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HMP Metrics™: Government Owned Hospitals October, 2010
 

HMP Metrics™: Government Owned Hospitals October, 2010

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HMP can easily create customized reports and mix or create new peer groups and compare them to state or national benchmarks.

HMP can easily create customized reports and mix or create new peer groups and compare them to state or national benchmarks.

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    HMP Metrics™: Government Owned Hospitals October, 2010 HMP Metrics™: Government Owned Hospitals October, 2010 Presentation Transcript

    • 1
    • Table of ContentsExecutive Summary 3-5Financial and Operational Study 6 - 59 • Total Profit Margin 6 - 14 • Total Operating Profit Margin 15 - 23 • Total Labor Cost as a Percentage of Total Operating Revenues 24 - 32 • Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 33 - 41 • Days Net Patient Revenue in Accounts Receivable (AR) 42 - 50 • Average Age of Plant and Equipment 51 - 59Introduction to Healthcare Management Partners 60 - 64Clients Our Professionals Have Served 65 - 66Firm Leadership 67 - 70Contact Information 71 October 2010 2
    • Executive Summary – OverviewHealthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its seniorexecutives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignmentsacross the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools arenecessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMPMetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparablefacilities and against “1st Quartile” or “High Performing” competitors.Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive studycomparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groupsselected include the following: 1. All General Acute Care Hospitals Regardless of Ownership or Sponsorship 2. All Investor Owned General Acute Care Hospitals 3. All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations 4. All State and Local Government Owned General Acute Care Hospitals 5. Free Standing Children’s Hospitals 6. All Non-Federal Major Teaching HospitalsUsing proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period orstatistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals,specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensedbeds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer groupcomparisons for dozens of standard industry metrics.This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustratethe benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess therelative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or createnew peer groups and compare them to state, local or national benchmarks. October 2010 3
    • Executive Summary – Key TermsQuartile Rankings: Quartile rankings were assigned based on the mean values calculated for all state and localgovernment owned general acute care hospitals within the peer groups.Total Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.94% 8.49% 169 10.55% 9.41% 176 12.36% 11.54% 183 2nd Quartile 3.56% 3.26% 170 4.40% 4.17% 180 5.67% 5.45% 185 3rd Quartile (0.03%) 0.07% 172 0.56% 0.73% 182 1.53% 1.48% 186 4th Quartile (7.07%) (6.18%) 174 (7.72%) (6.43%) 183 (5.76%) (4.82%) 187 Total Population 1.53% 1.72% 685 1.86% 2.64% 721 3.40% 3.17% 741 Excluded Cost Reports 50 53 45 Total Cost Reports 735 774 786As noted above, the first quartile contains the top 25% of the best performing hospitals in an applicable peer group,the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains thosehospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%.Mean Value: The mean value is the average of all amounts within a defined quartile or population.Median Value: The report also contains the median value by quartile or total population.Count: Actual number of qualified hospitals included in the mean or median calculation.Excluded Cost Reports: Represents those metrics values not considered normative (i.e., outlier values). Forexample, certain metric values that were greater than two standard deviations from the mean of a reported populationwould be excluded from the analysis and included in this category. October 2010 4
    • Executive Summary – Hospital Performance Metrics A measure of overall hospital profitability presented as a percentage. A negative percentageTotal Profit Margin indicates an overall loss, while a positive percentage indicates profitability. A measure of operating profitability presented as a percentage. A negative percentage indicatesTotal Operating Profit Margin overall loss, while a positive percentage indicates profitability. A measure of labor productivity. This metric divides labor costs by operating revenues. ATotal Labor Cost as a Percentage of higher percentage compared to its peers indicates that a hospital uses more labor to produce itsTotal Operating Revenues revenue. Measures the number of full-time equivalent (FTE) employees used for each occupied bed.Full-Time Equivalent Staff (FTEs) per Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospitalAdjusted Occupied Bed (AOB) uses more labor to treat its patients. Measures the number of days it typically takes to collect accounts receivable. A higherDays Net Patient Revenue in percentage compared to its peers indicates that the hospitals revenue cycle is not as efficient asAccounts Receivable (AR) its peers. Measures the average age of the hospital including capital improvements and major equipmentAverage Age of Plant and Equipment purchases. A higher age compared to its peers indicates that the hospital has deferred the replacement of its capital when compared to its peers, which can lead to further distress.Source: Metrics are based on data extracted from Medicare cost reports filed each year with the FederalGovernment. Accuracy of the data contained in the Medicare cost reports is certified by hospital managementwhen the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included inthe Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations.Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, andhospitals where the computed metric is more than 2 standard deviations from the mean. October 2010 5
    • Total Profit Margin - SummaryTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 1.28% 1.17% 284 2.37% 2.99% 303 3.77% 3.34% 308 26 to 100 Beds 0.87% 0.97% 193 1.46% 2.42% 197 2.82% 2.21% 209 101 to 200 Beds 2.21% 2.60% 78 2.02% 2.71% 82 2.74% 3.26% 88 201 to 300 Beds 1.13% 2.73% 44 1.30% 1.47% 47 4.22% 3.92% 44 301 to 400 Beds 4.80% 5.04% 27 1.98% 3.07% 31 4.10% 5.21% 30 401 to 500 Beds 2.68% 2.40% 26 0.38% 1.75% 26 1.75% 2.80% 27 Over 500 Beds 2.93% 4.20% 33 0.90% 3.06% 35 4.80% 5.73% 35 Total All Hospitals 1.53% 1.72% 685 1.86% 2.64% 721 3.40% 3.17% 741 Excluded Cost Reports 50 53 45 Total Cost Reports 735 774 786 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 3.50% 3.89% 291 2.40% 2.47% 253 2.39% 2.69% 216 26 to 100 Beds 2.48% 2.63% 204 2.55% 2.79% 220 1.99% 1.79% 265 101 to 200 Beds 3.29% 3.66% 83 2.65% 2.91% 88 2.23% 2.86% 89 201 to 300 Beds 4.55% 4.55% 46 4.34% 4.61% 45 2.77% 3.16% 46 301 to 400 Beds 5.52% 5.20% 33 3.75% 4.87% 32 3.02% 3.47% 31 401 to 500 Beds 2.44% 3.10% 28 1.38% 2.54% 28 1.69% 2.23% 27 Over 500 Beds 4.64% 5.27% 36 2.83% 4.42% 36 1.85% 3.13% 37 Total All Hospitals 3.37% 3.66% 721 2.64% 2.99% 702 2.22% 2.53% 711 Excluded Cost Reports 31 33 35 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 6
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.09% 8.41% 71 11.67% 10.94% 75 13.13% 12.47% 77 2nd Quartile 3.13% 2.86% 71 4.71% 4.46% 76 6.12% 5.65% 77 3rd Quartile (0.51%) (0.42%) 71 0.68% 0.91% 76 1.52% 1.75% 77 4th Quartile (7.57%) (6.60%) 71 (7.43%) (6.14%) 76 (5.68%) (4.76%) 77 Total Population 1.28% 1.17% 284 2.37% 2.99% 303 3.77% 3.34% 308 Excluded Cost Reports 21 21 19 Total Cost Reports 305 324 327 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.38% 11.42% 72 12.37% 10.41% 63 11.69% 10.51% 54 2nd Quartile 5.71% 5.54% 73 4.43% 4.43% 63 4.80% 4.66% 54 3rd Quartile 1.71% 1.45% 73 0.39% 0.62% 63 0.60% 0.61% 54 4th Quartile (5.66%) (4.47%) 73 (7.44%) (6.52%) 64 (7.52%) (6.20%) 54 Total Population 3.50% 3.89% 291 2.40% 2.47% 253 2.39% 2.69% 216 Excluded Cost Reports 13 10 10 Total Cost Reports 304 263 226Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 7
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.54% 7.83% 48 9.49% 8.34% 49 11.93% 10.77% 52 2nd Quartile 2.87% 2.84% 48 3.82% 3.66% 49 4.42% 4.31% 52 3rd Quartile (1.08%) (1.15%) 48 0.34% 0.57% 49 0.95% 0.99% 52 4th Quartile (7.65%) (6.49%) 49 (7.60%) (6.37%) 50 (5.86%) (4.86%) 53 Total Population 0.87% 0.97% 193 1.46% 2.42% 197 2.82% 2.21% 209 Excluded Cost Reports 10 13 8 Total Cost Reports 203 210 217 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.93% 9.26% 51 10.53% 9.39% 55 10.66% 9.10% 66 2nd Quartile 4.41% 4.39% 51 4.55% 4.34% 55 3.83% 3.94% 66 3rd Quartile 0.95% 1.02% 51 1.03% 1.04% 55 0.07% 0.11% 66 4th Quartile (6.36%) (5.24%) 51 (5.91%) (3.87%) 55 (6.48%) (5.18%) 67 Total Population 2.48% 2.63% 204 2.55% 2.79% 220 1.99% 1.79% 265 Excluded Cost Reports 4 9 12 Total Cost Reports 208 229 277Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 8
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.64% 8.39% 19 10.90% 9.32% 20 11.45% 10.01% 22 2nd Quartile 4.16% 3.89% 19 4.59% 4.33% 20 4.74% 4.78% 22 3rd Quartile 1.28% 1.44% 20 0.87% 1.30% 21 1.49% 1.44% 22 4th Quartile (5.79%) (6.01%) 20 (7.72%) (7.31%) 21 (6.70%) (6.33%) 22 Total Population 2.21% 2.60% 78 2.02% 2.71% 82 2.74% 3.26% 88 Excluded Cost Reports 8 11 8 Total Cost Reports 86 93 96 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.76% 10.42% 20 10.82% 8.96% 22 10.21% 8.45% 22 2nd Quartile 5.32% 5.35% 21 4.84% 4.43% 22 4.58% 4.44% 22 3rd Quartile 2.12% 1.88% 21 1.14% 1.30% 22 1.34% 1.13% 22 4th Quartile (5.64%) (4.73%) 21 (6.21%) (4.72%) 22 (6.78%) (4.72%) 23 Total Population 3.29% 3.66% 83 2.65% 2.91% 88 2.23% 2.86% 89 Excluded Cost Reports 9 8 6 Total Cost Reports 92 96 95Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 9
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.06% 5.67% 11 9.93% 9.50% 11 11.37% 10.77% 11 2nd Quartile 3.49% 3.63% 11 3.49% 3.56% 12 6.64% 6.45% 11 3rd Quartile 0.62% 0.84% 11 0.09% 0.54% 12 2.32% 2.06% 11 4th Quartile (7.64%) (8.63%) 11 (7.59%) (7.33%) 12 (3.43%) (1.88%) 11 Total Population 1.13% 2.73% 44 1.30% 1.47% 47 4.22% 3.92% 44 Excluded Cost Reports 3 2 3 Total Cost Reports 47 49 47 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.02% 10.59% 11 10.11% 9.52% 11 8.41% 8.10% 11 2nd Quartile 6.62% 6.31% 11 5.96% 6.18% 11 5.15% 5.04% 11 3rd Quartile 3.66% 3.87% 12 3.11% 2.82% 11 1.99% 2.00% 12 4th Quartile (2.37%) (2.07%) 12 (1.32%) (1.26%) 12 (3.80%) (3.08%) 12 Total Population 4.55% 4.55% 46 4.34% 4.61% 45 2.77% 3.16% 46 Excluded Cost Reports 3 3 3 Total Cost Reports 49 48 49Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 10
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.24% 10.67% 6 10.45% 10.72% 7 13.07% 11.93% 7 2nd Quartile 6.94% 7.10% 7 5.61% 5.99% 8 8.82% 9.10% 7 3rd Quartile 4.04% 4.05% 7 1.58% 1.60% 8 2.68% 3.13% 8 4th Quartile (2.10%) (1.73%) 7 (8.65%) (7.69%) 8 (6.45%) (2.55%) 8 Total Population 4.80% 5.04% 27 1.98% 3.07% 31 4.10% 5.21% 30 Excluded Cost Reports 2 1 3 Total Cost Reports 29 32 33 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 15.01% 12.97% 8 10.07% 9.80% 8 11.18% 11.00% 7 2nd Quartile 7.01% 6.52% 8 6.27% 5.99% 8 5.36% 5.42% 8 3rd Quartile 3.65% 3.34% 8 3.70% 4.21% 8 1.98% 1.96% 8 4th Quartile (2.56%) 0.05% 9 (5.04%) (3.52%) 8 (5.41%) (1.79%) 8 Total Population 5.52% 5.20% 33 3.75% 4.87% 32 3.02% 3.47% 31 Excluded Cost Reports 0 1 2 Total Cost Reports 33 33 33Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 11
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.92% 9.97% 6 6.88% 6.53% 6 8.86% 8.23% 6 2nd Quartile 4.74% 4.34% 6 4.44% 4.78% 6 5.70% 5.96% 7 3rd Quartile 1.62% 1.62% 7 0.92% 1.02% 7 0.78% 0.10% 7 4th Quartile (6.81%) (2.62%) 7 (9.21%) (8.34%) 7 (7.33%) (5.52%) 7 Total Population 2.68% 2.40% 26 0.38% 1.75% 26 1.75% 2.80% 27 Excluded Cost Reports 3 3 2 Total Cost Reports 29 29 29 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.04% 8.68% 7 8.55% 7.68% 7 8.41% 8.02% 6 2nd Quartile 4.30% 4.11% 7 4.04% 3.75% 7 3.62% 3.24% 7 3rd Quartile 1.32% 1.16% 7 1.25% 1.19% 7 1.41% 1.79% 7 4th Quartile (5.89%) (4.30%) 7 (8.34%) (10.59%) 7 (5.73%) (6.08%) 7 Total Population 2.44% 3.10% 28 1.38% 2.54% 28 1.69% 2.23% 27 Excluded Cost Reports 1 1 2 Total Cost Reports 29 29 29Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 12
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.12% 10.67% 8 9.35% 9.18% 8 13.53% 12.61% 8 2nd Quartile 6.40% 6.26% 8 4.70% 4.33% 9 7.69% 7.64% 9 3rd Quartile 1.51% 1.83% 8 (0.46%) (2.22%) 9 3.58% 3.56% 9 4th Quartile (6.17%) (4.26%) 9 (9.04%) (8.03%) 9 (4.65%) (2.18%) 9 Total Population 2.93% 4.20% 33 0.90% 3.06% 35 4.80% 5.73% 35 Excluded Cost Reports 3 2 2 Total Cost Reports 36 37 37 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 13.49% 12.15% 9 10.80% 10.21% 9 10.21% 8.95% 9 2nd Quartile 6.47% 6.28% 9 5.38% 5.13% 9 4.36% 4.48% 9 3rd Quartile 3.94% 4.27% 9 1.50% 1.72% 9 0.89% 0.60% 9 4th Quartile (5.33%) (4.31%) 9 (6.35%) (6.71%) 9 (7.05%) (6.48%) 10 Total Population 4.64% 5.27% 36 2.83% 4.42% 36 1.85% 3.13% 37 Excluded Cost Reports 1 1 0 Total Cost Reports 37 37 37Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 13
    • Peer Group Comparison – Total Profit MarginTotal Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.94% 8.49% 169 10.55% 9.41% 176 12.36% 11.54% 183 2nd Quartile 3.56% 3.26% 170 4.40% 4.17% 180 5.67% 5.45% 185 3rd Quartile (0.03%) 0.07% 172 0.56% 0.73% 182 1.53% 1.48% 186 4th Quartile (7.07%) (6.18%) 174 (7.72%) (6.43%) 183 (5.76%) (4.82%) 187 Total Population 1.53% 1.72% 685 1.86% 2.64% 721 3.40% 3.17% 741 Excluded Cost Reports 50 53 45 Total Cost Reports 735 774 786 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.89% 10.94% 178 11.11% 9.59% 175 10.70% 9.33% 175 2nd Quartile 5.40% 5.43% 180 4.73% 4.73% 175 4.39% 4.45% 177 3rd Quartile 1.86% 1.61% 181 1.10% 1.26% 175 0.70% 0.79% 178 4th Quartile (5.48%) (4.23%) 182 (6.27%) (5.05%) 177 (6.60%) (5.50%) 181 Total Population 3.37% 3.66% 721 2.64% 2.99% 702 2.22% 2.53% 711 Excluded Cost Reports 31 33 35 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 14
    • Total Operating Profit Margin - SummaryTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less (6.16%) (5.87%) 247 (5.71%) (5.11%) 254 (4.88%) (4.01%) 269 26 to 100 Beds (6.13%) (4.46%) 176 (5.36%) (3.95%) 180 (4.22%) (3.40%) 194 101 to 200 Beds (2.96%) (1.83%) 69 (2.49%) (1.66%) 72 (1.87%) (1.82%) 76 201 to 300 Beds (1.22%) (0.45%) 40 (1.29%) (0.34%) 41 (0.26%) (0.10%) 39 301 to 400 Beds 0.13% (0.68%) 25 (2.07%) (1.38%) 29 (2.69%) (1.48%) 28 401 to 500 Beds (2.86%) (3.21%) 21 (5.07%) (5.08%) 23 (3.65%) (4.11%) 22 Over 500 Beds (3.43%) (2.97%) 27 (6.97%) (7.30%) 29 (6.91%) (6.43%) 29 Total All Hospitals (4.97%) (4.26%) 605 (4.82%) (3.97%) 628 (4.02%) (3.32%) 657 Excluded Cost Reports 130 146 129 Total Cost Reports 735 774 786 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less (4.94%) (4.55%) 256 (6.26%) (5.84%) 214 (6.54%) (5.53%) 177 26 to 100 Beds (4.41%) (2.95%) 194 (3.98%) (3.38%) 212 (3.88%) (2.87%) 248 101 to 200 Beds (1.54%) (0.09%) 73 (2.40%) (1.43%) 81 (2.70%) (1.48%) 81 201 to 300 Beds (0.29%) (0.12%) 43 0.79% 1.39% 42 (0.83%) 0.83% 42 301 to 400 Beds (0.09%) (0.10%) 31 (1.21%) 0.92% 30 (2.11%) (0.47%) 30 401 to 500 Beds (1.71%) 0.71% 24 (3.24%) (0.37%) 23 (3.12%) (0.50%) 25 Over 500 Beds (5.05%) (4.98%) 32 (5.69%) (6.44%) 30 (5.23%) (4.55%) 29 Total All Hospitals (3.75%) (2.76%) 653 (4.16%) (3.42%) 632 (4.22%) (2.88%) 632 Excluded Cost Reports 99 103 114 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 15
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.06% 3.03% 61 4.42% 3.30% 63 6.11% 5.79% 67 2nd Quartile (2.98%) (3.00%) 62 (2.77%) (2.63%) 63 (1.35%) (1.76%) 67 3rd Quartile (8.76%) (8.83%) 62 (7.51%) (7.02%) 64 (7.08%) (6.82%) 67 4th Quartile (17.79%) (17.31%) 62 (16.79%) (16.48%) 64 (17.01%) (17.19%) 68 Total Population (6.16%) (5.87%) 247 (5.71%) (5.11%) 254 (4.88%) (4.01%) 269 Excluded Cost Reports 58 70 58 Total Cost Reports 305 324 327 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.83% 3.90% 64 4.66% 3.19% 53 3.30% 2.65% 44 2nd Quartile (1.89%) (1.91%) 64 (3.12%) (3.08%) 53 (2.72%) (2.84%) 44 3rd Quartile (7.47%) (7.34%) 64 (8.13%) (8.26%) 54 (8.99%) (9.12%) 44 4th Quartile (16.24%) (15.20%) 64 (18.20%) (18.17%) 54 (17.49%) (16.70%) 45 Total Population (4.94%) (4.55%) 256 (6.26%) (5.84%) 214 (6.54%) (5.53%) 177 Excluded Cost Reports 48 49 49 Total Cost Reports 304 263 226Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 16
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.78% 3.71% 44 5.28% 4.40% 45 6.10% 3.77% 48 2nd Quartile (2.39%) (2.25%) 44 (1.51%) (1.23%) 45 (1.71%) (1.91%) 48 3rd Quartile (8.58%) (8.55%) 44 (7.72%) (7.94%) 45 (5.94%) (6.06%) 49 4th Quartile (18.34%) (18.17%) 44 (17.49%) (16.47%) 45 (15.08%) (14.54%) 49 Total Population (6.13%) (4.46%) 176 (5.36%) (3.95%) 180 (4.22%) (3.40%) 194 Excluded Cost Reports 27 30 23 Total Cost Reports 203 210 217 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.95% 4.02% 48 6.06% 4.63% 53 7.11% 5.41% 62 2nd Quartile (0.87%) (0.94%) 48 (0.75%) (0.77%) 53 (0.64%) (0.54%) 62 3rd Quartile (5.77%) (5.52%) 49 (6.11%) (6.03%) 53 (6.10%) (5.81%) 62 4th Quartile (16.65%) (15.28%) 49 (15.12%) (14.11%) 53 (15.89%) (13.76%) 62 Total Population (4.41%) (2.95%) 194 (3.98%) (3.38%) 212 (3.88%) (2.87%) 248 Excluded Cost Reports 14 17 29 Total Cost Reports 208 229 277Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 17
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.83% 4.95% 17 8.22% 5.70% 18 8.84% 6.70% 19 2nd Quartile (0.25%) (0.14%) 17 0.45% (0.36%) 18 0.53% (0.03%) 19 3rd Quartile (4.70%) (4.49%) 17 (3.82%) (3.37%) 18 (3.60%) (3.52%) 19 4th Quartile (14.08%) (13.58%) 18 (14.82%) (14.31%) 18 (13.26%) (12.68%) 19 Total Population (2.96%) (1.83%) 69 (2.49%) (1.66%) 72 (1.87%) (1.82%) 76 Excluded Cost Reports 17 21 20 Total Cost Reports 86 93 96 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.02% 8.63% 18 6.85% 5.72% 20 6.33% 4.70% 20 2nd Quartile 1.55% 1.26% 18 0.65% 0.46% 20 0.58% 0.31% 20 3rd Quartile (2.60%) (1.98%) 18 (3.51%) (3.07%) 20 (3.99%) (4.16%) 20 4th Quartile (13.47%) (12.09%) 19 (13.05%) (10.88%) 21 (13.21%) (12.08%) 21 Total Population (1.54%) (0.09%) 73 (2.40%) (1.43%) 81 (2.70%) (1.48%) 81 Excluded Cost Reports 19 15 14 Total Cost Reports 92 96 95Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 18
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.43% 9.91% 10 10.21% 8.85% 10 9.27% 8.63% 9 2nd Quartile 0.38% (0.22%) 10 1.47% 1.40% 10 1.99% 1.35% 10 3rd Quartile (3.78%) (4.16%) 10 (1.54%) (1.73%) 10 (1.30%) (0.73%) 10 4th Quartile (12.91%) (12.13%) 10 (14.03%) (12.74%) 11 (10.07%) (9.80%) 10 Total Population (1.22%) (0.45%) 40 (1.29%) (0.34%) 41 (0.26%) (0.10%) 39 Excluded Cost Reports 7 8 8 Total Cost Reports 47 49 47 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.59% 7.74% 10 9.79% 6.41% 10 6.97% 5.12% 10 2nd Quartile 1.76% 1.26% 11 2.59% 2.65% 10 1.95% 1.89% 10 3rd Quartile (1.94%) (1.58%) 11 (0.20%) (0.23%) 11 (1.02%) (1.23%) 11 4th Quartile (9.65%) (8.76%) 11 (8.05%) (6.18%) 11 (10.26%) (10.28%) 11 Total Population (0.29%) (0.12%) 43 0.79% 1.39% 42 (0.83%) 0.83% 42 Excluded Cost Reports 6 6 7 Total Cost Reports 49 48 49Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 19
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.97% 8.13% 6 7.12% 4.74% 7 8.76% 6.78% 7 2nd Quartile 2.59% 2.77% 6 1.54% 2.09% 7 1.90% 3.03% 7 3rd Quartile (2.29%) (2.63%) 6 (3.90%) (3.98%) 7 (4.62%) (4.95%) 7 4th Quartile (7.47%) (6.35%) 7 (11.66%) (11.59%) 8 (16.77%) (17.13%) 7 Total Population 0.13% (0.68%) 25 (2.07%) (1.38%) 29 (2.69%) (1.48%) 28 Excluded Cost Reports 4 3 5 Total Cost Reports 29 32 33 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.42% 13.03% 7 10.83% 9.05% 7 11.07% 10.71% 7 2nd Quartile 2.30% 2.84% 8 2.98% 3.30% 7 1.17% 0.97% 7 3rd Quartile (2.38%) (2.11%) 8 (2.55%) (3.92%) 8 (1.96%) (1.41%) 8 4th Quartile (11.15%) (8.06%) 8 (14.09%) (14.89%) 8 (16.67%) (16.80%) 8 Total Population (0.09%) (0.10%) 31 (1.21%) 0.92% 30 (2.11%) (0.47%) 30 Excluded Cost Reports 2 3 3 Total Cost Reports 33 33 33Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 20
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.08% 4.65% 5 4.22% 4.15% 5 5.22% 4.31% 5 2nd Quartile (1.24%) (0.86%) 5 (0.74%) (0.49%) 6 0.15% 0.43% 5 3rd Quartile (5.04%) (5.36%) 5 (6.32%) (6.16%) 6 (5.91%) (5.85%) 6 4th Quartile (9.03%) (8.13%) 6 (15.88%) (17.06%) 6 (11.94%) (12.17%) 6 Total Population (2.86%) (3.21%) 21 (5.07%) (5.08%) 23 (3.65%) (4.11%) 22 Excluded Cost Reports 8 6 7 Total Cost Reports 29 29 29 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.11% 5.73% 6 4.39% 3.20% 5 5.79% 6.30% 6 2nd Quartile 2.23% 2.51% 6 1.26% 1.41% 6 1.28% 1.22% 6 3rd Quartile (3.85%) (2.93%) 6 (3.30%) (3.33%) 6 (2.49%) (1.84%) 6 4th Quartile (12.33%) (12.37%) 6 (14.03%) (12.39%) 6 (15.08%) (15.59%) 7 Total Population (1.71%) 0.71% 24 (3.24%) (0.37%) 23 (3.12%) (0.50%) 25 Excluded Cost Reports 5 6 4 Total Cost Reports 29 29 29Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 21
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.36% 3.38% 6 3.53% 1.53% 7 2.39% 1.13% 7 2nd Quartile 0.03% (0.27%) 7 (4.96%) (5.48%) 7 (3.08%) (3.56%) 7 3rd Quartile (5.32%) (4.88%) 7 (8.61%) (8.38%) 7 (8.29%) (8.33%) 7 4th Quartile (12.51%) (12.59%) 7 (16.47%) (15.73%) 8 (17.19%) (15.26%) 8 Total Population (3.43%) (2.97%) 27 (6.97%) (7.30%) 29 (6.91%) (6.43%) 29 Excluded Cost Reports 9 8 8 Total Cost Reports 36 37 37 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.63% 2.86% 8 5.47% 2.29% 7 3.72% 3.25% 7 2nd Quartile (1.68%) (0.85%) 8 (2.05%) (1.87%) 7 (2.16%) (1.72%) 7 3rd Quartile (7.33%) (6.07%) 8 (8.43%) (8.75%) 8 (7.05%) (6.40%) 7 4th Quartile (18.84%) (19.83%) 8 (15.90%) (16.48%) 8 (14.17%) (14.60%) 8 Total Population (5.05%) (4.98%) 32 (5.69%) (6.44%) 30 (5.23%) (4.55%) 29 Excluded Cost Reports 5 7 8 Total Cost Reports 37 37 37Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 22
    • Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.89% 4.08% 149 5.56% 4.74% 155 6.53% 5.32% 162 2nd Quartile (1.86%) (1.74%) 151 (1.59%) (1.52%) 156 (0.92%) (0.98%) 163 3rd Quartile (7.38%) (7.38%) 151 (6.61%) (6.63%) 157 (5.89%) (5.83%) 165 4th Quartile (16.15%) (15.84%) 154 (16.27%) (15.82%) 160 (15.42%) (15.34%) 167 Total Population (4.97%) (4.26%) 605 (4.82%) (3.97%) 628 (4.02%) (3.32%) 657 Excluded Cost Reports 130 146 129 Total Cost Reports 735 774 786 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.88% 5.49% 161 6.06% 4.63% 155 5.90% 4.73% 156 2nd Quartile (0.60%) (0.78%) 163 (0.97%) (0.99%) 156 (0.82%) (0.77%) 156 3rd Quartile (5.67%) (5.76%) 164 (5.89%) (6.39%) 160 (5.98%) (5.97%) 158 4th Quartile (15.34%) (14.76%) 165 (15.35%) (14.80%) 161 (15.52%) (14.99%) 162 Total Population (3.75%) (2.76%) 653 (4.16%) (3.42%) 632 (4.22%) (2.88%) 632 Excluded Cost Reports 99 103 114 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 23
    • Total Labor Cost as a Percentage of Total Operating Revenues - SummaryTotal Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 52.34% 52.58% 250 52.65% 53.18% 266 52.67% 52.82% 267 26 to 100 Beds 52.83% 53.77% 173 53.34% 53.77% 184 53.22% 53.21% 194 101 to 200 Beds 49.95% 49.82% 72 50.91% 49.53% 75 51.21% 50.46% 79 201 to 300 Beds 49.68% 47.12% 38 50.12% 48.60% 39 49.37% 49.16% 38 301 to 400 Beds 51.18% 50.94% 24 53.52% 53.95% 28 53.02% 52.36% 26 401 to 500 Beds 53.95% 52.79% 22 55.51% 58.00% 24 54.26% 55.02% 22 Over 500 Beds 49.32% 48.28% 28 51.73% 50.95% 28 51.15% 49.39% 30 Total All Hospitals 51.90% 52.04% 607 52.59% 52.64% 644 52.46% 52.20% 656 Excluded Cost Reports 128 130 130 Total Cost Reports 735 774 786 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 51.71% 52.27% 260 52.55% 53.20% 218 52.64% 53.32% 187 26 to 100 Beds 53.72% 54.37% 189 54.21% 54.71% 210 54.18% 54.34% 244 101 to 200 Beds 52.30% 51.48% 81 51.16% 50.89% 85 51.50% 50.46% 83 201 to 300 Beds 50.98% 50.84% 41 51.83% 51.52% 41 50.53% 50.92% 40 301 to 400 Beds 51.92% 52.85% 31 52.80% 51.96% 30 53.05% 52.89% 30 401 to 500 Beds 53.18% 53.99% 25 52.22% 52.65% 24 51.77% 53.47% 23 Over 500 Beds 51.25% 51.03% 31 52.21% 51.61% 31 51.35% 50.65% 29 Total All Hospitals 52.36% 52.38% 658 52.85% 53.01% 639 52.88% 52.98% 636 Excluded Cost Reports 94 96 110 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 24
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.06% 41.45% 62 41.24% 41.94% 66 41.62% 42.60% 66 2nd Quartile 49.30% 49.29% 62 49.51% 49.72% 66 49.20% 49.32% 67 3rd Quartile 55.75% 55.60% 63 56.02% 55.63% 67 55.96% 55.89% 67 4th Quartile 63.03% 62.16% 63 63.60% 62.83% 67 63.72% 63.53% 67 Total Population 52.34% 52.58% 250 52.65% 53.18% 266 52.67% 52.82% 267 Excluded Cost Reports 55 58 60 Total Cost Reports 305 324 327 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 40.45% 40.49% 65 40.77% 41.52% 54 40.49% 40.70% 46 2nd Quartile 48.59% 48.64% 65 49.21% 49.38% 54 49.22% 48.71% 47 3rd Quartile 55.40% 55.70% 65 56.27% 56.41% 55 56.66% 56.76% 47 4th Quartile 62.42% 61.57% 65 63.66% 63.40% 55 63.93% 63.66% 47 Total Population 51.71% 52.27% 260 52.55% 53.20% 218 52.64% 53.32% 187 Excluded Cost Reports 44 45 39 Total Cost Reports 304 263 226Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 25
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.06% 41.38% 43 42.79% 43.83% 46 42.61% 43.10% 48 2nd Quartile 50.91% 51.22% 43 50.80% 50.71% 46 51.06% 51.17% 48 3rd Quartile 56.07% 55.68% 43 56.37% 56.46% 46 55.78% 55.77% 49 4th Quartile 63.03% 62.22% 44 63.38% 63.05% 46 63.17% 62.97% 49 Total Population 52.83% 53.77% 173 53.34% 53.77% 184 53.22% 53.21% 194 Excluded Cost Reports 30 26 23 Total Cost Reports 203 210 217 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.42% 44.20% 47 44.12% 45.50% 52 45.37% 45.94% 61 2nd Quartile 51.37% 51.10% 47 51.78% 51.55% 52 51.91% 51.67% 61 3rd Quartile 57.08% 57.00% 47 56.84% 56.78% 53 56.31% 56.04% 61 4th Quartile 62.85% 62.04% 48 63.88% 64.02% 53 63.14% 62.21% 61 Total Population 53.72% 54.37% 189 54.21% 54.71% 210 54.18% 54.34% 244 Excluded Cost Reports 19 19 33 Total Cost Reports 208 229 277Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 26
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.04% 42.60% 18 40.83% 42.43% 18 42.52% 43.76% 19 2nd Quartile 47.05% 47.11% 18 48.05% 48.13% 19 48.67% 48.59% 20 3rd Quartile 51.81% 51.61% 18 52.79% 52.69% 19 52.46% 52.17% 20 4th Quartile 59.91% 60.41% 18 61.44% 61.05% 19 60.77% 60.32% 20 Total Population 49.95% 49.82% 72 50.91% 49.53% 75 51.21% 50.46% 79 Excluded Cost Reports 14 18 17 Total Cost Reports 86 93 96 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.28% 44.68% 20 41.85% 43.17% 21 42.76% 43.52% 20 2nd Quartile 49.18% 48.98% 20 49.01% 49.32% 21 48.69% 48.68% 21 3rd Quartile 53.84% 53.45% 20 52.96% 52.21% 21 52.87% 52.68% 21 4th Quartile 62.38% 61.15% 21 60.37% 59.91% 22 61.26% 61.66% 21 Total Population 52.30% 51.48% 81 51.16% 50.89% 85 51.50% 50.46% 83 Excluded Cost Reports 11 11 12 Total Cost Reports 92 96 95Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 27
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.53% 42.07% 9 41.80% 42.84% 9 40.35% 41.40% 9 2nd Quartile 44.99% 45.15% 9 45.29% 44.86% 10 45.60% 45.02% 9 3rd Quartile 50.11% 48.62% 10 51.59% 51.11% 10 51.10% 50.60% 10 4th Quartile 60.79% 60.20% 10 60.98% 60.68% 10 59.14% 60.13% 10 Total Population 49.68% 47.12% 38 50.12% 48.60% 39 49.37% 49.16% 38 Excluded Cost Reports 9 10 9 Total Cost Reports 47 49 47 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.99% 43.02% 10 44.42% 45.26% 10 42.72% 44.07% 10 2nd Quartile 48.23% 47.29% 10 50.38% 50.56% 10 49.24% 49.30% 10 3rd Quartile 53.07% 52.90% 10 53.55% 53.98% 10 52.68% 52.57% 10 4th Quartile 59.76% 59.41% 11 58.33% 57.09% 11 57.47% 56.36% 10 Total Population 50.98% 50.84% 41 51.83% 51.52% 41 50.53% 50.92% 40 Excluded Cost Reports 8 7 9 Total Cost Reports 49 48 49Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 28
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.11% 44.32% 6 44.42% 46.51% 7 44.80% 46.21% 6 2nd Quartile 48.35% 47.82% 6 51.63% 51.74% 7 50.17% 50.38% 6 3rd Quartile 54.16% 54.53% 6 55.61% 55.83% 7 54.03% 53.84% 7 4th Quartile 59.10% 59.10% 6 62.43% 61.55% 7 61.49% 61.58% 7 Total Population 51.18% 50.94% 24 53.52% 53.95% 28 53.02% 52.36% 26 Excluded Cost Reports 5 4 7 Total Cost Reports 29 32 33 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.81% 45.27% 7 44.80% 45.71% 7 45.77% 46.02% 7 2nd Quartile 47.79% 47.06% 8 50.22% 50.63% 7 49.79% 50.55% 7 3rd Quartile 54.99% 54.93% 8 54.05% 54.16% 8 53.56% 53.39% 8 4th Quartile 60.08% 58.66% 8 60.80% 58.93% 8 61.75% 61.38% 8 Total Population 51.92% 52.85% 31 52.80% 51.96% 30 53.05% 52.89% 30 Excluded Cost Reports 2 3 3 Total Cost Reports 33 33 33Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 29
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 44.35% 46.41% 5 43.78% 43.73% 6 42.98% 41.84% 5 2nd Quartile 49.05% 48.45% 5 52.34% 51.46% 6 48.51% 47.62% 5 3rd Quartile 56.03% 55.70% 6 60.52% 60.56% 6 57.95% 58.46% 6 4th Quartile 63.96% 64.49% 6 65.39% 65.48% 6 64.76% 64.03% 6 Total Population 53.95% 52.79% 22 55.51% 58.00% 24 54.26% 55.02% 22 Excluded Cost Reports 7 5 7 Total Cost Reports 29 29 29 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.13% 42.85% 6 42.85% 43.48% 6 41.28% 41.76% 5 2nd Quartile 49.03% 47.89% 6 49.51% 48.70% 6 48.59% 49.21% 6 3rd Quartile 55.81% 55.69% 6 54.78% 54.74% 6 54.68% 54.27% 6 4th Quartile 63.09% 62.58% 7 61.74% 61.82% 6 60.80% 60.92% 6 Total Population 53.18% 53.99% 25 52.22% 52.65% 24 51.77% 53.47% 23 Excluded Cost Reports 4 5 6 Total Cost Reports 29 29 29Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 30
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 40.77% 42.96% 7 42.46% 44.98% 7 41.61% 43.81% 7 2nd Quartile 46.95% 47.08% 7 49.21% 49.95% 7 48.50% 48.55% 7 3rd Quartile 51.51% 52.19% 7 54.47% 55.23% 7 52.15% 52.01% 8 4th Quartile 58.04% 56.65% 7 60.77% 58.65% 7 60.83% 60.56% 8 Total Population 49.32% 48.28% 28 51.73% 50.95% 28 51.15% 49.39% 30 Excluded Cost Reports 8 9 7 Total Cost Reports 36 37 37 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.02% 46.30% 7 42.48% 42.44% 7 43.75% 44.91% 7 2nd Quartile 49.14% 49.42% 8 49.59% 50.00% 8 48.88% 48.70% 7 3rd Quartile 51.74% 51.51% 8 53.91% 53.75% 8 52.08% 51.73% 7 4th Quartile 60.07% 59.70% 8 61.64% 60.45% 8 59.50% 59.45% 8 Total Population 51.25% 51.03% 31 52.21% 51.61% 31 51.35% 50.65% 29 Excluded Cost Reports 6 6 8 Total Cost Reports 37 37 37Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 31
    • Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.26% 41.80% 150 41.97% 42.54% 159 42.11% 42.82% 160 2nd Quartile 49.08% 49.07% 150 49.63% 49.87% 161 49.47% 49.65% 162 3rd Quartile 54.76% 54.91% 153 55.55% 55.40% 162 55.00% 55.26% 167 4th Quartile 62.18% 61.62% 154 63.01% 62.82% 162 62.74% 62.83% 167 Total Population 51.90% 52.04% 607 52.59% 52.64% 644 52.46% 52.20% 656 Excluded Cost Reports 128 130 130 Total Cost Reports 735 774 786 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 42.11% 42.71% 162 42.59% 43.19% 157 43.24% 43.92% 156 2nd Quartile 49.44% 49.39% 164 50.18% 50.36% 158 50.17% 50.23% 159 3rd Quartile 55.36% 55.47% 164 55.58% 55.79% 161 55.35% 55.40% 160 4th Quartile 62.17% 61.57% 168 62.62% 62.53% 163 62.44% 62.11% 161 Total Population 52.36% 52.38% 658 52.85% 53.01% 639 52.88% 52.98% 636 Excluded Cost Reports 94 96 110 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 32
    • Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB) - SummaryFull-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 4.92 4.84 264 4.90 4.76 292 4.84 4.76 290 26 to 100 Beds 4.67 4.61 194 4.72 4.68 202 4.72 4.70 205 101 to 200 Beds 4.86 4.66 85 4.86 4.82 91 4.85 4.78 94 201 to 300 Beds 5.08 5.00 44 5.24 4.87 47 5.16 4.95 44 301 to 400 Beds 5.25 5.19 27 5.34 5.21 30 5.28 5.08 31 401 to 500 Beds 5.99 5.89 26 5.94 6.00 27 5.93 5.60 27 Over 500 Beds 5.83 5.71 34 5.90 5.98 35 5.83 5.72 35 Total All Hospitals 4.95 4.86 674 4.97 4.85 724 4.93 4.86 726 Excluded Cost Reports 61 50 60 Total Cost Reports 735 774 786 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 4.83 4.72 267 4.96 5.06 222 5.11 5.18 180 26 to 100 Beds 4.78 4.73 197 4.72 4.65 215 4.81 4.67 263 101 to 200 Beds 4.70 4.68 89 4.68 4.58 94 4.72 4.53 94 201 to 300 Beds 5.22 4.96 47 5.21 5.04 47 5.09 5.10 47 301 to 400 Beds 5.12 5.04 31 5.05 4.92 31 5.13 4.95 32 401 to 500 Beds 5.69 5.48 26 5.85 5.52 27 5.77 5.49 27 Over 500 Beds 5.83 5.70 35 5.73 5.67 35 5.63 5.44 34 Total All Hospitals 4.92 4.82 692 4.94 4.84 671 4.99 4.84 677 Excluded Cost Reports 60 64 69 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 33
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.10 3.31 66 3.12 3.31 73 3.11 3.31 72 2nd Quartile 4.38 4.37 66 4.34 4.39 73 4.28 4.23 72 3rd Quartile 5.38 5.38 66 5.32 5.35 73 5.22 5.20 73 4th Quartile 6.82 6.74 66 6.84 6.75 73 6.72 6.55 73 Total Population 4.92 4.84 264 4.90 4.76 292 4.84 4.76 290 Excluded Cost Reports 41 32 37 Total Cost Reports 305 324 327 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 2.90 3.08 66 3.07 3.17 55 3.16 3.29 45 2nd Quartile 4.28 4.31 67 4.45 4.39 55 4.63 4.57 45 3rd Quartile 5.28 5.32 67 5.43 5.43 56 5.57 5.54 45 4th Quartile 6.82 6.74 67 6.85 6.83 56 7.06 7.00 45 Total Population 4.83 4.72 267 4.96 5.06 222 5.11 5.18 180 Excluded Cost Reports 37 41 46 Total Cost Reports 304 263 226Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 34
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.25 3.43 48 3.30 3.45 50 3.33 3.50 51 2nd Quartile 4.20 4.19 48 4.27 4.34 50 4.34 4.34 51 3rd Quartile 4.98 4.98 49 4.99 4.93 51 5.01 4.97 51 4th Quartile 6.21 6.18 49 6.30 6.13 51 6.17 6.00 52 Total Population 4.67 4.61 194 4.72 4.68 202 4.72 4.70 205 Excluded Cost Reports 9 8 12 Total Cost Reports 203 210 217 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.45 3.61 49 3.51 3.64 53 3.46 3.59 65 2nd Quartile 4.43 4.46 49 4.37 4.36 54 4.40 4.42 66 3rd Quartile 5.06 5.07 49 4.95 4.95 54 5.07 5.06 66 4th Quartile 6.15 6.03 50 6.05 5.97 54 6.30 6.21 66 Total Population 4.78 4.73 197 4.72 4.65 215 4.81 4.67 263 Excluded Cost Reports 11 14 14 Total Cost Reports 208 229 277Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 35
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.61 3.74 21 3.63 3.73 22 3.61 3.80 23 2nd Quartile 4.42 4.43 21 4.44 4.41 23 4.48 4.49 23 3rd Quartile 5.01 5.01 21 5.10 5.12 23 5.07 5.09 24 4th Quartile 6.33 6.03 22 6.20 5.92 23 6.18 5.97 24 Total Population 4.86 4.66 85 4.86 4.82 91 4.85 4.78 94 Excluded Cost Reports 1 2 2 Total Cost Reports 86 93 96 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.51 3.71 22 3.62 3.79 23 3.63 3.67 23 2nd Quartile 4.38 4.33 22 4.30 4.25 23 4.28 4.28 23 3rd Quartile 4.91 4.87 22 4.83 4.76 24 4.81 4.80 24 4th Quartile 5.95 5.85 23 5.91 5.79 24 6.08 5.83 24 Total Population 4.70 4.68 89 4.68 4.58 94 4.72 4.53 94 Excluded Cost Reports 3 2 1 Total Cost Reports 92 96 95Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 36
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.84 3.92 11 3.89 4.04 11 3.92 4.00 11 2nd Quartile 4.63 4.65 11 4.60 4.60 12 4.61 4.66 11 3rd Quartile 5.20 5.13 11 5.30 5.20 12 5.41 5.22 11 4th Quartile 6.66 6.52 11 7.05 6.75 12 6.71 6.49 11 Total Population 5.08 5.00 44 5.24 4.87 47 5.16 4.95 44 Excluded Cost Reports 3 2 3 Total Cost Reports 47 49 47 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.90 4.02 11 3.85 4.00 11 3.89 4.00 11 2nd Quartile 4.57 4.53 12 4.57 4.57 12 4.54 4.55 12 3rd Quartile 5.40 5.38 12 5.46 5.44 12 5.33 5.37 12 4th Quartile 6.89 6.63 12 6.84 6.44 12 6.51 6.33 12 Total Population 5.22 4.96 47 5.21 5.04 47 5.09 5.10 47 Excluded Cost Reports 2 1 2 Total Cost Reports 49 48 49Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 37
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.20 4.38 6 4.36 4.48 7 4.48 4.62 7 2nd Quartile 4.75 4.68 7 4.94 4.90 7 4.94 4.94 8 3rd Quartile 5.47 5.46 7 5.37 5.30 8 5.29 5.30 8 4th Quartile 6.42 6.37 7 6.50 6.27 8 6.31 6.09 8 Total Population 5.25 5.19 27 5.34 5.21 30 5.28 5.08 31 Excluded Cost Reports 2 2 2 Total Cost Reports 29 32 33 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.21 4.27 7 4.10 4.32 7 4.13 4.28 8 2nd Quartile 4.75 4.74 8 4.63 4.64 8 4.66 4.61 8 3rd Quartile 5.19 5.17 8 5.19 5.22 8 5.21 5.17 8 4th Quartile 6.22 6.10 8 6.18 5.80 8 6.50 5.95 8 Total Population 5.12 5.04 31 5.05 4.92 31 5.13 4.95 32 Excluded Cost Reports 2 2 1 Total Cost Reports 33 33 33Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 38
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.44 4.46 6 4.36 4.61 6 4.38 4.68 6 2nd Quartile 5.23 5.25 6 5.30 5.20 7 5.31 5.33 7 3rd Quartile 6.34 6.30 7 6.29 6.14 7 6.15 6.22 7 4th Quartile 7.61 7.64 7 7.59 7.45 7 7.66 7.52 7 Total Population 5.99 5.89 26 5.94 6.00 27 5.93 5.60 27 Excluded Cost Reports 3 2 2 Total Cost Reports 29 29 29 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.28 4.55 6 4.45 4.70 6 4.33 4.56 6 2nd Quartile 5.01 5.01 6 5.17 5.12 7 5.16 5.21 7 3rd Quartile 5.91 6.04 7 6.07 6.03 7 6.06 6.01 7 4th Quartile 7.27 7.24 7 7.49 7.20 7 7.33 7.34 7 Total Population 5.69 5.48 26 5.85 5.52 27 5.77 5.49 27 Excluded Cost Reports 3 2 2 Total Cost Reports 29 29 29Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 39
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.59 4.69 8 4.56 4.66 8 4.64 4.69 8 2nd Quartile 5.35 5.40 8 5.36 5.36 9 5.40 5.47 9 3rd Quartile 6.05 6.02 9 6.29 6.28 9 6.01 5.94 9 4th Quartile 7.15 7.10 9 7.23 7.14 9 7.14 7.09 9 Total Population 5.83 5.71 34 5.90 5.98 35 5.83 5.72 35 Excluded Cost Reports 2 2 2 Total Cost Reports 36 37 37 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.60 4.67 8 4.62 4.65 8 4.60 4.72 8 2nd Quartile 5.20 5.17 9 5.22 5.15 9 5.13 5.16 8 3rd Quartile 6.04 6.04 9 5.93 5.93 9 5.73 5.84 9 4th Quartile 7.33 7.26 9 7.00 6.86 9 6.89 6.71 9 Total Population 5.83 5.70 35 5.73 5.67 35 5.63 5.44 34 Excluded Cost Reports 2 2 3 Total Cost Reports 37 37 37Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 40
    • Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.42 3.54 166 3.44 3.52 177 3.45 3.53 178 2nd Quartile 4.44 4.40 167 4.46 4.43 181 4.47 4.42 181 3rd Quartile 5.28 5.21 170 5.28 5.22 183 5.23 5.17 183 4th Quartile 6.61 6.52 171 6.65 6.49 183 6.53 6.37 184 Total Population 4.95 4.86 674 4.97 4.85 724 4.93 4.86 726 Excluded Cost Reports 61 50 60 Total Cost Reports 735 774 786 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.39 3.50 169 3.51 3.64 163 3.55 3.68 166 2nd Quartile 4.45 4.45 173 4.49 4.42 168 4.53 4.47 169 3rd Quartile 5.24 5.18 174 5.23 5.19 170 5.26 5.22 171 4th Quartile 6.54 6.33 176 6.46 6.29 170 6.57 6.54 171 Total Population 4.92 4.82 692 4.94 4.84 671 4.99 4.84 677 Excluded Cost Reports 60 64 69 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 41
    • Days Net Patient Revenue in Accounts Receivable (AR) - SummaryDays Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 58.27 56.57 280 62.83 62.44 295 63.95 62.74 299 26 to 100 Beds 56.07 54.57 187 59.77 58.06 189 62.29 60.45 196 101 to 200 Beds 54.58 52.05 78 54.65 52.67 82 55.81 54.15 85 201 to 300 Beds 52.35 49.42 42 51.11 51.11 45 53.63 49.43 42 301 to 400 Beds 47.91 49.13 27 53.63 53.37 29 56.88 54.72 30 401 to 500 Beds 58.79 57.56 29 57.27 54.15 27 61.29 61.03 27 Over 500 Beds 51.77 50.84 35 57.55 51.24 35 55.39 55.01 35 Total All Hospitals 56.15 54.26 678 59.44 58.03 702 61.10 59.71 714 Excluded Cost Reports 57 72 72 Total Cost Reports 735 774 786 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 63.93 63.06 285 63.46 62.05 242 64.34 63.24 208 26 to 100 Beds 60.56 60.90 191 60.77 59.51 210 62.82 61.45 253 101 to 200 Beds 58.42 55.37 79 54.65 55.33 79 58.15 59.55 81 201 to 300 Beds 55.18 50.84 46 54.54 54.55 44 57.35 56.03 46 301 to 400 Beds 55.81 54.18 30 54.53 53.86 30 59.08 61.00 30 401 to 500 Beds 60.83 59.52 27 60.18 59.48 26 59.77 62.19 26 Over 500 Beds 55.26 54.80 36 53.25 55.19 34 56.65 56.11 34 Total All Hospitals 60.88 59.85 694 59.92 59.02 665 61.77 61.02 678 Excluded Cost Reports 58 70 68 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 42
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 38.89 40.49 70 40.63 43.58 73 43.86 45.84 74 2nd Quartile 52.09 51.93 70 56.38 56.46 74 57.25 57.16 75 3rd Quartile 62.20 61.79 70 67.69 67.32 74 68.26 67.63 75 4th Quartile 79.90 75.68 70 86.33 83.97 74 86.18 83.90 75 Total Population 58.27 56.57 280 62.83 62.44 295 63.95 62.74 299 Excluded Cost Reports 25 29 28 Total Cost Reports 305 324 327 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.91 44.89 71 43.27 44.98 60 42.63 44.51 52 2nd Quartile 58.53 58.82 71 57.02 57.10 60 58.34 58.58 52 3rd Quartile 67.97 68.30 71 67.77 67.74 61 68.85 68.04 52 4th Quartile 85.03 83.20 72 85.36 82.81 61 87.54 87.60 52 Total Population 63.93 63.06 285 63.46 62.05 242 64.34 63.24 208 Excluded Cost Reports 19 21 18 Total Cost Reports 304 263 226Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 43
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 35.03 37.98 46 37.08 39.44 47 40.53 42.04 49 2nd Quartile 48.90 48.97 47 51.84 52.35 47 55.21 55.48 49 3rd Quartile 60.32 60.35 47 64.34 63.76 47 67.02 67.29 49 4th Quartile 79.59 77.69 47 85.28 84.64 48 86.43 84.76 49 Total Population 56.07 54.57 187 59.77 58.06 189 62.29 60.45 196 Excluded Cost Reports 16 21 21 Total Cost Reports 203 210 217 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 38.56 41.60 47 39.79 41.59 52 42.22 42.24 63 2nd Quartile 53.86 54.16 48 54.13 54.22 52 56.71 56.52 63 3rd Quartile 64.96 64.60 48 64.75 64.26 53 67.21 66.54 63 4th Quartile 84.41 82.35 48 83.87 80.99 53 84.79 82.49 64 Total Population 60.56 60.90 191 60.77 59.51 210 62.82 61.45 253 Excluded Cost Reports 17 19 24 Total Cost Reports 208 229 277Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 44
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 35.73 38.38 19 37.26 37.43 20 35.31 37.78 21 2nd Quartile 46.43 45.89 19 47.79 48.06 20 49.94 50.60 21 3rd Quartile 55.10 54.43 20 56.71 55.97 21 58.50 58.31 21 4th Quartile 79.72 76.63 20 75.70 70.07 21 78.40 78.18 22 Total Population 54.58 52.05 78 54.65 52.67 82 55.81 54.15 85 Excluded Cost Reports 8 11 11 Total Cost Reports 86 93 96 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 38.11 37.86 19 32.82 33.89 19 34.68 37.35 20 2nd Quartile 51.07 51.84 20 49.79 50.27 20 53.60 52.72 20 3rd Quartile 59.95 59.18 20 58.81 58.51 20 63.00 63.45 20 4th Quartile 83.55 87.23 20 76.08 73.16 20 80.20 77.34 21 Total Population 58.42 55.37 79 54.65 55.33 79 58.15 59.55 81 Excluded Cost Reports 13 17 14 Total Cost Reports 92 96 95Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 45
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 33.92 34.84 10 31.74 33.39 11 33.66 35.08 10 2nd Quartile 44.00 44.69 10 45.92 47.66 11 45.63 46.27 10 3rd Quartile 53.92 53.72 11 54.09 53.24 11 55.72 53.70 11 4th Quartile 75.14 72.30 11 70.90 72.26 12 76.98 75.64 11 Total Population 52.35 49.42 42 51.11 51.11 45 53.63 49.43 42 Excluded Cost Reports 5 4 5 Total Cost Reports 47 49 47 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 37.77 39.54 11 32.62 34.20 11 33.16 35.06 11 2nd Quartile 48.37 48.48 11 47.69 45.99 11 49.28 49.25 11 3rd Quartile 55.11 54.75 12 59.32 58.83 11 63.18 62.29 12 4th Quartile 77.45 72.32 12 78.55 74.76 11 81.08 80.12 12 Total Population 55.18 50.84 46 54.54 54.55 44 57.35 56.03 46 Excluded Cost Reports 3 4 3 Total Cost Reports 49 48 49Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 46
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 31.99 33.78 6 36.88 36.62 7 38.78 41.96 7 2nd Quartile 44.42 43.17 7 49.53 49.15 7 50.14 49.40 7 3rd Quartile 51.49 51.36 7 58.28 59.16 7 59.36 60.10 8 4th Quartile 61.46 63.50 7 67.79 67.21 8 76.14 71.66 8 Total Population 47.91 49.13 27 53.63 53.37 29 56.88 54.72 30 Excluded Cost Reports 2 3 3 Total Cost Reports 29 32 33 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 38.06 38.50 7 35.16 35.30 7 35.88 36.50 7 2nd Quartile 49.24 48.87 7 50.00 50.16 7 53.43 52.76 7 3rd Quartile 58.01 58.16 8 57.07 57.10 8 63.52 62.55 8 4th Quartile 74.91 69.06 8 72.91 65.85 8 79.88 76.45 8 Total Population 55.81 54.18 30 54.53 53.86 30 59.08 61.00 30 Excluded Cost Reports 3 3 3 Total Cost Reports 33 33 33Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 47
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 38.82 39.84 7 40.80 42.13 6 43.54 44.79 6 2nd Quartile 51.27 49.64 7 50.57 50.91 7 51.61 49.61 7 3rd Quartile 61.74 62.25 7 60.53 61.12 7 66.56 66.73 7 4th Quartile 80.25 78.13 8 74.84 73.52 7 80.90 76.37 7 Total Population 58.79 57.56 29 57.27 54.15 27 61.29 61.03 27 Excluded Cost Reports 0 2 2 Total Cost Reports 29 29 29 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 40.59 42.80 6 39.26 40.85 6 39.64 41.28 6 2nd Quartile 53.70 53.72 7 53.42 53.47 6 54.78 55.90 6 3rd Quartile 65.66 66.20 7 65.05 67.48 7 66.20 66.89 7 4th Quartile 80.47 74.26 7 79.03 77.30 7 74.88 73.85 7 Total Population 60.83 59.52 27 60.18 59.48 26 59.77 62.19 26 Excluded Cost Reports 2 3 3 Total Cost Reports 29 29 29Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 48
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 35.38 36.92 8 39.65 41.23 8 37.29 38.46 8 2nd Quartile 43.87 43.70 9 47.90 48.60 9 48.51 47.34 9 3rd Quartile 54.73 56.08 9 59.83 59.31 9 59.82 58.46 9 4th Quartile 71.27 67.21 9 80.83 75.34 9 73.91 70.65 9 Total Population 51.77 50.84 35 57.55 51.24 35 55.39 55.01 35 Excluded Cost Reports 1 2 2 Total Cost Reports 36 37 37 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 37.62 37.58 9 37.61 38.64 8 40.10 40.82 8 2nd Quartile 49.42 49.13 9 46.15 46.38 8 52.34 52.22 8 3rd Quartile 59.05 56.92 9 58.36 59.24 9 58.54 57.87 9 4th Quartile 74.94 72.67 9 68.34 67.16 9 73.32 71.74 9 Total Population 55.26 54.80 36 53.25 55.19 34 56.65 56.11 34 Excluded Cost Reports 1 3 3 Total Cost Reports 37 37 37Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 49
    • Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 36.74 38.29 166 38.51 40.34 172 40.80 42.14 175 2nd Quartile 49.30 49.63 169 52.58 52.37 175 54.23 54.34 178 3rd Quartile 59.47 59.46 171 63.58 64.60 176 65.13 65.80 180 4th Quartile 78.31 75.66 172 82.21 81.51 179 83.49 82.09 181 Total Population 56.15 54.26 678 59.44 58.03 702 61.10 59.71 714 Excluded Cost Reports 57 72 72 Total Cost Reports 735 774 786 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 40.69 41.62 170 39.45 40.49 163 40.39 41.75 167 2nd Quartile 54.68 54.68 173 53.64 53.57 164 55.94 56.29 167 3rd Quartile 64.34 64.56 175 64.09 64.12 169 66.26 65.56 171 4th Quartile 83.02 81.40 176 81.59 79.65 169 83.58 81.70 173 Total Population 60.88 59.85 694 59.92 59.02 665 61.77 61.02 678 Excluded Cost Reports 58 70 68 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 50
    • Average Age of Plant and Equipment - SummaryAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 9.56 8.90 245 9.94 9.82 253 10.25 9.68 238 26 to 100 Beds 10.39 10.04 155 10.73 10.41 160 10.82 10.79 167 101 to 200 Beds 9.86 9.75 66 9.88 9.91 66 10.14 10.24 65 201 to 300 Beds 9.49 10.04 36 9.01 9.35 38 9.82 9.34 39 301 to 400 Beds 11.61 10.44 19 11.27 9.85 21 11.02 10.18 22 401 to 500 Beds 11.45 10.60 21 11.40 11.10 23 11.28 11.26 21 Over 500 Beds 10.54 9.56 29 11.12 9.59 31 10.74 9.97 28 Total All Hospitals 10.01 9.68 571 10.25 9.94 592 10.46 10.11 580 Excluded Cost Reports 164 182 206 Total Cost Reports 735 774 786 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 10.77 10.33 236 11.13 10.79 211 10.82 10.67 152 26 to 100 Beds 10.75 10.41 163 10.28 10.25 171 10.27 9.83 75 101 to 200 Beds 10.91 10.67 65 10.46 10.26 68 7.91 7.79 15 201 to 300 Beds 10.17 9.42 37 9.62 9.29 39 7.62 7.65 8 301 to 400 Beds 10.83 9.46 24 10.49 9.31 21 12.26 12.26 1 401 to 500 Beds 11.52 11.21 23 10.01 10.60 19 10.56 10.65 4 Over 500 Beds 10.71 9.99 29 11.51 10.38 30 9.08 9.08 2 Total All Hospitals 10.77 10.33 577 10.64 10.34 559 10.38 9.91 257 Excluded Cost Reports 175 176 489 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 51
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.86 4.23 61 4.52 4.75 63 4.83 5.13 59 2nd Quartile 7.67 7.67 61 8.10 8.09 63 8.59 8.67 59 3rd Quartile 10.53 10.41 61 11.11 11.19 63 11.10 11.19 60 4th Quartile 16.09 15.98 62 15.93 15.94 64 16.35 16.36 60 Total Population 9.56 8.90 245 9.94 9.82 253 10.25 9.68 238 Excluded Cost Reports 60 71 89 Total Cost Reports 305 324 327 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.07 5.25 59 4.98 5.32 52 4.65 5.10 38 2nd Quartile 8.98 8.92 59 9.38 9.35 53 9.29 9.54 38 3rd Quartile 12.00 11.85 59 12.55 12.56 53 12.35 12.26 38 4th Quartile 17.02 16.71 59 17.48 17.27 53 16.98 16.58 38 Total Population 10.77 10.33 236 11.13 10.79 211 10.82 10.67 152 Excluded Cost Reports 68 52 74 Total Cost Reports 304 263 226Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 52
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.59 4.60 38 5.33 5.73 40 5.24 6.00 41 2nd Quartile 8.70 8.71 39 9.22 9.24 40 9.42 9.45 42 3rd Quartile 11.53 11.41 39 11.71 11.59 40 12.07 11.89 42 4th Quartile 16.60 16.70 39 16.67 16.48 40 16.42 15.89 42 Total Population 10.39 10.04 155 10.73 10.41 160 10.82 10.79 167 Excluded Cost Reports 48 50 50 Total Cost Reports 203 210 217 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.58 6.40 40 5.04 5.53 42 4.84 5.04 18 2nd Quartile 9.21 9.10 41 8.90 8.90 43 8.86 8.99 19 3rd Quartile 11.94 11.93 41 11.38 11.29 43 10.95 10.83 19 4th Quartile 16.15 15.16 41 15.68 15.28 43 16.14 15.70 19 Total Population 10.75 10.41 163 10.28 10.25 171 10.27 9.83 75 Excluded Cost Reports 45 58 202 Total Cost Reports 208 229 277Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 53
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.47 4.48 16 4.66 5.18 16 5.36 6.67 16 2nd Quartile 8.61 8.38 16 8.95 8.97 16 9.35 9.34 16 3rd Quartile 11.17 10.98 17 10.94 11.04 17 11.23 11.17 16 4th Quartile 14.79 13.74 17 14.61 14.03 17 14.37 13.78 17 Total Population 9.86 9.75 66 9.88 9.91 66 10.14 10.24 65 Excluded Cost Reports 20 27 31 Total Cost Reports 86 93 96 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.28 6.90 16 6.11 6.84 17 3.77 3.15 3 2nd Quartile 9.58 9.38 16 9.21 9.38 17 6.40 6.39 4 3rd Quartile 11.76 11.70 16 11.27 11.28 17 8.28 8.36 4 4th Quartile 15.74 15.16 17 15.25 14.24 17 12.14 11.40 4 Total Population 10.91 10.67 65 10.46 10.26 68 7.91 7.79 15 Excluded Cost Reports 27 28 80 Total Cost Reports 92 96 95Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 54
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.77 5.03 9 3.99 5.18 9 5.14 5.66 9 2nd Quartile 8.71 8.68 9 8.32 8.36 9 8.39 8.34 10 3rd Quartile 10.89 10.71 9 10.12 10.17 10 10.28 10.35 10 4th Quartile 13.57 12.75 9 13.03 12.16 10 15.00 14.09 10 Total Population 9.49 10.04 36 9.01 9.35 38 9.82 9.34 39 Excluded Cost Reports 11 11 8 Total Cost Reports 47 49 47 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.45 6.72 9 6.23 6.74 9 3.24 3.24 2 2nd Quartile 8.80 9.05 9 8.35 8.44 10 7.11 7.11 2 3rd Quartile 10.22 10.12 9 10.12 10.19 10 8.28 8.28 2 4th Quartile 14.70 14.72 10 13.43 13.94 10 11.84 11.84 2 Total Population 10.17 9.42 37 9.62 9.29 39 7.62 7.65 8 Excluded Cost Reports 12 9 41 Total Cost Reports 49 48 49Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 55
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.40 7.90 4 7.80 8.06 5 7.37 7.65 5 2nd Quartile 9.30 9.30 5 8.85 8.63 5 8.76 8.63 5 3rd Quartile 11.63 11.49 5 10.83 10.46 5 11.06 10.98 6 4th Quartile 17.25 17.31 5 16.54 15.59 6 15.92 15.44 6 Total Population 11.61 10.44 19 11.27 9.85 21 11.02 10.18 22 Excluded Cost Reports 10 11 11 Total Cost Reports 29 32 33 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.13 6.96 6 6.60 6.87 5 12.26 12.26 1 2nd Quartile 8.74 8.92 6 8.42 8.19 5 0.00 0.00 0 3rd Quartile 10.51 10.42 6 10.57 11.09 5 0.00 0.00 0 4th Quartile 16.93 16.65 6 15.40 14.73 6 0.00 0.00 0 Total Population 10.83 9.46 24 10.49 9.31 21 12.26 12.26 1 Excluded Cost Reports 9 12 32 Total Cost Reports 33 33 33Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 56
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.65 8.67 5 5.98 6.49 5 5.36 6.46 5 2nd Quartile 10.09 10.31 5 9.94 10.00 6 10.16 10.59 5 3rd Quartile 11.79 11.91 5 11.70 11.73 6 12.31 12.32 5 4th Quartile 16.29 16.74 6 17.08 17.53 6 16.29 15.98 6 Total Population 11.45 10.60 21 11.40 11.10 23 11.28 11.26 21 Excluded Cost Reports 8 6 8 Total Cost Reports 29 29 29 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.26 6.78 5 4.46 5.23 4 7.42 7.42 1 2nd Quartile 9.91 10.06 6 9.04 9.06 5 9.97 9.97 1 3rd Quartile 12.21 11.89 6 10.96 10.95 5 11.32 11.32 1 4th Quartile 17.66 18.36 6 14.45 12.33 5 13.54 13.54 1 Total Population 11.52 11.21 23 10.01 10.60 19 10.56 10.65 4 Excluded Cost Reports 6 10 25 Total Cost Reports 29 29 29Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 57
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.99 7.52 7 7.30 7.36 7 7.60 8.15 7 2nd Quartile 8.54 8.37 7 8.89 8.89 8 9.15 9.26 7 3rd Quartile 10.60 10.80 7 10.96 11.01 8 11.57 12.23 7 4th Quartile 15.36 15.02 8 16.86 17.31 8 14.62 13.99 7 Total Population 10.54 9.56 29 11.12 9.59 31 10.74 9.97 28 Excluded Cost Reports 7 6 9 Total Cost Reports 36 37 37 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.42 7.10 7 7.71 7.82 7 8.94 8.94 1 2nd Quartile 9.35 9.47 7 9.48 9.45 7 9.22 9.22 1 3rd Quartile 10.73 10.44 7 11.33 11.09 8 0.00 0.00 0 4th Quartile 14.75 14.34 8 16.78 15.90 8 0.00 0.00 0 Total Population 10.71 9.99 29 11.51 10.38 30 9.08 9.08 2 Excluded Cost Reports 8 7 35 Total Cost Reports 37 37 37Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 58
    • Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll State and Local Government Owned General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.55 5.01 140 5.02 5.42 145 5.27 5.71 142 2nd Quartile 8.31 8.29 142 8.65 8.63 147 8.99 8.96 144 3rd Quartile 10.99 10.96 143 11.19 11.20 149 11.40 11.36 146 4th Quartile 15.92 15.67 146 15.90 15.80 151 15.95 15.62 148 Total Population 10.01 9.68 571 10.25 9.94 592 10.46 10.11 580 Excluded Cost Reports 164 182 206 Total Cost Reports 735 774 786 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.65 6.26 142 5.41 5.84 136 4.85 5.04 64 2nd Quartile 9.15 9.09 144 9.10 9.06 140 8.93 9.20 65 3rd Quartile 11.73 11.68 144 11.67 11.37 141 11.54 11.48 64 4th Quartile 16.37 15.94 147 16.15 15.85 142 16.21 16.09 64 Total Population 10.77 10.33 577 10.64 10.34 559 10.38 9.91 257 Excluded Cost Reports 175 176 489 Total Cost Reports 752 735 746Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 59
    • Introduction to Healthcare Management PartnersWho We AreHMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experienceincluding CEO, COO and CFO assignments across the spectrum of healthcare service providers. Our senior management has deepexperience in building and operating thriving healthcare organizations. Part of that experience includes taking decisive action in crisesor turnaround situations. This knowledge base gives HMP a unique perspective and all the tools necessary to handle the issues facingany healthcare provider organization. HMP provides Hospital Contract Management, Turnaround Management and Interim or CrisisManagement services.Our ApproachOur approach to every assignment is built upon the straightforward application of three simple steps or guiding principles.Listen – We listen carefully to our clients, their key stakeholders and the marketplace throughout each assignment.Evaluate – We employ detailed, fact-based analysis to evaluate and validate assumptions, findings and recommended actions.Implement – We have a bias toward “getting it done.” We take decisive action to quickly convert opportunities or solve problems .The HMP Difference Total commitment to providing C-Level attention throughout each assignment by experienced healthcare executives Small, dedicated teams of operating professionals for each assignment Absolute integrity of our fact-based approach Action-oriented diagnostic and business planning processes Proven ability to drive positive outcomes in all sectors of healthcare Depth of HMP network, providing critical access to key resources and people Commitment to the highest professional standards October 2010 60
    • Introduction to Healthcare Management PartnersManagement ServicesHMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experienceincluding CEO, COO and CFO assignments across the spectrum of health services. Examples of specific assignments include serving asthe Chief Executive Officer (CEO) of the following types of healthcare organizations: Religious affiliated or sponsored multihospital systems Free standing not-for-profit or government owned community hospitals University and major teaching hospitals Single site and multihospital regional operations for investor owned hospital management companies De Novo organizations (start-up) planning, construction and operation of new general acute care hospitals, free-standing heart and cancer hospitals, a continuing care retirement community and many other related facilities Hospitals that are in bankruptcy or for sale Financially distressed skilled nursing facilities Home health, hospice and physician practices“HMP’s senior staff members are professional healthcare service executives who also possess consulting skills,not professional consultants. We understand and are committed to the provision of quality healthcare services at every provider organization where we have a management role.” October 2010 61
    • Introduction to Healthcare Management PartnersHospital Contract ManagementHMP is positioned to undertake the long-term (3 to 5 years) contract management of hospitals of all sizes and stages ofdevelopment. Our executives are experienced in leading the development of new or replacement general acute care or specialtyhospitals or the turnaround and repositioning of existing hospitals. They can effectively lead initiatives in the following areas: Strategic Leadership Clinical Excellence Operational Excellence Financial Performance Market Positioning Clinical Process Redesign Patient Throughput Revenue Cycle Brand Development Evidence‐Based Care Emergency Department Clinical Business Office Consolidation Efficiency Service Line Development Resource Utilization and Cost of Surgical Services Clinical Managed Care Contracting Quality Efficiency Capital Planning and Investment Pay for Performance Inpatient Length of Stay and Level Risk Management and Insurance of Care Physician Relations Care and Case Management Human Resources Management Budgeting / Financial Planning Processes Physician Integration Quality and Safety Indicators Ambulatory Care Capital Programs Continuum of Care Design and Implementation Hospice and Home Care Supply Chain Strategic Plans Corporate and Medical Staff Mission and Vision Best Practices and Operating Financial Reporting and Accounting Governance MetricsWe will be directly accountable to the board of directors and will assume full responsibility to plan, organize, staff, direct andcontrol the successful and cost effective operations of the hospital.Because HMP is not a management consulting firm, our contract management executives are free to always bring the best and mostcost-effective solution, from whatever source, to the hospital should outside assistance prove necessary to implement a givenstrategic or tactical initiative. October 2010 62
    • Introduction to Healthcare Management PartnersTurnaround ManagementHMP’s executives have served as chief restructuring officers of healthcare companies through bankruptcies, crisis situations and in theearly stages of high-profile criminal and civil fraud investigations. In each of these situations, their leadership helped theseorganizations bolster performance through discipline and carefully planned action.Some consultants assess your problems and provide a recommended course of action. But HMP executives take the helm of failingorganizations and assume direct responsibility for transforming them. Time and again, they have succeeded in revitalizing providers ofall kinds, from a rural nursing home chain to a 1,000 bed teaching hospital or a 179 bed county owned community hospital.There are no quick fixes in turnaround management, but HMP has developed a highly effective, streamlined approach for achievinglasting improvements as soon as possible. We begin by developing a strong knowledge base of your organization. Individuals fromevery level of the organization are interviewed: management, medical and nursing staff members, board of directors, employees,patients and their families. Their input, combined with a depth of healthcare industry knowledge, allows HMP to: Stabilize the crises, Identify immediate opportunities and challenges, Develop a strategic plan, including milestones and deadlines, Define expected outcomes, Build consensus with all constituents – medical and nursing staffs, management, unions, and the local community, Change cultures, and Optimize performance.In all of its healthcare provider turnaround assignments, HMP has successfully designed and executed plans that simultaneously addedpatient volume and revenues, reduced costs and improved profitability and cash flow.From the outset, HMP builds on each organization’s strengths, working side‐by‐side with management, directors and other keystakeholders to drive desired results. HMP also focuses on winning the support and active participation of the medical and nursingstaffs, which is fundamental for delivering quality healthcare services and improving financial results. October 2010 63
    • Introduction to Healthcare Management PartnersInterim and Crisis ManagementHMP serves in interim and crisis management roles when required to help guide providers through periods of crisis or change.Companies that are underperforming and in crisis, or healthy but in transition, may need additional experienced healthcare industryleaders to stabilize operations and improve financial performance or maintain continuity in the rapid implementation of critical strategicinitiatives.Our professionals can offer critical advice or step into key leadership positions such as Chief Restructuring Officer, Chief FinancialOfficer, or Chief Executive Officer to provide needed stability during periods of change. Our proven interim management capabilitiesadd valuable support in crisis situations. We immediately fill critical leadership vacancies and shorten the lead‐time for implementingspecific initiatives. HMP provides much needed leadership and speed to create value in executing crisis management and restructuringplans.Our crisis and interim management services include: Immediate staffing of critical senior management positions Reducing lead‐time for implementing strategic initiatives Managing communications processes with Members of the medical and nursing staffs, board members, employees and regulators, and if required Bankruptcy process planning and administration October 2010 64
    • Clients Our Professionals Have Served Not-For-Profit or Governmental Hospitals or SystemsBaylor College of Medicine Hahnemann University New York United Hospital Southern Chester County Hospital Medical Center Medical CenterThe Brooklyn Hospital Center Health Alliance of Cincinnati Nyack Hospital St Vincent’s Catholic Medical Centers, New YorkDevereux Foundation National Health Service, Rahway Hospital Temple Health System United KingdomFranciscan Health System Legacy Health System Raritan Bay Health System Tri‐Lakes Medical CenterGeneral Health System Mercy Health System Robert Wood Johnson Health University Hospital Network Consortium of PennsylvaniaGood Samaritan Hospital Natchez Regional Medical Sisters of Mercy Health System Center Investor Owned Hospitals or Health SystemsAmeris Health Systems Health South Corporation Integrated Healthcare Shasta Regional Medical Holdings, Inc. CenterDoctors Hospital, Houston Hospital Corporation of Lakeside Hospital at Bastrop St. Joseph Hospital, Houston AmericaDoctors Hospital, Los Angeles Hugh Chatham Memorial LifePoint Hospitals Tenet Healthcare Corporation HospitalHealthPlus Hughston Hospital and Clinic Monroe Hospital, LLC Vanguard Health SystemsHospital Partners of America Integra Healthcare Promise Healthcare October 2010 65
    • Clients Our Professionals Have Served Senior Care and/or Continuing Care Retirement CommunitiesGrace Care of Texas Monarch Landing, Inc.Jenner’s Pond Continuing Care Retirement Community National Senior Campuses (Erickson Retirement Communities)Life Care Centers of America Sedgebrook, Inc.Linden Ponds, Inc. St. Edward Mercy Health Systems (Ft. Smith, AR)Mercy Hospitals of Texas St. Johns Nursing Home (St. Louis, MO) Law and Accounting FirmsBird Marella LLP Deloitte Kantrow, Spaht, Weaver & Blitzer Patton BoggsBradley Arant Boult Cummings Gearhiser, Peters, Lockaby, Cavett KPMG Ramirez International, Inc.LLP & Elliott, PLLCBrown McCarroll LLP Hogan & Hartson LLP Latham & Watkins Whiteford Taylor Preston, LLPFulbright & Jaworski LLP Hooper, Lundy & Bookman Mancuso & Franco PC Schiavetti, Corgan, Soscia, DiEdwards and Nicholson, LLPDecosimo Jones Day Milbank, Tweed, Hadley and Waller Lansden Dortch & Davis McCloy LLP Other Providers / PayorsBlue Cross of Tennessee Best Choice Home Health Community Behavioral Health Columbia Home Care Network of PA October 2010 66
    • Firm Leadership Scott Phillips Title Managing Director Education B.S. from University of Florida CPA Boards & Organizations American Bankruptcy Institute Healthcare Subcommittee Chair Telephone 267.207.2929 Mobile 267.804.3885 E-Mail sphillips@hcmpllc.comScott has more than 30 years of healthcare industry management and consulting experience. Prior to founding HMP in 1997, he served as thepresident and chief executive officer of a 636-bed academic medical center, as national partner and regional healthcare practice director for ToucheRoss & Co., and as the chief financial officer of a faith-based multihospital system operating 12 hospitals across seven states.Scott has significant management and consulting experience with government, tax-exempt and investor owned healthcare service providers. Heunderstands the organization and delivery of high-quality health services, including the role of corporate and medical staff governance duringdifficult periods of transition. Scott has executive level experience with mergers, acquisitions and turnaround situations, including restructuring inbankruptcy. In all of his many healthcare provider turnaround assignments, he has successfully designed and implemented plans that simultaneouslyadded patient volume and revenues while conserving cash and reducing unit costs. He understands this approach builds on the organization’sstrengths and attracts the support of the local community and medical and nursing staffs, which is essential for the long-term provision of qualityhealthcare services.Over the past several years, Scott has served as the chairman and CEO of an investor owned healthcare provider with operations in 15 states andchief executive officer of a publicly traded medical staffing company with more than 2,000 employees. Both turnaround assignments included thecrises management of complex organizations in the early stages of high-profile criminal and civil fraud investigations by multiple federal agencies.Scott has expert knowledge of the bankruptcy process as well as its implications and obligations on an operating provider of healthcare services. Herecently led the successful financial turnaround and Chapter 9 reorganization of a 179-bed county-owned hospital.Recently he was the financial advisor to 18 tax-exempt continuing care retirement communities with more than 20,000 residents in twelve states,affected by the bankruptcy and sale of Erickson Retirement Communities.Scott graduated from the University of Florida with a Bachelor of Science in accounting. He is a licensed certified public accountant and member ofnumerous professional organizations. He is currently serving Leader Special Projects, Healthcare Committee, American Bankruptcy Institute. October 2010 67
    • Firm Leadership Michael Morgan Title Managing Director Education MBA from University of Central Oklahoma B.S. from University of Science and Arts of Oklahoma Boards & Organizations Fellow of American College of Healthcare Executives Telephone 713.968.6521 Mobile 214.701.9990 E-Mail mmorgan@hcmpllc.comMichael is a former hospital chief executive officer with more than 30 years of experience in healthcare management. He brings expertise and talentfor turning around ailing healthcare providers and optimizing healthy organizations.In his 25-year career at the Sisters of Mercy Health System, Michael was responsible for turning around five of the system’s 19 hospitals. He servedas president and chief executive officer for several Sisters of Mercy hospitals, including St. John’s Mercy Health Care, which has over $800 millionin operating revenues, employs more than 8,000 individuals and includes the system’s flagship 957-bed teaching hospital. As the CEO, he has setsuccessful new strategies, improved clinical and administrative operations and changed organizational cultures. His trademark is developing capablemanagement teams that in turn increase service quality, employee and medical staff satisfaction, patient volume, profitability and maximize cashflow.After leaving the Sisters of Mercy system, Michael served as the chief restructuring officer and CEO for a two-hospital, investor owned system inTexas. In eight months, he led the successful turnaround, emergence from bankruptcy and recapitalization of the hospitals by a physician-led limitedpartnership. He led the turnaround of a chain of five nursing homes in Texas and the bankruptcy turnaround of a two-campus, acute-care hospital inMississippi. He was the oversight Managing Director for a two-campus rehab and specialty hospital chapter 11 bankruptcy. He also recently servedas the CRO for three individual CCRC’s under a large CCRC management company bankruptcy, and provided financial advisory services for a largeinvestment banking group on a 500-bed hospital system.Michael holds a Bachelor of Science in business administration from the University of Science and Arts of Oklahoma and a Master of Science inbusiness administration from the University of Central Oklahoma. He is a fellow of the American College of Healthcare Executives and has servedas an officer or director of numerous hospitals and business organizations, including a 280,000-member for-profit health insurance plan. October 2010 68
    • Firm Leadership Bruce Buchanan Title Managing Director Education MBA from George Mason University MHSA from University of Michigan B.A. from Princeton University Boards & Organizations Fellow of American College of Healthcare Executives Mobile 602.363.1140 Fax 866.794.9501 E-Mail bbuchanan@hcmpllc.comBruce has more than 30 years of experience in the healthcare field and is a senior healthcare executive with a successful track record in both the not-for-profit and investor owned sectors. He possesses multimarket experience at the hospital and health system chief executive officer level. He hasdeep experience and expertise in revenue growth, physician collaboration/integration, organizational development, productivity improvement andquality enhancement.Before joining HMP, Bruce served as CEO of Phoenix Baptist Hospital, where he turned around the distressed 236-bed teaching hospital by reducingoperating costs while enhancing the quality of care. Bruce led a similar turnaround of Northeast Baptist Hospital in San Antonio, including recruitingnew physicians, doubling the hospital’s physical space and growing market share. He also served as president and CEO of Atlanta Medical Centerand Mercy Health System Oklahoma and its Mercy Health Center in Oklahoma City. Bruce also held senior management positions with HillcrestHealthcare System and Saint Joseph Hospital and worked for Invalesco Group as an operations consultant to healthcare organizations.Most recently with HMP, Bruce served as Chief Restructuring Officer for a rehabilitation hospital company with two facilities. He successfully ledthe company through a Chapter 11 bankruptcy process and a Section 363 sale to a new, privately held owner. He also served as CEO of a countyhospital and guided it through a Chapter 9 bankruptcy, which resulted in all unsecured creditors receiving three year notes for full payment plusinterest.Bruce has a Bachelor of Arts in sociology from Princeton University, a Master of Health Services Administration from University of Michigan, and aMaster of Business Administration from George Mason University. He is board-certified in healthcare management and a Fellow in the AmericanCollege of Healthcare Executives. He also is a member of the Turnaround Management Association. October 2010 69
    • Firm Leadership Derek Pierce Title Managing Director Education B.S. from Samford University Telephone 205.202.0459 Mobile 615.584.0719 E-Mail dpierce@hcmpllc.comDerek has over 20 years of professional experience focused solely in the healthcare industry, having served as chief financial officer, chiefrestructuring officer, director of reimbursement, court-appointed examiner, Medicare auditor, Medicare cost report preparer, forensic accountant,compliance consultant, financial auditor, and financial advisor. He has audited, managed and consulted with all types of healthcare providers,including government owned, community not-for-profit, academic, and investor owned entities.Most recently, Derek served as the restructuring chief financial officer of a two-campus, not-for-profit hospital in Chapter 11 bankruptcy. In additionto his CFO responsibilities, he led the Section 363 sale process and conducted a forensic review into the circumstances that led to the hospital’sbankruptcy filing. Throughout the project, Derek worked closely with senior lenders, debtor-in-possession lenders and the applicable federal loanprogram to a successful plan of reorganization.Starting his career with the Medicare fiscal intermediary as a Medicare auditor, Derek developed deep expert knowledge of the patient revenue cycle,third-party contracting, and Medicare and Medicaid rules and regulations. He is expert in the areas of corporate and regulatory compliance andforensic accounting in conjunction with the defense of civil and criminal fraud claims or allegations. He led teams conducting forensic analysis insupport of settlement negotiations with the government at both Hospital Corporation of America (HCA) and HealthSouth Corporation, two of thelargest and most complex civil fraud settlements in history.In his career, Derek has led or participated in interim management and consulting assignments for more than 40 healthcare providers, includingBaptist Memorial Health Care, National Health Service (United Kingdom) Washington Hospital Center, Lifepoint Hospitals, Tampa GeneralHospital, Legacy Health System and IASIS Healthcare.Prior to joining HMP as a managing director, Derek was a Director with Alvarez & Marsal in its New York-based healthcare practice. Before that,he was a senior manager with Arthur Andersen in its Atlanta-based healthcare consulting practice.Derek is a graduate of Samford University with a Bachelor of Science in accounting and is a member of numerous professional associations. October 2010 70
    • Contact Information Philadelphia New York Houston• Contact: Scott Phillips • Contact: Nihal Shah • Contact: Mike Morgan Managing Director Director Managing Director• Address: • Address: • Address: One Liberty Place 1185 Avenue of the Americas 5100 Westheimer 1650 Market Street 30th Floor Suite 200 36th Floor New York, NY 10036 Houston, TX 77056 Philadelphia, PA 19103 • Phone: 212.461.4243 • Phone: 713.968.6521• Phone: 267.804.3885 • Fax: 212.461.4252 • Fax: 866.422.6176• Fax: 215.689.4386 Birmingham Phoenix London, UK• Contact: Derek Pierce • Contact: Bruce Buchanan • Contact: Tim Bolot Managing Director Managing Director Managing Director• Address: • Address: • Address: 2001 Park Place, Suite 1400 243 E. Glenn Drive Bolt Partners LLP Birmingham, AL 35203 Phoenix, AZ 85020 192 Haverstock Hill,• Phone: 205.202.0459 • Mobile: 602.363.1140 Belsize Park,• Fax: 615.523.1835 • Fax: 866.794.9501 London NW3 2AJ • Phone: +44 (0)20 7435 7349 October 2010 71