Jackson-Madison County General Hospital Changes in Active Medical Staff

Jackson-Madison County General Hospital Changes in Active Medical Staff 2016-2017 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 18 22 4 18 82% 43 2,947 40 39 (I) 28 72% 50 1,233 Obstetrics/Gynecology 29 28 (I) 26 93% 50 3,388 Neonatology 3 3 0 3 100% 53 1,006 Pediatrics 16 16 0 12 75% 49 473 Subtotal 106 108 2 9,047 MEDICINE Cardiology 27 28 I 26 93% 49 5,235 Dennatology 0 3 0 0 0% 347 Gastroenterology 10 II 1 JO 91% 53 2,284 Hematology/Mycology 4 5 I 5 100% 49 248 Nephrology 10 11 I 10 91% 57 1,767 Neurology 6 6 0 6 100% 46 1,712 Physical Medicine/Rehab 2 2 0 2 100% 58 922 Pulmonary 7 6 (I) 6 100% 54 2,558 ' Subtotal 66 69 3 15,073 SURGERY General Surgery 10 12 2 10 83% 46 1,742 Cardiac Surgery 3 2 2 100% 52 803 Neurosurgery 2 2 (I) 2 100% 44 308 Ophthalmology 7 7 0 7 100% 49 20 Otolaryngology 4 3 0 3 100% 47 64 Orthopedics 14 15 (I) 13 87% 47 1,930 Plastic Surgery 4 2 1 2 100% 48 69 Urology 8 9 (2) 9 100% 51 363 Subtotal 52 52 0 5,299 OTHER SPECIAL TIES Psychiatry 0 0 0 0% 55 Anesthesia 18 19 I 15 79% 50 Emergency Medicine 16 14 (2) 12 86% 45 Pathology 4 4 0 4 100% 54 Radiology 11 12 I 12 100% 45 All Others 3 3 0 3 100% 55 2,560 Therapeutic Radiology 2 2 0 2 100% 56 Subtotal 54 54 0 2,615 Total 278 283 5 248 88% 32,034

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 1,970 52 740 40 709 60 692 37 685 35 681 35 680 46 666 48 625 54 619 8,067 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% 100.00%

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

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 2017. Fiscal Year Ended June 30, 2017 2016 2015 Medicare 53% 51% 51% Medicaid/TennCare 14% 14% 13% Commercial 27% 29% 29% Self-Pay and Other 6% 6% 7% Totals 100% 100% 100%

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, 2015 2016 2016 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 $19,450 4.19 x $ 10,365 44,561 15,154 6,603 $76,683 $19,450 3.94 x $ 40,558 46,622 14,864 (21,199) $80,845 $19,450 4.16 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, 2015 2016 2017 Increase in net position from Audited Financial Statemer $ 15,500 $ 9,424 $ 39,642 Add: Contribution to City of Jackson and Madison County 400 400 400 Contribution to City of Jackson: Sportsplex 150 150 150 Contribution to WTH Foundation 363 391 366 Income before Capital Contributions $ 16,413 $ 10,365 $ 40,558

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, 2017 8,956 4,535 1,691 2,024 1,678 1,409 1,375 1,310 22,978 Fiscal Year Ended June 30, 2016 8,972 4,739 1,940 1,742 1,657 1,316 1,341 1,238 22,945 2015 8,491 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 1,311 872 854 842 820 640 598 458 191 8,162 1,499 1,453 896 885 787 737 607 577 523 213 8,177 1,308 1,187 828 808 764 716 566 512 490 195 7,374 Total Service Area 31,140 31, 122 28,993 Other Areas Total 894 32,034 838 31,960 753 29,746 [c 11 Data includes newborns.] Source: Joint Annual Report of Hospitals.

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, 2017 2016 2015 Licensed beds< 1 l 690 635 635 Beds in,service 0 l 690 635 635 Average daily census 483 480 446 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) 176,141 175,525 162,628 Outpatient equivalent days 184,801 181,179 183,319 Adjusted patient days 360,942 356,704 345,947 Average length of stay 5.6 5.6 5.6 Discharges (excluding newborns) 30,174 29,956 27,769 Emergency room visits 101,155 103,711 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 20,418 111 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, 2017. 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.

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 2017. Lig_uidity Position June 30, 2015 2016 Cash and cash equivalents $ 34,564,905 $ 30,912,492 $ Total Assets limited as to use 362,267,972 358,517,017 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 236 214 2017 29,492,260 353,320, 719 (5,573,059) 377,239,920 718,136,284 14,864,198 ( 46,621, 770) 686,378,712 1,880,490 201 Cae_italization June 30, 2015 2016 Long-term indebtedness $301,861,110 $294,329,299 Unrestricted net assets 363,341,894 366,007,377 Net Investment in capital assets 114,835,077 121,618,646 Total capitalization $780,038,081 $781,955,322 Long-term indebtedness to capitalization ratio 39% 38% 2017 $287,252,650 394,269,833 133,066,138 $814,588,621 35% Cash to Debt June 30, 2015 2016 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 295,591,110 288,444,299 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 $6,095,000 281,157,650 $287,252,650 131%

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 6/30/2035 10,215,000 3,485,150 13,700,150 3,905,000 1,844,056 5,749,056 14,120,000 5,329,206 19,449,206 6/30/2036 10,720,000 2,974,400 13,694,400 4,125,000 1,624,400 5,749,400 14,845,000 4,598,800 19,443,800 6/30/2037 11,255,000 2,438,400 13,693,400 4,360,000 1,392,369 5,752,369 15,615,000 3,830,769 19,445,769 6/30/2038 11,705,000 1,988,200 13,693,200 4,605,000 1,147,119 5,752,119 16,310,000 3,135,319 19,445,319 6/30/2039 12,175,000 1,520,000 13,695,000 4,865,000 888,088 5,753,088 17,040,000 2,408,088 19,448,088 6/30/2040 12,665,000 1,033,000 13,698,000 5,140,000 608,350 5,748,350 17,805,000 1,641,350 19,446,350 6/30/2041 13,160,000 526,400 13,686,400 5,440,000 312,800 5,752,800 18,600,000 839,200 19,439,200 Total 205,965,000 150,092,585 356,057,585 78,015,000 71,508,194 149,523,194 283,980,000 221,600,779 505,580,779