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You are the administrator of the medical - surgical department
at UMUC Health. Review the transcripts from the budget
meeting and recent voicemails from your CFO and, using the
available information and resources, develop an operating
budget for your department.
Your budget should include a 2-4 page document with an
accompanying Excel spreadsheet (available in the classroom)
that:
· Provides the revenue and expenses through the current month
of the current year.
· Estimates the revenue and expenses for the rest of the current
fiscal year based on the assumptions provided in the transcript
documents.
· Prepares a budget for the next fiscal year.
Note: See Course Announcements for specific data to complete
the analysis.
Health Care Finance
March 16, 2020
Assignment 3
Assignment #2
Break-even Analysis Due Sunday, March 15th
Should MHCBS invest in a multipurpose Senior Center to
expend it service offerings to appeal to the growing senior
market in the area?
Details of revenue as well as direct and indirect expenses
provided in Announcement; formula’s provided in PowerPoint
from March 5th Zoom Meeting
To approve the expansion, the Board of MHCBS has two
requirements:
Evidence that the expanded program is a benefit to the
community
A break-even analysis that indicates MHCBS can recoup its
investment in 5 years
Assumptions
Current fiscal year July 1, 2019 – June 30, 2020
Patient Service Revenue
Projected total hospital patient revenue to be under budget by
$10 million
Of the projected $1.2 billion in patient services revenue,
approximately 57% of the total projected revenue is for in-
patient care; the other 43% is for outpatient revenue
The Medical Surgical Budget reflects only in-patient revenue
Yearly budgeted Medical Surgical Dept. in-patient revenue:
$50,000,000
As a percent of the total in-patient revenue: 7%
In-patient revenue for the Dept. in the first 6 months is below
budget by approximately $1.9 million – is this likely to increase
given the information in the Budget Mtg transcript?
Next Fiscal Year July 1, 2020 – June 30, 2021
Assumptions
Projected total hospital revenue to increase by 5% due to
marketing and managed care contract negotiation
When projecting revenue take into consideration that Medical-
Surgical Dept. will only see increases relative to in-patient
revenue
Overall hospital goal is to decrease total spending by up to 5%
Cuts in expenses may be targeted, not all expense categories
need to be decreased
2019 – 2020 Medical-Surgical Budget 6 Month Revenue 2019 –
2020 Budget RevenueFY 2019 - 2020 6 Month
Variance$23,123,516
$50,000,000
$(1,876,484)
6 Month Expenses 2019 - 2020 Budget Expenses FY 2019
Variance $22,433,565
$40,895,000 $1,986,065
For the first 6 months -- Revenue is below budget, expenses
exceed the budget
Budget for Fiscal Year 2019 – 2020
Estimate the revenue and expenses for the Medical – Surgical
Dept. through the current month of the current fiscal year – July
2019 thru February 2020 (8 Month Budget projections)
Estimate the revenue and expenses for the Medical-Surgical
Dept. for the rest of the 2019-2020 fiscal year based on the
assumptions provided in the transcript documents (12 Month
Budget Projections)
Detailed Excel Spreadsheet with the 2019-2020 yearly budget
and explanation of projections in budget Memo
Total in-patient revenue (take into consideration the percent
difference between budgeted vs. actual revenue and make
adjustments to account for the projected shortfall in revenue)
Total expenses (Highlight specific categories that are projected
to be significantly over budget and make any recommended cuts
in specific categories of expenses)
In the Memo, discuss changes in projected revenue, and
highlight the rationale for any proposed cuts in select expenses
Your projections will vary from the projected 2019 -2020
budget provided to reflect any changes you may make to
revenue and expenses based on the information contained in the
Budget Meeting Transcript
2020-2021 Fiscal Year Budget
Prepare a Medical Surgical budget for the next fiscal year –
July 1, 2020– June 30, 2021
Detailed Excel spreadsheet providing revenue and expenses by
category and discuss revenue and expense projections in budget
Memo
Total in-patient revenue (Take into consideration the total
projected revenue increases due to contracting and marketing
that are projected to benefit the whole hospital – remember the
Medical-Surgical budget only includes in-patient revenue)
Detailed Expenses by category
Highlight any percent expense increases and reductions based
on the 2019 – 2020 projected yearly budget by category and
explain rationale in budget Memo
Assignment Deliverables
Excel Spreadsheets
Projected budget for Fiscal Year 2019 through February 2020
(8 Month Budget)
Projected remaining Fiscal Year 2019-2020 Budget (12 Month
Budget)
Revenue and Expenses
Note: Your projections for the yearly budget will differ if you
make any changes to the revenue and expenses given the Budget
Meeting Transcript
Projected Fiscal Year 2020-2021 Budget
Revenue and Expenses (12 Month Budget)
Budget Memo
Explain rationale for any increases or shortfalls in revenue and
the rationale behind any cuts in specific expense categories
Reminder – the fiscal year for this hospital is July 1st thru June
30th
Assignment Due Dates
The due date for submission of Assignment 3 is March 22nd
The due date for submission of Assignment 4 is March 29th
Assignment #4
Using the OIG website (https://oig.hhs.gov/) or another of your
choosing, select a real-time healthcare fraud news report from
your local area to feature within your paper to educate the
organization on the various case(s), the importance of
healthcare finance compliance practices and the potential
criminal and monetary fines that can be imposed on the
individual and/or organization from the case.
Develop a 3-5 page white paper that provides a succinct
overview of the specific healthcare finance fraud committed
including the details specified at the end of the course syllabus.
Due Sunday, March 29th
Transcript of the VOICEMAIL FROM George Costanza (CFO):
Hi, it's George. I hear you're working on a budget for the Med-
Surg department for FY 2019. I'd like you to come to the budget
meeting this afternoon, because I'm going to be sharing some
numbers that are likely to have an impact on your budget. I've
sent you the year-to-date statements through December, the
overall budget for the year, and the year-to-date budget variance
for your department. Take a look at them, and bring them with
you to the meeting. See you later!
Transcript from BUDGET MEETING:
George C., CFO
Hi, everyone. Thanks for coming. We've got some important
numbers to go through and a big challenge to respond to, so I
think we better get started.
Jerry, Vice President of Operations
That sounds ominous.
Newman, Vice President of Medical Support
Well, can we at least get an idea of how we're doing year-to-
date before you go to the 40,000-foot level?
George
I think you might need to hear this first. Here's the situation:
The hospital has to cut operating expenses by 5 percent for next
fiscal year.
Kramer, Director of Clinical Operations
I'm sorry, did you say 5 percent? Operating expenses?
George
That's right.
Jerry
That's a big ask. We're already operating awfully lean.
George
Agreed. But it's the situation we're in. I'll get to the reasons, but
based on what I'm going to go over, I just want everyone to
keep in mind that we can't make assumptions we were making
before. So let me give you an overview of the budget and the
year-to-date numbers, and I think you'll see why we're going to
have to make those cuts.
Now, last year, for the entire hospital, we assumed that we
would see $1.2 billion in total patient revenue. But as you can
see, for half the year, we've only hit just over $607 million. By
this point in the year, we should be over $612 million. So
already in terms of total patient revenue, we've got a deficit of
nearly $5 million that we didn't expect. The problem is made
worse when we see that other operating revenue is also under
budget by $1.5 million.
I believe that recent efforts in the billing department coupled
with some of the solid work by the c-suite team on physician
engagement and external marketing are going to have an impact
on the revenue side of things. We’re also currently negotiating
with a couple of our primary commercial payers, but those
negotiations remain uncertain. All things considered, I’m
hoping for about a 5% bump on the revenue side for FY 19. Our
operating expenses are fairly close to target so far this year, but
given the situation with uncertain revenue, we will need to try
to find some additional cost savings opportunities. I want to be
reasonably conservative in case market conditions change or
negotiations with our payers don’t go as expected.
Newman
Wow. Well, okay, so that's the reality. What's the timeline?
How long do we have to make these cuts?
George
Well, implementation is obviously by June 30 since the next
fiscal year starts July 1. The board will approve the new budget
probably by mid-June, but all the negotiation at the unit and
department level will be going on this month. Our first official
budget committee meeting is in early May. So I'd suggest
getting your ducks in a row within the next week or so.
In your proposal, think through the cuts that are being proposed.
Do you simply want to take a ‘salami slice’ cut across all areas
of expense? Or, are there areas where it might make more sense
to protect while others are more flexible? Since this is a
simulation, you won’t know everything that you normally would
about the organization, the people involved, etc. However, think
through what the second and third order effects are of a budget
cut and provide some commentary regarding what other issues
might surface and/or may need to be addressed as a result.
Sheet1Medical - Surgical Budget Med Surg 8 Month Budget FY
2019 - 2020 YTD (Jul - Feb)* FY 2019 - 2020 Budget FY 2019
- 2020 Variance TYDOPERATING REVENUE:Inpatient
Revenue$ 23,123,516$ 50,000,000$ 1,876,484TOTAL
PATIENT SERVICES REVENUE$ 23,123,516$ 50,000,000$
1,876,484OPERATING EXPENSESSalaries and Wages$
12,157,632$ 23,000,000$ 657,632Employee Benefits$
3,040,408$ 5,750,000$ 165,408Professional Fees$ 250,160$
400,000$ 50,160Supplies$ 5,883,497$ 10,000,000$
883,497Purchased Services - Utilities$ 27,456$ 50,000$
2,456Purchased Services - Other$ 23,484$ 50,000$
1,516Insurance$ 57,315$ 105,000$ 4,815License and
Taxes$ 21,456$ 40,000$ 1,456Other Direct Expenses$
972,157$ 1,500,000$ 222,157TOTAL OPERATING
EXPENSES$ 22,433,565$ 40,895,000$ 1,986,065NET
REVENUE OR (EXPENSE)$ 689,951$ 9,105,000$
3,862,549* Your budget may vary from the FY 2029-2020
budget given changes you are projecting based on the hospitals
experience ov er the last 8 months Med Surge 12 month Budget
2019-2020FY 2019 - 2020 Year** FY 2019 - 2020 Budget FY
2019 - 2020 Variance TYDOPERATING REVENUE:Inpatient
Revenue$ 50,000,000TOTAL PATIENT SERVICES
REVENUE$ 50,000,000OPERATING EXPENSESSalaries and
Wages$ 23,000,000Employee Benefits$
5,750,000Professional Fees$ 400,000Supplies$
10,000,000Purchased Services - Utilities$ 50,000Purchased
Services - Other$ 50,000Insurance$ 105,000License and
Taxes$ 40,000Other Direct Expenses$ 1,500,000TOTAL
OPERATING EXPENSES$ - 0$ 40,895,000NET REVENUE
OR (EXPENSE)$ 9,105,000** Your budget may vary from the
FY 2029-2020 budget given changes you are projecting based
on the hopsitals experience over the last 12 months Provide
the rationale for your projections in the Memo Med-Surg
Budget Fiscal Year 2020-2021 FY 2020 - 2021 FY 2019 -
2020 Budget Variance (% increase or Decrease)***
OPERATING REVENUE:Inpatient Revenue$ 46,247,032$
50,000,000TOTAL PATIENT SERVICES
REVENUEOPERATING EXPENSESSalaries and Wages$
24,315,262$ 23,000,000Employee Benefits$ 6,080,816$
5,750,000Professional Fees$ 500,320$ 400,000Supplies$
11,766,994$ 10,000,000Purchased Services - Utilities$
55,092$ 50,000Purchased Services - Other$ 46,968$
50,000Insurance$ 114,630$ 105,000License and Taxes$
42,912$ 40,000Other Direct Expenses$ 1,944,314$
1,500,000TOTAL OPERATING EXPENSES$ 44,867,310$
40,895,000NET REVENUE OR (EXPENSE)$ 50,000,000***
For your project 2020-2021 budget highlight the percent
changes from the previous FY, provide a rationale for your
decisions in the Memo
Trinity Budget Execution YTDThe UMUC Medical CenterFY
2019 YTD (Jul - Dec) FY 2019 Budget FY 2019 Variance
YTDOPERATING REVENUE:Inpatient Revenue$
375,040,349$ 700,000,000$ 25,040,349Outpatient Revenue$
232,498,397$ 525,000,000$ (30,001,603)TOTAL PATIENT
SERVICES REVENUE$ 607,538,746$ 1,225,000,000$
(4,961,254)DEDUCTIONS FROM REVENUE:Contractual
Adjustments$ 476,543,215$ 950,000,000$ 1,543,215Charity
and Uncompensated Care$ 6,725,412$ 14,000,000$
(274,588)TOTAL DEDUCTIONS FROM REVENUE$
483,268,627$ 964,000,000$ 1,268,627NET PATIENT
SERVICE REVENUE$ 124,270,119$ 261,000,000$
(6,229,881)OTHER OPERATING REVENUEOther Operating
Revenue$ 3,500,000$ 10,000,000$ (1,500,000)TOTAL
OPERATING REVENUE$ 127,770,119$ 271,000,000$
(7,729,881)OPERATING EXPENSESSalaries and Wages$
42,932,230$ 88,000,000$ (1,067,770)Employee Benefits$
12,624,012$ 25,000,000$ 124,012Professional Fees$
4,082,215$ 9,000,000$ (417,785)Supplies$ 23,883,407$
46,000,000$ 883,407Purchased Services - Utilities$
1,632,191$ 3,000,000$ 132,191Purchased Services - Other$
11,536,320$ 22,000,000$ 536,320Depreciation$ 8,455,254$
17,000,000$ (44,746)Rentals and Leases$ 2,252,670$
4,000,000$ 252,670Insurance$ 2,715,378$ 5,000,000$
215,378License and Taxes$ 7,992,144$ 18,000,000$
(1,007,856)Interest$ 8,393,790$ 18,000,000$
(606,210)Provision For Bad Debts$ - 0$ - 0$ - 0Other
Direct Expenses$ 4,744,642$ 8,000,000$ 744,642TOTAL
OPERATING EXPENSES$ 131,244,253$ 263,000,000$
(255,747)NET OPERATING REVENUE$ (3,474,134)$
8,000,000$ (7,474,134)NET REVENUE BEFORE ITEMS
LISTED BELOW$ (3,474,134)$ 8,000,000$
(7,474,134)EXTRAORDINARY ITEM$ - 0$ - 0$ - 0NET
REVENUE OR (EXPENSE)$ (3,474,134)$ 8,000,000$
(7,474,134)Med/Surg Department BudgetFY 2019 YTD (Jul -
Dec) FY 2019 Budget FY 2019 Variance TYDOPERATING
REVENUE:Inpatient Revenue$ 23,123,516$ 50,000,000$
(1,876,484)TOTAL PATIENT SERVICES REVENUE$
23,123,516$ 50,000,000$ (1,876,484)OPERATING
EXPENSESSalaries and Wages$ 12,157,632$ 23,000,000$
657,632Employee Benefits$ 3,040,408$ 5,750,000$
165,408Professional Fees$ 250,160$ 400,000$
50,160Supplies$ 5,883,497$ 10,000,000$ 883,497Purchased
Services - Utilities$ 27,456$ 50,000$ 2,456Purchased
Services - Other$ 23,484$ 50,000$ (1,516)Insurance$
57,315$ 105,000$ 4,815License and Taxes$ 21,456$
40,000$ 1,456Other Direct Expenses$ 972,157$ 1,500,000$
222,157TOTAL OPERATING EXPENSES$ 22,433,565$
40,895,000$ 1,986,065NET REVENUE OR (EXPENSE)$
689,951$ 9,105,000$ (3,862,549)
2015FS-1 BALANCE SHEET - UNRESTRICTED
FUNDHospital: St. Anthony Medical Center, Vila Health
System FYE: 12/31/2015ASSETSLic.#: H-0371CURRENT
ASSETS:2Cash(2,464,387)3Marketable Securities04Accounts
Receivable39,102,4645Less-Estimated Uncollectable &
Allowances2,038,6506Receivables From Third Party
Payors(3,067,704)7Pledges And Other
Receivables1,770,5818Due From Restricted
Funds09Inventory7,328,98410Prepaid
Expenses1,230,05311Current Portion Of Funds Held In
Trust012TOTAL CURRENT ASSETS41,861,3411314BOARD
DESIGNATED ASSETS:15Cash016Marketable
Securities017Other Assets018TOTAL BOARD DESIGNATED
ASSETS:01920PROPERTY, PLANT AND
EQUIPMENT:21Land15,239,20122Land
Improvements1,005,84323Buildings85,916,24524Fixed
Equipment - Building Service28,562,66525Fixed Equipment -
Other9,305,05226Equipment57,547,95727Leasehold
Improvements425,60628Construction In
Progress225,68229TOTAL198,228,25130Less Accumulated
Depreciation62,102,06931NET PROPERTY, PLANT &
EQUIPMENT136,126,1823233INVESTMENTS AND OTHER
ASSETS:34Investments In Property, Plant & Equipment035Less
- Accumulated Depreciation036Other
Investments1,200,00037Other Assets038TOTAL
INVESTMENTS & OTHER
ASSETS1,200,0003940INTANGIBLE
ASSETS:41Goodwill042Unamortized Loan Costs043Preopening
And Other Organization Costs044Other Intangible
Assets8,785,27645TOTAL INTANGIBLE
ASSETS8,785,27646TOTAL ASSETS187,972,799DOH -
OHPDBALANCE SHEET - UNRESTRICTED FUNDHospital:
St. Anthony Medical Center, Vila Health SystemFYE:
12/31/2015LIABILITIES AND FUND BALANCES-
UNRESTRICTEDLic.#: H-0371CURRENT
LIABILITIES2Notes and Loans Payable03Accounts Payable
15,538,8634Accrued Compensation and Related
Liabilities10,399,5905Other Accrued
Expenses2,147,2376Advances from Third Party
Payors07Payables to Third Party Payors08Due to Restricted
Funds09Income Taxes Payable010Other Current
Liabilities011Current Maturities of Long Term
Debt110,03612TOTAL CURRENT
LIABILITIES28,195,7261314DEFERRED
CREDITS:15Deferred Income Taxes016Deferred Third Party
Revenue017Other Deferred Credits185,54818TOTAL
DEFERRED CREDITS185,5481920LONG TERM
DEBT21Mortgage Payable022Construction Loans-Interim
Financing023Notes Payable5,674,82724Capitalized Lease
Obligations025Bonds Payable026Notes and Loans Payable to
Parent189,173,76127Noncurrent
Liabilities028TOTAL194,848,58829Less Current Maturities of
Long Term Debt110,03630TOTAL LONG TERM
DEBT194,738,5523132UNRESTRICTED FUND
BALANCE03334EQUITY (INVESTOR OWNED)35Preferred
Stock3637Common Stock3839Additional Paid In
Stock04041Retained Earnings (Capital Account for
Partnership(35,147,027)42 (or Sole
Proprietorship)4344Less Treasury Stock45TOTAL
EQUITY(35,147,027)46TOTAL LIABILITIES AND FUND
BALANCE OR EQUITY187,972,799DOH -
OHPDCOMPARISON STATEMENT OF REVENUE &
EXPENSE - UNRESTRICTED FUNDSHospital: St. Anthony
Medical Center, Vila Health System FYE: 12/31/2015Lic.#: H-
0371OPERATING REVENUE:2Inpatient
Revenue666,080,6983Outpatient Revenue464,996,7934TOTAL
PATIENT SERVICES
REVENUE1,131,077,49156DEDUCTIONS FROM
REVENUE:7Contractual Adjustments855,811,0218Charity and
Uncompensated Care13,400,0009Other Adjustments and
Allowances010TOTAL DEDUCTIONS FROM
REVENUE869,211,02111NET PATIENT SERVICE
REVENUE261,866,4701213OTHER OPERATING
REVENUE14Other Operating Revenue9,969,04815Tax
Revenues016TOTAL OTHER OPERATING
REVENUE9,969,04817TOTAL OPERATING
REVENUE271,835,5181819OPERATING EXPENSES20Salaries
and Wages85,864,45921Employee
Benefits25,248,02422Professional
Fees8,144,42623Supplies47,766,81324Purchased Services -
Utilities3,264,38225Purchased Services -
Other23,072,64026Depreciation16,910,50827Rentals and
Leases4,505,34028Insurance5,430,75629License and
Taxes15,984,28830Interest16,787,58031Provision For Bad
Debts2,564,19732Other Direct Expenses9,489,28333TOTAL
OPERATING EXPENSES265,032,69634NET OPERATING
REVENUE6,802,8223536NON-OPERATING REVENUE-NET
OF EXPENSES03738NET REVENUE BEFORE ITEMS LISTED
BELOW6,802,8223940EXTRAORDINARY
ITEM1,374,00041FEDERAL INCOME TAX04243NET
REVENUE OR
(EXPENSE)8,176,82244EXPLANATION:45DOH - OHPD
2016FS-1 BALANCE SHEET - UNRESTRICTED
FUNDHospital: St. Anthony Medical Center, Vila Health
System FYE: 12/31/2016ASSETSLic.#: H-0371CURRENT
ASSETS:2Cash(1,027,622)3Marketable Securities04Accounts
Receivable32,410,2075Less-Estimated Uncollectable &
Allowances3,891,9826Receivables From Third Party
Payors(247,989)7Pledges And Other Receivables1,889,6178Due
From Restricted Funds09Inventory8,014,98810Prepaid
Expenses1,301,47611Current Portion Of Funds Held In
Trust012TOTAL CURRENT ASSETS38,448,6951314BOARD
DESIGNATED ASSETS:15Cash016Marketable
Securities017Other Assets018TOTAL BOARD DESIGNATED
ASSETS:01920PROPERTY, PLANT AND
EQUIPMENT:21Land15,239,20122Land
Improvements1,009,49223Buildings122,015,47724Fixed
Equipment - Building Service77,067,37325Fixed Equipment -
Other026Equipment027Leasehold
Improvements425,60628Construction In
Progress1,089,60329TOTAL216,846,75230Less Accumulated
Depreciation75,384,79131NET PROPERTY, PLANT &
EQUIPMENT141,461,9613233INVESTMENTS AND OTHER
ASSETS:34Investments In Property, Plant & Equipment035Less
- Accumulated Depreciation036Other
Investments1,200,00037Other Assets038TOTAL
INVESTMENTS & OTHER
ASSETS1,200,0003940INTANGIBLE
ASSETS:41Goodwill042Unamortized Loan Costs043Preopening
And Other Organization Costs044Other Intangible
Assets10,135,57345TOTAL INTANGIBLE
ASSETS10,135,57346TOTAL ASSETS191,246,229DOH -
OHPDBALANCE SHEET - UNRESTRICTED FUNDHospital:
St. Anthony Medical Center, Vila Health SystemFYE:
12/31/2016LIABILITIES AND FUND BALANCES-
UNRESTRICTEDLic.#: H-0371CURRENT
LIABILITIES2Notes and Loans Payable03Accounts Payable
16,230,0754Accrued Compensation and Related
Liabilities11,777,8365Other Accrued
Expenses1,866,9676Advances from Third Party
Payors07Payables to Third Party Payors08Due to Restricted
Funds09Income Taxes Payable010Other Current
Liabilities011Current Maturities of Long Term Debt012TOTAL
CURRENT LIABILITIES29,874,8781314DEFERRED
CREDITS:15Deferred Income Taxes016Deferred Third Party
Revenue017Other Deferred Credits018TOTAL DEFERRED
CREDITS01920LONG TERM DEBT21Mortgage
Payable022Construction Loans-Interim Financing023Notes
Payable5,296,93024Capitalized Lease Obligations025Bonds
Payable026Notes and Loans Payable to
Parent196,170,11727Noncurrent
Liabilities028TOTAL201,467,04729Less Current Maturities of
Long Term Debt030TOTAL LONG TERM
DEBT201,467,0473132UNRESTRICTED FUND
BALANCE03334EQUITY (INVESTOR OWNED)35Preferred
Stock3637Common Stock3839Additional Paid In
Stock04041Retained Earnings (Capital Account for
Partnership(40,095,696)42 (or Sole
Proprietorship)4344Less Treasury Stock45TOTAL
EQUITY(40,095,696)46TOTAL LIABILITIES AND FUND
BALANCE OR EQUITY191,246,229DOH -
OHPDCOMPARISON STATEMENT OF REVENUE &
EXPENSE - UNRESTRICTED FUNDSHospital: St. Anthony
Medical Center, Vila Health System FYE: 12/31/2016Lic.#: H-
0371OPERATING REVENUE:2Inpatient
Revenue752,813,1803Outpatient Revenue529,706,9184TOTAL
PATIENT SERVICES
REVENUE1,282,520,09856DEDUCTIONS FROM
REVENUE:7Provision For Bad Debts5,083,7188Contractual
Adjustments1,010,760,5259Charity and Uncompensated
Care2,400,00010Other Adjustments and Allowances011TOTAL
DEDUCTIONS FROM REVENUE1,018,244,24312NET
PATIENT SERVICE REVENUE264,275,8551314OTHER
OPERATING REVENUE15Other Operating
Revenue10,171,42816Tax Revenues017TOTAL OTHER
OPERATING REVENUE10,171,42818TOTAL OPERATING
REVENUE274,447,2831920OPERATING EXPENSES21Salaries
and Wages88,523,45322Employee
Benefits25,937,60723Professional
Fees9,613,65624Supplies46,386,98925Purchased Services -
Utilities3,043,36826Purchased Services -
Other22,184,38827Depreciation17,408,82428Rentals and
Leases4,866,38429Insurance5,740,78830License and
Taxes18,828,50431Interest18,671,13632Other Direct
Expenses8,522,13633TOTAL OPERATING
EXPENSES269,727,23334NET OPERATING
REVENUE4,720,0503536NON-OPERATING REVENUE-NET
OF EXPENSES03738NET REVENUE BEFORE ITEMS LISTED
BELOW4,720,0503940EXTRAORDINARY
ITEM750,00041FEDERAL INCOME TAX04243NET
REVENUE OR
(EXPENSE)5,470,05044EXPLANATION:45DOH - OHPD

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You are the administrator of the medical - surgical department at .docx

  • 1. You are the administrator of the medical - surgical department at UMUC Health. Review the transcripts from the budget meeting and recent voicemails from your CFO and, using the available information and resources, develop an operating budget for your department. Your budget should include a 2-4 page document with an accompanying Excel spreadsheet (available in the classroom) that: · Provides the revenue and expenses through the current month of the current year. · Estimates the revenue and expenses for the rest of the current fiscal year based on the assumptions provided in the transcript documents. · Prepares a budget for the next fiscal year. Note: See Course Announcements for specific data to complete the analysis. Health Care Finance March 16, 2020 Assignment 3 Assignment #2 Break-even Analysis Due Sunday, March 15th Should MHCBS invest in a multipurpose Senior Center to expend it service offerings to appeal to the growing senior market in the area? Details of revenue as well as direct and indirect expenses provided in Announcement; formula’s provided in PowerPoint from March 5th Zoom Meeting
  • 2. To approve the expansion, the Board of MHCBS has two requirements: Evidence that the expanded program is a benefit to the community A break-even analysis that indicates MHCBS can recoup its investment in 5 years Assumptions Current fiscal year July 1, 2019 – June 30, 2020 Patient Service Revenue Projected total hospital patient revenue to be under budget by $10 million Of the projected $1.2 billion in patient services revenue, approximately 57% of the total projected revenue is for in- patient care; the other 43% is for outpatient revenue The Medical Surgical Budget reflects only in-patient revenue Yearly budgeted Medical Surgical Dept. in-patient revenue: $50,000,000 As a percent of the total in-patient revenue: 7% In-patient revenue for the Dept. in the first 6 months is below budget by approximately $1.9 million – is this likely to increase given the information in the Budget Mtg transcript? Next Fiscal Year July 1, 2020 – June 30, 2021 Assumptions Projected total hospital revenue to increase by 5% due to marketing and managed care contract negotiation When projecting revenue take into consideration that Medical- Surgical Dept. will only see increases relative to in-patient revenue Overall hospital goal is to decrease total spending by up to 5% Cuts in expenses may be targeted, not all expense categories need to be decreased
  • 3. 2019 – 2020 Medical-Surgical Budget 6 Month Revenue 2019 – 2020 Budget RevenueFY 2019 - 2020 6 Month Variance$23,123,516 $50,000,000 $(1,876,484) 6 Month Expenses 2019 - 2020 Budget Expenses FY 2019 Variance $22,433,565 $40,895,000 $1,986,065 For the first 6 months -- Revenue is below budget, expenses exceed the budget Budget for Fiscal Year 2019 – 2020 Estimate the revenue and expenses for the Medical – Surgical Dept. through the current month of the current fiscal year – July 2019 thru February 2020 (8 Month Budget projections) Estimate the revenue and expenses for the Medical-Surgical Dept. for the rest of the 2019-2020 fiscal year based on the assumptions provided in the transcript documents (12 Month Budget Projections) Detailed Excel Spreadsheet with the 2019-2020 yearly budget and explanation of projections in budget Memo Total in-patient revenue (take into consideration the percent difference between budgeted vs. actual revenue and make adjustments to account for the projected shortfall in revenue) Total expenses (Highlight specific categories that are projected to be significantly over budget and make any recommended cuts in specific categories of expenses) In the Memo, discuss changes in projected revenue, and highlight the rationale for any proposed cuts in select expenses Your projections will vary from the projected 2019 -2020 budget provided to reflect any changes you may make to revenue and expenses based on the information contained in the Budget Meeting Transcript
  • 4. 2020-2021 Fiscal Year Budget Prepare a Medical Surgical budget for the next fiscal year – July 1, 2020– June 30, 2021 Detailed Excel spreadsheet providing revenue and expenses by category and discuss revenue and expense projections in budget Memo Total in-patient revenue (Take into consideration the total projected revenue increases due to contracting and marketing that are projected to benefit the whole hospital – remember the Medical-Surgical budget only includes in-patient revenue) Detailed Expenses by category Highlight any percent expense increases and reductions based on the 2019 – 2020 projected yearly budget by category and explain rationale in budget Memo Assignment Deliverables Excel Spreadsheets Projected budget for Fiscal Year 2019 through February 2020 (8 Month Budget) Projected remaining Fiscal Year 2019-2020 Budget (12 Month Budget) Revenue and Expenses Note: Your projections for the yearly budget will differ if you make any changes to the revenue and expenses given the Budget Meeting Transcript Projected Fiscal Year 2020-2021 Budget Revenue and Expenses (12 Month Budget) Budget Memo Explain rationale for any increases or shortfalls in revenue and the rationale behind any cuts in specific expense categories
  • 5. Reminder – the fiscal year for this hospital is July 1st thru June 30th Assignment Due Dates The due date for submission of Assignment 3 is March 22nd The due date for submission of Assignment 4 is March 29th Assignment #4 Using the OIG website (https://oig.hhs.gov/) or another of your choosing, select a real-time healthcare fraud news report from your local area to feature within your paper to educate the organization on the various case(s), the importance of healthcare finance compliance practices and the potential criminal and monetary fines that can be imposed on the individual and/or organization from the case. Develop a 3-5 page white paper that provides a succinct overview of the specific healthcare finance fraud committed including the details specified at the end of the course syllabus. Due Sunday, March 29th Transcript of the VOICEMAIL FROM George Costanza (CFO): Hi, it's George. I hear you're working on a budget for the Med- Surg department for FY 2019. I'd like you to come to the budget meeting this afternoon, because I'm going to be sharing some numbers that are likely to have an impact on your budget. I've sent you the year-to-date statements through December, the overall budget for the year, and the year-to-date budget variance for your department. Take a look at them, and bring them with
  • 6. you to the meeting. See you later! Transcript from BUDGET MEETING: George C., CFO Hi, everyone. Thanks for coming. We've got some important numbers to go through and a big challenge to respond to, so I think we better get started. Jerry, Vice President of Operations That sounds ominous. Newman, Vice President of Medical Support Well, can we at least get an idea of how we're doing year-to- date before you go to the 40,000-foot level? George I think you might need to hear this first. Here's the situation: The hospital has to cut operating expenses by 5 percent for next fiscal year. Kramer, Director of Clinical Operations I'm sorry, did you say 5 percent? Operating expenses? George That's right. Jerry That's a big ask. We're already operating awfully lean. George Agreed. But it's the situation we're in. I'll get to the reasons, but based on what I'm going to go over, I just want everyone to keep in mind that we can't make assumptions we were making before. So let me give you an overview of the budget and the year-to-date numbers, and I think you'll see why we're going to have to make those cuts.
  • 7. Now, last year, for the entire hospital, we assumed that we would see $1.2 billion in total patient revenue. But as you can see, for half the year, we've only hit just over $607 million. By this point in the year, we should be over $612 million. So already in terms of total patient revenue, we've got a deficit of nearly $5 million that we didn't expect. The problem is made worse when we see that other operating revenue is also under budget by $1.5 million. I believe that recent efforts in the billing department coupled with some of the solid work by the c-suite team on physician engagement and external marketing are going to have an impact on the revenue side of things. We’re also currently negotiating with a couple of our primary commercial payers, but those negotiations remain uncertain. All things considered, I’m hoping for about a 5% bump on the revenue side for FY 19. Our operating expenses are fairly close to target so far this year, but given the situation with uncertain revenue, we will need to try to find some additional cost savings opportunities. I want to be reasonably conservative in case market conditions change or negotiations with our payers don’t go as expected. Newman Wow. Well, okay, so that's the reality. What's the timeline? How long do we have to make these cuts? George Well, implementation is obviously by June 30 since the next fiscal year starts July 1. The board will approve the new budget probably by mid-June, but all the negotiation at the unit and department level will be going on this month. Our first official budget committee meeting is in early May. So I'd suggest getting your ducks in a row within the next week or so. In your proposal, think through the cuts that are being proposed. Do you simply want to take a ‘salami slice’ cut across all areas of expense? Or, are there areas where it might make more sense
  • 8. to protect while others are more flexible? Since this is a simulation, you won’t know everything that you normally would about the organization, the people involved, etc. However, think through what the second and third order effects are of a budget cut and provide some commentary regarding what other issues might surface and/or may need to be addressed as a result. Sheet1Medical - Surgical Budget Med Surg 8 Month Budget FY 2019 - 2020 YTD (Jul - Feb)* FY 2019 - 2020 Budget FY 2019 - 2020 Variance TYDOPERATING REVENUE:Inpatient Revenue$ 23,123,516$ 50,000,000$ 1,876,484TOTAL PATIENT SERVICES REVENUE$ 23,123,516$ 50,000,000$ 1,876,484OPERATING EXPENSESSalaries and Wages$ 12,157,632$ 23,000,000$ 657,632Employee Benefits$ 3,040,408$ 5,750,000$ 165,408Professional Fees$ 250,160$ 400,000$ 50,160Supplies$ 5,883,497$ 10,000,000$ 883,497Purchased Services - Utilities$ 27,456$ 50,000$ 2,456Purchased Services - Other$ 23,484$ 50,000$ 1,516Insurance$ 57,315$ 105,000$ 4,815License and Taxes$ 21,456$ 40,000$ 1,456Other Direct Expenses$ 972,157$ 1,500,000$ 222,157TOTAL OPERATING EXPENSES$ 22,433,565$ 40,895,000$ 1,986,065NET REVENUE OR (EXPENSE)$ 689,951$ 9,105,000$ 3,862,549* Your budget may vary from the FY 2029-2020 budget given changes you are projecting based on the hospitals experience ov er the last 8 months Med Surge 12 month Budget 2019-2020FY 2019 - 2020 Year** FY 2019 - 2020 Budget FY 2019 - 2020 Variance TYDOPERATING REVENUE:Inpatient Revenue$ 50,000,000TOTAL PATIENT SERVICES REVENUE$ 50,000,000OPERATING EXPENSESSalaries and Wages$ 23,000,000Employee Benefits$ 5,750,000Professional Fees$ 400,000Supplies$ 10,000,000Purchased Services - Utilities$ 50,000Purchased Services - Other$ 50,000Insurance$ 105,000License and Taxes$ 40,000Other Direct Expenses$ 1,500,000TOTAL
  • 9. OPERATING EXPENSES$ - 0$ 40,895,000NET REVENUE OR (EXPENSE)$ 9,105,000** Your budget may vary from the FY 2029-2020 budget given changes you are projecting based on the hopsitals experience over the last 12 months Provide the rationale for your projections in the Memo Med-Surg Budget Fiscal Year 2020-2021 FY 2020 - 2021 FY 2019 - 2020 Budget Variance (% increase or Decrease)*** OPERATING REVENUE:Inpatient Revenue$ 46,247,032$ 50,000,000TOTAL PATIENT SERVICES REVENUEOPERATING EXPENSESSalaries and Wages$ 24,315,262$ 23,000,000Employee Benefits$ 6,080,816$ 5,750,000Professional Fees$ 500,320$ 400,000Supplies$ 11,766,994$ 10,000,000Purchased Services - Utilities$ 55,092$ 50,000Purchased Services - Other$ 46,968$ 50,000Insurance$ 114,630$ 105,000License and Taxes$ 42,912$ 40,000Other Direct Expenses$ 1,944,314$ 1,500,000TOTAL OPERATING EXPENSES$ 44,867,310$ 40,895,000NET REVENUE OR (EXPENSE)$ 50,000,000*** For your project 2020-2021 budget highlight the percent changes from the previous FY, provide a rationale for your decisions in the Memo Trinity Budget Execution YTDThe UMUC Medical CenterFY 2019 YTD (Jul - Dec) FY 2019 Budget FY 2019 Variance YTDOPERATING REVENUE:Inpatient Revenue$ 375,040,349$ 700,000,000$ 25,040,349Outpatient Revenue$ 232,498,397$ 525,000,000$ (30,001,603)TOTAL PATIENT SERVICES REVENUE$ 607,538,746$ 1,225,000,000$ (4,961,254)DEDUCTIONS FROM REVENUE:Contractual Adjustments$ 476,543,215$ 950,000,000$ 1,543,215Charity and Uncompensated Care$ 6,725,412$ 14,000,000$ (274,588)TOTAL DEDUCTIONS FROM REVENUE$ 483,268,627$ 964,000,000$ 1,268,627NET PATIENT SERVICE REVENUE$ 124,270,119$ 261,000,000$ (6,229,881)OTHER OPERATING REVENUEOther Operating Revenue$ 3,500,000$ 10,000,000$ (1,500,000)TOTAL
  • 10. OPERATING REVENUE$ 127,770,119$ 271,000,000$ (7,729,881)OPERATING EXPENSESSalaries and Wages$ 42,932,230$ 88,000,000$ (1,067,770)Employee Benefits$ 12,624,012$ 25,000,000$ 124,012Professional Fees$ 4,082,215$ 9,000,000$ (417,785)Supplies$ 23,883,407$ 46,000,000$ 883,407Purchased Services - Utilities$ 1,632,191$ 3,000,000$ 132,191Purchased Services - Other$ 11,536,320$ 22,000,000$ 536,320Depreciation$ 8,455,254$ 17,000,000$ (44,746)Rentals and Leases$ 2,252,670$ 4,000,000$ 252,670Insurance$ 2,715,378$ 5,000,000$ 215,378License and Taxes$ 7,992,144$ 18,000,000$ (1,007,856)Interest$ 8,393,790$ 18,000,000$ (606,210)Provision For Bad Debts$ - 0$ - 0$ - 0Other Direct Expenses$ 4,744,642$ 8,000,000$ 744,642TOTAL OPERATING EXPENSES$ 131,244,253$ 263,000,000$ (255,747)NET OPERATING REVENUE$ (3,474,134)$ 8,000,000$ (7,474,134)NET REVENUE BEFORE ITEMS LISTED BELOW$ (3,474,134)$ 8,000,000$ (7,474,134)EXTRAORDINARY ITEM$ - 0$ - 0$ - 0NET REVENUE OR (EXPENSE)$ (3,474,134)$ 8,000,000$ (7,474,134)Med/Surg Department BudgetFY 2019 YTD (Jul - Dec) FY 2019 Budget FY 2019 Variance TYDOPERATING REVENUE:Inpatient Revenue$ 23,123,516$ 50,000,000$ (1,876,484)TOTAL PATIENT SERVICES REVENUE$ 23,123,516$ 50,000,000$ (1,876,484)OPERATING EXPENSESSalaries and Wages$ 12,157,632$ 23,000,000$ 657,632Employee Benefits$ 3,040,408$ 5,750,000$ 165,408Professional Fees$ 250,160$ 400,000$ 50,160Supplies$ 5,883,497$ 10,000,000$ 883,497Purchased Services - Utilities$ 27,456$ 50,000$ 2,456Purchased Services - Other$ 23,484$ 50,000$ (1,516)Insurance$ 57,315$ 105,000$ 4,815License and Taxes$ 21,456$ 40,000$ 1,456Other Direct Expenses$ 972,157$ 1,500,000$ 222,157TOTAL OPERATING EXPENSES$ 22,433,565$ 40,895,000$ 1,986,065NET REVENUE OR (EXPENSE)$ 689,951$ 9,105,000$ (3,862,549)
  • 11. 2015FS-1 BALANCE SHEET - UNRESTRICTED FUNDHospital: St. Anthony Medical Center, Vila Health System FYE: 12/31/2015ASSETSLic.#: H-0371CURRENT ASSETS:2Cash(2,464,387)3Marketable Securities04Accounts Receivable39,102,4645Less-Estimated Uncollectable & Allowances2,038,6506Receivables From Third Party Payors(3,067,704)7Pledges And Other Receivables1,770,5818Due From Restricted Funds09Inventory7,328,98410Prepaid Expenses1,230,05311Current Portion Of Funds Held In Trust012TOTAL CURRENT ASSETS41,861,3411314BOARD DESIGNATED ASSETS:15Cash016Marketable Securities017Other Assets018TOTAL BOARD DESIGNATED ASSETS:01920PROPERTY, PLANT AND EQUIPMENT:21Land15,239,20122Land Improvements1,005,84323Buildings85,916,24524Fixed Equipment - Building Service28,562,66525Fixed Equipment - Other9,305,05226Equipment57,547,95727Leasehold Improvements425,60628Construction In Progress225,68229TOTAL198,228,25130Less Accumulated Depreciation62,102,06931NET PROPERTY, PLANT & EQUIPMENT136,126,1823233INVESTMENTS AND OTHER ASSETS:34Investments In Property, Plant & Equipment035Less - Accumulated Depreciation036Other Investments1,200,00037Other Assets038TOTAL INVESTMENTS & OTHER ASSETS1,200,0003940INTANGIBLE ASSETS:41Goodwill042Unamortized Loan Costs043Preopening And Other Organization Costs044Other Intangible Assets8,785,27645TOTAL INTANGIBLE ASSETS8,785,27646TOTAL ASSETS187,972,799DOH - OHPDBALANCE SHEET - UNRESTRICTED FUNDHospital: St. Anthony Medical Center, Vila Health SystemFYE: 12/31/2015LIABILITIES AND FUND BALANCES- UNRESTRICTEDLic.#: H-0371CURRENT LIABILITIES2Notes and Loans Payable03Accounts Payable
  • 12. 15,538,8634Accrued Compensation and Related Liabilities10,399,5905Other Accrued Expenses2,147,2376Advances from Third Party Payors07Payables to Third Party Payors08Due to Restricted Funds09Income Taxes Payable010Other Current Liabilities011Current Maturities of Long Term Debt110,03612TOTAL CURRENT LIABILITIES28,195,7261314DEFERRED CREDITS:15Deferred Income Taxes016Deferred Third Party Revenue017Other Deferred Credits185,54818TOTAL DEFERRED CREDITS185,5481920LONG TERM DEBT21Mortgage Payable022Construction Loans-Interim Financing023Notes Payable5,674,82724Capitalized Lease Obligations025Bonds Payable026Notes and Loans Payable to Parent189,173,76127Noncurrent Liabilities028TOTAL194,848,58829Less Current Maturities of Long Term Debt110,03630TOTAL LONG TERM DEBT194,738,5523132UNRESTRICTED FUND BALANCE03334EQUITY (INVESTOR OWNED)35Preferred Stock3637Common Stock3839Additional Paid In Stock04041Retained Earnings (Capital Account for Partnership(35,147,027)42 (or Sole Proprietorship)4344Less Treasury Stock45TOTAL EQUITY(35,147,027)46TOTAL LIABILITIES AND FUND BALANCE OR EQUITY187,972,799DOH - OHPDCOMPARISON STATEMENT OF REVENUE & EXPENSE - UNRESTRICTED FUNDSHospital: St. Anthony Medical Center, Vila Health System FYE: 12/31/2015Lic.#: H- 0371OPERATING REVENUE:2Inpatient Revenue666,080,6983Outpatient Revenue464,996,7934TOTAL PATIENT SERVICES REVENUE1,131,077,49156DEDUCTIONS FROM REVENUE:7Contractual Adjustments855,811,0218Charity and Uncompensated Care13,400,0009Other Adjustments and Allowances010TOTAL DEDUCTIONS FROM REVENUE869,211,02111NET PATIENT SERVICE
  • 13. REVENUE261,866,4701213OTHER OPERATING REVENUE14Other Operating Revenue9,969,04815Tax Revenues016TOTAL OTHER OPERATING REVENUE9,969,04817TOTAL OPERATING REVENUE271,835,5181819OPERATING EXPENSES20Salaries and Wages85,864,45921Employee Benefits25,248,02422Professional Fees8,144,42623Supplies47,766,81324Purchased Services - Utilities3,264,38225Purchased Services - Other23,072,64026Depreciation16,910,50827Rentals and Leases4,505,34028Insurance5,430,75629License and Taxes15,984,28830Interest16,787,58031Provision For Bad Debts2,564,19732Other Direct Expenses9,489,28333TOTAL OPERATING EXPENSES265,032,69634NET OPERATING REVENUE6,802,8223536NON-OPERATING REVENUE-NET OF EXPENSES03738NET REVENUE BEFORE ITEMS LISTED BELOW6,802,8223940EXTRAORDINARY ITEM1,374,00041FEDERAL INCOME TAX04243NET REVENUE OR (EXPENSE)8,176,82244EXPLANATION:45DOH - OHPD 2016FS-1 BALANCE SHEET - UNRESTRICTED FUNDHospital: St. Anthony Medical Center, Vila Health System FYE: 12/31/2016ASSETSLic.#: H-0371CURRENT ASSETS:2Cash(1,027,622)3Marketable Securities04Accounts Receivable32,410,2075Less-Estimated Uncollectable & Allowances3,891,9826Receivables From Third Party Payors(247,989)7Pledges And Other Receivables1,889,6178Due From Restricted Funds09Inventory8,014,98810Prepaid Expenses1,301,47611Current Portion Of Funds Held In Trust012TOTAL CURRENT ASSETS38,448,6951314BOARD DESIGNATED ASSETS:15Cash016Marketable Securities017Other Assets018TOTAL BOARD DESIGNATED ASSETS:01920PROPERTY, PLANT AND EQUIPMENT:21Land15,239,20122Land Improvements1,009,49223Buildings122,015,47724Fixed Equipment - Building Service77,067,37325Fixed Equipment -
  • 14. Other026Equipment027Leasehold Improvements425,60628Construction In Progress1,089,60329TOTAL216,846,75230Less Accumulated Depreciation75,384,79131NET PROPERTY, PLANT & EQUIPMENT141,461,9613233INVESTMENTS AND OTHER ASSETS:34Investments In Property, Plant & Equipment035Less - Accumulated Depreciation036Other Investments1,200,00037Other Assets038TOTAL INVESTMENTS & OTHER ASSETS1,200,0003940INTANGIBLE ASSETS:41Goodwill042Unamortized Loan Costs043Preopening And Other Organization Costs044Other Intangible Assets10,135,57345TOTAL INTANGIBLE ASSETS10,135,57346TOTAL ASSETS191,246,229DOH - OHPDBALANCE SHEET - UNRESTRICTED FUNDHospital: St. Anthony Medical Center, Vila Health SystemFYE: 12/31/2016LIABILITIES AND FUND BALANCES- UNRESTRICTEDLic.#: H-0371CURRENT LIABILITIES2Notes and Loans Payable03Accounts Payable 16,230,0754Accrued Compensation and Related Liabilities11,777,8365Other Accrued Expenses1,866,9676Advances from Third Party Payors07Payables to Third Party Payors08Due to Restricted Funds09Income Taxes Payable010Other Current Liabilities011Current Maturities of Long Term Debt012TOTAL CURRENT LIABILITIES29,874,8781314DEFERRED CREDITS:15Deferred Income Taxes016Deferred Third Party Revenue017Other Deferred Credits018TOTAL DEFERRED CREDITS01920LONG TERM DEBT21Mortgage Payable022Construction Loans-Interim Financing023Notes Payable5,296,93024Capitalized Lease Obligations025Bonds Payable026Notes and Loans Payable to Parent196,170,11727Noncurrent Liabilities028TOTAL201,467,04729Less Current Maturities of Long Term Debt030TOTAL LONG TERM DEBT201,467,0473132UNRESTRICTED FUND
  • 15. BALANCE03334EQUITY (INVESTOR OWNED)35Preferred Stock3637Common Stock3839Additional Paid In Stock04041Retained Earnings (Capital Account for Partnership(40,095,696)42 (or Sole Proprietorship)4344Less Treasury Stock45TOTAL EQUITY(40,095,696)46TOTAL LIABILITIES AND FUND BALANCE OR EQUITY191,246,229DOH - OHPDCOMPARISON STATEMENT OF REVENUE & EXPENSE - UNRESTRICTED FUNDSHospital: St. Anthony Medical Center, Vila Health System FYE: 12/31/2016Lic.#: H- 0371OPERATING REVENUE:2Inpatient Revenue752,813,1803Outpatient Revenue529,706,9184TOTAL PATIENT SERVICES REVENUE1,282,520,09856DEDUCTIONS FROM REVENUE:7Provision For Bad Debts5,083,7188Contractual Adjustments1,010,760,5259Charity and Uncompensated Care2,400,00010Other Adjustments and Allowances011TOTAL DEDUCTIONS FROM REVENUE1,018,244,24312NET PATIENT SERVICE REVENUE264,275,8551314OTHER OPERATING REVENUE15Other Operating Revenue10,171,42816Tax Revenues017TOTAL OTHER OPERATING REVENUE10,171,42818TOTAL OPERATING REVENUE274,447,2831920OPERATING EXPENSES21Salaries and Wages88,523,45322Employee Benefits25,937,60723Professional Fees9,613,65624Supplies46,386,98925Purchased Services - Utilities3,043,36826Purchased Services - Other22,184,38827Depreciation17,408,82428Rentals and Leases4,866,38429Insurance5,740,78830License and Taxes18,828,50431Interest18,671,13632Other Direct Expenses8,522,13633TOTAL OPERATING EXPENSES269,727,23334NET OPERATING REVENUE4,720,0503536NON-OPERATING REVENUE-NET OF EXPENSES03738NET REVENUE BEFORE ITEMS LISTED BELOW4,720,0503940EXTRAORDINARY ITEM750,00041FEDERAL INCOME TAX04243NET