MONTHLY STATISTICAL SUMMARY Prior YTD YEAR - TO - DATE OUTPATIENT SERVICES Actual Actual Budget Variance Outpatient Surgeries 4,057 4,282 3,842 440 Laboratory Tests 218,240 225,011 216,341 8,670 Physical Therapy 35,884 37,486 35,864 1,622 Dialysis Treatments 3,496 0 0 0 Diagnostic Radiology 63,658 62,321 64,324 (2,003) MRI Procedures 3,077 3,400 3,561 (161) MICU 4,328 2,930 3,460 (530) Cardiac Cath Lab 181 144 174 (30) Cardiac Cath Lab PCI 0 0 0 0 Therapeutic Radiology - HDR 19 54 46 8 Therapeutic Radiology - IMRT/Megavolt 1,846 2,050 1,780 270 Therapeutic Radiology - General 1,933 1,966 1,706 260 Emergency Room 35,634 34,925 36,662 (1,737) TOTAL OUTPATIENT SERVICES 372,353 374,569 367,760 6,809 OBSERVATIONS 4,031 3,476 3,530 (54) NEW INPATIENT CASES Admissions - Adult & Pediatric 7,167 7,110 7,098 12 Special Care Nursery & NICU 61 64 57 7 Transitional Care Unit 0 0 0 0 Subtotal 7,228 7,174 7,155 19 Mental Health 671 635 652 (17) TOTAL NEW INPATIENT CASES 7,899 7,809 7,807 2 BIRTHS 743 701 728 (27) PATIENT DAYS Adults & Pediatrics 29,946 31,668 29,624 2,044 Special Care Nursery & NICU 1,051 1,100 1,082 18 Transitional Care Unit 0 0 0 0 Subtotal 30,997 32,768 30,706 2,062 Mental Health 4,776 4,668 4,627 41 TOTAL PATIENT DAYS 35,773 37,436 35,333 2,103
MONTHLY STATISTICAL SUMMARY Prior YTD YEAR - TO - DATE AVERAGE DAILY CENSUS Adults & Pediatrics 329 352 329 22.71 Special Care Nursery & NICU 12 12 12 0.20 Transitional Care Unit 0 0 0 0.00 Subtotal 340.63 364.09 341.18 22.91 Mental Health 52 52 51 0.46 TOTAL AVERAGE DAILY CENSUS 393.11 415.96 392.59 23.37 AVERAGE LENGTH OF STAY Adults & Pediatrics 4.2 4.5 4.2 (0.3) Special Care Nursery & NICU 17.2 17.2 19.0 1.8 Transitional Care Unit 0.0 0.0 0.0 0.0 Subtotal 4.3 4.6 4.3 (0.3) Mental Health 7.1 7.4 7.1 (0.3) TOTAL AVERAGE LENGTH OF STAY 4.5 4.8 4.5 (0.3) TOTAL OCCUPANCY 61.4% 65.0% 61.3% 3.7%
BALANCE SHEET ASSETS LIABILITIES & NET ASSETS 2017 2017 2016 2017 2017 2016 February March December February March December CURRENT ASSETS: CURRENT LIABILITIES: Cash & Cash Equivalents $173,250,260 $130,525,416 $166,652,347 Current Portion of Debt $6,829,843 $6,830,512 $6,828,311 Assets Limited as to Use 5,782,414 6,950,834 7,436,125 Accounts Payable 11,307,237 10,527,911 9,320,150 Patient Service Receivables, Net 74,286,744 72,213,923 67,867,338 Accrued Expenses 61,438,341 60,071,510 61,746,521 Accrued Payroll 15,766,048 7,481,878 12,811,503 Due from Affiliates, Net 48,325,346 44,746,104 43,757,924 Accrued Pension 183,299 183,299 183,299 Inventory 5,835,212 5,898,289 5,892,156 Deferred Support 6,334,383 6,544,666 5,810,603 Other Current Assets 17,361,188 17,499,064 16,740,973 Accrued Interest Payable 2,073,618 2,893,636 4,859,374 Other Current Assets - TKC Receivable 2,428,725 0 2,394,060 Estimated Third Party Payables 54,276,254 55,020,881 50,436,197 Other Current Liablity - Cooper Bone & Joint Receivables 0 0 0 Other Current Assets - Cooper Bone & Joint Receivables 553,662 553,662 552,542 Accrued Vacation/ PTO 20,227,412 20,522,925 17,800,101 TOTAL CURRENT ASSETS 327,823,551 278,387,292 311,293,465 TOTAL CURRENT LIABILITIES 178,436,435 170,077,218 169,796,059 LONG TERM ASSETS LIMITED AS TO USE: ACCRUED RETIREMENT BENEFITS 7,730,422 7,135,364 6,866,176 By Board of Directors 411,846,020 459,071,449 400,644,208 INTEREST RATE SWAPS 8,880,715 8,725,526 9,149,781 Interest Rate Swaps 8,880,715 8,725,526 9,149,781 OTHER LIABILITIES 55,406,281 55,369,180 59,894,143 Debt Service Reserve 0 0 9,552,038 LONG-TERM DEBT 194,982,703 194,753,527 195,448,203 PROPERTY, PLANT, & EQUIPMENT, NET 347,785,356 347,396,296 345,174,787 TOTAL LIABILITIES 445,436,556 436,060,815 441,154,362 NET DEFERRED FINANCING COSTS & OTHER ASSETS 32,924,080 34,278,593 33,672,311 BENEFICIAL INTEREST IN CAPITAL CAMPAIGN 1,081,409 1,133,690 1,194,909 INVESTMENT IN SUBSIDIARY 0 0 135,306 TRUSTEE HELD ASSETS 8,253,226 8,376,013 8,260,707 TOTAL NET ASSETS 693,157,801 701,308,044 668,371,112 TOTAL ASSETS $1,138,594,357 $1,137,368,859 $1,119,077,512 TOTAL LIABILITIES & NET ASSETS $1,138,594,357 $1,137,368,859 $1,109,525,474
STATEMENT OF REVENUES AND EXPENSES YEAR - TO - DATE 2016 2017 Variance from Actual Actual Budget Budget Unrestricted net assets Operating Revenue: Net Patient Revenue $155,510,795 $164,059,756 $162,234,192 $1,825,564 Other Operating Revenue 4,670,889 5,686,919 4,558,144 1,128,775 Subsidy Revenue 2,355,353 1,399,286 1,414,287 (15,001) Asset Released from Restriction 2,271 5,317 0 5,317 Total Operating Revenue: 162,539,308 171,151,278 168,206,623 2,944,655 Operating Expenses: Salaries & Wages 61,496,442 63,757,886 64,307,543 549,657 Physician Fees 7,050,415 7,192,657 7,482,919 290,262 Employee Health & Welfare 22,344,524 24,231,614 22,804,347 (1,427,267) Agency Personnel 0 28,920 0 (28,920) Supplies & Other Expenses 45,620,500 46,094,682 45,363,594 (731,088) Depreciation & Amortization 11,128,881 10,942,605 10,942,611 6 Interest 2,361,763 1,917,129 1,957,967 40,838 Total Operating Expenses 150,002,525 154,165,493 152,858,981 (1,306,512) Excess (Deficit) from Operations 12,536,783 16,985,785 15,347,642 1,638,143 Non Operating Income 314,946 12,487,027 2,334,660 10,152,367 Change in unrealized gains/(losses) on investments 19,548 2,302,950 0 2,302,950 Excess (deficiency) of revenue and gains over expenses 12,871,277 31,775,762 17,682,302 14,093,460
STATEMENT OF REVENUES AND EXPENSES YEAR - TO - DATE 2016 2017 Variance from Actual Actual Budget Budget Excess (deficiency) of revenue and gains over expenses 12,871,277 31,775,762 17,682,302 14,093,460 Other changes in unrestricted net assets: Net transfers to/(from) affiliates 390,204 378,073 0 378,073 Assets released from restriction (5,825) (980) 0 (980) Other Changes in Net Assets 562,251 320,316 0 320,316 Increase (decrease) in unrestricted net assets 13,817,907 32,473,171 17,682,302 14,790,869 Temporarily restricted net assets: Contributions 269 0 0 0 Other Transfers 0 0 0 0 Assets released from restriction 3,554 (4,337) 0 (4,337) Increase (decrease) in beneficial interest in temporary trust 7,549 0 0 0 Increase (decrease) in beneficial interest in capital campaign 0 352,793 0 352,793 Increase (decrease) in temporarily restricted net assets 11,372 348,456 0 348,456 Permanently restricted net assets: Increase (decrease) in beneficial interest in perpetual trust (268,911) 115,305 0 115,305 Increase (decrease) in permanently restricted net assets (268,911) 115,305 0 115,305 Increase (decrease) in net assets 13,560,368 32,936,932 17,682,302 15,254,630 Net assets, beginning of year 581,089,011 668,371,112 Net assets, end of year 594,649,379 701,308,044
STATEMENT OF CASH FLOWS YTD 2016 Operating Activities: Excess/(deficit) $32,936,932 Adjustments to reconcile increase in net assets to net cash provided by operating activities: Transfers from affiliates, net 0 Depreciation & amortization 10,942,077 Net realized and unrealized losses/(gains) on investments (15,335,833) Beneficial interest in perpetual and temporary trusts (115,306) Estimated other liability costs (4,524,963) Change in certain assets and liabilities: 0 Patient accounts receivable (4,346,585) Inventory (6,133) Prepaid expenses and other current assets 1,569,034 Due from affiliates (922,365) Due to Inspira Medical Centers 0 Accounts payable & accrued expenses (2,070,800) Accrued interest payable (1,965,738) Estimated settlements to third-party payers 4,584,684 Net cash provided by/(used in) operating activities 20,745,004 Investing Activities: Additions to property and equipment, net (13,118,034) (Increase) / Decrease in assets limited as to use (42,181,862) Increase in other assets (768,175) Net cash provided by/(used in) investing activities (56,068,071) Financing Activities: (Increase) / Decrease in deferred financing costs 312,866 Proceeds from additional borrowings 0 (Increase) / decrease in interst rate swap (424,255) Principal payments of long-term debt (692,475) Net cash provided by/(used in) financing activities (803,864) Increase/(decrease) in cash (36,126,931) Cash and equivalents, beginning of month/year 166,652,347 Cash and equivalents, end of month/year $130,525,416
FINANCIAL RATIOS FAST Moody's Preferred 75th Percentile "A" Rated March Movement 12/31/2016 FY 2015 2017 Total Occupancy (Maintained Beds) Increase 69.48% 65.95% 65.00% Total Occupancy (Licensed Beds) Increase 58.10% N/A 72.20% Operating Margin (%) Increase 8.39% 4.90% 9.90% Operating Cash Flow Margin (%) Increase N/A 11.80% 17.44% Total Margin (%) Increase 9.07% 6.60% 17.09% Current Ratio Increase 2.85 2.20 1.64 Days Cash On Hand Increase 198.24 255.00 370.50 Cash-to-debt (%) Increase N/A 1.81 2.96 Cash Flow to Total Debt (%) Increase 30.00% N/A 34.07% LT Debt-to-equity (%) Decrease 38.00% N/A 27.77% A/R Days Outstanding Decrease 38.33 47.70 39.28 Charity Care As A Percentage Of Gross Charges Decrease 1.56% N/A 0.74% Debt Service Coverage Increase N/A 6.00 6.21 Cushion Ratio Increase N/A 24.40 39.23
DEBT SERVICE CALCULATION Actual Actual Projected March Annualized from Budget Budgeted* Net Income, year to date 31,775,762 127,103,048 80,535,659 66,721,215 Interest Expense 1,917,129 1,917,129 1,917,129 7,789,503 Depreciation & Amortization 10,942,605 43,770,420 10,942,605 43,770,440 Funds Available for Debt Service $44,635,496 $172,790,597 $93,395,393 $118,281,158 Maximum Annual Principle & Interest Payments 15,030,584 15,030,584 15,030,584 Debt Service Coverage Ratio 11.50 6.21 7.87