Financial Statements Kit Carson County Health Service District
Kit Carson County Health Service District Rooted in excellence. Growing in trust. FINANCIAL STATEMENT SUMMARY Income Statement Summary Kit Carson County Health Service District (KCCHSD) had a net income of $11,858 for the month and a net profit of $422,982 YTD. KCCHSD had YTD budgeted income of $50,961. The budget is set up in to twelve equal months rather than volume based. KCCHSD s Net Operating Income was $11,858 for the month and a profit of $386,545 YTD. YTD Budgeted Net Operating Income was $218,699. Revenue: Gross Patient Revenue was $2,022,014 for the month and $21,493,902 YTD compared to the budget of $2,034,730 and $20,347,295. Net Patient revenue was $1,359,045 for the month and $13,051,281 YTD compared to the budget of $1,325,431 and $13,254,310. The District continues reviewing contractual and doubtful account allowances calculations quarterly to ensure accuracy throughout the year. Additional allowance has been accrued to aid in the offset of the overall AR clean-up including self-pay accounts. Expense: Operating Expense Less Depreciation at $1,258,464 was over budget for the month by $73,834. YTD Operating expense less depreciation was under budget by $79,135. Non-Operating Income (Expense): Non-Operating Income was $1,245 compared to the budget expense of $16,801. YTD the income is $36,437. Kit Carson County Health Service District 286 16 th Street Burlington, CO 80807 Phone 719-346-5311 www.kcchsd.org
Kit Carson County Health Service District Rooted in excellence. Growing in trust. Notes District is under budget YTD on all expense categories with the exception of Salaries and Wages, Purchased Service, Professional fees, and Travel and Education. o Salaries and wages is over budget by $112,137. Contract physician expense has increased substantially for ER coverage and clinic coverage of PHC and SMC. Traveler expense is substantially over budget in nursing and it is not likely this expense will decline in the near future. Home health utilized a traveler to accommodate patient needs which was not budgeted. CEO and CFO positions have increased salaries and wages. o Purchased services are over budget by $232,332 27% over budget and the deficit will continue to increase through year end. Imaging budget is not sufficient for the current purchased maintenance Home Health and Hospice is utilizing their EMR vendor for billing recovery. Transcription services were not factored in the budget Multiple interfaces have been built with Prognosis which has increased the monthly expense. Patient Financial Services is over budget due to several factors: Implementation of HRM for statement processing and patient billing follow up. Prognosis expense for the development of specific reports to implement HRM and BC Services (collection services). Implementation of ESolutions for claim scrubbing o Professional fees is over budget by $22,749 Consulting and legal fees are over budget due to the needs of the District; however, consulting expense has seen a large decline recently. ER coverage is over budget due to updating contracts for market competitiveness o Travel and Education continues to be over budget YTD. From James Butch Forrest, KCCHSD C.F.O.: Just a word of caution. Board members that have been on the board awhile may realize this, but for the board members that are new this may be new information, keep in mind as reductions in expenses have been made this year that the real savings is not $1 for $1. Because as a Critical Access Hospital we are reimbursed on a reasonable cost basis for Medicare beneficiaries. Therefore, any benefit of cost reductions will be reduced by whatever percentage of those costs which are related to Medicare Beneficiaries. For example if a cost reduction of $100 is made in an area that is 40% Medicare, your true savings is only $60, because your Medicare reimbursement when you settle up on your cost report will be reduced by $40 ($100 x 40%). Unless there have been additional contractual allowances made to account for this (and I have not had time to determine this), then your financials Year To Date may look better than what they in reality will be once the cost report is finalized. I know that the cost report preparer is working on an interim cost report for 2018 now, which should give us an idea of the impact once it is done. Kit Carson County Health Service District 286 16 th Street Burlington, CO 80807 Phone 719-346-5311 www.kcchsd.org
Kit Carson County Health Service District Rooted in excellence. Growing in trust. Days Cash on Hand KCCHSD Days Cash on Hand is 155 in October compared to 164 as of September. Days Cash on Hand calculation does not include the restricted fund CD balances. Note: Days Cash on Hand is calculated on a YTD basis consistent with the bond covenant calculation. Gross Days in AR Gross Days in AR for the District in October were 116 compared to 104.5 as of September and 104.3 as of December 2017. The AR balance has increased and the revenue has decreased. When revenue decreases, the revenue per day will be lower resulting in an increase in days in AR. Note: Gross Days in AR are calculated using a 6 month average for daily revenue Kit Carson County Health Service District 286 16 th Street Burlington, CO 80807 Phone 719-346-5311 www.kcchsd.org
Kit Carson County Health Service District Rooted in excellence. Growing in trust. Volume Inpatient volume decreased in October from September. With the exception of 2017, October volume was similar to previous years. Inpatient Volume Patient Admits 55 50 45 40 35 30 25 20 15 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2015 34 32 46 31 50 34 28 36 24 35 43 46 2016 40 49 39 45 37 40 23 36 33 30 26 35 2017 41 36 36 32 33 40 24 42 22 44 16 28 2018 43 33 38 33 41 25 38 31 36 34 Outpatient volume for October saw an increase from September. The month volume falls within the same range of previous years. Outpatient Volume Visits 1,400 1,300 1,200 1,100 1,000 900 800 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2015 1,115 945 1,297 1,066 1,010 1,084 1,190 1,199 1,073 1,066 1,000 1,099 2016 1,008 999 1,221 1,107 1,146 1,159 1,016 1,170 1,063 924 980 1,022 2017 1,045 996 1,055 994 1,010 1,035 916 1,135 955 976 953 1,008 2018 1,119 1,060 1,194 1,159 1,108 1,101 1,054 1,206 946 991 Kit Carson County Health Service District 286 16 th Street Burlington, CO 80807 Phone 719-346-5311 www.kcchsd.org
Kit Carson County Health Service District Rooted in excellence. Growing in trust. Debt Service Ratio Debt Service Ratio for October is at 1.84 which is a decrease from September at 1.87. The bond covenant requires the district to have a debt service ratio of 1.25. Debt Service Coverage Ratio Net Income 422,982 Interest exp 604,002 Dep Exp 933,532 Revenue Available for Debt Service 1,960,516 MRI 101,290 CT 81,150 Bonds 882,417 Annual Debt Service 1,064,857 Debt Service Coverage Ratio 1.84 **YTD Figures in accordance with bond convenants Kit Carson County Health Service District 286 16 th Street Burlington, CO 80807 Phone 719-346-5311 www.kcchsd.org
KIT CARSON COUNTY HEALTH SERVICE DISTRICT STATEMENT OF CHANGES IN CASH FLOW Year-to-Date Beginning Cash 4,750,083 Income From Operations: Net Operating Income (Loss) $386,545 Noncash Expenses and Revenues Included in Income: Depreciation 933,532 Changes in Operating Assets and Liabilities: Patient Receivables (823,208) Cost Report and Settlements 936,556 Inventories (44,273) Prepaid Expenses 21,098 Other Receivables 0 Accounts Payable and Accrued Expense (782,779) Nonoperating Revenues, Net 627,530 Cash Flows from Investing Activities: Investment Income 12,910 Change in Restricted Funds 222,911 Cash Flows from Financing Activities: Property Tax Receivable 579,709 Interest Expense (604,002) Change in Long Term Debt 0 Change in Fixed Assets (383,583) Change in Restricted Cash 181,511 Ending Cash $6,014,540
KIT CARSON COUNTY HEALTH SERVICE DISTRICT COMPARATIVE BALANCE SHEET Increase/ UNRESTRICTED FUNDS - ASSETS: 10/31/2018 12/31/2017 (Decrease) CURRENT ASSETS: Cash: $ 6,014,540 $ 4,750,083 $ 1,264,456 Receivables: Patient $ 8,330,239 $ 6,284,250 2,045,989 Less: Allowances for Bad Debts $ (1,883,813) $ (1,763,566) (120,247) Less: Contractual Allowances $ (3,535,628) $ (2,433,094) (1,102,534) Net Patient Receivables 2,910,798 2,087,590 823,208 Medicare / Medicaid / Cost Report $ (270,751) $ 665,805 (936,556) Property Tax Receivable $ - $ 579,709 (579,709) Other Receivables $ 29,372 $ 29,372 - Total Receivables 2,669,419 3,362,476 (693,057) Other Current Assets: Inventories $ 505,973 $ 461,700 44,273 Prepaid Expense $ 191,990 $ 213,088 (21,098) Total Other Current Assets 697,963 674,789 23,174 Total Current Assets 9,381,922 4,037,265 594,574 OTHER ASSETS: Property, Plant and Equipment $ 23,467,010 $ 23,072,705 394,305 Less: Accumulated Depreciation $ (16,547,507) $ (15,603,254) (944,254) Net Property Plant and Equipment 6,919,503 7,469,452 (549,949) Bond Funds $ 1,650,037 $ 1,831,547 (181,511) Restricted Fund Assets $ 790,915 $ 1,013,826 (222,911) Total Other Assets 9,360,454 10,314,825 (954,371) TOTAL ASSETS $ 18,742,376 $ 19,102,173 $ (359,797)
KIT CARSON COUNTY HEALTH SERVICE DISTRICT COMPARATIVE BALANCE SHEET Increase/ LIABILITIES AND FUND BALANCE: 10/31/2018 12/31/2017 (Decrease) CURRENT LIABILITIES: Accounts Payable and Accrued Expenses $ 778,072 $ 611,994 $ 166,077 Leases Payable - Current 35,450 198,561 (163,111) Bonds Payable - current - 360,000 (360,000) Vacation Payable 153,839 211,804 (57,965) Salary & Salary Deductions Payable 84,653 187,825 (103,172) Interest Payable 234,675 364,163 (129,488) Deferred Income County Tax 97,654 585,926 (488,272) Medicare / Medicaid / Cost Report 353,151 0 353,151 Total Current Liabilities 1,737,494 2,520,271 (782,779) LONG TERM LIABILITIES: Leases 318,432 318,432 0 Bonds Payable 10,430,000 10,430,000 0 Total Long Term Debt 10,748,432 10,748,432 0 Total Liabilities 12,485,925 13,268,702 (782,779) FUND BALANCE: Operating Fund 5,833,469 8,086,309 (2,252,840) Revenues over Expenses 422,982 (2,252,840) 2,675,822 Total Fund Balance 6,256,451 5,833,469 422,982 TOTAL LIABILITIES AND FUND BALANCE $ 18,742,376 $ 19,102,173 $ (359,797)
KIT CARSON COUNTY HEALTH SERVICE DISTRICT COMBINED INCOME STATEMENT Month 2018 2017 YTD 2018 2017 Actual Budget Actual OPERATING REVENUE: Actual Budget Actual $ 2,022,014 $ 2,034,730 1,914,755 Patient Revenue, Gross $ 21,493,902 20,347,295 $ 18,780,975 $ (655,200) $ (657,648) (547,105) Less: Contractual Adjustments $ (7,586,083) (6,576,481) $ (5,800,046) 1,366,814 1,377,081 1,367,651 Patient Revenue, Net of Contractual Adjustments 13,907,819 13,770,814 12,980,929 $ (7,769) $ (51,650) (38,382) Less: Provision for Uncollectable Accounts $ (856,538) (516,504) $ (682,134) 1,359,045 1,325,431 1,329,269 Patient Revenue, Net 13,051,281 13,254,310 12,298,795 $ 4,148 $ 3,103 2,399 Other Operating Revenue $ 35,963 31,029 $ 38,309 1,363,193 1,328,534 1,331,667 NET OPERATING REVENUE 13,087,244 13,285,339 12,337,105 67% 65% 69% 61% 65% 65% OPERATING EXPENSE: $ 831,895 $ 757,342 767,414 Salary and Benefits $ 7,685,560 7,573,423 $ 7,949,474 $ 128,572 $ 117,695 158,307 Supplies, Drugs and Food $ 1,025,487 1,176,949 $ 1,216,216 $ 57,677 $ 75,037 92,475 Professional Fees $ 773,123 750,373 $ 812,463 $ 103,434 $ 84,272 95,384 Purchased Service $ 1,075,050 842,718 $ 912,587 $ 7,469 $ 9,746 14,739 Repair and Maintenance $ 46,962 97,460 $ 94,431 $ 11,439 $ 12,282 11,734 Insurance $ 114,385 122,820 $ 119,989 $ 30,212 $ 26,664 36,492 Utilities $ 251,846 266,636 $ 286,415 $ 4,388 $ 4,236 4,496 Travel and Education $ 48,308 42,363 $ 108,764 $ 17,339 $ 14,731 11,113 Lease $ 132,660 147,314 $ 143,471 $ 7,499 $ 9,488 6,591 Dues, Books and Subscriptions $ 69,523 94,879 $ 80,263 $ 288 $ 1,493 378 Advertising $ 5,130 14,932 $ 13,781 $ 58,252 $ 71,644 83,149 Other $ 539,136 716,436 $ 751,047 1,258,464 1,184,630 1,282,271 Total Operating Expense Less Depreciation 11,767,168 11,846,303 12,488,899 104,729 143,904 49,397 EBIDA 1,320,076 1,439,036 (151,795) $ 94,116 $ 122,034 99,676 Depreciation $ 933,532 1,220,337 $ 1,170,963 10,613 21,870 (50,279) NET OPERATING INCOME 386,545 218,699 (1,322,758) NON-OPERATING INCOME (EXPENSE) $ (60,939) $ (63,443) (62,958) Interest (Expense) $ (604,002) (634,434) $ (631,744) $ 2,063 $ 1,340 856 Interest Income $ 12,910 13,399 $ 11,442 $ 57,382 $ 40,080 47,266 Tax Revenue $ 539,116 400,802 $ 443,957 $ 2,177 $ 110 4,254 Donations and Grants $ 10,643 1,103 $ 8,024 $ 563 $ 5,112 3,399 Other Non-Operating Income/(Loss) $ 77,770 51,122 $ 44,177 1,245 (16,801) (7,183) Total 36,437 (168,008) (124,143) $ 11,858 $ 5,069 (57,462) NET INCOME $ 422,982 50,691 $ (1,446,901)