Cook County Health and Hospitals System. Financial Statements. Year To Date February 28, 2014

Transcription

1 Cook County Health and Hospitals System Financial Statements Year To Date February 28, As of May 30, 2014

2 Index Page 1. Mission Statement Attestation Statement Management Discussion and Analysis Combining Balance Sheet Assets Combining Balance Sheet Liabilities and Net Assets Combining Income Statement Comparative Income Statements: Cook County Health Facilities (Consolidated) Stroger Hospital ACHN (Clinics) Medicaid Expansion Oak Forest Health Center Provident Hospital Bureau of Health Department of Public Health Cermak Disclosure Checklist

3 COOK COUNTY HEALTH & HOSPITALS SYSTEM MISSION STATEMENT The Cook County Health and Hospitals System will deliver integrated health services with dignity and respect regardless of a patient's ability to pay; and, Foster partnerships with other health providers and communities to enhance the health of the public; and, Advocate for policies, which promote and protect the physical, mental and social well being of the people of Cook County. 3

4 Board of Directors Cook County Health and Hospitals System The accompanying financial statements of Cook County Health and Hospitals System and the related Management's Discussion and Analysis for the month ended February 28, 2014 have been prepared by Management who is responsible for their presentation and disclosure. The statements have not been compiled, reviewed or audited by independent accountants. CCHHS maintains an internal control structure designed to provide reasonable assurance that assets are safeguarded and that transactions are properly executed, recorded and summarized to produce reliable records and reports, To the best of Management's knowledge and belief the statements were prepared in conformity with generally accepted accounting principles and governmental accounting standards using the accrual basis of accounting and are based on recorded transactions and Management's best estimates and judgment. John Cookinham, Chief Financial Officer Dorothy M. Loving, Executive Director of Finance 4

5 MANAGEMENT S DISCUSSION AND ANALYSIS INTRODUCTION This discussion and analysis provides the readers of the monthly unaudited financial statements of the Cook County Health and Hospital System (CCHHS) with an overview of the financial activities for the month ended February 28, This discussion focuses on the significant financial issues and major financial activities during the current month. It should be read in conjunction with the accompanying financial statements of the CCHHS. The CCHHS includes the following entities: John H. Stroger Jr. Hospital (JSH), Oak Forest Health Center (OFC) Provident Hospital (PHCC), the Department of Public Health (DPH), the Ambulatory and Community Health Network (ACHN), the Bureau of Health Services (BHS), CORE Center (for reporting purposes part of Stroger Hospital), and Cermak Health Services (CHS). Starting this fiscal year 2013, we have added the Medicaid Expansion. Collectively, these entities provide primary, intermediate, acute, and tertiary medical care to patients, without regard to their ability to pay. The Bureau of Health Services oversees the operational, planning, and policy activities of the CCHHS. The CCHHS is included in the reporting entity of the Cook County, Illinois, as an enterprise fund. As an enterprise fund, the CCHHS financial statements are prepared using proprietary fund accounting that focuses on the determination of changes in net assets, financial position, and cash flows in a manner similar to private sector businesses. The financial statements are prepared on an accrual basis of accounting, which recognizes revenue when earned and expenses when incurred. In 2008 the Cook County Health and Hospital System Board was created by the Cook County Board of Commissioners to provide independent oversight of health care operations, and in 2010 the Cook County Board of Commissioners voted to make the Cook County Health and Hospital System Board permanent. In 2012 the Cook County Health and Hospitals System and Cook County Board Officials collaborated to cut Medicaid costs, help county taxpayers, and transform Cook County s hospital system by jump-starting national health care reform in Cook County. In November, 2012 the federal governmnent approved the 1115 Medicaid Waiver for Cook County, allowing CCHHS to enroll more than 115,000 individuals who will be eligible for Medicaid in 2014 into a Cook County network with no cost to the state of Illinois. Medicaid Expansion allows the Cook County s Health System to early enroll certain uninsured patients into Medicaid. Specifically, these are patients who are not currently eligible for Medicaid, but who will be eligible in 2014 under the Accountable Care Act. Many of these individuals are patients who already are being treated by our system without compensation. The Waiver is funded entirely by the federal government. 5

6 FINANCIAL HIGHLIGHTS (IN THOUSANDS) The Cook County Health and Hospitals System finished the three months with overall revenue of $302,950 and overall expenses was $283,452. Net Patient revenue for the three months was $249,761. Net Patient revenue consists of all charges including automated contractual allowances and bad debt adjustments. Write-off of Bad Debt is a CCHHS Board approved policy. Other revenue was $1,417. Other revenue consists primarily of parking revenue. Patient Accounts Receivable General As compared to November 30, 2013, Total Patient Accounts Receivable at the end of February-2014 increased by 3 to 108 days. Additionally, there was a 2 day increase in this figure, as compared to the previous month s figure. Days of Revenue Outstanding measures the average number of days charges remain in accounts receivable after service has been rendered before collection activities have been completed, including charity care and bad debt write-offs. Days of Revenue Outstanding is measured in charges, not cash collections. Days of Revenue Outstanding is a useful tool to measure collection efforts over time (i.e., whether this number is growing or decreasing). This number will be large due to the large number of Self-Pay patients CCHHS services and the processes CCHHS must complete before patient accounts are collected or written-off to bad debt. These processes include, but are not limited to, the following: Making an effort to attain third-party insurance coverage, including the Medicaid Expansion Program and MANG applications; Processing charity care applications; Sending three (3) monthly statements before accounts are turned over to collections; Placing accounts bi-monthly with the collection agency; and Permitting patients to pay their account balances over time (time payment). Total billed accounts declined by $10.986M (-3.4%) as compared to the November-2013 balance. As compared to the previous month, this figure increased by $10.073M (3.4%). The growth in this figure indicates a decreasing number of accounts are completing the collection process, which includes charity care and bad debt write-offs. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims based upon the diagnosis, regardless of charges on the patient accounts. Additionally, charity 6

7 care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Finally, the reimbursement for Medicaid Expansion Program patients is made through a per-member-per-month payment, not a claim-by-claim basis. Inpatient Accounts Receivable Discharged Not Final Billed Inpatient discharged but not final billed accounts at the end of February-2014 increased by $5.907M (69.8%), as compared the November 30, 2013 balance and increased by $1.805M (14.4%), as compared to the previous month s balance. This indicates that fewer inpatient accounts are moving to a Billed status, as compared to the previous month. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims based upon the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Finally, the reimbursement for Medicaid Expansion Program patients is made through a per-member-per-month payment, not a claim-by-claim basis. Billed Inpatient Accounts Billed inpatient accounts at the end of February-2014 increased by $7.483M (4.7%) as compared to the November 30, 2013 balance. This figure grew by $8.604M (5.4%) compared to the previous month s total. The increase in this number indicates fewer accounts had the collection process completed than in the previous month and that a lower number of accounts are being removed from active accounts receivable. CCHHS collection process includes charity care and bad debt write-offs. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims based up on the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Finally, the reimbursement for Medicaid Expansion Program patients is made through a per-member-per-month payment, not a claim-by-claim basis. Outpatient Accounts Receivable Unbilled Outpatient Accounts The balance of unbilled outpatient accounts increased by $0.887M (8.2%) by the end of February-2014, as compared to the level of unbilled accounts as of November 30, This balance was $0.507M (-4.1%) less than the previous month s balance. This change indicates that more outpatient accounts are moving to a Billed status, as compared to the previous month. 7

8 The change in this figure does not translate dollar-for-dollar into actual cash receipts due to Medicaid s and Medicare s reimbursement configuration. Billed Outpatient Accounts The billed outpatient accounts receivable at the end of February-2014 decreased by $18.469M (-11.5%), as compared to the balance as of November 30, This figure is $1.469M (1.0%) greater than last month s figure. The growth in this figure indicates that fewer Out-Patient accounts had their collection and write-off related activities completed, as compared to the prior month. The change in this figure does not translate dollar-for-dollar into actual cash receipts due to Medicaid and Medicare s reimbursement configuration and to charity care and bad debt write-offs. Carelink Program Activities (Charity Care) The volume and dollar amounts written-off to charity care are as follows: Cumulative Number of Accounts Through February-2014 Cumulative Value of Accounts Through February-2014 Number of Accounts for February-2014 Value of Accounts for February-2014 In-Patient 378 $ 6.861M 1,195 $ M Out-Patient 18,051 $ 9.653M 56,946 $ M Totals 18,429 $ M 58,141 $ M The above data does not include bad-debt write-offs; it includes only the amounts written-off directly to charity care. Operating Expenses at the end of the three months was $ M broken down as follows: Salaries and Wages - $ M Benefits - $33.063M Supplies - $33.910M Purchased Services, Rental, and Other - $81.155M Insurance M Depreciation - $8.395M Utilities - $1.308M Nonoperating Revenue was $49.726M. The largest portions of this are attributed to cigarette tax in the amount of $ and property tax in the amount of $9.128M. For 8

9 the current fiscal year, Nonoperating revenues allocated to CCHHS are Cigarette Tax, Other Tobacco products and Firearms Tax. There is no Sales Tax allocated to CCHHS for the current fiscal year. Taxes collected for the Health to date have been fully credited to the Health Fund. OVERVIEW OF THE FINANCIAL STATEMENTS This discussion and analysis are intended to serve as an introduction to the CCHHS financial statements. CCHHS basic monthly unaudited financial statements are comprised of fund financial statements. A fund is a grouping of related accounts that is used to maintain control over resources that have been segregated for specific activities or objectives. The CCHHS, like other state and local governments, uses fund accounting to ensure and demonstrate compliance with finance-related legal requirements. 9

10 Accounts Receivable Comparison Cook County Health and Hospitals System Fiscal Year 2014 December-2013 January-2014 February-2014 BEPA BEPA BEPA Inpatient In-House $ 10,796, $ 13,917, $ 14,385, Discharged Not Final Billed $ 8,255, $ 12,566, $ 14,371, Billed $ 159,968, $ 158,273, $ 166,876, Total Inpatient Asccounts Receivable $ 179,021, $ 184,756, $ 195,633, Outpatient Unbilled $ 9,889, $ 12,239, $ 11,731, Billed $ 141,634, $ 140,498, $ 141,967, Total Outpatient Accounts Receivable $ 151,524, $ 152,737, $ 153,699, Combined Inpatient and Outpatient A/R Unbilled $ 28,942, $ 38,722, $ 40,488, Billed $ 301,603, $ 298,771, $ 308,844, Total IP and OP Accounts Receivable $ 330,545, $ 337,494, $ 349,332, Average Daily Revenue $ 3,268, $ 3,170, $ 3,223, Days of Revenue Outstanding

11 ASSETS CURRENT ASSETS: Cash and cash equivalents: Stroger Hospital ACHN (Clinics) Medicaid Expansion Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) February 28, 2014 Stroger, ACHN & Medicaid Exp O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Intra-Activity Eliminations Grand Total Cash in banks 1, , ,510 1,510 Cash held by Cook Co Treas 730,306 46, ,786 96, ,516 1,009, ,367 (1,136,941) 8,515 Due from working cash fund 60,540 34,607 95,147 95,147 95,147 Total cash & cash equivalent 792,114 34,608 46, ,202 96, ,735 1,105, ,367 (1,136,941) 105,172 Property taxes receivable: Tax levy - current year 2,671 2,515 5, , ,810 9,731 Tax levy - prior year 25,693 30,278 55,972 3,411 4,585 2,596 66,564 7,391 73,955 Total property taxes rec 28,365 32,794 61,158 3,676 4,961 3,304 73,099 7,777 2,810 83,687 Receivables: Patient AR-net of allowances 55,417 6,419 61,836 2,372 64,209 64,209 Third-party settlements 3,060 3,060 3,060 3,060 Other receivables , ,287 Due from State 1,769 1, , , , , ,142 Due from Restricted Funds 3,462 3,462 Total receivables 60,944 1, , , , ,513 4,179 1, ,160 Inventories 2,518 2, , ,909 TOTAL CURRENT ASSETS 883,941 69, ,593 1,108, , ,082 3,482 1,358, ,323 4,854 (1,136,941) 374,928 CAPITAL ASSETS: Depreciable assets - net 348,066 5, ,560 26,901 23,366 14, , ,688 TOTAL ASSETS 1,232,007 74, ,593 1,462, , ,448 17,722 1,776, ,356 5,441 (1,136,941) 793,615 11

12 LIABILITIES & NET POSITION CURRENT LIABILITIES: Stroger Hospital ACHN (Clinics) Medicaid Expansion Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) February 28, 2014 Stroger, ACHN & Medicaid Exp O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Intra-Activity Eliminations Due to Cook County Treasurer 75,936 75, ,703 1,032, ,301 (1,136,941) Grand Total Accounts payable 17, ,767 31, ,324 20,417 55, ,032 Claims Payable 40,840 40,840 40,840 40,840 Accrued salaries, wages, & other liabilities 11,926 1, , ,211 1,792 16, ,595 18,886 Compensated absences 4, , , ,412 Deferred revenue 73,949 73,949 2,612 76,562 76,562 Third-party settlements 33,500 33, ,545 33,545 Advance from State 30,051 30,051 30,051 30,051 Due to other co govt funds Due to others Interacct payable (receivabl) 167,432 28,965 (29,472) 166,925 6,390 43,979 (225,601) (8,306) 2 8,305 TOTAL CURRENT LIABILITIES 275, ,251 89, ,936 7,446 50, ,894 1,283, ,829 (1,136,941) 262,737 LONG-TERM LIABILITIES: Compensated absences longterm 23,727 2, , ,658 3,308 33, ,287 36,334 Reserve-tax objection suits 3,979 4,690 8, ,520 1,144 11,665 TOTAL LIABILITIES 303, ,709 89, ,464 8,503 54, ,604 1,327,584 2, ,116 (1,136,941) 310,736 NET POSITION: Investment in capital assets 348,066 5, ,560 26,901 23,366 14, , ,688 Unrestricted 580,624 (45,344) 66, ,434 92,727 91,069 (754,122) 31, ,346 (112,263) 64,192 TOTAL NET POSITION 928,691 (39,851) 66, , , ,435 (739,881) 449, ,380 (111,675) 482,880 TOTAL LIABILITIES & NET POSITION 1,232,007 74, ,593 1,462, , ,448 17,722 1,776, ,356 5,441 (1,136,941) 793,615 12

13 Cook County Health Facilities Combining Income Statement of General Funds (Unaudited) February 28, 2014 Stroger Hospital ACHN (Clinics) Medicaid Expansion Stroger, ACHN & Medicaid Exp O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Grand Total REVENUE: Net patient service revenue 66,504 34, , , , , ,761 Grant revenue EHR incentive program revenue 1,370 1, ,644 1,644 Other revenue 1, , , ,417 Total Revenue: 69,065 34, , , , , ,224 OPERATING EXPENSES: Salaries and wages 75,035 9,009 2,382 86,427 1,578 8,108 11, ,259 2,493 9, ,448 Employee benefits 20,669 2, , ,107 3,034 29, ,735 33,063 Supplies 5,819 4,932 11,423 22, ,092 33, ,910 Purchased svs, rental & other 11, ,688 67, ,406 11,775 80, ,155 Insurance expense 3, , , ,174 Depreciation 5, , ,564 8, ,395 Utilities , ,308 TOTAL OPERATING EXPENSES 123,373 18,156 68, ,462 3,414 12,989 39, ,324 3,809 13, ,452 GAIN (LOSS) FROM OPERATIONS (54,308) 16,381 76,050 38,124 (3,341) (8,882) (39,459) (13,558) (3,352) (13,318) (30,228) NONOPERATING REVENUE: Property taxes 2,466 2,272 4, , ,810 9,128 Sales taxes 1,769 1,949 3, , ,468 7,449 Cigarette taxes 6,247 7,365 13,612 1,017 1, ,375 1,797 18,172 Other Tobacco Product taxes Fire Arms taxes Interest income Retirement plan contribution 8,796 1, , ,229 12, ,096 14,210 TOTAL NONOPERATING REVENUE 19,603 13, ,876 1,983 3,281 2,740 40,880 3,471 5,374 49,726 INCOME (LOSS) (34,705) 29,448 76,257 71,000 (1,358) (5,600) (36,719) 27, (7,944) 19,498 Capital contributions Change In net position (34,202) 29,448 76,257 71,503 (1,358) (5,600) (36,468) 28, (7,944) 20,251 Net Position at beginning of year 962,893 (69,299) (10,103) 883, , ,035 (703,413) 421, ,261 (103,731) 462,628 Net Position at end of year 928,691 (39,851) 66, , , ,435 (739,881) 449, ,380 (111,675) 482,880 13

14 Cook County Health Facilities Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue 141, , ,761 Grant revenue EHR incentive program revenue 0 1,644 1,644 Other revenue 1, ,417 Total Revenue 142, , ,224 OPERATING EXPENSES: Salaries and wages 79,830 39, ,448 Employee benefits 22,037 11,026 33,063 Supplies 22,401 11,508 33,910 Purchased svs, rental & other 58,033 23,122 81,155 Insurance expense 4,116 2,058 6,174 Depreciation 5,629 2,766 8,395 Utilities 137 1,171 1,308 TOTAL OPERATING EXPENSES 192,183 91, ,452 GAIN (LOSS) FROM OPERATIONS (49,447) 19,219 (30,228) NONOPERATING REVENUE: Property taxes 6,028 3,100 9,128 Sales taxes 4,978 2,471 7,449 Cigarette taxes 10,607 7,565 18,172 Other tobacco product taxes Fire Arms taxes Interest income Retirement plan contribution 9,473 4,737 14,210 TOTAL NONOPERATING REVENUE 31,523 18,203 49,726 NET INCOME (LOSS) (17,924) 37,422 19,498 14

15 Stroger Hospital Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue 55,484 11,021 66,504 EHR incentive program revenue 0 1,370 1,370 Other revenue ,191 Total Revenue 56,426 12,639 69,065 OPERATING EXPENSES: Salaries and wages 49,980 25,056 75,035 Employee benefits 13,779 6,890 20,669 Supplies 4,032 1,787 5,819 Purchased svs, rental & other 8,442 3,299 11,740 Insurance expense 2,593 1,297 3,890 Depreciation 3,683 1,841 5,524 Utilities TOTAL OPERATING EXPENSES 82,509 40, ,373 GAIN (LOSS) FROM OPERATIONS (26,084) (28,224) (54,308) NONOPERATING REVENUE: Property taxes 1, ,466 Sales taxes 1, ,769 Cigarette taxes 3,617 2,630 6,247 Other tobacco product taxes Fire Arms taxes Interest income Retirement plan contribution 5,864 2,932 8,796 TOTAL NONOPERATING REVENUE 12,465 7,138 19,603 NET INCOME (LOSS) (13,619) (21,086) (34,705) 15

16 ACHN (Clinics) Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue 23,387 11,106 34,492 Other revenue Total Revenue 23,432 11,106 34,537 OPERATING EXPENSES: Salaries and wages 6,046 2,963 9,009 Employee benefits 1, ,740 Supplies 3,373 1,559 4,932 Purchased svs, rental & other Insurance expense Depreciation Utilities TOTAL OPERATING EXPENSES 12,357 5,799 18,156 GAIN (LOSS) FROM OPERATIONS 11,075 5,307 16,381 NONOPERATING REVENUE: Property taxes 1, ,272 Sales taxes 1, ,949 Cigarette taxes 4,265 3,100 7,365 Other tobacco product taxes Interest income Retirement plan contribution ,209 TOTAL NONOPERATING REVENUE 8,022 5,045 13,067 NET INCOME (LOSS) 19,096 10,351 29,448 16

17 Medicaid Expansion Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue 59,387 85, ,983 Total Revenue 59,387 85, ,983 OPERATING EXPENSES: Salaries and wages 1, ,382 Employee benefits Supplies 6,078 5,345 11,423 Purchased svs, rental & other 39,080 15,608 54,688 Insurance expense TOTAL OPERATING EXPENSES 47,003 21,930 68,933 GAIN (LOSS) FROM OPERATIONS 12,384 63,666 76,050 NONOPERATING REVENUE: Retirement plan contribution TOTAL NONOPERATING REVENUE NET INCOME (LOSS) 12,522 63,735 76,257 17

18 Oak Forest Health Center Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 1, ,578 Employee benefits Supplies Purchased svs, rental & other Insurance expense Depreciation Utilities TOTAL OPERATING EXPENSES 1,950 1,463 3,414 GAIN (LOSS) FROM OPERATIONS (1,897) (1,444) (3,341) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes ,017 Other tobacco product taxes Interest income Retirement plan contribution TOTAL NONOPERATING REVENUE 1, ,983 NET INCOME (LOSS) (582) (776) (1,358) 18

19 Provident Hospital Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue 2, ,779 Other revenue Total Revenue 3,000 1,108 4,108 OPERATING EXPENSES: Salaries and wages 5,596 2,513 8,108 Employee benefits 1, ,107 Supplies Purchased svs, rental & other ,406 Insurance expense Depreciation Utilities TOTAL OPERATING EXPENSES 8,641 4,349 12,989 GAIN (LOSS) FROM OPERATIONS (5,641) (3,241) (8,882) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes ,114 Other tobacco product taxes Interest income Retirement plan contribution TOTAL NONOPERATING REVENUE 2,084 1,197 3,281 NET INCOME (LOSS) (3,556) (2,044) (5,600) 19

20 Bureau of Health Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Net patient service revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 7,468 3,677 11,146 Employee benefits 2,022 1,011 3,034 Supplies 8,485 2,608 11,092 Purchased svs, rental & other 8,761 3,014 11,775 Insurance expense Depreciation 1, ,564 Utilities TOTAL OPERATING EXPENSES 28,302 11,157 39,459 GAIN (LOSS) FROM OPERATIONS (28,302) (11,157) (39,459) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes Other tobacco product taxes Retirement plan contribution ,229 TOTAL NONOPERATING REVENUE 1, ,740 NET INCOME (LOSS) (26,534) (10,185) (36,719) 20

21 Dept of Public Health Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Grant revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 1, ,493 Employee benefits Supplies Purchased svs, rental & other Insurance expense Depreciation 36 (31) 5 Utilities TOTAL OPERATING EXPENSES 2,596 1,214 3,809 GAIN (LOSS) FROM OPERATIONS (2,159) (1,193) (3,352) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes 1, ,797 Other tobacco product taxes Interest income 0 0 Retirement plan contribution TOTAL NONOPERATING REVENUE 2,146 1,325 3,471 NET INCOME (LOSS) (13) Note: The decrease in depreciation expenses is due to correction made on the depreciation of a building that was transferred to Homeland Security on fiscal year

22 Cermak Comparative Income Statement of General Funds (Unaudited) Year to Date February 28, 2014 January 31, 2014 Inc (Dec) February 28, 2014 REVENUE: Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 6,471 3,224 9,695 Employee benefits 1, ,735 Supplies Purchased svs, rental & other Insurance expense Depreciation Utilities TOTAL OPERATING EXPENSES 8,824 4,495 13,319 GAIN (LOSS) FROM OPERATIONS (8,824) (4,494) (13,318) NONOPERATING REVENUE: Property taxes 1, ,810 Sales taxes ,468 Interest income Retirement plan contribution ,096 TOTAL NONOPERATING REVENUE 3,585 1,789 5,374 NET INCOME (LOSS) (5,239) (2,705) (7,944) 22

23 OBJECTIVE: COOK COUNTY HEALTH AND HOSPITALS SYSTEM FINANCIAL STATEMENT DISCLOSURE CHECKLIST Fiscal Year 2013 The object of this checklist is to help determine if the form and contents of the financial statements are in conformity with the accounting standards applicable to financial statement basis of accounting. DISCLOSURE PRINCIPLES: Note: Management can comply with a disclosure principle by making disclosure in body of financial statements or in the notes accompanying the financial statements. In a compilation engagement, management's election to omit substantially all disclosures applies to all disclosure principles in GAAP financial statements. Yes, N/A, No? If no, state reason (immaterial, estimated, etc.) FINANCIAL STATEMENT REFERENCES: 1. Do the financial statements reference footnotes (MD&A) or selected information? Yes GENERAL DISCLOSURES: A. Estimates: 1. General disclosure about use of estimates (MD&A)? Yes 2. Disclosure of possible changes in estimates? Yes B. Vulnerabilities do to concentrations in following areas disclosed?: 1. Customers? Yes 2. Suppliers? Yes 3. Lenders? Yes 4. Products? Yes 5. Supply of materials, labor or supplies? Yes 6. Location of assets in geographic area? Yes C. Related parties (FASB 57): 1. Known common control and economic dependency disclosure? Yes 2. Known transactions with related parties disclosed? Yes OTHER DISCLOSURE AREAS TO BE CONSIDERED: 1. Method of consolidations? Yes 2. Accounting changes including changes in GAAP and in estimates? Yes 3. Business combinations? Yes 4. Discontinues operations? Yes 5. Going concern? Yes COMMENTS: Completed by Reviewed by Date Date 23