,800,000 4,800, % 5,146,500 5,146,500 Subscription revenue 95, , , % 118, , ,000 Special Events 100, , , % 99, , ,000 Other - 6,000 6, % - 6,000 6,000 Total patient service revenue 71,295,000 73,206, ,501, % 70,135,500 71,575, ,711,000 Deductions from revenue 44,300,000 47,900,000 92,200, % 42,837,000 47,155,500 89,992,500 Net patient service revenue 26,995,000 25,306,000 52,301, % 27,298,500 24,420,000 51,718,500 Operating expenses other than depreciation and amortization: Ambulance service contract 20,400,000 25,900,000 46,300, % 19,200,000 24,300,000 43,500,000 First responder fee 1,764,000 1,764,000 1,764,000 1,764,000 Employee compensation and benefits* 1,220,000 1,432,000 2,652, % 1,240,500 1,378,500 2,619,000 Medical supplies Nondisposable equipment and supplies 826, ,000 1,326, % 765, ,000 1,257,000 Medical waste disposal 11,000 13,000 24, % 10,650 12,000 22,650 Building rent, utilities and maintenance expense Rent 16, , , % 16, , ,250 Utilities 88, , , % 90, , ,000 Repairs and maintenance 130, , , % 144, , ,050 Janitorial 24,500 43,500 68, % 22,800 41,400 64,200 TotalCare campaign expenses 24,000 40,000 64, % 26, , ,347 Equipment maintenance expense Radio and communication equipment 180, , , % 150, , ,250 CAD equipment 44,800 52,600 97, % 43,200 51,450 94,650 Computer equipment 52,000 63, , % 53,250 59, ,650 Office equipment 42,000 50,800 92, % 44,550 52,500 97,050 Medical equipment 21,000 22,000 43, % 40,350 40,950 81,300 1
7 EMSA Comparison of Budget to Actual 6/30/11 June 30, 2011 Actual for June 30, 2010 Eastern Western EMSA % Eastern Western EMSA Division Division Total Change Division Division Total Ambulances 32,000 33,000 65, % 31,050 30,150 61,200 Other 15,000 12,000 27, % 17,100 10,050 27,150 Quality assurance fees 327, , , % 341, , ,000 Telephone expense Base 235, , , % 267, , ,000 Cellular 110, , , % 117, , ,850 Professional services expense Accounting and auditing 15,200 17,800 33, % 19,000 21,000 40,000 Legal 25,000 30,000 55, % 19,050 22,500 41,550 Pension plans 2,000 3,000 5, % 2,000 3,000 5,000 Government relations 20,500 24,000 44, % 19,200 22,800 42,000 Medicare consulting 8,300 9,500 17, % 8,000 9,000 17,000 Other consulting 85,000 98, , % 73, , ,950 Community relations Professional services 16,600 19,400 36, % 18,900 24,000 42,900 State fair 9,000 9, % 9,000-9,000 Other 16,000 16,800 32, % 14,700 17,400 32,100 Postage and courier expense Postage - general 20,000 22,000 42, % 18,600 21,300 39,900 Courier service 14,000 14,500 28, % 10,800 13,050 23,850 Equipment lease expense Towers 20,000 76,000 96, % 23,850 79, ,350 Other 6,800 8,000 14, % 3,750 11,000 14,750 Office supplies expense 19,000 26,000 45, % 17,700 28,950 46,650 Miscellaneous supplies expense Janitorial 3,500 4,000 7, % 2,850 3,300 6,150 Software 9,500 12,000 21, % 4,000 6,000 10,000 Repair supplies 37,000 43,000 80, % 40,800 48,450 89,250 Outside copying/printing 13,000 14,000 27, % 11,700 13,950 25,650 Other 70,000 82, , % 88, , ,000 Insurance expense 59,900 48, , % 48,300 56, ,700 Business travel and training expense 53,000 66, , % 48,000 53, ,000 2
8 EMSA Comparison of Budget to Actual 6/30/11 June 30, 2011 Actual for June 30, 2010 Eastern Western EMSA % Eastern Western EMSA Division Division Total Change Division Division Total Other fees and expenses Medicaid terminal 10,000 13,000 23, % 10,200 12,000 22,200 Pike Pass 800 1,000 1, % ,500 Outside mailing services 100, , , % 92, , ,500 Offsite storage 17,000 8,000 25, % 15,300 6,300 21,600 Bank charges 23,000 29,000 52, % 22,950 26,700 49,650 Weather paging/archiving/acog 45,000 55, , % 43,350 51,000 94,350 Miscellaneous other fees (89,000) 89, % (84,000) 84,000 0 Utility bill processing fees 150, , , ,000 Subscriptions 2,700 3,500 6, % 2,700 3,500 6,200 Dues 14,000 13,000 27, % 14,250 11,000 25,250 26,360,800 30,778,900 57,139, % 25,155,347 29,278,250 54,433,597 Operating income (loss) before depreciation 634,200 (5,472,900) (4,838,700) 78.2% 2,143,153 (4,858,250) (2,715,097) - Depreciation & Amortization 2,331,000 1,987,000 4,318, % 1,700,000 1,000,000 2,700,000 Operating income (loss) (1,696,800) (7,459,900) (9,156,700) 69.1% 443,153 (5,858,250) (5,415,097) Nonoperating income (expense): Interest expense 49,200 49, % - 88,050 88,050 Interest income 50,000 50, % 84,600 2,550 87,150 Total nonoperating income (expense) 50,000 (49,200) % 84,600 (85,500) (900) Net income (loss) (1,646,800) (7,509,100) (9,155,900) 69.1% 527,753 (5,943,750) (5,415,997) Note: Please refer to the accompanying narrative for a discussion of the assumptions utilized in the preparation of this budget. Note: 6/30/10 figures are annualized seven months ended 2/28/10 * Additional information included in schedules that follow 3
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10 EMSA Eastern Division Capital Budget Years Ending June 30, 2011 through 2015 Description Ambulances 2011 ambulance replacement - (nine) New units 1,254,000 Miscellaneous ( logos, sirens, power supply) 20, ambulance replacement - (eight) New units 1,147,000 Miscellaneous ( logos, sirens, power supply) 20, ambulance replacement - (eight) New units 1,198,000 Miscellaneous ( logos, sirens, power supply) 20, ambulance replacement - (ten) New units 1,572,000 Miscellaneous ( logos, sirens, power supply) 20, ambulance replacement - (nine) New units 1,457,000 Miscellaneous ( logos, sirens, power supply) 20,000 On-board equipment: Power cots 410,000 Lifepack 12's/15's 1,015,000 30,000 30,000 30,000 30,000 Stair chairs 60,000 First responder equipment 203, , , , ,000 Equipment for new units(2) 64,000 64,000 64,000 64,000 64,000 Miscellaneous 27,000 28,000 29,000 30,000 31,000 CAD and radio equipment: Saber III portables 18,800 19,200 20,000 21,000 22,000 Mobile data terminals 110,000 Clinical computer pads 180,000 Base station upgrade 50,000 50,000 50,000 50,000 50,000 Equipment for new units 109,100 78,100 19,100 15,100 15,100 5
11 EMSA Eastern Division Capital Budget Years Ending June 30, 2011 through 2015 Description Building expenses: Office furniture 10,000 10,000 10,000 Garage 15,000 15,000 Security equipment 15,000 15,000 15,000 Common use vehicle 35,000 35,000 Building expansion 2,500,000 Miscellaneous 37,000 38,000 39,000 40,000 41,000 Computer equipment: Optical storage system 35,000 Server upgrade (network) 10,000 Server upgrade (accounting) 8,000 UPS batteries 5,000 Disaster backup 33,000 Billing/CAD system hardware 10,000 10,000 Web site development 15,000 15,000 15,000 15,000 15,000 Miscellaneous 50,000 50,000 50,000 50,000 50,000 TOTAL 2,955,900 2,362,300 4,400,100 2,235,100 2,043,100 NOTE: Please refer to the accompanying narrative for a discussion of the assumptions utilized in the preparation of this budget. 6
12 EMSA Western Division Capital Budget Years Ending June 30,2011 through 2015 Description Ambulances 2011 ambulance replacement - (ten) New units 1,358,000 Miscellaneous (springs, logos, sirens, power supply) 20, ambulance replacement - (eight) New units 1,141,000 Miscellaneous (springs, logos, sirens, power supply) 20, ambulance replacement - (ten) New units 1,497,000 Miscellaneous (springs, logos, sirens, power supply) 20, ambulance replacement - (eleven) New units 1,729,000 Miscellaneous (springs, logos, sirens, power supply) 20, ambulance replacement - (ten) New units 1,650,000 Miscellaneous (springs, logos, sirens, power supply) 20,000 On-board equipment: Power cots 450, ,000 Stair chairs Lifepack 12's /15's 1,015,000 30,000 30,000 30,000 30,000 Training manikin 8,000 8,000 Equipment for new units 64,000 64,000 64,000 64,000 64,000 Miscellaneous 34,000 35,000 36,000 37,000 38,000 CAD and radio equipment: Mobile data terminals 150,000 Saber III portables 34,000 35,000 36,000 37,000 38,000 Clinical computer pads 150, ,000 Base station upgrade 40,000 40,000 40,000 40,000 40,000 Equipment for new units 121,000 75,000 19,000 15,000 7
13 EMSA Western Division Capital Budget Years Ending June 30,2011 through 2015 Description Building expenses: Carpet offices and training room 30,000 Office furniture 10,000 10,000 Parking lot and grounds 5,000 Common use vehicle 35,000 Miscellaneous 41,000 42,000 43,000 44,000 45,000 Computer equipment: Server upgrade (accounting) 10,000 UPS batteries 8,000 Server upgrade (network) 20,000 20,000 Billing/CAD system hardware 20,000 20,000 Disaster backup 42,000 Web site development 15,000 15,000 15,000 15,000 15,000 Miscellaneous 50,000 50,000 50,000 50,000 50,000 3,024,000 2,188,000 1,915,000 2,411,000 2,008,000 NOTE: Please refer to the accompanying narrative for a discussion of the assumptions utilized in the preparation of this budget. 8
14 EMSA Eastern Division P&L Forecast Years Ending June 30, Ambulance revenue 66,400,000 67,728,000 80,200,000 81,800,000 83,400,000 Utility bill revenue 4,800,000 4,800,000 4,800,000 4,800,000 4,800,000 Subscription revenue 95,000 90,000 86,000 81,000 77,000 71,295,000 72,618,000 85,086,000 86,681,000 88,277,000 Deductions: Allowance and collection fees 44,300,000 45,200,000 55,600,000 56,700,000 57,800,000 Net Revenue 26,995,000 27,418,000 29,486,000 29,981,000 30,477,000 Operating expense: Contractor 20,400,000 21,500,000 22,200,000 23,600,000 25,200,000 Other 5,937,000 4,319,000 4,448,000 4,582,000 4,719,000 TotalCare 24,000 24,000 24,000 24,000 24,000 26,361,000 25,843,000 26,672,000 28,206,000 29,943,000 Depreciation & Amor 2,331,000 3,115,000 4,582,000 4,353,000 4,244,000 Operating income (1,697,000) (1,540,000) (1,768,000) (2,578,000) (3,710,000) Nonoperating income (expense): Interest expense Interest income 50,000 50,000 40,000 30,000 20,000 Net income (loss) (1,647,000) (1,490,000) (1,728,000) (2,548,000) (3,690,000) Note: Please refer to the accompanying narrative for a discussion of the assumptions utilized in the preparation of this forecast. 9
15 EMSA Western Division P&L Forecast Years Ending June 30, Ambulance revenue 72,956,000 74,400,000 88,600,000 90,400,000 92,200,000 Subscription revenue 250, , , , ,000 73,206,000 74,635,000 88,825,000 90,614,000 92,400,000 Deductions: Allowance & collection fees 47,900,000 48,700,000 60,900,000 62,000,000 63,400,000 Net Revenue 25,306,000 25,935,000 27,925,000 28,614,000 29,000,000 Operating expense: Contractor 25,900,000 27,300,000 28,200,000 29,900,000 32,100,000 Other 4,839,000 5,009,000 5,159,000 5,314,000 5,473,000 TotalCare 40,000 40,000 40,000 40,000 40,000 30,779,000 32,349,000 33,399,000 35,254,000 37,613,000 Depreciation & Amor 1,987,000 2,717,000 3,355,000 3,151,000 2,166,000 Operating income (loss) (7,460,000) (9,131,000) (8,829,000) (9,791,000) (10,779,000) Nonoperating income (expense): Interest expense 49,000 36,000 23,000 8,000 - Interest income Net income (loss) (7,509,000) (9,167,000) (8,852,000) (9,799,000) (10,779,000) Note: Please refer to the accompanying narrative for a discussion of the assumptions utilized in the preparation of this forecast. 10
16 EMSA Eastern Division Cash Projection Years Ending June 30, 2011 through year Receipts: Patient accounts 22,250,000 22,650,000 24,600,000 25,100,000 25,600, ,200,000 Utility bill receipts 4,800,000 4,800,000 4,800,000 4,800,000 4,800,000 24,000,000 Non-beneficiary subsisdy 496, , , , ,000 2,480,000 TotalCare receipts 95,000 90,000 86,000 81,000 77, ,000 Interest income 50,000 50,000 37,000 24,000 10, ,000 Total receipts 27,691,000 28,086,000 30,019,000 30,501,000 30,983, ,280,000 Disbursements: Ambulance contract 20,400,000 21,500,000 22,200,000 23,600,000 25,200, ,900,000 Operating expenses 5,787,000 4,169,000 4,298,000 4,432,000 4,570,000 23,256,000 TotalCare expenses 24,000 24,000 24,000 24,000 24, ,000 Utility bill processing cost 150, , , , , ,000 Capital expenditures 2,956,000 2,362,000 4,400,000 2,235,000 2,043,000 13,996,000 Total disbursements 29,317,000 28,205,000 31,072,000 30,441,000 31,987, ,022,000 Ending cash balance $ (1,626,000) $ (119,000) $ (1,053,000) $ 60,000 $ (1,004,000) (3,742,000) Cash balance at beginning of year $ 5,100,000 3,474,000 3,355,000 2,302,000 2,362,000 5,100,000 Increase (decrease) in cash balance for year (1,626,000) (119,000) (1,053,000) 60,000 (1,004,000) (3,742,000) Cash balance at end of year $ 3,474,000 3,355,000 2,302,000 2,362,000 1,358,000 1,358,000 11
17 EMSA Western Division Cash Projection Years Ending June 30, 2011 through year Receipts: Patient accounts $ 25,000,000 25,500,000 27,700,000 28,300,000 28,800, ,300,000 TotalCare proceeds 250, , , , ,000 1,124,000 Total receipts 25,250,000 25,735,000 27,925,000 28,514,000 29,000, ,424,000 Disbursements: Ambulance contract 25,800,000 27,000,000 28,200,000 29,900,000 32,100, ,000,000 Operating expenses 4,839,000 5,009,000 5,159,000 5,314,000 5,473,000 25,794,000 TotalCare expenses 40,000 40,000 40,000 40,000 40, ,000 Capital expenditures 3,024,000 2,188,000 1,915,000 2,411,000 2,008,000 11,546,000 Debt reduction 279, , , ,000-1,116,000 Total disbursements 33,982,000 34,516,000 35,593,000 37,944,000 39,621, ,656,000 Ending cash balance $ (8,732,000) $ (8,781,000) $ (7,668,000) $ (9,430,000) $ (10,621,000) $ (45,232,000) Note: Please refer to the accompanying narrative for a discussion of the assumptions utilized in the preparation of this forecast. 12
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