Flex Monitoring Team Data Summary Report No. 18:

CAH Financial Indicators Report: Summary of Indicator Medians

by State

March 2016

The Flex Monitoring Team is a consortium of the Rural Health Research Centers located at the Universities of Minnesota, North Carolina at Chapel Hill, and Southern Maine. Under contract with the federal Office of Rural Health Policy (PHS Grant No. U27RH01080), the Flex Monitoring Team is cooperatively conducting a performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program). The monitoring project is assessing the impact of the Flex Program on rural hospitals and communities and the role of states in achieving overall program objectives, including improving access to and the quality of health care services; improving the financial performance of Critical Access Hospitals; and engaging rural communities in health care system development.

The authors of this report are the CAH Financial Indicators Report Team at the North Carolina Rural Health Research and Policy Analysis Center, Cecil G. Sheps Center for Health Services Research. Email: CAH.finance@schsr.unc.edu

Flex Monitoring Team http://www.flexmonitoring.org

University of Minnesota Division of Health Services Research & Policy 420 Delaware Street, SE, Mayo Mail Code 729

Minneapolis, MN 55455-0392 612.624.8618

University of North Carolina at Chapel Hill Cecil B. Sheps Center for Health Services Research 725 Martin Luther King, Jr. Boulevard, CB #7590

Chapel Hill, NC 27599-7590 919.966.5541

University of Southern Maine Muskie School of Public Service

PO Box 9300 Portland, ME 04104-9300

207.780.4435

© 2010, University of North Carolina at Chapel Hill, for use in the public domain.

1

The Medicare Rural Hospital Flexibility Program

The Medicare Rural Hospital Flexibility Program (Flex Program), created by Congress in 1997, allows small hospitals to be licensed as Critical Access Hospitals (CAHs) and offers grants to States to help implement initiatives to strengthen the rural health care infrastructure. To participate in the Flex Program, States are required to develop a rural health care plan that provides for the creation of one or more rural health networks, promotes regionalization of rural health services in the State, and improves the quality of and access to hospital and other health services for rural residents of the State. Consistent with their rural health care plans, states may designate eligible rural hospitals as CAHs.

CAHs must be located in a rural area or an area treated as rural; be more than 35 miles (or 15 miles in areas with mountainous terrain or only secondary roads available) from another hospital, or be certified before January 1, 2006 by the State as being a necessary provider of heath care services. CAHs are required to make available 24-hour emergency care services that a State determines are necessary. CAHs may have a maximum of 25 acute care and swing beds, and must maintain an annual average length of stay of 96 hours or less for their acute care patients. CAHs are reimbursed by Medicare on a cost basis (i.e., for the reasonable costs of providing inpatient, outpatient, and swing bed services).

The legislative authority for the Flex Program and cost-based reimbursement for CAHs are described in the Social Security Act, Title XVIII, Sections 1814 and 1820, available at http://www.ssa.gov/OP_Home/ssact/title18/1800.htm.

2

Introduction

All hospitals, regardless of size and organizational structure, benefit from comparative data on financial condition and performance. The unique reimbursement and organizational structure of critical access hospitals (CAHs) make it important to have financial indicators that capture their own circumstances for performance assessment. CAHs differ from urban and other rural hospitals that are paid under the Medicare Prospective Payment System (PPS) in important aspects that affect the most appropriate way to measure financial condition. Unlike PPS hospitals, CAHs receive cost-based reimbursement for inpatient and outpatient care, and the incentives, financial management, and utilization practices under these two payment methods differ substantially. There are also organizational differences between CAHs and other hospitals that may affect financial performance; for instance, CAHs have relaxed staffing rules under Medicare, and they have limits on bed-size and average length of stay (and low volume hospitals have been found to face substantially more annual variation in demand for services, making financial planning difficult).

This Briefing Paper presents state and national median values of the twenty-two financial indicators included in the CAH Financial Indicators Report, a report that is distributed to each CAH administrator annually. As part of ongoing work of the Flex Monitoring Team, these indicators were specifically designed to capture the financial performance of CAHs. In order to identify the indicators that were most relevant to the financial performance of CAHs, a Technical Advisory Group (TAG) of four individuals knowledgeable in CAH financial and operational issues, data, and reporting practices was selected to provide advice to a research team from the University of North Carolina at Chapel Hill. The TAG evaluated frequently used indicators of hospital financial performance for their applicability to CAHs.1 Their evaluation relied on three criteria: feasibility (whether the indicator can be accurately calculated from Medicare cost report data2), importance (whether the indicator is an important measure of the financial management of CAHs), and usefulness (whether the indicator is useful to CAH administrators). The TAG retained 13 of the most frequently used indicators from the review. In addition, 7 other financial ratios were added that are not commonly used in the financial assessment of larger hospitals, but that group members believed capture important attributes of CAH financial management. Two more have been added since.

The resulting 22 indicators fall under six domains: profitability, liquidity, capital structure, revenue, cost, and utilization. In the pages that follow, a brief description of the domains and the indicators within them is provided, along with a table that allows comparison across states. The Appendix to this report includes the median values for each indicator by state, enabling the values for all indicators for one state to be viewed on a single page. More detailed information about the definition and interpretation of the indicators can be found in the document “Briefing Paper No. 7. Financial Indicators for Critical Access Hospitals May 2005” which can be downloaded from the Flex Monitoring Team website:

http://www.flexmonitoring.org/publications/bp7/

1 The list of potential indicators resulted from a review of financial ratios in articles, peer-reviewed journals, and other industry and scientific publications. 2 Medicare cost reports were selected as the data source for calculating indicator values because they are the only national data that use standard definitions, have sufficient detail, and will eventually include data for all CAHs.

3

The following table includes, by state, the total number of Critical Access Hospitals with a Medicare Cost Report for at least 360 days in period, the minimum required to be included in the calculation of medians. The number of CAHs for a particular indicator may be less than the number in the table if there were unusable data for one or more CAHs in the state.

State 2013 Number of CAHs

State 2013 Number of CAHs

AK 9 NC 20AL 3 ND 34AR 29 NE 64AZ 11 NH 13CA 29 NM 7CO 29 NV 11FL 13 NY 13GA 28 OH 33HI 9 OK 33IA 82 OR 25ID 25 PA 12IL 50 SC 5IN 35 SD 37KS 82 TN 15KY 27 TX 78LA 26 UT 11MA 3 VA 7ME 15 VT 8MI 35 WA 38MN 75 WI 51MO 34 WV 19MS 31 WY 16MT 45

*Median values calculated ONLY for states with post-conversion Medicare Cost Report data for at least 2critical access hospitals in 2013

4

Profitability Indicators

Profitability is the net result of a large number of reimbursement and managerial policies and decisions and it reflects the combined effects of liquidity, asset management, and debt on operating results. Profitability indicators measure the ability to generate the financial return required to replace assets, meet increases in service demands, and compensate investors (in the case of a for-profit organization).

Total Margin measures the control of expenses relative to revenues.

Total margin formula: Net income Total revenue

Cash Flow Margin measures the ability to generate cash flow from providing patient care services.

Cash flow margin formula:

Net income – (Contributions, investments, and appropriations +

Depreciation expense + Interest expense) Net patient revenue + Other income –

Contributions, investments, and appropriations

Return on Equity measures the net income generated by equity investment (net assets).

Return on equity formula: Net income Net assets

Operating margin measures the control of operating expenses relative to operating revenues.

Operating margin formula: Net operating income Operating revenue

State Total

Margin Cash Flow

Margin Return on

Equity Operating

Margin

% % % %

US 2.51 6.72 5.16 0.99 AK 8.20 10.47 10.81 6.65 AL -5.67 -7.55 -18.95 -13.22AR -0.22 6.09 2.27 -1.39AZ 4.62 6.68 10.78 1.84 CA 2.33 4.23 5.27 1.15 CO 2.13 2.73 4.03 -2.47FL -2.30 2.00 -1.53 -3.40GA 0.89 0.90 12.46 -4.09HI 1.61 -19.27 0.80 -24.19IA 2.97 8.82 3.82 1.21 ID 2.66 6.88 6.14 -0.02IL 3.85 9.37 6.15 2.78 IN 3.28 9.62 9.64 4.99 KS -0.90 -3.94 -3.09 -7.90KY -0.51 2.98 5.07 -2.65LA 2.81 6.43 5.82 2.11 MA 5.70 9.09 3.72 2.65 ME 1.55 4.56 3.72 0.21 MI 2.93 7.51 6.66 2.90 MN 3.20 8.93 5.41 2.87 MO 2.31 8.99 5.48 0.62 MS -0.93 1.53 -3.24 -3.47MT 4.06 3.74 7.96 -3.40NC 1.62 6.51 4.00 1.63 ND -0.03 5.59 0.67 -0.80NE 3.84 11.05 4.75 2.59 NH 3.10 9.18 5.45 2.75 NM 1.48 7.88 2.11 4.88 NV 4.34 8.06 11.69 3.21 NY 2.17 5.61 11.35 -1.85OH 4.55 9.49 8.27 4.10 OK 1.31 4.26 5.01 -2.41OR 3.88 5.39 5.76 0.89 PA 4.85 11.76 16.88 3.39 SC -4.32 -4.10 -6.37 -7.55SD 2.98 8.79 5.16 2.98 TN 0.50 6.23 16.42 0.50 TX 4.57 7.51 11.04 3.52 UT 5.35 13.16 6.82 4.85

VA 9.13 1.56 23.54 -2.73

VT 4.82 7.81 9.59 3.23

WA 0.82 3.87 2.71 -0.85

WI 4.93 10.09 5.91 3.71 WV 1.73 5.36 7.19 1.22 WY 6.79 8.27 7.18 0.70

5

Liquidity Indicators

A liquid asset is one that trades in an active market and hence can be quickly converted to cash at the going market price. An analysis of liquidity asks the question “will the organization be able to pay off its debts as they come due over the next year or so?” Liquidity indicators measure the ability to meet cash obligations in a timely manner.

Current Ratio measures the number of times short-term obligations can be paid using short-term assets.

Current ratio formula: Current assets Current liabilities

Days Cash on Hand measures the number of days an organization could operate if no cash was collected or received.

Days cash on hand formula:

Cash + Marketable securities + Unrestricted investments

(Total expenses – Depreciation) / Days in period

Days Revenue in Accounts Receivable measures the number of days that it takes an organization to collect its receivables.

Days revenue in accounts receivable formula:

Net patient accounts receivable (Net patient service revenue) / Days in period

State Current

Ratio

Days Cash on

Hand

Days Revenue in Accounts

Receivable

Times Days Days US 2.29 68.83 54.20

AK 3.17 37.94 88.42

AL 0.98 28.70 90.36

AR 1.50 11.13 57.33

AZ 2.21 20.55 51.95

CA 2.12 67.82 59.54

CO 3.19 93.70 53.64

FL 1.49 17.07 45.39

GA 2.27 29.15 50.54

HI 2.13 12.15 77.24

IA 2.41 128.89 49.32

ID 2.76 88.43 58.70

IL 2.50 112.82 59.08

IN 2.12 54.58 50.03

KS 2.11 47.21 57.93

KY 1.47 27.67 60.05

LA 4.15 91.98 60.52

MA 1.00 157.45 43.53

ME 1.25 59.72 40.45

MI 1.78 68.61 47.52

MN 2.78 133.79 54.45

MO 2.08 79.11 51.18

MS 1.37 14.18 56.38

MT 2.61 85.97 63.37

NC 1.73 39.53 53.48

ND 2.07 62.92 55.47

NE 3.23 139.84 56.94

NH 1.55 171.55 46.90

NM 3.79 101.45 57.53

NV 2.34 66.02 70.33

NY 1.52 75.28 44.53

OH 2.02 47.46 47.90

OK 2.14 21.58 58.02

OR 2.75 68.92 59.11

PA 1.44 48.68 52.89

SC 1.58 41.08 59.56

SD 2.37 43.59 49.35

TN 1.53 14.22 50.07

TX 2.69 65.33 57.99

UT 4.30 114.17 52.82

VA 2.18 98.34 45.64

VT 1.29 122.99 50.34

WA 2.55 54.97 55.57

WI 2.86 121.25 52.48

WV 1.42 29.13 52.97

WY 3.89 106.89 57.94

6

Capital Structure Indicators

The extent to which an organization uses debt financing, or financial leverage, has three important implications. First, debt allows not-for-profit organizations to provide more services than it could if it were financed only by contributed capital and retained earnings. Second, creditors look to the equity to provide a margin of safety, so the higher the proportion of total capital provided by the owners, the less the risk faced by creditors. Third, if the organization earns more on investments financed with borrowed funds than it pays in interest, the return on owner’s capital is magnified, or leveraged up. Capital structure indicators measure the extent of debt and equity financing.

Equity Financing measures the percentage of total assets financed by equity.

Equity financing formula: Net assets Total assets

Debt Service Coverage measures the ability to pay obligations related to long-term debt, principal payments and interest expense.

Debt service coverage formula:

Net income + Depreciation exp. + Interest exp. Current portion of long-term debt *

(365 / Days in period) + Interest expense

Long-Term Debt to Capitalization measures the percentage of total capital that is debt.

Long-term debt to capitalization formula:

Long-term debt Long-term debt + Net assets

State Equity

Financing

Debt Service

Coverage

Long-term Debt to

Capitalization

% Times % US 60.32 2.73 26.16AK 80.22 11.66 4.72AL 37.92 -15.14 3.83AR 59.98 2.84 24.58AZ 60.25 4.56 19.59CA 53.99 2.27 34.43CO 55.76 2.71 35.49FL 30.23 1.11 50.58GA 51.67 2.21 35.28HI 77.24 0.24 6.89IA 59.62 3.67 29.66ID 64.34 5.17 16.37IL 55.39 3.38 30.51IN 68.87 6.43 23.49KS 61.32 1.27 20.71KY 37.76 1.06 46.90LA 67.33 9.54 16.77MA 51.76 13.35 32.44ME 55.34 5.56 32.32MI 64.43 1.94 22.69MN 62.20 3.09 29.48MO 62.20 2.54 28.86MS 53.39 2.05 18.94MT 64.51 3.02 20.92NC 62.56 3.39 27.78ND 58.24 2.12 28.99NE 64.90 2.81 26.43NH 54.29 4.20 35.57NM 88.30 0.24 0.00NV 77.08 2.83 9.42NY 47.97 4.13 38.46OH 70.11 2.26 14.95OK 58.97 1.54 10.78OR 48.42 3.65 37.49PA 31.11 3.38 65.04SC 41.14 0.15 39.23SD 61.02 2.55 27.78TN 41.43 3.54 53.31TX 73.42 1.95 9.55UT 88.03 2.07 1.72VA 72.34 -0.55 3.74VT 55.66 6.48 33.97WA 52.69 2.42 36.25WI 63.62 3.77 29.00WV 44.53 2.59 30.86WY 82.19 5.87 8.27

7

Revenue Indicators

Most organizations receive revenues from many sources and relative profitability often varies among sources. A substantial proportion of revenue from commercial and private payers reduces reliance on the fixed margins of Medicare and Medicaid. Revenue indicators measure the amount and mix of different sources of revenue.

Outpatient Revenues to Total Revenues measures the percentage of total revenues that are for outpatient revenues (including, for example, Rural Health Clinics, free-standing clinics, and home health clinics).

Outpatient revenues to total revenues formula: Total outpatient revenue Total patient revenue

Patient Deductions measures the allowances and discounts per dollar of total patient revenues.

Patient deductions formula: Contractual allowances and discounts Gross total patient revenue

Medicare Inpatient Payer Mix measures the percentage of total inpatient days that are provided to Medicare patients.

Medicare inpatient payer mix formula:

Medicare inpatient days Total inpatient days – Nursery bed days – NF Swing bed days

Hospital Medicare Outpatient Payer Mix measures the percentage of total outpatient charges that are for Medicare patients.

Medicare outpatient payer mix formula: Outpatient Medicare charges Total outpatient charges

Hospital Medicare Outpatient Cost to Charge measures outpatient Medicare costs per dollar of outpatient Medicare charges.

Medicare outpatient cost to charge formula: Outpatient Medicare costs Outpatient Medicare charges

Medicare Acute Inpatient Cost per Day measures the measures the average daily cost of a Medicare acute inpatient.

Medicare revenue per day formula: Medicare acute inpatient cost Medicare inpatient days (excl HMO)

8

State

Outpatient Revenues to

Total Revenues Patient

Deductions

Medicare Inpatient

Payer Mix

Medicare Outpatient Payer Mix

Medicare Outpatient

Cost to ChargeMedicare

Revenue per Day

% % % % % $ US 74.43 39.92 73.01 37.90 0.47 2305AK 56.24 15.34 60.75 32.33 0.74 3975AL 67.55 52.02 91.81 39.32 0.42 1251AR 69.07 49.70 69.91 40.63 0.48 1510AZ 80.10 55.75 46.18 22.58 0.37 2331CA 64.83 50.62 57.90 38.89 0.38 3769CO 74.99 35.46 78.52 40.12 0.51 2794FL 72.10 69.77 66.63 32.05 0.26 1422GA 67.25 50.23 65.65 29.51 0.38 1460HI 55.33 38.22 36.72 12.14 0.76 2430IA 79.67 34.54 77.67 43.69 0.52 2273ID 68.04 33.46 65.46 34.94 0.56 2698IL 81.34 51.02 78.85 41.66 0.37 2079IN 80.82 56.08 64.80 32.33 0.33 2363KS 69.92 29.54 86.99 47.67 0.57 1963KY 77.44 60.42 70.40 34.31 0.33 1458LA 73.34 50.41 68.42 32.75 0.44 1921MA 82.61 49.37 70.36 31.92 0.38 2299ME 76.23 40.06 69.41 41.86 0.49 2420MI 83.36 43.56 61.98 36.63 0.42 2609MN 73.69 33.00 65.43 36.70 0.50 2873MO 77.78 47.74 77.40 41.81 0.39 2086MS 66.60 37.77 87.87 40.28 0.47 1565MT 64.91 21.65 74.17 38.93 0.57 2303NC 74.73 53.30 68.82 42.67 0.36 1944ND 67.72 22.69 87.70 43.47 0.61 1705NE 73.54 22.89 81.25 48.27 0.57 2655NH 79.82 44.34 77.37 38.41 0.43 3065NM 70.29 48.69 58.33 32.06 0.37 2639NV 76.08 42.78 57.13 38.28 0.39 3732NY 73.81 48.35 79.66 28.52 0.44 2116OH 79.27 52.60 58.83 27.50 0.36 2528OK 71.05 43.49 83.45 39.04 0.50 1879OR 75.69 40.53 53.78 37.64 0.52 3572PA 73.07 54.30 63.66 31.45 0.33 1593SC 78.17 49.07 58.55 28.15 0.40 1989SD 70.21 28.74 87.07 48.27 0.53 1925TN 84.44 65.19 70.45 28.41 0.31 1810TX 76.38 51.32 73.77 33.15 0.48 2219UT 72.45 34.05 56.78 26.29 0.51 2507VA 76.69 62.15 78.41 38.93 0.31 1842VT 74.12 45.36 64.22 35.30 0.43 2474WA 75.04 41.93 71.61 36.36 0.50 3361WI 77.03 41.38 64.86 30.66 0.45 2722WV 78.40 42.35 68.81 32.49 0.45 1564WY 66.90 26.70 67.27 40.19 0.60 2793

9

Cost Indicators

Most organizations incur labor, supply, and capital costs. Cost management reduces the likelihood of financial problems due to low productivity, poor inventory management, and excessive asset acquisition costs. Cost indicators measure the amount and mix of different types of costs.

Salaries to Net Patient Revenue measures the percentage of patient revenue that are labor costs.

Salaries to patient revenue formula:

Salary Expense Net Patient Revenue

Average Age of Plant measures the average age in years of the fixed assets of an organization.

Average age of plant formula:

Accumulated depreciation Depreciation expense * (365 / Days in period)

FTEs per Adjusted Occupied Bed measures the number of full-time employees per each occupied bed.

FTEs per adjusted occupied bed formula:

Number of FTEs Adjusted occupied beds1

1. (Inpatient days – NF Swing days –Nursery days) * (Total patient revenue /(Total inpatient revenue – Inpatient NFrevenue – Other LTC Revenue)) / Days inperiod

Average Salary per FTE measures the price and mix of labor.

Salary Expense Number of FTEs

State

Salaries to Net

Patient Revenue

Average Age of Plant

FTEs per Adjusted Occupied

Bed

Average Salary per

FTE

% Years FTEs Dollars

US 45.57 9.77 5.86 50,845 AK 46.63 10.44 12.76 57,940 AL 46.49 13.02 3.25 41,405 AR 47.06 9.18 4.96 42,014 AZ 47.42 10.11 6.07 57,096 CA 41.52 11.13 10.34 59,647 CO 48.93 8.16 7.85 54,854 FL 51.97 6.02 4.31 53,287GA 45.87 12.90 6.35 43,677 HI 63.76 13.80 6.40 58,104IA 42.31 8.78 5.27 49,728ID 47.52 9.30 9.43 54,168IL 40.07 9.06 4.86 48,370IN 39.99 7.94 5.22 53,834KS 52.62 10.46 5.90 45,342 KY 43.57 7.38 4.16 46,360 LA 53.72 9.02 4.82 46,999 MA 46.71 9.31 3.66 84,274 ME 49.49 12.31 6.32 63,577 MI 43.60 14.37 5.85 56,424MN 42.15 10.46 7.30 56,193 MO 42.26 7.90 4.88 49,220 MS 43.49 4.45 4.99 48,200 MT 53.17 12.75 10.15 48,179 NC 41.03 10.61 5.39 50,537 ND 49.58 12.38 6.29 45,696 NE 46.00 7.34 6.62 50,738 NH 43.12 11.29 6.24 63,981 NM 41.90 5.78 5.82 59,572 NV 38.81 10.60 7.52 61,524 NY 53.76 10.58 3.99 47,212 OH 37.94 10.84 5.41 51,989 OK 44.06 7.42 4.76 47,215 OR 46.14 9.16 7.27 73,082 PA 42.76 12.28 6.34 48,854 SC 48.76 23.03 5.20 50,315SD 47.95 10.39 5.72 48,350 TN 46.18 7.38 3.40 46,380 TX 49.88 9.33 4.84 44,496 UT 38.22 11.79 5.31 58,654 VA 36.52 8.09 3.70 57,973 VT 49.10 9.44 7.08 69,924 WA 50.47 11.77 6.72 65,970 WI 39.61 10.46 6.40 61,089 WV 46.61 10.08 5.47 46,283 WY 49.43 10.09 11.91 55,828

10

Utilization Indicators

Overhead costs are incurred on all assets, whether used or not. More patient activity generates higher revenues and reduces unit costs by spreading fixed costs over more patients. Utilization indicators measure the extent to which fixed assets (beds) are fully occupied.

Average Daily Census Swing-SNF Beds measures the average number of swing-SNF beds occupied per day.

Average daily census swing-SNF beds formula:

Inpatient swing bed SNF days Days in period

Average Daily Census Acute Beds measures the average number of acute care beds occupied per day.

Average daily census acute beds formula:

Inpatient acute care bed days Days in period

State Swing-SNF

Beds Acute Beds

Days Days US 1.52 3.22AK 0.86 1.23AL 4.77 1.52AR 1.38 5.82AZ 0.60 3.44CA 0.37 5.57CO 1.42 1.98FL 0.64 5.31GA 1.98 3.01HI 0.59 0.05IA 1.99 2.99ID 0.78 2.76IL 1.65 4.49IN 1.03 6.85KS 2.02 1.78KY 2.29 6.05LA 2.17 4.01MA 1.47 8.70ME 2.58 7.81MI 0.05 4.29MN 1.11 2.63MO 2.18 4.32MS 4.66 3.25MT 1.34 1.24NC 1.51 5.92ND 1.57 1.28NE 1.53 2.04NH 3.87 7.67NM 0.54 5.36NV 0.44 5.16NY 2.87 2.02OH 1.93 6.63OK 1.59 2.01OR 0.74 6.38PA 1.51 6.70SC 2.56 2.89SD 1.66 1.42TN 1.96 3.03TX 1.49 2.27UT 1.53 2.45VA 2.94 4.96VT 0.77 11.63WA 1.11 2.94 WI 1.16 4.68WV 1.67 3.51 WY 0.98 3.50

11

Appendix

2013 Median indicator values by state

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Alabama and the United StatesCAH Financial Indicators Report

Issue 12Indicator AL US

Total Margin -5.67 2.51

Cash Flow Margin -7.55 6.72

Return on Equity -18.95 5.16

Operating Margin -13.22 0.99

Current Ratio 0.98 2.29

Days Cash on Hand 28.70 68.83

Net Days Revenue in Accounts Receivable 90.36 54.20

Equity Financing 37.92 60.32

Debt Service Coverage -15.14 2.73

Long-Term Debt to Capitalization 3.83 26.16

Outpatient Revenues to Total Revenues 67.55 74.43

Patient Deductions 52.02 39.92

Medicare Inpatient Payer Mix 91.81 73.01

Medicare Outpatient Payer Mix 39.32 37.90

Medicare Outpatient Cost to Charge 0.42 0.47

Medicare Revenue per Day 1251 2305

Salaries to Net Patient Revenue 46.49 45.57

Average Age of Plant 13.02 9.77

FTEs per Adjusted Occupied Bed 3.25 5.86

Average Salary per FTE 41405 50845

Average Daily Census Swing-SNF Beds 4.77 1.52

Average Daily Census Acute Beds 1.52 3.22

Number of Included CAHs 3 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Alaska and the United StatesCAH Financial Indicators Report

Issue 12Indicator AK US

Total Margin 8.20 2.51

Cash Flow Margin 10.47 6.72

Return on Equity 10.81 5.16

Operating Margin 6.65 0.99

Current Ratio 3.17 2.29

Days Cash on Hand 37.94 68.83

Net Days Revenue in Accounts Receivable 88.42 54.20

Equity Financing 80.22 60.32

Debt Service Coverage 11.66 2.73

Long-Term Debt to Capitalization 4.72 26.16

Outpatient Revenues to Total Revenues 56.24 74.43

Patient Deductions 15.34 39.92

Medicare Inpatient Payer Mix 60.75 73.01

Medicare Outpatient Payer Mix 32.33 37.90

Medicare Outpatient Cost to Charge 0.74 0.47

Medicare Revenue per Day 3975 2305

Salaries to Net Patient Revenue 46.63 45.57

Average Age of Plant 10.44 9.77

FTEs per Adjusted Occupied Bed 12.76 5.86

Average Salary per FTE 57940 50845

Average Daily Census Swing-SNF Beds 0.86 1.52

Average Daily Census Acute Beds 1.23 3.22

Number of Included CAHs 9 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Arizona and the United StatesCAH Financial Indicators Report

Issue 12Indicator AZ US

Total Margin 4.62 2.51

Cash Flow Margin 6.68 6.72

Return on Equity 10.78 5.16

Operating Margin 1.84 0.99

Current Ratio 2.21 2.29

Days Cash on Hand 20.55 68.83

Net Days Revenue in Accounts Receivable 51.95 54.20

Equity Financing 60.25 60.32

Debt Service Coverage 4.56 2.73

Long-Term Debt to Capitalization 19.59 26.16

Outpatient Revenues to Total Revenues 80.10 74.43

Patient Deductions 55.75 39.92

Medicare Inpatient Payer Mix 46.18 73.01

Medicare Outpatient Payer Mix 22.58 37.90

Medicare Outpatient Cost to Charge 0.37 0.47

Medicare Revenue per Day 2331 2305

Salaries to Net Patient Revenue 47.42 45.57

Average Age of Plant 10.11 9.77

FTEs per Adjusted Occupied Bed 6.07 5.86

Average Salary per FTE 57096 50845

Average Daily Census Swing-SNF Beds 0.60 1.52

Average Daily Census Acute Beds 3.44 3.22

Number of Included CAHs 11 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Arkansas and the United StatesCAH Financial Indicators Report

Issue 12Indicator AR US

Total Margin -0.22 2.51

Cash Flow Margin 6.09 6.72

Return on Equity 2.27 5.16

Operating Margin -1.39 0.99

Current Ratio 1.50 2.29

Days Cash on Hand 11.13 68.83

Net Days Revenue in Accounts Receivable 57.33 54.20

Equity Financing 59.98 60.32

Debt Service Coverage 2.84 2.73

Long-Term Debt to Capitalization 24.58 26.16

Outpatient Revenues to Total Revenues 69.07 74.43

Patient Deductions 49.70 39.92

Medicare Inpatient Payer Mix 69.91 73.01

Medicare Outpatient Payer Mix 40.63 37.90

Medicare Outpatient Cost to Charge 0.48 0.47

Medicare Revenue per Day 1510 2305

Salaries to Net Patient Revenue 47.06 45.57

Average Age of Plant 9.18 9.77

FTEs per Adjusted Occupied Bed 4.96 5.86

Average Salary per FTE 42014 50845

Average Daily Census Swing-SNF Beds 1.38 1.52

Average Daily Census Acute Beds 5.82 3.22

Number of Included CAHs 29 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for California and the United StatesCAH Financial Indicators Report

Issue 12Indicator CA US

Total Margin 2.33 2.51

Cash Flow Margin 4.23 6.72

Return on Equity 5.27 5.16

Operating Margin 1.15 0.99

Current Ratio 2.12 2.29

Days Cash on Hand 67.82 68.83

Net Days Revenue in Accounts Receivable 59.54 54.20

Equity Financing 53.99 60.32

Debt Service Coverage 2.27 2.73

Long-Term Debt to Capitalization 34.43 26.16

Outpatient Revenues to Total Revenues 64.83 74.43

Patient Deductions 50.62 39.92

Medicare Inpatient Payer Mix 57.90 73.01

Medicare Outpatient Payer Mix 38.89 37.90

Medicare Outpatient Cost to Charge 0.38 0.47

Medicare Revenue per Day 3769 2305

Salaries to Net Patient Revenue 41.52 45.57

Average Age of Plant 11.13 9.77

FTEs per Adjusted Occupied Bed 10.34 5.86

Average Salary per FTE 59647 50845

Average Daily Census Swing-SNF Beds 0.37 1.52

Average Daily Census Acute Beds 5.57 3.22

Number of Included CAHs 29 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Colorado and the United StatesCAH Financial Indicators Report

Issue 12Indicator CO US

Total Margin 2.13 2.51

Cash Flow Margin 2.73 6.72

Return on Equity 4.03 5.16

Operating Margin -2.47 0.99

Current Ratio 3.19 2.29

Days Cash on Hand 93.70 68.83

Net Days Revenue in Accounts Receivable 53.64 54.20

Equity Financing 55.76 60.32

Debt Service Coverage 2.71 2.73

Long-Term Debt to Capitalization 35.49 26.16

Outpatient Revenues to Total Revenues 74.99 74.43

Patient Deductions 35.46 39.92

Medicare Inpatient Payer Mix 78.52 73.01

Medicare Outpatient Payer Mix 40.12 37.90

Medicare Outpatient Cost to Charge 0.51 0.47

Medicare Revenue per Day 2794 2305

Salaries to Net Patient Revenue 48.93 45.57

Average Age of Plant 8.16 9.77

FTEs per Adjusted Occupied Bed 7.85 5.86

Average Salary per FTE 54854 50845

Average Daily Census Swing-SNF Beds 1.42 1.52

Average Daily Census Acute Beds 1.98 3.22

Number of Included CAHs 29 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Florida and the United StatesCAH Financial Indicators Report

Issue 12Indicator FL US

Total Margin -2.30 2.51

Cash Flow Margin 2.00 6.72

Return on Equity -1.53 5.16

Operating Margin -3.40 0.99

Current Ratio 1.49 2.29

Days Cash on Hand 17.07 68.83

Net Days Revenue in Accounts Receivable 45.39 54.20

Equity Financing 30.23 60.32

Debt Service Coverage 1.11 2.73

Long-Term Debt to Capitalization 50.58 26.16

Outpatient Revenues to Total Revenues 72.10 74.43

Patient Deductions 69.77 39.92

Medicare Inpatient Payer Mix 66.63 73.01

Medicare Outpatient Payer Mix 32.05 37.90

Medicare Outpatient Cost to Charge 0.26 0.47

Medicare Revenue per Day 1422 2305

Salaries to Net Patient Revenue 51.97 45.57

Average Age of Plant 6.02 9.77

FTEs per Adjusted Occupied Bed 4.31 5.86

Average Salary per FTE 53287 50845

Average Daily Census Swing-SNF Beds 0.64 1.52

Average Daily Census Acute Beds 5.31 3.22

Number of Included CAHs 13 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Georgia and the United StatesCAH Financial Indicators Report

Issue 12Indicator GA US

Total Margin 0.89 2.51

Cash Flow Margin 0.90 6.72

Return on Equity 12.46 5.16

Operating Margin -4.09 0.99

Current Ratio 2.27 2.29

Days Cash on Hand 29.15 68.83

Net Days Revenue in Accounts Receivable 50.54 54.20

Equity Financing 51.67 60.32

Debt Service Coverage 2.21 2.73

Long-Term Debt to Capitalization 35.28 26.16

Outpatient Revenues to Total Revenues 67.25 74.43

Patient Deductions 50.23 39.92

Medicare Inpatient Payer Mix 65.65 73.01

Medicare Outpatient Payer Mix 29.51 37.90

Medicare Outpatient Cost to Charge 0.38 0.47

Medicare Revenue per Day 1460 2305

Salaries to Net Patient Revenue 45.87 45.57

Average Age of Plant 12.90 9.77

FTEs per Adjusted Occupied Bed 6.35 5.86

Average Salary per FTE 43677 50845

Average Daily Census Swing-SNF Beds 1.98 1.52

Average Daily Census Acute Beds 3.01 3.22

Number of Included CAHs 28 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Hawaii and the United StatesCAH Financial Indicators Report

Issue 12Indicator HI US

Total Margin 1.61 2.51

Cash Flow Margin -19.27 6.72

Return on Equity 0.80 5.16

Operating Margin -24.19 0.99

Current Ratio 2.13 2.29

Days Cash on Hand 12.15 68.83

Net Days Revenue in Accounts Receivable 77.24 54.20

Equity Financing 77.24 60.32

Debt Service Coverage 0.24 2.73

Long-Term Debt to Capitalization 6.89 26.16

Outpatient Revenues to Total Revenues 55.33 74.43

Patient Deductions 38.22 39.92

Medicare Inpatient Payer Mix 36.72 73.01

Medicare Outpatient Payer Mix 12.14 37.90

Medicare Outpatient Cost to Charge 0.76 0.47

Medicare Revenue per Day 2430 2305

Salaries to Net Patient Revenue 63.76 45.57

Average Age of Plant 13.80 9.77

FTEs per Adjusted Occupied Bed 6.40 5.86

Average Salary per FTE 58104 50845

Average Daily Census Swing-SNF Beds 0.59 1.52

Average Daily Census Acute Beds 0.05 3.22

Number of Included CAHs 9 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Idaho and the United StatesCAH Financial Indicators Report

Issue 12Indicator ID US

Total Margin 2.66 2.51

Cash Flow Margin 6.88 6.72

Return on Equity 6.14 5.16

Operating Margin -0.02 0.99

Current Ratio 2.76 2.29

Days Cash on Hand 88.43 68.83

Net Days Revenue in Accounts Receivable 58.70 54.20

Equity Financing 64.34 60.32

Debt Service Coverage 5.17 2.73

Long-Term Debt to Capitalization 16.37 26.16

Outpatient Revenues to Total Revenues 68.04 74.43

Patient Deductions 33.46 39.92

Medicare Inpatient Payer Mix 65.46 73.01

Medicare Outpatient Payer Mix 34.94 37.90

Medicare Outpatient Cost to Charge 0.56 0.47

Medicare Revenue per Day 2698 2305

Salaries to Net Patient Revenue 47.52 45.57

Average Age of Plant 9.30 9.77

FTEs per Adjusted Occupied Bed 9.43 5.86

Average Salary per FTE 54168 50845

Average Daily Census Swing-SNF Beds 0.78 1.52

Average Daily Census Acute Beds 2.76 3.22

Number of Included CAHs 25 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Illinois and the United StatesCAH Financial Indicators Report

Issue 12Indicator IL US

Total Margin 3.85 2.51

Cash Flow Margin 9.37 6.72

Return on Equity 6.15 5.16

Operating Margin 2.78 0.99

Current Ratio 2.50 2.29

Days Cash on Hand 112.82 68.83

Net Days Revenue in Accounts Receivable 59.08 54.20

Equity Financing 55.39 60.32

Debt Service Coverage 3.38 2.73

Long-Term Debt to Capitalization 30.51 26.16

Outpatient Revenues to Total Revenues 81.34 74.43

Patient Deductions 51.02 39.92

Medicare Inpatient Payer Mix 78.85 73.01

Medicare Outpatient Payer Mix 41.66 37.90

Medicare Outpatient Cost to Charge 0.37 0.47

Medicare Revenue per Day 2079 2305

Salaries to Net Patient Revenue 40.07 45.57

Average Age of Plant 9.06 9.77

FTEs per Adjusted Occupied Bed 4.86 5.86

Average Salary per FTE 48370 50845

Average Daily Census Swing-SNF Beds 1.65 1.52

Average Daily Census Acute Beds 4.49 3.22

Number of Included CAHs 50 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Indiana and the United StatesCAH Financial Indicators Report

Issue 12Indicator IN US

Total Margin 3.28 2.51

Cash Flow Margin 9.62 6.72

Return on Equity 9.64 5.16

Operating Margin 4.99 0.99

Current Ratio 2.12 2.29

Days Cash on Hand 54.58 68.83

Net Days Revenue in Accounts Receivable 50.03 54.20

Equity Financing 68.87 60.32

Debt Service Coverage 6.43 2.73

Long-Term Debt to Capitalization 23.49 26.16

Outpatient Revenues to Total Revenues 80.82 74.43

Patient Deductions 56.08 39.92

Medicare Inpatient Payer Mix 64.80 73.01

Medicare Outpatient Payer Mix 32.33 37.90

Medicare Outpatient Cost to Charge 0.33 0.47

Medicare Revenue per Day 2363 2305

Salaries to Net Patient Revenue 39.99 45.57

Average Age of Plant 7.94 9.77

FTEs per Adjusted Occupied Bed 5.22 5.86

Average Salary per FTE 53834 50845

Average Daily Census Swing-SNF Beds 1.03 1.52

Average Daily Census Acute Beds 6.85 3.22

Number of Included CAHs 35 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Iowa and the United StatesCAH Financial Indicators Report

Issue 12Indicator IA US

Total Margin 2.97 2.51

Cash Flow Margin 8.82 6.72

Return on Equity 3.82 5.16

Operating Margin 1.21 0.99

Current Ratio 2.41 2.29

Days Cash on Hand 128.89 68.83

Net Days Revenue in Accounts Receivable 49.32 54.20

Equity Financing 59.62 60.32

Debt Service Coverage 3.67 2.73

Long-Term Debt to Capitalization 29.66 26.16

Outpatient Revenues to Total Revenues 79.67 74.43

Patient Deductions 34.54 39.92

Medicare Inpatient Payer Mix 77.67 73.01

Medicare Outpatient Payer Mix 43.69 37.90

Medicare Outpatient Cost to Charge 0.52 0.47

Medicare Revenue per Day 2273 2305

Salaries to Net Patient Revenue 42.31 45.57

Average Age of Plant 8.78 9.77

FTEs per Adjusted Occupied Bed 5.27 5.86

Average Salary per FTE 49728 50845

Average Daily Census Swing-SNF Beds 1.99 1.52

Average Daily Census Acute Beds 2.99 3.22

Number of Included CAHs 82 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Kansas and the United StatesCAH Financial Indicators Report

Issue 12Indicator KS US

Total Margin -0.90 2.51

Cash Flow Margin -3.94 6.72

Return on Equity -3.09 5.16

Operating Margin -7.90 0.99

Current Ratio 2.11 2.29

Days Cash on Hand 47.21 68.83

Net Days Revenue in Accounts Receivable 57.93 54.20

Equity Financing 61.32 60.32

Debt Service Coverage 1.27 2.73

Long-Term Debt to Capitalization 20.71 26.16

Outpatient Revenues to Total Revenues 69.92 74.43

Patient Deductions 29.54 39.92

Medicare Inpatient Payer Mix 86.99 73.01

Medicare Outpatient Payer Mix 47.67 37.90

Medicare Outpatient Cost to Charge 0.57 0.47

Medicare Revenue per Day 1963 2305

Salaries to Net Patient Revenue 52.62 45.57

Average Age of Plant 10.46 9.77

FTEs per Adjusted Occupied Bed 5.90 5.86

Average Salary per FTE 45342 50845

Average Daily Census Swing-SNF Beds 2.02 1.52

Average Daily Census Acute Beds 1.78 3.22

Number of Included CAHs 82 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Kentucky and the United StatesCAH Financial Indicators Report

Issue 12Indicator KY US

Total Margin -0.51 2.51

Cash Flow Margin 2.98 6.72

Return on Equity 5.07 5.16

Operating Margin -2.65 0.99

Current Ratio 1.47 2.29

Days Cash on Hand 27.67 68.83

Net Days Revenue in Accounts Receivable 60.05 54.20

Equity Financing 37.76 60.32

Debt Service Coverage 1.06 2.73

Long-Term Debt to Capitalization 46.90 26.16

Outpatient Revenues to Total Revenues 77.44 74.43

Patient Deductions 60.42 39.92

Medicare Inpatient Payer Mix 70.40 73.01

Medicare Outpatient Payer Mix 34.31 37.90

Medicare Outpatient Cost to Charge 0.33 0.47

Medicare Revenue per Day 1458 2305

Salaries to Net Patient Revenue 43.57 45.57

Average Age of Plant 7.38 9.77

FTEs per Adjusted Occupied Bed 4.16 5.86

Average Salary per FTE 46360 50845

Average Daily Census Swing-SNF Beds 2.29 1.52

Average Daily Census Acute Beds 6.05 3.22

Number of Included CAHs 27 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Louisiana and the United StatesCAH Financial Indicators Report

Issue 12Indicator LA US

Total Margin 2.81 2.51

Cash Flow Margin 6.43 6.72

Return on Equity 5.82 5.16

Operating Margin 2.11 0.99

Current Ratio 4.15 2.29

Days Cash on Hand 91.98 68.83

Net Days Revenue in Accounts Receivable 60.52 54.20

Equity Financing 67.33 60.32

Debt Service Coverage 9.54 2.73

Long-Term Debt to Capitalization 16.77 26.16

Outpatient Revenues to Total Revenues 73.34 74.43

Patient Deductions 50.41 39.92

Medicare Inpatient Payer Mix 68.42 73.01

Medicare Outpatient Payer Mix 32.75 37.90

Medicare Outpatient Cost to Charge 0.44 0.47

Medicare Revenue per Day 1921 2305

Salaries to Net Patient Revenue 53.72 45.57

Average Age of Plant 9.02 9.77

FTEs per Adjusted Occupied Bed 4.82 5.86

Average Salary per FTE 46999 50845

Average Daily Census Swing-SNF Beds 2.17 1.52

Average Daily Census Acute Beds 4.01 3.22

Number of Included CAHs 26 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Maine and the United StatesCAH Financial Indicators Report

Issue 12Indicator ME US

Total Margin 1.55 2.51

Cash Flow Margin 4.56 6.72

Return on Equity 3.72 5.16

Operating Margin 0.21 0.99

Current Ratio 1.25 2.29

Days Cash on Hand 59.72 68.83

Net Days Revenue in Accounts Receivable 40.45 54.20

Equity Financing 55.34 60.32

Debt Service Coverage 5.56 2.73

Long-Term Debt to Capitalization 32.32 26.16

Outpatient Revenues to Total Revenues 76.23 74.43

Patient Deductions 40.06 39.92

Medicare Inpatient Payer Mix 69.41 73.01

Medicare Outpatient Payer Mix 41.86 37.90

Medicare Outpatient Cost to Charge 0.49 0.47

Medicare Revenue per Day 2420 2305

Salaries to Net Patient Revenue 49.49 45.57

Average Age of Plant 12.31 9.77

FTEs per Adjusted Occupied Bed 6.32 5.86

Average Salary per FTE 63577 50845

Average Daily Census Swing-SNF Beds 2.58 1.52

Average Daily Census Acute Beds 7.81 3.22

Number of Included CAHs 15 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Massachusetts and the United StatesCAH Financial Indicators Report

Issue 12Indicator MA US

Total Margin 5.70 2.51

Cash Flow Margin 9.09 6.72

Return on Equity 3.72 5.16

Operating Margin 2.65 0.99

Current Ratio 1.00 2.29

Days Cash on Hand 157.45 68.83

Net Days Revenue in Accounts Receivable 43.53 54.20

Equity Financing 51.76 60.32

Debt Service Coverage 13.35 2.73

Long-Term Debt to Capitalization 32.44 26.16

Outpatient Revenues to Total Revenues 82.61 74.43

Patient Deductions 49.37 39.92

Medicare Inpatient Payer Mix 70.36 73.01

Medicare Outpatient Payer Mix 31.92 37.90

Medicare Outpatient Cost to Charge 0.38 0.47

Medicare Revenue per Day 2299 2305

Salaries to Net Patient Revenue 46.71 45.57

Average Age of Plant 9.31 9.77

FTEs per Adjusted Occupied Bed 3.66 5.86

Average Salary per FTE 84274 50845

Average Daily Census Swing-SNF Beds 1.47 1.52

Average Daily Census Acute Beds 8.70 3.22

Number of Included CAHs 3 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Michigan and the United StatesCAH Financial Indicators Report

Issue 12Indicator MI US

Total Margin 2.93 2.51

Cash Flow Margin 7.51 6.72

Return on Equity 6.66 5.16

Operating Margin 2.90 0.99

Current Ratio 1.78 2.29

Days Cash on Hand 68.61 68.83

Net Days Revenue in Accounts Receivable 47.52 54.20

Equity Financing 64.43 60.32

Debt Service Coverage 1.94 2.73

Long-Term Debt to Capitalization 22.69 26.16

Outpatient Revenues to Total Revenues 83.36 74.43

Patient Deductions 43.56 39.92

Medicare Inpatient Payer Mix 61.98 73.01

Medicare Outpatient Payer Mix 36.63 37.90

Medicare Outpatient Cost to Charge 0.42 0.47

Medicare Revenue per Day 2609 2305

Salaries to Net Patient Revenue 43.60 45.57

Average Age of Plant 14.37 9.77

FTEs per Adjusted Occupied Bed 5.85 5.86

Average Salary per FTE 56424 50845

Average Daily Census Swing-SNF Beds 0.05 1.52

Average Daily Census Acute Beds 4.29 3.22

Number of Included CAHs 35 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Minnesota and the United StatesCAH Financial Indicators Report

Issue 12Indicator MN US

Total Margin 3.20 2.51

Cash Flow Margin 8.93 6.72

Return on Equity 5.41 5.16

Operating Margin 2.87 0.99

Current Ratio 2.78 2.29

Days Cash on Hand 133.79 68.83

Net Days Revenue in Accounts Receivable 54.45 54.20

Equity Financing 62.20 60.32

Debt Service Coverage 3.09 2.73

Long-Term Debt to Capitalization 29.48 26.16

Outpatient Revenues to Total Revenues 73.69 74.43

Patient Deductions 33.00 39.92

Medicare Inpatient Payer Mix 65.43 73.01

Medicare Outpatient Payer Mix 36.70 37.90

Medicare Outpatient Cost to Charge 0.50 0.47

Medicare Revenue per Day 2873 2305

Salaries to Net Patient Revenue 42.15 45.57

Average Age of Plant 10.46 9.77

FTEs per Adjusted Occupied Bed 7.30 5.86

Average Salary per FTE 56193 50845

Average Daily Census Swing-SNF Beds 1.11 1.52

Average Daily Census Acute Beds 2.63 3.22

Number of Included CAHs 75 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Mississippi and the United StatesCAH Financial Indicators Report

Issue 12Indicator MS US

Total Margin -0.93 2.51

Cash Flow Margin 1.53 6.72

Return on Equity -3.24 5.16

Operating Margin -3.47 0.99

Current Ratio 1.37 2.29

Days Cash on Hand 14.18 68.83

Net Days Revenue in Accounts Receivable 56.38 54.20

Equity Financing 53.39 60.32

Debt Service Coverage 2.05 2.73

Long-Term Debt to Capitalization 18.94 26.16

Outpatient Revenues to Total Revenues 66.60 74.43

Patient Deductions 37.77 39.92

Medicare Inpatient Payer Mix 87.87 73.01

Medicare Outpatient Payer Mix 40.28 37.90

Medicare Outpatient Cost to Charge 0.47 0.47

Medicare Revenue per Day 1565 2305

Salaries to Net Patient Revenue 43.49 45.57

Average Age of Plant 4.45 9.77

FTEs per Adjusted Occupied Bed 4.99 5.86

Average Salary per FTE 48200 50845

Average Daily Census Swing-SNF Beds 4.66 1.52

Average Daily Census Acute Beds 3.25 3.22

Number of Included CAHs 31 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Missouri and the United StatesCAH Financial Indicators Report

Issue 12Indicator MO US

Total Margin 2.31 2.51

Cash Flow Margin 8.99 6.72

Return on Equity 5.48 5.16

Operating Margin 0.62 0.99

Current Ratio 2.08 2.29

Days Cash on Hand 79.11 68.83

Net Days Revenue in Accounts Receivable 51.18 54.20

Equity Financing 62.20 60.32

Debt Service Coverage 2.54 2.73

Long-Term Debt to Capitalization 28.86 26.16

Outpatient Revenues to Total Revenues 77.78 74.43

Patient Deductions 47.74 39.92

Medicare Inpatient Payer Mix 77.40 73.01

Medicare Outpatient Payer Mix 41.81 37.90

Medicare Outpatient Cost to Charge 0.39 0.47

Medicare Revenue per Day 2086 2305

Salaries to Net Patient Revenue 42.26 45.57

Average Age of Plant 7.90 9.77

FTEs per Adjusted Occupied Bed 4.88 5.86

Average Salary per FTE 49220 50845

Average Daily Census Swing-SNF Beds 2.18 1.52

Average Daily Census Acute Beds 4.32 3.22

Number of Included CAHs 34 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Montana and the United StatesCAH Financial Indicators Report

Issue 12Indicator MT US

Total Margin 4.06 2.51

Cash Flow Margin 3.74 6.72

Return on Equity 7.96 5.16

Operating Margin -3.40 0.99

Current Ratio 2.61 2.29

Days Cash on Hand 85.97 68.83

Net Days Revenue in Accounts Receivable 63.37 54.20

Equity Financing 64.51 60.32

Debt Service Coverage 3.02 2.73

Long-Term Debt to Capitalization 20.92 26.16

Outpatient Revenues to Total Revenues 64.91 74.43

Patient Deductions 21.65 39.92

Medicare Inpatient Payer Mix 74.17 73.01

Medicare Outpatient Payer Mix 38.93 37.90

Medicare Outpatient Cost to Charge 0.57 0.47

Medicare Revenue per Day 2303 2305

Salaries to Net Patient Revenue 53.17 45.57

Average Age of Plant 12.75 9.77

FTEs per Adjusted Occupied Bed 10.15 5.86

Average Salary per FTE 48179 50845

Average Daily Census Swing-SNF Beds 1.34 1.52

Average Daily Census Acute Beds 1.24 3.22

Number of Included CAHs 45 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Nebraska and the United StatesCAH Financial Indicators Report

Issue 12Indicator NE US

Total Margin 3.84 2.51

Cash Flow Margin 11.05 6.72

Return on Equity 4.75 5.16

Operating Margin 2.59 0.99

Current Ratio 3.23 2.29

Days Cash on Hand 139.84 68.83

Net Days Revenue in Accounts Receivable 56.94 54.20

Equity Financing 64.90 60.32

Debt Service Coverage 2.81 2.73

Long-Term Debt to Capitalization 26.43 26.16

Outpatient Revenues to Total Revenues 73.54 74.43

Patient Deductions 22.89 39.92

Medicare Inpatient Payer Mix 81.25 73.01

Medicare Outpatient Payer Mix 48.27 37.90

Medicare Outpatient Cost to Charge 0.57 0.47

Medicare Revenue per Day 2655 2305

Salaries to Net Patient Revenue 46.00 45.57

Average Age of Plant 7.34 9.77

FTEs per Adjusted Occupied Bed 6.62 5.86

Average Salary per FTE 50738 50845

Average Daily Census Swing-SNF Beds 1.53 1.52

Average Daily Census Acute Beds 2.04 3.22

Number of Included CAHs 64 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Nevada and the United StatesCAH Financial Indicators Report

Issue 12Indicator NV US

Total Margin 4.34 2.51

Cash Flow Margin 8.06 6.72

Return on Equity 11.69 5.16

Operating Margin 3.21 0.99

Current Ratio 2.34 2.29

Days Cash on Hand 66.02 68.83

Net Days Revenue in Accounts Receivable 70.33 54.20

Equity Financing 77.08 60.32

Debt Service Coverage 2.83 2.73

Long-Term Debt to Capitalization 9.42 26.16

Outpatient Revenues to Total Revenues 76.08 74.43

Patient Deductions 42.78 39.92

Medicare Inpatient Payer Mix 57.13 73.01

Medicare Outpatient Payer Mix 38.28 37.90

Medicare Outpatient Cost to Charge 0.39 0.47

Medicare Revenue per Day 3732 2305

Salaries to Net Patient Revenue 38.81 45.57

Average Age of Plant 10.60 9.77

FTEs per Adjusted Occupied Bed 7.52 5.86

Average Salary per FTE 61524 50845

Average Daily Census Swing-SNF Beds 0.44 1.52

Average Daily Census Acute Beds 5.16 3.22

Number of Included CAHs 11 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for New Hampshire and the United StatesCAH Financial Indicators Report

Issue 12Indicator NH US

Total Margin 3.10 2.51

Cash Flow Margin 9.18 6.72

Return on Equity 5.45 5.16

Operating Margin 2.75 0.99

Current Ratio 1.55 2.29

Days Cash on Hand 171.55 68.83

Net Days Revenue in Accounts Receivable 46.90 54.20

Equity Financing 54.29 60.32

Debt Service Coverage 4.20 2.73

Long-Term Debt to Capitalization 35.57 26.16

Outpatient Revenues to Total Revenues 79.82 74.43

Patient Deductions 44.34 39.92

Medicare Inpatient Payer Mix 77.37 73.01

Medicare Outpatient Payer Mix 38.41 37.90

Medicare Outpatient Cost to Charge 0.43 0.47

Medicare Revenue per Day 3065 2305

Salaries to Net Patient Revenue 43.12 45.57

Average Age of Plant 11.29 9.77

FTEs per Adjusted Occupied Bed 6.24 5.86

Average Salary per FTE 63981 50845

Average Daily Census Swing-SNF Beds 3.87 1.52

Average Daily Census Acute Beds 7.67 3.22

Number of Included CAHs 13 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for New Mexico and the United StatesCAH Financial Indicators Report

Issue 12Indicator NM US

Total Margin 1.48 2.51

Cash Flow Margin 7.88 6.72

Return on Equity 2.11 5.16

Operating Margin 4.88 0.99

Current Ratio 3.79 2.29

Days Cash on Hand 101.45 68.83

Net Days Revenue in Accounts Receivable 57.53 54.20

Equity Financing 88.30 60.32

Debt Service Coverage 0.24 2.73

Long-Term Debt to Capitalization 0.00 26.16

Outpatient Revenues to Total Revenues 70.29 74.43

Patient Deductions 48.69 39.92

Medicare Inpatient Payer Mix 58.33 73.01

Medicare Outpatient Payer Mix 32.06 37.90

Medicare Outpatient Cost to Charge 0.37 0.47

Medicare Revenue per Day 2639 2305

Salaries to Net Patient Revenue 41.90 45.57

Average Age of Plant 5.78 9.77

FTEs per Adjusted Occupied Bed 5.82 5.86

Average Salary per FTE 59572 50845

Average Daily Census Swing-SNF Beds 0.54 1.52

Average Daily Census Acute Beds 5.36 3.22

Number of Included CAHs 7 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for New York and the United StatesCAH Financial Indicators Report

Issue 12Indicator NY US

Total Margin 2.17 2.51

Cash Flow Margin 5.61 6.72

Return on Equity 11.35 5.16

Operating Margin -1.85 0.99

Current Ratio 1.52 2.29

Days Cash on Hand 75.28 68.83

Net Days Revenue in Accounts Receivable 44.53 54.20

Equity Financing 47.97 60.32

Debt Service Coverage 4.13 2.73

Long-Term Debt to Capitalization 38.46 26.16

Outpatient Revenues to Total Revenues 73.81 74.43

Patient Deductions 48.35 39.92

Medicare Inpatient Payer Mix 79.66 73.01

Medicare Outpatient Payer Mix 28.52 37.90

Medicare Outpatient Cost to Charge 0.44 0.47

Medicare Revenue per Day 2116 2305

Salaries to Net Patient Revenue 53.76 45.57

Average Age of Plant 10.58 9.77

FTEs per Adjusted Occupied Bed 3.99 5.86

Average Salary per FTE 47212 50845

Average Daily Census Swing-SNF Beds 2.87 1.52

Average Daily Census Acute Beds 2.02 3.22

Number of Included CAHs 13 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for North Carolina and the United StatesCAH Financial Indicators Report

Issue 12Indicator NC US

Total Margin 1.62 2.51

Cash Flow Margin 6.51 6.72

Return on Equity 4.00 5.16

Operating Margin 1.63 0.99

Current Ratio 1.73 2.29

Days Cash on Hand 39.53 68.83

Net Days Revenue in Accounts Receivable 53.48 54.20

Equity Financing 62.56 60.32

Debt Service Coverage 3.39 2.73

Long-Term Debt to Capitalization 27.78 26.16

Outpatient Revenues to Total Revenues 74.73 74.43

Patient Deductions 53.30 39.92

Medicare Inpatient Payer Mix 68.82 73.01

Medicare Outpatient Payer Mix 42.67 37.90

Medicare Outpatient Cost to Charge 0.36 0.47

Medicare Revenue per Day 1944 2305

Salaries to Net Patient Revenue 41.03 45.57

Average Age of Plant 10.61 9.77

FTEs per Adjusted Occupied Bed 5.39 5.86

Average Salary per FTE 50537 50845

Average Daily Census Swing-SNF Beds 1.51 1.52

Average Daily Census Acute Beds 5.92 3.22

Number of Included CAHs 20 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for North Dakota and the United StatesCAH Financial Indicators Report

Issue 12Indicator ND US

Total Margin -0.03 2.51

Cash Flow Margin 5.59 6.72

Return on Equity 0.67 5.16

Operating Margin -0.80 0.99

Current Ratio 2.07 2.29

Days Cash on Hand 62.92 68.83

Net Days Revenue in Accounts Receivable 55.47 54.20

Equity Financing 58.24 60.32

Debt Service Coverage 2.12 2.73

Long-Term Debt to Capitalization 28.99 26.16

Outpatient Revenues to Total Revenues 67.72 74.43

Patient Deductions 22.69 39.92

Medicare Inpatient Payer Mix 87.70 73.01

Medicare Outpatient Payer Mix 43.47 37.90

Medicare Outpatient Cost to Charge 0.61 0.47

Medicare Revenue per Day 1705 2305

Salaries to Net Patient Revenue 49.58 45.57

Average Age of Plant 12.38 9.77

FTEs per Adjusted Occupied Bed 6.29 5.86

Average Salary per FTE 45696 50845

Average Daily Census Swing-SNF Beds 1.57 1.52

Average Daily Census Acute Beds 1.28 3.22

Number of Included CAHs 34 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Ohio and the United StatesCAH Financial Indicators Report

Issue 12Indicator OH US

Total Margin 4.55 2.51

Cash Flow Margin 9.49 6.72

Return on Equity 8.27 5.16

Operating Margin 4.10 0.99

Current Ratio 2.02 2.29

Days Cash on Hand 47.46 68.83

Net Days Revenue in Accounts Receivable 47.90 54.20

Equity Financing 70.11 60.32

Debt Service Coverage 2.26 2.73

Long-Term Debt to Capitalization 14.95 26.16

Outpatient Revenues to Total Revenues 79.27 74.43

Patient Deductions 52.60 39.92

Medicare Inpatient Payer Mix 58.83 73.01

Medicare Outpatient Payer Mix 27.50 37.90

Medicare Outpatient Cost to Charge 0.36 0.47

Medicare Revenue per Day 2528 2305

Salaries to Net Patient Revenue 37.94 45.57

Average Age of Plant 10.84 9.77

FTEs per Adjusted Occupied Bed 5.41 5.86

Average Salary per FTE 51989 50845

Average Daily Census Swing-SNF Beds 1.93 1.52

Average Daily Census Acute Beds 6.63 3.22

Number of Included CAHs 33 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Oklahoma and the United StatesCAH Financial Indicators Report

Issue 12Indicator OK US

Total Margin 1.31 2.51

Cash Flow Margin 4.26 6.72

Return on Equity 5.01 5.16

Operating Margin -2.41 0.99

Current Ratio 2.14 2.29

Days Cash on Hand 21.58 68.83

Net Days Revenue in Accounts Receivable 58.02 54.20

Equity Financing 58.97 60.32

Debt Service Coverage 1.54 2.73

Long-Term Debt to Capitalization 10.78 26.16

Outpatient Revenues to Total Revenues 71.05 74.43

Patient Deductions 43.49 39.92

Medicare Inpatient Payer Mix 83.45 73.01

Medicare Outpatient Payer Mix 39.04 37.90

Medicare Outpatient Cost to Charge 0.50 0.47

Medicare Revenue per Day 1879 2305

Salaries to Net Patient Revenue 44.06 45.57

Average Age of Plant 7.42 9.77

FTEs per Adjusted Occupied Bed 4.76 5.86

Average Salary per FTE 47215 50845

Average Daily Census Swing-SNF Beds 1.59 1.52

Average Daily Census Acute Beds 2.01 3.22

Number of Included CAHs 33 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Oregon and the United StatesCAH Financial Indicators Report

Issue 12Indicator OR US

Total Margin 3.88 2.51

Cash Flow Margin 5.39 6.72

Return on Equity 5.76 5.16

Operating Margin 0.89 0.99

Current Ratio 2.75 2.29

Days Cash on Hand 68.92 68.83

Net Days Revenue in Accounts Receivable 59.11 54.20

Equity Financing 48.42 60.32

Debt Service Coverage 3.65 2.73

Long-Term Debt to Capitalization 37.49 26.16

Outpatient Revenues to Total Revenues 75.69 74.43

Patient Deductions 40.53 39.92

Medicare Inpatient Payer Mix 53.78 73.01

Medicare Outpatient Payer Mix 37.64 37.90

Medicare Outpatient Cost to Charge 0.52 0.47

Medicare Revenue per Day 3572 2305

Salaries to Net Patient Revenue 46.14 45.57

Average Age of Plant 9.16 9.77

FTEs per Adjusted Occupied Bed 7.27 5.86

Average Salary per FTE 73082 50845

Average Daily Census Swing-SNF Beds 0.74 1.52

Average Daily Census Acute Beds 6.38 3.22

Number of Included CAHs 25 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Pennsylvania and the United StatesCAH Financial Indicators Report

Issue 12Indicator PA US

Total Margin 4.85 2.51

Cash Flow Margin 11.76 6.72

Return on Equity 16.88 5.16

Operating Margin 3.39 0.99

Current Ratio 1.44 2.29

Days Cash on Hand 48.68 68.83

Net Days Revenue in Accounts Receivable 52.89 54.20

Equity Financing 31.11 60.32

Debt Service Coverage 3.38 2.73

Long-Term Debt to Capitalization 65.04 26.16

Outpatient Revenues to Total Revenues 73.07 74.43

Patient Deductions 54.30 39.92

Medicare Inpatient Payer Mix 63.66 73.01

Medicare Outpatient Payer Mix 31.45 37.90

Medicare Outpatient Cost to Charge 0.33 0.47

Medicare Revenue per Day 1593 2305

Salaries to Net Patient Revenue 42.76 45.57

Average Age of Plant 12.28 9.77

FTEs per Adjusted Occupied Bed 6.34 5.86

Average Salary per FTE 48854 50845

Average Daily Census Swing-SNF Beds 1.51 1.52

Average Daily Census Acute Beds 6.70 3.22

Number of Included CAHs 12 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for South Carolina and the United StatesCAH Financial Indicators Report

Issue 12Indicator SC US

Total Margin -4.32 2.51

Cash Flow Margin -4.10 6.72

Return on Equity -6.37 5.16

Operating Margin -7.55 0.99

Current Ratio 1.58 2.29

Days Cash on Hand 41.08 68.83

Net Days Revenue in Accounts Receivable 59.56 54.20

Equity Financing 41.14 60.32

Debt Service Coverage 0.15 2.73

Long-Term Debt to Capitalization 39.23 26.16

Outpatient Revenues to Total Revenues 78.17 74.43

Patient Deductions 49.07 39.92

Medicare Inpatient Payer Mix 58.55 73.01

Medicare Outpatient Payer Mix 28.15 37.90

Medicare Outpatient Cost to Charge 0.40 0.47

Medicare Revenue per Day 1989 2305

Salaries to Net Patient Revenue 48.76 45.57

Average Age of Plant 23.03 9.77

FTEs per Adjusted Occupied Bed 5.20 5.86

Average Salary per FTE 50315 50845

Average Daily Census Swing-SNF Beds 2.56 1.52

Average Daily Census Acute Beds 2.89 3.22

Number of Included CAHs 5 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for South Dakota and the United StatesCAH Financial Indicators Report

Issue 12Indicator SD US

Total Margin 2.98 2.51

Cash Flow Margin 8.79 6.72

Return on Equity 5.16 5.16

Operating Margin 2.98 0.99

Current Ratio 2.37 2.29

Days Cash on Hand 43.59 68.83

Net Days Revenue in Accounts Receivable 49.35 54.20

Equity Financing 61.02 60.32

Debt Service Coverage 2.55 2.73

Long-Term Debt to Capitalization 27.78 26.16

Outpatient Revenues to Total Revenues 70.21 74.43

Patient Deductions 28.74 39.92

Medicare Inpatient Payer Mix 87.07 73.01

Medicare Outpatient Payer Mix 48.27 37.90

Medicare Outpatient Cost to Charge 0.53 0.47

Medicare Revenue per Day 1925 2305

Salaries to Net Patient Revenue 47.95 45.57

Average Age of Plant 10.39 9.77

FTEs per Adjusted Occupied Bed 5.72 5.86

Average Salary per FTE 48350 50845

Average Daily Census Swing-SNF Beds 1.66 1.52

Average Daily Census Acute Beds 1.42 3.22

Number of Included CAHs 37 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Tennessee and the United StatesCAH Financial Indicators Report

Issue 12Indicator TN US

Total Margin 0.50 2.51

Cash Flow Margin 6.23 6.72

Return on Equity 16.42 5.16

Operating Margin 0.50 0.99

Current Ratio 1.53 2.29

Days Cash on Hand 14.22 68.83

Net Days Revenue in Accounts Receivable 50.07 54.20

Equity Financing 41.43 60.32

Debt Service Coverage 3.54 2.73

Long-Term Debt to Capitalization 53.31 26.16

Outpatient Revenues to Total Revenues 84.44 74.43

Patient Deductions 65.19 39.92

Medicare Inpatient Payer Mix 70.45 73.01

Medicare Outpatient Payer Mix 28.41 37.90

Medicare Outpatient Cost to Charge 0.31 0.47

Medicare Revenue per Day 1810 2305

Salaries to Net Patient Revenue 46.18 45.57

Average Age of Plant 7.38 9.77

FTEs per Adjusted Occupied Bed 3.40 5.86

Average Salary per FTE 46380 50845

Average Daily Census Swing-SNF Beds 1.96 1.52

Average Daily Census Acute Beds 3.03 3.22

Number of Included CAHs 15 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Texas and the United StatesCAH Financial Indicators Report

Issue 12Indicator TX US

Total Margin 4.57 2.51

Cash Flow Margin 7.51 6.72

Return on Equity 11.04 5.16

Operating Margin 3.52 0.99

Current Ratio 2.69 2.29

Days Cash on Hand 65.33 68.83

Net Days Revenue in Accounts Receivable 57.99 54.20

Equity Financing 73.42 60.32

Debt Service Coverage 1.95 2.73

Long-Term Debt to Capitalization 9.55 26.16

Outpatient Revenues to Total Revenues 76.38 74.43

Patient Deductions 51.32 39.92

Medicare Inpatient Payer Mix 73.77 73.01

Medicare Outpatient Payer Mix 33.15 37.90

Medicare Outpatient Cost to Charge 0.48 0.47

Medicare Revenue per Day 2219 2305

Salaries to Net Patient Revenue 49.88 45.57

Average Age of Plant 9.33 9.77

FTEs per Adjusted Occupied Bed 4.84 5.86

Average Salary per FTE 44496 50845

Average Daily Census Swing-SNF Beds 1.49 1.52

Average Daily Census Acute Beds 2.27 3.22

Number of Included CAHs 78 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Utah and the United StatesCAH Financial Indicators Report

Issue 12Indicator UT US

Total Margin 5.35 2.51

Cash Flow Margin 13.16 6.72

Return on Equity 6.82 5.16

Operating Margin 4.85 0.99

Current Ratio 4.30 2.29

Days Cash on Hand 114.17 68.83

Net Days Revenue in Accounts Receivable 52.82 54.20

Equity Financing 88.03 60.32

Debt Service Coverage 2.07 2.73

Long-Term Debt to Capitalization 1.72 26.16

Outpatient Revenues to Total Revenues 72.45 74.43

Patient Deductions 34.05 39.92

Medicare Inpatient Payer Mix 56.78 73.01

Medicare Outpatient Payer Mix 26.29 37.90

Medicare Outpatient Cost to Charge 0.51 0.47

Medicare Revenue per Day 2507 2305

Salaries to Net Patient Revenue 38.22 45.57

Average Age of Plant 11.79 9.77

FTEs per Adjusted Occupied Bed 5.31 5.86

Average Salary per FTE 58654 50845

Average Daily Census Swing-SNF Beds 1.53 1.52

Average Daily Census Acute Beds 2.45 3.22

Number of Included CAHs 11 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Vermont and the United StatesCAH Financial Indicators Report

Issue 12Indicator VT US

Total Margin 4.82 2.51

Cash Flow Margin 7.81 6.72

Return on Equity 9.59 5.16

Operating Margin 3.23 0.99

Current Ratio 1.29 2.29

Days Cash on Hand 122.99 68.83

Net Days Revenue in Accounts Receivable 50.34 54.20

Equity Financing 55.66 60.32

Debt Service Coverage 6.48 2.73

Long-Term Debt to Capitalization 33.97 26.16

Outpatient Revenues to Total Revenues 74.12 74.43

Patient Deductions 45.36 39.92

Medicare Inpatient Payer Mix 64.22 73.01

Medicare Outpatient Payer Mix 35.30 37.90

Medicare Outpatient Cost to Charge 0.43 0.47

Medicare Revenue per Day 2474 2305

Salaries to Net Patient Revenue 49.10 45.57

Average Age of Plant 9.44 9.77

FTEs per Adjusted Occupied Bed 7.08 5.86

Average Salary per FTE 69924 50845

Average Daily Census Swing-SNF Beds 0.77 1.52

Average Daily Census Acute Beds 11.63 3.22

Number of Included CAHs 8 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Virginia and the United StatesCAH Financial Indicators Report

Issue 12Indicator VA US

Total Margin 9.13 2.51

Cash Flow Margin 1.56 6.72

Return on Equity 23.54 5.16

Operating Margin -2.73 0.99

Current Ratio 2.18 2.29

Days Cash on Hand 98.34 68.83

Net Days Revenue in Accounts Receivable 45.64 54.20

Equity Financing 72.34 60.32

Debt Service Coverage -0.55 2.73

Long-Term Debt to Capitalization 3.74 26.16

Outpatient Revenues to Total Revenues 76.69 74.43

Patient Deductions 62.15 39.92

Medicare Inpatient Payer Mix 78.41 73.01

Medicare Outpatient Payer Mix 38.93 37.90

Medicare Outpatient Cost to Charge 0.31 0.47

Medicare Revenue per Day 1842 2305

Salaries to Net Patient Revenue 36.52 45.57

Average Age of Plant 8.09 9.77

FTEs per Adjusted Occupied Bed 3.70 5.86

Average Salary per FTE 57973 50845

Average Daily Census Swing-SNF Beds 2.94 1.52

Average Daily Census Acute Beds 4.96 3.22

Number of Included CAHs 7 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Washington and the United StatesCAH Financial Indicators Report

Issue 12Indicator WA US

Total Margin 0.82 2.51

Cash Flow Margin 3.87 6.72

Return on Equity 2.71 5.16

Operating Margin -0.85 0.99

Current Ratio 2.55 2.29

Days Cash on Hand 54.97 68.83

Net Days Revenue in Accounts Receivable 55.57 54.20

Equity Financing 52.69 60.32

Debt Service Coverage 2.42 2.73

Long-Term Debt to Capitalization 36.25 26.16

Outpatient Revenues to Total Revenues 75.04 74.43

Patient Deductions 41.93 39.92

Medicare Inpatient Payer Mix 71.61 73.01

Medicare Outpatient Payer Mix 36.36 37.90

Medicare Outpatient Cost to Charge 0.50 0.47

Medicare Revenue per Day 3361 2305

Salaries to Net Patient Revenue 50.47 45.57

Average Age of Plant 11.77 9.77

FTEs per Adjusted Occupied Bed 6.72 5.86

Average Salary per FTE 65970 50845

Average Daily Census Swing-SNF Beds 1.11 1.52

Average Daily Census Acute Beds 2.94 3.22

Number of Included CAHs 38 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for West Virginia and the United StatesCAH Financial Indicators Report

Issue 12Indicator WV US

Total Margin 1.73 2.51

Cash Flow Margin 5.36 6.72

Return on Equity 7.19 5.16

Operating Margin 1.22 0.99

Current Ratio 1.42 2.29

Days Cash on Hand 29.13 68.83

Net Days Revenue in Accounts Receivable 52.97 54.20

Equity Financing 44.53 60.32

Debt Service Coverage 2.59 2.73

Long-Term Debt to Capitalization 30.86 26.16

Outpatient Revenues to Total Revenues 78.40 74.43

Patient Deductions 42.35 39.92

Medicare Inpatient Payer Mix 68.81 73.01

Medicare Outpatient Payer Mix 32.49 37.90

Medicare Outpatient Cost to Charge 0.45 0.47

Medicare Revenue per Day 1564 2305

Salaries to Net Patient Revenue 46.61 45.57

Average Age of Plant 10.08 9.77

FTEs per Adjusted Occupied Bed 5.47 5.86

Average Salary per FTE 46283 50845

Average Daily Census Swing-SNF Beds 1.67 1.52

Average Daily Census Acute Beds 3.51 3.22

Number of Included CAHs 19 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Wisconsin and the United StatesCAH Financial Indicators Report

Issue 12Indicator WI US

Total Margin 4.93 2.51

Cash Flow Margin 10.09 6.72

Return on Equity 5.91 5.16

Operating Margin 3.71 0.99

Current Ratio 2.86 2.29

Days Cash on Hand 121.25 68.83

Net Days Revenue in Accounts Receivable 52.48 54.20

Equity Financing 63.62 60.32

Debt Service Coverage 3.77 2.73

Long-Term Debt to Capitalization 29.00 26.16

Outpatient Revenues to Total Revenues 77.03 74.43

Patient Deductions 41.38 39.92

Medicare Inpatient Payer Mix 64.86 73.01

Medicare Outpatient Payer Mix 30.66 37.90

Medicare Outpatient Cost to Charge 0.45 0.47

Medicare Revenue per Day 2722 2305

Salaries to Net Patient Revenue 39.61 45.57

Average Age of Plant 10.46 9.77

FTEs per Adjusted Occupied Bed 6.40 5.86

Average Salary per FTE 61089 50845

Average Daily Census Swing-SNF Beds 1.16 1.52

Average Daily Census Acute Beds 4.68 3.22

Number of Included CAHs 51 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016

Calendar Year of Data: 2013 Data Excerpt: State and National Medians

2013 Median Indicator Values for Wyoming and the United StatesCAH Financial Indicators Report

Issue 12Indicator WY US

Total Margin 6.79 2.51

Cash Flow Margin 8.27 6.72

Return on Equity 7.18 5.16

Operating Margin 0.70 0.99

Current Ratio 3.89 2.29

Days Cash on Hand 106.89 68.83

Net Days Revenue in Accounts Receivable 57.94 54.20

Equity Financing 82.19 60.32

Debt Service Coverage 5.87 2.73

Long-Term Debt to Capitalization 8.27 26.16

Outpatient Revenues to Total Revenues 66.90 74.43

Patient Deductions 26.70 39.92

Medicare Inpatient Payer Mix 67.27 73.01

Medicare Outpatient Payer Mix 40.19 37.90

Medicare Outpatient Cost to Charge 0.60 0.47

Medicare Revenue per Day 2793 2305

Salaries to Net Patient Revenue 49.43 45.57

Average Age of Plant 10.09 9.77

FTEs per Adjusted Occupied Bed 11.91 5.86

Average Salary per FTE 55828 50845

Average Daily Census Swing-SNF Beds 0.98 1.52

Average Daily Census Acute Beds 3.50 3.22

Number of Included CAHs 16 1275

Number of Included CAHs is the Number of CAHs with a Medicare Cost Report for at least 360 days (used in analysis).

N/A denotes medians that could not be calculated since there were no valid values for this indicator for 2013. See complete report for

discussion.

Report Produced: Spring 2016