hmp metrics™: teaching 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.

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Page 1: HMP Metrics™: Teaching Hospitals October, 2010
Page 2: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 2

Table of Contents

Executive Summary 3 - 5

Financial and Operational Study 6 - 50

• Total Profit Margin 6 - 12• Total Operating Profit Margin 13 - 20• Total Labor Cost as a Percentage of Total Operating Revenues 21 - 26• Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 27 - 33• Days Net Patient Revenue in Accounts Receivable (AR) 34 - 40• Average Age of Plant and Equipment 41 - 50

Introduction to Healthcare Management Partners 51 - 52

Clients Our Professionals Have Served 53 - 54

Firm Leadership 55 - 58

Contact Information 59

Page 3: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 3

Healthcare 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 Sponsorship2. All Investor Owned General Acute Care Hospitals3. All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations4. All State and Local Government Owned General Acute Care Hospitals5. Free Standing Children’s Hospitals6. All Non-Federal Major Teaching Hospitals

Using 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.

Executive Summary – Overview

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Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for all major teaching hospitals within the peer groups.

As 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 those hospitals 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). For example, certain metric values that were greater than two standard deviations from the mean of a reported population would be excluded from the analysis and included in this category.

Executive Summary – Key Terms

Mean Median Count Mean Median Count Mean Median Count1st Quartile 12.03% 11.15% 60 9.77% 8.90% 72 14.24% 13.62% 742nd Quartile 5.65% 5.89% 62 4.03% 4.30% 72 7.74% 7.72% 763rd Quartile 1.54% 1.66% 64 (0.73%) (1.05%) 74 3.14% 3.15% 764th Quartile (7.25%) (5.96%) 64 (9.21%) (8.31%) 75 (3.87%) (2.15%) 78

Total Population 2.83% 3.59% 250 0.85% 1.69% 293 5.20% 5.63% 304Excluded Cost Reports 15 22 13

Total Cost Reports 265 315 317

Total Profit MarginAll Major Teaching Hospitals in the United States Regardless of Bed Size

Quartile Rank2009 2008 2007

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October 2010 5

Executive Summary – Hospital Performance Metrics

Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in the 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, and hospitals where the computed metric is more than 2 standard deviations from the mean.

Total Profit MarginA measure of overall hospital profitability presented as a percentage. A negative percentage indicates an overall loss, while a positive percentage indicates profitability.

Total Operating Profit MarginA measure of operating profitability presented as a percentage. A negative percentage indicates overall loss, while a positive percentage indicates profitability.

Total Labor Cost as a Percentage of Total Operating Revenues

A measure of labor productivity. This metric divides labor costs by operating revenues. A higher percentage compared to its peers indicates that a hospital uses more labor to produce its revenue.

Full-Time Equivalent Staff (FTEs) per Adjusted Occupied Bed (AOB)

Measures the number of full-time equivalent (FTE) employees used for each occupied bed. Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital uses more labor to treat its patients.

Days Net Patient Revenue in Accounts Receivable (AR)

Measures the number of days it typically takes to collect accounts receivable. A higher percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as its peers.

Average Age of Plant and EquipmentMeasures the average age of the hospital including capital improvements and major 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.

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Total Profit Margin - Summary

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 2.21% 1.02% 20 1.13% (1.01%) 22 5.41% 5.62% 23201 to 300 Beds 1.39% 2.73% 30 (1.45%) (0.23%) 36 3.52% 5.20% 36301 to 400 Beds 4.65% 5.42% 34 1.06% 1.15% 42 4.17% 4.76% 45401 to 500 Beds 3.51% 3.31% 47 0.60% 1.87% 49 4.98% 5.01% 51Over 500 Beds 2.50% 3.68% 119 1.41% 3.05% 144 5.95% 5.77% 149

Total All Hospitals 2.83% 3.59% 250 0.85% 1.69% 293 5.20% 5.63% 304Excluded Cost Reports 15 22 13

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 3.02% 2.13% 22 2.72% 1.59% 23 4.53% 3.82% 23201 to 300 Beds 2.97% 2.46% 37 2.98% 2.82% 35 0.27% (1.38%) 36301 to 400 Beds 4.96% 4.71% 48 3.98% 4.16% 45 3.63% 3.40% 45401 to 500 Beds 4.42% 5.01% 50 4.33% 5.50% 51 4.21% 3.34% 50Over 500 Beds 5.63% 5.38% 149 3.83% 4.16% 151 3.24% 3.70% 153

Total All Hospitals 4.82% 5.01% 306 3.75% 4.05% 305 3.20% 3.32% 307Excluded Cost Reports 13 14 12

Total Cost Reports 319 319 319

Total Profit MarginAll Major Teaching Hospitals in the United States Ranked by Number of Licensed Beds

Number of Licensed Beds2009 2008 2007

Number of Licensed Beds2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Profit Margin

Mean Median Count Mean Median Count Mean Median Count1st Quartile 12.52% 11.35% 5 12.88% 12.67% 5 16.50% 17.11% 52nd Quartile 3.84% 3.60% 5 2.98% 2.72% 5 7.91% 7.53% 63rd Quartile (0.44%) 0.02% 5 (1.78%) (1.48%) 6 2.74% 2.81% 64th Quartile (7.09%) (6.89%) 5 (7.30%) (7.90%) 6 (3.65%) (3.48%) 6

Total Population 2.21% 1.02% 20 1.13% (1.01%) 22 5.41% 5.62% 23Excluded Cost Reports 1 1 1

Total Cost Reports 21 23 24

Mean Median Count Mean Median Count Mean Median Count1st Quartile 15.23% 15.29% 5 13.58% 15.69% 5 14.52% 14.86% 52nd Quartile 4.13% 3.44% 5 3.14% 2.90% 6 5.40% 4.45% 63rd Quartile 1.04% 0.94% 6 0.84% 1.18% 6 2.35% 2.19% 64th Quartile (6.10%) (6.17%) 6 (4.87%) (3.61%) 6 (2.48%) (1.55%) 6

Total Population 3.02% 2.13% 22 2.72% 1.59% 23 4.53% 3.82% 23Excluded Cost Reports 3 2 2

Total Cost Reports 25 25 25

Total Profit MarginAll Major Teaching Hospitals in the United States with 200 Licensed Beds or Less

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Profit Margin

Mean Median Count Mean Median Count Mean Median Count1st Quartile 9.44% 7.05% 7 5.90% 4.16% 9 12.48% 12.34% 92nd Quartile 5.26% 5.56% 7 1.51% 1.86% 9 7.72% 7.55% 93rd Quartile 0.70% 0.45% 8 (2.38%) (1.79%) 9 1.15% 1.56% 94th Quartile (8.34%) (9.05%) 8 (10.82%) (11.27%) 9 (7.28%) (7.46%) 9

Total Population 1.39% 2.73% 30 (1.45%) (0.23%) 36 3.52% 5.20% 36Excluded Cost Reports 4 4 3

Total Cost Reports 34 40 39

Mean Median Count Mean Median Count Mean Median Count1st Quartile 11.24% 11.46% 9 12.52% 12.46% 8 9.90% 9.68% 92nd Quartile 7.03% 7.41% 9 6.54% 7.00% 9 2.98% 3.54% 93rd Quartile 1.14% 1.76% 9 0.93% 0.86% 9 (2.46%) (2.19%) 94th Quartile (6.49%) (4.06%) 10 (7.01%) (4.53%) 9 (9.34%) (7.29%) 9

Total Population 2.97% 2.46% 37 2.98% 2.82% 35 0.27% (1.38%) 36Excluded Cost Reports 3 5 4

Total Cost Reports 40 40 40

Total Profit MarginAll Major Teaching Hospitals in the United States with Between 201 and 300 Licensed Beds

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Profit Margin

Mean Median Count Mean Median Count Mean Median Count1st Quartile 15.33% 15.33% 8 10.66% 9.27% 10 13.21% 12.22% 112nd Quartile 7.58% 7.76% 8 4.82% 5.91% 10 7.26% 7.01% 113rd Quartile 3.47% 3.39% 9 (0.79%) (0.37%) 11 1.89% 1.61% 114th Quartile (6.27%) (6.98%) 9 (9.23%) (9.11%) 11 (4.85%) (3.48%) 12

Total Population 4.65% 5.42% 34 1.06% 1.15% 42 4.17% 4.76% 45Excluded Cost Reports 2 5 3

Total Cost Reports 36 47 48

Mean Median Count Mean Median Count Mean Median Count1st Quartile 13.99% 12.50% 12 11.95% 11.18% 11 11.20% 10.87% 112nd Quartile 6.42% 6.16% 12 6.18% 6.06% 11 4.83% 4.57% 113rd Quartile 2.63% 1.92% 12 2.34% 2.66% 11 2.27% 2.38% 114th Quartile (3.21%) (2.28%) 12 (3.83%) (3.06%) 12 (3.16%) (3.20%) 12

Total Population 4.96% 4.71% 48 3.98% 4.16% 45 3.63% 3.40% 45Excluded Cost Reports 0 3 3

Total Cost Reports 48 48 48

Total Profit MarginAll Major Teaching Hospitals in the United States with Between 301 and 400 Licensed Beds

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Profit Margin

Mean Median Count Mean Median Count Mean Median Count1st Quartile 12.30% 11.47% 11 9.00% 8.10% 12 13.89% 13.87% 122nd Quartile 6.26% 6.29% 12 4.08% 4.31% 12 7.52% 7.70% 133rd Quartile 1.93% 2.17% 12 0.23% 0.59% 12 3.24% 3.04% 134th Quartile (5.73%) (4.05%) 12 (10.00%) (9.38%) 13 (4.06%) (1.44%) 13

Total Population 3.51% 3.31% 47 0.60% 1.87% 49 4.98% 5.01% 51Excluded Cost Reports 3 2 1

Total Cost Reports 50 51 52

Mean Median Count Mean Median Count Mean Median Count1st Quartile 13.41% 12.98% 12 11.56% 11.89% 12 11.74% 10.93% 122nd Quartile 7.08% 7.05% 12 6.97% 6.63% 13 7.23% 7.49% 123rd Quartile 2.75% 2.50% 13 3.34% 3.65% 13 2.40% 2.58% 134th Quartile (4.66%) (3.64%) 13 (4.00%) (2.60%) 13 (3.74%) (2.35%) 13

Total Population 4.42% 5.01% 50 4.33% 5.50% 51 4.21% 3.34% 50Excluded Cost Reports 2 1 2

Total Cost Reports 52 52 52

Total Profit MarginAll Major Teaching Hospitals in the United States with Between 401 and 500 Licensed Beds

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Profit Margin

Mean Median Count Mean Median Count Mean Median Count1st Quartile 11.55% 10.64% 29 10.32% 9.14% 36 14.79% 15.33% 372nd Quartile 5.28% 5.26% 30 4.57% 4.68% 36 7.94% 7.87% 373rd Quartile 1.35% 1.35% 30 (0.44%) (0.73%) 36 4.02% 4.07% 374th Quartile (7.88%) (5.96%) 30 (8.83%) (7.70%) 36 (2.72%) (0.05%) 38

Total Population 2.50% 3.68% 119 1.41% 3.05% 144 5.95% 5.77% 149Excluded Cost Reports 5 10 5

Total Cost Reports 124 154 154

Mean Median Count Mean Median Count Mean Median Count1st Quartile 13.31% 12.69% 37 11.22% 10.63% 37 10.72% 9.44% 382nd Quartile 7.09% 7.25% 37 5.83% 5.91% 38 5.71% 5.65% 383rd Quartile 3.80% 3.57% 37 2.22% 2.07% 38 1.78% 1.77% 384th Quartile (1.47%) 0.20% 38 (3.76%) (2.52%) 38 (5.03%) (2.65%) 39

Total Population 5.63% 5.38% 149 3.83% 4.16% 151 3.24% 3.70% 153Excluded Cost Reports 5 3 1

Total Cost Reports 154 154 154

Total Profit MarginAll Major Teaching Hospitals in the United States with Over 500 Licensed Beds

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Profit Margin

Mean Median Count Mean Median Count Mean Median Count1st Quartile 12.03% 11.15% 60 9.77% 8.90% 72 14.24% 13.62% 742nd Quartile 5.65% 5.89% 62 4.03% 4.30% 72 7.74% 7.72% 763rd Quartile 1.54% 1.66% 64 (0.73%) (1.05%) 74 3.14% 3.15% 764th Quartile (7.25%) (5.96%) 64 (9.21%) (8.31%) 75 (3.87%) (2.15%) 78

Total Population 2.83% 3.59% 250 0.85% 1.69% 293 5.20% 5.63% 304Excluded Cost Reports 15 22 13

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count1st Quartile 13.32% 12.47% 75 11.69% 11.18% 73 11.11% 10.55% 752nd Quartile 6.78% 6.93% 75 5.94% 5.97% 77 5.47% 5.53% 763rd Quartile 2.91% 2.94% 77 2.17% 2.05% 77 1.51% 1.92% 774th Quartile (3.25%) (1.79%) 79 (4.27%) (2.89%) 78 (4.83%) (3.61%) 79

Total Population 4.82% 5.01% 306 3.75% 4.05% 305 3.20% 3.32% 307Excluded Cost Reports 13 14 12

Total Cost Reports 319 319 319

Total Profit MarginAll Major Teaching Hospitals in the United States Regardless of Bed Size

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Total Operating Profit Margin - Summary

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less (3.21%) 0.05% 15 (4.41%) (5.70%) 17 (3.66%) (2.89%) 18201 to 300 Beds (1.51%) (0.60%) 25 (0.80%) 0.53% 28 (1.25%) 1.97% 32301 to 400 Beds (0.38%) 1.18% 33 (3.48%) (3.34%) 43 (3.24%) (2.71%) 43401 to 500 Beds (1.95%) (1.18%) 40 (3.46%) (2.56%) 42 (2.97%) (0.93%) 45Over 500 Beds (0.85%) 0.08% 111 (2.63%) (1.91%) 135 (1.59%) (0.81%) 136

Total All Hospitals (1.21%) (0.23%) 224 (2.82%) (2.09%) 265 (2.17%) (1.33%) 274Excluded Cost Reports 41 50 43

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less (0.76%) (1.87%) 18 (2.80%) (1.95%) 19 (4.10%) (4.07%) 18201 to 300 Beds (1.76%) (1.18%) 33 (2.24%) (1.20%) 31 (4.82%) (3.87%) 32301 to 400 Beds (2.37%) (2.45%) 45 (3.94%) (4.70%) 44 (3.75%) (2.77%) 44401 to 500 Beds (2.99%) (1.26%) 45 (2.30%) (0.30%) 44 (2.89%) (0.70%) 46Over 500 Beds (2.08%) (1.00%) 140 (2.87%) (1.58%) 138 (2.77%) (1.74%) 135

Total All Hospitals (2.15%) (1.36%) 281 (2.88%) (1.54%) 276 (3.27%) (1.87%) 275Excluded Cost Reports 38 43 44

Total Cost Reports 319 319 319

Number of Licensed Beds2006 2005 2004

Total Operating Profit MarginAll Major Teaching Hospitals in the United States Ranked by Number of Licensed Beds

Number of Licensed Beds2009 2008 2007

Notes:• 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.

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Peer Group Comparison – Total Operating Profit Margin

All Major Teaching Hospitals in the United States with 200 Licensed Beds or Less

Mean Median Count Mean Median Count Mean Median Count1st Quartile 13.17% 11.58% 3 9.59% 10.04% 4 13.25% 12.69% 42nd Quartile 2.32% 2.67% 4 0.22% 0.90% 4 3.00% 3.05% 43rd Quartile (4.39%) (5.51%) 4 (7.24%) (7.24%) 4 (6.69%) (5.33%) 54th Quartile (19.85%) (21.00%) 4 (17.04%) (16.20%) 5 (19.47%) (17.32%) 5

Total Population (3.21%) 0.05% 15 (4.41%) (5.70%) 17 (3.66%) (2.89%) 18Excluded Cost Reports 6 6 6

Total Cost Reports 21 23 24

Mean Median Count Mean Median Count Mean Median Count1st Quartile 16.29% 16.42% 4 13.82% 14.95% 4 9.24% 9.94% 42nd Quartile 5.50% 5.27% 4 3.56% 3.93% 5 2.77% 2.80% 43rd Quartile (3.97%) (4.34%) 5 (6.04%) (6.67%) 5 (6.84%) (7.34%) 54th Quartile (16.21%) (14.23%) 5 (19.21%) (19.57%) 5 (17.53%) (19.16%) 5

Total Population (0.76%) (1.87%) 18 (2.80%) (1.95%) 19 (4.10%) (4.07%) 18Excluded Cost Reports 7 6 7

Total Cost Reports 25 25 25

Quartile Rank2006 2005 2004

Total Operating Profit Margin

Quartile Rank2009 2008 2007

Notes:• 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.

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Peer Group Comparison – Total Operating Profit Margin

All Major Teaching Hospitals in the United States with Between 201 and 300 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 14.03% 14.65% 6 11.04% 10.09% 7 11.16% 10.46% 82nd Quartile 3.34% 3.21% 6 2.54% 3.07% 7 3.74% 3.70% 83rd Quartile (5.25%) (5.65%) 6 (2.97%) (2.66%) 7 (4.35%) (3.33%) 84th Quartile (15.77%) (15.20%) 7 (13.79%) (12.74%) 7 (15.53%) (15.03%) 8

Total Population (1.51%) (0.60%) 25 (0.80%) 0.53% 28 (1.25%) 1.97% 32Excluded Cost Reports 9 12 7

Total Cost Reports 34 40 39

Mean Median Count Mean Median Count Mean Median Count1st Quartile 11.39% 10.34% 8 11.72% 8.82% 7 8.19% 6.77% 82nd Quartile 1.71% 1.37% 8 1.72% 1.80% 8 (1.60%) (1.76%) 83rd Quartile (4.64%) (4.85%) 8 (4.85%) (3.22%) 8 (8.17%) (8.60%) 84th Quartile (13.99%) (13.58%) 9 (15.81%) (15.47%) 8 (17.72%) (18.37%) 8

Total Population (1.76%) (1.18%) 33 (2.24%) (1.20%) 31 (4.82%) (3.87%) 32Excluded Cost Reports 7 9 8

Total Cost Reports 40 40 40

Total Operating Profit Margin

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Operating Profit Margin

All Major Teaching Hospitals in the United States with Between 301 and 400 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 9.86% 9.18% 8 7.82% 7.27% 10 8.52% 8.15% 102nd Quartile 2.54% 2.81% 8 (0.03%) 0.09% 11 0.02% (1.30%) 113rd Quartile (0.77%) (0.90%) 8 (5.77%) (5.24%) 11 (5.99%) (5.39%) 114th Quartile (11.73%) (12.00%) 9 (14.94%) (12.89%) 11 (14.44%) (12.77%) 11

Total Population (0.38%) 1.18% 33 (3.48%) (3.34%) 43 (3.24%) (2.71%) 43Excluded Cost Reports 3 4 5

Total Cost Reports 36 47 48

Mean Median Count Mean Median Count Mean Median Count1st Quartile 8.53% 7.31% 11 7.99% 6.44% 11 8.49% 5.24% 112nd Quartile 0.12% (0.07%) 11 (1.41%) (1.07%) 11 (0.76%) (0.93%) 113rd Quartile (4.54%) (3.76%) 11 (6.52%) (5.63%) 11 (5.72%) (5.65%) 114th Quartile (12.67%) (9.71%) 12 (15.84%) (15.51%) 11 (16.99%) (17.58%) 11

Total Population (2.37%) (2.45%) 45 (3.94%) (4.70%) 44 (3.75%) (2.77%) 44Excluded Cost Reports 3 4 4

Total Cost Reports 48 48 48

Total Operating Profit Margin

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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Peer Group Comparison – Total Operating Profit Margin

All Major Teaching Hospitals in the United States with Between 401 and 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 7.06% 5.49% 10 6.28% 4.56% 10 6.15% 4.96% 112nd Quartile 0.56% 0.32% 10 0.26% 1.14% 10 0.78% 0.52% 113rd Quartile (4.02%) (4.12%) 10 (4.75%) (4.84%) 11 (3.48%) (3.41%) 114th Quartile (11.41%) (10.67%) 10 (14.42%) (12.46%) 11 (14.31%) (12.28%) 12

Total Population (1.95%) (1.18%) 40 (3.46%) (2.56%) 42 (2.97%) (0.93%) 45Excluded Cost Reports 10 9 7

Total Cost Reports 50 51 52

Mean Median Count Mean Median Count Mean Median Count1st Quartile 7.68% 5.93% 11 7.32% 4.41% 11 7.78% 5.97% 112nd Quartile 1.55% 1.41% 11 1.55% 1.67% 11 0.44% 0.20% 113rd Quartile (4.55%) (4.28%) 11 (2.65%) (1.75%) 11 (2.52%) (1.97%) 124th Quartile (15.50%) (14.99%) 12 (15.43%) (15.83%) 11 (16.09%) (17.58%) 12

Total Population (2.99%) (1.26%) 45 (2.30%) (0.30%) 44 (2.89%) (0.70%) 46Excluded Cost Reports 7 8 6

Total Cost Reports 52 52 52

Total Operating Profit Margin

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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October 2010 18

Peer Group Comparison – Total Operating Profit Margin

All Major Teaching Hospitals in the United States with Over 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 9.58% 9.96% 27 8.14% 6.73% 33 10.39% 9.04% 342nd Quartile 1.98% 1.88% 28 0.66% 0.57% 34 1.39% 1.44% 343rd Quartile (2.76%) (2.59%) 28 (4.88%) (4.97%) 34 (3.84%) (4.04%) 344th Quartile (11.84%) (11.02%) 28 (14.13%) (13.04%) 34 (14.28%) (14.24%) 34

Total Population (0.85%) 0.08% 111 (2.63%) (1.91%) 135 (1.59%) (0.81%) 136Excluded Cost Reports 13 19 18

Total Cost Reports 124 154 154

Mean Median Count Mean Median Count Mean Median Count1st Quartile 8.42% 7.23% 35 7.30% 6.43% 34 6.87% 5.82% 332nd Quartile 0.91% 0.84% 35 0.33% 0.33% 34 0.34% 0.39% 343rd Quartile (3.67%) (3.53%) 35 (4.12%) (4.21%) 35 (3.44%) (3.10%) 344th Quartile (13.96%) (13.86%) 35 (14.63%) (12.77%) 35 (14.59%) (13.37%) 34

Total Population (2.08%) (1.00%) 140 (2.87%) (1.58%) 138 (2.77%) (1.74%) 135Excluded Cost Reports 14 16 19

Total Cost Reports 154 154 154

Quartile Rank2006 2005 2004

Total Operating Profit Margin

Quartile Rank2009 2008 2007

Notes:• 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.

Page 19: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 19

Peer Group Comparison – Total Operating Profit Margin

All Major Teaching Hospitals in the United States Regardless of Bed Size

Mean Median Count Mean Median Count Mean Median Count1st Quartile 9.85% 9.49% 54 8.21% 6.95% 64 9.68% 8.74% 672nd Quartile 1.98% 1.88% 56 0.66% 0.83% 66 1.44% 1.67% 683rd Quartile (3.08%) (2.78%) 56 (4.95%) (4.94%) 67 (4.39%) (4.02%) 694th Quartile (12.77%) (11.70%) 58 (14.49%) (13.04%) 68 (14.82%) (14.17%) 70

Total Population (1.21%) (0.23%) 224 (2.82%) (2.09%) 265 (2.17%) (1.33%) 274Excluded Cost Reports 41 50 43

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count1st Quartile 9.12% 8.33% 69 8.27% 7.05% 67 7.58% 6.04% 672nd Quartile 1.25% 1.07% 69 0.64% 0.33% 69 0.09% 0.17% 683rd Quartile (4.08%) (3.90%) 70 (4.48%) (4.54%) 70 (4.42%) (3.70%) 704th Quartile (14.16%) (13.72%) 73 (15.41%) (15.36%) 70 (15.79%) (16.17%) 70

Total Population (2.15%) (1.36%) 281 (2.88%) (1.54%) 276 (3.27%) (1.87%) 275Excluded Cost Reports 38 43 44

Total Cost Reports 319 319 319

Total Operating Profit Margin

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

Page 20: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 20

Total Labor Cost as a Percentage of Total Operating Revenues - Summary

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 54.55% 56.83% 15 54.26% 56.75% 16 53.60% 52.44% 17201 to 300 Beds 51.54% 52.25% 26 50.93% 49.77% 29 49.14% 48.25% 29301 to 400 Beds 48.04% 48.27% 30 50.86% 50.05% 40 51.83% 52.48% 41401 to 500 Beds 50.91% 48.96% 43 52.57% 52.37% 45 50.90% 50.18% 46Over 500 Beds 49.52% 48.68% 109 50.75% 50.33% 134 50.34% 49.27% 139

Total All Hospitals 50.16% 49.20% 223 51.31% 50.67% 264 50.73% 50.10% 272Excluded Cost Reports 42 51 45

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 51.93% 54.87% 19 49.60% 50.37% 17 52.87% 54.01% 18201 to 300 Beds 49.95% 51.04% 29 51.23% 52.98% 28 51.34% 52.40% 32301 to 400 Beds 51.93% 51.76% 44 52.20% 52.78% 43 52.99% 53.54% 43401 to 500 Beds 50.99% 49.93% 47 50.19% 50.03% 47 50.95% 49.96% 46Over 500 Beds 50.45% 50.13% 139 50.54% 50.42% 138 50.97% 49.94% 135

Total All Hospitals 50.82% 50.24% 278 50.75% 50.53% 273 51.45% 50.99% 274Excluded Cost Reports 41 46 45

Total Cost Reports 319 319 319

Number of Licensed Beds2006 2005 2004

Total Labor Cost as a Percentage of Total Operating RevenuesAll Major Teaching Hospitals in the United States Ranked by Number of Licensed Beds

Number of Licensed Beds2009 2008 2007

Notes:• 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.

Page 21: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 21

Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.

All Major Teaching Hospitals in the United States with 200 Licensed Beds or Less

Mean Median Count Mean Median Count Mean Median Count1st Quartile 42.20% 42.87% 3 45.05% 46.03% 4 43.04% 42.41% 42nd Quartile 53.37% 54.41% 4 53.09% 53.01% 4 51.40% 51.41% 43rd Quartile 57.55% 57.55% 4 58.05% 57.84% 4 56.14% 56.75% 44th Quartile 62.01% 60.48% 4 60.86% 60.41% 4 61.78% 62.06% 5

Total Population 54.55% 56.83% 15 54.26% 56.75% 16 53.60% 52.44% 17Excluded Cost Reports 6 7 7

Total Cost Reports 21 23 24

Mean Median Count Mean Median Count Mean Median Count1st Quartile 35.33% 35.85% 4 35.79% 37.86% 4 37.76% 38.32% 42nd Quartile 48.35% 49.62% 5 46.09% 46.12% 4 50.55% 50.18% 43rd Quartile 56.86% 56.27% 5 54.65% 55.26% 4 55.93% 56.26% 54th Quartile 63.86% 65.04% 5 59.42% 59.87% 5 63.74% 62.66% 5

Total Population 51.93% 54.87% 19 49.60% 50.37% 17 52.87% 54.01% 18Excluded Cost Reports 6 8 7

Total Cost Reports 25 25 25

Quartile Rank2006 2005 2004

Total Labor Cost as a Percentage of Total Operating Revenues

Quartile Rank2009 2008 2007

Notes:• 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.

Page 22: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 22

Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.

All Major Teaching Hospitals in the United States with Between 201 and 300 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 38.82% 38.69% 6 39.70% 42.39% 7 37.55% 40.11% 72nd Quartile 46.43% 45.42% 6 47.09% 46.78% 7 45.18% 45.02% 73rd Quartile 53.60% 54.18% 7 53.23% 53.65% 7 52.70% 54.02% 74th Quartile 64.74% 65.85% 7 62.10% 61.81% 8 59.62% 58.86% 8

Total Population 51.54% 52.25% 26 50.93% 49.77% 29 49.14% 48.25% 29Excluded Cost Reports 8 11 10

Total Cost Reports 34 40 39

Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.34% 36.18% 7 40.32% 42.74% 7 38.67% 37.83% 82nd Quartile 47.42% 47.40% 7 48.60% 47.61% 7 48.65% 49.10% 83rd Quartile 54.11% 54.26% 7 54.05% 54.15% 7 54.51% 53.94% 84th Quartile 60.44% 59.79% 8 61.95% 63.03% 7 63.52% 62.61% 8

Total Population 49.95% 51.04% 29 51.23% 52.98% 28 51.34% 52.40% 32Excluded Cost Reports 11 12 8

Total Cost Reports 40 40 40

Total Labor Cost as a Percentage of Total Operating Revenues

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

Page 23: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 23

Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.

All Major Teaching Hospitals in the United States with Between 301 and 400 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 40.71% 40.88% 7 42.26% 43.01% 10 42.09% 43.04% 102nd Quartile 45.27% 45.03% 7 48.12% 48.17% 10 48.69% 48.62% 103rd Quartile 50.03% 49.85% 8 53.44% 53.69% 10 54.74% 55.30% 104th Quartile 54.87% 55.09% 8 59.62% 59.84% 10 60.90% 58.67% 11

Total Population 48.04% 48.27% 30 50.86% 50.05% 40 51.83% 52.48% 41Excluded Cost Reports 6 7 7

Total Cost Reports 36 47 48

Mean Median Count Mean Median Count Mean Median Count1st Quartile 42.37% 43.00% 11 42.80% 42.44% 10 45.31% 45.83% 102nd Quartile 48.46% 48.01% 11 48.69% 48.10% 11 49.88% 48.94% 113rd Quartile 54.77% 55.02% 11 55.11% 55.17% 11 55.14% 55.64% 114th Quartile 62.12% 61.36% 11 61.36% 59.83% 11 60.92% 58.46% 11

Total Population 51.93% 51.76% 44 52.20% 52.78% 43 52.99% 53.54% 43Excluded Cost Reports 4 5 5

Total Cost Reports 48 48 48

Total Labor Cost as a Percentage of Total Operating Revenues

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

Page 24: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 24

Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.

All Major Teaching Hospitals in the United States with Between 401 and 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 41.59% 42.54% 10 42.92% 43.44% 11 41.45% 41.84% 112nd Quartile 47.45% 47.82% 11 49.06% 48.23% 11 47.62% 47.33% 113rd Quartile 52.76% 53.16% 11 55.40% 55.74% 11 52.84% 53.16% 124th Quartile 61.01% 60.57% 11 62.02% 61.14% 12 60.61% 60.03% 12

Total Population 50.91% 48.96% 43 52.57% 52.37% 45 50.90% 50.18% 46Excluded Cost Reports 7 6 6

Total Cost Reports 50 51 52

Mean Median Count Mean Median Count Mean Median Count1st Quartile 41.97% 42.70% 11 42.66% 43.94% 11 42.33% 42.57% 112nd Quartile 47.83% 48.19% 12 46.86% 47.17% 12 47.75% 48.15% 113rd Quartile 52.37% 52.12% 12 51.74% 52.00% 12 52.30% 52.42% 124th Quartile 61.04% 60.20% 12 58.85% 57.84% 12 60.43% 59.78% 12

Total Population 50.99% 49.93% 47 50.19% 50.03% 47 50.95% 49.96% 46Excluded Cost Reports 5 5 6

Total Cost Reports 52 52 52

Total Labor Cost as a Percentage of Total Operating Revenues

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

Page 25: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 25

Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.

All Major Teaching Hospitals in the United States with Over 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 41.72% 42.35% 27 42.27% 42.96% 33 41.33% 42.04% 342nd Quartile 47.25% 47.27% 27 47.93% 48.28% 33 47.23% 47.07% 353rd Quartile 51.20% 51.48% 27 52.31% 52.03% 34 52.26% 52.66% 354th Quartile 57.62% 57.29% 28 60.14% 58.63% 34 60.28% 58.43% 35

Total Population 49.52% 48.68% 109 50.75% 50.33% 134 50.34% 49.27% 139Excluded Cost Reports 15 20 15

Total Cost Reports 124 154 154

Mean Median Count Mean Median Count Mean Median Count1st Quartile 41.81% 42.36% 34 41.83% 42.29% 34 42.86% 43.68% 332nd Quartile 48.27% 48.44% 35 47.85% 47.79% 34 47.84% 48.22% 343rd Quartile 52.20% 52.04% 35 52.60% 52.49% 35 53.01% 53.32% 344th Quartile 59.26% 57.05% 35 59.55% 58.48% 35 59.94% 58.65% 34

Total Population 50.45% 50.13% 139 50.54% 50.42% 138 50.97% 49.94% 135Excluded Cost Reports 15 16 19

Total Cost Reports 154 154 154

Quartile Rank2006 2005 2004

Total Labor Cost as a Percentage of Total Operating Revenues

Quartile Rank2009 2008 2007

Notes:• 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.

Page 26: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 26

Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.

All Major Teaching Hospitals in the United States Regardless of Bed Size

Mean Median Count Mean Median Count Mean Median Count1st Quartile 41.26% 42.35% 53 42.27% 43.00% 65 41.17% 41.49% 662nd Quartile 47.39% 47.29% 55 48.38% 48.23% 65 47.55% 47.59% 673rd Quartile 52.08% 52.07% 57 53.44% 53.35% 66 53.00% 53.58% 684th Quartile 59.05% 58.01% 58 60.67% 60.09% 68 60.46% 59.10% 71

Total Population 50.16% 49.20% 223 51.31% 50.67% 264 50.73% 50.10% 272Excluded Cost Reports 42 51 45

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count1st Quartile 40.97% 42.20% 67 41.59% 42.54% 66 42.32% 43.55% 662nd Quartile 48.14% 48.25% 70 47.79% 47.62% 68 48.41% 48.54% 683rd Quartile 53.16% 52.83% 70 53.12% 53.13% 69 53.60% 53.80% 704th Quartile 60.46% 59.62% 71 59.94% 59.40% 70 60.86% 59.90% 70

Total Population 50.82% 50.24% 278 50.75% 50.53% 273 51.45% 50.99% 274Excluded Cost Reports 41 46 45

Total Cost Reports 319 319 319

Total Labor Cost as a Percentage of Total Operating Revenues

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

Page 27: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 27

Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB) - Summary

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 5.70 4.97 17 5.69 5.10 17 5.44 5.12 17201 to 300 Beds 5.71 5.54 29 5.71 5.72 31 5.71 5.65 31301 to 400 Beds 5.43 5.10 29 5.41 5.23 40 5.38 5.26 41401 to 500 Beds 5.96 5.87 42 5.95 5.85 44 6.02 5.90 46Over 500 Beds 5.93 5.82 112 5.85 5.78 143 5.75 5.70 143

Total All Hospitals 5.83 5.78 229 5.78 5.72 275 5.71 5.67 278Excluded Cost Reports 36 40 39

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 5.52 5.28 19 5.40 5.05 19 5.24 5.03 19201 to 300 Beds 5.86 5.78 33 5.75 5.61 33 5.71 5.52 34301 to 400 Beds 5.36 5.13 41 5.29 5.10 41 5.41 5.14 42401 to 500 Beds 5.91 6.04 43 6.04 5.99 48 6.01 5.96 47Over 500 Beds 5.81 5.74 143 5.74 5.69 144 5.67 5.65 142

Total All Hospitals 5.75 5.68 279 5.70 5.60 285 5.66 5.58 284Excluded Cost Reports 40 34 35

Total Cost Reports 319 319 319

Number of Licensed Beds2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied BedAll Major Teaching Hospitals in the United States Ranked by Number of Licensed Beds

Number of Licensed Beds2009 2008 2007

Notes:• 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.

Page 28: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 28

Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)

All Major Teaching Hospitals in the United States with 200 Licensed Beds or Less

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.11 4.13 4 4.10 4.12 4 4.01 4.00 42nd Quartile 4.75 4.77 4 4.61 4.57 4 4.35 4.23 43rd Quartile 5.79 5.88 4 5.85 5.92 4 5.66 5.71 44th Quartile 7.66 7.67 5 7.71 7.90 5 7.27 7.43 5

Total Population 5.70 4.97 17 5.69 5.10 17 5.44 5.12 17Excluded Cost Reports 4 6 7

Total Cost Reports 21 23 24

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.00 3.97 4 3.85 3.84 4 3.91 3.91 42nd Quartile 4.58 4.43 5 4.40 4.34 5 4.33 4.22 53rd Quartile 5.85 5.99 5 5.79 5.94 5 5.73 5.83 54th Quartile 7.33 7.35 5 7.25 7.40 5 6.71 6.86 5

Total Population 5.52 5.28 19 5.40 5.05 19 5.24 5.03 19Excluded Cost Reports 6 6 6

Total Cost Reports 25 25 25

Quartile Rank2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed

Quartile Rank2009 2008 2007

Notes:• 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.

Page 29: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 29

Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)

All Major Teaching Hospitals in the United States with Between 201 and 300 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.18 4.10 7 4.22 4.14 7 4.24 4.25 72nd Quartile 5.15 5.24 7 5.16 5.23 8 5.13 5.10 83rd Quartile 6.00 5.86 7 6.18 6.11 8 6.04 5.99 84th Quartile 7.29 7.32 8 7.09 6.96 8 7.23 7.08 8

Total Population 5.71 5.54 29 5.71 5.72 31 5.71 5.65 31Excluded Cost Reports 5 9 8

Total Cost Reports 34 40 39

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.36 4.42 8 4.39 4.56 8 4.21 4.17 82nd Quartile 5.21 5.22 8 5.08 5.09 8 5.06 5.03 83rd Quartile 6.25 6.28 8 6.02 6.02 8 6.02 6.15 94th Quartile 7.44 7.19 9 7.33 7.23 9 7.31 7.14 9

Total Population 5.86 5.78 33 5.75 5.61 33 5.71 5.52 34Excluded Cost Reports 7 7 6

Total Cost Reports 40 40 40

Quartile Rank2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed

Quartile Rank2009 2008 2007

Notes:• 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.

Page 30: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 30

Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)

All Major Teaching Hospitals in the United States with Between 301 and 400 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.41 4.59 7 4.23 4.42 10 4.08 4.19 102nd Quartile 4.96 4.96 7 4.96 4.99 10 4.91 4.92 103rd Quartile 5.44 5.43 7 5.53 5.53 10 5.52 5.42 104th Quartile 6.73 6.59 8 6.93 6.77 10 6.86 6.59 11

Total Population 5.43 5.10 29 5.41 5.23 40 5.38 5.26 41Excluded Cost Reports 7 7 7

Total Cost Reports 36 47 48

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.11 4.27 10 4.05 4.10 10 4.11 4.30 102nd Quartile 4.84 4.83 10 4.82 4.78 10 4.81 4.83 103rd Quartile 5.42 5.39 10 5.37 5.34 10 5.43 5.26 114th Quartile 6.92 6.54 11 6.77 6.48 11 7.11 6.87 11

Total Population 5.36 5.13 41 5.29 5.10 41 5.41 5.14 42Excluded Cost Reports 7 7 6

Total Cost Reports 48 48 48

Quartile Rank2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed

Quartile Rank2009 2008 2007

Notes:• 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.

Page 31: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 31

Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)

All Major Teaching Hospitals in the United States with Between 401 and 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.60 4.75 10 4.53 4.59 11 4.53 4.58 112nd Quartile 5.43 5.46 10 5.48 5.50 11 5.43 5.33 113rd Quartile 6.27 6.41 11 6.32 6.31 11 6.36 6.48 124th Quartile 7.38 7.23 11 7.49 7.37 11 7.61 7.74 12

Total Population 5.96 5.87 42 5.95 5.85 44 6.02 5.90 46Excluded Cost Reports 8 7 6

Total Cost Reports 50 51 52

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.44 4.52 10 4.61 4.69 12 4.64 4.64 112nd Quartile 5.40 5.41 11 5.49 5.41 12 5.34 5.26 123rd Quartile 6.30 6.28 11 6.33 6.28 12 6.31 6.29 124th Quartile 7.36 7.24 11 7.72 7.74 12 7.62 7.49 12

Total Population 5.91 6.04 43 6.04 5.99 48 6.01 5.96 47Excluded Cost Reports 9 4 5

Total Cost Reports 52 52 52

Quartile Rank2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed

Quartile Rank2009 2008 2007

Notes:• 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.

Page 32: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 32

Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)

All Major Teaching Hospitals in the United States with Over 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.80 4.90 28 4.63 4.69 35 4.46 4.64 352nd Quartile 5.63 5.62 28 5.49 5.43 36 5.48 5.49 363rd Quartile 6.13 6.15 28 6.06 6.07 36 5.95 5.92 364th Quartile 7.18 7.11 28 7.18 7.11 36 7.05 6.96 36

Total Population 5.93 5.82 112 5.85 5.78 143 5.75 5.70 143Excluded Cost Reports 12 11 11

Total Cost Reports 124 154 154

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.50 4.61 35 4.49 4.64 36 4.45 4.63 352nd Quartile 5.45 5.49 36 5.42 5.46 36 5.39 5.40 353rd Quartile 6.02 6.03 36 5.97 5.92 36 5.87 5.86 364th Quartile 7.23 7.18 36 7.07 7.04 36 6.90 6.70 36

Total Population 5.81 5.74 143 5.74 5.69 144 5.67 5.65 142Excluded Cost Reports 11 10 12

Total Cost Reports 154 154 154

Quartile Rank2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed

Quartile Rank2009 2008 2007

Notes:• 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.

Page 33: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 33

Peer Group Comparison – Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)

All Major Teaching Hospitals in the United States Regardless of Bed Size

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.59 4.63 56 4.48 4.54 67 4.37 4.48 672nd Quartile 5.39 5.51 56 5.32 5.35 69 5.28 5.33 693rd Quartile 6.03 6.07 57 6.03 6.08 69 5.95 5.92 704th Quartile 7.21 7.14 60 7.22 7.05 70 7.15 7.03 72

Total Population 5.83 5.78 229 5.78 5.72 275 5.71 5.67 278Excluded Cost Reports 36 40 39

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.39 4.51 67 4.40 4.59 70 4.37 4.48 682nd Quartile 5.26 5.34 70 5.24 5.28 71 5.19 5.28 703rd Quartile 5.99 6.05 70 5.94 5.94 71 5.88 5.87 734th Quartile 7.24 7.19 72 7.18 7.11 73 7.09 6.98 73

Total Population 5.75 5.68 279 5.70 5.60 285 5.66 5.58 284Excluded Cost Reports 40 34 35

Total Cost Reports 319 319 319

Quartile Rank2006 2005 2004

Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed

Quartile Rank2009 2008 2007

Notes:• 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.

Page 34: HMP Metrics™: Teaching Hospitals October, 2010

October 2010 34

Days Net Patient Revenue in Accounts Receivable (AR) - Summary

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 49.24 46.24 20 50.71 49.31 22 50.53 49.16 23201 to 300 Beds 50.67 49.27 30 53.66 50.72 35 52.11 50.29 35301 to 400 Beds 45.85 43.98 36 50.84 49.80 45 50.64 50.15 45401 to 500 Beds 52.93 49.64 49 54.97 53.16 50 57.40 55.62 50Over 500 Beds 49.97 49.02 117 52.94 50.70 141 51.65 51.82 142

Total All Hospitals 49.98 48.65 252 52.89 51.56 293 52.44 52.34 295Excluded Cost Reports 13 22 22

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 49.75 46.45 23 50.36 48.34 23 52.32 55.47 23201 to 300 Beds 55.96 50.94 33 54.68 49.59 32 51.50 49.20 33301 to 400 Beds 51.31 51.59 41 51.95 52.06 42 54.36 55.00 42401 to 500 Beds 56.67 57.66 49 57.23 56.93 49 58.33 56.88 49Over 500 Beds 51.82 51.17 141 51.72 51.74 135 54.07 52.91 139

Total All Hospitals 52.88 51.46 287 52.94 51.99 281 54.40 53.81 286Excluded Cost Reports 32 38 33

Total Cost Reports 319 319 319

Number of Licensed Beds2006 2005 2004

Days Patient Revenue in Accounts Receivable (AR)All Major Teaching Hospitals in the United States Ranked by Number of Licensed Beds

Number of Licensed Beds2009 2008 2007

Notes:• 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.

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October 2010 35

Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)

All Major Teaching Hospitals in the United States with 200 Licensed Beds or Less

Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.57 37.37 5 33.39 33.54 5 33.19 36.25 52nd Quartile 43.93 44.47 5 44.55 44.97 5 43.90 45.17 63rd Quartile 49.60 49.98 5 51.74 52.11 6 52.78 51.90 64th Quartile 66.87 60.43 5 69.24 65.00 6 69.36 63.86 6

Total Population 49.24 46.24 20 50.71 49.31 22 50.53 49.16 23Excluded Cost Reports 1 1 1

Total Cost Reports 21 23 24

Mean Median Count Mean Median Count Mean Median Count1st Quartile 30.41 29.41 5 33.33 34.12 5 35.17 36.72 52nd Quartile 41.26 40.03 6 44.40 44.55 6 46.98 46.44 63rd Quartile 50.95 47.91 6 52.98 52.08 6 56.70 56.08 64th Quartile 73.15 67.76 6 67.90 69.20 6 67.55 66.01 6

Total Population 49.75 46.45 23 50.36 48.34 23 52.32 55.47 23Excluded Cost Reports 2 2 2

Total Cost Reports 25 25 25

Quartile Rank2006 2005 2004

Days Patient Revenue in Accounts Receivable (AR)

Quartile Rank2009 2008 2007

Notes:• 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.

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All Major Teaching Hospitals in the United States with Between 201 and 300 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 31.38 31.49 7 31.57 31.37 8 30.82 34.05 82nd Quartile 43.68 43.49 7 45.41 46.46 9 41.74 40.63 93rd Quartile 52.26 50.74 8 55.63 54.64 9 56.98 56.32 94th Quartile 72.08 66.47 8 79.57 78.32 9 76.54 75.64 9

Total Population 50.67 49.27 30 53.66 50.72 35 52.11 50.29 35Excluded Cost Reports 4 5 4

Total Cost Reports 34 40 39

Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.09 37.54 8 31.10 32.36 8 25.28 23.18 82nd Quartile 46.81 46.92 8 43.38 42.88 8 44.55 44.08 83rd Quartile 59.63 60.24 8 57.82 56.09 8 54.54 52.74 84th Quartile 80.28 78.29 9 86.44 85.50 8 78.28 77.95 9

Total Population 55.96 50.94 33 54.68 49.59 32 51.50 49.20 33Excluded Cost Reports 7 8 7

Total Cost Reports 40 40 40

Days Patient Revenue in Accounts Receivable (AR)

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)

Notes:• 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.

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All Major Teaching Hospitals in the United States with Between 301 and 400 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 33.30 34.57 9 34.63 38.09 11 34.88 36.93 112nd Quartile 40.42 40.34 9 43.70 43.35 11 45.16 44.83 113rd Quartile 47.68 47.79 9 54.21 53.30 11 54.21 53.48 114th Quartile 61.99 59.86 9 69.14 66.32 12 66.85 62.21 12

Total Population 45.85 43.98 36 50.84 49.80 45 50.64 50.15 45Excluded Cost Reports 0 2 3

Total Cost Reports 36 47 48

Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.14 38.10 10 34.75 37.30 10 35.82 38.68 102nd Quartile 47.15 47.07 10 46.25 47.08 10 48.49 48.52 103rd Quartile 53.76 53.35 10 54.17 54.45 11 57.90 57.78 114th Quartile 68.48 61.52 11 70.56 64.30 11 73.02 68.10 11

Total Population 51.31 51.59 41 51.95 52.06 42 54.36 55.00 42Excluded Cost Reports 7 6 6

Total Cost Reports 48 48 48

Days Patient Revenue in Accounts Receivable (AR)

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)

Notes:• 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.

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October 2010 38

All Major Teaching Hospitals in the United States with Between 401 and 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 37.98 40.09 12 41.33 42.84 12 39.65 42.41 122nd Quartile 47.39 48.17 12 50.58 51.61 12 51.70 52.43 123rd Quartile 54.41 53.77 12 55.56 55.33 13 59.50 58.34 134th Quartile 70.47 65.71 13 71.03 70.06 13 76.93 74.38 13

Total Population 52.93 49.64 49 54.97 53.16 50 57.40 55.62 50Excluded Cost Reports 1 1 2

Total Cost Reports 50 51 52

Mean Median Count Mean Median Count Mean Median Count1st Quartile 39.01 40.19 12 38.71 39.16 12 41.28 42.52 122nd Quartile 51.64 52.05 12 50.51 50.49 12 51.42 50.61 123rd Quartile 59.66 59.12 12 60.61 60.04 12 62.56 62.17 124th Quartile 74.83 73.49 13 77.42 72.14 13 76.55 76.45 13

Total Population 56.67 57.66 49 57.23 56.93 49 58.33 56.88 49Excluded Cost Reports 3 3 3

Total Cost Reports 52 52 52

Days Patient Revenue in Accounts Receivable (AR)

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)

Notes:• 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.

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All Major Teaching Hospitals in the United States with Over 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.35 37.24 29 36.11 39.70 35 34.02 35.34 352nd Quartile 45.30 45.45 29 47.65 48.37 35 47.80 48.01 353rd Quartile 51.56 51.39 29 55.00 54.60 35 55.24 54.60 364th Quartile 68.03 66.42 30 72.47 66.61 36 68.96 66.41 36

Total Population 49.97 49.02 117 52.94 50.70 141 51.65 51.82 142Excluded Cost Reports 7 13 12

Total Cost Reports 124 154 154

Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.39 35.14 35 36.82 38.96 33 38.65 40.70 342nd Quartile 47.97 48.06 35 47.42 47.32 34 50.06 49.89 353rd Quartile 55.46 56.39 35 54.63 53.97 34 57.00 56.88 354th Quartile 68.96 66.17 36 67.55 64.80 34 70.12 67.81 35

Total Population 51.82 51.17 141 51.72 51.74 135 54.07 52.91 139Excluded Cost Reports 13 19 15

Total Cost Reports 154 154 154

Quartile Rank2006 2005 2004

Days Patient Revenue in Accounts Receivable (AR)

Quartile Rank2009 2008 2007

Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)

Notes:• 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.

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All Major Teaching Hospitals in the United States Regardless of Bed Size

Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.74 36.49 62 36.06 37.63 71 34.69 36.25 712nd Quartile 44.70 44.62 62 47.04 47.25 72 46.97 47.37 733rd Quartile 51.48 50.89 63 54.79 54.26 74 55.84 55.71 754th Quartile 68.09 65.07 65 72.28 67.79 76 70.92 69.42 76

Total Population 49.98 48.65 252 52.89 51.56 293 52.44 52.34 295Excluded Cost Reports 13 22 22

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.83 36.83 70 35.92 37.92 68 36.89 39.46 692nd Quartile 47.78 48.04 71 47.06 46.96 70 49.19 49.44 713rd Quartile 56.02 56.56 71 55.79 55.21 71 57.77 57.64 724th Quartile 71.60 69.53 75 71.92 69.27 72 72.47 70.60 74

Total Population 52.88 51.46 287 52.94 51.99 281 54.40 53.81 286Excluded Cost Reports 32 38 33

Total Cost Reports 319 319 319

Days Patient Revenue in Accounts Receivable (AR)

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)

Notes:• 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.

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Average Age of Plant and Equipment - Summary

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 8.75 8.82 18 8.68 8.98 18 8.86 8.63 18201 to 300 Beds 9.66 9.75 26 9.79 9.74 32 10.05 9.79 32301 to 400 Beds 11.04 10.86 30 10.43 10.28 37 10.48 10.44 37401 to 500 Beds 11.72 10.76 36 11.77 11.22 37 12.05 11.26 37Over 500 Beds 10.64 10.07 98 10.83 10.25 121 10.99 10.26 118

Total All Hospitals 10.60 10.21 208 10.62 10.27 245 10.79 10.21 242Excluded Cost Reports 57 70 75

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count200 Beds or Less 8.98 8.42 18 8.45 8.54 16 7.66 8.45 8201 to 300 Beds 10.23 9.64 29 10.72 9.41 32 8.44 8.13 13301 to 400 Beds 9.86 9.97 36 10.27 10.14 37 10.99 11.05 9401 to 500 Beds 10.91 10.51 39 11.07 10.61 40 9.85 10.45 8Over 500 Beds 10.73 9.65 118 10.53 9.63 119 10.10 9.42 15

Total All Hospitals 10.44 9.66 240 10.47 9.81 244 9.44 9.42 53Excluded Cost Reports 79 75 266

Total Cost Reports 319 319 319

Number of Licensed Beds2006 2005 2004

Average Age of Plant and EquipmentAll Major Teaching Hospitals in the United States Ranked by Number of Licensed Beds

Number of Licensed Beds2009 2008 2007

Notes:• 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.

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October 2010 42

Peer Group Comparison - Average Age of Plant and Equipment

All Major Teaching Hospitals in the United States with 200 Licensed Beds or Less

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.53 5.70 4 3.95 5.15 4 4.68 4.80 42nd Quartile 8.03 8.21 4 7.48 7.68 4 7.18 7.14 43rd Quartile 9.45 9.02 5 9.85 9.82 5 9.37 9.54 54th Quartile 12.00 11.68 5 12.26 12.13 5 13.02 13.04 5

Total Population 8.75 8.82 18 8.68 8.98 18 8.86 8.63 18Excluded Cost Reports 3 5 6

Total Cost Reports 21 23 24

Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.89 5.18 4 4.22 4.64 4 2.08 2.08 22nd Quartile 7.26 7.29 4 7.57 7.30 4 7.09 7.09 23rd Quartile 9.28 9.44 5 9.78 10.06 4 9.72 9.72 24th Quartile 13.33 12.61 5 12.25 12.01 4 11.77 11.77 2

Total Population 8.98 8.42 18 8.45 8.54 16 7.66 8.45 8Excluded Cost Reports 7 9 17

Total Cost Reports 25 25 25

Quartile Rank2006 2005 2004

Average Age of Plant and Equipment

Quartile Rank2009 2008 2007

Notes:• 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.

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Peer Group Comparison - Average Age of Plant and Equipment

All Major Teaching Hospitals in the United States with Between 201 and 300 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 5.15 5.65 6 4.83 5.89 8 5.51 6.35 82nd Quartile 8.63 8.41 6 8.71 8.74 8 8.92 8.87 83rd Quartile 10.59 10.64 7 10.62 10.70 8 10.58 10.59 84th Quartile 13.47 12.75 7 15.02 15.08 8 15.19 15.01 8

Total Population 9.66 9.75 26 9.79 9.74 32 10.05 9.79 32Excluded Cost Reports 8 8 7

Total Cost Reports 34 40 39

Mean Median Count Mean Median Count Mean Median Count1st Quartile 7.42 7.86 7 7.05 7.25 8 5.56 7.22 32nd Quartile 8.86 8.59 7 8.64 8.77 8 7.60 7.45 33rd Quartile 10.31 10.30 7 10.53 10.14 8 8.43 8.56 34th Quartile 13.81 13.91 8 16.67 16.39 8 11.26 11.34 4

Total Population 10.23 9.64 29 10.72 9.41 32 8.44 8.13 13Excluded Cost Reports 11 8 27

Total Cost Reports 40 40 40

Average Age of Plant and Equipment

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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October 2010 44

Peer Group Comparison - Average Age of Plant and Equipment

All Major Teaching Hospitals in the United States with Between 301 and 400 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 6.67 7.24 7 6.04 5.74 9 5.51 6.18 92nd Quartile 9.48 9.47 7 8.94 8.70 9 8.93 8.63 93rd Quartile 11.67 11.16 8 11.09 10.93 9 11.24 11.09 94th Quartile 15.61 14.35 8 15.13 14.16 10 15.68 15.60 10

Total Population 11.04 10.86 30 10.43 10.28 37 10.48 10.44 37Excluded Cost Reports 6 10 11

Total Cost Reports 36 47 48

Mean Median Count Mean Median Count Mean Median Count1st Quartile 5.52 6.50 9 5.08 4.87 9 3.88 3.88 22nd Quartile 8.59 8.78 9 8.99 8.93 9 10.24 10.24 23rd Quartile 11.12 10.98 9 11.17 11.34 9 11.09 11.09 24th Quartile 14.20 13.42 9 15.28 15.49 10 16.16 16.35 3

Total Population 9.86 9.97 36 10.27 10.14 37 10.99 11.05 9Excluded Cost Reports 12 11 39

Total Cost Reports 48 48 48

Average Age of Plant and Equipment

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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October 2010 45

Peer Group Comparison - Average Age of Plant and Equipment

All Major Teaching Hospitals in the United States with Between 401 and 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 6.45 7.53 9 6.06 6.49 9 5.72 6.46 92nd Quartile 9.68 9.73 9 9.96 10.17 9 10.00 10.26 93rd Quartile 12.51 12.58 9 12.84 12.20 9 13.03 13.22 94th Quartile 18.25 18.27 9 17.59 17.29 10 18.71 18.94 10

Total Population 11.72 10.76 36 11.77 11.22 37 12.05 11.26 37Excluded Cost Reports 14 14 15

Total Cost Reports 50 51 52

Mean Median Count Mean Median Count Mean Median Count1st Quartile 5.12 5.84 9 4.98 5.39 10 5.92 5.92 22nd Quartile 8.86 8.83 10 9.56 9.61 10 8.70 8.70 23rd Quartile 11.83 11.66 10 11.81 11.65 10 11.12 11.12 24th Quartile 17.25 17.85 10 17.94 17.94 10 13.66 13.66 2

Total Population 10.91 10.51 39 11.07 10.61 40 9.85 10.45 8Excluded Cost Reports 13 12 44

Total Cost Reports 52 52 52

Average Age of Plant and Equipment

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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October 2010 46

Peer Group Comparison - Average Age of Plant and Equipment

All Major Teaching Hospitals in the United States with Over 500 Licensed Beds

Mean Median Count Mean Median Count Mean Median Count1st Quartile 6.33 6.31 24 6.64 6.98 30 6.49 6.64 292nd Quartile 8.90 8.90 24 9.13 9.27 30 9.24 9.26 293rd Quartile 11.21 11.12 25 11.37 11.16 30 11.69 11.93 304th Quartile 15.89 15.45 25 16.00 16.20 31 16.32 16.13 30

Total Population 10.64 10.07 98 10.83 10.25 121 10.99 10.26 118Excluded Cost Reports 26 33 36

Total Cost Reports 124 154 154

Mean Median Count Mean Median Count Mean Median Count1st Quartile 6.29 6.91 29 6.60 7.01 29 5.45 5.42 32nd Quartile 8.92 9.02 29 8.75 8.71 30 8.88 9.00 43rd Quartile 11.40 11.36 30 11.16 11.03 30 10.60 10.93 44th Quartile 16.10 15.58 30 15.47 14.92 30 14.31 14.25 4

Total Population 10.73 9.65 118 10.53 9.63 119 10.10 9.42 15Excluded Cost Reports 36 35 139

Total Cost Reports 154 154 154

Average Age of Plant and Equipment

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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October 2010 47

Peer Group Comparison - Average Age of Plant and Equipment

All Major Teaching Hospitals in the United States Regardless of Bed Size

Mean Median Count Mean Median Count Mean Median Count1st Quartile 6.11 6.31 50 6.04 6.49 60 5.97 6.46 592nd Quartile 9.02 9.06 50 9.06 8.94 60 9.13 9.15 593rd Quartile 11.25 11.12 54 11.32 11.12 61 11.48 11.46 614th Quartile 15.57 15.22 54 15.70 15.66 64 16.19 15.91 63

Total Population 10.60 10.21 208 10.62 10.27 245 10.79 10.21 242Excluded Cost Reports 57 70 75

Total Cost Reports 265 315 317

Mean Median Count Mean Median Count Mean Median Count1st Quartile 6.03 6.80 58 6.00 6.80 60 4.73 5.18 122nd Quartile 8.74 8.80 59 8.83 8.77 61 8.49 8.15 133rd Quartile 11.13 10.94 61 11.09 11.09 61 10.12 10.85 134th Quartile 15.49 15.08 62 15.78 15.79 62 13.44 12.72 15

Total Population 10.44 9.66 240 10.47 9.81 244 9.44 9.42 53Excluded Cost Reports 79 75 266

Total Cost Reports 319 319 319

Average Age of Plant and Equipment

Quartile Rank2009 2008 2007

Quartile Rank2006 2005 2004

Notes:• 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.

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October 2010 48

Introduction to Healthcare Management PartnersWho We Are

HMP 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 Approach

Our 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

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Introduction to Healthcare Management Partners

Management Services

HMP 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 heartand 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.”

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October 2010

Hospital Contract Management

HMP 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:

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Introduction to Healthcare Management Partners

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 Efficiency

Business Office Consolidation

Service Line Development Resource Utilization and Cost of Quality

Surgical Services Clinical Efficiency

Managed Care Contracting

Capital Planning and Investment Pay for Performance Inpatient Length of Stay and Level of Care

Risk Management and Insurance

Physician Relations Care and Case Management Processes

Human Resources Management Budgeting / Financial Planning

Physician Integration Quality and Safety Indicators Ambulatory Care Capital Programs

Continuum of Care Design and Implementation Strategic Plans

Hospice and Home Care Supply Chain

Corporate and Medical Staff Governance

Mission and Vision Best Practices and Operating Metrics

Financial Reporting and Accounting

We 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.

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October 2010

Turnaround Management

HMP’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.

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Introduction to Healthcare Management Partners

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October 2010

Interim and Crisis Management

HMP 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

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Introduction to Healthcare Management Partners

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October 2010

Clients Our Professionals Have Served

53

Investor Owned Hospitals or Health SystemsAmeris Health Systems Health South Corporation Integrated Healthcare

Holdings, Inc.Shasta Regional Medical Center

Doctors Hospital, Houston Hospital Corporation of America

Lakeside Hospital at Bastrop St. Joseph Hospital, Houston

Doctors Hospital, Los Angeles Hugh Chatham Memorial Hospital

LifePoint Hospitals Tenet Healthcare Corporation

HealthPlus Hughston Hospital and Clinic Monroe Hospital, LLC Vanguard Health Systems

Hospital Partners of America Integra Healthcare Promise Healthcare

Not-For-Profit or Governmental Hospitals or SystemsBaylor College of Medicine Hahnemann University

HospitalNew York United Hospital Medical Center

Southern Chester County Medical Center

The Brooklyn Hospital Center Health Alliance of Cincinnati Nyack Hospital St Vincent’s Catholic Medical Centers, New York

Devereux Foundation National Health Service, United Kingdom

Rahway Hospital Temple Health System

Franciscan Health System Legacy Health System Raritan Bay Health System Tri‐Lakes Medical Center

General Health System Mercy Health System Robert Wood Johnson Health Network

University Hospital Consortium of Pennsylvania

Good Samaritan Hospital Natchez Regional Medical Center

Sisters of Mercy Health System

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Law and Accounting FirmsBird Marella LLP Deloitte Kantrow, Spaht, Weaver & Blitzer Patton Boggs

Bradley Arant Boult Cummings LLP

Gearhiser, Peters, Lockaby, Cavett & Elliott, PLLC

KPMG Ramirez International, Inc.

Brown McCarroll LLP Hogan & Hartson LLP Latham & Watkins Whiteford Taylor Preston, LLP

Fulbright & Jaworski LLP Hooper, Lundy & Bookman Mancuso & Franco PC Schiavetti, Corgan, Soscia, DiEdwards and Nicholson, LLP

Decosimo Jones Day Milbank, Tweed, Hadley and McCloy LLP

Waller Lansden Dortch & Davis

Clients Our Professionals Have Served

Senior Care and/or Continuing Care Retirement CommunitiesGrace Care of Texas Monarch Landing, Inc.

Jenner’s Pond Continuing Care Retirement Community National Senior Campuses (Erickson Retirement Communities)

Life Care Centers of America Sedgebrook, Inc.

Linden Ponds, Inc. St. Edward Mercy Health Systems (Ft. Smith, AR)

Mercy Hospitals of Texas St. Johns Nursing Home (St. Louis, MO)

Other Providers / PayorsBlue Cross of Tennessee Best Choice Home Health Community Behavioral Health

Network of PAColumbia Home Care

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Firm Leadership

Scott PhillipsTitle Managing Director

Education B.S. from University of FloridaCPA

Boards & Organizations American Bankruptcy Institute Healthcare Subcommittee Chair

Telephone 267.207.2929

Mobile 267.804.3885

E-Mail [email protected]

Scott 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.

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Firm Leadership

Michael MorganTitle Managing Director

Education MBA from University of Central OklahomaB.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 [email protected]

Michael 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.

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Firm Leadership

Bruce BuchananTitle Managing Director

Education MBA from George Mason UniversityMHSA from University of MichiganB.A. from Princeton University

Boards & Organizations Fellow of American College of Healthcare Executives

Mobile 602.363.1140

Fax 866.794.9501

E-Mail [email protected]

Bruce 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.

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Firm Leadership

Derek PierceTitle Managing Director

Education B.S. from Samford University

Telephone 205.202.0459

Mobile 615.584.0719

E-Mail [email protected]

Derek 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.

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October 2010

Contact Information

Philadelphia• Contact: Scott Phillips

Managing Director• Address:

One Liberty Place1650 Market Street36th FloorPhiladelphia, PA 19103

• Phone: 267.804.3885• Fax: 215.689.4386

New York• Contact: Nihal Shah

Director• Address:

1185 Avenue of the Americas30th FloorNew York, NY 10036

• Phone: 212.461.4243• Fax: 212.461.4252

Houston• Contact: Mike Morgan

Managing Director• Address:

5100 WestheimerSuite 200Houston, TX 77056

• Phone: 713.968.6521• Fax: 866.422.6176

Birmingham• Contact: Derek Pierce

Managing Director• Address:

2001 Park Place, Suite 1400Birmingham, AL 35203

• Phone: 205.202.0459• Fax: 615.523.1835

Phoenix• Contact: Bruce Buchanan

Managing Director• Address:

243 E. Glenn DrivePhoenix, AZ 85020

• Mobile: 602.363.1140 • Fax: 866.794.9501

London, UK• Contact: Tim Bolot

Managing Director• Address:

Bolt Partners LLP 192 Haverstock Hill,Belsize Park,London NW3 2AJ

• Phone: +44 (0)20 7435 7349

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