Mary Washington Healthcare and Subsidiaries Consolidated Balance Sheets Assets Current assets: Cash and cash equivalents $ 46,496,328 $ 42,878,889 Accounts receivable: Patient accounts receivable, less allowance for uncollectible accounts of $42,173,117 in 2014 and $38,558,633 in 2013 (Note 10) 73,598,481 70,042,633 Settlements due from third parties 7,206,307 13,146,096 Other 1,911,009 2,615,545 82,715,797 85,804,274 Notes receivable 399,003 26,280 Inventories 11,761,916 10,760,790 Prepaid expenses and other 7,053,101 7,125,852 Total current assets 148,426,145 146,596,085 Assets whose use is limited (Note 2): Internally designated for healthcare programs and capital acquisitions 168,038,962 148,022,108 Internally restricted for malpractice claims 11,389,947 11,023,951 Externally restricted by donors 16,270,905 17,545,906 Externally restricted under bond indenture agreement (held by trustees) 7,370 6,286,409 195,707,184 182,878,374 Less amounts available for current liabilities - - 195,707,184 182,878,374 Property, plant and equipment, less accumulated depreciation and amortization of $459,722,413 in 2014 and $459,703,062 in 2013 (Note 4) 310,854,279 315,696,550 Other assets: Notes receivable 958,658 2,216,210 Deferred financing costs, less accumulated amortization of $829,402 in 2014 and $617,027 in 2013 1,829,416 1,809,442 M iscellaneous 3,560,415 3,747,809 6,348,489 7,773,461 Total Assets $ 661,336,097 $ 652,944,470 3
Mary Washington Healthcare and Subsidiaries Consolidated Balance Sheets - continued Liabilities and net assets Current liabilities: Accounts payable and accrued expenses $ 39,660,867 $ 33,303,038 Employee compensation and professional fees 37,092,504 34,665,673 Interest payable 505,655 541,083 Pension liability, current portion (Note 6) - - Current maturities of long-term obligations (Notes 5 and 9) 6,865,132 8,241,428 Total Current Liabilities 84,124,158 76,751,222 Long-term obligations, less current maturities (Notes 5 and 9) 271,805,969 282,360,903 Other liabilities: Accrued losses on malpractice claims (Note 7) 14,457,786 15,544,734 Pension liability (Note 6) 64,401,991 30,371,075 Other 37,793 39,486 78,897,570 45,955,295 Total liabilities 434,827,697 405,067,420 Net assets: Unrestricted - General 204,003,352 223,643,389 Unrestricted - Noncontrolling interest 6,234,143 6,687,756 Temporarily restricted (Note 3) 15,012,695 16,287,695 Permanently restricted (Note 3) 1,258,210 1,258,210 226,508,400 247,877,050 Total liabilities and net assets $ 661,336,097 $ 652,944,470 See accompanying notes. 4
Mary Washington Healthcare and Subsidiaries Consolidated Statements of Operations and Changes in Net Assets Year ended Unrestricted net assets Revenues and other support: Net patient service revenue: Patient service revenue (net of contractual allowances and discounts) $ 638,367,471 $ 616,329,888 Provision for bad debts (70,313,594) (55,328,623) 568,053,877 561,001,265 Retail and pharmacy sales 6,733,365 7,040,154 Rental of facilities 2,867,157 2,799,038 M anagement and personnel services 3,618,770 3,855,621 Investment income (Note 2) 4,444,373 3,448,338 Unrestricted contributions 523,167 651,216 Other 10,766,993 13,755,875 597,007,702 592,551,507 Expenses (Note 8) Salaries and wages 237,172,684 244,448,282 Employee benefits (Note 6) 50,545,834 53,417,767 Contract personnel 5,585,207 6,560,499 Professional fees 43,259,764 54,101,556 General and administrative 14,946,029 16,013,641 Provisions for depreciation and amortization 37,577,589 37,688,151 Interest (Note 5) 12,491,256 13,397,653 Cost of goods sold from retail operations 5,252,849 5,586,786 Contract services 44,610,837 39,936,104 Supplies 100,939,032 101,486,265 Utilities 5,840,944 5,621,846 Insurance (Note 7) 2,037,957 3,909,939 Rent 13,077,198 14,382,757 Other 3,926,494 4,177,333 577,263,674 600,728,579 Income from operations 19,744,028 (8,177,072) Nonoperating gains (losses): Net appreciation (depreciation) of investments (Note 2) 1,124,512 9,514,687 Gain on disposal of fixed assets (328,082) 144,360 Loss on defeasance of bonds (Note 5) (847,199) - Loss on investments in partnerships and other 1,466,181 43,008 Excess (deficit) of revenues, gains and other support over expenses and losses before noncontrolling interest $ 21,159,440 $ 1,524,983 (continued) 5
Mary Washington Healthcare and Subsidiaries Consolidated Statements of Operations and Changes in Net Assets continued Year ended Unrestricted net assets Excess (deficit) of revenues, gains and other support over expenses and losses $ 21,159,440 $ 1,524,983 Other changes in unrestricted net assets: Noncontrolling interest (5,389,549) (6,042,534) Adjustments to net pension liability exclusive of net periodic pension cost (Note 6) (37,354,304) 33,348,688 Other 1,944,376 (9,522) Increase (decrease) in unrestricted net assets (19,640,037) 28,821,615 Noncontrolling interest Contributions - 739,509 Distributions (5,770,015) (5,762,339) Change in ownership (73,147) 183,268 Income 5,389,549 6,042,534 (453,613) 1,202,972 Temporarily restricted net assets Contributions 652,957 628,142 Investment income (Note 2) 310,247 1,419,311 Net assets released from restrictions used in operations (1,953,542) (2,716,278) Net assets released from restrictions for purchase of property, plant and equipment (29,798) (13,986) Unrealized gain (loss) on investments (Note 2) (222,851) (135,645) Other (32,013) (113,332) Increase (decrease) in temporarily restricted net assets (1,275,000) (931,788) Increase (decrease) in net assets (21,368,650) 29,092,799 Net assets at beginning of year 247,877,050 218,784,251 Net assets at end of year $ 226,508,400 $ 247,877,050 See accompanying notes. 6
Mary Washington Healthcare and Subsidiaries Consolidated Statements of Cash Flows Year ended Cash flows from operating activities and nonoperating gains (losses) Increase (decrease) in net assets $ (21,368,650) $ 29,092,799 Adjustments to reconcile increase (decrease) in net assets to net cash provided by operating activities and nonoperating gains (losses): Net (appreciation) depreciation of investments (1,124,512) (9,514,687) Other nonoperating (gains) losses (1,466,181) (43,008) Gain on disposal of fixed assets 328,082 (144,360) Provisions for depreciation and amortization 37,577,589 37,688,151 Amortization of original issue premium and discount (227,166) (647,292) Amortization of physician loans receivable 1,043,227 1,655,270 Provision for bad debts 70,313,594 55,328,623 Change in pension obligation other than net periodic pension cost 37,354,304 (33,348,688) (Increase) decrease in: Accounts receivable (73,164,906) (43,169,839) Settlements due from third-party programs 5,939,789 1,062,206 Inventories (1,001,126) (853,874) Prepaid expenses and other 72,751 (1,273,347) M iscellaneous 1,388,968 117,668 Increase (decrease) in: Accounts payable and accrued expenses 6,357,829 (970,823) Employee compensation and professional fees 2,426,831 2,943,833 Interest payable (35,428) (60,158) Insurance claims (1,086,948) (198,145) Pension liability (3,323,388) 2,870,853 Net cash provided by operating activities and nonoperating gains (losses) 60,004,659 40,535,182 (continued) 7
Mary Washington Healthcare and Subsidiaries Consolidated Statements of Cash Flows continued Year ended Cash flows from investing activities Change in assets whose use is limited: Net increase in cash and cash equivalents 11,980,094 (1,838,778) Purchases of investments (109,389,642) (72,816,969) Proceeds from sale of property, plant and equipment 85,163,213 47,575,091 Payments received on pledges receivable 542,037 528,363 Acquisition of property, plant and equipment (34,198,516) (25,344,631) Proceeds from sale of property, plant and equipment 1,687,235 1,211,891 Changes in notes receivable (158,398) 95,206 Net cash used in investing activities (44,373,977) (50,589,827) Cash flows from financing activities Proceeds from issuance of long-term debt 60,989,810 30,551,367 Repayment of long-term obligations (7,693,873) (8,724,913) Refunding of long-term obligations (65,000,000) (30,000,000) Increase in deferred financing costs (309,180) (578,559) Net cash used in financing activities (12,013,243) (8,752,105) Net (decrease) increase in cash and cash equivalents 3,617,439 (18,806,750) Cash and cash equivalents at beginning of year 42,878,889 61,685,639 Cash and cash equivalents at end of year $ 46,496,328 $ 42,878,889 See accompanying notes. 8
Mary Washington Healthcare and Subsidiaries Obligated Group Consolidated Balance Sheet 2014 Assets Current Assets: Cash and cash equivalents $ 37,598,994 Accounts receivable: Patient accounts receivable, less allowances 66,278,902 Settlements due from third parties 7,206,307 Due from affiliates 9,223,264 Other 1,643,122 84,351,595 Notes receivable 399,003 Inventories 10,188,873 Prepaid expenses and other 6,620,303 Total current assets 139,158,768 Assets whose use is limited: Internally designated for healthcare programs and capital acquisitions 163,342,460 Externally restricted by donors 16,151,650 Externally restricted by bond indenture agreement 7,370 179,501,480 Property, plant and equipment 303,844,593 Other assets: Notes receivable 958,658 Deferred financing costs 1,829,416 Miscellaneous 3,018,523 Equity in subsidiaries 13,204,747 Total assets $ 641,516,185 42
Mary Washington Healthcare and Subsidiaries Obligated Group Consolidated Balance Sheet - continued 2014 Liabilities and net assets Current liabilities: Accounts payable and accrued expenses 39,095,656 Employee compensation and professional fees 34,962,518 Interest payable 505,655 Pension liability, current portion - Current maturities of long-term obligations 6,668,212 Total current liabilities 81,232,041 Long-term obligations, less current maturities 271,125,265 Other liabilities: Accrued losses on insurance claims 4,345,629 Pension liability 64,401,991 Other 37,793 Total liabilities 421,142,719 Net assets: Unrestricted - General 204,003,352 Unrestricted - Noncontrolling interest 99,209 Temp restricted net assets 15,012,695 Perm restricted net assets 1,258,210 220,373,466 Total liabilities & net assets $ 641,516,185 43
Mary Washington Healthcare and Subsidiaries Obligated Group Consolidated Statements of Operations Year Ended 2014 Revenue and other support: Net patient service revenue Net patient service revenue (net of allowance and discounts) $ 550,060,508 Provision for bad debs (65,674,306) 484,386,202 Rental of facilities 7,534,876 Management and personnel services 7,952,485 Investment Income 3,692,209 Unrestricted contributions 482,226 Other 7,183,535 511,231,533 Expenses: Salaries and wages 198,664,779 Employee benefits 42,670,428 Contract personnel 4,440,504 Professional fees 32,970,869 General and administrative 13,008,749 Provision for depreciation and amortization 35,422,935 Interest 12,420,428 Contract services 39,131,802 Supplies 92,763,409 Utilities 5,526,497 Insurance 2,196,306 Rent 10,403,400 Other 3,996,712 493,616,818 Income (loss) from operations 17,614,715 Nonoperating gains (losses): Net appreciation (depreciation) of investments 1,241,022 Gain (loss) on disposal of fixed assets (308,358) Loss of defeasance of bonds (847,199) Gain on investments in partnerships and other 1,335,792 Excess of revenues, gains and other support over expenses and losses before equity in earnings of subsidiaries and noncontrolling interest $ 19,035,972 44
Mary Washington Healthcare and Subsidiaries Obligated Group Consolidated Statement of Cash Flows Year ended 2014 Cash flows from operating activities and nonoperating gains (losses) Increase in net assets $ (20,894,099) Adjustments to reconcile increase in net assets to net cash provided by operating activities and nonoperating gains (losses): Net appreciation of investments (1,241,022) Other nonoperating (gains) losses (1,335,792) Loss (gain) on disposal of fixed assets 308,358 Provisions for depreciation and amortization 35,422,935 Amortization of original issue premiums and discounts (227,166) Amortization of physician loans receivable 999,529 Provision for bad debts 65,674,306 Change in pension obligation other than net periodic pension cost 37,354,304 (Increase) decrease in: Accounts receivable (69,322,353) Settlements due from third-party programs 5,939,789 Inventories (986,111) Prepaid expenses and other (217,632) Due from non-obligated affiliates (972,194) M iscellaneous 2,222,019 Increase (decrease) in: Accounts payable and accrued expenses 6,690,311 Employee compensation and professional fees 2,368,421 Interest payable (35,428) Insurance claims (424,694) Pension liability (3,323,388) Net cash provided by operating activities and nonoperating gains (losses) 58,000,093 (continued) 45
Mary Washington Healthcare and Subsidiaries Obligated Group Consolidated Statement of Cash Flows - continued Year ended 2014 Cash flows from investing activities Change in assets whose use is limited: Net (increase) decrease in cash and cash equivalents 12,021,306 Purchases of investments (102,734,901) Sales of investments 79,158,809 Payments received on pledges receivable 528,386 Acquisition of property, plant and equipment (32,621,491) Proceeds from sale of property, plant and equipment 1,629,520 Changes in notes receivable (158,399) Net cash used in investing activities (42,176,770) Cash flows from financing activities Proceeds from issuance of long-term obligations $ 60,172,089 Repayment of long-term obligations (7,611,230) Refunding of long-term obligations (65,000,000) Decrease in deferred financing costs (309,180) Original issue premium - Proceeds from restricted contributions - Net cash provided by (used in) financing activities (12,748,321) Net increase in cash and cash equivalents 3,075,002 Cash and cash equivalents at beginning of year 34,523,992 Cash and cash equivalents at end of year $ 37,598,994 46