summary of financial performance quarter ended september 2010 san joaquin general hospital french...
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Summary of Financial PerformanceQuarter Ended September 2010
San Joaquin General HospitalFrench Camp, California
May 31, 2009
San Joaquin General HospitalFrench Camp, California
November 23, 2010
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Dashboard – Volume, Payer Mix
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010Level of Concern
($1,600) ($933) ($955) ($752) ($2,640) ($2,797) ($5,136)
VolumeAverage Daily Census (excl. Nursery) 103.5 99.1 99.8 107.4 102.0 102.3 107.8
Clinic visits 11,363 9,739 9,754 9,717 29,210 32,858 34,443
ER visits 3,687 3,922 3,921 3,779 11,622 10,937 11,185
Outpatient Dialysis visits 1,885 2,015 2,003 2,023 6,041 5,997 5,918
Total surgery volume 302 301 307 300 908 879 900
Number of deliveries 195 219 207 220 646 653 640
Net Operating Income / (Loss) (in thousands)
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Dashboard – Volume, Payer Mix
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010Level of Concern
Payer MixMedicare 15.0% 16.9% 16.7% 16.9% 16.8% 13.6% 15.0%
Medi-Cal 53.8% 46.3% 47.1% 50.4% 47.9% 51.7% 53.8%
Corrections System 1.9% 3.0% 5.2% 4.9% 4.4% 2.0% 1.9%
Indigent and Self Pay 22.7% 27.9% 24.8% 22.4% 25.0% 25.6% 22.7%
Commercial and Other 6.6% 5.9% 6.2% 5.3% 5.8% 7.1% 6.6%
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Dashboard – Revenue
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010Level of Concern
Revenue
Net Patient Revenues (in thousands) $7,159 $8,473 $8,086 $8,072 $24,631 $23,389 $22,519
Net Physician Revenues (in thousands)
$726 $615 $839 $696 $2,150 $2,309 $2,240
Net Patient and Physician Revenues per APD
$1,695 $1,977 $1,926 $1,857 $1,919 $1,935 $1,712
Net Patient and Physician Revenues per APD - for paying patients only
$2,202 $2,741 $2,560 $2,395 $2,560 $2,593 $2,317
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Dashboard – Revenue
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010Level of Concern
Bad Debt (in thousands) $2,630 $3,723 $2,478 $2,361 $8,562 $7,083 $6,924
Bad Debt percentage 36.7% 43.9% 30.6% 29.3% 34.8% 30.3% 30.7%
Charity Write Offs (in thousands) $4,945 $4,989 $5,846 $6,465 $17,299 $18,190 $12,201
Additional Funding
Additional Funding (in thousands) $6,499 $5,879 $5,965 $6,557 $18,401 $17,894 $18,766
One Time Hospital Fee Program (in thousands)
$1,002 $1,002 $1,002 $1,002 $3,007 $0 $3,007
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Dashboard – Expenses
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010
Level of Concern
Salary and Benefits
Total Salary and Benefits (in thousands)
$9,345 $9,355 $9,034 $9,365 $27,753 $28,082 $28,939
Benefits percentage 63.2% 69.9% 59.7% 72.0% 67.1% 66.6% 62.2%
Salary and benefit per APD $2,008 $2,035 $1,949 $1,984 $1,989 $2,115 $2,001
Full Time Equivalents 1,243 1,200 1,157 1,178 1,178 1,177 1,276
FTEs per AOB 8.1 8.1 7.7 7.5 7.8 8.2 8.1
Average Hourly Rate $43.38 $48.72 $48.80 $49.69 $49.07 $49.70 $47.25
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Dashboard – Expenses
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010
Level of Concern
Purchased Services per APD $198 $184 $194 $200 $193 $205 $185
Professional Services per APD $476 $454 $471 $450 $458 $441 $435
MIA Outside Services per APD $37 $31 $33 $36 $34 $39 $37
Supplies per APD $398 $402 $437 $421 $420 $401 $390
Non-wage Expenses
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Dashboard – Cash and Accounts Receivable
IndicatorAverage Month
FY2009-2010July 2010
August 2010
September 2010
YTDYear-to-
Date Budget
Year-to-date FY
2009-2010
Level of Concern
Accounts Receivable
AR, net of contractuals (in thousands) $28,717 $29,609 $29,342 $30,271 $27,992 $28,899
Net Days in AR 111.1 101.0 101.9 103.6 100.2 107.4
Percent of AR over 120 days 33.2% 25.7% 26.7% 28.3% 25.0% 37.0%
CashCash Collected, Total (in thousands)
$8,248 $8,748 $9,491 $7,947 $26,187 $25,129 $25,522
As a Percent of Net Revenue 104.6% 96.3% 106.4% 90.6% 97.8% 97.8% 103.1%
Additional Funding (Cash Total) (in thousands)
$7,738 $2,262 $474 $4,003 $6,740 $11,346 $13,083
11/23/2010ι 9
ADC vs. Non-physician FTEs
Non-physician full time equivalents (FTEs) have declined over the past three fiscal years but have increased slightly in the first quarter due to the higher inpatient census.
1,000
1,050
1,100
1,150
1,200
1,250
1,300
1,350
1,400
1,450
1,500
90.0
100.0
110.0
120.0
130.0
140.0
150.0
160.0
Jul-
08
Au
g-0
8
Se
p-0
8
Oct
-08
No
v-0
8
De
c-0
8
Jan
-09
Fe
b-0
9
Ma
r-0
9
Ap
r-0
9
Ma
y-0
9
Jun
-09
Jul-
09
Au
g-0
9
Se
p-0
9
Oct
-09
No
v-0
9
De
c-0
9
Jan
-10
Fe
b-1
0
Ma
r-1
0
Ap
r-1
0
Ma
y-1
0
Jun
-10
Jul-
10
Au
g-1
0
Se
p-1
0
FT
Es
AD
C
ADC FTE Linear (ADC) Linear (FTE)
ADC
FTEs (non-physician)
FY 08-09 FY 09-10 FY 10-11
11/23/2010ι 10
Monthly Trends
Since April 2010 the average monthly losses have been about $1 million.
$2.3
$0.8
$2.0
$1.8
$2.6
$1.8 $2.0
$1.0
$1.9
$0.6
$1.2 $1.1
$0.9 $1.0
$0.8
$0.0
$0.5
$1.0
$1.5
$2.0
$2.5
$3.0
Mill
ions
Monthly Net Losses for FY 2009-10 and FY 2010-11 (in millions)
Actual Budget Linear (Actual)
11/23/2010ι 11
Important Developments
Federally Qualified Health Center (FQHC) – Currently recruiting Board of Directors and preparing to receive tax-exempt status approval.
Medical Guarded Unit (MGU) – Finalizing budget with CDCR to complete Phase 2 construction.
Medi-Cal 1115 Waiver – CMS approved Waiver on November 2, 2010. Components include: Delivery System Reform Incentive Pool (DSRIP) Low Income Health Program (LIHP) Medi-Cal Managed Care Expansion for SPD Continuation of the SNCP
11/23/2010ι 12
Medi-Cal Section 1115 Waiver
Delivery System Reform Incentive Pool (DSRIP) –Funds based on achievement of milestones over specific time frames.
Low Income Health Program (LIHP) Medicaid Coverage Expansion (MCE) – Adults up to 133% of FPL Health Care Coverage Initiative (HCCI) – Adults between 134% and
200% of FPL Responsibility for out-of-network Emergency Department visits,
non-emergency transportation, mental health benefits County must expend their funds first to draw the new federal funds
1115 Waiver details to be developed over the next 60 days.