CONDENSED FINANCIAL REPORT
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1 CONDENSED AN EQUAL OPPORTUNITY/ADA INSTITUTION
2 CONDENSED Index Page Financial Performance Review 3 Financial Report by Operating Entity 4 Consolidated Balance Sheet 5 Consolidated Statement of Revenues and Expenses 6 Definitions of Terms 7 Page 2
3 FINANCIAL PERFORMANCE REVIEW Change in Net Assets (000s) University and Women's and Children's Hospitals & Clinics Variance University Hospitals & Clinics (UH)* $ 3,097 $ 1,322 $ 1,775 Women's and Children's Hospital & Clinics (WCH) 3,356 1,935 1,420 Operating Income After State Appropriations 6,453 3,257 $ 3,195 NonOperating Revenues (Expenses) (1,770) (822) (948) Transfers In (Out) and Other Additions (2,677) (134) (2,543) Consolidated Change in Net Assets $ 2,006 $ 2,302 $ (296) University and Women's and Children's Hospitals & Clinics Variance Prior Year University Hospitals & Clinics (UH)* $ 58,518 $ 21,488 $ 37,031 $ 50,950 Women's and Children's Hospital & Clinics (WCH) 40,191 16,139 24,052 22,518 Operating Income After State Appropriations 98,709 37,626 61,083 73,468 NonOperating Revenues (Expenses) 1,094 (10,966) 12,060 (8,008) Transfers In (Out) and Other Additions (30,382) (1,604) (28,778) (21,285) Consolidated Change in Net Assets $ 69,421 $ 25,056 $ 44,365 $ 44,175 *Includes Shared Services Year-to-Date Operations Overview (YTD) MUHC has a Consolidated Change in Net Assets of $69.4 million which is $44.3 million above budget for the period. Operating Income of $98.7 million is $61.0 million above the budgeted amount of $37.6 million. The positive operating income results at University Hospital & Clinics, and Women's and Children's Hospital & Clinics are principally due to higher than budgeted utilizations. Ratios -University Hospitals & Clinics had an Operating Income of $58.5 million, which is above the budgeted gain of $21.5 million. The Excess Margin was 5.1%, as compared to a budgeted 1.8%. Discharges at University Hospitals and Clinics are above budget 383 and Patient Days are above budget 6,649. Compared to the prior year, Discharges are above 430 and Patient Days are above 8,078. -Women's and Children's Hospital & Clinics generated an Operating Income of $40.2 million compared to a budgeted gain of $16.1. The Excess Margin was 14.8%, as compared to a budgeted 7.2%. Discharges at Women's and Children's Hospital & Clinics are above budget 315 and Patient Days are above budget 3,450. Compared to prior year, Discharges are above 126 and Patient Days are above 185. MUHC Consolidated Current YTD Current YTD Prior YTD FY 17 Annual Moody's A-Rated Excess Margin 7.3% 3.0% 5.3% 3.0% 6.7% Annualized Return on Total Assets 6.0% 2.2% 4.1% 2.2% 5.1% Cash to Total Debt 148.8% 140.9% 128.9% 140.9% 125.5% Debt to Capitalization 30.5% 31.8% 33.6% 31.8% 32.8% Maximum Annual Debt Service Coverage Days Cash on Hand Net Days Revenue in AR Page 3
4 BY OPERATING ENTITY Year to Date Year to Date Prior Year to Date University Hospitals and Clinics: Discharges 1,776 1,820 21,602 21,219 21,172 Patient Days 9,201 8, , , ,443 Intensity - Case Mix Index (excludes Psychiatry) Intensity - Average Length of Stay Staffing Volumes - Fully Allocated FTE 3,714 3,491 3,468 3,460 3,357 Staffing Indicator - Paid FTE per Adj Occupied Bed Net Patient Revenues*(In Thousands) $ 63,783 $ 53,313 $ 704,942 $ 636,778 $ 632,073 Operating Income (Loss) After State Appropriations*(In Thousands) $ 3,097 $ 1,322 $ 58,518 $ 21,488 $ 50,949 Net Revenue Per Adjusted Discharge* $ 19,797 $ 17,079 $ 18,530 $ 17,578 $ 17,533 Costs per Adjusted Discharge* $ 18,860 $ 16,717 $ 17,038 $ 17,054 $ 16,159 Profitability - Excess Margin Percent* -0.6% 1.1% 5.1% 1.8% 4.3% Women's and Children's Hospital and Clinics: Discharges ,393 5,078 5,267 Patient Days 2,912 2,210 30,781 27,331 30,596 Intensity - Case Mix Index Intensity - Average Length of Stay Staffing Volumes - Fully Allocated FTE 1, Staffing Indicator - Paid FTE per Adj Occupied Bed Net Patient Revenues (In Thousands) $ 22,013 $ 15,983 $ 218,789 $ 183,832 $ 188,415 Operating Income (Loss) After State Appropriations (In Thousands) $ 3,356 $ 1,935 $ 40,191 $ 16,139 $ 22,518 Net Revenue Per Adjusted Discharge $ 25,198 $ 19,618 $ 19,332 $ 17,008 $ 17,640 Costs per Adjusted Discharge $ 21,390 $ 17,261 $ 15,806 $ 15,526 $ 15,548 Profitability - Excess Margin Percent 10.9% 10.6% 14.8% 7.2% 8.5% MUHC Consolidated: Discharges 2,222 2,198 26,995 26,297 26,439 Patient Days 12,113 10, , , ,039 Intensity - Case Mix Index (Excluding MRC) Clinic Visits 54,004 54, , , ,755 Staffing Volumes - Fully Allocated FTE 4,761 4,428 4,449 4,399 4,297 Staffing Indicator - Paid FTE per Adj Occupied Bed Net Patient Revenues (In Thousands) $ 85,795 $ 69,296 $ 923,732 $ 820,610 $ 820,488 Operating Income (Loss) After State Appropriations (In Thousands) $ 6,453 $ 3,258 $ 98,709 $ 37,626 $ 73,468 Change in Net Assets (In Thousands) $ 2,006 $ 2,302 $ 69,421 $ 25,056 $ 44,175 *Includes Shared System Services Page 4
5 UNIVERSITY OF MISSOURI HEALTH CARE CONSOLIDATED BALANCE SHEET (Dollars in Thousands) ASSETS Current Assets: June 2016 Cash and Temp Investments $ 65,743 $ 59,197 Bond Proceeds 596 7,175 Committed Funds - - Accounts Receivable Patients $ 449,563 $ 355,983 Less: Allowances (333,662) (256,504) Net Patient 115,901 99,480 Other Receivables 28,569 23,619 Inventories 21,367 19,761 Prepaid Expense 10,326 7,306 Total Current Assets 242, ,539 Noncurrent Assets: Deferred Charges and Other Assets 2,917 3,168 Long Term Investments 397, ,685 Property, Plant & Equipment $ 1,000,061 $ 960,522 Accumulated Depreciation (492,787) (453,198) Net Property, Plant & Equipment 507, ,325 Total Noncurrent Assets 907, ,178 TOTAL ASSETS $ 1,149,925 $ 1,084,717 LIABILITIES AND FUND BALANCES Current Liabilities: Accounts Payable $ 28,506 $ 17,240 Accounts Payable to Third Parties 19,966 25,852 Accrued Payroll 8,755 7,160 Accrued Vacation 18,485 18,000 Internal Debt Obligations & Capital Lease, current 12,482 11,861 Deferred Revenue- current portion Columbia Campus Payable - - Total Current Liabilities 88,851 80,119 Noncurrent Liabilities: Amount Due System 55,000 55,000 Capital Lease Obligations 1,439 2,488 Internal Debt Obligations 297, ,043 Total Noncurrent Liabilities 353, ,531 TOTAL LIABILITIES 442,438 $ 446,649 NET ASSETS 707, ,067 TOTAL LIABILITIES AND NET ASSETS $ 1,149,925 $ 1,084,717 Page 5
6 University of Missouri Health Care Statement of Revenues, Expenses and Changes in Net Assets Consolidated Year-to-Date Variance % Var Variance % Var 16 Revenues Inpatient Revenue $ 126,011,445 $ 115,153,495 $ 10,857, % $ 117,070,732 $ 1,393,428,569 $ 1,339,159,845 $ 54,268, % $ 1,291,869,110 FRA 6,475,222 5,929, , % 5,938,657 79,799,890 71,149,619 8,650, % 71,147,904 Total Inpatient Revenues 132,486, ,082,630 11,404, % 123,009,389 1,473,228,459 1,410,309,464 62,918, % 1,363,017,014 Ancillary Outpatient 96,900,761 77,091,598 19,809, % 82,749,583 1,007,621, ,867,698 77,753, % 877,381,888 Emergency 12,348,183 10,098,166 2,250, % 11,157, ,133, ,219,903 5,913, % 113,893,262 Pharmacy Sales 5,378,967 3,426,309 1,952, % 5,090,403 61,276,794 41,077,377 20,199, % 43,418,940 Total Outpatient Revenues 114,627,911 90,616,073 24,011, % 98,997,004 1,202,031,882 1,098,164, ,866, % 1,034,694,090 Total Patient Revenues 247,114, ,698,703 35,415, % 222,006,393 2,675,260,340 2,508,474, ,785, % 2,397,711,104 Deductions from Revenues (161,155,552) (142,402,871) (18,752,681) -13.2% (144,665,156) (1,756,677,237) (1,687,864,766) (68,812,471) -4.1% (1,570,758,596) Prior Period Adjustments (163,534) - (163,534) (520,819) 5,148,427-5,148,427 (6,464,618) Net Patient Revenues 85,795,492 69,295,832 16,499, % 76,820, ,731, ,609, ,121, % 820,487,891 Other Operating Revenues 1,833,981 1,650, , % 887,947 20,958,543 20,827, , % 19,462,842 Total Net Revenues 87,629,474 70,946,190 16,683, % 77,708, ,690, ,437, ,252, % 839,950,733 Expenses Salary & Wages 26,319,882 22,018,996 (4,300,886) -19.5% 20,698, ,069, ,534,029 (6,535,462) -2.5% 247,143,649 Benefits 7,620,607 7,561,048 (59,560) -0.8% 7,093,937 89,695,972 91,366,436 1,670, % 84,702,521 Medical Supplies 10,437,661 7,961,555 (2,476,106) -31.1% 9,481, ,181,993 94,229,877 (13,952,116) -14.8% 96,288,096 Drug Supplies 6,485,535 6,724, , % 7,290,027 86,607,165 81,476,827 (5,130,338) -6.3% 74,755,754 Non Medical Supplies 1,120,672 1,028,878 (91,794) -8.9% 1,241,081 11,442,055 11,854, , % 10,901,850 Shared System Services % ,068 11, % - Purchased Services and Support 5,483,040 5,356,903 (126,137) -2.4% 6,947,886 68,467,034 63,891,792 (4,575,242) -7.2% 63,370,386 FRA 3,619,184 3,552,815 (66,369) -1.9% 3,338,574 43,395,809 42,633,786 (762,023) -1.8% 40,073,835 Depreciation 4,385,609 3,977,916 (407,694) -10.2% 4,025,100 46,935,235 47,734, , % 45,765,638 Other Expenses 15,704,390 9,666,989 (6,037,401) -62.5% 11,625, ,380, ,018,367 (12,361,904) -11.7% 103,481,249 Total Operating Expenses 81,176,581 67,849,979 (13,326,602) -19.6% 71,741, ,175, ,751,409 (40,423,615) -5.0% 766,482,979 Operating Income (Loss) 6,452,892 3,096,211 3,356, % 5,966,742 98,515,049 35,686,153 62,828, % 73,467,754 before State Appropriations State Appropriations - 161,667 (161,667) % - 194,001 1,940,000 (1,745,999) -90.0% - Operating Income (Loss) after State Appropriations 6,452,892 3,257,877 3,195, % 5,966,742 98,709,050 37,626,153 61,082, % 73,467,754 NonOperating Rev (Exp) Investment Income (1,758,406) 213,827 (1,972,234) % 501,348 11,256,366 1,600,000 9,656, % 1,012,869 Gift Income 427, , % 460,336 1,948,929-1,948, % 1,873,032 Gain (Loss) on Disposal (129,099) (36,034) (93,066) % (78,951) (57,368) (250,000) 192, % 318,914 Interest Expense (1,089,363) (999,889) (89,474) -8.9% (1,052,745) (12,892,510) (12,316,029) (576,480) -4.7% (12,985,056) Income (Loss) before Capital Additions and Transfers 3,903,767 2,435,781 1,467, % 5,796,730 98,964,467 26,660,123 72,304, % 63,687,514 Capital Gift Income 779, , % 1,735, , , % 1,772,142 School Support and Transfers (2,676,577) (133,654) (2,542,924) % (7,839,475) (30,381,942) (1,603,842) (28,778,100) % (21,284,624) Change in Net Assets $ 2,006,374 $ 2,302,128 $ (295,754) -12.8% $ (307,628) $ 69,421,319 $ 25,056,281 $ 44,365, % $ 44,175,032 Page 6
7 DEFINITIONS OF TERMS Adjusted Discharges = Inpatient Discharges times Total Charges divided by Inpatient Charges Adjusted Occupied Beds = (Inpatient Days times (Total Charges divided by Inpatient Charges)) divided by days in period Annualized Return on Net Assets = Net Income (Loss) divided by Total Assets Case Mix Index = Average case mix index for all patients based on Medicare intensity calculations Cash to Total Debt = Unrestricted Cash and Investments divided by Long Term and Short Term Debt Days Cash on Hand = (Cash and Investments) divided by ((Total Operating Expenses minus Depreciation and Amortization plus Interest Expense) divided by days in period) Debt to Capitalization = (Long-term Debt + short-term debt) / (Long term debt + short-term debt + unrestricted fund balance) FTEs = Total paid hours divided by 2080 (annual, or for monthly, number of normal working hours in the month) Fully Allocated FTEs = Operating entity FTEs including allocation of corporate staff Maximum Annual Debt Service Coverage = (Net Income plus Depreciation and Interest) divided by (estimated future peak principal and interest payments) Net Days Revenue in Accounts Receivable = Net Patient Accounts Receivable divided by Rolling 12 month average Net Patient Revenue Excess Margin = Change in Net Assets divided by Net Revenues Costs per Adjusted Discharge = Total Operating Expenses divided by Adjusted Discharges Page 7
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