PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD · 2013. 5. 31. · Public Health Trust Financial Recovery Board AGENDA May 31, 2013 Page 3 (e) Resolution authorizing Sandra L. Dorski,

PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD

Televised Meeting Agenda

May 31, 2013 – 3:00 p.m. to 5:00 p.m.

Stephen P. Clark Center

Board of County Commission Chambers Second Floor

111 N. W. First Street Miami, Florida 33128

PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD

Stephen P. Clark Center Board of County Commission Chambers

Second Floor 111 N. W. First Street Miami, Florida 33128

May 31, 2013 – 3:00 p.m. to 5 p.m.

AGENDA – PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD MEETING Any person making impertinent or slanderous remarks or who becomes boisterous while addressing the Public Health Trust Financial Recovery Board, shall be barred from further audience before the board, unless permission to continue or again address the board be granted by the Chairperson. No clapping, applauding, heckling or verbal outbursts in support or opposition to a speaker or his or her remarks shall be permitted. No signs or placards shall be allowed in the commission chambers. Persons exiting the commission chamber shall do so quietly. The use of cell phones in the commission chambers is not permitted. Ringers must be set to silent mode to avoid disruption of proceedings. Individuals, including those on the dais, must exit the chambers to answer incoming cell phone calls.

1. MOMENT OF SILENCE 2. PLEDGE OF ALLEGIANCE

3. CHAIRPERSON’S REPORT (a) Agenda item(s) to be added or withdrawn

(Marcos Jose Lapciuc, Chairperson, PHT Financial Recovery Board)

(b) Approval of the previous meeting minutes (Marcos Jose Lapciuc, Chairperson, PHT Financial Recovery Board)

(1) Meeting minutes as of April 29, 2013 – Regular Televised Meeting (2) Meeting minutes as of May 23, 2013 – Special Meeting

4. PRESIDENT’S REPORT, JACKSON HEALTH SYSTEM

(Carlos A. Migoya, President and Chief Executive Officer, Jackson Health System)

5. VICE PRESIDENT’S REPORT, FLORIDA INTERNATIONAL UNIVERSITY COLLEGE OF MEDICINE (John A. Rock, M.D., Dean, Florida International University College of Medicine)

6. UNIVERSITY OF MIAMI HEALTH SYSTEM REPORT

(Steven Falcone, M.D., Chief Executive, University of Miami at Jackson Memorial Hospital; Associate Vice President for Medical Affairs; Professor of Radiology, Neurological Surgery and Ophthalmology)

Public Health Trust Financial Recovery Board AGENDA May 31, 2013 Page 2

7. FISCAL COMMITTEE REPORT (Joe Arriola, Chairperson)

(1) Review of the Fiscal Committee Meeting Minutes as of May 23, 2013

(2) Subcommittee Reports (a) Audit and Compliance Subcommittee (Mojdeh L. Khaghan, Chairperson) (b) Pension Plan Subcommittee (Darryl K. Sharpton, Chairperson) (c) Purchasing and Facilities Subcommittee (Darryl K. Sharpton, Chairperson)

(3) Review of the Jackson Health System Financial Statements as of April 2013 (4) Resolutions recommended to be approved

(a) Resolution authorizing the President and CEO of the Public Health Trust to negotiate and execute an Interlocal Agreement between the Public Health Trust, South Broward Hospital District doing business as Memorial Health System, North Broward County Hospital District doing business as Parrish Medical Center, and Lee Memorial Health System for purposes of designating Low Income Pool funds to those taxing districts for demonstration year 5 to resolve excess Low Income Pool payment reconciliation matters, with transaction costs not to exceed Six Million Dollars ($6,000,000.00) (Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System)

(b) Resolution providing for the delegation of authority from the Financial

Recovery Board to the President or his designee to settle or compromise actual or threatened litigation, suits or claims against the Public Health Trust in amounts that do not exceed $250,000 per claim nor $1 million in the aggregate annually (Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System)

(c) Resolution approving Settlement of Complaint for damages in South Broward

Hospital District D.B.A. Memorial Hospital Pembroke v. JMH Health Plan, filed Under Case No. COWE 13-003349 in the County Court in and for Broward County, Florida in the amount of $9,523.00 (Brian Dean, Senior Vice President, Finance Division, Jackson Health System)

(d) Resolution approving Settlement of Small Claims Compliant for damages in

South Broward Hospital District D.B.A. Memorial Regional Hospital v. Christian Rhau, Public Health Trust of Dade County D.B.A. Jackson Health Plan, filed under Case No. COWE 13-2972 in the County Court in and for Broward County, Florida in the amount of $3,086.00 (Brian Dean, Senior Vice President, Finance Division, Jackson Health System)

Public Health Trust Financial Recovery Board AGENDA May 31, 2013

Page 3

(e) Resolution authorizing Sandra L. Dorski, Director of Risk Management to direct the Trustees of the Public Health Trust’s Risk Management Liability Account to conduct business including payment of Tort Claims, as requested by the Trustee Agreement between Sun Trust Bank and the Public Health Trust, superseding prior resolutions (Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System)

(f) Resolution authorizing and approving Award of Bids and Proposals, Waiver of

Bids, and other Purchasing Actions as recommended from the Fiscal Committee for May 2013, based on the Procurement Policy, Resolution No. PHT 12/05-231 (Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System)

8. JOINT CONFERENCE AND EFFICIENCIES COMMITTEE REPORT

(Stephen S. Nuell, Chairperson)

(1) Review of the Joint Conference and Efficiencies Meeting Minutes as of May 23, 2013

(2) Resolutions recommended to be approved

(a) Resolutions approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absence – May 2013 (Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System)

(b) Resolution approving and adopting a Jackson Health System Radiation Physicist

Delineation of Privileges of the Medical Staff – May 2013 (Kevin Andrews, Vice President, Quality and Patient Safety, Jackson Health System)

9. STRATEGY AND GROWTH COMMITTEE REPORT (Marcos Jose Lapciuc, Chairperson)

(1) Review of the Strategy and Growth Committee Meeting Minutes as of May 23, 2013

10. MIAMI-DADE COUNTY ATTORNEY REPORT (Eugene Shy, Jr., Assistant Miami-Dade County Attorney)

1. MOMENT OF SILENCE

2. PLEDGE OF ALLEGIANCE

3. CHAIRPERSON’S REPORT

3 (a) Agenda item(s) to be added or withdrawn

3 (b) Approval of the previous meeting minutes

PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD Public Health Trust Financial Recovery Board Marcos Jose Lapciuc, Chairperson Darryl K. Sharpton, Vice Chairperson Joe Arriola, Treasurer Michael Bileca Mojdeh L. Khaghan Irene Lipof Stephen S. Nuell Date: April 29, 2013 Time: 3:00 p.m. to 5:00 p.m. Place: Stephen P. Clark Center Board of County Commission Chambers 111 N. W. First Street Miami, Florida 33128 ATTENDANCE PHT Financial Recovery Board Darryl K. Sharpton Marcos J. Lapciuc Stephen S. Nuell Joe Arriola Mojdeh L. Khaghan Irene Lipof Excused Michael Bileca Jackson Health System Don S. Steigman Marilyn Moss Esther Caravia-Abolila Miami-Dade County Attorneys Valda Christian Christopher Kokoruda

Public Health Trust Financial Recovery Board Meeting April 29, 2013 Page 2 NEWSCLIPS Media reports highlighting the most resent medical related events, activities and services within Jackson Health System, and news stories featuring patients who received care at the hospital was shown prior to the Public Health Trust Financial Recovery Board meeting. EXPRESSION OF SYMPATHY Mr. Lapciuc expressed sympathy for the passing of the dear and beloved father of Carlos A. Migoya. MEETING CALL TO ORDER With a quorum being present, the televised meeting of the Pubic Health Trust Financial Recovery Board (PHT FRB) was called to order by Marcos Jose Lapciuc, Chairperson at 3:07 p.m. 1. MOMENT OF SILENCE

Mr. Lapciuc requested everyone to join in a moment of silence. 2. PLEDGE OF ALLEGIANCE Mr. Lapciuc requested everyone to join in the pledge of allegiance. 3. CHAIRPERSON’S REPORT

(a) Swearing In Ceremony On behalf of Irene Lipof, new appointed member to the Public Health Trust Financial Recovery Board, Christopher A. Agrippa, Division Chief, Clerk of the Board Division, Miami Dade Clerk of Courts, conducted the Swearing In Ceremony. Ms. Lipof was congratulated on becoming an official member of the Public Health Trust Financial Recovery Board.

(b) Fit Friendly Worksite Recognition Presentation Chad Buschell, Executive Director, American Heart Association of Greater Miami/Ft. Lauderdale presented Jackson Health System (JHS) with the 2013 Fit Friendly Gold Award. JHS was recognized for meeting a series of criteria around its worksite including the Wellness Program/Campaign which is a comprehensive program that is recognized for its devotion to physical activity, nutrition and healthy options as well as creating a culture of wellness for the JHS employees.

(d) Agenda item(s) to be added or withdrawn

Mr. Lapciuc questioned if there were agenda items to be added to or withdrawn. Valda Christian, Assistant Miami-Dade County Attorney stated for the record the following items to be added to the agenda and the items to be withdrawn from the agenda:

Public Health Trust Financial Recovery Board Meeting April 29, 2013 Page 3

Agenda items to be withdrawn from the agenda

7 (A) (3) (b) Resolution Authorizing the President or his designee to enter into a Lease Agreement With Sikma Corporation, a Florida Corporation for the Rental of three thousand eight hundred eighty six (3,886) square feet of office space in Suite 230 at the Regency Medical Center Building, located at 9195 Sunset Drive, Miami, Florida 33173 for a period of four years commencing on September 1, 2012, with a one (1) four year option to extend, for an annual payment of One Hundred Thirty-Three Thousand and Sixty Seven Dollars ($133,067) with an annual increase in base rent of three percent (3%) (Madeline Valdes, Corporate Director, Property Management Division, Jackson Health System)

(c) Support document for agenda item 7 (A) (3) (b)

Agenda items to be added to the agenda

(1) Resolution (1) Accepting and approving the 2012-2013 evaluation of Carlos A. Migoya, MBA, President and Chief Executive Officer of the Public Health Trust of Miami-Dade County, Florida; (2) Authorizing the Chairman of the Financial Recovery Board to execute said evaluation on behalf of the Board (Marcos Jose Lapciuc, Chairperson, Public Health Trust Financial Recovery Board)

(2) Resolution (1) Approving a two-year Agreement commencing on May 1, 2013,

between the Public Health Trust of Miami-Dade County, Florida and Carlos A. Migoya, MBA, for Trust President and Chief Executive Officer services with a base salary of $590,000.00 per year, performance bonus and executive benefits; (2) Authorizing the Chairman of the Financial Recovery Board to execute said Agreement upon all necessary approvals; (3) Recommending that the Miami-Dade Board of County Commissioners approve the Agreement; and (4) Directing staff to take all actions necessary to execute and implement the Agreement (Marcos Jose Lapciuc, Chairperson, Public Health Trust Financial Recovery Board)

Mr. Lapciuc requested a motion to withdraw agenda items 7 (A) (3) (b) and 7 (A) (3) (c) from the agenda and add items (1) and (2) to the agenda. Ms. Khaghan moved approval; seconded by Mr. Sharpton, and carried without dissent.


(c) Renewal of Contract – Carlos A. Migoya, President and Chief Executive Officer, Jackson Health System

Mr. Lapciuc reminded everyone that one of the PHT FRB most important responsibilities is the selection of the JHS President and Chief Executive Officer. Mr. Lapciuc stated that early in the spring of this year he began the negotiation process for renewing Mr. Migoya’s contract. The contract is for two (2) years which is the same as the original contract, the most substantial change to the contract is the structure of the performance bonus which is dependent on JHS net financial performance; core measures like patient safety; customers likelihood to recommend JHS to others; and completion of a comprehensive 3-year strategic and business plan that covers service-line development, primary care strategy, infrastructure and organizational compliance. Mr. Lapciuc stated for the record that Mr. Migoya agreed not to accept any increase to his current salary. Mr. Lapciuc stated that upon approval of the contract by the PHT FRB governing legislation requires that the contract be forwarded to the Board of County Commissioners for final action. Ms. Lipof questioned if Mr. Migoya received a performance bonus last year and if so was it donated to an area(s) within the hospital. Ms. Christian stated that she recalls that there was action whereby Mr. Migoya did earn a bonus, it was awarded and the decision was made by Mr. Migoya to donate the bonus to the Jackson Memorial Foundation. Ms. Lipof questioned the bonus as it relates to the targets set and current value for the set targets, and how often are the targets related to the bonus reported. Mr. Lapciuc stated that that in view of a historical perspective the qualitative and performance targets was very poor. A new campaign was started to better quantify and qualify JHS quality and targets. I t was decided that one year was completed to be able to develop a baseline measure of basic quality quotients. It was suggested to the PHT FRB that the September 30 2011-2012 final quality measures be used as the first baseline under the new management to measure. Mr. Lapciuc requested that the PHT FRB discuss quality matters related to the Agreement with Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System. After discussion, Mr. Lapciuc requested a motion for add-on agenda items (1) and (2) (1) PHT 04/13 – 022 Resolution (1) Accepting and approving the 2012-

2013 evaluation of Carlos A. Migoya, MBA, President and Chief Executive Officer of the Public Health Trust of Miami-Dade County, Florida; (2) Authorizing the Chairman of the Financial Recovery Board to execute said evaluation on behalf of the Board (Marcos Jose Lapciuc, Chairperson, Public Health Trust Financial Recovery Board)


(2) PHT 04/13 – 023 Resolution (1) Approving a two-year Agreement commencing on May 1, 2013, between the Public Health Trust of Miami-Dade County, Florida and Carlos A. Migoya, MBA, for Trust President and Chief Executive Officer services with a base salary of $590,000.00 per year, performance bonus and executive benefits; (2) Authorizing the Chairman of the Financial Recovery Board to execute said Agreement upon all necessary approvals; (3) Recommending that the Miami-Dade Board of County Commissioners approve the Agreement; and (4) Directing staff to take all actions necessary to execute and implement the Agreement (Marcos Jose Lapciuc, Chairperson, Public Health Trust Financial Recovery Board)

Mr. Arriola moved approval; seconded by Mr. Sharpton, and carried without dissent. Ms. Khaghan requested a motion approving of Mr. Migoya’s new contract by the Board of County Commissioners (BCC) not occur prior to May 1, 2013 which is the effective date of the new Agreement and proceed with Mr. Migoya’s employment under any manner necessary until such time the BCC ratifies the approval of the Agreement; seconded by Mr. Sharpton, and carried without dissent.

(b) Approval of the previous meetings minutes

(1) Meeting Minutes as of March 25, 2013 – Regular Televised Meeting (2) Meeting minutes as of April 18, 2013 – Special Meeting Mr. Lapciuc requested approval of the meeting minutes as of March 25, 2013 and April 18, 2013. Mr. Arriola moved approval; seconded by Mr. Sharpton,

and carried without dissent.

Public Health Trust Financial Recovery Board Meeting April 29, 2013 Page 6 4. PRESIDENT’S REPORT

In the absence of Carlos A. Migoya, President and Chief Executive Officer, Jackson Health System (JHS), Don S. Steigman, Executive Vice President and Chief Operation Officer, Jackson Health System reported that JHS is halfway through the 2012-2013 fiscal year and on budget toward a $35 million surplus. Much more progressive goals have been planned for the second half of the fiscal year; Wining the approval for a Helipad at Jackson South Community hospital is critical for JHS trauma strategy and puts JHS is a much stronger position to take immediate action when the State of Florida implements the new rules.; The week of April 29, 2013 is the last week of the 2013 Legislative Session. There continues to be a lot of moving parts that will impact JHS particularly as it relates to Medicaid, DRG’s and Trauma Regulations. The PHT FRB will be informed with the outcome of the 2013 Legislative Session.; and Representatives from JHS and University of Miami Health System Executive Management Teams engaged in a successful 3-hour meeting to discuss clinical and synergistic opportunities. Other meetings are planned for the future.

5. VICE PRESIDENT’S REPORT, FLORIDA INTERNATIONAL UNIVERSITY COLLEGE OF MEDICINE No report.


Steven Falcone, M.D., M.B.A., Associate Vice President for Medical Affairs and Chief Operating Officer, University of Miami Health Center expressed deepest sympathy to Mr. Migoya and his family for the loss of his father. Dr. Falcone reported that the meeting between UMHS and JHS Management Teams involved discussion having to do with opportunities to strengthen its relationship with a focus on growing clinical service lines at the Medical Center.; During the month of May 2013 UMHS will launch a promotional campaign that will feature some of its top programs as well as to programs at Jackson Memorial Hospital.; Omaida Velazquez, M.D., Professor of Surgery and Chief for the Division of Vascular and Endovascular Surgery is the first female in the State of Florida to become a member of the American Surgical Association. Dr. Velazquez was inducted in the Association of Surgeons at its 33rd Annual meeting and is a member of the elite group composed of the nation’s most prominent surgeons in the county’s leading academic medical institutions.: An application has been submitted to qualify as the first Joint Commission American Heart Association Certified Comprehensive Stroke Center in the State of Florida and among the first 70 in the United States. The Stroke Program is the recipient of the Target Plus Award for rapid treatment of acute strokes by the American Heart Association.; During the month of April the UMHS hosted the 2nd Annual Southeast Regional Emergency Medicine Students Symposium the where more than 50 students from five medical schools across South Florida attended to learn more about emergency medicine.; and UMHS is starting a Program of Music in Public Places and students from the Frost School of Music at the University of Miami will perform at the Medical Campus. The program was designed to gladden the hearts and brighten the days of patients and their families who visit the Medical Center as well as members of the faculty and staff.

Public Health Trust Financial Recovery Board Meeting April 29, 2013 Page 7 7. FISCAL COMMITTEE REPORT

The Fiscal Committee met on April 18, 2013. The Committee was presented with regular monthly updates, approved to accept the KPMG FY12 JMH Health Plan Audit Financial Statements, approval of resolutions having to do with the Interlocal Agreement and Lease Agreement with Sikma Corporation. The Committee agreed to forward the items approved to the PHT FRB for final action. The following update reports were presented:

(1) Subcommittee Reports

(c) Audit and Compliance Subcommittee The Subcommittee met on April 18, 2013. The Subcommittee reviewed and approved to accept the KPMG FY12 JMH Health Plan Audit Financial Statements as presented with a recommendation to the Fiscal Committee to accept the financial statements as presented. In addition to the regular month reports, quarterly updates were presented including a JMH Health Plan Compliance update.

(b) Purchasing and Facilities Subcommittee The Subcommittee meeting was held on April 18, 2013. The Subcommittee was provided with regular monthly update reports which highlighted information from the Vendor and Contract Performance Monitoring Report, Key Performance Indicators, Interactive Map Construction Projects, and Financial and Budget Tracking. Other discussion centered around the Helipad for the Jackson North Medical Center and Jackson South Community Hospital. The Subcommittee reviewed and approved a resolution authorizing the President or his designee to enter into a new Lease Agreement with Sikma Corporation and the April 2013 Purchasing Report with a recommendation that both items be forwarded to the Fiscal Committee for approval.

(2) Review of the Financial Statements, as of March 2013 Mr. Knight presented a summary of JHS financial activity ending March 31, 2013. As a recap of the financial statements that were extensively reviewed at the April 18, 2013 Fiscal Committee meeting, Mr. Knight highlighted information from the key performance indicators, balance sheet, and P& L report.


(3) Resolutions Recommended to be Approved

(a) PHT 04/13 – 024 Resolution authorizing and approving Award of Bids and Proposals, Waiver of Bids, and other Purchasing Actions as recommended from the Fiscal Committee for April 2013, based on the Procurement Policy, Resolution No. PHT 12/05-231 (Rosa Costanzo, Vice President and Chief Procurement Officer, Strategic Sourcing and Supply Chain Management Division, Jackson Health System)

Mr. Lapciuc requested a motion for the item.

Mr. Sharpton moved approval; seconded by Mr. Arriola, and carried without dissent.

(b) Resolution Authorizing the President or his designee to enter into a Lease Agreement

With Sikma Corporation, a Florida Corporation for the Rental of three thousand eight hundred eighty six (3,886) square feet of office space in Suite 230 at the Regency Medical Center Building, located at 9195 Sunset Drive, Miami, Florida 33173 for a period of four years commencing on September 1, 2012, with a one (1) four year option to extend, for an annual payment of One Hundred Thirty-Three Thousand and Sixty Seven Dollars ($133,067) with an annual increase in base rent of three percent (3%) (Madeline Valdes, Corporate Director, Property Management Division, Jackson Health System)

(c) Support document for agenda item 7 (3) (b)

Agenda items 7 (A) (3) (b) and (c) were withdrawn.

8. JOINT CONFERENCE AND EFFICIENCIES COMMITTEE REPORT

The Joint Conference and Efficiencies Committee met on April 18, 2013. The Committee was presented with regular monthly updates as well as approving the Credentials Committee decisions for the month of April 2013 and approval of resolutions having to do with policy and procedures and approval of the Physician Orders for Life Sustaining Treatment (POLST) Form for Adult Patients. The Committee agreed to forward the items to the PHT FRB with a recommendation for approval.


(1) Resolutions recommended to be approved

(a) PHT 04/13 – 025 Resolutions approving the Medical Staff and Health Professional Affiliate Staff Membership and Clinical Privileges; approving Initial Appointments, Reappointments and Clinical Privileges and Activities; approving Modifications to Medical Staff Membership Category and Clinical Privileges; accepting Resignations and Leaves of Absence – April 2013 (Kevin Andrews, Vice President, Quality & Patient Safety Division, Jackson Health System)

(b) PHT 04/13 – 026 Resolution approving and adopting revisions to the

Public Health Trust Withholding, Withdrawing and Foregoing Life-Sustaining Treatment (Adults) Policy and Procedure-April 2013 (Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System)

(1) Support Document: Policy 400.015

Withholding, Withdrawing and Foregoing Life Sustaining Treatment (Adults)

(c) PHT 04/13 – 027 Resolution approving and adopting to the Public Health

Trust perioperative Do-Not-Resuscitate (DNR) Orders (Adults) Policy and Procedure-April 2013 (Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System)

(1) Support Document: Policy 400.130

Perioperative Do-Not-Resuscitate (DNR) Orders

(d) PHT 04/13 - 028 Resolution approving and adopting to the Public Health Physician Orders for Life Sustaining Treatment (POLST) (Adults) Policy and Procedure-April 2013 (Kevin Andrews, Vice President, Quality and Patient Safety Division, Jackson Health System)

(1) Support Document: Policy 400.131 Physician

Orders for Life Sustaining Treatment(POLST) (ADULTS)


(e) PHT 04/13 - 029 Resolution approving and adopting to the Public Health Trust JHS –Physician Orders for Life Sustaining Treatment (POLST) for Adult Patients Form C-290ZL- April 2013 (Kevin Andrews, Vice President, Quality

and Patient Safety Division, Jackson Health System)

(1) Support Document: JHS - Physician Orders for Life Sustaining Treatment (POLST) for Adult Patients C-290ZL POLST Order Form

9. STRATEGY & GROWTH COMMITTEE REPORT

The Strategy & Growth Committee met on April 18, 2013. The Committee was presented with updates regarding PSN ITN, HB 711, Trauma, UM AOA and IT. Other discussion centered on the upcoming JHS Strategic Retreat.

10. MIAMI-DADE COUNTY ATTORNEY REPORT

No report. MEETING CALL TO ADJOURN The televised Public Health Trust Financial Recovery Board meeting adjourned at 3:58 p.m. Transcribed by Ivenette Cobb Executive Assistant Public Health Trust Financial Recovery Board

PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD Public Health Trust Financial Recovery Board Marcos Jose Lapciuc, Chairperson Darryl K. Sharpton, Vice Chairperson Joe Arriola, Treasurer Michael Bileca Mojdeh L. Khaghan

Irene Lipof Stephen S. Nuell Date, Time and Location May 23, 2013 – Followed the Audit and Compliance Subcommittee meeting Ira C. Clark Diagnostic Treatment Center Conference Room 259

ATTENDANCE PHT Financial Recovery Board Darryl K. Sharpton Mojdeh L. Khaghan Marcos Jose Lapciuc Joe Arriola Irene Lipof Excused Michael Bileca Stephen S. Nuell Jackson Health System Carlos A. Migoya Don S. Steigman Mark T. Knight Miami-Dade County Attorneys Valda Christian Christopher Kokoruda

Special Public Health Trust Financial Recovery Board Meeting May 23, 2013 Page 2 1. Special Meeting Called to Oder

With a quorum being present, the special Public Health Trust Financial Recovery Board (PHT FRB) meeting was called to order at 8:30 a.m. by Marcos Jose Lapciuc, Chairperson, PHT FRB. Purpose of the Special Meeting The purpose of the special PHT FRB meeting was to consider for approval the revision to the 2013 Committee Assignments adding Irene Lipof, new appointee to the PHT FRB.

2. Resolution Recommended To Be Approved

(a) PHT 05/13 – 030 Resolution approving revised Public Health Trust Financial Recovery

Board Committee Assignments, as of April 23, 2013 (Marcos Jose Lapciuc, Chairperson, Public Health Trust Financial Recovery Board)

Mr. Lapciuc presented and recommended approval of the revised 2013 Public Health Trust Financial Recovery Board Committee Assignments. Ms. Khaghan moved approval; seconded by Mr. Arriola, and carried without dissent.

6. Special Meeting Call To Adjourn

The special PHT Financial Recovery Board meeting adjourned at 8:31 a.m.

Transcribed by Ivenette Cobb, Executive Assistant Public Health Trust Financial Recovery Board

4. PRESIDENT’S REPORT, JACKSON HEALTH SYSTEM

5. VICE PRESIDENT’S REPORT, FIUCOM

7. FISCAL COMMITTEE REPORT

PUBLIC HEALTH TRUST FINANCIAL RECOVERY BOARD Fiscal Committee Joe Arriola, Chairperson Darryl K. Sharpton, Vice Chairperson Michael Bileca Mojdeh L. Khaghan Marcos Jose Lapciuc Irene Lipof Stephen S. Nuell Date, Time and Location May 23, 2013 – Followed the Purchasing and Facilities Subcommittee meeting Ira C. Clark Diagnostic Treatment Center Conference Room 259

ATTENDANCE

Fiscal Committee Darryl K. Sharpton Mojdeh L. Khaghan

Marcos Jose Lapciuc Joe Arriola Irene Lipof Excused Michael Bileca Stephen S. Nuell

Jackson Health System Carlos A. Migoya Brian Dean Mark T. Knight Don S. Steigman University of Miami Health System Joshua Lenchus, D.O. Miami-Dade County Attorneys

Eugene Shy, Jr. Jeffrey Poppel

Fiscal Committee Meeting May 23, 2013 Page 2 Meeting Called to Order With a quorum being present, the meeting of the Fiscal Committee was called to order at 10:40 a.m. by Joe Arriola, Chairperson, Fiscal Committee. 1. Approval of the Previous Meeting Minutes

(a) Meeting Minutes as of April 18, 2013.

The meeting minutes of April 18, 2013 was approved as presented. Add-on Agenda Items For the record, Eugene Shy, Jr., Assistant Miami-Dade County Attorney, presented the following add-on agenda items:

(1) Resolution authorizing the President and CEO of the Public Health Trust to negotiate and execute an Interlocal Agreement between the Public Health Trust, South Broward Hospital District doing business as Memorial Health System, North Brevard County Hospital District doing business as Parrish Medical Center, and Lee Memorial Health System for purposes of designating Low Income Pool funds to those taxing districts for demonstration year 5 to resolve excess Low Income Pool payment reconciliation matters, with transaction costs not to exceed six million dollars ($6,000,000.00) (Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System)

(2) Resolution providing for the delegation of authority from the Financial Recovery Board to the President or his designee to settle or compromise actual or threatened litigation, suits or claims against the Public Health Trust in amounts that do not exceed $250,000 (Carlos A. Migoya, President and Chief Executive Officer, Jackson Health System)

Mr. Arriola requested a motion approving add-on agenda item (1). Mr. Lapciuc moved approval; seconded by Ms. Lipof, and carried without dissent. Mr. Arriola requested a motion approving add-on agenda item (2). The Committee engaged in conversation having to do with the dollar amount that a claim(s) should not exceed, reporting process of settlement of claims. Following the discussion the following amendments were proposed: Mr. Migoya requested that the resolution be amended to include the following:

• Actual or threatened litigation, suits or claims against the PHT in amounts that do not exceed $250,000 per claim nor exceed $1 million in aggregate annually for all claims. The President shall report the settlement of claims individually and in the aggregate to the PHT FRB on a quarterly basis.

Fiscal Committee Meeting May 23, 2013 Page 3 M. Khaghan requested that a memorandum from Mr. Migoya to members of the PHT FRB regarding the settlement of claims be provided prior to presenting to the Fiscal Committee. Mr. Arriola requested a motion for add-on agenda item (2) as amended. Ms. Khaghan moved approval; seconded by Ms. Lipof, and carried without dissent. 2. KPMG Management Letter – JMH Health Plan

Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System presented a brief overview of the KPMG Management Letter for the JMH Health Plan which identified material weaknesses (General and Administrative Expenses and Information Technology General Controls) recommendations as well as management’s responses to make the necessary improvements to the Administrative Service Agreement between the JMH Health Plan and PHT and continue to monitor and update policies and procedures associated with IT general controls. Mr. Arriola requested a motion to accept the KPMG Management Letter for the JMH Health Plan as presented. Ms. Lipof moved approval; seconded by Mr. Sharpton, and carried without dissent.

4. Review of the Combined Financial Statements as of April 30, 2013

Mr. Knight presented a recap of the financial performance for the month of April 2013. The bottom line performance was positive in the amount of $5.9 million versus a budget totaling $2.6 million and a positive variance in the amount of $3.3 million. Out of cycle items received for the month was $1.7 Million from the Jackson Memorial Foundation for the renovation of the PICU Neonatal Intensive Care Unit and reconciled tax proceeds in the amount of approximately $1 million. On a year-to-date basis JHS has a positive bottom line totaling $18 million versus a budget of $15.5 million and approximately $2.5 million positive variance. JHS is currently on schedule as projected to reach the $35 million profited bottom line for fiscal year ending September 30, 2013. Overall the net revenue was strong relative to budget and despite experiencing lower inpatient volumes, experienced significant growth in outpatient/observation volumes, average daily census is ahead of budget and for the month of April was 4% higher over what was anticipated, continue to experience an increase in funded patients which attributes to increased net revenue, total operating expense was approximately $126 million versus a budget in the amount of $124.5 million and a negative variance totaling $1.5 million which is attributed to volumes, reduction in full time equivalent of 54 from prior months and overtime declined $500,00 from prior month and now operating with a 3% in overtime which is considered industry best-practice, continue to focus on premium pay such as overtime and agency, other expenses were largely favorable and overall a positive variance to budget and stronger performance than anticipated. Accounts payable for the month showed a significant reduction which attributes to a much better relationship with vendors and allowing for prompt pay discounts and/or discounts that are included in vendor agreements. Mr. Knight pointed out that JHS is technically solvent at the end of the month of April 2013 for the first time since 2008 which means that JHS has more current assets than current liabilities. Mr. Knight stated that the goal is to ensure that upon audit that there is no working capital deficit.

Fiscal Committee Meeting May 23, 2013 Page 4

Ms. Khaghan questioned the definition of observation patients and impact of observation patients in the future. Mr. Knight explained that observation is defined as a patient(s) admitted through Emergency Services that is held for observation which is theoretically not-to-exceed 23-hours. The difference for JHS is when a patient is admitted into a full admission status the reimbursement is increased, and reimbursement for a Medicare patient is significantly increased. He further explained that the 2014 operating budget does take into account the trend away from inpatient to outpatient and therefore presents a change to net revenue. With regards to observation patients Joshua Lenchus, DO, RPh, FACP, SFHM, University of Miami Health System stated that observation patients do not count toward a hospital’s readmission rate. With regards to additional reports, Mr. Knight presented and reviewed the following:

Monthly Line of Credit-April 2013 – Approved was a $75 million line of credit. At the end of April 2013 there was approximately $5.7 million outstanding. A larger draw was taken in the months of March and February of this year which would be replicated by the end of June 2013. Continue to access the line of credit as needed.

Overtime Trending Report – Continue to see further improvements. The overtime percentage for the pay period ending ended May 11, 2013 was 2.9% which was a reduction from what was previously reported in the month of April 2013.

Copies of the reports were distributed at the meeting. With regards to the continued reduction in overtime Martha Baker, RN, President SEIU, Local 1991, acknowledged that the reduction in overtime is an improvement from a couple of years ago and encouraged the Management Team to consider loosening up the hold on overtime, become more flexible and employ additional full-time staff which would also attribute to the continued reduction in overtime. Mr. Knight stated that employee positions have been posted in an attempt to recruit in the areas where heavy overtime is utilized.

4. Cost Accounting Update Brian Dean, Senior Vice President, Finance Division, Jackson Health System presented the Cost Accounting Update. Schedules were presented showing the product line reports for the new Cost Accounting System which highlighted inpatient information from a proprietary standpoint for Jackson South Community Hospital, Jackson North Medical Center, and Jackson Memorial Hospital. Copies of the schedules were distributed at the meeting. Following the update information the Committee was engaged in discussion regarding cost accounting particularly as it related to standards for cost accounting, allocation of services and expenses, evaluation process for cost accounting, testing of service line expansions, and impacts of direct costs to the contribution margin, With regards to the schedules, Mr. Lapciuc requested that it include percentages to be able to better determine the percentage margins and percentages for direct fixed costs. The Committee congratulated staff regarding the new Cost Accounting System and look forward to the continued roll out of the process going forward.

Fiscal Committee Meeting May 23, 2013 Page 5 5. Accounts Receivable Aging Report as of April 2013

Mr. Knight reported that the revenue cycle for the KPI’s for the month of April 2013 were largely favorable, cash collections for the month was $90.3 million versus a goal of $85.3 million, point of service collection showed $2.7 million which is a record for JHS, potential Medicaid conversion showed 89% of patients were converted over to Medicaid, AR greater than 90 days was 31% which exceeded the target, denial was 9.6%, and revenue integrity was 2.6% which is attributed to Emergency Room charges. Despite lower inpatient volumes and high observation cash, collections for the first seven months of the fiscal year increased slightly over $1 million.

6. Review and Recommend Approval of the Following Resolutions for Contracts and/or Agreements (a) Resolution approving Settlement of Complaint for damages in South Broward Hospital District D.B.A.

Memorial Hospital Pembroke v. JMH Health Plan, filed Under Case No. COWE 13-003349 in the County Court in and for Broward County, Florida in the amount of $9,523.00 (Brian Dean, Senior Vice President, Finance Division, Jackson Health System)

(b) Resolution approving Settlement of Small Claims Compliant for damages in South Broward Hospital

District D.B.A. Memorial Regional Hospital v. Christian Rhau, Public Health Trust of Dade County D.B.A. Jackson Health Plan, filed under Case No. COWE 13-2972 in the County Court in and for Broward County, Florida in the amount of $3,086.00 (Brian Dean, Senior Vice President, Finance Division, Jackson Health System)

Mr. Arriola requested a motion for agenda items 6 (a) and (b). Mr. Sharpton moved approval; seconded by Ms. Lipof, and carried without dissent.

(c) Resolution authorizing Sandra L. Dorski, Director of Risk Management to direct the Trustees of

the Public Health Trust’s Risk Management Liability Account to conduct business including payment of Tort Claims, as requested by the Trustee Agreement between Sun Trust Bank and the Public Health Trust, superseding prior resolutions (Mark T. Knight, Executive Vice President and Chief Financial Officer, Jackson Health System)

Mr. Arriola requested a motion for the item. Ms. Lipof moved approval; seconded by Mr. Sharpton, and carried without dissent.

7. Purchasing and Facilities Subcommittee Report The Purchasing and Facilities Subcommittee met on May 23, 2013. The Subcommittee was presented with routine monthly reports, reviewed and approved the May 2013 Purchasing Report with a recommendation that it be forwarded to the Fiscal Committee for approval. (a) Review and Recommend Approval of the Purchasing Report (1) Purchasing Report as of May 2013

Mr. Arriola requested a motion approving the May 2013 Purchasing Report.

Mr. Lapciuc moved approval; seconded by Mr. Sharpton

and carried without dissent.

Fiscal Committee Meeting May 23, 2013 Page 6 Other Discussion Mr. Lapciuc reminded everyone that the next PHT FRB televised meeting is scheduled for Friday, May 31, 2013. He also reminded everyone that at 12 midnight on May 31, 2013 the PHT FRB will no longer exist. With respect to the new board, an organizational meeting has been scheduled for June 3, 2013 for the purposes of the election of new officer’s, and review and approve the new bylaws. Mr. Lapciuc invited everyone to attend the Ribbon Cutting Ceremony for West Wing 6 on May 31, 2013. Meeting Call to Adjourn The meeting of the Fiscal Committee adjourned at 12:07 p.m. Transcribed by Ivenette Cobb-Black Executive Assistant Public Health Trust Financial Recovery Board

7 (2) Subcommittee Reports

7 (2) (a) Audit and Compliance Subcommittee

7 (2) (b) Pension Plan Subcommittee

7 (2) (c) Purchasing and Facilities Subcommittee

PUBLIC HEALTH TRUST

JACKSON HEALTH SYSTEM

COMBINED FINANCIAL STATEMENTS

April 30, 2013

PUBLIC HEALTH TRUST

JACKSON HEALTH SYSTEM

COMBINED FINANCIAL STATEMENTS

April 30, 2013

INDEX

1. Key Performance Indicators

2. Combined Balance Sheet

3. Combined Statement of Revenues, Expenses & Changes in Fund Net Assets

3A. Combined Statement of Revenues, Expenses & Changes in Fund Net Assets

excluding Division of Managed Care

4. P &L 12 Month Trend Analysis

5. Combining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding /Month

6. Combining Statement of Revenue & Expenses Reflecting Allocated Corporate Overhead & Public Support Funding /YTD

7. Combining Statement of Revenue & Expenses by Company

8. Combined Statement of Unrestricted/Restricted Cash Flow

9. Consolidated Portfolio Inventory Summary by Security /Account Type

10. Sales Tax Monthly Income Trend Analysis

11. Payor Mix Patient Days as % of Total Fiscal Year 2011-2012

(a) (b) (f) (g) (h) (i) (j) (k)

YTD Apr-13 Apr-13 Apr-12 Mar-13 YTD YTD YTD

Benchmark Status Actual Budget Actual Budget Prior Budget Prior Actual Actual Budget 2012 Budget Prior Budget Prior

JHS Financial

(1) Net Patient Revenue 85,248 83,306 85,897 1,942 (649) 2.3% (0.8)% 80,424 580,305 590,410 583,183 (10,105) (2,878) (1.7)% (0.5)%(2) Other Operating Revenue 14,742 14,648 15,076 94 (334) 0.6% (2.2)% 19,245 105,849 102,323 138,904 3,526 (33,055) 3.4% (23.8)%(4) Total Operating Revenue 99,990 97,954 100,973 2,036 (983) 2.1% (1.0)% 99,669 686,154 692,733 722,087 (6,579) (35,933) (0.9)% (5.0)%(6) Total Operating Expenses 125,978 124,528 129,912 (1,450) (3,934) (1.2)% (3.0)% 127,286 885,512 888,829 960,669 3,317 75,157 0.4% 7.8%(7) Gain and (Loss) from Operations (25,988) (26,574) (28,939) 586 2,951 2.2% 10.2% (27,617) (199,358) (196,097) (238,581) (3,261) 39,223 (1.7)% 16.4%(8) Total Net Non-operating Items (before GOB & Special Contributions) 30,214 29,247 28,976 967 1,238 3.3% 4.3% 30,799 213,423 211,559 209,561 1,863 3,862 0.9% 1.8%(9) Excess of Revs Over (Under) Expenses before GOB & Special Contrib. 4,226 2,673 37 1,553 4,189 58.1% 11,321.6% 3,182 14,065 15,463 (29,020) (1,398) 43,085 (9.0)% 148.5%

(10) GOB & Special Contributions 1,700 - 806 1,700 894 0.0% 110.9% 437 3,969 - 8,499 3,969 (4,531) 0.0% (53.3)%(11) Excess of Revenues Over (Under) Expenses 5,926 2,673 843 3,253 5,083 121.7% 603.0% 3,618 18,034 15,463 (20,522) 2,571 38,556 16.6% 187.9%

(12) Unrestricted Health Care Surtax 17,575 16,558 16,292 1,017 1,283 6.1% 7.9% 18,331 125,259 122,628 120,658 2,631 4,601 2.1% 3.8%(13) Miami Dade County Unrestricted Funds 11,094 11,094 11,085 0 9 0.0% 0.1% 11,094 77,658 77,657 77,595 1 63 0.0% 0.1%(14) Discharged Not Final Billed (DNFB) HIM 3,151 21,000 17,232 17,849 14,081 85.0% 81.7% 5,318 3,151 21,000 17,232 17,849 14,081 85.0% 81.7%

Financial Ratios

(15) Net Patient Revenue per Adjusted Patient Day 1,620 1,843 1,731 (224) (111) (12.1)% (6.4)% 1,648 1,772 1,869 1,833 (97) (61) (5.2)% (3.3)%(16) Total Cost per Adjusted Patient Day 2,676 2,755 2,924 79 248 2.9% 8.5% 2,608 2,705 2,814 3,020 110 315 3.9% 10.4%

Liquidity Indicators

(17) Days Net in Receivable 45.9 50.97 39.45 48.15 (11.52) (2.82) (29.2)% (5.9)% 51.96 50.97 39.45 48.15 (11.52) (2.82) (29.2)% (5.9)%(18) Days (Unrestricted) Cash on Hand 174.8 21.23 35.80 16.47 (14.57) 4.76 (40.7)% 28.9% 18.75 21.23 35.80 16.47 (14.57) 4.76 (40.7)% 28.9%(19) Current Ratio 2.4 1.01 0.91 0.72 0.10 0.29 10.8% 40.7% 0.97 1.01 0.91 0.72 0.10 0.29 10.8% 39.8%(20) Cash (Unrestricted) to Debt Ratio 1.29 0.23 0.24 0.19 (0.01) 0.04 (5.8)% 22.9% 0.20 0.23 0.24 0.19 (0.01) 0.04 (5.8)% 19.7%

Utilization

(21) Admissions excl. Newborn 4,847 5,117 4,872 (270) (25) (5.3)% (0.5)% 4,827 34,010 36,009 35,594 (1,999) (1,584) (5.6)% (4.5)%(22) Admissions % through ED 63.85% N/A 68.31% (4.5)% 0.0% (6.5)% 64.80% 64.07% N/A 70.19% 0.0% 0.0%(22) Observation Equivalent Days 1,312 835 1,009 477 303 57.1% 30.0% 1,352 8,407 5,861 6,044 2,546 2,363 43.4% 39.1%(23) Hospital Patient Census Days excl. Newborn 32,510 31,758 30,966 752 1,544 2.4% 5.0% 34,296 231,195 222,511 223,033 8,684 8,162 3.9% 3.7%(24) Average Length of Stay 4.5 6.71 6.21 6.36 (0.50) (0.35) (8.1)% (5.5)% 7.11 6.80 6.18 6.27 (0.62) (0.53) (10.0)% (8.4)%(25) Outpatient Visits 30,417 27,320 28,960 3,097 1,457 11.3% 5.0% 28,132 197,915 196,074 194,833 1,841 3,082 0.9% 1.6%(26) JMH Number of O/R Cases 1,230 1,249 1,186 (19) 44 (1.5)% 3.7% 1,116 8,058 8,919 8,446 (861) (388) (9.7)% (4.6)%(27) Overtime % of Productive Hours 3.00% N/A N/A 3.55% 3.19% N/A N/A

FTE's

(28) JHS FTE per Adjusted Occupied Bed 6.65 6.29 6.39 6.91 0.10 0.62 1.5% 9.0% 6.31 6.41 6.44 6.76 0.03 0.35 0.5% 5.2%(29) Jackson Health System FTE's 9,875 9,630 10,237 (245) 362 (2.5)% 3.5% 9,929 9,900 9,598 10,095 (302) 195 (3.1)% 1.9%

Payor Mix Self Pay Patient Days as % of Total

(30) Jackson Memorial Hospital 13.41% 16.90% 17.70% 3.49% 4.29% 20.7% 24.2% 13.80% 13.62% 17.02% 17.20% 3.40% 3.58% 20.0% 20.8%(31) Jackson North 10.08% 14.05% 18.20% 3.97% 8.12% 28.3% 44.6% 10.50% 11.18% 14.06% 14.90% 2.88% 3.72% 20.5% 25.0%(32) Jackson South 15.63% 19.34% 17.20% 3.71% 1.57% 19.2% 9.1% 14.50% 14.95% 19.19% 19.40% 4.24% 4.45% 22.1% 22.9%(33) Inpatient Charges as Percent of Total 69.07% 70.27% 69.71% 1.20% 0.64% 1.7% 0.9% 70.27% 70.61% 70.45% 70.12% 0.16% 0.49% 0.2% 0.7%(34) Realization Rate 25.29% 24.80% 25.96% -0.49% 0.67% (2.0)% 2.6% 23.15% 24.70% 24.88% 24.55% -0.18% 0.15% (0.7)% 0.6%

Key: Positive variance or no major concerns Year-to-date numbers are ok or explained, but concern for future trend Negative variance or area of current concern

Variance are Favorable (positive number) and Unfavorable (negative number)

(l)

$ Variance % Variance $ YTD Variance % YTD Variance

NEW KEY PERFORMANCE INDICATORS Fiscal Year 2012 - 2013

(Dollars in 000)

(e) (d) (e)

FS-1

Mar 13 Dollar Change Sep 12

72,200 9,235

21,444 3,335

15,129 28,567

671,900 1,604

(524,866) (4,892)

147,034 (3,287)

92,023 (41,969)

44,600 1,273

4,509 (389)

23,393 144

5,850 309

426,182 (2,782)

0 0

22,909 590

59,165 (823)

444,585 (1,739)

6,981 (25)

533,640 (1,996)

959,822$

7,325 0

120,333 (7,994)

124,162 4,869

117,866 (10,852)

18,614 (667)

6,078 51

43,384 (2,591)

437,762 (17,185)

350,598 29

71,293 6,451

859,653 (10,705)

(66,775) 1,973

163,185 3,501

3,758 452

100,168 5,926 88,059

959,822$

Notes

* Reserves for AR is comprised of $348 million in cont. adjustments, $41 million in charity care

and $141 million in prov. for doubtful accounts.

** Amounts due to the University total $29.3 million of which $18 million is reported in other current liab.

and the remaining $11.3 million is reported in other liabilities.

Public Health Trust of Miami-Dade County (Consolidated)

Combined Balance Sheet

April 2013

(Amounts in thousands)

Apr 13 Dollar Change

ASSETS:

Cash and Investments 81,436 51,148 30,288

Cash and Investments Restricted 24,779 18,204 6,574

Cash and Investments Limited as to Use 43,695 12,088 31,607

Gross Patient Accounts Receivable 673,504 675,129 (1,624)

Allowances for Contractuals and Bad Debt (529,758) (525,109) (4,649)

Net Accounts Receivable 143,746 150,019 (6,273)

Third Party Receivable 50,054 152,724 (102,670)

Due From Miami-Dade County 45,873 33,247 12,626

Other Receivables - Restricted 4,121 3,861 259

Inventories 23,537 23,854 (317)

Prepaid Expenses and Other Current Assets 6,159 5,079 1,080

Total Current Assets 423,400 450,224 (26,825)

Due From Restricted Funds 0 0 0

Cash and Investments Limited as to Use - LT 23,499 24,085 (586)

Cash and Investments Restricted - LT 58,342 66,575 (8,233)

Capital Assets, Net 442,846 462,237 (19,390)

Other Assets 6,956 6,925 31

Total Non-Current Assets 531,643 559,822 (28,178)

Total Assets 955,043$ (4,779)$ 1,010,046$ (55,003)$

Current Portion of Long Term Debt 7,325 7,325 0

Accounts Payable and Accrued Expenses 112,338 138,431 (26,093)

Accrued Salaries and Payroll Taxes Withheld 129,031 132,835 (3,803)

Due to Other Third Party 107,013 156,821 (49,808)

Due to Miami-Dade County 17,948 23,791 (5,844)

Other Restricted 6,128 6,696 (568)

Other Current Liabilities 40,793 29,458 11,335

Total Current Liabilities 420,577 495,358 (74,781)

Long Term Debts, Excluding Current Portion 350,627 350,425 201

Other Liabilities 77,744 76,203 1,541

Total Liabilities 848,948 921,987 (73,038)

NET ASSETS:

Unrestricted Net Assets (64,802) (100,850) 36,049

Invested in Capital Assets 166,686 185,409 (18,723)

Restricted Net Assets 4,210 3,501 709

Total Net Assets 106,095 18,035

FS-2

Total Liabilities & Net Assets 955,043$ (4,779)$ 1,010,046$ (55,003)$

C:/Documents and Settings/edgar.rodriguez/Local Settings/Temporary Internet Files/Content.IE5/7ECPEB70/Drill.jsp?_TYP=DT&_SYS=IF&_TLL=43&_KNB=01&01=1000

April 2013

Combined Statement of Revenue, Expenses & Change in Fund Net AssetsPublic Health Trust of Miami-Dade County


Apr 13

Actual

Apr 12

Actual

Apr 13

Budget

$ Variance

Month of April 2013

Apr 13 Actual

YTD

Apr 13

Budget YTD

Apr 12 Actual

YTD

7 Months Ended April 30, 2013

Budget Prior

% Variance

PriorBudget

$ Variance

PriorBudget

% Variance

PriorBudget

83,063 2,075 81,368 Hospital and physician services 564,974 574,039 (9,065) 559,070 80,988 5,904 1 %(2)% 1,695 3 % 2 %

226 Community Medical Practices 214 12 1,367 1,567 1,514 52 8,493 (6,926) (82)% 3 %(1,141) 5 % (83)%

Primary Care Centers 155 196 (41) 774 1,107 1,389 (282) 2,355 (1,248) (53)%(20)%(619) (21)% (80)%

1,804 Continuing Care (SNF) 1,907 (103) 2,388 12,659 13,468 (808) 13,266 (584) (5)% (24)% (606) (6)% (5)%

Net Patient Service Revenue 85,248 83,306 1,942 85,896 580,307 590,410 (10,103) 583,183 (2,876) 0 %(2)%(648) 2 % (1)%

Division of Managed Care 6,563 7,249 (686) 7,214 49,227 50,025 (798) 90,293 (651) (9)% (9)% (41,066) (2)% (45)%

1,502 (393) 1,882 Grants Revenue 12,083 13,393 (1,311) 12,920 1,895 (837) (6)%(10)%(380) (21)% (20)%

6,677 1,174 5,980 Other Operating Revenue 44,539 38,904 5,634 35,692 5,504 8,847 25 % 14 % 697 21 % 12 %

2,036 Total Operating Revenue (6,578) 99,990 97,954 100,973 686,155 692,733 722,088 (983) 2 % (1)% (35,933) (1)% (5)%

66,919 (3,201) 70,789 Salaries & Related Costs 468,860 448,358 (20,503) 509,512 63,718 40,652 8 %(5)% 3,870 (5)% 5 %

27,873 1,392 30,600 Contractual and Purchased Serv. 204,039 214,215 10,176 198,375 29,266 (5,665) (3)% 5 % 2,727 5 % 9 %

Division of Managed Care - Paid Claims 6,950 7,174 224 4,902 49,779 50,216 437 82,517 (2,048) 3 % (42)% 32,739 1 % 40 %

16,591 (823) 14,655 Supplies 109,442 111,780 2,338 104,856 15,769 (4,586) (4)% 2 %(1,936) (5)% (13)%

4,534 737 5,556 Depreciation 33,138 40,939 7,801 41,526 5,271 8,388 20 % 19 % 1,022 14 % 18 %

1,487 34 1,470 Interest 10,083 10,646 563 10,248 1,521 165 2 % 5 %(17) 2 % (1)%

1,623 188 1,940 Other Operating Expenses 10,171 12,675 2,504 13,635 1,811 3,464 25 % 20 % 317 10 % 16 %

125,978 124,528 (1,450) 129,912 Total Operating Expenses 885,512 888,829 3,317 960,669 3,935 (1)% 3 % 75,157 0 % 8 %

(25,988) (26,574) 586 Gain (Loss) From Operations (199,357) (196,097) (3,261)(238,581)(28,940) 2,952 2 % 10 % 39,224 (2)% 16 %

48 (30) 76 Investment Income 361 549 (187) 626 78 (264) (42)%(34)%(29) (39)% (38)%

1,498 (20) 1,524 Other Income 10,146 10,725 (579) 10,687 1,518 (540) (5)%(5)%(26) (1)% (2)%

11,094 0 11,085 Dade County Unrestricted Funds 77,657 77,657 0 77,594 11,094 64 0 % 0 % 9 0 % 0 %

17,575 1,017 16,292 Unrestricted Health Care Surtax 125,258 122,628 2,630 120,654 16,558 4,603 4 % 2 % 1,283 6 % 8 %

30,214 29,247 967 28,976 Total Non-Operating Gain Net 213,423 211,559 1,864 209,561 1,238 3 % 4 % 3,862 1 % 2 %

4,226 2,673 1,553 37 Revenue & Gain in Excess of Exp. & Loss 14,066 15,463 (1,397)(29,020) 4,190 58 %(11463)% 43,086 9 % 148 %

0 0 0 Capital Contributions – Grants and Other 0 0 0 0 0 0 0 % 0 % 0 0 % 0 %

1,700 1,700 0 JM Foundation 2,268 0 2,268 0 0 2,268 0 % 0 % 1,700 0 % 0 %

0 0 806 Miami Dade County GOB 1,701 0 1,701 8,499 0 (6,798) (80)% 0 %(806) 0 % (100)%

5,926 2,673 3,253 843 Revenue & Gain after Extraordinary Loss 18,035 15,463 2,572 (20,521) 5,083 122 % (603)% 38,556 (17)% 188 %

FS-3

April 2013

Combined Statement of Revenue, Expenses & Change in Fund Net AssetsPublic Health Trust of Miami-Dade County


excluding Division of Managed Care

Apr 13

Actual

Apr 12

Actual

Apr 13

Budget

$ Variance

Month of April 2013

Apr 13

Actual YTD

Apr 13

Budget YTD

Apr 12 Actual

YTD

7 Months Ended April 30, 2013

Budget Prior

% Variance

PriorBudget

$ Variance

PriorBudget

% Variance

PriorBudget

83,063 2,075 81,368 Hospital and physician services 564,974 574,039 (9,065) 559,070 80,988 5,904 1 %(2)% 1,695 3 % 2 %

226 Community Medical Practices 214 12 1,367 1,567 1,514 52 8,493 (6,926) (82)% 3 %(1,141) 5 % (83)%

Primary Care Centers 155 196 (41) 774 1,107 1,389 (282) 2,355 (1,248) (53)%(20)%(619) (21)% (80)%

1,804 Continuing Care (SNF) 1,907 (103) 2,388 12,659 13,468 (808) 13,266 (584) (5)% (24)% (606) (6)% (5)%

Net Patient Service Revenue 85,248 83,306 1,942 85,896 580,307 590,410 (10,103) 583,183 (2,876) 0 %(2)%(648) 2 % (1)%

1,502 (393) 1,882 Grants Revenue 12,083 13,393 (1,311) 12,920 1,895 (837) (6)%(10)%(380) (21)% (20)%

6,677 1,174 5,980 Other Operating Revenue 44,539 38,904 5,634 35,692 5,504 8,847 25 % 14 % 697 21 % 12 %

2,722 Total Operating Revenue (5,779) 93,427 90,705 93,759 636,928 642,708 631,795 (331) 3 % 0 % 5,133 (1)% 1 %

66,919 (3,201) 70,792 Salaries & Related Costs 468,860 448,358 (20,503) 506,451 63,718 37,590 7 %(5)% 3,873 (5)% 5 %

27,873 1,392 30,600 Contractual and Purchased Serv. 204,039 214,215 10,176 198,375 29,266 (5,665) (3)% 5 % 2,727 5 % 9 %

16,591 (823) 14,655 Supplies 109,442 111,780 2,338 104,855 15,769 (4,587) (4)% 2 %(1,936) (5)% (13)%

4,528 737 5,551 Depreciation 33,098 40,899 7,801 41,484 5,265 8,386 20 % 19 % 1,022 14 % 18 %

1,487 34 1,470 Interest 10,083 10,646 563 10,248 1,521 165 2 % 5 %(17) 2 % (1)%

1,623 188 1,940 Other Operating Expenses 10,171 12,675 2,504 13,635 1,811 3,464 25 % 20 % 317 10 % 16 %

119,022 117,349 (1,674) 125,008 Total Operating Expenses 835,693 838,573 2,880 875,047 5,985 (1)% 5 % 39,354 0 % 4 %

(25,595) (26,644) 1,049 Gain (Loss) From Operations (198,765) (195,866) (2,900)(243,252)(31,249) 5,654 4 % 18 % 44,487 (1)% 18 %

43 (32) 76 Investment Income 350 532 (182) 625 75 (275) (44)%(34)%(33) (43)% (44)%

1,498 (20) 1,524 Other Income 10,146 10,725 (579) 10,687 1,518 (540) (5)%(5)%(26) (1)% (2)%

11,094 0 11,085 Dade County Unrestricted Funds 77,657 77,657 0 77,594 11,094 64 0 % 0 % 9 0 % 0 %

17,575 1,017 16,292 Unrestricted Health Care Surtax 125,258 122,628 2,630 120,654 16,558 4,603 4 % 2 % 1,283 6 % 8 %

30,209 29,245 965 28,976 Total Non-Operating Gain Net 213,412 211,543 1,869 209,560 1,233 3 % 4 % 3,852 1 % 2 %

4,614 2,601 2,013 (2,273) Revenue & Gain in Excess of Exp. & Loss 14,647 15,677 (1,030)(33,692) 6,887 77 % 303 % 48,339 7 % 143 %

0 0 0 Capital Contributions – Grants and Other 0 0 0 0 0 0 0 % 0 % 0 0 % 0 %

1,700 1,700 0 JM Foundation 2,268 0 2,268 0 0 2,268 0 % 0 % 1,700 0 % 0 %

0 0 806 Miami Dade County GOB 1,701 0 1,701 8,499 0 (6,798) (80)% 0 %(806) 0 % (100)%

6,314 2,601 3,713 (1,467) Revenue & Gain after Extraordinary Loss 18,616 15,677 2,939 (25,193) 7,781 143 % 531 % 43,809 (19)% 174 %

FS-3A

April 2013

P & L 12 Month Trend Analysis

Public Health Trust of Miami-Dade County

Apr 13 Mar 13 Feb 13 Jan 13 Dec 12 Nov 12 Oct 12 Sep 12 Aug 12 Jul 12 Jun 12 May 12

232,799 Inpatient Services 244,119 226,302 251,495 232,232 233,610 238,341 222,392 237,745 233,008 226,910 236,055

104,258 Ambulatory Services 103,280 93,105 100,923 91,335 93,994 103,439 96,082 101,763 96,816 97,900 108,562

Gross Patient Service Revenue 337,057 347,398 319,406 352,418 323,567 341,780 318,474 339,509 329,824 324,810 327,604 344,616

186,441 Contractual Adjustments 195,560 181,026 193,444 181,197 184,877 190,412 387,022 177,993 175,101 172,262 182,144

Charity Care 31,720 32,153 27,261 30,416 27,873 29,693 32,713 29,139 34,824 30,236 31,075 34,709

Net Patient Revenue Adjustment 0 0 0 0 0 0 0 0 0 0 0 0

33,648 Provision for Doubtful Accounts 39,261 33,268 41,338 31,904 31,317 33,403 22,027 36,824 36,728 41,478 37,229

251,809 Total Deductions From Revenue 266,974 241,555 265,198 240,974 245,886 256,529 438,188 249,641 242,065 244,815 254,082

Net Patient Service Revenue 80,424 77,851 87,220 82,593 81,718 85,251 (119,714) 89,867 87,760 79,995 90,534 85,248

6,563 Division of Managed Care 6,547 7,458 6,610 7,423 7,229 7,398 7,351 7,006 8,298 7,167 7,347

6,677 Other Operating Revenue 10,757 5,657 5,447 4,904 6,242 4,855 223,884 6,114 4,708 11,206 5,535

1,502 Grants Revenue 1,941 2,041 2,217 1,581 1,094 1,707 1,357 1,535 1,617 2,525 2,146

99,990 Total Operating Revenue 99,669 93,006 101,495 96,501 96,282 99,211 112,879 104,522 102,384 100,894 105,562

66,919 Salaries & Related Costs 69,234 63,648 65,753 69,628 64,674 69,004 64,361 69,882 69,747 66,184 70,679

Contractual and Purchased Services 27,873 30,595 28,942 30,468 25,832 29,320 31,009 32,754 30,962 31,021 32,715 31,499

16,591 Supplies 15,039 15,596 16,239 14,492 16,380 15,105 13,522 16,712 16,255 17,524 17,785

Division of Managed Care Paid Claims 6,950 6,335 7,357 6,540 8,432 7,022 7,143 5,036 4,703 6,023 4,854 5,023

1,487 Interest 1,274 1,490 1,461 1,462 1,453 1,455 1,396 1,897 1,479 1,361 1,545

535 Provision for Self-Insured Claims 368 703 535 535 535 535 (3,942) 583 583 595 577

1,090 Public Med/Assist. Trust F. Assess (199) 1,090 1,096 1,090 1,102 1,141 1,245 821 1,203 1,358 1,358

4,534 Depreciation 4,641 4,684 4,684 4,648 4,688 5,259 4,451 4,666 4,947 5,035 5,690

(1)Other Operating Expenses 0 4 0 0 0 13 1 1 6 0 (5)

125,978 Total Operating Expenses 123,513 127,286 126,776 126,120 125,175 130,665 118,823 130,227 131,262 129,626 134,151

(25,988)Gain (Loss) From Operations (27,617) (30,507) (25,281) (29,618) (28,893) (31,454) (5,944) (25,704) (28,878) (28,732) (28,589)

1,271 Med. Edu. and Tert. Care Fund 1,162 1,289 1,289 1,157 1,355 1,355 621 1,355 1,355 1,355 1,355

48 Interest Income - Non. Operating 56 57 31 47 52 76 (360) 53 82 76 64

(1)Unrealized Gains and Losses (1) (1) (1) (1) (1) (1) (65) (1) (1) (1) (1)

228 Other Non-Operating 156 211 163 167 175 171 (415) 202 188 164 157

11,094 Dade County Unrestricted Funds 11,094 11,094 11,094 11,094 11,094 11,094 11,429 11,085 11,085 11,085 11,085

17,575 Unrestricted Health Care Surtax 18,331 20,878 17,855 16,172 18,144 16,304 15,853 15,895 16,256 16,571 17,252

TOTAL Non-Operating Gain Net 30,214 30,799 33,527 30,431 28,636 30,818 28,998 27,063 28,588 28,964 29,249 29,912

4,226 Revenue & Gain in Excess of Exp. & Loss 3,181 3,020 5,150 (982) 1,925 (2,456) 21,119 2,884 86 516 1,322

0 Capital Contributions – Grants and Other 0 0 0 0 0 0 0 0 0 0 0

1,700 JM Contributions 437 0 77 0 54 0 0 0 0 200 0

0 Miami Dade Cty. GOB 0 1,321 285 5 90 0 1,479 298 466 350 0

5,926 Revenue & Gain after Extraordinary Loss 3,618 4,342 5,512 (977) 2,070 (2,456) 22,598 3,182 552 1,066 1,322

FS-4

Jackson Health System Jackson Health System

April 2013 Actual April 2013 YTD ActualCombining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding

Jackson

Memorial

Hospital

Jackson

South

Jackson

North

Physician

Services

JHS

Health Plan

Nursing

Homes

Primary

Care

Corrections

Health

Services

Jackson

Medical

Towers Total

Total Gross Inpatient Revenue 178,344 20,293 31,126 3,036 1 232,799

Total Gross Outpatient Revenue 76,819 12,669 11,702 1,103 355 1,611 104,258

Total Gross Revenue 255,163 32,961 42,828 1,103 3,391 1,612 337,057

Total Deductions from Revenue -189,042 -25,166 -33,681 -877 -1,587 -1,457 -251,809

Total Net Patient Revenue 66,121 7,796 9,146 226 1,804 155 85,248

Other Operating Revenue 4,884 269 93 779 242 33 378 6,677

Managed Care Revenue 6,563 6,563

Grant Revenue 1,502 1,502

Total Other Operating Revenue 6,385 269 93 779 6,563 242 33 378 14,742

Total Revenue 72,506 8,065 9,239 1,005 6,563 2,047 188 378 99,990

Operating Expenses

Salaries & Wages 44,003 3,605 3,558 964 -1 1,562 659 1,397 44 55,792

Benefits 9,000 632 617 145 1 372 116 238 6 11,127

Total Salaries & Benefits 53,002 4,237 4,175 1,109 1,934 776 1,635 51 66,919

Purchased Services 13,627 1,312 2,759 708 547 324 588 299 95 20,256

Managed Care Paid Claims 1 6,403 6,404

UM AOA Purchased Service 8,402 -1 6 8 8,415

Total Purchased Service 22,030 1,312 2,758 708 6,950 329 596 299 95 35,076

Supplies 14,289 1,070 732 31 289 56 -138 10 16,339

Total Direct Operating Cost 89,322 6,620 7,665 1,847 6,950 2,552 1,427 1,796 155 118,333

Depreciation 3,359 844 237 4 6 51 10 4 19 4,534

Interest 1,456 2 30 1,487

Self Insurance 421 21 91 2 535

HCCB Assessment 857 93 140 1,090

Other Operating Expense 1 -2 -1

Total Other Operating Cost 6,094 956 469 4 6 51 12 4 48 7,645

Total Operating Expenses Before

Allocations 95,416 7,576 8,134 1,851 6,955 2,603 1,439 1,799 203 125,978

Allocated Corporate Services:

Clinical Trials Office -19 -2 -2 -1 -1 -26Corporate Administration 1,648 174 187 43 13 60 33 41 5 2,203

Financial Services 520 55 59 13 4 19 10 13 1 695Human Resources 1,259 91 91 13 64 16 37 2 1,573

Integrity 135 14 15 3 1 5 3 3 180Information Technology 3,613 446 580 7 6 7 22 7 6 4,694

Public Safety 590 80 105 35 56 866Revenue Cycle Management 2,848 368 478 18 3,711

Strategic Sourcing 1,005 86 126 27 20 22 23 6 4 1,317

Total Allocated Corporate Services 11,599 1,312 1,638 105 44 210 180 107 19 15,213Total Expenses Subject to Allocation -15,213 -15,213

Total Operating Expenses Including

Allocations 91,801 8,888 9,772 1,956 6,999 2,814 1,620 1,906 222 125,978

Excess of Operating Revenue over

(under) Operating Expenses -19,295 -823 -533 -952 -436 -767 -1,431 -1,906 156 -25,988

Non Operating Revenue and Expenses

Investment Income 44 5 48

Unrestricted Health Care Surtax 17,575 17,575

Miami Dade County Unrestricted Funds 11,094 11,094

Other Income 1,266 14 217 1,497

JMH Foundation 1,700 1,700

Total Non Operating Revenue 31,678 14 5 217 31,914

Redistribution of Revenue -5,323 2,567 2,135 278 343

Total Non Operating Revenue After

Redistribution 26,355 2,581 2,135 5 278 343 217 31,914

Excess of Revenue over (under)

Expenses before GOB and County

Special Contributions 7,060 1,758 1,601 -952 -432 -489 -1,088 -1,906 373 5,926

Miami Dade County GOB Contributions

Miami Dade County Special Contributions

Total Miami Dade GOB and Special

Contributions

Excess of Revenue over (under)

Expenses 7,060 1,758 1,601 -952 -432 -489 -1,088 -1,906 373 5,926

FS-5 FS-6

Jackson Health System

April 2013 YTD ActualCombining Statement of Revenue & Expense Reflecting Allocated Corporate Overhead & Public Support Funding

Jackson

Memorial

Hospital

Jackson

South

Jackson

North

Physician

Services

JHS

Health Plan

Nursing

Homes

Primary

Care

Corrections

Health

Services

Jackson

Medical

Towers Total

Total Gross Inpatient Revenue 1,269,799 135,994 231,727 21,375 4 1,658,898

Total Gross Outpatient Revenue 503,518 88,272 78,807 7,714 2,121 9,903 690,333

Total Gross Revenue 1,773,316 224,265 310,533 7,714 23,496 9,906 2,349,232

Total Deductions from Revenue -1,339,952 -167,232 -235,958 -6,148 -10,837 -8,799 -1,768,925

Total Net Patient Revenue 433,364 57,034 74,576 1,567 12,659 1,107 580,307

Other Operating Revenue 33,902 1,756 694 4,447 838 316 7 2,579 44,539

Managed Care Revenue 49,227 49,227

Grant Revenue 11,926 157 12,083

Total Other Operating Revenue 45,828 1,756 694 4,447 49,227 995 316 7 2,579 105,848

Total Revenue 479,192 58,789 75,270 6,014 49,227 13,654 1,423 7 2,579 686,155

Operating Expenses

Salaries & Wages 309,086 25,100 25,827 6,280 -8 10,852 4,090 9,490 321 391,038

Benefits 62,558 4,542 4,519 1,061 8 2,687 700 1,693 55 77,822

Total Salaries & Benefits 371,644 29,642 30,346 7,340 13,538 4,790 11,183 376 468,860

Purchased Services 96,890 8,684 19,047 4,451 2,696 2,502 4,283 591 651 139,795

Managed Care Paid Claims 1 47,083 47,084

UM AOA Purchased Service 67,017 2 40 129 67,188

Total Purchased Service 163,908 8,686 19,047 4,451 49,779 2,543 4,412 591 651 254,067

Supplies 89,006 8,527 8,963 143 1,785 259 447 59 109,189

Total Direct Operating Cost 624,558 46,855 58,356 11,935 49,779 17,866 9,462 12,221 1,086 832,116

Depreciation 24,651 5,920 1,918 29 40 356 71 26 131 33,141

Interest 9,862 14 207 10,083

Self Insurance 2,954 144 635 14 3,748

HCCB Assessment 4,994 552 863 6,409

Other Operating Expense 1 15 16

Total Other Operating Cost 42,462 6,632 3,429 29 40 356 85 26 338 53,396

Total Operating Expenses Before

Allocations 667,019 53,487 61,785 11,963 49,819 18,221 9,546 12,247 1,424 885,512

Allocated Corporate Services:

Clinical Trials Office 256 28 32 6 1 10 5 6 1 346Corporate Administration 11,415 1,251 1,445 280 64 425 220 286 33 15,420

Financial Services 3,021 331 382 74 17 113 58 76 9 4,081Human Resources 7,215 519 541 73 1 362 78 204 13 9,005

Integrity 1,070 117 135 26 6 40 21 27 3 1,446Information Technology 23,769 2,869 3,970 46 44 47 128 46 44 30,965

Public Safety 5,075 808 1,054 351 562 7,852Revenue Cycle Management 25,853 3,270 4,527 144 33,795

Strategic Sourcing 6,710 621 1,011 166 97 155 164 37 26 8,988

Total Allocated Corporate Services 84,384 9,815 13,099 671 231 1,503 1,381 683 129 111,896Total Expenses Subject to Allocation -111,896 -111,896

Total Operating Expenses Including

Allocations 639,507 63,302 74,884 12,635 50,050 19,724 10,927 12,930 1,553 885,512

Excess of Operating Revenue over (under)

Operating Expenses -160,316 -4,513 386 -6,621 -823 -6,070 -9,504 -12,923 1,026 -199,357

Non Operating Revenue and Expenses

Investment Income 356 11 368

Unrestricted Health Care Surtax 125,258 125,258

Miami Dade County Unrestricted Funds 77,657 77,657

Other Income 9,417 9 715 10,140

JMH Foundation 2,268 2,268

Total Non Operating Revenue 214,956 9 11 715 215,691

Redistribution of Revenue -40,378 18,576 17,427 2,076 2,298

Total Non Operating Revenue After

Redistribution 174,579 18,585 17,427 11 2,076 2,298 715 215,691

Excess of Revenue over (under) Expenses

before GOB and County Special

Contributions 14,263 14,072 17,813 -6,621 -812 -3,994 -7,206 -12,923 1,741 16,334

Miami Dade County GOB Contributions

Miami Dade County Special Contributions 1,701 1,701

Total Miami Dade GOB and Special

Contributions 1,701 1,701

Excess of Revenue over (under) Expenses 15,964 14,072 17,813 -6,621 -812 -3,994 -7,206 -12,923 1,741 18,035

FS-6

Combining Statement of Revenue & Expenses by Company

Public Health Trust of Miami-Dade County Consolidated


Month of April 2013

Jackson

SouthJackson

Memorial

Jackson

North

Physician

Services

JHS Health

Plan

Primary

Care

Centers

Corrections

Health

Services

Skilled

Nursing

Facilities

Jackson

Medical

Towers Total

Prior

Year

Actual

Revenue

178,344 230,623 20,293 31,126 Inpatient Revenue 0 0 1 0 3,036 0 232,799

76,819 100,215 12,669 11,702 Outpatient Revenue 1,103 0 1,611 0 355 0 104,258

330,838 Gross Patient Service Revenue 32,961 42,828 1,103 0 1,612 0 3,391 0 337,057 255,163

Deductions From Revenue:

139,885 164,165 17,887 26,576 Contractual Adjustments 877 0 461 0 755 0 186,441

Provisions For Charity Care 26,823 1,922 1,284 0 0 996 0 694 0 31,720 31,803

Net Patient Revenue Adjustment 0 0 0 0 0 0 0 0 0 0 0

22,334 48,973 5,357 5,821 Provision for Doubtful Accounts 0 0 0 0 137 0 33,648

189,042 244,941 Total Deductions From Revenue 25,166 33,681 877 0 1,457 0 1,587 0 251,809

66,121 85,896 Net Patient Service Revenue 7,796 9,146 226 0 155 0 1,804 0 85,248

0 7,214 0 0 Division of Managed Care 0 6,563 0 0 0 0 6,563

4,884 5,980 269 93 Other Operating Revenue 779 0 33 0 242 378 6,677

1,502 1,882 0 0 Grants Revenue 0 0 0 0 0 0 1,502

72,506 100,973 Total Operating Revenue 8,065 9,239 1,005 6,563 188 0 2,047 378 99,990

Operating Expenses

53,002 70,789 4,237 4,175 Salaries & Related Costs 1,109 0 776 1,635 1,934 51 66,919

22,030 35,502 1,312 2,758 Contractual and Purchased Services 708 6,950 596 46 329 95 34,823

14,289 14,655 1,070 732 Supplies 31 0 56 115 289 10 16,591

1,456 1,470 0 2 Interest 0 0 0 0 0 30 1,487

3,359 5,556 844 237 Depreciation 4 6 10 4 51 19 4,534

1,278 1,940 112 231 Other Operating Expenses 0 0 2 0 0 0 1,623

95,415 129,912 Total Operating Expenses 7,576 8,134 1,851 6,955 1,440 1,799 2,603 203 125,978

(28,940)Excess of operating revenue over (under)

operating expenses 489 1,105 (847) (393) (1,252) (1,799) (557) 175 (25,988)(22,909)

Other Revenues (Expenses)

44 76 (1) 0 Investment Income 0 5 0 0 0 0 48

17,575 16,292 0 0 Unrestricted Health Care Surtax 0 0 0 0 0 0 17,575

11,094 11,085 0 0 Miami Dade County Unrestricted Funds 0 0 0 0 0 0 11,094

1,266 1,524 15 0 Other Income 0 0 0 0 0 217 1,498

0 0 0 0 Miami Dade County Special Contributions 0 0 0 0 0 0 0

1,700 0 0 0 JM Foundation 0 0 0 0 0 0 1,700

0 806 0 0 Miami Dade County GOB Contributions 0 0 0 0 0 0 0

Total Other Revenues (expenses) 31,678 14 0 0 5 0 0 0 217 31,914 29,783

8,769 843 Excess of revenues over (under) expenses 502 1,105 (847) (388) (1,252) (1,799) (557) 392 5,926

FS-7

Unaudited

Current Month Year to Date Year to Date

April 30, 2013 April 30, 2013 September 30, 2012

Cash generated (used) by operations:

Funds available for working capital/facilities improvements $5,926 $18,035 $8,200

Non cash expenses:

Depreciation 4,534 33,138 66,316

Loss on disposal of capital assets (15) (65) 791

Total 10,445 51,108 75,307

Cash provided (used) for current assets:

Decreases (increases) in:

Patient Receivable and Other Third Party payor 43,984 96,317 (73,668)

Cash and Invst. Restricted - - -

Cash and Invst. Limited as to Use (28,566) (31,607) 28,181

Inventories, Prepaid Expenses and Other Receivables (65) (1,023) (1,132)

Total 15,353 63,687 (46,619)

Cash provided (used) for current liabilities:

Increases (decreases) in:

Current Installment of Long Term Debt - - 305

Accounts Payable and Accrued Expenses (3,126) (29,897) (73,894)

Due to other third party (11,519) (55,651) 46,128

Other Liabilities (2,591) 11,335 (12,146)

Other- Restricted 50 (568) (5,531)

Total (17,186) (74,781) (45,138)

Decreases (increases) in:

Cash and Invst. Limited as to Use (590) 586 8,982

Cash and Invst. Restricted 823 8,233 20,755

Long Term Investment - - -

-

-

Cash provided (used) for Other Assets 25 (31) 695

-

Cash provided (used) for Long Term Liabilities: -

Increases (decreases) in: -

Long Term Debt 30 203 (6,980)

Other Liabilities 6,451 1,540 (5,245)

Total 6,481 1,743 (12,225)

Cash provided (used) for Prop., Plant and Equipment:

Purchases of Prop. Plant and Equipment (2,780) (13,682) (27,697)

- -

Total (2,780) (13,682) (27,697)

- - -

Net Increase in Cash and Cash Equivalents 12,571 36,863 (25,940)

-

Cash, beginning of period 93,644 69,352 95,292

Cash, end of period 106,215 106,215 69,352

Public Health Trust


Combined Statement of Unrestricted / Restricted Cash Flow

As of April 30, 2013

FS-8

PUBLIC HEALTH TRUST

CONSOLIDATED PORTFOLIO INVENTORY SUMMARY BY SECURITY/ACCOUNT TYPE

April 30, 2013

# of Investments Description Par Value Avg. Interest Rate Market Value

2 Money Markets 13,534,523$ 0.010% 13,534,523

2 Total Investments Portfolio 13,534,523

Non-interest bearing account - Restricted 0.000% 1,194,844

Wells Fargo interest bearing accts 0.250% 144,864,454

Bond Proceeds Invested at Miami-Dade County 0.435% 72,156,765

Total Cash and Investments 231,750,585$

FS-9

PUBLIC HEALTH TRUSTSALES TAX

MONTHLY INCOME STATEMENT TREND ANALYSIS

FISCAL YEAR 2011

Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11

monthly est 13,824,281 14,678,092 16,682,866 13,920,256 14,838,038 16,271,145 14,306,810 13,703,273 14,469,444 14,750,928 13,821,758 14,713,753

mo portion of qtly est: 1,000,647 1,000,647 1,000,647 1,028,196 1,028,196 1,028,196 1,059,468 1,059,468 1,059,468 1,065,225 1,065,225 1,065,225

State revision to Sales Tax Projection

+/-est vs. actual rec'd; mo of (517,641) 101,749 25,778 192,040 (226,996) (267,975) 667,173 576,264 (49,580) (574,440)

+/-est vs. actual rec'd; qt of 236,771 457,528 - - 304,129

Monthly Revenue 14,824,928 15,678,739 17,165,872 15,286,972 15,892,012 17,491,381 15,139,283 14,952,294 16,196,085 16,392,417 15,141,532 15,204,538

FISCAL YEAR 2012


monthly est 14,482,634 14,779,176 17,607,553 15,330,625 15,914,413 17,395,891 15,855,155 15,355,434 15,563,007 14,907,488 15,041,626 14,844,604

mo portion of qtly est: 1,079,571 1,079,571 1,079,571 1,180,705 1,180,705 1,180,705 1,160,844 1,160,844 1,160,844 1,143,468 1,143,468 1,143,468

State revision to Sales Tax Projection 500,000

+/-est vs. actual rec'd; mo of 10,720 1,238,686 671,986 (106,944) (724,478) 335,025 (153,187) (295,446) (757,063) 16,220

+/-est vs. actual rec'd; qt of 257,405 400,370 466,672

Monthly Revenue 15,562,205 15,858,747 18,697,844 17,750,016 18,024,509 18,469,652 16,291,521 17,251,673 16,570,664 16,255,510 15,894,703 16,004,292

FISCAL YEAR 2013


monthly est 15,096,482 16,870,407 15,156,957 15,600,201 15,600,201 15,600,201 15,600,201

mo portion of qtly est: 1,207,668 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109 1,273,109

State revision to Sales Tax Projection

+/-est vs. actual rec'd; mo of (257,802) 981,343 3,665,869 1,457,919 701,194

+/-est vs. actual rec'd; qt of 338,409

Monthly Revenue 16,304,150 18,143,516 16,172,264 17,854,653 20,877,588 18,331,229 17,574,504 - - - - -

Comments:

• Estimate was calculated based on same month prior year adjusted for percentage change of recent receipts

vs. recent estimates.

FS-10

Actual Budget % Variance Actual Actual Budget % Variance

FC Group Apr-13 Apr-13 Budget Mar-13 YTD YTD Budget


Combined percentages:

Commercial 1.76% 2.33% -0