Cook County Health and Hospitals System. Financial Statements. Year To Date January 31, 2014

Transcription

1 Cook County Health and Hospitals System Financial Statements Year To Date January 31, As of May 2, 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 January 31, 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 January 31, 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 two months with overall revenue of $174,258 and overall expenses was $192,183. Net Patient revenue for the twelve months was $141,221. 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 $1,113. 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 January-2014 increased by 1 to 106 days. Additionally, there was a 5 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 1115 waiver 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 $21.058M (-6.6%) as compared to the November-2013 balance. As compared to the previous month, this figure decreased by $2.832M (-0.9%). The decline in this figure indicates an increasing 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 1115 Waiver 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 January-2014 increased by $4.103M (48.5%), as compared the November 30, 2013 balance and increased by $4.311M (52.2%), 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 1115 Waiver 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 January-2014 decreased by $1.121M (-0.7%) as compared to the November 30, 2013 balance. This figure fell by $1.696M (-1.1%) compared to the previous month s total. The decrease in this number indicates more accounts had the collection process completed than in the previous month and that a greater 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 1115 Waiver 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 $1.394M (12.9%) by the end of January-2014, as compared to the level of unbilled accounts as of November 30, This balance was $2.350M (23.8%) larger than the previous month s balance. This change indicates that fewer outpatient accounts are moving to a Billed status, as compared to the previous month. Billed Outpatient Accounts 7

8 The billed outpatient accounts receivable at the end of January-2014 decreased by $19.937M (-12.4%), as compared to the balance as of November 30, This figure fell by $1.136M (-0.8%) compared to the previous month s total. The decline in this figure indicates that more 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 January-2014 Cumulative Value of Accounts Through January-2014 Number of Accounts for January-2014 Value of Accounts for January-2014 In-Patient 394 $ 4.606M 817 $ M Out-Patient 18,606 $ 9.192M 38,895 $ M Totals 19,000 $ M 39,712 $ 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 two months was $192,.183M broken down as follows: Salaries and Wages - $79.830M Benefits - $22.037M Supplies - $22.401M Purchased Services, Rental, and Other - $58.033M Insurance M Depreciation - $5.629M Utilities - $0.137M Nonoperating Revenue was $31.523M. The largest portions of this are attributed to cigarette tax in the amount of $ and property tax in the amount of $6.028M. Sales tax revenues are recognized by CCHHS when earned; this occurs when the underlying sales transactions occur. The amount recorded as Due from State of Illinois - Sales Tax represents the amounts earned by CCHHS, however, the cash is not yet received from the state. There is a 3 months lag from the time of the underlying sales transaction to the receipt of funds. 8

9 Taxes collected for the Health to date have been fully credited to the Health Fund except as mentioned in the previous paragraph. 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 BEPA January-2014 BEPA Inpatient In-House $ 10,796, $ 13,917, Discharged Not Final Billed $ 8,255, $ 12,566, Billed $ 159,968, $ 158,273, Total Inpatient Asccounts Receivable $ 179,021, $ 184,756, Outpatient Unbilled $ 9,889, $ 12,239, Billed $ 141,634, $ 140,498, Total Outpatient Accounts Receivable $ 151,524, $ 152,737, Combined Inpatient and Outpatient A/R Unbilled $ 28,942, $ 38,722, Billed $ 301,603, $ 298,771, Total IP and OP Accounts Receivable $ 330,545, $ 337,494, Average Daily Revenue $ 3,268, $ 3,170, 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) January 31, 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, , ,520 1,520 Cash held by Cook Co Treas 733,306 36, ,029 96, ,975 1,002, ,425 (1,127,548) 10,638 Due from working cash fund 60,540 34,607 95,147 95,147 95,147 Total cash & cash equivalent 795,124 34,608 36, ,455 96, ,194 1,099, ,425 (1,127,548) 107,305 Property taxes receivable: Tax levy - current year 1,781 1,677 3, , ,873 6,487 Tax levy - prior year 29,143 34,344 63,487 3,868 5,200 2,944 75,499 8,383 83,883 Total property taxes rec 30,924 36,021 66,944 4,045 5,451 3,416 79,856 8,641 1,873 90,370 Receivables: Patient AR-net of allowances 63,469 6,419 69,889 2,364 72,253 72,253 Third-party settlements 2,011 2,011 2,011 2,011 Other receivables , ,279 Due from State 1,769 1,949 49,612 53, , ,468 57,061 Total receivables 67,948 1,963 56, , , , , ,604 Inventories 2,629 2, , ,944 TOTAL CURRENT ASSETS 896,625 72,591 92,755 1,061, , ,939 3,594 1,313, ,783 3,917 (1,127,548) 334,223 CAPITAL ASSETS: Depreciable assets - net 349,405 5, ,965 27,096 23,519 14, , ,700 TOTAL ASSETS 1,246,030 78,151 92,755 1,416, , ,458 18,105 1,733, ,785 4,525 (1,127,548) 754,923 11

12 Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) January 31, 2014 LIABILITIES & NET POSITION CURRENT LIABILITIES: 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 Intra-Activity Eliminations Due to Cook County Treasurer 80,257 80, ,610 1,026, ,681 (1,127,548) Grand Total Accounts payable 19, ,227 29, ,159 18,880 50, ,567 Claims Payable 35,056 35,056 35,056 35,056 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 Advance from State 30,051 30,051 30,051 30,051 Due to other co govt funds Due to others Interacct (payable)receivabl 159,127 38,243 (31,351) 166,018 6,121 43,077 (223,523) (8,306) 2 8,305 TOTAL CURRENT LIABILITIES 269, ,896 43, ,316 7,203 49, ,343 1,234, ,207 (1,127,548) 219,082 LONG-TERM LIABILITIES: Compensated absences 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 296, ,353 43, ,844 8,260 52, ,053 1,278,136 2, ,494 (1,127,548) 267,081 NET POSITION: Investment in capital assets 349,405 5, ,965 27,096 23,519 14, , ,700 Beginning balance 609,805 (74,990) 36, ,312 93,500 96,210 (718,967) 42, ,760 (104,379) 79,437 Bond depreciation 3, , ,043 5, ,629 Excess revenue (expenses) (13,619) 19,096 12,522 18,000 (582) (3,556) (26,534) (12,673) (13) (5,239) (17,924) Ending balance 949,274 (50,202) 49, , , ,479 (729,948) 455, ,786 (108,970) 487,842 TOTAL LIABILITIES & NET POSITION 1,246,030 78,151 92,755 1,416, , ,458 18,105 1,733, ,785 4,525 (1,127,548) 754,923 12

13 Cook County Health Facilities Combining Income Statement of General Funds (Unaudited) January 31, 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 55,484 23,387 59, , , , ,221 Grant revenue EHR incentive program revenue Other revenue , ,113 Total Revenue: 56,426 23,432 59, , , , ,736 OPERATING EXPENSES: Salaries and wages 49,980 6,046 1,551 57,578 1,056 5,596 7,468 71,697 1,661 6,471 79,830 Employee benefits 13,779 1, , ,399 2,022 19, ,823 22,037 Supplies 4,032 3,373 6,078 13, ,485 22, ,401 Purchased svs, rental & other 8, ,080 48, ,761 57, ,033 Insurance expense 2, , , ,116 Depreciation 3, , ,043 5, ,629 Utilities TOTAL OPERATING EXPENSES 82,509 12,357 47, ,870 1,950 8,641 28, ,763 2,596 8, ,183 GAIN (LOSS) FROM OPERATIONS (26,084) 11,075 12,384 (2,625) (1,897) (5,641) (28,302) (38,464) (2,159) (8,824) (49,447) NONOPERATING REVENUE: Property taxes 1,625 1,492 3, , ,873 6,028 Sales taxes 1,182 1,302 2, , ,978 Cigarette taxes 3,617 4,265 7, ,566 1,041 10,607 Other Tobacco Product taxes Fire Arms taxes Interest income Retirement plan contribution 5, , , ,473 TOTAL NONOPERATING REVENUE 12,465 8, ,625 1,315 2,084 1,768 25,791 2,146 3,585 31,523 NET INCOME (LOSS) (13,619) 19,096 12,522 18,000 (582) (3,556) (26,534) (12,673) (13) (5,239) (17,924) 13

14 Cook County Health Facilities Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 74,360 66, ,221 Grant revenue EHR incentive program revenue 0 Other revenue ,113 Total Revenue 75,180 67, ,736 OPERATING EXPENSES: Salaries and wages 39,541 40,288 79,830 Employee benefits 11,022 11,015 22,037 Supplies 7,374 15,028 22,401 Purchased svs, rental & other 30,748 27,285 58,033 Insurance expense 2,058 2,058 4,116 Depreciation 2,815 2,815 5,629 Utilities TOTAL OPERATING EXPENSES 93,690 98, ,183 GAIN (LOSS) FROM OPERATIONS (18,509) (30,937) (49,447) NONOPERATING REVENUE: Property taxes 3,312 2,717 6,028 Sales taxes 2,520 2,458 4,978 Cigarette taxes 10,607 10,607 Other tobacco product taxes Fire Arms taxes Interest income 0 0 Retirement plan contribution 4,737 4,737 9,473 TOTAL NONOPERATING REVENUE 10,569 20,954 31,523 NET INCOME (LOSS) (7,941) (9,984) (17,924) 14

15 Stroger Hospital Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 39,086 16,398 55,484 EHR incentive program revenue 0 0 Other revenue Total Revenue 39,525 16,901 56,426 OPERATING EXPENSES: Salaries and wages 24,730 25,249 49,980 Employee benefits 6,890 6,890 13,779 Supplies 1,560 2,472 4,032 Purchased svs, rental & other 4,447 3,994 8,442 Insurance expense 1,297 1,297 2,593 Depreciation 1,841 1,841 3,683 Utilities 0 0 TOTAL OPERATING EXPENSES 40,765 41,744 82,509 GAIN (LOSS) FROM OPERATIONS (1,241) (24,843) (26,084) NONOPERATING REVENUE: Property taxes ,625 Sales taxes ,182 Cigarette taxes 3,617 3,617 Other tobacco product taxes Fire Arms taxes Interest income 0 0 Retirement plan contribution 2,932 2,932 5,864 TOTAL NONOPERATING REVENUE 4,444 8,021 12,465 NET INCOME (LOSS) 3,203 (16,822) (13,619) 15

16 ACHN (Clinics) Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 11,901 11,486 23,387 Other revenue Total Revenue 11,946 11,486 23,432 OPERATING EXPENSES: Salaries and wages 2,992 3,054 6,046 Employee benefits ,827 Supplies 1,677 1,696 3,373 Purchased svs, rental & other Insurance expense Depreciation Utilities 4 4 TOTAL OPERATING EXPENSES 6,133 6,224 12,357 GAIN (LOSS) FROM OPERATIONS 5,813 5,261 11,075 NONOPERATING REVENUE: Property taxes ,492 Sales taxes ,302 Cigarette taxes 4,265 4,265 Other tobacco product taxes Interest income 0 0 Retirement plan contribution TOTAL NONOPERATING REVENUE 1,928 6,094 8,022 NET INCOME (LOSS) 7,741 11,355 19,096 16

17 Medicaid Expansion Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 21,383 38,004 59,387 Total Revenue 21,383 38,004 59,387 OPERATING EXPENSES: Salaries and wages ,551 Employee benefits Supplies 5 6,074 6,078 Purchased svs, rental & other 19,234 19,846 39,080 Insurance expense TOTAL OPERATING EXPENSES 20,156 26,847 47,003 GAIN (LOSS) FROM OPERATIONS 1,227 11,157 12,384 NONOPERATING REVENUE: Retirement plan contribution TOTAL NONOPERATING REVENUE NET INCOME (LOSS) 1,296 11,226 12,522 17

18 Oak Forest Health Center Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue (0) 0 0 Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages ,056 Employee benefits Supplies Purchased svs, rental & other Insurance expense Depreciation TOTAL OPERATING EXPENSES ,950 GAIN (LOSS) FROM OPERATIONS (960) (937) (1,897) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes Other tobacco product taxes Interest income 0 0 Retirement plan contribution TOTAL NONOPERATING REVENUE ,315 NET INCOME (LOSS) (631) 49 (582) 18

19 Provident Hospital Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 1, ,963 Other revenue Total Revenue 1,998 1,002 3,000 OPERATING EXPENSES: Salaries and wages 2,733 2,863 5,596 Employee benefits ,399 Supplies Purchased svs, rental & other Insurance expense Depreciation TOTAL OPERATING EXPENSES 4,043 4,598 8,641 GAIN (LOSS) FROM OPERATIONS (2,044) (3,596) (5,641) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes Other tobacco product taxes Interest income 0 0 Retirement plan contribution TOTAL NONOPERATING REVENUE 729 1,355 2,084 NET INCOME (LOSS) (1,315) (2,241) (3,556) 19

20 Bureau of Health Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 3,743 3,725 7,468 Employee benefits 1,011 1,011 2,022 Supplies 3,968 4,516 8,485 Purchased svs, rental & other 6,319 2,442 8,761 Insurance expense Depreciation ,043 Utilities TOTAL OPERATING EXPENSES 15,889 12,413 28,302 GAIN (LOSS) FROM OPERATIONS (15,889) (12,413) (28,302) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes Other tobacco product taxes Retirement plan contribution TOTAL NONOPERATING REVENUE 705 1,062 1,768 NET INCOME (LOSS) (15,184) (11,351) (26,534) 20

21 Dept of Public Health Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Grant revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages ,661 Employee benefits Supplies Purchased svs, rental & other Insurance expense Depreciation Utilities TOTAL OPERATING EXPENSES 1,310 1,286 2,596 GAIN (LOSS) FROM OPERATIONS (1,001) (1,158) (2,159) NONOPERATING REVENUE: Property taxes Sales taxes Cigarette taxes 1,041 1,041 Other tobacco product taxes Retirement plan contribution TOTAL NONOPERATING REVENUE 566 1,580 2,146 NET INCOME (LOSS) (435) 422 (13) 21

22 Cermak Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 3,222 3,249 6,471 Employee benefits ,823 Supplies Purchased svs, rental & other Insurance expense Depreciation Utilities 1 1 TOTAL OPERATING EXPENSES 4,414 4,410 8,824 GAIN (LOSS) FROM OPERATIONS (4,414) (4,410) (8,824) NONOPERATING REVENUE: Property taxes ,873 Sales taxes Interest income 0 0 Retirement plan contribution TOTAL NONOPERATING REVENUE 1,799 1,786 3,585 NET INCOME (LOSS) (2,615) (2,623) (5,239) 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