Cooper Health Care Financial Report: December 2015 The Obligated Group reported an operating gain for the year of $55,727,000 against a budget gain of $49,661,000 and prior year gain of $43,908,000. Our total revenue growth is 11.8% above prior year and 4.2% above budget while our expense growth is 11.3% above prior year and 4.5% ahead of budget (excluding interest, depreciation and amortization). Total operating revenue for the year was favorable to budget by $42,477,000. Total net patient revenue was favorable to budget principally as a result of higher than anticipated patient volumes for admissions, cardiac catherizations, cancer, trauma, physician visits, and payer mix index. Other operating revenue was favorable to budget due to the increase in physician service contracts, and grant revenue related to the neighborhood revitalization project with Department of Community Affairs. Total operating expenses year to date were unfavorable to budget by $36,411,000. The unfavorable variances were principally the result of higher than anticipated expenses for physician compensation plan and the onboarding of new clinical staff to handle the increased volume we have had over the prior year. Medical and surgical supplies were unfavorable to budget due to favorable patient volume, specifically cardiac caths and cancer. In addition, other supplies and expenses were unfavorable to budget due to the neighborhood revitalization project with Department of Community Affairs, offset by other operating revenue. This unfavorable variance was offset by favorable variances in employee benefits, interest expense, and depreciation and amortization expenses. Below are key performance indicators & statistics for the month and year to date: Key Performance Indicators Year to Date Financial Performance Indicators Actual Target Var PY Actual Total Operating Revenue Growth % 11.7% 7.3% 59.8% 8.1% Total Operating Expense (less depn/int) Growth % 11.3% 6.5% 73.8% 5.5% Total Operating Revenue $ 1,056,738 $ 1,014,261 4.2% $ 945,597 Total Operating Expenses $ 1,001,011 $ 964,600 3.8% $ 901,689 EBITDA $ 107,783 $ 105,840 1.8% $ 92,666 Volume Indicators Total Admissions 29,473 29,419 0.2% 27,859 Adult Patient Days 136,931 136,210 0.5% 128,879 ² Total outpatient volumes 249,626 256,921 2.8% 237,116 ¹ Cancer 84,612 73,974 14.4% 69,898 Total ER Visits 76,571 80,686 5.1% 77,865 CUP Visits 1,150,694 1,105,616 4.1% 1,027,751 Total Ambulatory Procedures 17,613 16,852 4.5% 16,375 Cyber Knife & Gamma Knife Ga 268 258 3.9% 270 Total Cardiac Cath Lab 6,928 6,489 6.8% 6,334 Total Surgical Volume 17,823 18,247 2.3% 17,113 Trauma Registry 3,625 3,492 3.8% 3,412 FTEs per Adjusted Occupied Bed 5.44 5.46 0.4% 5.55 Case mix index all payer 1.64 1.64 0.0% 1.62 Payor Mix Index 1.17 1.15 1.7% 1.16 1 - Outpatient Cancer Volumes 2 - Total Outpatient Volumes (Excluding Cancer) 1
The Obligated Group s current financial statements reflect the following key ratios: Ratio or Value December December NJ FAST Report Moody s Baa2 2015 2014 50 th Percentile Rating Operating margin % YTD 5.3% 4.6% 4.3% 1.0% Current ratio 2.2 2.3 1.9 1.9 Modified Days Cash on Hand 125.4 138.2 122.0 150.5 Days in A/R 44.7 40.5 44.2 49.7 2
THE OBLIGATED GROUP FINANCIAL STATEMENTS December-15
Obligated Group Combined Balance Sheets (Dollars in thousands) December 31, November 30, December 31, December 31, November 30, December 31, 2015 2015 2014 2015 2015 2014 Current Assets Current Liabilities Cash and cash equivalents $ 145,306 $ 147,574 $ 165,907 Accounts payable 42,988 27,346 17,182 Accrued payroll and taxes 15,841 33,648 29,364 Assets limited as to use 23,718 22,852 18,368 Accrued vacation 15,018 17,174 13,731 Accrued Liabilities 44,505 40,057 49,126 Patient accounts receivable 153,923 159,730 134,030 Accrued Interest 3,802 2,954 2,055 Allowance for doubtful accounts (25,718) (30,321) (28,145) Settlements with third party payors 10,124 9,176 12,587 Net patient accounts receivable 128,205 129,409 105,885 Current portion of long term debt 6,569 6,317 1,987 Current portion of self-insured reserve 18,549 18,642 18,642 Other receivables, net 18,259 15,653 10,679 Inventories 22,583 21,895 19,663 Total current liabilities 157,396 155,314 144,674 Prepaid expenses 7,444 6,263 7,793 Due from affiliates 364 1,659 (1,137) Total current assets 345,879 345,305 327,158 Settlements with third party payors 2,165 9,881 10,309 Assets Limited as to use Accrued pension costs 11,965 14,209 11,690 Internally designated by board 206,022 207,605 186,733 Funds held by trustee - debt service reserve 256 256 - Notes Payable 22,296 22,296 22,296 Funds held by trustee-designated for capital 18,955 22,646 26,462 Self-insured programs 25,876 24,316 32,354 Deferred revenue 16,048 16,522 13,673 Endowment fund 633 642 660 Long term debt 267,740 271,944 279,555 Total asets limited as to use 251,742 255,465 246,209 Self-insured reserves 47,575 45,703 50,552 Total liabilities 525,185 535,869 532,749 Property, plant and equipment 909,882 897,009 832,799 Accumulated depreciation and amortization (453,503) (447,808) (412,615) Net Assets Net property, plant and equipment 456,379 449,201 420,184 Unrestricted 547,795 537,154 483,609 Temporarily restricted - - - Deferred charges 775 4,669 5,174 Permanently restricted 439 439 439 Notes Receivable 15,781 15,781 15,781 Other Asset 2,861 3,040 2,287 Total Net Assets 548,234 537,593 484,048 TOTAL $ 1,073,419 $ 1,073,462 $ 1,016,797 TOTAL $ 1,073,419 $ 1,073,462 $ 1,016,797
Obligated Group Combined Statements of Operations and Changes in Net Assets for the month and the 12 months ended December 31, 2015 (Dollars in thousands) Year-to-date Current Year Prior Year T Actual S Budget S Variance S Actual Inpatient $ 508,076 $ 500,515 $ 7,561 $ 459,941 Outpatient 538,696 533,074 5,622 495,976 Net patient revenue 1,046,772 1,033,589 13,183 955,917 Provision for bad debt (60,798) (80,527) 19,729 (70,002) Net patient revenue, net of bad debts 985,974 953,062 32,912 885,915 Other operating revenue 70,764 61,199 9,565 59,682 Total operating revenue 1,056,738 1,014,261 42,477 945,597 Salaries and wages 513,615 496,900 (16,715) 463,230 Temp staff expenses 1,989 328 (1,661) 819 Employee benefits 95,292 98,929 3,637 88,302 Medical and surgical supplies 149,773 132,425 (17,348) 129,894 Consulting and Management Fees 40,836 37,688 (3,148) 32,096 Other supplies and expenses 110,834 106,087 (4,747) 99,186 Malpractice expense 11,764 11,856 92 15,607 Leases and rentals 24,854 24,208 (646) 23,797 Depreciation and amortization 39,027 42,989 3,962 38,154 Interest expense 13,027 13,190 163 10,604 Total operating expenses 1,001,011 964,600 (36,411) 901,689 Operating margin 55,727 49,661 6,066 43,908 Investment income and realized gains (losses) 7,214-7,214 9,690 Unrealized G/L from market valuation swap (379) - (379) (4,375) Gain/Loss On Equity Method Investment (984) - (984) - Net unrealized g/l on trading securities (5,907) - (5,907) 5,361 Loss on Partial Pension Termination (6,239) - (6,239) - Excess / (Deficit) of revenues over expenses 49,432 49,661 (229) 50,210 Contributions for capital acquisitions 7,904-7,904 10,553 Changes in unrealized gains (losses) (1,635) - (1,635) (509) Additional Minimum Pension Liability 8,483 8,483 (8,413) Increase / (Decrease) in unrestricted net assets $ 64,184 $ 49,661 $ 14,523 $ 51,841
Obligated Group Statement of Cash Flows for the month and the 12 months ended December 31, 2015 (Dollars in thousands) Year-to-date Operating activities: Increase (decrease) in net assets $ 64,186 Adjustments to reconcile increase (decrease) in net assets to net cash provided by operating activities: Change in pension benefits obligation 8,483 Loss on Partial Pension Termination 6,239 Depreciation and amortization 39,027 Provision for bad debt 60,798 Contributions for capital acquisitions (7,904) Net realized and unrealized (gain/loss) on investments 7,125 Changes in certain assets and liabilities: Patient accounts receivable (83,117) Prepaid and other current assets (5,070) Assets limited as to use (25,169) Accounts payable and accrued expenses 11,757 Self-insured programs (11,278) Settlements with third party payors (10,607) Due to /from affiliates, net (1,501) Other liabilities 2,375 Net cash provided by operating activities 55,344 Investing activities: Decrease (increase) in assets limited as to use 7,161 Capital expenditures (77,538) Net cash provided by investing activities (70,377) Financing activities: Repayments of long-term debt (7,233) Accounting for Capital Lease - Loss on extinguishment of debt Financing fees incurred Payments on extinguishment of debt Proceeds from long-term debt Contributions for capital acquisitions 7,904 Net cash provided by financing activities 671 Net increase (decrease) in cash and cash equivalents (20,601) Cash and cash equivalents at beginning of period 165,907 Cash and cash equivalents at end of period $ 145,306