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BUDGET PROJECT ASSIGNMENT INSTRUCTIONS
OVERVIEW
The student will complete a project involving the creation of a budget. Specific budgets to be
produced and other requirements may be found in Canvas.
INSTRUCTIONS
Complete each part of the following Case Study. You will need to use Microsoft Word and
Excel. Tables referenced in the case study are located in the Excel file labeled “Case Study
Tables”. Label your written responses by part number. For example, your memo for Part 1 must
be labeled Part 1 as a level 1 heading, then proceed with your memo, and then a new level 1
heading Part 2, followed by answers to those questions. A title page must be included in your
submission. Analysis must be supported with scholarly, peer-reviewed journal articles (5 or
more) as well as include Biblical integration.
Financial Management
Part 1 Financial Statement Analysis
The loan committee of a major bank needs a financial assessment. Analyze the
financial statement for (your instructor will provide the company name). Download the
financial statements into Microsoft Excel and then use horizontal statement analysis as
well as financial ratios to assess the organization’s liquidity, profitability, financial
efficiency (turnover), and capital/debt structure. Based on your assessment, present a
2–4-page memo that describes the financial strengths and weaknesses of the
organization as of their most recent year-end. Your memo must indicate the maximum
loan amount that should be authorized.
Part 2 Budget Analysis
Table 1 includes PCS’s proposed budget for 2018. Using this as a basis, develop a
revenue and expenses budget for each PCS center. Note that professional reading fees
and laboratory expenses are variable costs that need to be allocated based on the type of
visit. Generally, an occupational health visit (Categories 8 and 9 on Tables 2 and 3)
including all physicals has reading and laboratory costs 1.4 times what a general
medical visit incurs (Category 1, 2, or 3). For each line item in the budget, indicate
whether the item is a fixed or variable expense and the basis of allocation or assignment
for the budget for each center. Each center is expected to generate approximately the
same profit margin. Given your analysis, will it? Should management change its
expectations regarding average revenue per visit by center?
Part 3 Monthly Cash Budget
Table 4 includes the 2018 budget for Jasper Gardens Nursing Home. For your
monthly cash budget, assume that one-twelfth of cash expenses and revenues are
incurred per month. Use the following aging analysis to estimate cash inflows. What
Page 1 of 4
are the management implications of this analysis?
Table III.4 Aging Analysis
Percent of Bills Paid in Cash Within
days of Billing
Days
Medicare
Medicaid
Commercial
Insurance
Private Insurance
Self-Pay
VA
30 or less
31–60
61–90
91–120
121–150
5
0
20
25
30
25
40
25
5
25
25
30
40
25
25
30
30
15
25
30
20
10
10
10
0
45
15
0
10
5
Assume that Accounts Receivable – Net as of December 31, 2017, are the same
percentage as anticipated revenue to be earned during 2018.
Part 4 Webster Hospital—Long-Term Debt Financial Analysis
OHA has indicated that we should maintain a debt to asset ratio no higher than 40
percent. Given this, how much additional long-term debt could have been added in 2017?
We would use this additional debt to finance new construction, renovations, and the
acquisition of technology. To finance this additional long-term debt we would use bonds.
As such, we need to assess our credit worthiness. The following are the select median
values for specific financial ratios for hospitals that received “below investment grade
(BBB)” and “high investment grade (AA)” bond ratings.
Assess and report Webster’s position with recommendations. Are Webster’s bonds
more likely to be rated as AA or BBB? Why?
Table III.5
Comparison of Financial Ratios by Bond Rating
Bond Grade
AA
BBB
Days Cash on Hand
Days in Accounts Receivables
Days in Current Liabilities
Cash to Debt (%)
Total Margin-%
194
58.0
62.3
153.9
4.1
53.6
47.7
64.7
37.9
(0.3)
Page 2 of 4
Salaries and benefit costs as
% of Total Revenue
49.9
56.3
Average Age of Plant (years)
Capital Expenditures
as % of Depreciation Expense
9.5
13.4
169.9
76.2
Our annual interest cost of long-term borrowing would be 3.0 percent if our bonds were
rated “high grade” and 7.5 percent if rated “below investment grade.” Assume that tenyear bonds are used to finance this additional debt. What would be the annual principal
and interest payment for this amount? Can Webster Hospital afford this increased
annual expense? Note that for every $100,000 borrowed over ten years, our monthly
payments would be $989 at 3.5 percent or $1,136 at 6.5 percent.
Part 5 Surgery for Middleboro
As you are aware, Medical Associates has achieved its targeted utilization and financial
projections for ambulatory surgery in Jasper. It is now time to consider a similar service
at our offices in Middleboro. The physical facilities needed for ambulatory surgery will
cost $450,000. Our cost of capital is 4 percent and the hurdle rate is 6 percent. The
anticipated salvage value of these new fixed assets will be $150,000 after five years. To
do this we will need to recruit two new general surgeons for our Jasper office, thereby
freeing our Middleboro general surgeons to work in this new ambulatory surgical
facility. We anticipate opening no earlier than January 2, 2016
Based on operational estimates, we anticipate that this project’s annual operational
revenue will exceed its operational expenses (R-E) for each of the first five years in
accordance with the following schedule. Note that the operational expenses include all
direct costs including salaries and benefits.
Table III.6
Fiscal Implications of New Ambulatory Surgery Service
Year 01
Year 02
Year 03
Year 04
Year 05
R-E ($)
Median Cases per Day (M–F)
20,000
40,000
60,000
100,000
140,000
9.0
10.0
12.5
12.5
14.0
We estimate that this unit, employing the standard RVU system used in hospitals, will
generate 1.1 surgical procedures per case. Assess the financial implication. Should we
do this? Why?
Page 3 of 4
Part 6 Hospital Discounts
A coalition of key area employers has approached MCH or WH demanding an
additional 10 percent discount per patient day for all of their employees admitted to the
hospital. If not offered, they will change their health insurance to favor the one hospital
in Middleboro with the lowest prices. What would be the implications of such a
change? Structure the analysis that would be undertaken to respond to this demand.
Part 7 Medicaid Expansion
The state legislature and governor have just rejected additional Federal funding for
Medicaid expansion. Assess the financial impact of this decision on MCH or WH.
Part 8 New Primary Care Practices in Jasper
Determine the costs to MCH of establishing two new primary care practices in Jasper.
The analysis should include estimates of all costs (recruitment, compensation
arrangements, facility, staffing, information technology, etc.) and assess the advantages
and disadvantages of leasing or purchasing building space.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Page 4 of 4
Table 1.5
Hillsboro County Health Insurance Profile 2016–2017 (Special Study by Chamber of Commerce, Percent of T
Percent of Coverage
All Residents
Covered by
own
Not
employmentcovered
Covered by
based
any time employment- insurance
during the
based
(selfyear
insurance
employed)
Covered by
Medicaid and
private
insurance
Covered
by
Medicare
and
private
insurance
19.3
55.1
28.6
2.8
7.5
32.7
25.6
14.9
13.6
0.0
50.6
70.5
76.6
78.8
0.0
12.4
8.3
5.6
0.0
0.0
1.0
1.5
1.5
0.7
0.0
0.2
0.1
0.2
0.2
0.0
28.3
22.8
13.2
9.3
7.3
43.4
64.1
79.5
8.2
23.6
30.5
39.4
0.00
0.00
0.00
0.00
8.1
15.4
7.5
5.7
Employer size, workers aged 18–64
Fewer than 25 employees
25–99 employees
100–499 employees
500–999 employees
1,000+ employees
Household income
Less than $25,000
$25,000 to $49,999
$50,000 to $74,999
$75,000 or more
NOTE: Percentages may exceed 100% depending on changes during the year of study and multiple coverage.
r of Commerce, Percent of Total)
rage.
Covered
by
Medicare
and
Medicaid
2.1
0.2
0
0.3
0.3
0.0
0.00
0.00
0.00
0.00
Table 1.9
HIV and AIDS in Capital City and Hillsboro County, 2007–2017
2017
2012
AIDS cases
Rate per 100,000 Population, All Ages
Hillsboro County
6.9
7.2
Capital City
8.4
9.3
Statewide
12.5
13.4
2007
7.8
11.2
14.5
AIDS cases
Rate per 100,000 Population, Adults and Adolescents
Hillsboro County
7.0
7.4
8.2
Capital City
8.5
9.6
11.5
Statewide
15.2
16.0
18.3
AIDS case rates
Adults and Adolescents, Rates per 100,000 by Sex
Hillsboro County
Male
20.9
23.5
17.2
Female
6.3
7.9
5.4
Capital City
Male
22.9
24.0
21.3
Female
7.7
7.7
7.9
Statewide
Male
22.9
26.3
30.1
Female
7.7
6.7
6.7
AIDS cases
Distribution of Persons Estimated to be Living with AIDS (%)
Hillsboro County
White
70.9
71.2
67.3
Black
18.8
19.3
20.3
Hispanic
4.4
4.4
6.2
Other
5.9
5.1
6.2
Capital City
White
48.2
40.3
35.5
Black
35.7
40.7
44.5
Hispanic
13.4
16.7
17.3
Other
2.7
2.3
2.7
Statewide
White
34.1
30.2
28.4
Black
42.7
44
44.3
Hispanic
20.9
23.2
25.2
Other
2.3
2.6
2.1
HIV
HIV
Age-Adjusted Death Rate per 100,000 for HIV
Hillsboro County
1.1
1.2
1.1
Capital City
3.8
3.2
3.2
Statewide
4.2
4.6
4.8
Estimated Rate per 100,000 for Persons Living with HIV
Infections (not AIDS)
Hillsboro County
22.7
21.3
24.3
Capital City
34.5
36.7
39.5
Statewide
51.7
48.3
50.2
HIV—2017
Hillsboro County
Whites
Blacks
Hispanics
Capital City
Whites
Blacks
Hispanics
Statewide
Whites
Blacks
Hispanics
Rates per 100,000 of New HIV Infections in Adults and
Adolescents
Males
Females
Total
10.5
80.7
31.2
2.2
21.7
6.3
7.1
51.9
19.2
13.5
112.4
47.5
4.1
50.9
13.0
9.1
82.7
30.7
19.6
115.7
43.8
3.9
55.7
14.4
11.5
83.7
29.3
Table 2.2
Service Area Utilization by Town and Division for Calendar Years Ending December 31
Division
Boalsburg
Carterville
Harris City
Jasper
Middleboro
Mifflenville
Minortown
1,702
330
422
150
56
10
26
2,004
356
82
26
59
13
24
3,404
676
823
301
107
18
47
3,220
666
863
605
101
20
51
16,071
3,264
4,904
1,547
490
91
230
3,794
725
967
335
100
21
53
3,020
445
106
18
71
11
38
73
794
957
844
10
54
290
1,487
1,513
194
1,448
1,741
1,291
798
7,109
9,479
7,658
6
64
150
1,571
2,155
2,040
0
61
293
1,315
1,729
43
154
1,241
1,835
1,517
21
18
7
38
23
56
11
34
44
190
198
101
131
16
12
72
0
0
246
653
0
114
0
12
0
Service
Home Care
RN visits
LPN visits
HHA visits
PT visits
OT visits
ST visits
Social worker visits
Private Duty
RN in-home hours
LPN in-home hours
PCA in-home hours
HHA in-home hours
Other in-home hours
39
Community Health
Ante/postpartum visits
Child health visits
Senior Health Clinic attendees by HCHHA Office Location
Seen at Middleboro office
Seen at Jasper office
15
0
12
0
Stateville
Total
820
200
263
92
30
5
18
34,035
6,662
8,430
3,074
1,014
189
487
50
419
376
426
8
1,534
13,165
19,345
17,018
191
23
30
476
456
45
8
923
254
Table 2.3
Services to Patients, Calendar Years Ending December 31
Division/Program
2017
2016
Home Care
1,596
1,582
Unduplicated client census
RN home visits 34,035 35,463
LPN home visits
6,662
5,678
Home health aide visits
8,430
8,230
PT visits
3,074
2,647
OT visits
1,014
993
ST visits
189
165
SW visits
487
472
Total visits 53,891 53,648
Private Duty
Unduplicated client census
RN in-home hours
LPN in-home hours
Personal care attendant in-home hours
HHA in-home hours
Other in-home hours
Total hours
Community Health
Ante/postpartum visits
Child health visits
Prenatal class enrollees
Children seen, Middleboro
Children seen, Jasper
High Blood Pressure Program
People screened
MD referrals
Senior Health Clinics
Clients seen, Middleboro
Clients seen, Jasper
2015
2014
2013
1,578
35,867
5,980
8,356
2,630
897
174
434
54,338
1,498
36,304
4,823
8,856
2,240
899
178
445
53,745
1,499
37,192
4,725
8,923
2,430
903
156
342
54,671
260
1,534
13,165
19,345
17,018
212
51,274
225
1,267
12,564
16,745
11,788
180
42,544
145
1,050
9,160
14,290
8,304
210
33,014
476
456
139
901
301
512
502
140
740
222
500
656
123
634
305
499
450
130
812
317
412
496
112
845
328
7,456
398
6,867
423
7,234
307
7,124
456
6,838
512
923
254
902
243
920
289
934
389
978
412
Table 2.6
Statement of Revenue and Expenses for Calendar Year Ending December 31
2017
2016
Home Care Division
6,736,375
6,322,329
Less allowances for bad debt
-85,240
-88,340
Less contractual allowances
-2,049,283
-1,737,912
Net revenue
4,601,852
4,496,077
Private Duty Division
3,165,221
2,843,959
Less allowances for bad debt
-65,340
-45,230
Less contractual allowances
-18,469
-12,669
Net revenue
3,081,412
2,786,060
Community Health Division
Support from state and towns
208,750
240,000
United Appeal
20,000
20,000
Other
1,935
1,257
Net revenue
230,685
261,257
Total net operational revenue
7,913,949
7,543,394
Expenses
Divisional
Salaries and wages
4,186,227
4,086,160
Fringe benefits
1,255,868
1,022,548
Travel
725,388
701,383
Supplies
453,778
398,202
Equipment
152,430
122,494
Total divisional
6,773,691
6,330,787
Administrative
Salaries and wages
360,233
340,229
Fringe benefits
102,339
98,334
Supplies
157,910
158,705
Equipment
45,929
42,393
Insurance
56,729
54,202
Interest
54,894
53,890
Maintenance—Middleboro
138,595
79,303
Rent—Jasper office
40,500
40,500
Computer services
84,253
80,150
Travel
18,356
18,430
Heat/light—Middleboro
11,488
10,004
Legal/audit
55,088
44,411
Printing and postage
15,540
13,450
Telecommunications
21,364
19,560
Staff development
10,060
7,010
Board expenses
10,150
10,445
Publications and memberships
10,700
10,500
Depreciation expense
38,240
39,440
Total administrative
1,232,368
1,120,956
Total expenses
8,006,059
7,451,743
Gain (or loss) from operations
-92,110
91,651
Other Income
202,445
245,300
110,335
336,951
Gain (or loss)
2015
5,936,445
-72,450
-1,365,999
4,497,996
1,893,345
-24,550
-8,738
1,860,057
240,000
60,000
1,458
301,458
6,659,511
3,604,595
1,021,445
604,387
258,304
82,394
5,571,125
335,110
96,990
140,680
34,220
45,043
53,004
78,380
40,500
73,229
13,450
7,545
28,340
12,000
18,334
7,500
6,342
8,550
44,350
1,043,567
6,614,692
44,819
295,606
340,425
Table 2.7
Balance Sheet as of December 31
2017
2016
2015
Current assets
Cash
Accounts receivable (net)
Prepaid insurance
Inventory
Total current assets
708,339
1,430,404
8,650
19,299
2,166,692
474,519
1,152,383
17,340
19,345
1,663,587
378,495
904,871
14,230
14,236
1,311,832
Property and equipment
Gross, property & equipment
(Less accumulated depreciation)
Net property and equipment
2,328,440
-603,559
1,724,881
2,255,606
-565,319
1,690,287
2,153,284
-525,879
1,627,405
Other assets
Investments (at market)
7,951,190
8,403,134
7,456,012
11,842,763
11,757,008
10,395,249
Liabilities and net assets
Current liabilities
Accounts payable
Accrued items
Current portion of long-term debt
Total current liabilities
487,220
284,570
68,244
840,034
433,291
255,683
69,262
758,236
415,073
306,492
70,385
791,950
Noncurrent Liabilities
Loan payable
448,292
472,445
492,558
1,288,326
1,230,681
1,284,508
6,917,307
3,024,604
612,526
6,961,213
3,062,923
502,191
5,423,731
3,521,770
165,240
Total net assets
10,554,437
10,526,327
9,110,741
Liabilities + net assets
11,842,763
11,757,008
10,395,249
Total assets
Total liabilities
Net assets
Donor-restricted fund
Investment fund (at market)
Working capital fund
Table 3.1
PCS Utilization Report
Alpha
Gross
Charges
($)
Beta
Gross
Charges
($)
230
78,450
94,040
207
251
87,650
102,272
165
204
221
92,425
93,092
481
190
187
242
101,925
96,844
988
480
103
167
238
82,660
92,876
June
1,067
493
150
195
229
94,625
94,168
July
1,195
460
252
219
264
112,940
107,748
August
1,276
503
260
217
296
120,075
116,812
September
1,031
406
165
209
251
87,050
102,552
October
1,048
403
233
205
207
101,635
89,144
November
905
329
225
168
183
90,625
76,956
December
799
325
230
119
125
91,225
53,160
Total
12,387
5,033
2,328
2,289
2,737
January
894
312
180
202
200
72,228
75,038
February
990
398
166
214
212
79,732
79,526
March
1,048
440
173
217
218
86,095
81,413
April
1,102
486
176
203
237
92,154
84,592
May
999
476
115
163
245
79,069
81,872
June
978
478
132
133
235
82,622
75,752
July
1,031
455
204
117
255
93,925
78,948
Alpha
Alpha
Beta
Beta
Total
Visits
Private
Visits
Occupational
Health Visits
Private
Visits
Occupational
Health Visits
January
909
302
185
192
February
1,030
402
170
March
1,039
449
April
1,100
May
2017
1,141,285 1,119,664
2016
August
1,276
501
251
269
255
108,564
97,036
September
970
396
160
202
212
78,324
78,098
October
1,056
447
203
199
207
92,778
76,466
November
1,005
423
254
178
150
99,867
59,432
December
1,000
405
240
190
165
94,995
64,685
Total
12,349
5,217
2,254
2,287
2,591
1,060,353
932,858
January
876
303
170
213
190
66,842
73,912
February
938
365
169
200
204
73,720
75,800
March
993
402
190
205
196
81,928
74,420
April
963
406
156
194
207
75,924
75,806
May
1,001
426
155
175
245
78,014
82,950
June
986
453
145
143
245
79,192
78,982
July
1,027
451
184
127
265
86,374
81,998
August
1,259
493
271
227
268
107,692
95,148
September
909
312
203
189
205
74,138
74,686
2015
October
1,057
449
213
178
217
91,656
76,322
November
974
425
207
164
178
87,780
64,836
December
1,012
401
231
193
187
89,604
70,682
Total
11,995
4,886
2,294
2,208
2,607
992,864
925,542
January
866
313
160
200
193
62,917
60,235
February
887
375
153
145
214
68,415
58,115
March
978
397
187
189
205
76,933
61,332
April
954
376
159
205
214
69,604
64,895
May
1,035
445
193
165
232
83,245
63,885
June
1,047
463
193
160
231
85,207
63,125
July
968
421
195
107
245
80,989
59,866
2013
August
1,212
504
241
207
260
98,316
74,091
September
October
November
986
990
974
323
409
400
200
198
212
188
156
145
275
227
217
71,207
80,221
81,760
74,869
61,893
58,700
December
960
394
223
156
187
83,086
54,093
Total
11,857
4,820
2,314
2,023
2,700
941,900
755,099
A
PP
B
OH
PP
OH
220
140
140
140
140
292
292
292
292
125
220
140
292 177.6680162
125
220
140
292 176.9381443
125
220
140
292 184.6761506
125
220
140
292 185.6481191
125
220
140
292 183.9010669
125
220
140
292 182.0410305
125
220
140
292 185.1723757
125
220
140
292 180.7071339
125
220
125
220
125
220
125
189.7579758 This is a “work area” – please do
184.3902913 not include in table.
178.5534167
180.6990909
292 182.5259546
119
195
119
255 164.7270694
119
195
119
255 160.8666667
119
195
119
255 159.8358779
119
195
119
255 160.3865699
119
195
119
255 161.1021021
119
195
119
255 161.9366053
119
195
119
255 167.6750727
119
195
119
255 161.1285266
119
195
119
255 161.2597938
119
119
119
195
195
195
119
119
119
255 160.2689394
255 158.5064677
255
159.68
161.4066726
114
114
114
114
114
114
114
114
114
114
114
114
190
190
190
190
190
190
190
190
190
190
190
190
124
124
124
124
124
124
124
124
124
124
124
124
250
250
250
250
250
250
250
250
250
250
250
250
160.6780822
159.4029851
157.4501511
157.5597092
160.8031968
160.4198783
163.9454722
161.1119936
163.7227723
158.9195837
156.6899384
158.3853755
159.9338058
109
109
109
109
109
109
109
109
109
109
109
109
180
180
180
180
180
180
180
180
180
180
180
180
113
113
113
113
113
113
113
113
113
113
113
113
195
195
195
195
195
195
195
195
195
195
195
195
142.2078522
142.6493799
141.3752556
140.9842767
142.1545894
141.6733524
145.5113636
142.25
148.1501014
143.5494949
144.2094456
142.8947917
143.122122
Total
Gross
Charges
($)
172,490
189,922
185,517
198,769
175,536
188,793
220,688
236,887
189,602
190,779
167,581
144,385
2,260,949
147,266
159,258
167,508
176,746
160,941
158,374
172,873
205,600
156,422
169,244
159,299
159,680
1,993,211
140,754
149,520
156,348
151,730
160,964
158,174
168,372
202,840
148,824
167,978
152,616
160,286
1,918,406
123,152
126,530
138,265
134,499
147,130
148,332
140,855
172,407
146,076
142,114
140,460
137,179
1,696,999
ork area” – please do
Table 3.5
Revenue Generation by Physician, Center, Day of Week, September 1–November 29, 2017
RECORD
DATE
MD/ARNP
DAY
CTR
REVENUE $
VISITS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
Sept 1
Sept 2
Sept 3
Sept 4
Sept 5
Sept 6
Sept 8
Sept 9
Sept 10
Sept 11
Sept 12
Sept 13
Sept 15
Sept 16
Sept 17
Sept 18
Sept 19
Sept 20
Sept 22
Sept 23
Sept 24
Sept 25
Sept 26
Sept 27
Sept 29
Sept 30
Oct 1
Oct 2
Oct 3
Oct 4
Oct 6
Oct 7
Oct 8
Oct 9
Oct 10
Oct 11
Oct 13
Oct 14
Oct 15
Oct 16
Oct 17
Holiday
1
3
3
1
11
1
1
3
3
4
11
1
1
3
3
4
11
1
1
3
3
4
11
1
1
3
3
5
11
1
1
3
3
4
11
1
1
3
3
5
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3,156
3,788
3,956
3,059
3,076
3,044
3,657
4,366
4,381
3,547
3,148
3,008
3,005
3,976
3,740
3,547
3,005
3,259
3,051
3,906
3,856
3,944
3,452
3,056
3,067
3,010
2,840
3,049
1,599
6,559
3,769
3,276
3,806
3,051
3,028
5,278
4,650
3,920
2,534
4,020
17
21
23
24
19
22
34
20
25
38
16
23
18
21
19
30
20
32
22
18
22
24
20
20
23
23
18
20
10
42
21
20
20
18
20
33
28
20
14
28
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
Oct 18
Oct 20
Oct 21
Oct 22
Oct 23
Oct 24
Oct 25
Oct 27
Oct 28
Oct 29
Oct 30
Oct 31
Nov 1
Nov 3
Nov 4
Nov 5
Nov 6
Nov 7
Nov 8
Nov 10
Nov 11
Nov 12
Nov 13
Nov 14
Nov 15
Nov 17
Nov 18
Nov 19
Nov 20
Nov 21
Nov 22
Nov 24
Nov 25
Nov 26
Nov 27
Nov 28
Nov 29
Sept 1
Sept 2
Sept 3
Sept 4
Sept 5
Sept 6
Sept 8
11
1
1
3
3
4
11
1
1
3
3
4
11
1
1
3
3
5
11
1
1
3
3
4
13
1
1
3
3
5
11
1
1
3
Holiday
9
11
Holiday
2
6
6
7
13
2
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
3,699
4,460
4,739
4,230
3,288
3,805
3,397
5,520
4,367
3,650
3,090
3,001
1,145
5,350
2,768
3,587
4,879
2,757
1,036
5,567
2,586
5,980
4,771
2,061
2,212
5,789
3,879
5,879
4,244
2,959
2,055
4,789
4,444
5,546
24
36
28
22
19
25
22
39
28
20
18
20
10
35
15
21
26
19
10
31
17
32
24
14
22
35
23
31
24
17
15
30
25
32
4,007
2,335
30
16
5,157
4,286
4,367
4,156
1,956
6,648
25
14
16
17
10
30
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
Sept 9
Sept 10
Sept 11
Sept 12
Sept 13
Sept 15
Sept 16
Sept 17
Sept 18
Sept 19
Sept 20
Sept 22
Sept 23
Sept 24
Sept 25
Sept 26
Sept 27
Sept 29
Sept 30
Oct 1
Oct 2
Oct 3
Oct 4
Oct 6
Oct 7
Oct 8
Oct 9
Oct 10
Oct 11
Oct 13
Oct 14
Oct 15
Oct 16
Oct 17
Oct 18
Oct 20
Oct 21
Oct 22
Oct 23
Oct 24
Oct 25
Oct 27
Oct 28
Oct 29
Oct 30
2
6
6
7
13
2
2
6
7
8
13
2
2
6
8
8
12
2
2
5
5
8
13
2
2
5
5
6
13
2
2
5
5
6
13
2
2
5
5
6
12
2
2
5
5
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
5,978
4,934
2,166
4,305
1,510
6,250
4,850
3,956
4,707
3,958
1,941
5,790
4,415
3,083
3,546
4,026
1,850
4,890
3,827
4,080
3,080
2,044
830
4,560
4,050
4,069
3,827
1,566
1,209
4,038
4,740
3,567
5,035
3,077
1,518
5,734
3,657
3,256
3,070
3,058
1,656
5,020
4,640
2,748
2,978
29
20
12
16
9
28
20
18
20
18
10
28
20
14
16
16
12
24
18
18
15
9
4
20
20
20
18
11
6
19
20
17
18
15
8
22
19
20
13
12
8
22
20
15
14
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
Oct 31
Nov 1
Nov 3
Nov 4
Nov 5
Nov 6
Nov 7
Nov 8
Nov 10
Nov 11
Nov 12
Nov 13
Nov 14
Nov 15
Nov 17
Nov 18
Nov 19
Nov 20
Nov 21
Nov 22
Nov 24
Nov 25
Nov 26
Nov 27
Nov 28
Nov 29
6
13
2
2
6
6
8
13
2
2
6
6
8
13
2
2
6
6
7
13
2
2
6
Holiday
9
13
CODES For Table 3-5
MD/ARNP
1
B. Casey
2
M. Welby
3
S. Tobias
4
J. Smooth
5
R. Hottle
6
L. Cytesmath
7
C. Withers
8
L. Jones
9
M. Foxx
10
M. Meyers
11
C. Withers, ARNP
12
J. Jones, ARNP
13
G Mattox, ARNP
Revenue = Total gross billed charges
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2,007
1,205
3,557
4,047
3,344
4,289
3,756
1,034
4,420
4,510
3,089
3,837
4,730
1,856
4,298
3,587
2,689
4,856
3,962
1,091
5,029
2,538
2,177
9
6
17
15
18
20
14
4
30
16
16
15
17
10
21
12
13
22
14
10
24
12
12
2,002
1,053
8
5
Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Center
Alpha
Beta
Visits = Number of paying patients
Table 3.6
Statement of Operations
2017
2016
2015
2014
2013
Revenue
Patient services, gross
Contractual alllowances
Patient revenue, net
Other revenue
Total revenue
2,246,188
179,695
2,066,493
18,520
2,085,013
1,993,211
159,457
1,833,754
22,463
1,856,217
1,918,406
153,472
1,764,934
22,252
1,787,186
1,696,999
135,760
1,561,239
23,595
1,584,834
1,690,252
135,220
1,555,032
23,684
1,578,716
Expenses
Salaries and wages
Staff benefits
Administrative expenses
Advertising
Collection fees
Computer support
Consultants
Equipment leases
Insurance
Laboratory
Laundry and housekeeping
Legal/audit
Medical supplies
Office supplies
Printing and postage
Professional fees
Rent
Repairs and maintenance
Telephone
Utilities
Depreciation
Bad debt expenses
Total expenses
1,131,608
392,301
18,330
3,000
1,267
21,556
1,529
4,100
28,100
44,870
12,830
8,450
61,450
18,437
10,122
23,955
78,500
3,167
10,315
18,925
72,556
8,437
1,973,805
1,001,556
310,482
17,339
3,400
845
31,443
1,270
4,100
24,100
45,292
12,256
8,450
58,220
29,348
9,450
23,425
78,750
2,966
7,495
16,800
70,449
5,629
1,763,065
982,450
294,735
10,494
3,856
342
34,256
948
4,100
24,100
42,550
8,156
8,450
57,354
28,420
9,014
23,302
58,900
1,529
6,519
13,560
70,383
4,303
1,687,721
839,229
243,376
10,056
3,003
659
35,378
805
1,800
18,560
44,691
3,440
7,850
58,556
28,556
3,588
23,884
58,900
2,349
2,550
13,720
68,363
3,494
1,472,807
838,226
234,703
9,562
2,340
589
25,398
355
1,800
24,100
39,254
2,440
7,850
28,340
28,360
2,013
24,885
58,900
3,620
2,044
13,900
79,262
3,102
1,431,043
Income (loss) before taxes
111,208
93,152
99,465
112,027
147,673
Federal and state taxes
Income (loss) after taxes
44,483
66,725
37,261
55,891
39,786
59,679
44,811
67,216
59,069
88,604
Table 3.7
Balance Sheet for Fiscal Year Ending December 31
2017
2016
2015
2014
2013
Current
Cash, operating
Accounts receivable
Inventory
Prepaid expenses
Total current assets
153,449
139,385
3,339
3,078
299,251
163,035
134,450
4,125
4,565
306,175
86,999
131,560
5,233
4,021
227,813
76,223
130,455
28,734
5,688
241,100
84,550
168,455
30,335
8,944
292,284
Investments
368,825
341,010
405,903
353,628
314,040
Property and equipment
Equipment and leasehold improvements, gross
Less accumulated depreciation
Equipment and leasehold improvements, net
Total assets
Liabilities and net assets
1,197,602
645,239
552,363
1,220,439
1,125,046
572,683
552,363
1,199,548
1,054,597
502,234
552,363
1,186,079
984,214
431,851
552,363
1,147,091
915,851
363,488
552,363
1,158,687
49,668
29,000
2,134
80,802
13,534
27,387
945
41,866
13,796
30,100
823
44,719
10,455
45,662
1,126
57,243
77,454
23,145
569
101,168
0
80,802
84,770
126,636
124,339
169,058
132,506
189,749
167,393
268,561
Common stock note1
Authorized and issued
720,000
720,000
720,000
720,000
720,000
Cumulative operating (deficit) or gain after taxes
371,637
352,912
297,021
237,342
170,126
Dividends payable
Net assets
48,000
1,139,637
1,072,912
1,017,021
957,342
890,126
Net assets and liabilities
1,220,439
1,199,548
1,186,079
1,147,091
1,158,687
Assets
Current liabilities
Accounts payable
Accrued expenses
Accrued payroll taxes
Total current liabilities
Long-term liabilities
Notes payable
Total liabilities
Net assets
NOTE: 1. Common stock: $12 par, 60,000 authorized and issued.
Table 4.1
Webster Hospital Medical Staff Information, 2017
Name
Office
Age
Specialty
Patient Days Discharges
Department of Medicine—Active Staff
General and Family Practice
A. Able
A. Adelson
A. Downs
B. Dawes
B. Lamb
C. Franklin
C. Newton
D. Dodger
E. Best
E. Devishson
E. Doogle
F. Walczek
F. Evans
G. Liu
H. Megg
J. Child
J. Kim
J. Lopez
K. Blood
K. Justin
M. Heart
B. Easter
C. Fisher
D. Hamilton
I. Kelly
I. Lasker
1
1
1
1
1
2
2
3
3
3
3
5
4
6
7
4
4
1
1
2
1
1
2
2
8
8
29
33
34
34
37
48
44
37
35
31
36
38
39
29
36
43
32
40
50
57
43
68
60
55
69
68
Family Practice*
Family Practice*
Family Practice*
Family Practice*
Family Practice*
Family Practice
Family Practice
Family Practice*
Family Practice*
Family Practice*
Family Practice*
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
Family Practice
General Practice
General Practice
General Practice
General Practice
General Practice
504
601
678
590
603
323
476
415
340
186
357
300
197
287
454
244
456
478
534
539
478
547
416
345
38
135
115
125
152
146
149
66
96
91
84
43
82
64
45
50
100
55
91
103
109
114
101
102
92
77
7
24
1
1
35
54
Internal Medicine
Internal Medicine
590
398
121
86
1
1
1
1
34
37
35
39
Pediatrics*
Pediatrics*
Pediatrics*
Pediatrics*
162
45
80
40
45
18
28
15
3
45
Cardiology
546
105
1
1
1
57
50
43
Endocrinology
ENT
ENT
129
365
356
24
70
66
Internal Medicine: General
J. Morgan
K. Organs
Pediatrics
D. White
H. Wall
N. Green
X. Hirsh
Cardiology
W. Snipes
Other: Medicine
A. Zook
J. Hogan
P. Taff
Department of Medicine—Consulting Staff
J. Washington
C. Eisenhower
S. Truman
L. Coolidge
W. G. Chan
W. Tafy
V. Kennedy
T. Johnson
C. Nixon
M. Polk
S. Warren
T. Werner
Others
3
9
9
3
3
9
3
9
9
3
9
9
9
43
50
43
44
37
57
64
47
54
40
50
53
Internal Medicine
Cardiology
Rheumatology
ENT
Pediatrics
Oncology
ENT
Cardiology
Internal Medicine
OB/GYN
Pulmonary Medicine
Pulmonary Medicine
65
243
334
143
132
356
140
176
160
112
655
503
168
10
41
62
31
25
50
26
32
24
20
113
90
32
1
1
1
1
31
50
37
46
General*
General*
Orthopedic
Orthopedic
759
671
766
792
155
142
155
164
1
47
Urology
403
77
1
1
1
1
1
1
40
43
44
41
47
49
OB/GYN*
OB/GYN
OB/GYN*
OB/GYN*
OB/GYN*
OB/GYN*
415
403
403
602
621
678
90
92
95
129
143
137
47
51
61
63
68
65
56
54
54
47
45
45
50
63
50
44
47
General
General
General
General
General
General
General
General
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
Orthopedic
48
153
100
140
45
32
116
124
216
106
95
96
54
20
22
20
27
8
27
19
26
7
5
20
22
Department of Surgery
General and Orthopedic
S. Saw
C. Blade
R. Runner
D. Dolittle
Other
D. Felix
OB/GYN
B. Shaw
D. Kirby
E. Munson
F. Zebra
G. Martinez
M. Lewis
Surgery—Consulting Staff
M. Merrill
W. Pierce
F. Stevensen
J. Tyler
P. Miller
J. McKinley
M. Dawes
S. Strimpf
S. Skier
W. Hockey
S. Fremont
M. Fremont
D. Davids
K. Nioxon
G. Grant
L. Goldwater
W. Miller
9
9
3
3
3
3
10
10
9
9
9
9
9
9
9
3
3
41
20
18
16
10
3
4
3
5
D. Garfield
K. McGovern
D. Chest
9
9
9
43
53
50
Thoraracic
Thoraracic
Thoraracic
Department of Pathology and Radiology—Active Staff
J. Ericksen
H. Holland
W. Jippel
D. Yip
M. Stern
M. Lincoln
1
1
1
1
1
1
48
62
46
43
44
34
Radiology
Radiology
Radiology
Pathology
Pathology
Pathology
Department of Pathology and Radiology—Consulting Staff
M. Currie
D. Douglas
W. Lewis
D. Slide
F. Fillerautz
G. Gathews
9
9
9
9
9
9
58
43
40
55
44
47
Radiology
Radiology
Radiology
Pathology
Pathology
Pathology
Department of Anesthesiology—Active Staff
N. Needle
S. Westerman
N. Chamerblin
S. Pak
D. Sleep
M. Halo
J. Jones
D. Dinckens
1
1
1
1
9
9
9
9
38
42
44
54
61
50
46
41
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Anesthesiology
Department of Emergency Medicine—Active Staff
E. Abelson
M. Gasp
I. Hurt
A. Lincoln
H. Calson
W. Hiller
S. Sams
G. Bodansky
1
1
1
1
1
1
1
1
44
51
42
34
40
47
45
50
Emergency
Emergency
Emergency
Emergency
Emergency
Emergency
Emergency
Emergency
Department of Emergency Medicine—Consulting Staff
J. Whitey
J. Sallowash
R. Ritco
TBD
9
9
9
9
47
51
41
Emergency
Emergency
Emergency
Emergency
NOTES
* = Medical practice owned by Webster Health System, Inc.
Office Location: 1 = Middleboro; 2 = Mifflenville; 3 = Jasper; 4 =
Harris City;
5 = Statesville; 6 = Carterville; 7 = Boalsburg; 8 = Minortown; 9 =
59
105
145
9
16
20
Table 4.2
Hospital Inpatient Occupancy by Service, 2017–2011
Hospital Service
2017
2016
2015
2014
2013
2012
2011
Beds
Patient days
Occupancy
2
450
61.6%
2
645
88.4%
3
706
64.5%
4
804
55.1%
4
903
61.8%
4
998
68.4%
6
1,212
55.3%
Beds
Patient days
Occupancy
Medical Surgical I
Beds
Patient days
Occupancy
Medical Surgical II
Beds
Patient days
Occupancy
Medical Surgical III
Beds
Patient days
Occupancy
Orthopedic
Beds
Patient days
Occupancy
ICU
Beds
Patient days
Occupancy
20
5,470
74.9%
20
4,956
67.9%
14
4,106
80.4%
14
3,845
75.2%
14
3,455
67.6%
11
2,840
70.7%
10
2,740
75.1%
20
5,270
72.2%
20
6,047
82.8%
22
6,070
75.6%
20
5,578
76.4%
20
6,129
84.0%
18
4,996
76.0%
20
5,582
76.5%
20
5,442
74.5%
20
5,163
70.7%
23
5,890
70.2%
21
5,830
76.1%
21
5,770
75.3%
24
6,556
74.8%
21
5,979
78.0%
20
5,067
69.4%
20
6,089
83.4%
20
5,378
73.7%
20
5,503
75.4%
20
5,586
76.5%
21
5,767
75.2%
20
5,830
79.9%
0
0
0.0%
0
0
0.0%
4
955
65.4%
7
1845
72.2%
8
2140
73.3%
12
3324
75.9%
13
3824
80.6
