University Medical Center of El Paso

University Medical Center of El Paso FINANCIAL REPORT April 2018

Chief Financial Officer Report.. 1-19 Financial Statements EL PASO COUNTY HOSPITAL DISTRICT MONTHLY FINANCIAL REPORT April 2018 TABLE OF CONTENTS Consolidated Balance Sheets.. Statements of Revenues, Expenses and Changes in Net Position MTD. Consolidating Statement of Revenues, Expenses and Changes in Net Position MTD Statements of Revenues, Expenses and Changes in Net Position YTD Consolidating Statement of Revenues, Expenses and Changes in Net Position YTD 20 21 22 23 24 Consolidated Statement of Cash Flows 25-26 Supplemental Information District Scorecard Campus Consolidating Balance Sheet... 27-28 29 Campus Consolidating Statement of Revenues, Expenses and Changes in Net Position MTD Campus Consolidating Statement of Revenues, Expenses and Changes in Net Position YTD 30 31 Graphs Days Cash on Hand & Average Length of Stay - Acute 32 Statistical 33-34 Financial.. Payor Mix Other 35 36 37-39

Chief Financial Officer Report For the month and seven months ended April 30, 2018 Bond Ratings FitchRatings AA, with a stable outlook February 21, 2017 Moody s A2, with a stable outlook March 22, 2017 Standard & Poors A, with a negative outlook February 16, 2017 ****************************************************************************** This section covers the following affiliates: University Medical Center of El Paso (UMC) El Paso Health (EPH) University Medical Center Foundation (the Foundation), to include UMC Foundation and El Paso Children s Foundation El Paso Children s Hospital (EPCH) ****************************************************************************** Monthly Change in Net Position (in 000 s) UMC EPH Foundation EPCH Elim Total Actual $ (1,275) (1,295) 37 (1,598) 127 $ (4,004) Budget (2,019) 216 279 (265) 127 (1,662) Variance $ 744 (1,511) (242) (1,333) 0 $ (2,342) Earnings before depreciation and amortization expense approximate ($1.8) million. Year to date Change in Net Position (in 000 s) UMC EPH Foundation EPCH Elim Total Actual $ (13,227) (2,218) 252 (8,842) 890 $ (23,145) Budget (1,177) 125 1,086 (334) 889 589 Variance $ (12,050) (2,343) (834) (8,508) 1 $ (23,734) Earnings before depreciation and amortization expense approximate ($6.5) million. 1

****************************************************************************** This section covers the following affiliates: University Medical Center of El Paso (UMC) El Paso Health (EPH) University Medical Center Foundation (the Foundation) ****************************************************************************** Key Ratios Current Ratio.92 Days Cash on Hand 43.0 Days Revenue in Receivables 53.1 Average Payment Period 44.2 Monthly Net Position Change (in 000 s) UMC EPH Foundation Total Actual $ (1,275) (1,295) 37 $ (2,533) Budget (2,019) 216 279 (1,524) Variance $ 744 (1,511) (242) $ (1,009) Prior year net position decrease was $2 million. Earnings before depreciation and amortization expense approximate ($431) thousand. Year to date Net Position Change (in 000 s) UMC EPH Foundation Total Actual $ (13,227) (2,218) 252 $ (15,193) Budget (1,177) 125 1,086 34 Variance $ (12,050) (2,343) (834) $ (15,227) Prior year year to date net position decrease was $9.5 million. Earnings before depreciation and amortization expense approximate $581 thousand. 2

April 2018 Key Operational Statistics UMC 4/30/18 4/30/18 4/30/17 Actual Budget Variance Actual Variance Outpatient Adjustment Factor 2.08 2.08 0% 2.10 1% Adjusted Admissions 2,700 2,537 6% 2,464 10% Admissions 1,295 1,222 6% 1,175 10% Average Daily Census 195.0 187.2 4% 182.7 7% Average Length of Stay 4.59 4.62 0.7% 4.64 1.0% Surgery cases 657 639 3% 596 10% Endoscopy procedures 723 565 28% 571 27% Births 199 261 24% 219 9% Emergency Room visits 5,105 4,805 6% 4,777 7% ER Admission Rate 91.9% 87.3% 5.2% 89.9% 2.2% Outpatient Visits 70,776 67,824 4% 61,091 16% Hospital Ancillary 59,093 55,767 6% 51,472 15% Primary Care Clinics 10,902 11,020 1% 8,610 27% Womens and Pre Natal 781 1,037 25% 1,009 23% 3

El Paso Health 4/30/18 4/30/18 4/30/17 Actual Budget Variance Actual Variance State Program Membership 75,288 78,523 4% 75,206 0% STAR 64,891 67,518 4% 64,398 1% CHIP 10,003 10,582 5% 10,419 4% Perinate 394 423 7% 389 1% Other Membership 21,118 21,125 0% 20,783 2% HealthCare Options 14,518 14,360 1% 14,154 3% UMC TPA 5,675 5,790 2% 5,661 0% UMC Retiree Program 28 0 100% 11 155% EPCH TPA 897 975 8% 957 6% 4

April 2018 Monthly Financial Results Operating Revenues For the month ended April 30, 2018 April 30, 2017 (unaudited) actual budget % variance fav/(unfav) actual % variance fav/(unfav) Operating Revenues Patient Service revenue, net $ 19,333,025 $ 16,810,913 15% $ 15,880,355 22% Premium revenue 14,326,899 14,155,230 1% 14,436,417-1% Medicaid Supplemental revenue 6,254,561 7,311,002-14% 6,733,069-7% Contract revenue, net 1,729,525 1,632,476 6% 1,761,468-2% In-kind revenue 890,805 775,514 15% 621,137 43% Contribution revenue 320,397 440,255-27% 134,528 138% Other revenue 2,328,737 2,292,741 2% 2,278,391 2% Total operating revenues 45,183,949 43,418,131 4% 41,845,365 8% Operating revenues of $45.2 million exceed budgeted revenues of $43.4 million by 4% or $1.8 million and exceed prior year revenues by 8% or $3.3 million. Net Patient Service revenue of $19.3 million exceeds budgeted revenue of $16.8 million by 15% or $2.5 million, due to increased inpatient admissions of 6% and increased outpatient visits of 4%. Net Patient Service revenue exceeds prior year revenue of $15.9 million by 22% or $3.5 million, due to increased inpatient admissions of 10% and increased outpatient visits of 16%. Revenue Payor Mix follows: The current year funded percentage is 63% and the unfunded percentage is 37%, whereas the prior year same period funded percentage was 60% and the unfunded percentage was 40%. 5

Cash collections of $20.2 million (the fourth monthly record this year and first time exceeding $20 million) exceed budgeted collections of $16.8 million by 20% or $3.4 million and exceed prior year cash collections of $16.1 million by 25% or $4.1 million. The Net Patient Service revenue per adjusted admission (AA) of $7,160 exceeds budgeted amount of $6,626 by 8% and exceeds prior year amount of $6,445 by 11%. Premium revenue of $14.3 million exceeds budgeted revenue of $14.2 million by 1% or $172 thousand primarily due to the Uniform Hospital Rate Increase Program (UHRIP) increase despite lower members, but is less than prior year revenue of $14.4 million by 1% or $110 thousand, primarily due to State Fiscal Year (SFY) 2018 capitation rate decreases. State Program membership of 75,288 is less than budgeted membership of 78,523 by 4% but approximates prior year membership of 75,206. Premium revenue per member per month (PMPM) of $190 exceeds budgeted amount of $180 by 6% but is less than prior year amount of $192 by 1%. Medicaid Supplemental revenue of $6.3 million is less than budgeted revenue of $7.3 million by 14% or $1.1 million, primarily due to Delivery System Reform Incentive Payment (DSRIP) annual decrease of $6 million ($543 monthly for the rest for the fiscal year), and Uncompensated Care (UC) payment decrease of $4 million ($447 thousand for the rest of the fiscal year). Medicaid Supplement revenue is also less than prior year revenue of $6.7 million by 7% or $479 thousand. o DSRIP DSRIP program revenue of $2.5 million is less than budgeted revenue of $3.1 million by $543 thousand and is less than prior year revenue of $3.1 million by $600 thousand. o Uncompensated Care (UC) UC program revenue of $1.5 million is less than budgeted revenue of $2.1 million by $547 thousand but exceeds prior year revenue of $1.3 million by $157 thousand. o Network Access Improvement Program (NAIP) NAIP program revenue of $1.3 million approximates budgeted revenue and exceeds prior year revenue of $1.27 million by $42 thousand. o Disproportionate Share (DSH) Program DSH revenue of $917 thousand exceeds budgeted revenue by $884 thousand by $33 thousand but is less than prior year revenue of $994 thousand by $77 thousand. Contract revenue of $1.7 million exceeds budgeted revenue of $1.6 million by 6% or $97 thousand but is less than prior year revenue of $1.8 million by 2% or $32 thousand. This revenue is eliminated in the campus wide combined financial statements. 6

Contribution revenue of $320 thousand is less than budgeted revenue of $440 thousand by 27% or $120 thousand primarily due to timing of pledges and large gifts, but exceeds prior year revenue of $135 thousand by 138% or $186 thousand. Other revenue (consisting mainly of EPH NAIP, cafeteria, grant, trauma & gift shop revenue) of $2.33 million exceeds budgeted revenue of $2.29 million by 2% or $36 thousand and exceeds prior year revenue of $2.28 million by 2% or $50 thousand. Operating Expenses For the month ended April 30, 2018 April 30, 2017 (unaudited) % variance fav/(unfav) % variance fav/(unfav) actual budget actual Operating Expenses Salaries and employee benefits 16,022,431 16,608,144 4% 16,881,505 5% Medical claims expense 14,004,075 12,215,463-15% 12,539,683-12% Supplies and pharmaceutical expenses 8,338,210 7,696,283-8% 7,933,091-5% Purchased services 5,751,337 4,701,281-22% 4,490,285-28% Intergovernmental transfers 4,292,298 3,083,334-39% 4,341,212 1% Professional fees 2,528,535 3,271,473 23% 109,056-2219% Other operating expenses 2,728,028 2,792,557 2% 2,675,701-2% Depreciation and amortization 2,101,327 2,485,280 15% 2,254,547 7% Total operating expenses 55,766,241 52,853,815-6% 51,225,080-9% Operating expenses of $55.8 million exceed budgeted expenses of $52.9 million by 6% or $2.9 million and exceed prior year expenses of $51.2 million by 9% or $4.5 million. Salaries and benefits of $16 million are less than budgeted expenses of $16.6 million by 4% or $586 thousand and are less than prior year expense of $16.9 million by 5% or $859 thousand. Salaries and employee benefits cost per AA of $5,934 is less than the budgeted amount of $6,546 and is less than prior year amount of $6,851. Salary expense of $13.2 million is less than budgeted expense of $13.7 million by 4% or $530 thousand, primarily in Patient Financial Services and the Neighborhood Health Clinics, and is less than prior year expense of $13.3 million by 1% or $173 thousand. Overtime hours are 1.9% of total paid hours (the lowest % this fiscal year) and approximates 51 Full Time Equivalents (FTEs) and are less than prior year percentage of 3.3% which approximated 91 FTEs. District s Paid FTEs, including contract labor, of 2,671 are less than budgeted paid FTEs of 2,778 by 4%, and are less than prior year paid FTEs of 2,775 by 4%. Contract labor approximates 21 FTE s (the lowest of the fiscal year), whereas prior year contract labor approximated 17 FTE s. 7

UMC s Paid FTE s per Adjusted Occupied Bed is 6.16, whereas the prior year amount was 6.81. Employee benefits expense of $2.8 million is less than budgeted expense of $2.9 million by 2% or $57 thousand, primarily due to the decrease in Other Post Employment Benefit (OPEB) expense of $732 thousand based on the recently approved OPEB plan amendment, offset by an increase in self insured health costs of $485 thousand and an increase in retirement costs of $231 thousand. Employee benefits are less than prior year expense of $3.5 million by 19% or $686 thousand due to decreased OPEB expense of $725 thousand and decreased health insurance expense of $303 thousand, offset by increased retirement expense of $336 thousand. Employee benefits expense to total salaries expense of 21.6% exceeds the budgeted percentage of 21.2% and exceeds prior year percentage of 26.5%. Medical Claims expense of $14 million exceeds the budgeted amount of $12.2 million by 15% or $1.8 million primarily due to increased medical claims cost of $2.3 million, offset by a decrease in pharmacy costs of $455 thousand. Medical Claims expense exceeds prior year expense of $12.5 million by 12% or $1.5 million primarily due to increased medical claims of $1.5 million. The Medical Expense PMPM of $186 exceeds the budgeted amount of $156 by 19% and exceeds the prior year amount of $167 by 11%. Supplies and pharmaceutical expense of $8.3 million exceeds the budgeted expense of $7.7 million by 8% or $642 thousand due to: o increased pharmaceuticals and free drug expense of $163 thousand o increased laboratory costs of $199 thousand o increased implant costs of $138 thousand Supplies and pharmaceutical expense of $8.3 million exceeds prior year expense of $7.9 million by 5% or $405 thousand due to: o increased pharmaceuticals and free drug expense of $342 thousand o increased laboratory costs of $223 thousand The supply expense per AA of $3,088 exceeds the budgeted amount of $3,034 by 2% but is less than prior year amount of $3,220 by 4%. Purchased Services expense of $5.8 million exceeds the budgeted expense of $4.7 million by 22% or $1.1 million due to: o increased other purchased services costs of $772 thousand, consisting of: Biomedical costs of $172 thousand 8

Materials Management costs of $142 thousand Care Management costs of $120 thousand Information Technology costs of $99 thousand Patient Financial Services costs of $93 thousand o increased Indigent referral costs of $339 thousand o increased repairs and maintenance costs of $191 thousand o increased contract labor costs of $198 thousand, consisting of: Perioperative unit (operating room and instrument processing) of $43 thousand Neuroscience unit of $30 thousand Orthopedic / Trauma Unit of $39 thousand Cardiovascular ICU of $26 thousand Purchased Services expense exceeds prior year expense of $4.5 million by 28% or $1.3 million due to: o increased other purchased services costs of $547 thousand, consisting of: Engineering costs of $200 thousand Materials Management costs of $130 thousand Information Technology of $99 thousand Patient Financial Services costs of $77 thousand o increased indigent referral costs (HealthCare Options program) of $315 thousand o increased repairs and maintenance costs of $249 thousand, consisting of: Engineering costs of $271 thousand o increased contract labor costs of $155 thousand, consisting of: Neuroscience unit of $51 thousand Neighborhood Health Centers of $51 thousand Orthopedic / Trauma Unit of $39 thousand Cardiovascular ICU unit of $26 thousand Intergovernmental Transfer (IGT) expense of $4.3 million exceeds the budgeted expense of $3.1 million by 39% or $1.2 million, due to certain El Paso private hospital collaborative (the Collaborative ) contracts not being transferred to UMC or were transferred at a later date than expected. IGT expense is less than prior year expense of $4.3 million by 1% or $49 thousand due to the reduction of the Collaborative physician contracts. Professional fees of $2.5 million are less than budgeted expense of $3.3 million by 23% or $743 thousand, primarily due to certain Collaborative contracts not being transferred to UMC or were transferred at a later date than expected. Professional fees exceed prior year expense of $109 thousand by $2.4 million due to the transfer of certain physician contracts from the Collaborative to UMC. Other operating expenses (consisting mainly of EPH NAIP, lease and rental, and Premium Revenue taxes) of $2.73 million is less than the budgeted expense of $2.79 million by 2% or $64 thousand but exceed prior year expense of $2.68 million by 2% or $52 thousand. 9

Nonoperating Revenues, net For the month ended April 30, 2018 April 30, 2017 (unaudited) % variance fav/(unfav) % variance fav/(unfav) actual budget actual Nonoperating Revenues (Expenses) County appropriation property taxes 8,860,264 8,721,603 2% 7,969,550 11% Investment return 126,079 57,897 118% 68,735 83% Tobacco settlement 181,037 133,700 35% 191,286-5% Miscellaneous - other 165,398 112,811 47% 132,519 25% Interest expense (1,029,640) (1,091,512) 6% (815,528) -26% Contributions to others (253,594) (22,554) -1024% (168,151) -51% Total nonoperating revenues, net 8,049,544 7,911,945 2% 7,378,411 9% Net Nonoperating revenues of $8 million exceed budgeted revenues of $7.9 million by 2% or $138 thousand, primarily due to property tax revenue being higher than budgeted. Net Nonoperating revenues exceed prior year revenues of $7.4 million by 9% or $671 thousand, primarily due to increased property tax revenue of $891 thousand. 10

April 2018 Year to Date Key Operational Statistics UMC 4/30/18 4/30/18 4/30/17 Actual Budget Variance Actual Variance Outpatient Adj. Factor 1.99 2.08 4% 2.10 5% Adjusted Admissions 18,573 17,978 3% 17,310 7% Admissions 9,314 8,638 8% 8,248 13% Average Daily Census 202.5 187.2 8% 176.9 14% Average Length of Stay 4.61 4.62 0.2% 4.55 1.4% Surgeries 4,540 4,513 1% 4,393 3% Endoscopy Procedures 4,878 3,993 22% 3,932 24% Births 1,622 1,844 12% 1,771 8% Emergency Room visits 35,369 33,957 4% 33,359 6% ER Admission Rate 86.5% 87.3% 0.9% 89.7% 3.6% Outpatient Visits 486,014 473,136 3% 431,704 13% Hospital Ancillary 405,781 391,816 4% 365,358 11% Primary Care Clinics 75,130 74,010 2% 59,919 25% Womens and Pre Natal 5,103 7,310 30% 6,427 21% 11

El Paso Health 4/30/18 4/30/18 4/30/17 Actual Budget Variance Actual Variance State Program Membership 530,282 541,869 2% 532,518 0% STAR 455,682 465,632 2% 458,357 1% CHIP 71,938 73,276 2% 71,643 0% Perinate 2,662 2,961 10% 2,518 6% Other Membership 147,231 147,875 0% 145,770 1% HealthCare Options 100,818 100,520 0% 99,887 1% UMC TPA 39,940 40,530 1% 39,118 2% UMC Retiree Program 190 100% 39 387% EPCH TPA 6,283 6,825 8% 6,726 7% 12

April 2018 Year to Date Financial Results Operating Revenues For the seven months ended April 30, 2018 April 30, 2017 (unaudited) actual budget % variance fav/(unfav) actual % variance fav/(unfav) Operating Revenues Patient service revenue, net $ 131,169,010 $ 118,290,370 11% $ 106,836,242 23% Premium revenue 99,854,613 98,020,153 2% 103,470,840-3% Medicaid Supplemental revenue 47,021,273 51,177,014-8% 47,672,576-1% Contract revenue, net 11,365,249 11,427,332-1% 12,324,411-8% Inkind revenue 5,568,596 4,858,983 15% 4,751,500 17% Contribution revenue 2,539,149 2,123,836 20% 971,044 161% Other revenue 16,267,788 15,963,198 2% 16,340,606 0% Total operating revenues 313,785,678 301,860,886 4% 292,367,219 7% Operating revenues of $314 million exceed budgeted revenues of $302 million by 4% or $12 million and also exceed prior year revenues of $292 million by 7% or $22 million. Net Patient Service revenue of $131 million exceeds the budgeted amount of $118 million by 11% or $13 million primarily due to increased inpatient admission of 8% and increased outpatient visits of 3%. Net Patient Service revenue exceeds prior year revenue of $107 million by 23% or $24 million primarily due to increased inpatient admissions of 13% and increased outpatient visits of 13%. Revenue Payor Mix is as follows: Funded percentage is 64% and the unfunded percentage is 36%, whereas the previous year funded percentage was 61% and the unfunded percentage was 39%. 13

Cash collections of $125 million exceed budgeted cash collections of $118 million by 6% or $7 million and also exceed prior year cash collections of $105 million by 19% or $20 million. The Net Patient Revenue per adjusted admission of $7,067 exceeds the budgeted amount of $6,581 by 7% and exceeds prior year amount of $6,176 by 14%. Premium revenue of $99.9 million exceeds budgeted revenue of $98 million by 2% or $1.8 million primarily due to the UHRIP increase in December 2017 despite less member months, but is less than prior year revenue of $103.4 million by 3% or $3.6 million, primarily due to SFY 2018 capitation rate decreases. State Program member months of 530,282 are less than budgeted member months of 541,869 thousand by 2.1% and are less than prior year member months of 532,518 by 0.4%. Premium revenue per member per month of $188 exceeds budgeted amount of $181 by 3.8% but is less than prior year amount of $194 by 3.1%. Medicaid Supplemental revenue of $47 million is less than budgeted revenue of $51.2 million by 8% or $4.2 million, primarily due to DSRIP annual decrease of $6 million ($543 monthly for the rest for the fiscal year) and forecasted UC payment decrease of $4 million ($447 thousand for the rest of the fiscal year). Medicaid Supplemental revenue is also less than prior year revenue of $47.7 million by 1% or $651 thousand. o DSRIP DSRIP program revenue of $18.6 million is less than budgeted revenue of $21.4 million by 13% or $2.9 million and is also less than prior year revenue of $21.2 million by 12% or $2.6 million. o UC UC program revenue of $13 million is less than budgeted revenue of $14.4 million by 10% or $1.4 million but exceeds prior year revenue of $11.5 million by 13% or $1.5 million. o NAIP NAIP program revenue of $9.2 million approximates budgeted revenue of $9.2 million and exceeds prior year revenue of $8.9 million by 3% or $292 thousand. o DSH DSH program revenue of $6.3 million exceeds budgeted of $6.2 million by 2% or $134 thousand and also exceeds prior year revenue of $6.1 million by 3% or $191 thousand. Contract revenue of $11.4 million approximates budgeted revenue of $11.4 million but is less than prior year revenue of $12.3 million by 8% or $959 thousand, primarily due to 14

decreases in the medical equipment and information technology leases. This revenue is eliminated in the campus wide combined financial statements. Contribution revenue of $2.5 million exceeds budgeted revenue of $2.1 million by 20% or $415 thousand due to increased pledges received and exceeds prior year same period revenue of $971 thousand by 161% or $1.6 million. Other revenue (consisting mainly of EPH NAIP, cafeteria, grant, trauma & gift shop revenue) of $16.3 million exceeds budgeted revenue of $16 million by 2% or $305 thousand and approximates prior year revenue. Operating Expenses For the seven months ended April 30, 2018 April 30, 2017 (unaudited) % variance fav/(unfav) % variance fav/(unfav) actual budget actual Operating Expenses Salaries and employee benefits 115,506,559 109,856,349-5% 109,707,482-5% Medical claims expense 90,922,454 86,165,746-6% 87,608,246-4% Supplies and pharmaceutical expenses 60,752,375 53,775,053-13% 54,915,263-11% Purchased services 37,413,102 30,478,869-23% 30,340,931-23% Intergovernmental transfers 27,182,721 21,583,338-26% 34,159,337 20% Professional fees 16,262,661 19,784,916 18% 804,692-1921% Other operating expenses 20,031,582 19,401,124-3% 18,802,864-7% Depreciation and amortization 15,773,798 16,189,174 3% 15,873,163 1% Total operating expenses 383,845,252 357,234,569-7% 352,211,978-9% Operating expenses of $384 million exceed budgeted expenses of $357 million by 7% or $27 million and exceed prior year expenses of $352 million by 9% or $32 million. Salaries and benefits of $116 million exceed budgeted and prior year expense of $110 million by 5% or $6 million. Salaries and benefits per AA of $6,223 exceeds the budgeted amount of $6,112 by 2% but is less than the prior year amount of $6,342 by 2%. Salary costs of $95 million exceed budgeted and prior year expense of $90 million by 5% or $5 million. Overtime hours are 3.3% of total paid hours, approximating 91 FTEs, and are less than prior year percentage of 3.9%, approximating 107 FTEs. District Paid FTEs, including contract labor, of 2,788 exceed the budgeted paid FTEs of 2,658 by 5% and exceed prior year paid FTEs of 2,763 by 0.9%. Contract labor approximates 45 FTE s, whereas prior year contract labor approximates 21 FTE s. 15

UMC s Paid FTE s per AOB is 6.50, whereas the prior year amount was 7.00. Employee benefits of $20 million exceed budgeted expense of $19.5 million by 2.5% or $482 thousand due to increased retirement expense of $2.1 million for the forecasted GASB No. 68 actuarial adjustment, offset by decreased OPEB costs $1.3 million due to the recent plan amendment, decreased self insured medical costs of $485 thousand and decreased in FICA costs of $247 thousand. Employee benefits exceed prior year expense of $19 million by 5% or $984 thousand primarily due to increased retirement expense of $2.6 million for the forecasted GASB No. 68 actuarial report, offset by decreased OPEB costs $1.3 million due to the recent plan amendment and decreased self insured medical costs of $686 thousand. Employee benefits to total Salaries expense of 20.9% is less than the budgeted percentage of 21.6% and approximates prior year percentage of 20.9%. Medical Claims expense of $90.9 million exceeds the budgeted amount of $86.2 million by 6% or $4.8 million due to increased medical claims of $3.9 million and increased pharmacy costs of $913 thousand, and exceeds prior year expense of $88 million by 4% or $3.3 million due to increased pharmacy expenses of $1.9 million and increased medical claims cost of $1.4 million. The Medical Expense PMPM of $171 exceeds the budgeted amount of $159 by 7.5% and exceeds the prior year amount of $165 by 3.6%. Supplies and pharmaceutical expense of $60.8 million exceeds the budgeted expense of $53.8 million by 13% or $7 million due to: o increased pharmaceutical and free drug costs of $2.9 million o increased implant costs of $740 thousand o increased laboratory costs of $725 thousand o increased perioperative costs (endoscopy, operating room, ambulatory surgical unit and instrument processing) of $625 thousand o increased cardiac unit costs of $570 thousand o increased operating room medical supplies of $558 thousand o increased emergency department costs, to include the vascular unit, of $505 thousand Supplies and pharmaceutical expense exceeds prior year expense of $54.9 million by 11% or $5.8 million due to: o increased pharmaceutical drug costs by $3.8 million o increased laboratory costs of $768 thousand o increased operating room medical supplies of $530 thousand o increased emergency department, including vascular unit, costs of $483 thousand o increased perioperative costs of $305 thousand 16

The supply expense per AA of $3,273 exceeds the budgeted amount of $2,992 by 9% and exceeds prior year amount of $3,174 by 3%. Purchased Services expense of $37.4 million exceeds the budgeted expense of $30.5 million by 23% or $6.9 million due to: o increased contract labor costs of $3 million, consisting of: Perioperative unit, primarily Operating room, of $795 thousand Orthopedic / Trauma unit of $581 thousand Women s Surgical unit of $396 thousand ICU of $273 thousand Surgical unit of $252 thousand Neuroscience unit of $161 thousand Cardiovascular ICU costs of $160 thousand o increased other purchased services costs of $2.4 million, consisting of: Care Management costs of $663 thousand Laboratory costs of $562 thousand Fiscal Services of $499 thousand Materials Management costs of $172 thousand Patient Financial Services costs of $124 thousand o Increased Indigent referral costs of $1.7 million Purchased Services expense exceeds prior year expense of $30.3 million by 23% or $7 million due to: o increased contract labor costs of $2.5 million, consisting of: Perioperative unit, primarily operating room, of $593 thousand Orthopedic / Trauma Unit of $582 thousand Women s Surgical Unit of $396 thousand Surgical unit of $252 thousand Neuroscience unit of $235 thousand ICU unit of $225 thousand Cardiovascular ICU of $160 thousand o increased other purchased service costs of $2.2 million, consisting of: Engineering (primarily BioMed) of $503 thousand Fiscal Services of $486 thousand Laboratory (primarily specimen processing costs) of $390 thousand Patient Financial Services of $188 thousand Materials Management of $159 thousand o Increased Indigent referral costs of $1.7 million IGT expense of $27.2 million exceeds the budgeted expense of $21.6 million by 26% or $5.6 million primarily due to certain Collaborative physician contracts that were not transferred to UMC or were transferred at a later date than expected. IGT expense is less than prior year expense of $34.2 million by 20% or $7 million due to the transfer of physician contracts from the private hospital Collaborative back to UMC. 17

Professional fees of $16.3 million are less than budgeted expense of $19.8 million by 18% or $3.5 million primarily due to certain Collaborative physician contracts that were not transferred to UMC or were transferred at a later date than expected. Professional fees exceed prior year expense of $805 thousand by $15.5 million due to the transfer of physician contracts from the Collaborative back to UMC. Other operating expenses (consisting mainly of EPH NAIP, lease and rental, and Premium Revenue taxes) of $20 million exceed the budgeted amount of $19.4 million by 3% or $630 thousand, primarily due to increased lease and rental costs of $483 thousand, and NAIP medical claims of $124 thousand. Other operating expenses exceed prior year same period expense of $18.8 million by 7% or $1.2 million due to increased lease and rental costs of $509 thousand, increased advertising costs of $300 thousand, and increased NAIP medical claims of $228 thousand. Nonoperating Revenues, net For the seven months ended April 30, 2018 April 30, 2017 (unaudited) % variance fav/(unfav) % variance fav/(unfav) actual budget actual Nonoperating Revenues (Expenses) County appropriation property taxes 61,203,711 61,051,221 0% 55,781,374 10% Investment return 526,741 336,384 57% 215,697 144% Tobacco settlement 983,237 935,900 5% 868,524 13% Miscellaneous - other 1,116,099 885,609 26% 1,003,364 11% Interest expense (7,193,945) (7,384,076) -3% (6,537,675) -10% Contributions to others (1,769,247) (417,758) -324% (965,326) -83% Total nonoperating revenues 54,866,596 55,407,280-1% 50,365,958 9% Net Nonoperating revenues of $54.9 million are less than budgeted revenues of $55.4 million by 1% or $541 thousand, primarily due to contributions from the Foundation to EPCH which is directly related to Contribution revenue. This will be eliminated in the campus wide combined financial statements. Net Nonoperating revenues exceed prior year revenues of $50.4 million by 9% or $4.5 million, primarily due to increased property tax revenues of $5.4 million, offset by increased Contributions to others expense of $804 thousand. 18

Additional Financial & Operational Information Unrestricted Cash and Investments Unrestricted Cash and Investments approximate $74 million, representing 43 Days Cash on Hand, and are less than budgeted cash and investments of $101 million by $27 million. Restricted Cash and Investments Restricted Cash and Investments consist of the following (in millions): Held for Project Construction $ 60.0 Held for Debt Service 15.4 Held by Foundation 3.7 Held for Self Insured Programs 2.9 Held for Medical Claims 0.7 $ 82.7 Patient Accounts Receivable Patient Accounts Receivable consists of the following: Patient Accounts Receivable (in thousands) 9/30/2017 4/30/2018 % Change Medicare 6,336 6,210-2% Medicaid 3,759 3,892 4% Other third-party payers 27,963 30,601 9% Patients 50,311 52,478 4% 88,369 93,181 5% Less: allowance for uncollectible accounts 60,120 61,359 2% 28,249 31,822 13% 19

El Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Balance Sheets September 30, 2017, March 31, 2018 and April 30, 2018 (Excluding El Paso Children's Hospital) (Audited) (Unaudited) (Unaudited) 9/30/2017 3/31/2018 4/30/2018 Assets and Deferred Outflows of Resources Current Assets Cash and cash equivalents $ 68,903,801 $ 73,337,519 $ 74,216,263 Short-term investments 66,799 55,827 130,467 Held by trustee for self-insurance, current portion 2,196,518 2,196,518 2,196,518 Patient accounts receivable, net 28,249,489 32,977,014 31,821,649 County appropriation - property taxes receivable, net 1,531,181 5,880,540 5,132,610 Medicaid supplemental revenue receivable 5,032,042 (902,274) 3,328,656 Estimated amount due from third-party payers 1,813,309 1,996,390 1,195,752 Supplies 8,449,552 8,638,260 8,454,103 Contract receivable, net of allowance 3,720,619 6,340,316 6,612,473 Prepaid expenses and other 11,867,926 13,874,976 11,609,528 Total current assets 131,831,236 144,395,086 144,698,019 Noncurrent Cash and Investments Held for debt service - 15,390,894 15,410,524 Held for self-funded insurance 2,825,577 3,038,684 2,855,009 Held for project construction 62,893,053 62,290,820 60,005,694 Held by Foundation 4,087,031 3,823,321 3,744,468 Restricted for medical claims 700,000 700,000 700,000 70,505,661 85,243,719 82,715,695 Less amount required to meet current obligations 2,196,518 2,196,518 2,196,518 Total noncurrent cash and investments 68,309,143 83,047,201 80,519,177 Capital Assets, net 426,256,003 422,315,558 421,195,877 Long-Term Contract Receivable 8,805,096 8,823,233 Other Assets 1,716,819 2,647,960 2,643,754 Total assets 628,113,201 661,210,901 657,880,060 Deferred Outflows of Resources Loss on bond refunding 14,941,916 14,550,777 14,486,306 Pensions 30,085,941 28,235,941 27,885,941 Total deferred outflows of resources 45,027,857 42,786,718 42,372,247 Total assets and deferred outflows of resources $ 673,141,058 $ 703,997,619 $ 700,252,307 Liabilities, Deferred Inflows of Resources and Net Position Current Liabilities Accounts payable and accrued expenses $ 98,311,645 $ 90,309,835 $ 98,751,202 Current maturities of long-term debt 8,907,285 8,860,364 8,852,629 Deferred property tax revenues - 52,827,172 44,022,643 Estimated self-insurance costs, current 2,196,518 2,196,518 2,196,518 Total current liabilities 109,415,448 154,193,889 153,822,992 Estimated Self-insurance Costs 625,227 637,992 642,585 Other Long-Term Liabilities 242,755 349,945 367,810 Long-Term Debt 376,727,719 375,844,686 375,699,131 Net OPEB Liability 7,017,100 6,518,529 5,799,958 Net Pension Liability 46,486,847 46,486,847 46,486,847 Total liabilities 540,515,096 584,031,888 582,819,323 Deferred Inflows of Resources - Pension 1,778,796 1,778,796 1,778,796 Net Position Net investment in capital assets 119,761,822 119,761,822 119,761,822 Restricted - expendable 4,415,243 19,921,675 19,978,768 Restricted - non-expendable 1,032,490 1,147,387 1,147,387 Unrestricted 5,637,611 (22,643,949) (25,233,789) Total net position 130,847,166 118,186,935 115,654,188 Total liabilities, deferred inflows of resources and net position $ 673,141,058 $ 703,997,619 $ 700,252,307-20 -

El Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Statements of Revenues, Expenses and Changes in Net Position (Excluding El Paso Children's Hospital) For the month ended April 30, 2018 April 30, 2017 (unaudited) actual budget % variance fav/(unfav) actual % variance fav/(unfav) Operating Revenues Patient Service revenue, net $ 19,333,025 $ 16,810,913 15% $ 15,880,355 22% Premium revenue 14,326,899 14,155,230 1% 14,436,417-1% Medicaid Supplemental revenue 6,254,561 7,311,002-14% 6,733,069-7% Contract revenue, net 1,729,525 1,632,476 6% 1,761,468-2% In-kind revenue 890,805 775,514 15% 621,137 43% Contribution revenue 320,397 440,255-27% 134,528 138% Other revenue 2,328,737 2,292,741 2% 2,278,391 2% Total operating revenues 45,183,949 43,418,131 4% 41,845,365 8% Operating Expenses Salaries and employee benefits 16,022,431 16,608,144 4% 16,881,505 5% Medical claims expense 14,004,075 12,215,463-15% 12,539,683-12% Supplies and pharmaceutical expenses 8,338,210 7,696,283-8% 7,933,091-5% Purchased services 5,751,337 4,701,281-22% 4,490,285-28% Intergovernmental transfers 4,292,298 3,083,334-39% 4,341,212 1% Professional fees 2,528,535 3,271,473 23% 109,056-2219% Other operating expenses 2,728,028 2,792,557 2% 2,675,701-2% Depreciation and amortization 2,101,327 2,485,280 15% 2,254,547 7% Total operating expenses 55,766,241 52,853,815-6% 51,225,080-9% Operating Income (Loss) (10,582,292) (9,435,684) -12% (9,379,715) -13% Nonoperating Revenues (Expenses) County appropriation property taxes 8,860,264 8,721,603 2% 7,969,550 11% Investment return 126,079 57,897 118% 68,735 83% Tobacco settlement 181,037 133,700 35% 191,286-5% Miscellaneous - other 165,398 112,811 47% 132,519 25% Interest expense (1,029,640) (1,091,512) 6% (815,528) -26% Contributions to others (253,594) (22,554) -1024% (168,151) -51% Total nonoperating revenues, net 8,049,544 7,911,945 2% 7,378,411 9% Changes in Net Position $ (2,532,748) $ (1,523,739) 66% $ (2,001,304) -27% - 21 -

El Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Consolidating Statements of Revenues, Expenses and Changes in Net Position For the month ended April 30, 2018 (Unaudited) (Excluding El Paso Children's Hospital) Component Units UMC El Paso Health Foundation Eliminations Total Operating Revenues Net Patient Service revenue $ 19,333,025 $ - $ - $ - $ 19,333,025 Premium revenue - 14,326,899 - - 14,326,899 Medicaid Supplemental revenue 6,254,561 - - - 6,254,561 Contract revenue, net 1,729,525 - - - 1,729,525 Inkind revenue 815,225-141,694 (66,114) 890,805 Contribution revenue - - 320,397-320,397 Other revenue 1,579,489 1,661,938 (226) (912,464) 2,328,737 Total operating revenues 29,711,825 15,988,837 461,865 (978,578) 45,183,949 Operating Expenses Salaries and employee benefits 16,021,452 - - 979 16,022,431 Medical claims expense - 14,010,948 - (6,873) 14,004,075 Purchased services 5,237,646 1,291,786 101,049 (879,144) 5,751,337 Professional fees 2,528,535 - - - 2,528,535 Supplies and pharmaceutical expenses 8,255,045 5,586 77,579-8,338,210 Other operating expenses 940,509 1,881,442 6,490 (100,413) 2,728,028 Intergovernmental transfers 4,292,298 - - - 4,292,298 Depreciation and amortization 1,998,162 102,748 417-2,101,327 Total operating expenses 39,273,647 17,292,510 185,535 (985,451) 55,766,241 Operating Income (Loss) (9,561,822) (1,303,673) 276,330 6,873 (10,582,292) Nonoperating Revenues (Expenses) County appropriation property taxes 8,860,264 - - - 8,860,264 Investment return 117,180 8,899 - - 126,079 Tobacco settlement 181,037 - - - 181,037 Miscellaneous - other 172,271 - - (6,873) 165,398 Interest expense (1,029,640) - - - (1,029,640) Contributions to others (14,726) - (238,868) - (253,594) Total nonoperating revenues 8,286,386 8,899 (238,868) (6,873) 8,049,544 Changes in Net Position $ (1,275,436) $ (1,294,774) $ 37,462 $ - $ (2,532,748) Budget (2,018,931) 215,641 279,551 - (1,523,739) Variance $ 743,495 $ (1,510,415) $ (242,089) $ - $ (1,009,009) - 22 -

El Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Statements of Revenues, Expenses and Changes in Net Position (Excluding El Paso Children's Hospital) For the seven months ended April 30, 2018 April 30, 2017 (unaudited) actual budget % variance fav/(unfav) actual % variance fav/(unfav) Operating Revenues Patient service revenue, net $ 131,169,010 $ 118,290,370 11% $ 106,836,242 23% Premium revenue 99,854,613 98,020,153 2% 103,470,840-3% Medicaid Supplemental revenue 47,021,273 51,177,014-8% 47,672,576-1% Contract revenue, net 11,365,249 11,427,332-1% 12,324,411-8% Inkind revenue 5,568,596 4,858,983 15% 4,751,500 17% Contribution revenue 2,539,149 2,123,836 20% 971,044 161% Other revenue 16,267,788 15,963,198 2% 16,340,606 0% Total operating revenues 313,785,678 301,860,886 4% 292,367,219 7% Operating Expenses Salaries and employee benefits 115,506,559 109,856,349-5% 109,707,482-5% Medical claims expense 90,922,454 86,165,746-6% 87,608,246-4% Supplies and pharmaceutical expenses 60,752,375 53,775,053-13% 54,915,263-11% Purchased services 37,413,102 30,478,869-23% 30,340,931-23% Intergovernmental transfers 27,182,721 21,583,338-26% 34,159,337 20% Professional fees 16,262,661 19,784,916 18% 804,692-1921% Other operating expenses 20,031,582 19,401,124-3% 18,802,864-7% Depreciation and amortization 15,773,798 16,189,174 3% 15,873,163 1% Total operating expenses 383,845,252 357,234,569-7% 352,211,978-9% Operating Income (Loss) (70,059,574) (55,373,683) -27% (59,844,759) -17% Nonoperating Revenues (Expenses) County appropriation property taxes 61,203,711 61,051,221 0% 55,781,374 10% Investment return 526,741 336,384 57% 215,697 144% Tobacco settlement 983,237 935,900 5% 868,524 13% Miscellaneous - other 1,116,099 885,609 26% 1,003,364 11% Interest expense (7,193,945) (7,384,076) -3% (6,537,675) -10% Contributions to others (1,769,247) (417,758) -324% (965,326) -83% Total nonoperating revenues 54,866,596 55,407,280-1% 50,365,958 9% Changes in Net Position $ (15,192,978) $ 33,597-45321% $ (9,478,801) -60% - 23 -

El Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Consolidating Statements of Revenues, Expenses and Changes in Net Position For the seven months ended April 30, 2018 (Unaudited) (Excluding El Paso Children's Hospital) Component Units UMC El Paso Health Foundation Eliminations Total Operating Revenues Net patient service revenue $ 131,169,010 $ - $ - $ - $ 131,169,010 Premium revenue - 99,854,613 - - 99,854,613 Medicaid Supplemental revenue 47,021,273 - - - 47,021,273 Contract revenue, net 11,365,249 - - - 11,365,249 Inkind revenue 5,450,185-586,433 (468,022) 5,568,596 Contribution revenue 395,456-2,536,649 (392,956) 2,539,149 Other revenue 11,445,960 11,655,228 (106) (6,833,294) 16,267,788 Total operating revenues 206,847,133 111,509,841 3,122,976 (7,694,272) 313,785,678 Operating Expenses Salaries and employee benefits 115,971,621 - - (465,062) 115,506,559 Medical claims expense - 90,968,087 - (45,633) 90,922,454 Purchased services 33,985,078 8,937,007 620,159 (6,129,142) 37,413,102 Professional fees 16,262,661 - - - 16,262,661 Supplies and pharmaceutical expenses 60,547,309 63,418 141,648-60,752,375 Other operating expenses 7,489,652 13,194,689 51,311 (704,070) 20,031,582 Intergovernmental transfers 27,182,721 - - - 27,182,721 Depreciation and amortization 15,063,768 707,112 2,918-15,773,798 Total operating expenses 276,502,810 113,870,313 816,036 (7,343,907) 383,845,252 Operating Income (Loss) (69,655,677) (2,360,472) 2,306,940 (350,365) (70,059,574) Nonoperating Revenues (Expenses) County appropriation property taxes 61,203,711 - - - 61,203,711 Investment return 479,197 142,270 - (94,726) 526,741 Tobacco settlement 983,237 - - - 983,237 Miscellaneous - other 1,161,335 397 - (45,633) 1,116,099 Interest expense (7,288,671) - - 94,726 (7,193,945) Contributions to others (110,516) - (2,054,729) 395,998 (1,769,247) Total nonoperating revenues 56,428,293 142,667 (2,054,729) 350,365 54,866,596 Changes in Net Position $ (13,227,384) $ (2,217,805) $ 252,211 $ - $ (15,192,978) Budget (1,176,850) 124,557 1,085,890-33,597 Variance $ (12,050,534) $ (2,342,362) $ (833,679) $ - $ (15,226,575) - 24 -

EL PASO COUNTY HOSPITAL DISTRICT CONSOLIDATED STATEMENT OF CASH FLOWS FOR THE MONTH and YEAR ENDED APRIL 30, 2018 ($ in Thousands) Excluding El Paso Children's Hospital Month ended Year to date 04/30/2018 04/30/2018 OPERATING ACTIVITIES: Receipts from and on behalf of patients $ 35,614 228,068 Received from (payment to) uncompensated care related activities 1,086 43,868 Payments to employees (16,006) (114,457) Cash received from other operating activities 359 2,929 Payments received from El Paso Children's Hospital 1,494 7,978 Payments to suppliers and contractors (26,657) (228,310) Net cash provided by (used in) operating activities (4,110) (59,924) NONCAPITAL FINANCING ACTIVITES: County appropriations supporting operations 990 77,943 Received from tobacco settlement 1,888 1,888 Paid for contributions to others (212) (1,389) Received from Trauma Received from contributions 295 1,252 Other cash received 154 1,029 Other cash paid out Net cash provided by (used in) noncapital financing activities 3,115 80,723 CAPITAL AND RELATED FINANCING ACTIVITES: Purchase of capital assets (676) (10,477) Principal paid on bonds payable Principal paid on tax anticipation note Cash received from tax anticipation note County appropriations to acquire or retire debt for - acquisitions of capital assets 23,679 Interest paid on bonds payable/note (8,314) El Paso Children's LOC (8,750) Net cash provided by (used in) capital and financing activities (676) (3,862) INVESTING ACTIVITIES: Purchase of investments (11,048) (25,977) Proceeds from disposition of investments 7,317 45,397 Interest on investments 126 526 Net cash provided by (used in) investing activities (3,605) 19,946 INCREASE IN CASH AND CASH EQUIVALENTS (5,276) 36,883 CASH AND CASH EQUIVALENTS AT BEGINNING OF MONTH 127,260 85,101 CASH AND CASH EQUIVALENTS AT END OF MONTH $ 121,984 121,984-25 -

EL PASO COUNTY HOSPITAL DISTRICT CONSOLIDATED STATEMENT OF CASH FLOWS (continued) FOR THE MONTH and YEAR ENDED APRIL 30, 2018 ($ in Thousands) Excluding El Paso Children's Hospital Month ended Year to date 04/30/2018 04/30/2018 Reconciliation of Cash and Cash Equivalents to the Balance Sheet: Cash and cash equivalents in current assets $ 74,216 74,216 Cash and cash equivalents in current portion of cash and investments held for self-funded insurance reserves 2,197 2,197 Cash and cash equivalents in noncurrent cash and investments 45,571 45,571 Total Cash and Cash Equivalents 121,984 121,984 Reconciliation of operating loss used for operating activities: Operating income (loss) (10,582) (70,060) Depreciation and amortization 2,101 15,774 Accrued self-insurance costs 4 17 Provison for uncollectible accounts 11,659 85,517 Changes in operating assets and liabilities: 0 0 Patient accounts receivable, net (10,504) (89,089) Other assets and liabilities (4,512) (1,181) Accounts payable and accrued expenses 7,724 (902) Net cash provided by (used in) operating activities $ (4,110) (59,924) - 26 -

El Paso County Hospital District District Scorecard For the Month Ending 04/30/2018 Single Month Single Month FY18 FY18 FY17 FY18 FY17 % Var. % Var. + / ( ) Actual Budget Actual + / ( ) District Indicators Days Cash on Hand 43.0 N/A N/A 62.7 31.5% Days In AR 53.1 N/A N/A 53.1 0.0% Days In AP 44.2 N/A N/A 38.9 13.5% LT Debt to Capital 0.787 N/A N/A 0.737 6.8% Paid FTEs (Contract Personnel Included) (All District) 2,711 2,778 2.4% 2,806 3.4% Paid FTEs (W/O PTO Bank) (All District) 2,650 2,778 4.6% 2,755 3.8% EBIDA (In thousands) 598 2,053 70.9% 1,069 44.0% Excess Margin 4.67% 2.91% 60.5% 4.00% 16.8% Current Ratio 0.92 N/A N/A 1.14 N/A Supply costs as a percent of Operating Revenue 18.45% 17.73% 4.1% 18.96% 2.7% Salaries and Benefits as a percent of Operating Revenue 35.46% 39.31% 9.8% 40.34% 12.1% Hospital Indicators Adjusted Admissions 2,700 2,537 6.4% 2,464 9.6% Admissions, excluding well baby 1,295 1,222 6.0% 1,175 10.2% Patient Days, excluding well baby 5,850 5,616 4.2% 5,480 6.8% Average Length of Stay 4.6 4.6 0.7% 4.6 1.0% Average Daily Census, excluding well baby 195.0 187.2 4.2% 182.7 6.8% Surgeries 657 639 2.8% 596 10.2% Endo Procedures 723 565 28.0% 571 26.6% Endo Cases 588 479 22.8% 463 27.0% Catheterization Laboratory 374 465 19.6% 415 9.9% Births 199 261 23.8% 219 9.1% ED LWBS 23 91 74.7% 74 68.9% ED Visits (w/o LWBS) 5,082 4,714 7.8% 4,703 8.1% Total ED Visits 5,105 4,805 6.2% 4,777 6.9% Case Mix Index, All Payors 1.330 N/A N/A 1.317 1.0% Case Mix Index, Medicare 1.482 N/A N/A 1.529 3.1% Outpatient Visits 70,776 67,824 4.4% 61,091 15.9% Infusion 528 523 1.0% 541 2.4% Occupational Health 2,780 2,203 26.2% 1,802 54.3% Lab Outreach Visits 20,993 20,509 2.4% 19,626 7.0% Radiology Visits 8,089 7,039 14.9% 6,331 27.8% Pharmacy Visits 21,898 21,231 3.1% 19,045 15.0% Rehabilitative Visits 4,805 4,262 12.7% 4,127 16.4% Hospital Ancillary Total 59,093 55,767 6.0% 51,472 14.8% Primary Care County Clinic 262 261 0.4% 178 47.2% Primary Care Fabens Clinic 1,465 1,487 1.5% 1,332 10.0% Primary Care Employee Clinic 365 333 9.6% 269 35.7% Primary Care Ysleta Clinic 2,888 2,874 0.5% 2,560 12.8% Primary Care G. Dieter Clinic 1,116 1,211 7.8% 1,176 5.1% Primary Care Mattox 157 146 7.5% 130 20.8% Primary Care Crossroads 0.0% 438 100.0% Primary Care Neuro Surgical Clinic 129 133 3.0% 131 1.5% Primary Care County Delta 235 100.0% 179 100.0% Primary Care NHC West 1,947 2,280 14.6% 700 178.1% Primary Care NHC East 2,573 2,060 24.9% 1,517 69.6% Primary Care Total 10,902 11,020 1.1% 8,610 26.6% WHS Annex 440 442 0.5% 453 2.9% PRENATAL Fabens 92 121 24.0% 128 28.1% PRENATAL Ysleta 249 273 8.8% 322 22.7% WHS/PRENATAL G.Dieter 77 100.0% 106 100.0% WHS West 62 0.0% 0.0% WHS East 62 0.0% 0.0% Womens Health Services Total 781 1,037 24.7% 1,009 22.6% Total Cash Collections PFS, Lab and Pharmacy (In Thousands) 20,230 16,811 20.3% 16,078 25.8% Net Patient Revenue 19,333 16,811 15.0% 15,880 21.7% Net Patient Revenue as % of Gross Patient Revenue 20.14% 18.43% 9.3% 17.69% 13.8% Worked Hours per Adj Adm (District excl EPH, grants) 143.42 157.63 9.0% 135.70 5.7% Worked FTE per Adj Occupied Bed (District excl EPH, grants) 5.57 6.02 7.4% 6.04 7.7% Paid FTE per Adj Occupied Bed (District excl EPH, grants) 6.16 6.69 7.8% 6.81 9.5% Bad Debt as % of Gross Patient Revenue 11.70% 16.68% 29.8% 12.17% 3.9% Charity Care as % of Gross Patient Revenue 21.08% 20.93% 0.7% 19.13% 10.2% El Paso Health Indicators STAR Membership 64,891 67,518 3.9% 64,398 0.8% CHIP Membership 10,397 11,005 5.5% 10,808 3.8% UMC Retiree Program 28 0.0% 11 154.5% Other Membership 21,090 21,125 0.2% 20,772 1.5% 27

El Paso County Hospital District District Scorecard Year to Date as of 04/30/2018 District Indicators Days Cash on Hand Days In AR Days In AP LT Debt to Capital Paid FTEs (Contract Personnel Included) (All District) Paid FTEs (W/O PTO Bank) (All District) EBIDA (In thousands) Excess Margin Current Ratio Supply costs as a percent of Operating Revenue Salaries and Benefits as a percent of Operating Revenue Hospital Indicators Adjusted Admissions Admissions, excluding well baby Patient Days, excluding well baby Average Length of Stay Average Daily Census, excluding well baby Surgeries Endo Procedures Endo Cases Catheterization Laboratory Births ED LWBS ED Visits (w/o LWBS) Total ED Visits Case Mix Index, All Payors Case Mix Index, Medicare Outpatient Visits Infusion Occupational Health Lab Outreach Visits Radiology Visits Pharmacy Visits Rehabilitative Visits Hospital Ancillary Total Primary Care County Clinic Primary Care Fabens Clinic Primary Care Employee Clinic Primary Care Ysleta Clinic Primary Care G. Dieter Clinic Primary Care Mattox Primary Care Crossroads Primary Care Neuro Surgical Clinic Primary Care County Delta Primary Care NHC West Primary Care NHC East Primary Care Total WHS Annex PRENATAL Fabens PRENATAL Ysleta WHS/PRENATAL G.Dieter WHS West WHS East Womens Health Services Total Year To Date Year To Date FY18 FY18 FY17 FY18 FY17 % Var. % Var. + / ( ) Actual Budget Actual + / ( ) 43.0 N/A N/A 62.7 31.5% 53.1 N/A N/A 53.1 0.0% 44.2 N/A N/A 38.9 13.5% 0.787 N/A N/A 0.737 6.8% 2,780 2,658 4.6% 2,756 0.9% 2,744 2,658 3.2% 2,742 0.1% 7,775 23,607 67.1% 12,932 39.9% 4.04% 0.01% 40500.0% 2.72% 48.5% 0.92 N/A N/A 1.14 N/A 19.36% 17.81% 8.7% 18.78% 3.1% 36.81% 36.53% 0.8% 37.52% 1.9% 18,573 17,979 3.3% 17,310 7.3% 9,314 8,638 7.8% 8,248 12.9% 42,931 39,684 8.2% 37,506 14.5% 4.6 4.6 0.2% 4.5 1.4% 202.5 187.2 8.2% 177.0 14.4% 4,540 4,513 0.6% 4,393 3.3% 4,878 3,993 22.2% 3,932 24.1% 4,180 3,387 23.4% 3,312 26.2% 2,886 3,287 12.2% 3,181 9.3% 1,622 1,844 12.0% 1,771 8.4% 229 643 64.4% 637 64.1% 35,140 33,314 5.5% 32,722 7.4% 35,369 33,957 4.2% 33,359 6.0% 1.305 N/A N/A 1.266 3.0% 1.593 N/A N/A 1.556 2.3% 486,014 473,136 2.7% 431,704 12.6% 3,972 3,699 7.4% 3,654 8.7% 17,784 15,566 14.2% 14,904 19.3% 146,618 141,631 3.5% 138,200 6.1% 52,811 49,702 6.3% 44,908 17.6% 152,591 148,966 2.4% 134,600 13.4% 32,005 32,252 0.8% 29,092 10.0% 405,781 391,816 3.6% 365,358 11.1% 1,654 1,935 14.5% 1,714 3.5% 11,151 10,341 7.8% 9,543 16.9% 2,563 2,332 9.9% 2,369 8.2% 19,782 20,082 1.5% 19,332 2.3% 8,331 7,910 5.3% 8,491 1.9% 999 1,022 2.3% 1,165 14.2% 0.0% 3,677 100.0% 987 931 6.0% 930 6.1% 1,046 1,645 36.4% 1,561 33.0% 12,080 15,899 24.0% 4,557 165.1% 16,537 11,913 38.8% 6,580 151.3% 75,130 74,010 1.5% 59,919 25.4% 2,684 3,128 14.2% 3,086 13.0% 615 849 27.6% 840 26.8% 1,804 1,928 6.4% 1,943 7.2% 537 100.0% 558 100.0% 434 0.0% 0.0% 434 0.0% 0.0% 5,103 7,310 30.2% 6,427 20.6% Total Cash Collections PFS, Lab and Pharmacy (In Thousands) Net Patient Revenue Net Patient Revenue as % of Gross Patient Revenue Worked Hours per Adj Adm (District excl EPH, grants) Worked FTE per Adj Occupied Bed (District excl EPH, grants) Paid FTE per Adj Occupied Bed (District excl EPH, grants) Bad Debt as % of Gross Patient Revenue Charity Care as % of Gross Patient Revenue El Paso Health Indicators STAR Membership CHIP Membership UMC Retiree Program Other Membership 125,076 118,290 5.7% 104,700 19.5% 131,169 118,290 10.9% 106,836 22.8% 19.13% 18.43% 3.8% 17.26% 10.9% 152.54 162.51 6.1% 133.14 14.6% 5.81 6.21 6.4% 6.22 6.7% 6.50 6.90 5.8% 7.00 7.2% 12.18% 16.02% 23.9% 13.21% 7.8% 21.05% 21.07% 0.1% 21.93% 4.0% 455,682 465,632 2.1% 458,357 0.6% 74,600 76,237 2.1% 74,161 0.6% 190 0.0% 39 387.2% 147,041 147,875 0.6% 145,731 0.9% 28