HMP Metrics™: Not-For-Profit Hospitals October, 2010
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HMP Metrics™: Not-For-Profit 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™: Not-For-Profit Hospitals October, 2010 Presentation Transcript

  • 1. 1
  • 2. 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
  • 3. 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
  • 4. Executive Summary – Key TermsQuartile Rankings: Quartile rankings were assigned based on the mean values calculated for all not-for-profitgeneral acute care hospitals within the peer groups.Total Profit MarginAll Not-For-Profit 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 11.42% 10.12% 433 10.16% 8.94% 503 13.47% 12.63% 513 2nd Quartile 4.04% 4.03% 433 3.26% 3.24% 505 6.40% 6.35% 516 3rd Quartile 0.15% 0.14% 436 (0.73%) (0.61%) 507 2.29% 2.36% 518 4th Quartile (7.04%) (5.98%) 438 (8.21%) (7.33%) 510 (4.80%) (3.68%) 519 Total Population 2.11% 2.08% 1740 1.08% 1.33% 2025 4.31% 4.19% 2066 Excluded Cost Reports 111 128 112 Total Cost Reports 1851 2153 2178As 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
  • 5. 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
  • 6. Total Profit Margin - SummaryTotal Profit MarginAll Not-For-Profit 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 0.95% 1.06% 338 0.84% 1.14% 383 2.84% 3.15% 388 26 to 100 Beds 2.15% 1.73% 324 1.29% 1.38% 382 3.95% 3.44% 389 101 to 200 Beds 2.10% 2.14% 381 0.95% 0.85% 453 3.94% 3.91% 455 201 to 300 Beds 1.69% 1.60% 254 0.81% 1.19% 293 4.40% 4.60% 303 301 to 400 Beds 3.44% 3.80% 181 1.01% 1.64% 203 5.62% 5.32% 214 401 to 500 Beds 3.13% 3.07% 102 1.40% 1.83% 121 6.02% 5.89% 123 Over 500 Beds 3.05% 3.57% 160 1.78% 3.17% 190 6.15% 6.05% 194 Total All Hospitals 2.11% 2.08% 1740 1.08% 1.33% 2025 4.31% 4.19% 2066 Excluded Cost Reports 111 128 112 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 2.56% 2.68% 359 1.99% 1.81% 305 1.50% 1.99% 249 26 to 100 Beds 3.98% 3.77% 381 3.68% 3.57% 408 2.12% 3.13% 455 101 to 200 Beds 3.17% 3.33% 467 2.89% 3.18% 470 2.42% 2.79% 471 201 to 300 Beds 3.23% 3.80% 304 3.24% 3.43% 311 2.77% 3.09% 309 301 to 400 Beds 5.19% 5.21% 218 4.51% 4.79% 219 4.33% 4.40% 216 401 to 500 Beds 5.19% 5.07% 122 5.04% 4.96% 123 4.79% 4.66% 123 Over 500 Beds 5.63% 5.43% 193 4.75% 5.02% 197 4.39% 4.80% 196 Total All Hospitals 3.79% 3.96% 2044 3.45% 3.64% 2033 2.83% 3.30% 2019 Excluded Cost Reports 96 83 101 Total Cost Reports 2140 2116 2120Notes:• 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
  • 7. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 9.91% 8.39% 84 9.46% 8.32% 95 11.35% 10.59% 97 2nd Quartile 3.00% 2.98% 84 3.02% 2.93% 96 4.98% 4.85% 97 3rd Quartile (0.92%) (0.97%) 85 (1.04%) (1.03%) 96 1.14% 1.26% 97 4th Quartile (8.06%) (6.88%) 85 (7.99%) (6.83%) 96 (6.10%) (4.70%) 97 Total Population 0.95% 1.06% 338 0.84% 1.14% 383 2.84% 3.15% 388 Excluded Cost Reports 23 24 20 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.46% 10.82% 89 10.54% 9.66% 76 9.30% 8.54% 62 2nd Quartile 4.74% 4.84% 90 4.20% 4.48% 76 3.96% 4.17% 62 3rd Quartile 0.76% 0.93% 90 0.14% 0.08% 76 (0.02%) (0.15%) 62 4th Quartile (6.63%) (4.93%) 90 (6.81%) (5.94%) 77 (7.11%) (5.52%) 63 Total Population 2.56% 2.68% 359 1.99% 1.81% 305 1.50% 1.99% 249 Excluded Cost Reports 17 15 20 Total Cost Reports 376 320 269Notes:• 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
  • 8. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 12.86% 11.42% 81 12.23% 11.52% 95 14.59% 13.25% 97 2nd Quartile 3.96% 3.97% 81 3.42% 3.20% 95 6.28% 6.28% 97 3rd Quartile (0.58%) (0.58%) 81 (1.16%) (1.16%) 96 1.43% 1.67% 97 4th Quartile (7.64%) (6.65%) 81 (9.17%) (8.21%) 96 (6.40%) (5.37%) 98 Total Population 2.15% 1.73% 324 1.29% 1.38% 382 3.95% 3.44% 389 Excluded Cost Reports 23 22 25 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 13.77% 12.50% 95 13.22% 11.88% 102 11.27% 10.09% 113 2nd Quartile 5.90% 5.72% 95 5.46% 5.25% 102 4.69% 4.63% 114 3rd Quartile 2.07% 2.12% 95 1.76% 1.80% 102 0.80% 0.92% 114 4th Quartile (5.72%) (4.40%) 96 (5.73%) (4.49%) 102 (8.20%) (6.85%) 114 Total Population 3.98% 3.77% 381 3.68% 3.57% 408 2.12% 3.13% 455 Excluded Cost Reports 19 18 22 Total Cost Reports 400 426 477Notes:• 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
  • 9. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 11.37% 10.13% 95 9.83% 7.82% 113 13.09% 12.39% 113 2nd Quartile 3.82% 3.84% 95 2.89% 2.87% 113 5.88% 5.96% 114 3rd Quartile 0.16% 0.17% 95 (0.76%) (0.71%) 113 2.10% 2.22% 114 4th Quartile (6.86%) (5.38%) 96 (8.08%) (7.33%) 114 (5.21%) (3.49%) 114 Total Population 2.10% 2.14% 381 0.95% 0.85% 453 3.94% 3.91% 455 Excluded Cost Reports 22 26 29 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.81% 10.89% 116 10.92% 9.93% 117 10.42% 9.21% 117 2nd Quartile 4.93% 4.66% 117 5.10% 5.10% 117 4.50% 4.41% 118 3rd Quartile 1.81% 1.83% 117 1.54% 1.69% 118 1.17% 1.23% 118 4th Quartile (5.78%) (4.16%) 117 (5.91%) (4.82%) 118 (6.34%) (4.82%) 118 Total Population 3.17% 3.33% 467 2.89% 3.18% 470 2.42% 2.79% 471 Excluded Cost Reports 18 20 22 Total Cost Reports 485 490 493Notes:• 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
  • 10. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 10.26% 9.57% 63 9.31% 8.13% 73 13.37% 13.04% 75 2nd Quartile 3.46% 3.01% 63 2.95% 3.03% 73 6.53% 6.42% 76 3rd Quartile (0.16%) (0.23%) 64 (0.95%) (0.81%) 73 2.48% 2.72% 76 4th Quartile (6.64%) (5.27%) 64 (7.94%) (6.65%) 74 (4.68%) (3.23%) 76 Total Population 1.69% 1.60% 254 0.81% 1.19% 293 4.40% 4.60% 303 Excluded Cost Reports 20 22 15 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.43% 10.09% 76 10.77% 9.69% 77 10.34% 9.19% 77 2nd Quartile 5.57% 5.61% 76 5.03% 5.12% 78 4.84% 4.76% 77 3rd Quartile 1.75% 1.66% 76 1.67% 1.84% 78 1.32% 1.45% 77 4th Quartile (5.85%) (4.86%) 76 (4.41%) (3.43%) 78 (5.32%) (4.22%) 78 Total Population 3.23% 3.80% 304 3.24% 3.43% 311 2.77% 3.09% 309 Excluded Cost Reports 21 15 16 Total Cost Reports 325 326 325Notes:• 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
  • 11. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 12.19% 11.24% 45 9.41% 8.65% 50 14.35% 13.60% 53 2nd Quartile 5.50% 5.77% 45 3.43% 3.55% 51 7.50% 7.39% 53 3rd Quartile 1.69% 1.71% 45 (0.58%) (0.34%) 51 3.42% 3.34% 54 4th Quartile (5.43%) (4.48%) 46 (8.04%) (7.47%) 51 (2.57%) (1.54%) 54 Total Population 3.44% 3.80% 181 1.01% 1.64% 203 5.62% 5.32% 214 Excluded Cost Reports 12 20 13 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.74% 11.83% 54 12.03% 11.20% 54 11.36% 10.59% 54 2nd Quartile 6.76% 6.37% 54 6.33% 6.14% 55 5.41% 5.33% 54 3rd Quartile 3.74% 3.87% 55 3.06% 2.98% 55 2.84% 2.86% 54 4th Quartile (2.30%) (0.90%) 55 (3.24%) (2.17%) 55 (2.28%) (0.92%) 54 Total Population 5.19% 5.21% 218 4.51% 4.79% 219 4.33% 4.40% 216 Excluded Cost Reports 9 9 13 Total Cost Reports 227 228 229Notes:• 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
  • 12. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 12.82% 11.64% 25 9.57% 8.07% 30 15.28% 14.22% 30 2nd Quartile 5.35% 5.48% 25 3.11% 3.07% 30 7.88% 7.69% 31 3rd Quartile 1.25% 1.26% 26 0.18% 0.25% 30 3.62% 3.29% 31 4th Quartile (6.44%) (5.17%) 26 (7.00%) (6.01%) 31 (2.40%) (1.06%) 31 Total Population 3.13% 3.07% 102 1.40% 1.83% 121 6.02% 5.89% 123 Excluded Cost Reports 6 6 5 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 13.07% 11.71% 30 13.55% 12.29% 30 12.17% 11.43% 30 2nd Quartile 6.78% 6.70% 30 7.02% 6.72% 31 7.11% 6.85% 31 3rd Quartile 3.78% 3.94% 31 3.56% 3.62% 31 2.84% 2.82% 31 4th Quartile (2.56%) (0.88%) 31 (3.71%) (1.36%) 31 (2.74%) (1.04%) 31 Total Population 5.19% 5.07% 122 5.04% 4.96% 123 4.79% 4.66% 123 Excluded Cost Reports 6 4 5 Total Cost Reports 128 127 128Notes:• 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
  • 13. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 11.88% 11.00% 40 10.67% 9.56% 47 14.39% 13.20% 48 2nd Quartile 5.41% 5.36% 40 4.74% 4.90% 47 8.36% 8.63% 48 3rd Quartile 1.89% 2.14% 40 0.40% 0.15% 48 4.28% 4.20% 49 4th Quartile (6.99%) (5.50%) 40 (8.44%) (7.49%) 48 (2.22%) 0.06% 49 Total Population 3.05% 3.57% 160 1.78% 3.17% 190 6.15% 6.05% 194 Excluded Cost Reports 5 8 5 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.86% 12.09% 48 11.62% 11.12% 49 11.34% 10.37% 49 2nd Quartile 7.09% 7.15% 48 6.73% 6.70% 49 6.44% 6.32% 49 3rd Quartile 3.98% 3.89% 48 3.51% 3.56% 49 3.25% 3.09% 49 4th Quartile (1.27%) 0.79% 49 (2.69%) (0.19%) 50 (3.47%) (0.61%) 49 Total Population 5.63% 5.43% 193 4.75% 5.02% 197 4.39% 4.80% 196 Excluded Cost Reports 6 2 3 Total Cost Reports 199 199 199Notes:• 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
  • 14. Peer Group Comparison – Total Profit MarginTotal Profit MarginAll Not-For-Profit 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 11.42% 10.12% 433 10.16% 8.94% 503 13.47% 12.63% 513 2nd Quartile 4.04% 4.03% 433 3.26% 3.24% 505 6.40% 6.35% 516 3rd Quartile 0.15% 0.14% 436 (0.73%) (0.61%) 507 2.29% 2.36% 518 4th Quartile (7.04%) (5.98%) 438 (8.21%) (7.33%) 510 (4.80%) (3.68%) 519 Total Population 2.11% 2.08% 1740 1.08% 1.33% 2025 4.31% 4.19% 2066 Excluded Cost Reports 111 128 112 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.33% 11.46% 508 11.65% 10.83% 505 10.76% 9.91% 502 2nd Quartile 5.68% 5.62% 510 5.43% 5.41% 508 4.97% 4.95% 505 3rd Quartile 2.19% 2.23% 512 1.87% 2.00% 509 1.45% 1.65% 505 4th Quartile (4.93%) (3.74%) 514 (5.04%) (4.07%) 511 (5.77%) (4.63%) 507 Total Population 3.79% 3.96% 2044 3.45% 3.64% 2033 2.83% 3.30% 2019 Excluded Cost Reports 96 83 101 Total Cost Reports 2140 2116 2120Notes:• 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
  • 15. Total Operating Profit Margin - SummaryTotal Operating Profit MarginAll Not-For-Profit 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 (2.20%) (1.87%) 328 (1.97%) (1.26%) 368 (1.68%) (0.89%) 379 26 to 100 Beds (0.84%) (1.26%) 324 (1.51%) (1.16%) 374 (0.70%) (0.28%) 385 101 to 200 Beds 0.04% (0.24%) 384 (1.29%) (1.28%) 454 (0.89%) (0.41%) 456 201 to 300 Beds (0.92%) (0.65%) 252 (1.18%) (1.25%) 291 (0.79%) (0.69%) 299 301 to 400 Beds 1.09% 0.89% 181 (0.55%) (0.23%) 208 0.02% (0.39%) 212 401 to 500 Beds 0.27% 0.05% 101 (1.14%) (0.93%) 121 (0.90%) (0.24%) 123 Over 500 Beds 0.32% 0.75% 160 (0.62%) (0.03%) 190 0.24% 0.20% 188 Total All Hospitals (0.54%) (0.36%) 1730 (1.29%) (1.04%) 2006 (0.79%) (0.47%) 2042 Excluded Cost Reports 121 147 136 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less (2.57%) (1.58%) 351 (2.42%) (2.01%) 297 (2.69%) (2.64%) 238 26 to 100 Beds (0.28%) (0.01%) 376 (0.30%) (0.05%) 403 (2.04%) (0.64%) 451 101 to 200 Beds (1.17%) (0.86%) 463 (0.54%) (0.44%) 464 (1.59%) (0.82%) 470 201 to 300 Beds (1.13%) (1.14%) 301 (1.17%) (1.07%) 307 (1.57%) (1.33%) 305 301 to 400 Beds (0.15%) 0.14% 215 0.07% 0.52% 217 (0.17%) (0.18%) 218 401 to 500 Beds (0.89%) 0.31% 121 (0.14%) 1.11% 119 (0.12%) 0.53% 122 Over 500 Beds (0.72%) 0.38% 189 (0.36%) 0.33% 189 (0.39%) 0.08% 187 Total All Hospitals (1.07%) (0.65%) 2016 (0.76%) (0.37%) 1996 (1.46%) (0.76%) 1991 Excluded Cost Reports 124 120 129 Total Cost Reports 2140 2116 2120Notes:• 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
  • 16. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 8.56% 6.70% 82 8.15% 6.36% 92 8.86% 7.59% 94 2nd Quartile 0.77% 0.73% 82 0.64% 0.51% 92 0.99% 0.75% 95 3rd Quartile (4.11%) (3.89%) 82 (3.88%) (3.87%) 92 (3.30%) (3.48%) 95 4th Quartile (14.02%) (13.43%) 82 (12.81%) (11.59%) 92 (13.14%) (12.32%) 95 Total Population (2.20%) (1.87%) 328 (1.97%) (1.26%) 368 (1.68%) (0.89%) 379 Excluded Cost Reports 33 39 29 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.83% 6.50% 87 7.87% 6.94% 74 7.73% 7.08% 59 2nd Quartile 0.59% 0.55% 88 0.50% 0.47% 74 0.28% 0.72% 59 3rd Quartile (3.96%) (3.96%) 88 (4.42%) (4.13%) 74 (4.89%) (4.72%) 60 4th Quartile (14.61%) (13.53%) 88 (13.46%) (12.05%) 75 (13.65%) (12.72%) 60 Total Population (2.57%) (1.58%) 351 (2.42%) (2.01%) 297 (2.69%) (2.64%) 238 Excluded Cost Reports 25 23 31 Total Cost Reports 376 320 269Notes:• 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
  • 17. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 10.96% 9.72% 81 10.34% 9.61% 93 10.58% 10.13% 96 2nd Quartile 1.51% 1.48% 81 1.53% 1.12% 93 2.35% 1.88% 96 3rd Quartile (3.58%) (3.59%) 81 (4.00%) (4.09%) 94 (2.96%) (2.59%) 96 4th Quartile (12.27%) (11.10%) 81 (13.74%) (13.13%) 94 (12.65%) (11.12%) 97 Total Population (0.84%) (1.26%) 324 (1.51%) (1.16%) 374 (0.70%) (0.28%) 385 Excluded Cost Reports 23 30 29 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.75% 9.52% 94 10.63% 9.03% 100 8.65% 7.61% 112 2nd Quartile 2.04% 1.88% 94 1.94% 1.74% 101 1.35% 1.35% 113 3rd Quartile (2.82%) (2.89%) 94 (2.03%) (1.89%) 101 (3.51%) (3.36%) 113 4th Quartile (11.11%) (9.25%) 94 (11.63%) (10.50%) 101 (14.56%) (14.53%) 113 Total Population (0.28%) (0.01%) 376 (0.30%) (0.05%) 403 (2.04%) (0.64%) 451 Excluded Cost Reports 24 23 26 Total Cost Reports 400 426 477Notes:• 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
  • 18. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 9.94% 8.66% 96 8.72% 8.07% 113 9.04% 8.00% 114 2nd Quartile 1.87% 2.06% 96 0.67% 0.58% 113 1.86% 1.88% 114 3rd Quartile (2.15%) (2.20%) 96 (2.99%) (2.84%) 114 (2.56%) (2.48%) 114 4th Quartile (9.51%) (7.67%) 96 (11.45%) (9.65%) 114 (11.91%) (10.42%) 114 Total Population 0.04% (0.24%) 384 (1.29%) (1.28%) 454 (0.89%) (0.41%) 456 Excluded Cost Reports 19 25 28 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.67% 7.04% 115 9.12% 7.83% 116 7.98% 6.30% 117 2nd Quartile 1.04% 1.12% 116 1.82% 1.72% 116 0.79% 0.61% 117 3rd Quartile (2.74%) (2.79%) 116 (2.32%) (1.91%) 116 (3.33%) (3.03%) 118 4th Quartile (11.58%) (10.02%) 116 (10.78%) (9.05%) 116 (11.70%) (10.32%) 118 Total Population (1.17%) (0.86%) 463 (0.54%) (0.44%) 464 (1.59%) (0.82%) 470 Excluded Cost Reports 22 26 23 Total Cost Reports 485 490 493Notes:• 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
  • 19. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 8.32% 6.83% 63 8.43% 7.42% 72 8.94% 7.16% 74 2nd Quartile 1.34% 1.11% 63 0.81% 0.43% 73 1.11% 1.10% 75 3rd Quartile (2.49%) (2.44%) 63 (2.89%) (2.68%) 73 (2.84%) (2.87%) 75 4th Quartile (10.85%) (9.55%) 63 (10.96%) (9.63%) 73 (10.24%) (9.19%) 75 Total Population (0.92%) (0.65%) 252 (1.18%) (1.25%) 291 (0.79%) (0.69%) 299 Excluded Cost Reports 22 24 19 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.61% 7.00% 75 8.51% 6.58% 76 8.18% 6.07% 76 2nd Quartile 0.93% 0.93% 75 0.81% 0.61% 77 0.66% 0.61% 76 3rd Quartile (3.17%) (3.11%) 75 (3.23%) (3.22%) 77 (3.73%) (3.66%) 76 4th Quartile (10.77%) (9.63%) 76 (10.64%) (9.43%) 77 (11.28%) (10.45%) 77 Total Population (1.13%) (1.14%) 301 (1.17%) (1.07%) 307 (1.57%) (1.33%) 305 Excluded Cost Reports 24 19 20 Total Cost Reports 325 326 325Notes:• 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
  • 20. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 10.31% 8.98% 45 9.26% 8.40% 52 9.63% 9.02% 53 2nd Quartile 2.57% 2.72% 45 1.46% 1.27% 52 2.10% 2.31% 53 3rd Quartile (0.24%) (0.09%) 45 (2.21%) (2.40%) 52 (2.16%) (2.05%) 53 4th Quartile (8.09%) (5.03%) 46 (10.72%) (8.50%) 52 (9.50%) (9.19%) 53 Total Population 1.09% 0.89% 181 (0.55%) (0.23%) 208 0.02% (0.39%) 212 Excluded Cost Reports 12 15 15 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.49% 8.49% 53 9.23% 8.50% 54 8.58% 7.30% 54 2nd Quartile 2.25% 2.11% 54 2.44% 2.53% 54 1.56% 1.37% 54 3rd Quartile (1.91%) (1.73%) 54 (1.48%) (1.45%) 54 (1.74%) (1.75%) 55 4th Quartile (10.24%) (9.25%) 54 (9.72%) (7.70%) 55 (8.88%) (7.54%) 55 Total Population (0.15%) 0.14% 215 0.07% 0.52% 217 (0.17%) (0.18%) 218 Excluded Cost Reports 12 11 11 Total Cost Reports 227 228 229Notes:• 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
  • 21. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 8.94% 7.61% 25 8.10% 7.40% 30 9.07% 6.96% 30 2nd Quartile 2.36% 2.39% 25 1.37% 1.70% 30 1.75% 1.76% 31 3rd Quartile (1.41%) (1.13%) 25 (2.66%) (2.57%) 30 (2.20%) (1.66%) 31 4th Quartile (8.47%) (6.72%) 26 (11.02%) (10.45%) 31 (11.92%) (10.88%) 31 Total Population 0.27% 0.05% 101 (1.14%) (0.93%) 121 (0.90%) (0.24%) 123 Excluded Cost Reports 7 6 5 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.90% 6.04% 30 9.41% 8.99% 29 9.44% 7.31% 30 2nd Quartile 1.85% 1.79% 30 2.73% 2.78% 30 2.19% 2.21% 30 3rd Quartile (2.25%) (2.42%) 30 (1.01%) (1.18%) 30 (1.31%) (1.44%) 31 4th Quartile (10.71%) (10.01%) 31 (11.36%) (10.88%) 30 (10.43%) (8.99%) 31 Total Population (0.89%) 0.31% 121 (0.14%) 1.11% 119 (0.12%) 0.53% 122 Excluded Cost Reports 7 8 6 Total Cost Reports 128 127 128Notes:• 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
  • 22. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 9.77% 9.78% 40 8.70% 8.47% 47 10.85% 9.77% 47 2nd Quartile 2.85% 2.68% 40 2.73% 2.98% 47 3.07% 2.94% 47 3rd Quartile (1.48%) (1.46%) 40 (2.38%) (2.26%) 48 (1.89%) (1.56%) 47 4th Quartile (9.87%) (8.13%) 40 (11.29%) (10.47%) 48 (11.08%) (9.42%) 47 Total Population 0.32% 0.75% 160 (0.62%) (0.03%) 190 0.24% 0.20% 188 Excluded Cost Reports 5 8 11 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.90% 7.82% 47 9.12% 8.37% 47 9.45% 8.16% 46 2nd Quartile 2.04% 1.80% 47 1.98% 1.75% 47 2.05% 1.75% 47 3rd Quartile (2.24%) (2.21%) 47 (1.56%) (1.39%) 47 (1.54%) (1.45%) 47 4th Quartile (11.34%) (8.06%) 48 (10.77%) (8.23%) 48 (11.33%) (9.19%) 47 Total Population (0.72%) 0.38% 189 (0.36%) 0.33% 189 (0.39%) 0.08% 187 Excluded Cost Reports 10 10 12 Total Cost Reports 199 199 199Notes:• 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
  • 23. Peer Group Comparison – Total Operating Profit MarginTotal Operating Profit MarginAll Not-For-Profit 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 9.60% 8.43% 432 8.89% 8.10% 499 9.51% 8.49% 508 2nd Quartile 1.71% 1.81% 432 1.16% 1.01% 500 1.81% 1.71% 511 3rd Quartile (2.54%) (2.38%) 432 (3.17%) (2.99%) 503 (2.69%) (2.57%) 511 4th Quartile (10.89%) (9.77%) 434 (11.94%) (10.73%) 504 (11.71%) (10.37%) 512 Total Population (0.54%) (0.36%) 1730 (1.29%) (1.04%) 2006 (0.79%) (0.47%) 2042 Excluded Cost Reports 121 147 136 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.97% 7.66% 501 9.17% 7.90% 496 8.43% 7.08% 494 2nd Quartile 1.40% 1.40% 504 1.63% 1.57% 499 1.12% 1.12% 496 3rd Quartile (2.87%) (2.83%) 504 (2.47%) (2.27%) 499 (3.15%) (2.90%) 500 4th Quartile (11.68%) (10.01%) 507 (11.25%) (10.11%) 502 (12.09%) (10.75%) 501 Total Population (1.07%) (0.65%) 2016 (0.76%) (0.37%) 1996 (1.46%) (0.76%) 1991 Excluded Cost Reports 124 120 129 Total Cost Reports 2140 2116 2120Notes:• 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
  • 24. Total Labor Cost as a Percentage of Total Operating Revenues - SummaryTotal Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 48.66% 48.99% 338 49.05% 49.65% 375 49.13% 49.12% 375 26 to 100 Beds 49.99% 49.98% 329 50.77% 51.01% 379 50.83% 50.93% 397 101 to 200 Beds 50.02% 50.48% 390 51.08% 50.99% 460 51.14% 50.83% 465 201 to 300 Beds 50.43% 49.91% 259 51.15% 50.58% 292 51.08% 50.68% 297 301 to 400 Beds 49.93% 49.64% 181 50.61% 50.58% 203 51.22% 50.83% 214 401 to 500 Beds 49.57% 48.23% 105 51.07% 49.94% 121 51.07% 50.77% 122 Over 500 Beds 48.70% 47.91% 158 49.65% 49.56% 191 49.35% 48.60% 193 Total All Hospitals 49.66% 49.54% 1760 50.47% 50.48% 2021 50.54% 50.33% 2063 Excluded Cost Reports 91 132 115 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 48.68% 48.35% 346 48.16% 48.16% 294 48.89% 48.67% 244 26 to 100 Beds 51.06% 50.75% 383 51.53% 51.32% 407 52.72% 52.83% 449 101 to 200 Beds 51.42% 51.69% 470 50.76% 50.66% 469 51.74% 51.71% 472 201 to 300 Beds 51.19% 50.90% 300 51.52% 51.60% 306 52.30% 51.95% 307 301 to 400 Beds 50.81% 50.52% 214 50.55% 50.81% 215 51.25% 51.13% 216 401 to 500 Beds 51.15% 50.68% 120 51.04% 50.47% 121 51.13% 50.84% 124 Over 500 Beds 49.57% 49.36% 190 49.48% 48.69% 191 50.01% 49.17% 192 Total All Hospitals 50.59% 50.34% 2023 50.53% 50.45% 2003 51.44% 51.29% 2004 Excluded Cost Reports 117 113 116 Total Cost Reports 2140 2116 2120Notes:• 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
  • 25. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 36.52% 37.15% 84 37.76% 38.09% 93 37.28% 37.58% 93 2nd Quartile 45.70% 45.77% 84 46.40% 46.52% 94 46.40% 47.00% 94 3rd Quartile 52.12% 52.31% 85 52.31% 52.46% 94 52.61% 53.08% 94 4th Quartile 60.12% 60.04% 85 59.59% 58.88% 94 60.10% 59.36% 94 Total Population 48.66% 48.99% 338 49.05% 49.65% 375 49.13% 49.12% 375 Excluded Cost Reports 23 32 33 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 37.37% 37.61% 86 36.86% 37.30% 73 37.87% 38.45% 61 2nd Quartile 45.28% 45.38% 86 44.28% 43.98% 73 44.99% 44.92% 61 3rd Quartile 51.70% 51.93% 87 51.55% 51.50% 74 52.00% 51.98% 61 4th Quartile 60.18% 59.10% 87 59.76% 59.35% 74 60.68% 59.79% 61 Total Population 48.68% 48.35% 346 48.16% 48.16% 294 48.89% 48.67% 244 Excluded Cost Reports 30 26 25 Total Cost Reports 376 320 269Notes:• 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
  • 26. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 39.70% 40.43% 82 40.76% 41.51% 94 40.84% 41.07% 99 2nd Quartile 47.25% 47.27% 82 48.29% 48.46% 95 48.47% 48.56% 99 3rd Quartile 52.91% 52.73% 82 53.22% 53.24% 95 53.04% 53.10% 99 4th Quartile 59.99% 58.78% 83 60.71% 60.20% 95 60.85% 60.27% 100 Total Population 49.99% 49.98% 329 50.77% 51.01% 379 50.83% 50.93% 397 Excluded Cost Reports 18 25 17 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.56% 42.86% 95 42.10% 43.22% 101 43.82% 44.66% 112 2nd Quartile 48.48% 48.44% 96 49.20% 49.48% 102 50.26% 50.24% 112 3rd Quartile 53.37% 53.21% 96 53.77% 53.69% 102 54.99% 54.81% 112 4th Quartile 60.72% 60.56% 96 60.98% 61.00% 102 61.74% 61.51% 113 Total Population 51.06% 50.75% 383 51.53% 51.32% 407 52.72% 52.83% 449 Excluded Cost Reports 17 19 28 Total Cost Reports 400 426 477Notes:• 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
  • 27. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 40.81% 41.58% 97 41.76% 42.28% 115 42.01% 42.68% 116 2nd Quartile 47.62% 47.67% 97 48.59% 48.54% 115 48.46% 48.66% 116 3rd Quartile 52.49% 52.51% 98 53.36% 53.37% 115 53.61% 53.88% 116 4th Quartile 59.02% 58.04% 98 60.62% 59.96% 115 60.40% 60.00% 117 Total Population 50.02% 50.48% 390 51.08% 50.99% 460 51.14% 50.83% 465 Excluded Cost Reports 13 19 19 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.91% 42.79% 117 41.38% 42.60% 117 42.53% 43.50% 118 2nd Quartile 48.91% 49.06% 117 48.29% 48.42% 117 49.35% 49.42% 118 3rd Quartile 54.17% 54.20% 118 53.32% 53.34% 117 54.21% 54.06% 118 4th Quartile 60.58% 60.04% 118 59.99% 59.99% 118 60.89% 60.33% 118 Total Population 51.42% 51.69% 470 50.76% 50.66% 469 51.74% 51.71% 472 Excluded Cost Reports 15 21 21 Total Cost Reports 485 490 493Notes:• 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
  • 28. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 41.86% 42.82% 64 42.83% 43.45% 73 42.89% 43.64% 74 2nd Quartile 47.60% 47.46% 65 48.48% 48.38% 73 48.72% 48.67% 74 3rd Quartile 52.40% 52.45% 65 53.17% 53.38% 73 52.72% 52.93% 74 4th Quartile 59.74% 58.83% 65 60.12% 59.25% 73 59.87% 59.27% 75 Total Population 50.43% 49.91% 259 51.15% 50.58% 292 51.08% 50.68% 297 Excluded Cost Reports 15 23 21 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 42.50% 42.73% 75 42.82% 43.68% 76 43.46% 44.23% 76 2nd Quartile 48.87% 49.07% 75 49.29% 49.28% 76 49.75% 49.77% 77 3rd Quartile 53.25% 53.09% 75 53.54% 53.43% 77 54.47% 54.44% 77 4th Quartile 60.14% 60.03% 75 60.30% 59.39% 77 61.43% 60.77% 77 Total Population 51.19% 50.90% 300 51.52% 51.60% 306 52.30% 51.95% 307 Excluded Cost Reports 25 20 18 Total Cost Reports 325 326 325Notes:• 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
  • 29. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 42.64% 43.54% 45 42.46% 43.12% 50 43.02% 44.02% 53 2nd Quartile 47.67% 48.00% 45 48.35% 48.38% 51 48.70% 48.66% 53 3rd Quartile 51.41% 51.37% 45 52.52% 52.41% 51 53.11% 53.04% 54 4th Quartile 57.82% 56.50% 46 58.97% 58.15% 51 59.85% 58.59% 54 Total Population 49.93% 49.64% 181 50.61% 50.58% 203 51.22% 50.83% 214 Excluded Cost Reports 12 20 13 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.14% 43.79% 53 42.44% 42.81% 53 43.78% 44.94% 54 2nd Quartile 48.13% 47.81% 53 48.05% 47.70% 54 49.01% 48.88% 54 3rd Quartile 52.75% 52.85% 54 52.89% 52.87% 54 53.44% 53.51% 54 4th Quartile 59.05% 58.35% 54 58.68% 57.88% 54 58.76% 57.87% 54 Total Population 50.81% 50.52% 214 50.55% 50.81% 215 51.25% 51.13% 216 Excluded Cost Reports 13 13 13 Total Cost Reports 227 228 229Notes:• 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
  • 30. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 40.85% 42.09% 26 42.18% 43.32% 30 42.25% 43.11% 30 2nd Quartile 46.41% 46.56% 26 48.13% 48.05% 30 48.27% 48.41% 30 3rd Quartile 51.64% 51.76% 26 53.82% 54.03% 30 53.50% 53.83% 31 4th Quartile 59.01% 58.77% 27 59.85% 58.97% 31 59.90% 59.89% 31 Total Population 49.57% 48.23% 105 51.07% 49.94% 121 51.07% 50.77% 122 Excluded Cost Reports 3 6 6 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 43.37% 43.82% 30 43.21% 44.05% 30 43.08% 43.74% 31 2nd Quartile 48.35% 48.40% 30 48.25% 47.93% 30 48.48% 48.42% 31 3rd Quartile 53.13% 52.95% 30 52.64% 52.35% 30 53.64% 53.30% 31 4th Quartile 59.74% 59.23% 30 59.77% 59.53% 31 59.33% 58.91% 31 Total Population 51.15% 50.68% 120 51.04% 50.47% 121 51.13% 50.84% 124 Excluded Cost Reports 8 6 4 Total Cost Reports 128 127 128Notes:• 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
  • 31. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 41.26% 42.04% 39 41.82% 42.64% 47 41.13% 42.07% 48 2nd Quartile 46.22% 46.43% 39 46.89% 47.07% 48 46.51% 46.31% 48 3rd Quartile 50.29% 49.92% 40 51.19% 50.78% 48 51.07% 50.93% 48 4th Quartile 56.77% 55.92% 40 58.54% 57.74% 48 58.49% 57.34% 49 Total Population 48.70% 47.91% 158 49.65% 49.56% 191 49.35% 48.60% 193 Excluded Cost Reports 7 7 6 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.49% 42.21% 47 41.54% 42.31% 47 42.22% 42.59% 48 2nd Quartile 47.29% 47.40% 47 46.86% 46.96% 48 47.33% 46.96% 48 3rd Quartile 51.13% 50.80% 48 50.80% 50.64% 48 51.49% 51.03% 48 4th Quartile 58.13% 56.63% 48 58.55% 57.27% 48 58.99% 58.07% 48 Total Population 49.57% 49.36% 190 49.48% 48.69% 191 50.01% 49.17% 192 Excluded Cost Reports 9 8 7 Total Cost Reports 199 199 199Notes:• 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
  • 32. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.Total Labor Cost as a Percentage of Total Operating RevenuesAll Not-For-Profit 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 40.16% 40.90% 437 41.09% 41.81% 502 41.09% 41.76% 513 2nd Quartile 46.99% 47.01% 438 47.90% 48.05% 506 47.96% 48.17% 514 3rd Quartile 52.13% 52.14% 441 52.85% 52.78% 506 52.90% 53.07% 516 4th Quartile 59.19% 58.40% 444 59.96% 59.25% 507 60.09% 59.42% 520 Total Population 49.66% 49.54% 1760 50.47% 50.48% 2021 50.54% 50.33% 2063 Excluded Cost Reports 91 132 115 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.33% 42.27% 503 41.32% 42.29% 497 42.53% 43.46% 500 2nd Quartile 47.93% 48.02% 504 47.88% 48.04% 500 48.80% 48.91% 501 3rd Quartile 52.96% 52.98% 508 52.86% 52.85% 502 53.77% 53.81% 501 4th Quartile 60.03% 59.51% 508 59.91% 59.43% 504 60.63% 60.10% 502 Total Population 50.59% 50.34% 2023 50.53% 50.45% 2003 51.44% 51.29% 2004 Excluded Cost Reports 117 113 116 Total Cost Reports 2140 2116 2120Notes:• 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
  • 33. Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (A0B) - SummaryFull-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Not-For-Profit 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 4.76 4.67 329 4.74 4.58 373 4.79 4.65 374 26 to 100 Beds 4.97 4.90 332 4.97 4.82 386 4.83 4.69 397 101 to 200 Beds 4.79 4.73 395 4.74 4.65 471 4.69 4.55 476 201 to 300 Beds 5.05 4.88 271 5.00 4.82 312 4.94 4.80 314 301 to 400 Beds 5.19 5.05 190 5.15 5.07 220 5.14 5.03 224 401 to 500 Beds 5.30 5.05 106 5.24 5.10 126 5.21 5.04 127 Over 500 Beds 5.58 5.55 155 5.55 5.44 189 5.50 5.44 191 Total All Hospitals 5.00 4.92 1778 4.97 4.86 2077 4.93 4.79 2103 Excluded Cost Reports 73 76 75 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 4.80 4.79 340 4.77 4.72 285 4.69 4.66 230 26 to 100 Beds 4.87 4.73 386 4.79 4.65 407 4.91 4.83 458 101 to 200 Beds 4.67 4.55 481 4.62 4.50 487 4.58 4.47 488 201 to 300 Beds 4.92 4.79 321 4.88 4.72 319 4.88 4.75 321 301 to 400 Beds 5.17 5.02 223 5.11 5.01 222 5.12 4.99 225 401 to 500 Beds 5.23 5.04 126 5.18 4.95 127 5.11 4.90 127 Over 500 Beds 5.56 5.51 192 5.50 5.44 192 5.46 5.44 191 Total All Hospitals 4.94 4.84 2069 4.88 4.77 2039 4.89 4.79 2040 Excluded Cost Reports 71 77 80 Total Cost Reports 2140 2116 2120Notes:• 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
  • 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 Not-For-Profit 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 3.08 3.15 82 3.04 3.16 93 3.08 3.20 93 2nd Quartile 4.22 4.19 82 4.17 4.16 93 4.21 4.23 93 3rd Quartile 5.12 5.11 82 5.10 5.07 93 5.14 5.11 94 4th Quartile 6.61 6.40 83 6.65 6.45 94 6.72 6.63 94 Total Population 4.76 4.67 329 4.74 4.58 373 4.79 4.65 374 Excluded Cost Reports 32 34 34 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.08 3.20 85 3.00 3.08 71 2.89 3.10 57 2nd Quartile 4.30 4.29 85 4.27 4.31 71 4.15 4.10 57 3rd Quartile 5.20 5.17 85 5.13 5.09 71 5.12 5.11 58 4th Quartile 6.62 6.35 85 6.64 6.58 72 6.54 6.40 58 Total Population 4.80 4.79 340 4.77 4.72 285 4.69 4.66 230 Excluded Cost Reports 36 35 39 Total Cost Reports 376 320 269Notes:• 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
  • 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 Not-For-Profit 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 3.42 3.52 83 3.47 3.56 96 3.43 3.53 99 2nd Quartile 4.52 4.51 83 4.48 4.52 96 4.35 4.35 99 3rd Quartile 5.28 5.26 83 5.24 5.21 97 5.10 5.10 99 4th Quartile 6.64 6.36 83 6.67 6.53 97 6.43 6.30 100 Total Population 4.97 4.90 332 4.97 4.82 386 4.83 4.69 397 Excluded Cost Reports 15 18 17 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.43 3.55 96 3.42 3.53 101 3.50 3.62 114 2nd Quartile 4.38 4.38 96 4.30 4.32 102 4.47 4.47 114 3rd Quartile 5.13 5.13 97 5.05 5.03 102 5.17 5.14 115 4th Quartile 6.50 6.29 97 6.35 6.23 102 6.48 6.34 115 Total Population 4.87 4.73 386 4.79 4.65 407 4.91 4.83 458 Excluded Cost Reports 14 19 19 Total Cost Reports 400 426 477Notes:• 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
  • 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 Not-For-Profit 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 3.49 3.60 98 3.48 3.60 117 3.48 3.61 119 2nd Quartile 4.41 4.44 99 4.32 4.32 118 4.27 4.27 119 3rd Quartile 5.07 5.06 99 4.98 4.97 118 4.89 4.85 119 4th Quartile 6.21 5.98 99 6.18 6.01 118 6.13 5.90 119 Total Population 4.79 4.73 395 4.74 4.65 471 4.69 4.55 476 Excluded Cost Reports 8 8 8 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.48 3.54 120 3.44 3.50 121 3.44 3.53 122 2nd Quartile 4.24 4.25 120 4.22 4.25 122 4.20 4.20 122 3rd Quartile 4.88 4.85 120 4.81 4.80 122 4.75 4.73 122 4th Quartile 6.07 5.86 121 6.00 5.78 122 5.94 5.78 122 Total Population 4.67 4.55 481 4.62 4.50 487 4.58 4.47 488 Excluded Cost Reports 4 3 5 Total Cost Reports 485 490 493Notes:• 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
  • 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 Not-For-Profit 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 3.80 3.88 67 3.78 3.84 78 3.73 3.77 78 2nd Quartile 4.56 4.54 68 4.50 4.50 78 4.48 4.46 78 3rd Quartile 5.27 5.24 68 5.22 5.21 78 5.13 5.10 79 4th Quartile 6.56 6.39 68 6.49 6.28 78 6.40 6.13 79 Total Population 5.05 4.88 271 5.00 4.82 312 4.94 4.80 314 Excluded Cost Reports 3 3 4 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.75 3.80 80 3.66 3.72 79 3.65 3.76 80 2nd Quartile 4.50 4.51 80 4.44 4.44 80 4.43 4.44 80 3rd Quartile 5.12 5.06 80 5.07 5.07 80 5.09 5.09 80 4th Quartile 6.31 6.02 81 6.33 6.11 80 6.34 6.15 81 Total Population 4.92 4.79 321 4.88 4.72 319 4.88 4.75 321 Excluded Cost Reports 4 7 4 Total Cost Reports 325 326 325Notes:• 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
  • 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 Not-For-Profit 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 3.93 4.02 47 3.93 4.04 55 3.90 4.04 56 2nd Quartile 4.82 4.82 47 4.72 4.69 55 4.73 4.71 56 3rd Quartile 5.38 5.38 48 5.34 5.29 55 5.36 5.33 56 4th Quartile 6.60 6.49 48 6.60 6.44 55 6.56 6.41 56 Total Population 5.19 5.05 190 5.15 5.07 220 5.14 5.03 224 Excluded Cost Reports 3 3 3 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.99 4.09 55 3.92 3.98 55 3.95 4.06 56 2nd Quartile 4.74 4.75 56 4.67 4.70 55 4.69 4.67 56 3rd Quartile 5.38 5.36 56 5.35 5.38 56 5.30 5.27 56 4th Quartile 6.57 6.49 56 6.45 6.32 56 6.53 6.32 57 Total Population 5.17 5.02 223 5.11 5.01 222 5.12 4.99 225 Excluded Cost Reports 4 6 4 Total Cost Reports 227 228 229Notes:• 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
  • 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 Not-For-Profit 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 4.12 4.36 26 3.96 4.13 31 3.97 4.06 31 2nd Quartile 4.84 4.85 26 4.76 4.77 31 4.72 4.67 32 3rd Quartile 5.51 5.59 27 5.48 5.52 32 5.44 5.37 32 4th Quartile 6.66 6.51 27 6.70 6.52 32 6.65 6.52 32 Total Population 5.30 5.05 106 5.24 5.10 126 5.21 5.04 127 Excluded Cost Reports 2 1 1 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.06 4.16 31 3.96 4.02 31 3.90 3.97 31 2nd Quartile 4.71 4.69 31 4.67 4.70 32 4.62 4.62 32 3rd Quartile 5.44 5.41 32 5.34 5.30 32 5.26 5.21 32 4th Quartile 6.65 6.41 32 6.73 6.47 32 6.63 6.39 32 Total Population 5.23 5.04 126 5.18 4.95 127 5.11 4.90 127 Excluded Cost Reports 2 0 1 Total Cost Reports 128 127 128Notes:• 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
  • 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 Not-For-Profit 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 4.36 4.52 38 4.37 4.52 47 4.33 4.47 47 2nd Quartile 5.20 5.15 39 5.19 5.20 47 5.12 5.17 48 3rd Quartile 5.82 5.79 39 5.77 5.77 47 5.75 5.71 48 4th Quartile 6.91 6.72 39 6.85 6.66 48 6.77 6.71 48 Total Population 5.58 5.55 155 5.55 5.44 189 5.50 5.44 191 Excluded Cost Reports 10 9 8 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.34 4.51 48 4.34 4.48 48 4.33 4.44 47 2nd Quartile 5.17 5.13 48 5.14 5.12 48 5.14 5.14 48 3rd Quartile 5.80 5.79 48 5.70 5.70 48 5.68 5.68 48 4th Quartile 6.92 6.76 48 6.82 6.72 48 6.68 6.48 48 Total Population 5.56 5.51 192 5.50 5.44 192 5.46 5.44 191 Excluded Cost Reports 7 7 8 Total Cost Reports 199 199 199Notes:• 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
  • 41. Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Not-For-Profit 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 3.61 3.66 441 3.60 3.67 517 3.59 3.64 523 2nd Quartile 4.55 4.54 444 4.50 4.47 518 4.46 4.43 525 3rd Quartile 5.27 5.25 446 5.23 5.20 520 5.17 5.15 527 4th Quartile 6.55 6.40 447 6.54 6.40 522 6.47 6.34 528 Total Population 5.00 4.92 1778 4.97 4.86 2077 4.93 4.79 2103 Excluded Cost Reports 73 76 75 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.62 3.68 515 3.58 3.65 506 3.59 3.66 507 2nd Quartile 4.49 4.48 516 4.44 4.40 510 4.46 4.43 509 3rd Quartile 5.19 5.14 518 5.12 5.09 511 5.12 5.09 511 4th Quartile 6.44 6.28 520 6.38 6.26 512 6.37 6.25 513 Total Population 4.94 4.84 2069 4.88 4.77 2039 4.89 4.79 2040 Excluded Cost Reports 71 77 80 Total Cost Reports 2140 2116 2120Notes:• 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
  • 42. Days Net Patient Revenue in Accounts Receivable (AR) - SummaryDays Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 52.42 51.57 344 56.12 54.65 388 57.20 56.34 389 26 to 100 Beds 47.24 45.92 323 51.24 49.38 375 52.23 50.53 392 101 to 200 Beds 46.82 45.32 377 49.35 48.74 450 49.85 49.42 456 201 to 300 Beds 46.13 45.28 250 49.39 49.09 286 50.96 50.29 293 301 to 400 Beds 46.73 45.39 179 49.32 48.24 202 50.42 50.02 211 401 to 500 Beds 47.45 47.36 101 49.69 49.60 123 51.51 50.25 120 Over 500 Beds 47.90 47.44 158 50.91 50.47 186 50.59 50.83 187 Total All Hospitals 48.04 46.65 1732 51.18 50.16 2010 52.08 51.18 2048 Excluded Cost Reports 119 143 130 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 57.30 56.22 361 55.90 53.65 302 57.33 56.39 252 26 to 100 Beds 52.38 51.38 370 52.08 51.11 395 54.13 53.04 445 101 to 200 Beds 51.22 50.19 455 50.95 49.96 463 53.04 51.75 467 201 to 300 Beds 51.27 50.62 297 51.29 50.03 297 53.43 52.48 296 301 to 400 Beds 50.54 50.60 211 50.26 49.80 211 52.00 51.60 214 401 to 500 Beds 50.69 50.27 122 49.82 48.87 117 53.39 52.06 123 Over 500 Beds 51.35 51.16 184 52.05 52.13 184 54.03 53.50 187 Total All Hospitals 52.45 51.54 2000 51.95 51.14 1969 53.89 52.89 1984 Excluded Cost Reports 140 147 136 Total Cost Reports 2140 2116 2120Notes:• 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
  • 43. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 33.38 35.66 86 37.16 39.48 97 38.54 40.83 97 2nd Quartile 47.04 47.09 86 50.44 50.69 97 51.89 52.13 97 3rd Quartile 56.51 56.15 86 59.67 59.26 97 60.65 60.35 97 4th Quartile 72.76 70.68 86 77.22 75.23 97 77.49 74.46 98 Total Population 52.42 51.57 344 56.12 54.65 388 57.20 56.34 389 Excluded Cost Reports 17 19 19 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 39.17 41.91 90 37.36 40.42 75 38.90 40.50 63 2nd Quartile 51.83 51.30 90 50.23 50.59 75 52.43 52.65 63 3rd Quartile 60.56 60.55 90 59.14 59.00 76 60.43 60.21 63 4th Quartile 77.42 76.23 91 76.56 74.64 76 77.57 75.23 63 Total Population 57.30 56.22 361 55.90 53.65 302 57.33 56.39 252 Excluded Cost Reports 15 18 17 Total Cost Reports 376 320 269Notes:• 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
  • 44. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 29.88 31.71 80 34.15 35.84 93 34.15 35.99 98 2nd Quartile 42.00 42.19 81 45.75 46.11 94 46.30 46.21 98 3rd Quartile 49.50 49.36 81 53.99 53.94 94 54.86 54.44 98 4th Quartile 67.39 63.64 81 70.89 67.54 94 73.62 70.54 98 Total Population 47.24 45.92 323 51.24 49.38 375 52.23 50.53 392 Excluded Cost Reports 24 29 22 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 34.28 36.02 92 34.11 35.44 98 34.76 37.23 111 2nd Quartile 47.10 47.46 92 47.43 47.14 99 49.05 49.23 111 3rd Quartile 56.10 56.16 93 55.08 55.02 99 57.44 57.26 111 4th Quartile 71.77 68.76 93 71.53 68.48 99 75.09 72.20 112 Total Population 52.38 51.38 370 52.08 51.11 395 54.13 53.04 445 Excluded Cost Reports 30 31 32 Total Cost Reports 400 426 477Notes:• 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
  • 45. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 31.59 33.10 94 33.31 35.74 112 33.33 36.76 114 2nd Quartile 42.04 42.05 94 44.49 44.20 112 45.35 45.21 114 3rd Quartile 49.00 48.87 94 52.11 51.93 113 52.98 52.56 114 4th Quartile 64.48 61.12 95 67.30 63.41 113 67.75 64.61 114 Total Population 46.82 45.32 377 49.35 48.74 450 49.85 49.42 456 Excluded Cost Reports 26 29 28 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 34.31 36.58 113 34.01 36.66 115 35.57 36.95 116 2nd Quartile 46.21 46.08 114 46.42 46.65 116 47.93 47.94 117 3rd Quartile 54.40 54.40 114 53.92 53.79 116 56.05 55.98 117 4th Quartile 69.79 67.68 114 69.32 66.40 116 72.47 68.10 117 Total Population 51.22 50.19 455 50.95 49.96 463 53.04 51.75 467 Excluded Cost Reports 30 27 26 Total Cost Reports 485 490 493Notes:• 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
  • 46. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 32.84 35.02 62 33.60 36.10 71 34.34 37.42 73 2nd Quartile 41.55 41.35 62 45.31 45.56 71 45.59 45.74 73 3rd Quartile 48.51 48.71 63 52.43 52.38 72 54.34 54.14 73 4th Quartile 61.34 58.26 63 65.93 61.89 72 69.31 66.73 74 Total Population 46.13 45.28 250 49.39 49.09 286 50.96 50.29 293 Excluded Cost Reports 24 29 25 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 35.41 36.96 74 34.19 36.33 74 36.66 39.32 74 2nd Quartile 46.60 46.80 74 46.30 46.57 74 48.55 49.08 74 3rd Quartile 54.26 54.18 74 54.92 54.83 74 56.83 56.52 74 4th Quartile 68.56 65.85 75 69.49 66.63 75 71.69 69.75 74 Total Population 51.27 50.62 297 51.29 50.03 297 53.43 52.48 296 Excluded Cost Reports 28 29 29 Total Cost Reports 325 326 325Notes:• 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
  • 47. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 33.50 35.69 44 35.56 37.39 50 35.58 37.59 52 2nd Quartile 42.07 42.24 45 44.91 45.04 50 46.11 46.03 53 3rd Quartile 48.59 48.30 45 51.87 51.92 51 52.65 52.28 53 4th Quartile 62.48 60.09 45 64.59 60.66 51 67.07 62.22 53 Total Population 46.73 45.39 179 49.32 48.24 202 50.42 50.02 211 Excluded Cost Reports 14 21 16 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 34.75 37.03 52 34.32 36.65 52 35.66 38.62 53 2nd Quartile 46.37 46.55 53 45.49 45.57 53 47.07 46.95 53 3rd Quartile 54.06 53.55 53 54.11 54.36 53 55.33 55.55 54 4th Quartile 66.67 64.22 53 66.84 64.30 53 69.54 63.96 54 Total Population 50.54 50.60 211 50.26 49.80 211 52.00 51.60 214 Excluded Cost Reports 16 17 15 Total Cost Reports 227 228 229Notes:• 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
  • 48. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 35.44 36.51 25 36.67 38.47 30 37.53 39.85 30 2nd Quartile 44.28 43.80 25 46.76 46.77 31 47.99 48.08 30 3rd Quartile 50.08 49.75 25 52.30 52.17 31 54.39 54.45 30 4th Quartile 59.51 59.12 26 62.60 60.80 31 66.13 66.39 30 Total Population 47.45 47.36 101 49.69 49.60 123 51.51 50.25 120 Excluded Cost Reports 7 4 8 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 34.71 35.47 30 35.67 38.44 29 37.75 40.04 30 2nd Quartile 46.87 46.87 30 45.26 44.88 29 48.59 48.97 31 3rd Quartile 55.16 55.06 31 53.35 52.92 29 55.87 55.92 31 4th Quartile 65.38 62.16 31 64.51 63.18 30 70.85 68.60 31 Total Population 50.69 50.27 122 49.82 48.87 117 53.39 52.06 123 Excluded Cost Reports 6 10 5 Total Cost Reports 128 127 128Notes:• 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
  • 49. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 33.03 35.09 39 35.67 37.69 46 34.16 35.92 46 2nd Quartile 43.91 43.81 39 47.17 48.05 46 47.78 48.03 47 3rd Quartile 50.21 50.20 40 53.74 53.31 47 54.19 53.98 47 4th Quartile 63.99 60.93 40 66.67 64.25 47 65.90 62.01 47 Total Population 47.90 47.44 158 50.91 50.47 186 50.59 50.83 187 Excluded Cost Reports 7 12 12 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 34.43 36.40 46 37.20 38.61 46 37.42 39.88 46 2nd Quartile 47.79 48.10 46 48.03 47.69 46 50.25 50.62 47 3rd Quartile 55.54 56.16 46 55.74 55.89 46 57.84 57.96 47 4th Quartile 67.65 66.03 46 67.24 65.31 46 70.25 67.81 47 Total Population 51.35 51.16 184 52.05 52.13 184 54.03 53.50 187 Excluded Cost Reports 15 15 12 Total Cost Reports 199 199 199Notes:• 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
  • 50. Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)Days Net Patient Revenue in Accounts Receivable (AR)All Not-For-Profit 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 32.36 34.20 430 34.90 37.25 499 35.17 37.32 510 2nd Quartile 43.26 43.18 432 46.42 46.47 501 47.26 47.35 512 3rd Quartile 50.64 50.07 434 54.10 53.39 505 55.15 54.44 512 4th Quartile 65.65 62.76 436 69.06 66.56 505 70.62 68.11 514 Total Population 48.04 46.65 1732 51.18 50.16 2010 52.08 51.18 2048 Excluded Cost Reports 119 143 130 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 35.43 37.12 497 35.00 37.03 489 36.29 38.28 493 2nd Quartile 47.65 47.72 499 47.17 47.28 492 49.01 49.36 496 3rd Quartile 55.92 55.90 501 55.26 54.92 493 57.11 57.03 497 4th Quartile 70.56 68.14 503 70.15 67.49 495 72.96 69.75 498 Total Population 52.45 51.54 2000 51.95 51.14 1969 53.89 52.89 1984 Excluded Cost Reports 140 147 136 Total Cost Reports 2140 2116 2120Notes:• 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
  • 51. Average Age of Plant and Equipment - SummaryAverage Age of Plant and EquipmentAll Not-For-Profit 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 9.05 8.70 297 9.20 8.83 335 9.27 9.26 327 26 to 100 Beds 9.81 9.62 289 9.63 9.13 339 9.41 8.95 331 101 to 200 Beds 10.16 9.77 323 10.11 9.68 388 10.24 9.84 387 201 to 300 Beds 10.66 10.73 221 11.07 10.94 252 11.24 11.06 250 301 to 400 Beds 11.10 10.70 159 10.97 10.76 188 10.74 10.62 190 401 to 500 Beds 11.19 11.10 89 11.40 11.26 105 11.76 11.46 100 Over 500 Beds 10.78 10.55 136 10.87 10.68 163 10.90 10.40 163 Total All Hospitals 10.17 9.95 1514 10.22 10.10 1770 10.25 10.08 1748 Excluded Cost Reports 337 383 430 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 9.37 9.06 309 9.60 9.32 257 9.64 9.54 191 26 to 100 Beds 9.63 9.38 334 9.67 9.21 344 9.17 8.73 88 101 to 200 Beds 10.13 9.89 397 10.23 10.04 397 8.18 8.29 69 201 to 300 Beds 11.24 11.33 248 11.18 10.92 258 11.59 11.69 41 301 to 400 Beds 10.85 10.55 195 10.59 10.37 190 10.34 11.38 24 401 to 500 Beds 11.99 11.26 101 11.57 11.07 103 12.83 13.78 7 Over 500 Beds 10.74 10.27 159 10.63 10.41 159 10.44 10.85 23 Total All Hospitals 10.30 10.13 1743 10.32 10.12 1708 9.63 9.38 443 Excluded Cost Reports 397 408 1677 Total Cost Reports 2140 2116 2120Notes:• 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
  • 52. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 3.53 3.50 74 3.48 3.24 83 3.62 3.68 81 2nd Quartile 7.33 7.25 74 7.40 7.39 84 7.46 7.31 82 3rd Quartile 10.15 9.89 74 10.33 10.23 84 10.55 10.46 82 4th Quartile 15.11 14.47 75 15.53 15.11 84 15.39 14.66 82 Total Population 9.05 8.70 297 9.20 8.83 335 9.27 9.26 327 Excluded Cost Reports 64 72 81 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 3.51 3.88 77 3.41 3.50 64 2.88 2.62 47 2nd Quartile 7.55 7.61 77 7.80 7.88 64 7.73 7.97 48 3rd Quartile 10.66 10.74 77 10.96 10.86 64 11.24 11.29 48 4th Quartile 15.67 15.48 78 16.14 15.27 65 16.58 16.22 48 Total Population 9.37 9.06 309 9.60 9.32 257 9.64 9.54 191 Excluded Cost Reports 67 63 78 Total Cost Reports 376 320 269Notes:• 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
  • 53. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 4.33 4.57 72 4.20 4.27 84 3.94 4.25 82 2nd Quartile 8.11 8.14 72 7.97 8.02 85 7.86 7.91 83 3rd Quartile 11.21 11.04 72 10.73 10.80 85 10.47 10.45 83 4th Quartile 15.53 14.68 73 15.58 15.08 85 15.31 14.90 83 Total Population 9.81 9.62 289 9.63 9.13 339 9.41 8.95 331 Excluded Cost Reports 58 65 83 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.21 4.19 83 4.33 4.63 86 3.69 4.15 22 2nd Quartile 8.07 8.05 83 7.93 7.90 86 7.71 7.87 22 3rd Quartile 10.77 10.85 84 10.72 10.74 86 9.96 9.61 22 4th Quartile 15.37 14.93 84 15.72 15.29 86 15.33 15.16 22 Total Population 9.63 9.38 334 9.67 9.21 344 9.17 8.73 88 Excluded Cost Reports 66 82 389 Total Cost Reports 400 426 477Notes:• 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
  • 54. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 5.00 5.41 80 4.74 5.06 97 4.84 5.13 96 2nd Quartile 8.66 8.65 81 8.53 8.54 97 8.62 8.53 97 3rd Quartile 11.06 11.05 81 11.18 11.15 97 11.39 11.50 97 4th Quartile 15.87 15.14 81 16.00 15.19 97 16.05 15.39 97 Total Population 10.16 9.77 323 10.11 9.68 388 10.24 9.84 387 Excluded Cost Reports 80 91 97 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 4.78 5.05 99 4.73 4.83 99 2.89 2.14 17 2nd Quartile 8.35 8.29 99 8.71 8.81 99 7.19 7.30 17 3rd Quartile 11.21 11.33 99 11.29 11.26 99 8.85 8.72 17 4th Quartile 16.11 15.91 100 16.11 15.75 100 13.47 12.95 18 Total Population 10.13 9.89 397 10.23 10.04 397 8.18 8.29 69 Excluded Cost Reports 88 93 424 Total Cost Reports 485 490 493Notes:• 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
  • 55. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 4.83 5.46 55 5.30 5.82 63 5.92 6.41 62 2nd Quartile 9.39 9.54 55 9.66 9.73 63 9.80 9.71 62 3rd Quartile 11.97 11.94 55 12.34 12.35 63 12.55 12.48 63 4th Quartile 16.37 16.37 56 16.98 16.82 63 16.58 16.20 63 Total Population 10.66 10.73 221 11.07 10.94 252 11.24 11.06 250 Excluded Cost Reports 53 63 68 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.09 6.41 62 5.84 6.32 64 7.27 7.39 10 2nd Quartile 10.00 9.94 62 9.57 9.49 64 9.96 10.10 10 3rd Quartile 12.52 12.47 62 12.45 12.33 65 12.35 12.34 10 4th Quartile 16.37 16.01 62 16.74 16.31 65 16.32 15.47 11 Total Population 11.24 11.33 248 11.18 10.92 258 11.59 11.69 41 Excluded Cost Reports 77 68 284 Total Cost Reports 325 326 325Notes:• 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
  • 56. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 6.06 7.22 39 5.79 6.71 47 5.70 6.34 47 2nd Quartile 9.70 9.72 40 9.50 9.43 47 9.33 9.30 47 3rd Quartile 12.10 11.91 40 12.09 12.12 47 11.88 11.79 48 4th Quartile 16.44 16.46 40 16.50 15.82 47 15.93 15.77 48 Total Population 11.10 10.70 159 10.97 10.76 188 10.74 10.62 190 Excluded Cost Reports 34 35 37 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.76 6.34 48 5.66 6.53 47 4.97 6.13 6 2nd Quartile 9.48 9.48 49 9.48 9.51 47 9.80 10.18 6 3rd Quartile 11.73 11.80 49 11.68 11.66 48 12.23 12.29 6 4th Quartile 16.31 16.01 49 15.43 15.11 48 14.38 13.46 6 Total Population 10.85 10.55 195 10.59 10.37 190 10.34 11.38 24 Excluded Cost Reports 32 38 205 Total Cost Reports 227 228 229Notes:• 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
  • 57. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 6.55 7.30 22 6.69 7.03 26 7.11 7.31 25 2nd Quartile 9.56 9.55 22 10.25 10.24 26 10.65 10.74 25 3rd Quartile 12.25 12.20 22 12.04 11.95 26 12.43 12.31 25 4th Quartile 16.18 15.84 23 16.43 15.74 27 16.85 16.72 25 Total Population 11.19 11.10 89 11.40 11.26 105 11.76 11.46 100 Excluded Cost Reports 19 22 28 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.28 7.73 25 6.84 8.04 25 5.60 5.60 1 2nd Quartile 10.40 10.41 25 10.21 10.21 26 11.35 11.35 2 3rd Quartile 12.91 13.12 25 12.06 12.13 26 13.93 13.93 2 4th Quartile 17.14 17.16 26 16.98 17.26 26 16.83 16.83 2 Total Population 11.99 11.26 101 11.57 11.07 103 12.83 13.78 7 Excluded Cost Reports 27 24 121 Total Cost Reports 128 127 128Notes:• 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
  • 58. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 6.63 7.38 34 6.54 7.10 40 6.50 7.03 40 2nd Quartile 9.61 9.67 34 9.54 9.55 41 9.48 9.43 41 3rd Quartile 11.65 11.51 34 11.69 11.65 41 11.78 11.84 41 4th Quartile 15.23 14.30 34 15.60 15.22 41 15.71 14.97 41 Total Population 10.78 10.55 136 10.87 10.68 163 10.90 10.40 163 Excluded Cost Reports 29 35 36 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 6.28 6.91 39 6.42 6.93 39 6.77 7.54 5 2nd Quartile 9.16 9.26 40 9.09 9.15 40 9.57 9.54 6 3rd Quartile 11.86 11.86 40 11.66 11.61 40 11.10 11.06 6 4th Quartile 15.55 14.82 40 15.26 14.76 40 13.70 13.36 6 Total Population 10.74 10.27 159 10.63 10.41 159 10.44 10.85 23 Excluded Cost Reports 40 40 176 Total Cost Reports 199 199 199Notes:• 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
  • 59. Peer Group Comparison - Average Age of Plant and EquipmentAverage Age of Plant and EquipmentAll Not-For-Profit 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 4.90 5.25 376 4.87 5.11 440 4.97 5.19 433 2nd Quartile 8.65 8.69 378 8.67 8.65 443 8.70 8.76 437 3rd Quartile 11.28 11.18 378 11.29 11.31 443 11.37 11.38 439 4th Quartile 15.75 15.30 382 16.01 15.56 444 15.86 15.44 439 Total Population 10.17 9.95 1514 10.22 10.10 1770 10.25 10.08 1748 Excluded Cost Reports 337 383 430 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 5.02 5.20 433 5.00 5.24 424 3.77 4.02 108 2nd Quartile 8.71 8.76 435 8.76 8.77 426 8.12 8.13 111 3rd Quartile 11.43 11.48 436 11.43 11.39 428 10.82 10.92 111 4th Quartile 15.96 15.56 439 16.03 15.59 430 15.55 15.09 113 Total Population 10.30 10.13 1743 10.32 10.12 1708 9.63 9.38 443 Excluded Cost Reports 397 408 1677 Total Cost Reports 2140 2116 2120Notes:• 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
  • 60. 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
  • 61. 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
  • 62. 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
  • 63. 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
  • 64. 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
  • 65. 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
  • 66. Clients Our Professionals Have Served (continued) 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
  • 67. 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
  • 68. 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
  • 69. 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
  • 70. 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
  • 71. 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