Jackson-Madison County General Hospital Changes in Active Medical Staff

Transcription

1 Jackson-Madison County General Hospital Changes in Active Medical Staff Change from Number of Active Active June 30, 2016 # Percentage Discharges Medical Staff Medical Staff to Board Board Average June 30, Specialty June 30, 2016 June 30, 2017 June 30, 2017 Certified Certified Age 2017 PRIMARY CARE General/Family Practice % 43 2, (I) 28 72% 50 1,233 Obstetrics/Gynecology (I) 26 93% 50 3,388 Neonatology % 53 1,006 Pediatrics % Subtotal ,047 MEDICINE Cardiology I 26 93% 49 5,235 Dennatology % 347 Gastroenterology 10 II 1 JO 91% 53 2,284 Hematology/Mycology 4 5 I 5 100% Nephrology I 10 91% 57 1,767 Neurology % 46 1,712 Physical Medicine/Rehab % Pulmonary 7 6 (I) 6 100% 54 2,558 ' Subtotal ,073 SURGERY General Surgery % 46 1,742 Cardiac Surgery % Neurosurgery 2 2 (I) 2 100% Ophthalmology % Otolaryngology % Orthopedics (I) 13 87% 47 1,930 Plastic Surgery % Urology 8 9 (2) 9 100% Subtotal ,299 OTHER SPECIAL TIES Psychiatry % 55 Anesthesia I 15 79% 50 Emergency Medicine (2) 12 86% 45 Pathology % 54 Radiology I % 45 All Others % 55 2,560 Therapeutic Radiology % 56 Subtotal ,615 Total % 32,034

2 Specialty Family Medicine Internal> Medicine Family Medicine Family Medicine Subtotal for Top Ten Total Discharges Jackson-Madison County General Hospital Top Ten Discharging Physicians For Fiscal Year Ending June 30, 2017 Number of Age Discharges 49 1, ,067 32,034 Percentage of Total 6.15% 2.31% 2.21% 2.16% 2.14% 2.13% 2.12% 2.08% 1.95% 1.93% 25.18% %

3 Jackson-Madison County General Hospital Licensed and Staffed Beds The existing bed complement of Jackson-Madison County General Hospital as of June 30, 2017 is as follows: Licensed and Type of Service Staffed Beds Medical/Surgical 233 Pediatrics 13 Obstetrics 42 Neonatal Intensive Care 34 Intensive Care 75 Intermediate Care 245 Total 642

4 Jackson-Madison County General Hospital Third Party Reimbursement Programs The following table sets forth the sources of the Jackson-Madison County General Hospital gross patient revenue by type ofpayor, expressed as percentages of total gross patient revenue, for the three fiscal years ended June 30, 2015 through Fiscal Year Ended June 30, Medicare 53% 51% 51% Medicaid/TennCare 14% 14% 13% Commercial 27% 29% 29% Self-Pay and Other 6% 6% 7% Totals 100% 100% 100%

5 The following table sets forth, the fiscal years ended June 30, 2015, 2016 and 2017, the Net Revenue Available for Debt Service and how many times the Net Revenue Available for Debt Service would have covered the principal and interest requirements on the Funded Hospital Debt for each such fiscal years. West Tennessee Healthcare (and Related Affiliates) Maximum Annual Debt Service Coverage (Dollars in Thousands) Fiscal Years Ended June 30, Income before Capital Contributions (1) Plus: Depreciation and amortization Interest Expense Unrealized loss (gain) on investments Net Revenue Available for Debt Service Maximum annual debt service Historical maximum annual debt service coverage ratio $16,413 45,362 16,672 2,993 $81,440 $19, x $ 10,365 44,561 15,154 6,603 $76,683 $19, x $ 40,558 46,622 14,864 (21,199) $80,845 $19, x Cl) In the audited financial statements the Statement of Revenues and Expenses and Changes in Net Position reflects contributions made by the District to the City, the County and West Tennessee Healthcare Foundation, Inc. as a component of Non-operating expense. The following schedule reflects the impact and related adjustment reflected in "Income" in the table. Fiscal Years Ended June 30, Increase in net position from Audited Financial Statemer $ 15,500 $ 9,424 $ 39,642 Add: Contribution to City of Jackson and Madison County Contribution to City of Jackson: Sportsplex Contribution to WTH Foundation Income before Capital Contributions $ 16,413 $ 10,365 $ 40,558

6 County of Origin Primmy Service Area: Madison Gibson Hardeman Henderson Carroll Haywood Crockett Chester Subtotal Jackson-Madison County General Hospital Patient Origin By County Fiscal Year Ending June 30, ,956 4,535 1,691 2,024 1,678 1,409 1,375 1,310 22,978 Fiscal Year Ended June 30, ,972 4,739 1,940 1,742 1,657 1,316 1,341 1,238 22, ,491 4,489 1,684 1,676 1,569 1,309 1,276 1,125 21,619 Secondmy Service Area: McNairy Dyer Lauderdale Decatur Hardin Weakley Obion: Benton Henry Lake Subtotal 1,576 1, ,162 1,499 1, ,177 1,308 1, ,374 Total Service Area 31,140 31, ,993 Other Areas Total , , ,746 [c 11 Data includes newborns.] Source: Joint Annual Report of Hospitals.

7 JACKSON-MADISON COUNTY GENERAL HOSPITAL OPERATING STATISTICS The following table sets forth certain statistical information relating to the operation of the hospital. Fiscal Year Ended June 30, Licensed beds< 1 l Beds in,service 0 l Average daily census Percentage occupancy of licensed beds 69.9% 75.6% 70.2% Percentage occupancy of beds in service 69.9% 75.6% 70.2% Patient days (excluding newborns) 176, , ,628 Outpatient equivalent days 184, , ,319 Adjusted patient days 360, , ,947 Average length of stay Discharges (excluding newborns) 30,174 29,956 27,769 Emergency room visits 101, ,711 97,020 Newborn deliveries 3,041 3,107 2,941 Surgical procedures: Inpatient 5,604 5,771 5,295 Outpatient 15,241 15,198 15,123 Total surgical procedures: 20,845 20,969 20, At June 30, 2017, the District transferred its inpatient rehabilitation facility (formerly known as the West Tennessee Rehabilitation Center) located within Jackson-Madison County General Hospital to a joint venture. As a result of this transfer, the District reduced its licensed bed count by 48 licensed beds to 642 licensed beds at June 30, This table does not reflect such reduction and includes the licensed bed count for the former West Tennessee Rehabilitation Center. See "WEST TENNESSEE HEALTHCARE-Joint Ventures" herein.

8 JACKSON-MADISON COUNTY GENERAL HOSPITAL DISTRICT Supplemental Financial Ratios The following table presents certain key historical liquidity and leverage ratios as of June 30, 2015, 2016, and Lig_uidity Position June 30, Cash and cash equivalents $ 34,564,905 $ 30,912,492 $ Total Assets limited as to use 362,267, ,517,017 Debt service reserve fund (5,760,394) (5, 753,059) Total cash and investments $ 391,072,483 $ 383,676,450 $ Total operating expenses $ 631,044,839 $ 685,920,430 $ Interest expense 18,327,900 15,153,732 Depreciation and amortization ( 45,362,267) (44,560,702) Total adjusted expenses $ 604,010,472 $ 656,513,460 $ Adjusted expenses per day $ 1,654,823 $ 1,793,753 $ Days' Cash on Hand ,492, ,320, 719 (5,573,059) 377,239, ,136,284 14,864,198 ( 46,621, 770) 686,378,712 1,880, Cae_italization June 30, Long-term indebtedness $301,861,110 $294,329,299 Unrestricted net assets 363,341, ,007,377 Net Investment in capital assets 114,835, ,618,646 Total capitalization $780,038,081 $781,955,322 Long-term indebtedness to capitalization ratio 39% 38% 2017 $287,252, ,269, ,066,138 $814,588,621 35% Cash to Debt June 30, Total cash and investments $391,074,498 $383,678,466 Current portion oflong-term indebtedness $6,270,000 $5,885,000 Long-term indebtedness, net of current portion 295,591, ,444,299 Total Jong-term indebtedness $301,861,110 $294,329,299 Total cash and investments as a percent oflong-term indebtedness 130% 130% 2017 $377,059,920 $6,095, ,157,650 $287,252, %

9 West Tennessee Healthcare Annual Debt Service Requirements 1 The City of Jackson, Tennessee Hospital Revenue Refunding Bonds (Jackson-Madison County General Hospital), Series 201S, $20S,96S,OOO, Dated: April 22, 201S 2 The City of Jackson, Tennessee Hospital Revenue Refunding and Improvement Bonds (Jackson-Madison County General Hospital Project) Series 2008, $318,980,000, Dated: August 26, 2008 (West Tennessee Healthcare) - Series 2015 Bonds Series 2008 Bonds Total Debt Service Fiscal Year Ending Principal Interest Total Principal Interest Debt Service Principal Interest Debt Service ; ".:,,, ~ " -.-,-., ,o.\,;,-,,",,' - ;, " ',.,_,,_, -- 6/30/2016 4,815,000 8,883,460 13,698,460 1,455,000 4,296,069 5,751,069 6,270,000 13,179,528 19,449,528 6/30/2017 4,355,000 9,337,463 13,692,463 1,530,000 4,220,644 5,750,644 5,885,000 13,558,106 19,443,106 6/30/2018 4,490,000 9,206,813 13,696,813 1,605,000 4,147,594 5,752,594 6,095,000 13,354,406 19,449,406 6/30/2019 4,670,000 9,027,213 13,697,213 1,685,000 4,064,281 5,749,281 6,355,000 13,091,494 19,446,494 6/30/2020 4,900,000 8,793,713 13,693,713 1,775,000 3,975,819 5,750,819 6,675,000 12,769,531 19,444,531 6/30/2021 5,145,000 8,548,713 13,693,713 1,870,000 3,882,631 5,752,631 7,015,000 12,431,344 19,446,344 6/30/2022 5,405,000 8,291,463 13,696,463 1,965,000 3,784,456 5,749,456 7,370,000 12,075,919 19,445,919 6/30/2023 5,675,000 8,021,213 13,696,213 2,070,000 3,681,294 5,751,294 7,745,000 11,702,506 19,447,506 6/30/2024 5,955,000 7,737,463 13,692,463 2,180,000 3,572,619 5,752,619 8,135,000 11,310,081 19,445,081 6/30/2025 6,255,000 7,439,713 13,694,713 2,295,000 3,455,444 5,750,444 8,550,000 10,895,156 19,445,156 6/30/2026 6,565,000 7,126,963 13,691,963 2,420,000 3,332,088 5,752,088 8,985,000 10,459,050 19,444,050 6/30/2027 6,895,000 6,798,713 13,693,713 2,550,000 3,202,013 5,752,013 9,445,000 10,000,725 19,445,725 6/30/2028 7,240,000 6,453,963 13,693,963 2,685,000 3,064,950 5,749,950 9,925,000 9,518,913 19,443,913 6/30/2029 7,600,000 6,091,963 13,691,963 2,830,000 2,920,631 5,750,631 10,430,000 9,012,594 19,442,594 6/30/2030 7,980,000 5,711,963 13,691,963 2,985,000 2,764,981 5,749,981 10,965,000 8,476,944 19,441,944 6/30/2031 8,380,000 5,312,963 13,692,963 3,150,000 2,600,806 5,750,806 11,530,000 7,913,769 19,443,769 6/30/2032 8,780,000 4,916,763 13,696,763 3,320,000 2,427,556 5,747,556 12,100,000 7,344,319 19,444,319 6/30/2033 9,240,000 4,455,813 13,695,813 3,505,000 2,244,956 5,749,956 12,745,000 6,700,769 19,445,769 6/30/2034 9,725,000 3,970,713 13,695,713 3,700,000 2,052,181 5,752,181 13,425,000 6,022,894 19,447,894 6/30/ ,215,000 3,485,150 13,700,150 3,905,000 1,844,056 5,749,056 14,120,000 5,329,206 19,449,206 6/30/ ,720,000 2,974,400 13,694,400 4,125,000 1,624,400 5,749,400 14,845,000 4,598,800 19,443,800 6/30/ ,255,000 2,438,400 13,693,400 4,360,000 1,392,369 5,752,369 15,615,000 3,830,769 19,445,769 6/30/ ,705,000 1,988,200 13,693,200 4,605,000 1,147,119 5,752,119 16,310,000 3,135,319 19,445,319 6/30/ ,175,000 1,520,000 13,695,000 4,865, ,088 5,753,088 17,040,000 2,408,088 19,448,088 6/30/ ,665,000 1,033,000 13,698,000 5,140, ,350 5,748,350 17,805,000 1,641,350 19,446,350 6/30/ ,160, ,400 13,686,400 5,440, ,800 5,752,800 18,600, ,200 19,439,200 Total 205,965, ,092, ,057,585 78,015,000 71,508, ,523, ,980, ,600, ,580,779