Cook County Health and Hospitals System. Financial Statements. Year To Date January 31, 2014

Similar documents
Cook County Health and Hospitals System. Financial Statements. Year To Date December 31, 2013

Cook County Health and Hospitals System. Financial Statements. Year To Date February 28, 2014

Cook County Health and Hospitals System. Financial Statements for the Month Ended June 30, 2010

Cook County Health and Hospitals System of Illinois An Enterprise Fund of Cook County, Illinois. Financial Report November 30, 2013

Chairman Heather O Donnell, JD, LLM and Directors Quin R. Golden; Edward L. Michael; and Carmen Velasquez (4)

Cook County Health and Hospitals System of Illinois An Enterprise Fund of Cook County, Illinois. Financial Report November 30, 2011

Mercy Health Quarterly Financial Report. As of and for the three months ended December 31, 2018 and 2017

Cook County Health & Hospitals System. Finance Committee Meeting October Ekerete Akpan CFO

Cook County Health & Hospitals System. Finance Committee Meeting November Ekerete Akpan CFO

GREENWOOD LEFLORE HOSPITAL. Audited Financial Statements Years Ended September 30, 2015 and 2014

Greenville Health System, GHS Partners In Health, Inc. and The Endowment Fund of the Greenville Hospital System, Inc.

ATHENS REGIONAL HEALTH SERVICES, INC. AND SUBSIDIARIES. Consolidated Financial Statements and Consolidating Schedules. September 30, 2014 and 2013

COOK COUNTY HEALTH & HOSPITALS SYSTEM

Report of Independent Auditors and Financial Statements. Marin Healthcare District

Tarrant County Hospital District d/b/a JPS Health Network A Component Unit of Tarrant County, Texas

COOK COUNTY PRELIMINARY BUDGET ESTIMATES. Toni Preckwinkle PRESIDENT Cook County Board of Commissioners FY 2014

Tarrant County Hospital District d/b/a JPS Health Network A Component Unit of Tarrant County, Texas

Grady Memorial Hospital Authority

^asasssss-- MANAGEMENT'S DISCUSSION AND ANALYSIS AND BASIC FINANCIAL STATEMENTS. Release Date. H'

SOUTH CENTRAL REGIONAL MEDICAL CENTER Laurel, Mississippi. Audited Financial Statements As of and for the Years Ended September 30, 2015 and 2014

Agenda Key Budget Drivers Revenue & Expenditure Summary Cook County Health Fund Allocation Budget Summary FY15 Initiatives

COOK COUNTY HEALTH & HOSPITALS SYSTEM

EXCEL TRAINING. 4th Annual DZA Seminar. The Davenport Hotel, Spokane, Washington Guadalupe County Hospital. October 25-27, 2011

GREENWOOD LEFLORE HOSPITAL. Audited Financial Statements Years Ended September 30, 2016 and 2015

Oklahoma State University Medical Authority

WEST ASCENSION PARISH HOSPITAL SERVICE DISTRICT OF ASCENSION PARISH. LOUISIANA FINANCIAL STATEMENTS

Trinity Health Operating Revenue Grows 5.5% to $9.5 billion in the First Half of FY19

Tarrant County Hospital District d/b/a JPS Health Network A Component Unit of Tarrant County, Texas

Oklahoma State University Medical Authority

Report of Independent Auditors and Financial Statements. Marin Healthcare District

Report of Independent Auditors and Consolidated Financial Statements with Supplemental Schedules for. Tri-City Healthcare District

Oklahoma State University Medical Authority

Ashland Hospital Corporation and Subsidiaries d/b/a King s Daughters Medical Center

Catawba Valley Medical Center and Affiliate (Component Unit of Catawba County) Combined Financial Statements and Supplementary Information

Shands Jacksonville HealthCare, Inc. and Subsidiaries Consolidated Basic Financial Statements, Required Supplementary Information and Supplemental

Advocate Health Care Network and Subsidiaries FINANCIAL REPORT

Trinity Health Operating Income continues to climb in Q1 FY19

PUBLIC HOSPITAL DISTRICT NO. 1 OF KING COUNTY, WASHINGTON, DBA VALLEY MEDICAL CENTER (A Component Unit of the University of Washington)

Report of Independent Auditors and Financial Statements for. Public Hospital District No. 3, Snohomish County, Washington

THE HOSPITAL AUTHORITY OF WAYNE COUNTY, GEORGIA (A Component Unit of Wayne County, Georgia) FINANCIAL STATEMENTS

HOSPITAL AUTHORITY OF WASHINGTON COUNTY FINANCIAL STATEMENTS. for the years ended August 31, 2012 and 2011

Atchison Hospital Association, Inc. and Riverbend Regional Healthcare Foundation. Consolidated Financial Report September 30, 2015

ATHENS REGIONAL HEALTH SERVICES, INC. AND SUBSIDIARIES. Consolidated Financial Statements. September 30, 2012 and 2011

El Paso County Hospital District d/b/a University Medical Center of El Paso A Component Unit of El Paso County, Texas Auditor s Report and Financial

Avita Health System. Consolidated Financial Report with Additional Information June 30, 2016

GREENWOOD LEFLORE HOSPITAL. Audited Financial Statements Years Ended September 30, 2017 and 2016

Estes Park Medical Center

LAKELAND REGIONAL HEALTH SYSTEMS, INC. AND SUBSIDIARIES. Consolidated Financial Statements. September 30, 2017

PUBLIC HOSPITAL DISTRICT NO. 1, SNOHOMISH COUNTY, WASHINGTON DBA: EVERGREENHEALTH MONROE FINANCIAL STATEMENTS AND SUPPLEMENTARY INFORMATION

South Central Colfax County Special Hospital District. Springer, New Mexico

Scripps Health and Affiliates Years Ended September 30, 2014 and 2013 With Report of Independent Auditors

South Broward Hospital District d/b/a Memorial Healthcare System Year Ended April 30, 2016 With Report of Independent Certified Public Accountants

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC Form 10-Q

Community Consolidated School District 15

Baptist Health Care Corporation and Subsidiaries Years Ended September 30, 2014 and 2013 With Report of Independent Certified Public Accountants

FINANCIAL STATEMENTS AND INDEPENDENT AUDITORS REPORT FLORIDA HEALTH PROFESSIONS ASSOCIATION, INC. GAINESVILLE, FLORIDA JUNE 30, 2018

Report of Independent Auditors and Financial Statements for. Tehachapi Valley Health Care District

Iowa Health System and Subsidiaries d/b/a UnityPoint Health

SELF REGIONAL HEALTHCARE AND AFFILIATES. Combined Financial Statements. September 30, 2013 and ( with Independent Auditors Report thereon )

HOSPITAL SERVICE DISTRICT NO. 1 OF TERREBONNE PARISH, STATE OF LOUISIANA MANAGEMENT'S DISCUSSION AND ANALYSIS AND CONSOLIDATED FINANCIAL STATEMENTS

Houghton County Medical Care Facility. Financial Report with Supplemental Information September 30, 2016

Mount Sinai Medical Center of Florida, Inc. and Subsidiaries

CONSOLIDATED FINANCIAL STATEMENTS AND OTHER INFORMATION INDIANA UNIVERSITY HEALTH, INC. AND SUBSIDIARIES AS OF AND FOR THE THREE MONTHS AND YEARS

Jennie Stuart Medical Center, Inc.

Mission Hospital, Inc. d/b/a Mission Regional Medical Center

Financial Statements and Report of Independent Certified Public Accountants. AU Medical Center, Inc. (a component unit of AU Health System, Inc.

Robinson Memorial Portage County Hospital and Affiliates. Financial Report December 31, 2012

Baptist Health Care Corporation and Subsidiaries Years Ended September 30, 2017 and 2016 With Report of Independent Certified Public Accountants

C ONSOLIDATED F INANCIAL S TATEMENTS AND O THER F INANCIAL I NFORMATION

Northern Westchester Hospital Association and Subsidiaries

Aspen Valley Hospital District

Good Samaritan Hospital A Component Unit of Knox County, Indiana

Iowa Health System and Subsidiaries d/b/a UnityPoint Health

Teton County Hospital District d/b/a St. John s Medical Center

MCG Health, Inc. d/b/a Georgia Regents Medical Center (a component unit of MCG Health System, Inc.)

BRATTLEBORO MEMORIAL HOSPITAL FINANCIAL STATEMENTS. With Independent Auditors' Report

Harris County Hospital District and Affiliates, a Component Unit of Harris County, Texas

d. 8-4, Recognizing a CCRC s performance obligation(s) to provide future services and use of facilities to residents

Board of Governors Exam Online Tutorial Finance

Financial Statements and Report of Independent Certified Public Accountants. Cape Regional Medical Center, Inc. December 31, 2015 and 2014

A Resident s Guide to the Cook County Budget

TIFT COUNTY HOSPITAL AUTHORITY (A Component Unit of Tift County, Georgia) FINANCIAL STATEMENTS. for the years ended September 30, 2012 and 2011

FAU Clinical Practice Organization, Inc. (A Component Unit of Florida Atlantic University) Financial Report For the Year Ended June 30, 2017

UNIVERSITY OF MISSOURI HEALTH CARE. Financial Statements. June 30, 2014 and (With Independent Auditors Report Thereon)

Mount Sinai Medical Center of Florida, Inc. and Subsidiaries

FAU Clinical Practice Organization, Inc. (A Component Unit of Florida Atlantic University) Financial Report For the Year Ended June 30, 2016

CONTENTS PAGE REPORT OF INDEPENDENT AUDITORS 1 MANAGEMENT S DISCUSSION AND ANALYSIS 2 7

Sierra Vista Hospital

C ONSOLIDATED F INANCIAL S TATEMENTS

Aurora Health Care, Inc. and Affiliates

JUPITER MEDICAL CENTER, INC. AND AFFILIATED COMPANIES. Jupiter, Florida. CONSOLIDATED FINANCIAL STATEMENTS September 30, 2014 and 2013

UK HealthCare Hospital System

REPORT OF INDEPENDENT AUDITORS 1 2 MANAGEMENT S DISCUSSION AND ANALYSIS 3 8

Hudson Hospital Opco, LLC (d/b/a Christ Hospital)

NANTICOKE HEALTH SERVICES, INC. AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY INFORMATION YEARS ENDED JUNE 30, 2016 AND 2015

EXCEL TRAINING. 4th Annual DZA Seminar. The Davenport Hotel, Spokane, Washington St. Vincent General Hospital District

HARRIS COUNTY HOSPITAL DISTRICT

POWDER MOUNTAIN WATER AND SEWER DISTRICT. Financial Statements - December 31, (With Accountants Compilation Report Thereon)

HARRIS COUNTY HOSPITAL DISTRICT

SAINT BARNABAS CORPORATION d/b/a BARNABAS HEALTH. December 31, 2011 and 2010

Transcription:

Cook County Health and Hospitals System Financial Statements Year To Date January 31, 2014 1 As of May 2, 2014

Index Page 1. Mission Statement................................ 3 2. Attestation Statement.............................. 4 3. Management Discussion and Analysis................ 5-10 4. Combining Balance Sheet Assets................... 11 5. Combining Balance Sheet Liabilities and Net Assets.... 12 6. Combining Income Statement...................... 13 7. Comparative Income Statements: Cook County Health Facilities (Consolidated)..... 14 Stroger Hospital............................. 15 ACHN (Clinics)............................. 16 Medicaid Expansion.......................... 17 Oak Forest Health Center..................... 18 Provident Hospital........................... 19 Bureau of Health............................ 20 Department of Public Health................... 21 Cermak.................................... 22 8. Disclosure Checklist.............................. 23 2

COOK COUNTY HEALTH & HOSPITALS SYSTEM MISSION STATEMENT The Cook County Health and Hospitals System will deliver integrated health services with dignity and respect regardless of a patient's ability to pay; and, Foster partnerships with other health providers and communities to enhance the health of the public; and, Advocate for policies, which promote and protect the physical, mental and social well being of the people of Cook County. 3

Board of Directors Cook County Health and Hospitals System The accompanying financial statements of Cook County Health and Hospitals System and the related Management's Discussion and Analysis for the month ended January 31, 2014 have been prepared by Management who is responsible for their presentation and disclosure. The statements have not been compiled, reviewed or audited by independent accountants. CCHHS maintains an internal control structure designed to provide reasonable assurance that assets are safeguarded and that transactions are properly executed, recorded and summarized to produce reliable records and reports, To the best of Management's knowledge and belief the statements were prepared in conformity with generally accepted accounting principles and governmental accounting standards using the accrual basis of accounting and are based on recorded transactions and Management's best estimates and judgment. John Cookinham, Chief Financial Officer Dorothy M. Loving, Executive Director of Finance 4

MANAGEMENT S DISCUSSION AND ANALYSIS INTRODUCTION This discussion and analysis provides the readers of the monthly unaudited financial statements of the Cook County Health and Hospital System (CCHHS) with an overview of the financial activities for the month ended January 31, 2014. This discussion focuses on the significant financial issues and major financial activities during the current month. It should be read in conjunction with the accompanying financial statements of the CCHHS. The CCHHS includes the following entities: John H. Stroger Jr. Hospital (JSH), Oak Forest Health Center (OFC) Provident Hospital (PHCC), the Department of Public Health (DPH), the Ambulatory and Community Health Network (ACHN), the Bureau of Health Services (BHS), CORE Center (for reporting purposes part of Stroger Hospital), and Cermak Health Services (CHS). Starting this fiscal year 2013, we have added the Medicaid Expansion. Collectively, these entities provide primary, intermediate, acute, and tertiary medical care to patients, without regard to their ability to pay. The Bureau of Health Services oversees the operational, planning, and policy activities of the CCHHS. The CCHHS is included in the reporting entity of the Cook County, Illinois, as an enterprise fund. As an enterprise fund, the CCHHS financial statements are prepared using proprietary fund accounting that focuses on the determination of changes in net assets, financial position, and cash flows in a manner similar to private sector businesses. The financial statements are prepared on an accrual basis of accounting, which recognizes revenue when earned and expenses when incurred. In 2008 the Cook County Health and Hospital System Board was created by the Cook County Board of Commissioners to provide independent oversight of health care operations, and in 2010 the Cook County Board of Commissioners voted to make the Cook County Health and Hospital System Board permanent. In 2012 the Cook County Health and Hospitals System and Cook County Board Officials collaborated to cut Medicaid costs, help county taxpayers, and transform Cook County s hospital system by jump-starting national health care reform in Cook County. In November, 2012 the federal governmnent approved the 1115 Medicaid Waiver for Cook County, allowing CCHHS to enroll more than 115,000 individuals who will be eligible for Medicaid in 2014 into a Cook County network with no cost to the state of Illinois. Medicaid Expansion allows the Cook County s Health System to early enroll certain uninsured patients into Medicaid. Specifically, these are patients who are not currently eligible for Medicaid, but who will be eligible in 2014 under the Accountable Care Act. Many of these individuals are patients who already are being treated by our system without compensation. The Waiver is funded entirely by the federal government. 5

FINANCIAL HIGHLIGHTS (IN THOUSANDS) The Cook County Health and Hospitals System finished the two months with overall revenue of $174,258 and overall expenses was $192,183. Net Patient revenue for the twelve months was $141,221. Net Patient revenue consists of all charges including automated contractual allowances and bad debt adjustments. Write-off of Bad Debt is a CCHHS Board approved policy. Other revenue was $1,113. Other revenue consists primarily of parking revenue. Patient Accounts Receivable General As compared to November 30, 2013, Total Patient Accounts Receivable at the end of January-2014 increased by 1 to 106 days. Additionally, there was a 5 day increase in this figure, as compared to the previous month s figure. Days of Revenue Outstanding measures the average number of days charges remain in accounts receivable after service has been rendered before collection activities have been completed, including charity care and bad debt write-offs. Days of Revenue Outstanding is measured in charges, not cash collections. Days of Revenue Outstanding is a useful tool to measure collection efforts over time (i.e., whether this number is growing or decreasing). This number will be large due to the large number of Self-Pay patients CCHHS services and the processes CCHHS must complete before patient accounts are collected or written-off to bad debt. These processes include, but are not limited to, the following: Making an effort to attain third-party insurance coverage, including 1115 waiver and MANG applications; Processing charity care applications; Sending three (3) monthly statements before accounts are turned over to collections; Placing accounts bi-monthly with the collection agency; and Permitting patients to pay their account balances over time (time payment). Total billed accounts declined by $21.058M (-6.6%) as compared to the November-2013 balance. As compared to the previous month, this figure decreased by $2.832M (-0.9%). The decline in this figure indicates an increasing number of accounts are completing the collection process, which includes charity care and bad debt write-offs. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims based upon the diagnosis, regardless of charges on the patient accounts. Additionally, charity 6

care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Finally, the reimbursement for 1115 Waiver patients is made through a per-member-per-month payment, not a claim-by-claim basis. Inpatient Accounts Receivable Discharged Not Final Billed Inpatient discharged but not final billed accounts at the end of January-2014 increased by $4.103M (48.5%), as compared the November 30, 2013 balance and increased by $4.311M (52.2%), as compared to the previous month s balance. This indicates that fewer inpatient accounts are moving to a Billed status, as compared to the previous month. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims based upon the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Finally, the reimbursement for 1115 Waiver patients is made through a per-member-per-month payment, not a claim-by-claim basis. Billed Inpatient Accounts Billed inpatient accounts at the end of January-2014 decreased by $1.121M (-0.7%) as compared to the November 30, 2013 balance. This figure fell by $1.696M (-1.1%) compared to the previous month s total. The decrease in this number indicates more accounts had the collection process completed than in the previous month and that a greater number of accounts are being removed from active accounts receivable. CCHHS collection process includes charity care and bad debt write-offs. The change in this figure does not translate dollar-for-dollar into actual cash receipts, as Medicaid pays CCHHS claims on a per-diem and Medicare pays CCHHS claims based up on the diagnosis, regardless of charges on the patient accounts. Additionally, charity care and bad debt write-offs are part of the collection process and will not result in actual cash collections. Finally, the reimbursement for 1115 Waiver patients is made through a per-member-per-month payment, not a claim-by-claim basis. Outpatient Accounts Receivable Unbilled Outpatient Accounts The balance of unbilled outpatient accounts increased by $1.394M (12.9%) by the end of January-2014, as compared to the level of unbilled accounts as of November 30, 2013. This balance was $2.350M (23.8%) larger than the previous month s balance. This change indicates that fewer outpatient accounts are moving to a Billed status, as compared to the previous month. Billed Outpatient Accounts 7

The billed outpatient accounts receivable at the end of January-2014 decreased by $19.937M (-12.4%), as compared to the balance as of November 30, 2013. This figure fell by $1.136M (-0.8%) compared to the previous month s total. The decline in this figure indicates that more Out-Patient accounts had their collection and write-off related activities completed, as compared to the prior month. The change in this figure does not translate dollar-for-dollar into actual cash receipts due to Medicaid and Medicare s reimbursement configuration and to charity care and bad debt write-offs. Carelink Program Activities (Charity Care) The volume and dollar amounts written-off to charity care are as follows: Cumulative Number of Accounts Through January-2014 Cumulative Value of Accounts Through January-2014 Number of Accounts for January-2014 Value of Accounts for January-2014 In-Patient 394 $ 4.606M 817 $ 10.195M Out-Patient 18,606 $ 9.192M 38,895 $ 18.565M Totals 19,000 $ 13.798M 39,712 $ 28.760M The above data does not include bad-debt write-offs; it includes only the amounts written-off directly to charity care. Operating Expenses at the end of the two months was $192,.183M broken down as follows: Salaries and Wages - $79.830M Benefits - $22.037M Supplies - $22.401M Purchased Services, Rental, and Other - $58.033M Insurance - 4.116M Depreciation - $5.629M Utilities - $0.137M Nonoperating Revenue was $31.523M. The largest portions of this are attributed to cigarette tax in the amount of $10.609 and property tax in the amount of $6.028M. Sales tax revenues are recognized by CCHHS when earned; this occurs when the underlying sales transactions occur. The amount recorded as Due from State of Illinois - Sales Tax represents the amounts earned by CCHHS, however, the cash is not yet received from the state. There is a 3 months lag from the time of the underlying sales transaction to the receipt of funds. 8

Taxes collected for the Health to date have been fully credited to the Health Fund except as mentioned in the previous paragraph. OVERVIEW OF THE FINANCIAL STATEMENTS This discussion and analysis are intended to serve as an introduction to the CCHHS financial statements. CCHHS basic monthly unaudited financial statements are comprised of fund financial statements. A fund is a grouping of related accounts that is used to maintain control over resources that have been segregated for specific activities or objectives. The CCHHS, like other state and local governments, uses fund accounting to ensure and demonstrate compliance with finance-related legal requirements. 9

Accounts Receivable Comparison Cook County Health and Hospitals System Fiscal Year 2014 December-2013 BEPA January-2014 BEPA Inpatient In-House $ 10,796,900.99 $ 13,917,134.62 Discharged Not Final Billed $ 8,255,685.28 $ 12,566,390.00 Billed $ 159,968,730.29 $ 158,273,172.95 Total Inpatient Asccounts Receivable $ 179,021,316.56 $ 184,756,697.57 Outpatient Unbilled $ 9,889,776.46 $ 12,239,462.73 Billed $ 141,634,392.86 $ 140,498,326.88 Total Outpatient Accounts Receivable $ 151,524,169.32 $ 152,737,789.61 Combined Inpatient and Outpatient A/R Unbilled $ 28,942,362.73 $ 38,722,987.35 Billed $ 301,603,123.15 $ 298,771,499.83 Total IP and OP Accounts Receivable $ 330,545,485.88 $ 337,494,487.18 Average Daily Revenue $ 3,268,842.00 $ 3,170,975.00 Days of Revenue Outstanding 101 106 10

ASSETS CURRENT ASSETS: Cash and cash equivalents: Stroger Hospital ACHN (Clinics) Medicaid Expansion Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) January 31, 2014 Stroger, ACHN & Medicaid Exp O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Intra-Activity Eliminations Grand Total Cash in banks 1,278 0 1,279 23 218 1,520 1,520 Cash held by Cook Co Treas 733,306 36,723 770,029 96,756 135,975 1,002,761 135,425 (1,127,548) 10,638 Due from working cash fund 60,540 34,607 95,147 95,147 95,147 Total cash & cash equivalent 795,124 34,608 36,723 866,455 96,780 136,194 1,099,428 135,425 (1,127,548) 107,305 Property taxes receivable: Tax levy - current year 1,781 1,677 3,458 177 250 472 4,357 257 1,873 6,487 Tax levy - prior year 29,143 34,344 63,487 3,868 5,200 2,944 75,499 8,383 83,883 Total property taxes rec 30,924 36,021 66,944 4,045 5,451 3,416 79,856 8,641 1,873 90,370 Receivables: Patient AR-net of allowances 63,469 6,419 69,889 2,364 72,253 72,253 Third-party settlements 2,011 2,011 2,011 2,011 Other receivables 699 15 713 0 556 9 1,278 0 1,279 Due from State 1,769 1,949 49,612 53,330 524 853 169 54,877 717 1,468 57,061 Total receivables 67,948 1,963 56,032 125,943 524 3,774 178 130,419 717 1,468 132,604 Inventories 2,629 2,629 219 521 3,369 575 3,944 TOTAL CURRENT ASSETS 896,625 72,591 92,755 1,061,971 101,568 145,939 3,594 1,313,072 144,783 3,917 (1,127,548) 334,223 CAPITAL ASSETS: Depreciable assets - net 349,405 5,559 354,965 27,096 23,519 14,511 420,090 2 608 420,700 TOTAL ASSETS 1,246,030 78,151 92,755 1,416,936 128,663 169,458 18,105 1,733,162 144,785 4,525 (1,127,548) 754,923 11

Cook County Health Facilities Combining Balance Sheet of General Funds (Unaudited) January 31, 2014 LIABILITIES & NET POSITION CURRENT LIABILITIES: Stroger Hospital ACHN (Clinics) Medicaid Expansion Stroger, ACHN & Medicaid Exp O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Intra-Activity Eliminations Due to Cook County Treasurer 80,257 80,257 946,610 1,026,867 100,681 (1,127,548) Grand Total Accounts payable 19,433 482 9,227 29,142 754 2,159 18,880 50,934 410 222 51,567 Claims Payable 35,056 35,056 35,056 35,056 Accrued salaries, wages, & other liabilities 11,926 1,425 323 13,674 244 1,211 1,792 16,921 370 1,595 18,886 Compensated absences 4,187 488 64 4,740 56 469 584 5,848 160 404 6,412 Deferred revenue 73,949 73,949 2,612 76,562 76,562 Third-party settlements 79 79 79 Advance from State 30,051 30,051 30,051 30,051 Due to other co govt funds 21 21 10 5 36 7 43 Due to others 407 407 19 426 426 Interacct (payable)receivabl 159,127 38,243 (31,351) 166,018 6,121 43,077 (223,523) (8,306) 2 8,305 TOTAL CURRENT LIABILITIES 269,050 120,896 43,371 433,316 7,203 49,612 744,343 1,234,475 949 111,207 (1,127,548) 219,082 LONG-TERM LIABILITIES: Compensated absences 23,727 2,767 365 26,859 316 2,658 3,308 33,141 906 2,287 36,334 Reserve-tax objection suits 3,979 4,690 8,669 741 709 401 10,520 1,144 11,665 TOTAL LIABILITIES 296,756 128,353 43,735 468,844 8,260 52,979 748,053 1,278,136 2,999 113,494 (1,127,548) 267,081 NET POSITION: Investment in capital assets 349,405 5,559 354,965 27,096 23,519 14,511 420,090 2 608 420,700 Beginning balance 609,805 (74,990) 36,497 571,312 93,500 96,210 (718,967) 42,056 141,760 (104,379) 79,437 Bond depreciation 3,683 132 3,815 389 306 1,043 5,553 36 40 5,629 Excess revenue (expenses) (13,619) 19,096 12,522 18,000 (582) (3,556) (26,534) (12,673) (13) (5,239) (17,924) Ending balance 949,274 (50,202) 49,020 948,091 120,404 116,479 (729,948) 455,026 141,786 (108,970) 487,842 TOTAL LIABILITIES & NET POSITION 1,246,030 78,151 92,755 1,416,936 128,663 169,458 18,105 1,733,162 144,785 4,525 (1,127,548) 754,923 12

Cook County Health Facilities Combining Income Statement of General Funds (Unaudited) January 31, 2014 Stroger Hospital ACHN (Clinics) Medicaid Expansion Stroger, ACHN & Medicaid Exp O F C (Oak Forest) Provident Hospital Bureau of Health Hospitals Total Dept of Public Health Cermak Grand Total REVENUE: Net patient service revenue 55,484 23,387 59,387 138,258 0 2,963 141,221 141,221 Grant revenue 402 402 EHR incentive program revenue 0 0 0 0 Other revenue 942 45 987 54 37 1,078 35 0 1,113 Total Revenue: 56,426 23,432 59,387 139,245 54 3,000 142,299 437 0 142,736 OPERATING EXPENSES: Salaries and wages 49,980 6,046 1,551 57,578 1,056 5,596 7,468 71,697 1,661 6,471 79,830 Employee benefits 13,779 1,827 255 15,861 279 1,399 2,022 19,561 652 1,823 22,037 Supplies 4,032 3,373 6,078 13,484 140 261 8,485 22,370 14 17 22,401 Purchased svs, rental & other 8,442 640 39,080 48,162 34 823 8,761 57,780 138 114 58,033 Insurance expense 2,593 335 38 2,966 53 255 394 3,667 90 358 4,116 Depreciation 3,683 132 3,815 389 306 1,043 5,553 36 40 5,629 Utilities 0 4 4 129 133 3 1 137 TOTAL OPERATING EXPENSES 82,509 12,357 47,003 141,870 1,950 8,641 28,302 180,763 2,596 8,824 192,183 GAIN (LOSS) FROM OPERATIONS (26,084) 11,075 12,384 (2,625) (1,897) (5,641) (28,302) (38,464) (2,159) (8,824) (49,447) NONOPERATING REVENUE: Property taxes 1,625 1,492 3,116 148 223 456 3,943 212 1,873 6,028 Sales taxes 1,182 1,302 2,484 350 570 113 3,518 479 981 4,978 Cigarette taxes 3,617 4,265 7,882 674 645 365 9,566 1,041 10,607 Other Tobacco Product taxes 134 158 291 25 24 13 353 38 392 Fire Arms taxes 43 43 43 43 Interest income 0 0 0 0 0 0 0 0 Retirement plan contribution 5,864 806 138 6,808 118 622 819 8,367 376 731 9,473 TOTAL NONOPERATING REVENUE 12,465 8,022 138 20,625 1,315 2,084 1,768 25,791 2,146 3,585 31,523 NET INCOME (LOSS) (13,619) 19,096 12,522 18,000 (582) (3,556) (26,534) (12,673) (13) (5,239) (17,924) 13

Cook County Health Facilities Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 74,360 66,861 141,221 Grant revenue 309 93 402 EHR incentive program revenue 0 Other revenue 511 602 1,113 Total Revenue 75,180 67,556 142,736 OPERATING EXPENSES: Salaries and wages 39,541 40,288 79,830 Employee benefits 11,022 11,015 22,037 Supplies 7,374 15,028 22,401 Purchased svs, rental & other 30,748 27,285 58,033 Insurance expense 2,058 2,058 4,116 Depreciation 2,815 2,815 5,629 Utilities 132 5 137 TOTAL OPERATING EXPENSES 93,690 98,493 192,183 GAIN (LOSS) FROM OPERATIONS (18,509) (30,937) (49,447) NONOPERATING REVENUE: Property taxes 3,312 2,717 6,028 Sales taxes 2,520 2,458 4,978 Cigarette taxes 10,607 10,607 Other tobacco product taxes 392 392 Fire Arms taxes 43 43 Interest income 0 0 Retirement plan contribution 4,737 4,737 9,473 TOTAL NONOPERATING REVENUE 10,569 20,954 31,523 NET INCOME (LOSS) (7,941) (9,984) (17,924) 14

Stroger Hospital Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 39,086 16,398 55,484 EHR incentive program revenue 0 0 Other revenue 438 504 942 Total Revenue 39,525 16,901 56,426 OPERATING EXPENSES: Salaries and wages 24,730 25,249 49,980 Employee benefits 6,890 6,890 13,779 Supplies 1,560 2,472 4,032 Purchased svs, rental & other 4,447 3,994 8,442 Insurance expense 1,297 1,297 2,593 Depreciation 1,841 1,841 3,683 Utilities 0 0 TOTAL OPERATING EXPENSES 40,765 41,744 82,509 GAIN (LOSS) FROM OPERATIONS (1,241) (24,843) (26,084) NONOPERATING REVENUE: Property taxes 914 711 1,625 Sales taxes 598 584 1,182 Cigarette taxes 3,617 3,617 Other tobacco product taxes 134 134 Fire Arms taxes 43 43 Interest income 0 0 Retirement plan contribution 2,932 2,932 5,864 TOTAL NONOPERATING REVENUE 4,444 8,021 12,465 NET INCOME (LOSS) 3,203 (16,822) (13,619) 15

ACHN (Clinics) Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 11,901 11,486 23,387 Other revenue 45 45 Total Revenue 11,946 11,486 23,432 OPERATING EXPENSES: Salaries and wages 2,992 3,054 6,046 Employee benefits 913 913 1,827 Supplies 1,677 1,696 3,373 Purchased svs, rental & other 316 324 640 Insurance expense 167 167 335 Depreciation 66 66 132 Utilities 4 4 TOTAL OPERATING EXPENSES 6,133 6,224 12,357 GAIN (LOSS) FROM OPERATIONS 5,813 5,261 11,075 NONOPERATING REVENUE: Property taxes 866 626 1,492 Sales taxes 659 643 1,302 Cigarette taxes 4,265 4,265 Other tobacco product taxes 158 158 Interest income 0 0 Retirement plan contribution 403 403 806 TOTAL NONOPERATING REVENUE 1,928 6,094 8,022 NET INCOME (LOSS) 7,741 11,355 19,096 16

Medicaid Expansion Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 21,383 38,004 59,387 Total Revenue 21,383 38,004 59,387 OPERATING EXPENSES: Salaries and wages 771 781 1,551 Employee benefits 127 127 255 Supplies 5 6,074 6,078 Purchased svs, rental & other 19,234 19,846 39,080 Insurance expense 19 19 38 TOTAL OPERATING EXPENSES 20,156 26,847 47,003 GAIN (LOSS) FROM OPERATIONS 1,227 11,157 12,384 NONOPERATING REVENUE: Retirement plan contribution 69 69 138 TOTAL NONOPERATING REVENUE 69 69 138 NET INCOME (LOSS) 1,296 11,226 12,522 17

Oak Forest Health Center Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue (0) 0 0 Other revenue 20 34 54 Total Revenue 20 34 54 OPERATING EXPENSES: Salaries and wages 529 527 1,056 Employee benefits 139 139 279 Supplies 76 64 140 Purchased svs, rental & other 15 19 34 Insurance expense 26 26 53 Depreciation 195 195 389 TOTAL OPERATING EXPENSES 980 971 1,950 GAIN (LOSS) FROM OPERATIONS (960) (937) (1,897) NONOPERATING REVENUE: Property taxes 93 55 148 Sales taxes 177 173 350 Cigarette taxes 674 674 Other tobacco product taxes 25 25 Interest income 0 0 Retirement plan contribution 59 59 118 TOTAL NONOPERATING REVENUE 329 986 1,315 NET INCOME (LOSS) (631) 49 (582) 18

Provident Hospital Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue 1,990 973 2,963 Other revenue 8 29 37 Total Revenue 1,998 1,002 3,000 OPERATING EXPENSES: Salaries and wages 2,733 2,863 5,596 Employee benefits 703 696 1,399 Supplies 78 183 261 Purchased svs, rental & other 248 575 823 Insurance expense 127 127 255 Depreciation 153 153 306 TOTAL OPERATING EXPENSES 4,043 4,598 8,641 GAIN (LOSS) FROM OPERATIONS (2,044) (3,596) (5,641) NONOPERATING REVENUE: Property taxes 129 93 223 Sales taxes 289 282 570 Cigarette taxes 645 645 Other tobacco product taxes 24 24 Interest income 0 0 Retirement plan contribution 311 311 622 TOTAL NONOPERATING REVENUE 729 1,355 2,084 NET INCOME (LOSS) (1,315) (2,241) (3,556) 19

Bureau of Health Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Net patient service revenue Other revenue Total Revenue OPERATING EXPENSES: Salaries and wages 3,743 3,725 7,468 Employee benefits 1,011 1,011 2,022 Supplies 3,968 4,516 8,485 Purchased svs, rental & other 6,319 2,442 8,761 Insurance expense 197 197 394 Depreciation 521 521 1,043 Utilities 129 129 TOTAL OPERATING EXPENSES 15,889 12,413 28,302 GAIN (LOSS) FROM OPERATIONS (15,889) (12,413) (28,302) NONOPERATING REVENUE: Property taxes 238 218 456 Sales taxes 57 56 113 Cigarette taxes 365 365 Other tobacco product taxes 13 13 Retirement plan contribution 410 410 819 TOTAL NONOPERATING REVENUE 705 1,062 1,768 NET INCOME (LOSS) (15,184) (11,351) (26,534) 20

Dept of Public Health Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Grant revenue 309 93 402 Other revenue 35 35 Total Revenue 309 128 437 OPERATING EXPENSES: Salaries and wages 821 841 1,661 Employee benefits 326 326 652 Supplies 1 13 14 Purchased svs, rental & other 96 42 138 Insurance expense 45 45 90 Depreciation 18 18 36 Utilities 3 1 3 TOTAL OPERATING EXPENSES 1,310 1,286 2,596 GAIN (LOSS) FROM OPERATIONS (1,001) (1,158) (2,159) NONOPERATING REVENUE: Property taxes 135 77 212 Sales taxes 242 236 479 Cigarette taxes 1,041 1,041 Other tobacco product taxes 38 38 Retirement plan contribution 188 188 376 TOTAL NONOPERATING REVENUE 566 1,580 2,146 NET INCOME (LOSS) (435) 422 (13) 21

Cermak Comparative Income Statement of General Funds (Unaudited) Year to Date January 31, 2014 December 21, 2013 Inc (Dec) January 31, 2014 REVENUE: Other revenue 0 0 0 Total Revenue 0 0 0 OPERATING EXPENSES: Salaries and wages 3,222 3,249 6,471 Employee benefits 912 912 1,823 Supplies 9 8 17 Purchased svs, rental & other 72 43 114 Insurance expense 179 179 358 Depreciation 20 20 40 Utilities 1 1 TOTAL OPERATING EXPENSES 4,414 4,410 8,824 GAIN (LOSS) FROM OPERATIONS (4,414) (4,410) (8,824) NONOPERATING REVENUE: Property taxes 937 937 1,873 Sales taxes 497 484 981 Interest income 0 0 Retirement plan contribution 365 365 731 TOTAL NONOPERATING REVENUE 1,799 1,786 3,585 NET INCOME (LOSS) (2,615) (2,623) (5,239) 22

OBJECTIVE: COOK COUNTY HEALTH AND HOSPITALS SYSTEM FINANCIAL STATEMENT DISCLOSURE CHECKLIST Fiscal Year 2013 The object of this checklist is to help determine if the form and contents of the financial statements are in conformity with the accounting standards applicable to financial statement basis of accounting. DISCLOSURE PRINCIPLES: Note: Management can comply with a disclosure principle by making disclosure in body of financial statements or in the notes accompanying the financial statements. In a compilation engagement, management's election to omit substantially all disclosures applies to all disclosure principles in GAAP financial statements. Yes, N/A, No? If no, state reason (immaterial, estimated, etc.) FINANCIAL STATEMENT REFERENCES: 1. Do the financial statements reference footnotes (MD&A) or selected information? Yes GENERAL DISCLOSURES: A. Estimates: 1. General disclosure about use of estimates (MD&A)? Yes 2. Disclosure of possible changes in estimates? Yes B. Vulnerabilities do to concentrations in following areas disclosed?: 1. Customers? Yes 2. Suppliers? Yes 3. Lenders? Yes 4. Products? Yes 5. Supply of materials, labor or supplies? Yes 6. Location of assets in geographic area? Yes C. Related parties (FASB 57): 1. Known common control and economic dependency disclosure? Yes 2. Known transactions with related parties disclosed? Yes OTHER DISCLOSURE AREAS TO BE CONSIDERED: 1. Method of consolidations? Yes 2. Accounting changes including changes in GAAP and in estimates? Yes 3. Business combinations? Yes 4. Discontinues operations? Yes 5. Going concern? Yes COMMENTS: Completed by Reviewed by Date Date 23