Montefiore THE UNIVERSITY HOSPITAL FOR ALBERT EINSTEIN COLLEGE OF MEOICINE August 12, 2013 Ms. Christine Conway The Bank ofnew York Mellon New York Municipal Finance Unit 101 Barclay Street, 7W New York, NY 10286 Ms. Rhonda Neal Client Service Manager Digital Assurance Certification 390 North Orange Avenue, Suite 1750 Orlando, FL 32801 Dear Ms. Conway and Ms. O'Brien: Re: GNMA Collateralized Taxable Revenue Bonds - Series 2011 Enclosed are the following documents for Montefiore Medical Center for the period ended June 30, 2013: Interim Un-audited Financial Statements Utilization and Payor Mix Statistics These documents satisfy the continuing disclosure reporting requirements under the following agreement: Trust Indenture, dated as of May 1, 20 11 If you have any questions, please call me at (718) 920-2749. Sincerely, C~~-~ Carmen Vargas Administrative Assistant Encl. cc: Lindsay Baker 111 East 21 Oth Street Bronx, New York 10467
UTILIZATION AND PAYOR MIX STATISTICS GNMA Collateralized Taxable Revenue Bonds -Series 2011 LICENSED BEDS ADMISSIONS (1) DISCHARGES (1) PATIENT DAYS (1) AVG LENGTH OF STAY (1) MEDICARE-CMI (1) NON-MEDICARE-CMI (1) AVG. OCCUPANCY % OUTPATIENT VISITS ER VISITS-NET (2) AMBULATORY SURGERY VISITS UTILIZATION STATISTICS JUNE 2013 1,491 20,003 40,899 255,209 6.24 1.68 1.94 94.57% 122,795 118,342 17,403 JUNE 2012 1,491 41,713 41,727 238,444 5.71 1.64 1.94 87.87% 128,957 118,425 16,102 (1) EXCLUDES NEWBORN (2) EXCLUDES EMERGENCY ROOM PATIENTS ADMITTED TO THE MEDICAL CENTER. MEDICARE MEDICARE HMO MEDICAID MEDICAID HMO COMMERCIAL COMMERCIAL HMO OTHER TOTAL (1) MEDICARE MEDICARE HMO MEDICAID MEDICAID HMO COMMERCIAL COMMERCIAL HMO OTHER TOTAL (1) DISCHARGES- DETAIL JUNE 2013 8,636 7,911 4,092 11,912 4,213 3,406 729 40,899 PERCENT OF DISCHARGES BY PAYOR SOURCE JUNE 2013 21.1 2% 19.34% 10.01 % 29.13% 10.30% 8.33% 1.77% 100.00% JUNE 2012 8,978 7,509 5,085 11,229 4,302 3,910 714 41,727 JUNE 2012 21.52% 18.00% 12.19% 26.91% 10.31% 9.37% 1.70% 100.00%
CONSOLIDATED FINANCIAL STATEMENTS June 30, 2013
CONSOLIDATED STATEMENTS OF FINANCIAL POSITION Assets June30 December 3 1 June30 December 31 2013 -- 2012 2013 2012 Liabilities and net assets Current assets: Current liabilities: Cash and cash equivalents $ 41,063 $ 30,779 Trade accounts payable $ 83,335 $ 93,992 Assets limited as to use - marketable securities 43,815 48,867 Other payables and accrued expenses 160,435 141,521 Receivables for patient care less Accrued salaries, wages and related items 214,625 203,927 allowances for doubtful accounts 173,357 159,831 Current malpractice insurance premiums payable 70,810 66,638 Other receivables 71,312 52,456 Estimated insurance claims liabilities 73,189 73,189 Marketable and other securities, at market 947,794 914,410 Current portion of long-term debt 40,954 41,742 Estimated insurance claims receivable 73,189 73,189 Other current assets 35,612 29,548 Total current assets 1,386,142 I 309,080 Total current liabilities 643,348 621,009 Assets limited as to use: Marketable and other securities : Long-term debt, less current portion 561,869 537,025 Sinking fimds 72,388 68,706 Non-current defined benefit and postretirement Employee deferred compensation plan 18,291 15,220 health plan and insurance liabilities 263,897 257,537 Marketable and other securities externally designated 115,946 111,929 Estimated insurance claims liabilities- non current 414,740 414,740 Employee deferred compensation 18,291 15,220 Other non-current liabilities 340,089 303,834 Total assets limited as to use 206,625 195 855 I,598,886 1,528,356 Estimated insurance claims receivable - non current 414,740 414,740 Marketable securities held as collateral 5,884 5,880 Net assets: Unrestricted 664,716 592,3 87 Property, buildings and equipment at cost, net 849,986 775,882 Temporarily restricted 74,947 74,300 Permanently restricted 25 350 25,350 Deferred financing costs and other Total net assets 765,013 692,037 non-current assets 143,870 139,965 Total assets $ 3,007,247 $ 2,841,402 Total liabilities and net assets $ 3,007,247 $ 2,84 1,402-1-
CONSOLIDATED STATEMENTS OF OPERATIONS ACTUAL AND BUDGET COMPARED YEAR-END FINANCIAL STATEMENT FORMAT FOR THE SIX MONTHS ENDED JUNE 30, 2013 YEAR TO DATE Operating Revenue ACTUAL BUDGET VARIANCE Inpatient $ 774,246 $ 757,205 $ 17,041 2.3% Outpatient 472,840 490,649 (17,809) -3.6% Premium Revenue 279,196 282,917 (3,721) -1.3% Net patient service revenue 1,526,282 1,530,771 (4,489) -0.3% Grants and contracts 40,485 40,283 202 0.5% Contributions 1,365 1,213 152 12.5% Other 63,667 60,820 2,847 4.7% Total operating revenue 1,631,799 1,633,087 (1,288) -0.1% Operating Expenses Salaries and wages 727,525 734,341 6,816 0.9% Employee benefits 232,369 237,107 4,738 2.0% Supplies and other expenses 552,812 543,903 (8,909) -1.6% Depreciation and amortization 57,948 56,970 (978) -1.7% Interest 13,671 13,873 202 1.5% Total operating expenses 1,584,325 1,586, 194 1,869 0.1% Income from operations before certain items 47,474 46,893 581 1.2% Net realized and changes in unrealized gains on marketable and other securities 23,830 23,830 100.0% Malpractice insurance program adjustments associated with investment gains 1,025 1,025 100.0% Increase in unrestricted net assets $ 72,329 $ 46,893 $ 25,436 54.2% -2-
CONSOLIDATED STATEMENTS OF CHANGES IN NET ASSETS Temporarily Permanently Unrestricted Restricted Restricted Total Net Assets Net Assets Net Assets Net Assets Net assets at January 1, 2012 $ 455,208 $ 72,794 $ 25,350 $ 553,352 Increase in unrestricted net assets 137,1 79 - - 137,1 79 Restricted gifts, bequests and similar items - 6,226-6,226 Investment income - 570-570 Net assets released from restrictions - (5,290) - (5,290) 137,179 1,506-138,685 Net assets at December 31, 2012 592,387 74,300 25,350 692,037 Increase in unrestricted net assets 72,329 - - 72,329 Restricted gifts, bequests and similar items - 2,092-2,092 Investment income - 469-469 Net assets released from restrictions - (1,914) - (1,914) 72,329 647-72,976 Net assets at June 30, 2013 $ 664,716 $ 74,947 $ 25,350 $ 765,013-3-
CONSOLIDATED STATEMENTS OF CASH FLOWS June 30 2013 Operating Activities Increase (decrease) in net assets: Unrestricted Temporarily restricted Increase in net assets Adjustments to reconcile increase in net assets to net cash provided by operating activities: Depreciation and amortization Net realized (gains) Change in net unrealized (gains) Equity earnings from investment in limited liability company Amortization of long-term mortgage premium Changes in operating assets and liabilities: Receivables for patient care Net change in other operating assets and liabilities Net cash provided by operating activities Investing activities Acquisition of property, buildings and equipment, net Increase in marketable and other securities, net Increase in marketable securities held as collateral, net Increase in assets limited to use marketable securities, net Net cash used in investing activities Financing activities Payments of long-term debt Proceeds from long-term debt Net cash provided by investing activities Net increase in cash and cash equivalents Cash and cash equivalents at beginning of year Cash and cash equivalents at June 30, 2013 $ $ 72,329 647 72,976 57,948 (7,127) (16,703) (6,427) (467) (13,526) 34,293 120,967 (119,928) (9,554) (4) (5,718) (135,204) (20,430) 44,951 24,521 10,284 30,779 41,063-4-