Finance Committee January 2019 1 November 2018 Financial Report - PowerPoint PPT Presentation

Finance Committee January 2019 1

November 2018 Financial Report AGENDA • October Highlights • November Highlights • Forecast 2

October 2018 Financial Report Volume Highlights Inpatient activity continues to be strong. • Acute days 3.1% > budget in October, 6.1% > budget YTD; • ALOS > budget 4.7% YTD. • Post Acute days > budget 0.3% in October, 0.6% > budget YTD. • Clinic Visits 2.5% > budget in October, 1.8% < budget YTD. • ER visits 7.6% < budget in October, 864 visits < prior year. • Physician wRVU’s 12.2% > budget in October, 7.1% > budget YTD, 19.4% > prior year. • October 2018 Year-To-Date FY 2018 Actual Budget Variance % Variance Actual Budget Variance % Variance YTD % Change Acute discharges 1,461 1,469 (8) (0.5)% 5,986 5,906 80 1.4% 6,077 (1.5)% Acute patient days 8,454 8,203 251 3.1% 34,396 32,426 1,970 6.1% 32,848 4.7% Acute average length of stay 5.8 5.6 0.2 3.8% 5.8 5.5 0.3 4.7% 5.4 6.3% Acute average daily census 273 265 8 3.0% 280 264 16 6.1% 267 4.9% Adjusted patient days (APD) 31,303 30,508 795 2.6% 123,849 120,899 2,950 2.4% 119,082 4.0% Post acute discharges 87 66 21 31.8% 303 293 10 3.4% 241 25.7% Post acute patient days 9,264 9,233 31 0.3% 36,915 36,712 203 0.6% 36,161 2.1% Post acute average daily census 299 298 1 0.3% 300 298 2 0.7% 294 2.0% Clinic Visits 31,703 30,939 764 2.5% 116,691 118,875 (2,184) (1.8)% 115,257 1.2% Visits per Clinic Day 1,441 1,406 35 2.5% 1,373 1,399 (26) (1.8)% 1,356 1.2% Physician wRVUs 88,998 79,341 9,657 12.2% 340,028 317,364 22,664 7.1% 284,780 19.4% 3

October 2018 Financial Report Highlights NPSR under budget by $1.0 million, YTD still looking at $27-29 million annual shortfall. • Supplemental Revenue slightly under budget. • Expenses under budget by $1.6 million more than offset revenue shortfall this month. • Operating Income $0.4 million over budget in October. YTD $0.5 mill under w/o capital • cost reimbursement. EBIDA over budget by 0.4% in October, 0.3% under budget YTD • Net Income $3.6 million over budget YTD due to long term portion of Pension Expense. • October 2018 Year-To-Date FY 2018 Actual Budget Variance % Var Actual Budget Variance % Var YTD % Change Net patient service revenue $ 54,270 $ 55,263 $ (993) (1.8)% $ 211,523 $ 219,455 $ (7,932) (3.6)% $ 202,390 4.5% Supplemental revenue 32,827 33,002 (176) (0.5)% 136,323 132,010 4,314 3.3% 125,428 8.7% Net operating revenue 87,097 88,265 (1,168) (1.3)% 347,846 351,465 (3,618) (1.0)% 327,818 6.1% Operating expense 82,298 83,906 (1,607) (1.9)% 334,169 341,684 (7,514) (2.2)% 324,140 3.1% Operating Income 4,799 4,359 439 10.1% 13,677 9,781 3,896 39.8% 3,678 271.9% Other non-operating activity (3,143) (4,154) 1,011 (211.6)% (16,961) (16,614) (347) (191.7)% (16,081) (356.1)% Net Income $ 1,655 $ 205 $ 1,450 706.9% $ (3,284) $ (6,833) $ 3,550 51.9% $ (12,403) 73.5% Operating Margin 5.5% 4.9% 0.6% 3.9% 2.8% 1.1% 1.1% EBIDA Margin 7.0% 6.6% 0.4% 4.1% 4.4% (0.3)% 2.8% Net Operating Revenue per APD 2,782 2,893 (111) (3.8)% 2,809 2,907 (98) (3.4)% 2,753 2.0% Expense per APD 2,629 2,750 (121) (4.4)% 2,698 2,826 (128) (4.5)% 2,722 (0.9)% Operating Income per APD 153 143 10 7.3% 110 81 30 36.5% 31 257.5% 4

November 2018 Financial Report Volume Highlights Inpatient activity continues to be strong. • Acute days 1.6% > budget in November, 5.4% > budget YTD; 4.7% > prior yr. • ALOS > budget 5.3% YTD. • Post Acute days > budget 2.1% in November, 2.1% > budget YTD; 3.6% > prior yr. • Clinic Visits 7.1% < budget in November, 2.8% < budget YTD; 0.2%> prior yr. • ER visits 7.8% < budget in November, 966 visits (1.9%) < prior yr. • Physician wRVU’s 7.0% > budget in November, 7.1% > budget YTD, 21.6% > prior yr. • November 2018 Year-To-Date FY 2018 Actual Budget Variance % Variance Actual Budget Variance % Variance YTD % Change Acute discharges 1,415 1,491 (76) (5.1)% 7,402 7,397 5 0.1% 7,642 (3.1)% Acute patient days 8,373 8,245 128 1.6% 42,884 40,671 2,213 5.4% 40,963 4.7% Acute average length of stay 5.9 5.5 0.4 7.1% 5.8 5.5 0.3 5.3% 5.4 8.0% Acute average daily census 279 275 4 1.5% 280 266 14 5.3% 268 4.5% Adjusted patient days (APD) 30,153 29,330 823 2.8% 155,163 150,221 4,942 3.3% 148,023 4.8% Post acute discharges 81 63 18 28.6% 383 356 27 7.6% 289 32.5% Post acute patient days 9,246 9,060 186 2.1% 46,716 45,772 944 2.1% 45,078 3.6% Post acute average daily census 308 302 6 2.0% 305 299 6 2.0% 295 3.4% Clinic Visits 26,060 28,054 (1,994) (7.1)% 142,802 146,929 (4,127) (2.8)% 142,546 0.2% Visits per Clinic Day 1,448 1,559 (111) (7.1)% 1,386 1,426 (40) (2.8)% 1,384 0.2% Physician wRVUs 84,932 79,341 5,591 7.0% 424,960 396,705 28,255 7.1% 349,445 21.6% 5

November 2018 Financial Report Highlights NPSR under budget by $3.2 million, YTD still looking at $27-29 million annual shortfall. • Supplemental Revenue slightly under budget. • Expenses under budget by $3.8 million more than offset revenue shortfall this month. • Operating Income $0.3 million over budget in November. • EBIDA over budget by 0.2% in November, 0.2% under budget YTD. • Net Income $4.9 million over budget YTD due to long term portion of Pension Expense. • November 2018 Year-To-Date FY 2018 Actual Budget Variance % Var Actual Budget Variance % Var YTD % Change Net patient service revenue $ 50,787 $ 54,025 $ (3,238) (6.0)% $ 262,310 $ 273,480 $ (11,170) (4.1)% $ 250,099 4.9% Supplemental revenue 32,669 33,002 (334) (1.0)% 168,992 165,012 3,980 2.4% 161,968 4.3% Net operating revenue 83,456 87,028 (3,572) (4.1)% 431,302 438,492 (7,190) (1.6)% 412,067 4.7% Operating expense 83,316 87,142 (3,826) (4.4)% 417,485 428,826 (11,341) (2.6)% 408,218 2.3% Operating Income 140 (115) 254 221.9% 13,817 9,666 4,150 42.9% 3,848 259.0% Other non-operating activity (3,052) (4,154) 1,102 69.5% (20,013) (20,768) 755 (142.0)% (20,534) 2.5% Net Income $ (2,913) $ (4,269) $ 1,356 31.8% $ (6,197) $ (11,102) $ 4,905 44.2% $ (16,685) 62.9% Operating Margin 0.2% (0.1)% 0.3% 3.2% 2.2% 1.0% 0.9% EBIDA Margin 1.7% 1.5% 0.2% 3.7% 3.9% (0.2)% 2.6% Net Operating Revenue per APD 2,768 2,967 (199) (6.7)% 2,780 2,919 (139) (4.8)% 2,784 (0.1)% Expense per APD 2,763 2,971 (208) (7.0)% 2,691 2,855 (164) (5.7)% 2,758 (2.4)% Operating Income per APD 5 (4) 9 (218.7)% 89 64 25 38.4% 26 242.5% 6

November 2018 Financial Report Revenue Highlights Gross Patient Service Revenue was consistent with activity for the month. • YTD Gross Revenue 2.7% above budget and 7.0% above prior year. • NPSR 4.9% above prior year. • Supplemental revenue over budget due to $4.4 million from County Capital Cost Reimb • FY16. NPSR Collection % is 2% less than prior yr – mainly due to charge increase of 2.4% • November 2018 Year-To-Date FY 2018 Actual Budget Variance % Variance Actual Budget Variance % Variance YTD % Change Inpatient service revenue $ 163,459 $ 161,979 $ 1,480 0.9% $ 827,511 $ 802,736 $ 24,775 3.1% $ 778,188 6.3% Outpatient service revenue 87,502 87,487 15 0.0% 462,990 459,960 3,029 0.7% 454,059 2.0% Professional service revenue 28,776 25,072 3,705 14.8% 142,523 132,305 10,218 7.7% 106,526 33.8% Gross patient service revenue 279,737 274,537 5,200 1.9% 1,433,024 1,395,001 38,023 2.7% 1,338,773 7.0% Deductions from revenues (232,046) (223,315) (8,732) (3.9)% (1,186,023) (1,135,535) (50,488) (4.4)% (1,102,506) 7.6% Capitation - HPAC 3,096 2,803 294 10.5% 15,309 14,014 1,295 9.2% 13,832 10.7% Net patient service revenue 50,787 54,025 (3,238) (6.0)% 262,310 273,480 (11,170) (4.1)% 250,099 4.9% Medi-Cal Waiver 9,541 9,546 (5) (0.1)% 47,705 47,730 (25) (0.1)% 51,375 (7.1)% Measure A, Parcel Tax, Other Support 9,942 10,025 (83) (0.8)% 49,708 50,125 (417) (0.8)% 49,120 1.2% Supplemental Programs 11,165 11,187 (22) (0.2)% 60,243 55,936 4,308 7.7% 49,751 21.1% Grants & Research Protocol 527 652 (125) (19.1)% 2,621 3,259 (638) (19.6)% 2,599 0.9% Other Operating Revenue 1,494 1,592 (99) (6.2)% 8,559 7,962 597 7.5% 9,123 (6.2)% Incentives - - - 0.0% 155 - 155 100.0% - 0.0% Supplemental revenue 32,669 33,002 (334) (1.0)% 168,992 165,012 3,980 2.4% 161,968 4.3% Net operating revenue $ 83,456 $ 87,028 $ (3,572) (4.1)% $ 431,302 $ 438,492 $ (7,190) (1.6)% $ 412,067 4.7% Collection % - NPSR 18.2% 19.7% (1.5)% 18.3% 19.6% (1.3)% 18.7% Collection % - Total 29.8% 31.7% (1.9)% 30.1% 31.4% (1.3)% 30.8% 7