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HomeMy WebLinkAbout20194265.tiff NCMC Board of Trustees Regular Session Minutes Monday, July 29, 2019 12:00 Noon The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday, July 29, 2019, in the Richard Stenner Boardroom located at North Colorado Medical Center. Mark Lawley, Chair, declared a quorum and called the meeting to order at 12:00 p.m. ATTENDANCE ROSTER NCMC Board of Trustees: Mark Lawley, Catherine Davis, Kevin Mullin, Michael Simone, and Jason Yeater, and Sean Conway (Commissioner, non-voting member), with Kay Kosmicki and Brian Underwood both Excused Banner Health: Margo Karsten (NCMC CEO)-Excused, Derek Strader (NCMC COO) Staff:Jeff Carlson (INC. Board Exec. Dir.)-Excused Recording Clerk: Esther Gesick (Weld County Clerk to the Board) PUBLIC COMMENT-There was no public comment. APPROVAL OF MINUTES It was MSC (Yeater/Davis) to approve the minutes from the June 24, 2019, Regular Session meeting. NCM CEO/COO REPORT Derek Strader reported there has been ongoing dialogue regarding the Colorado Department for Hospital Policy and Finance,which recently held a meeting with the NLCA and shared data through 2017,collected by their system called Prometheus,concerning UC Health and Banner in the market and each of the hospital margins and revenue. The focus for the Finance team was talking to local industry leaders and large employers that have healthy margins, becoming familiar with their data, and also working with the local RAE (Regional Accountable Entity) which owns Medicaid for the region on initiatives to reduce cost to the Medicaid population and being more proactive to prevent them from coming to higher acute settings that have associated costs. Mr. Strader stated they are also moving forward with the waiver where Medicaid will cover expenses of substance abuse disorder and pay for in-patient treatment. He stated the transition is complicated because the Emergency Department (ED) has a bed shortage but is also trying to address substance abuse among expectant mothers. He reported the UC Health Greeley Hospital is now open, which has created some capacity at NCMC and McKee, and as expected, there has been some ED volume shift on the in-patient side, which also translates to impacts on the financials. He stated they will continue to track the shift and anticipate a balance as the UC volume and wait times increase. Concerning the Ambulance Service, he stated Dave Lawson has been working with the VP of Ambulance Services, who reported the UC Health Ambulances have refused to bring patients to NCMC Page 1 of 3 July 29,2019 NCMC Board of Trustees Of:Winn ons 2019-4265 09/30( 19 and took them to the new hospital, whereas, the NCMC Ambulance Service has taken 60 patients to UC Health because it was the closest facility for care, or in response to a direct request of the patient. He stated the situation needs to be rectified and will be monitored, explaining if NCMC does not receive any ambulance patients from Evans, LaSalle and Kersey, • then they need to justify how the UC Health facility is closer than NCMC. Concerning Medicaid, Mr. Strader explained NCMC receives $0.19 per $1.00, and some services are provided but the reimbursement does not cover the cost of the service. The reimbursement for Medicare is a little higher, but it cannot sustain the margins, overall, and he discussed the contracted rates. COMMISSIONER'S REPORT Commissioner Conway reported the new Oil and Gas Regulations have been adopted and the Weld County Department of Oil and Gas Energy has been established, with Jason Maxey appointed as the Department Head. He stated staff is being hired and the department is set to open on August 5, 2019. He explained the County is taking advantage of its 1041 powers which are reserved to the Counties and, if the Colorado Oil and Gas Conservation Commission (COGCC) requires a 2A permit, the State will not have the opportunity to comment on local land use decisions. He stated the County Attorney met with Director Robbins this morning and the Commissioners are hopeful it will be a cooperative relationship in the coming years. He further stated there is a lot of municipal interest from local municipalities to have the County assist with their permitting needs. Commissioner Conway also discussed the plan for an upcoming, interactive process to review the Comprehensive Plan, as well as a Transportation Plan (in coordination with NFRMPO, DRCOG, and UFRMPO), in response to extensive growth throughout the County. The draft will be unveiled at the Farm Show in January and then start engaging in a robust public process to gain input and suggestions throughout 2020, prior to formal approval. In response to Mr. Mullin, Commissioner Conway discussed various regional transportation improvement projects, including U.S. Highway 34, the Boulder Turnpike, and the 1-25 project. VISITATION REPORT FOR JULY 29, 2019 BANNER CORPORATE (PHOENIX) CHATBOT: Josh Snyder, PMO Portfolio Director, was in attendance via a teleconference to provide an overview of the Chatbot technology. Following the meeting, Mr. Lawley submitted a summary of the presentation and related discussion, a written copy of which is attached as a part of these minutes. Mr. Yeater prepared and delivered a note of thanks. VISITATION REPORT FOR AUGUST 26, 2019 Kay Kosmicki and Michael Simone NCMC, INC. REPORT- None. NEW BUSINESS - None. Page 2 of 3 July 29,2019 NCMC Board of Trustees ADJOURN There being no further business to come before the Board, it was MSC [Simone/Davis] to adjourn the meeting at 1:00 p.m. Respectfully submitted, Esther Gesick Page 3 of 3 July 29,2019 NCMC Board of Trustees t r Department- Banner Corporate Trustee Report- Jason Yeater and Mark Lawley Presenter - Josh Snyder, PMO Portfolio Director, Chat Box Presentation History- Healthcare accounts for 18% of the US economy . 65% of its customers — patients -- believe their providers could do a better job of engaging them . More than half share experiences online and the reviews speak for themselves . Hospitals rank below most other service industries on Yelp, at 2 . 4 stars out of 5 . 75 % of patients are non - adherent to their care plans . Disengaged patients are expensive, costing sign75 % of patients are non - adherent to their care plans . Disengaged patients are expensive, costing significantly more than engaged patients in avoidable hospital admittances , higher treatment costs , low prescrip75 % of patients are non - adherent to their care plans . Disengaged patients are expensive, costing significantly more than engaged patients in avoidable hospital admittances , higher treatment costs, low prescription adherence , and preventable deaths . It' s a $ 300B problem . Healthcare providers must fix this . _ _ { .;r - _ '•per`n.'.t,-'a: _ 1.r- S pyf. Disengaged patients cost more Solutions- Better communication is key to engagement, but current strategies fall short . With 85% of adults owning smartphones, the world has clearly gone mobile . Apps, however, are not the answer. Adoption Rate 2% There are around 318 , 000 mobile health apps on the market, but only 2% of patients engage with hospital apps. Retention Rate 10% Only 10% of an app's users use the app 30 days after download, and users delete one app for every new one they get . r Time Outside Core Apps 12% People are downloading fewer apps and consolidating app usage, with only 12%of their time spent outside just five core apps. Text messaging is now the way people communicate. 93%of us are texting, and 98%of text messages are opened.Text messaging is convenient, intuitive, and doesn't require training or downloading. Chatbots are mobile,text-based conversations. By 2020, chatbots will automate$65B of consumer engagement. Healthcare's patient workflows are defined, repeatable, and primed for chatbot automation. Here are a feWs p]examples of how chatbots are improving healthcare: For Example- Emergency Department Chatbot Do you want to stay digitally connected during your emergency department visit? Provide your cell phone number at check-in and you will automatically receive a welcome text message with a link to access our chatbot tool. Don't worry, you can opt-out via text if you change your mind and do not wish to receive communications and updates during your stay. What's a chatbot? A chatbot is tool used to keep you connected, updated and informed throughout your emergency department visit. Examples of information included are: • Estimated time to see a doctor • Estimated time to receive lab or imaging results • Information on cafeteria hours • Information on how to connect with MyBanner Participating locations include: • Banner Desert Medical Center • Banner Gateway Medical Center • Banner North Colorado Emergency Care • Banner Thunderbird Medical Center • Banner - University Medical Center Phoenix • North Colorado Medical Center NCMC BOARD OF TRUSTEES Regular Session Meeting Monday, August 26, 2019 Attachment 2 Financial Statements for Second Quarter ending June 30, 2019 ri NCMC, Inc. 1801 16th Street Greeley, Colorado 80631 (970)810-6052 August 13, 2019 Via Email To: mlawleyl @msn.com Mr. Mark Lawley President NCMC Board of Trustees 1801 16th Street Greeley, CO 80631 Dear Mr. Lawley: Pursuant to the Amended and First Restated Operating Sublease dated May 1, 2016 between the Board of Trustees for North Colorado Medical Center and NCMC, Inc., we submit the following documents for your information and review: 1. Financial Statements of the Combined Entity (NCMC, Inc. and North Colorado Medical Center) for the Quarter ended June 30, 2019. 2. Financial Statements of NCMC, Inc. for the Quarter ended June 30, 2019. 3. Financial Statements of North Colorado Medical Center for the Quarter ended June 30, 2019 If you have any questions or concerns, please do not hesitate to contact me. Very truly yours, Jeff Carlson Executive Officer Enclosures (4) CONTINUING DISCLOSURE COMPLIANCE EXHIBITS A-1 through A-4 Covenant Ratios For the Quarter ended June 30, 2019 NCMC, Inc & Banner Health/NCMC (Recombined Entity) Covenant Ratio Analysis (Unaudited) For the Six Month Period Ended June 30, 2019 A-1. LIQUIDITY COVENANT - Unrestricted Cash & Investments-to-Days of Operating Expense (000s): A-3. DEBT COVERAGE COVENANT - Net Income Available for Debt Service-to-MADS (000s): Unaudited December 31, Unaudited December 31, 06/30/19 2018 2017 2016 2015 2014 2013 06/30/19 2018 2017 2016 2015 2014 2013 Cash and Cash Equivalents 14,445 11,295 10,302 7,925 12,218 7,932 20,873 Revenues in Excess of Expenses * 37,442 10,167 48,069 10,900 48,071 54,740 36,897 Long Term Investments 334,222 297,636 316,765 281,881 249,171 290,044 274,457 Depreciation Expense 11,863 24,171 24,562 27,861 22,033 20,787 21,762 348,667 308,931 327,067 289,806 261,389 297,976 295,330 Interest & Amortization Expense 3,374 6,958 7,229 6,966 7,645 7,861 5,778 Unrealized (Gain) Loss - Investments * (24,753) 29,973 (16,009) (5,232) - - - Net Operating Expenses (Cash) [Annualized) 422,329 397,169 396,118 380,456 378,574 365,434 376,365 Other Non-Cash & Non-Recurring Adjustments 456 26 (2,720) 12,994 - - - Net Income Available for Debt Service 28,382 71,295 61,131 53,489 77,749 83,388 64,437 Average Daily Operating Expense 1,157 1,088 1,085 1,042 1,037 1,001 1,031 Net Income Available for Debt Service [Annualized) 56,764 Days Cash-on-Hand 301 284 301 278 252 298 286 Maximum Annual Debt Service 17,431 17,431 17,692 17,826 19,256 19,2% 19,2% Required Days Cash-on-Hand 100 100 100 100 100 100 100 Debt Service Coverage Ratio 3.26 4.09 3.46 3.00 4.04 4.32 3.34 Conclusion: Required Ratio is Satisfied. Minimum Ratio Requirement to Avoid Reserve Funding 2.00 2.00 2.00 2.00 2.00 2.00 2.00 (2) Adjusted/Restated for Adoption of MU 2016-1 Conclusion: Required Ratio is Satisfied A-2. LEVERAGE COVENANT - Total Indebtedness-to-Capitalization (000s): A-4. DEBT COVERAGE COVENANT - Unrestricted Cash and Investments to MADS (000s): Unaudited December 31, Unaudited December 31, 06/30/19 2018 2017 2016 2015 2014 2013 06/30/19 2018 2017 2016 2015 2014 2013 Long-Term Debt 195,637 198,445 209,572 220,733 178,316 189,863 207,412 Cash and Cash Equivalents 14,445 11,295 10,302 7,925 12,218 7,932 20,873 Current Portion of Long-Term Debt 12,822 10,572 10,563 10,429 11,950 11,746 11,317 Board-Designated Investments 334,222 297,636 316,765 281,881 249,171 290,044 274,457 208,459 209,017 220,135 231,162 190,266 201,609 218,729 348,667 308,931 327,067 289,806 261,389 297,976 295,330 Fund Balance (Net Assets) 369,971 338,699 337,844 295,715 294,173 296,813 301,300 Pro Forma Maximum Annual Debt Service Coverage 17,431 17,431 17,692 17,826 19,256 19,2% 19,2% Total Capitalization 578,430 547,716 557,979 526,877 484,439 498,422 520,029 % of Cash and Investments to Debt Service 2000% 1772% 1849% 1626% 1357% 1544% 1531% % Total Indebtedness to Capitalization 36.0% 38.2% 39.5% 43.9% 39.3% 40.4% 42.1% Required % of Cash and Investments to Debt Service 200% 200% 200% 200% 200% 200% 200% Required % Total Indebtedness to Capitalization 65.0% 65.0% 65.0% 65.0% 65.0% 65.0% 65.0% Conclusion: Required % is Satisfied Conclusion: Required % is Satisfied * June 30, 2016 results have been restated to reflect adoption of ASU 2016-1 on January 1, 2016. Page 3 CONTINUING DISCLOSURE COMPLIANCE ATTACHMENT 1 Unaudited Combined Financial Statements of NCMC, Inc and North Colorado Medical Center For the Quarter ended June 30, 2019 , I NORTH COLORADO MEDICAL CENTER Recombined Financial Statements 06/30/2019 BALANCE SHEET Recombined Recombined Assets i NCMC,Inc Banner/NCMC Total Eliminations 06/30/2019 12/31/2018 Current Assets Cash&Cash Equivalents $ 14,208,000 $ 237,000 $ 14,445,000 - $ 14,445,000 $ 11,295,000 Assets Limited as to Use-Current 1,500,000 - 1,500,000 - 1,500,000 1,491,000 Accounts Receivable(Net) - 54,052,000 54,052,000 - 54,052,000 55,008,000 Due(To)From Others - 244,000 244,000 276,000 520,000 5,334,000 Due From Banner - - 0 - 0 0 Inventories - 10,220,000 10,220,000 - 10,220,000 10,550,000 Other Current Assets 834,000 , 822,000 1,656,000 (717,000) 939,000 2,021,000 Total Current Assets 16,542,000 ' 65,575,000 82,117,000 (441,000) 81,676,000 85,699,000 Assets Limited as to Use-Non-Current - - 0 - 0 0 Board Designated Investments 334,222,000 - 334,222,000 - 334,222,000 297,636,000 Real Estate Investments 11,900,000 - 11,900,000 - 11,900,000 11,951,000 Land,Building&Equipment,Net 180,262,000 1,584,000 181,846,000 - 181,846,000 188,812,000 Right of Use Assets,Net - 160,333,000 160,333,000 (155,353,000) 4,980,000 0 Other Assets 5,093,000 ' 90,000 5,183,000 - 5,183,000 5,296,000 Total Assets $ 548,019,000 $ 227,582,000 $ 775,601,000 $ (155,794,000) $ 619,807,000 $ 589,394,000 Liabilities and Net Assets Current Liabilities Current Maturities of Long Term Debt 10,953,000 36,073,000 $ 47,026,000 (34,204,000) $ 12,822,000 $ 10,572,000 Accounts Payable 241,000 3,885,000 4,126,000 - 4,126,000 4,944,000 Construction&Retainage Payable 1,310,000 - 1,310,000 - 1,310,000 426,000 Accrued Expenses - 15,149,000 15,149,000 - 15,149,000 15,371,000 Accrued Interest 809,000 - 809,000 - 809,000 814,000 Estimated Third Party Settlements - 119,000 119,000 - 119,000 268,000 Other Current Liabilities - 4,505,000 4,505,000 (376,000) 4,129,000 3,304,000 Total Current Liabilities 13,313,000 59,731,000 73,044,000 (34,580,000) 38,464,000 35,699,000 Accrued Pension Costs (128,000) - (128,000) - (128,000) (128,000) Other Long Term Liability 9,714,000 6,149,000 15,863,000 - 15,863,000 16,679,000 Long Term Debt,less CMLTD 192,433,000 123,837,000 316,270,000 (120,633,000) 195,637,000 198,445,000 Total Liabilities 215,332,000 189,717,000 , 405,049,000 (155,213,000) 249,836,000 250,695,000 Net Assets Restricted - 76,000 76,000 - 76,000 (14,000) Unrestricted 332,687,000 , 37,789,000 370,476,000 (581,000) 369,895,000 338,713,000 Total Net Assets 332,687,000 , 37,865,000 370,552,000 (581,000) 369,971,000 338,699,000 Total Liabilities and Net Assets $ 548,019,000 $ 227,582,000 $ 775,601,000 $ (155,794,000) $ 619,807,000 $ 589,394,000 1 NORTH COLORADO MEDICAL CENTER Recombined Financial Statements 6/30/2019 INCOME STATEMENT: Recombined Recombined NCMC, Inc. Banner/NCMC Total Eliminations 06/30/2019 12/31/2018 Revenue : Gross Patient Revenue - $241,982,000 $241,982,000 - $241,982,000 $485,889,000 Provision for Doubtful Accounts - (26,343,000) (26,343,000) - (26,343,000) (52, 106,000) Net Patient Revenue - 215, 639,000 215,639,000 - 215,639,000 433, 783,000 Other Income 16,367,000 9,824,000 26, 191,000 ( 18,359,000) 7,832,000 16,927,000 Total Revenue 16,367,000 225,463,000 241,830,000 ( 18,359,000) 223,471,000 450, 710,000 Expense : Interest Expense 3, 176,000 2, 146,000 5, 322,000 (2, 143,000) 3, 179,000 6,568,000 Depreciation Expense 11,836,000 14,820,000 26,656,000 (14,793,000) 11,863,000 24, 171,000 Amortization Expense 195,000 - 195,000 - 195,000 390,000 Bond Maintenance Fees 63,000 - 63,000 - 63,000 60,000 Administration Expense 179,000 179,000 - 179,000 297,000 Pension Cost - Periodic 456,000 - 456,000 - 456,000 26,000 Salaries and Benefits - 111, 256,000 111, 256,000 - 111,256,000 212,808,000 Purchased Services 5,837,000 5,837,000 - 5,837,000 11,605,000 Supplies - 32,940,000 32,940,000 - 32,940,000 62,661,000 Lease Payments - 847,000 847,000 (841,000) 6,000 0 Legal & Audit Expense 45,000 - 45,000 - 45,000 118,000 Education, Travel & Meetings 2,000 - 2,000 - 2,000 9,000 Grants 790,000 - 790,000 - 790,000 1,080,000 Environmental Remediation - - 0 - 0 0 Other Expense 153,C00 53,200,000 53,353,000 1, 323,000 54,676,000 101,937,000 Total Expense: 16,895,C00 221,046,000 237,941,000 ( 16,454,000) 221,487,000 421, 730,000 Operating Income (528,000) 4,417,000 3,889,000 ( 1,905,000) 1,984,000 28,980,000 Net Investment Income 35,458,000 - 35,458,000 - 35 ,458,000 ( 18,813,000) Loss on Debt Refinancing - - 0 - 0 0 Revenues in Excess of Expenses 34,930,000 4,417,000 39,347,000 ( 1,905,000) 37,442,000 10, 167,000 Unrealized Gain ( Loss) - Swaps (636,000) - (636,000) - (636,000) 730,000 Pension Related Changes 456,000 - 456,000 - 456,000 735,000 Contributions for Long-Lived Assets 148,000 - 148,000 - 148,000 609,000 Non-Operating Income ( Expense) - (52,000) (52,000) - (52,000) 15,000 Adjustments to Restricted Equity - 90,000 90,000 - 90,000 (383,000) Equity Transfers to Banner Health - 16,768,000 16,768,000 (22,944,000) (6, 176,000) ( 12,269,000) Increase (Decrease) Net Assets 34,898,000 21,223,000 56, 121,000 (24,849,000) 31,272,000 (396,000) Net Assets, Beginning 297, 790,030 16,641,000 314,431,000 24,268,000 338,699,000 Net Assets, Ending $ 332,688,000 $ 37,864,000 $ 370,552,000 $ (581,000) $ 369,971,000 $338,697,000 BOND COVENANT RATIOS (Annualized) : 06/30/2019 12/31/2018 Days Cash On-Hand 301 284 Debt-to-Total Capitalization 36.0% 38.2% Debt Service Coverage 3. 26 4.09 Cash-to-MADS 2000% 1772% 2 i 1 CONTINUING DISCLOSURE COMPLIANCE ATTACHMENT 2 Unaudited Financial Statements of NCMC, Inc For the Quarter ended June 30, 2019 NCMC, INC Balance Sheet June 30, 2019 & 2018 Assets 2019 2018 Liabilities and Net Assets 2019 2018 Current Assets Current Liabilities Cash and Cash Equivalents $ 14, 208, 534 $ 15, 478, 050 Current Maturities of Long Term Debt $ 10, 952, 931 $ 10, 660, 575 Assets Limited as to Use - Current 1, 499 , 598 1, 417, 052 Accounts Payable 240, 588 133 , 314 Accounts Receivable 833 , 745 479 , 291 Construction and Retainage Payable 1, 310, 286 761, 080 Swap Receivable - 811, 827 Accrued Pension Costs - Current - - Prepaid - 100, 000 Accrued Interest 809, 359 877, 141 16, 541, 876 18, 286, 220 Due to BHS - HealthcareFacility 0 66 13, 313, 164 12,432, 175 Assets Limited as to Use - Non-Current - - Obligations Under Interest Rate Swaps 4, 714, 442 3, 301 , 853 Investments Marketable Securities 334, 221, 811 316, 724, 695 Long Term Debt, Less Current Maturities 192, 432, 684 203 , 939 , 881 Real Estate 11, 900, 511 12, 001, 631 Total Investments 346, 122, 322 328, 726, 325 Accrued Pension Costs - Long Term ( 128, 019 ) 580, 310 Property and Equipment Other Long-Term Liabilities 5 , 000, 000 5 , 000, 000 Land and Improvements 8, 980, 969 8, 980, 501 Total Liabilities 215, 332, 271 225, 254, 219 Buildings and Improvements 325 , 657, 185 319, 474, 568 Equipment 193,487, 925 187, 628, 843 528, 126, 079 516, 083, 913 Less Accumulated Depreciation ( 350, 747, 787 ) ( 327, 641, 263 ) 177, 378, 292 188, 442, 651 Construction - in - Progress 2, 884, 080 1, 274, 534 180, 262, 372 189, 717, 185 Other Assets Investments in Affiliates 3 , 670, 929 3 , 670, 929 Property Held for Charitable Purposes 1, 422, 107 1, 531, 500 Deferred Financing Costs , Net Amorti ; - - Other Assets - - 5,093,036 5, 202,429 Net Assets - Unrestricted 332, 687, 335 316, 677, 940 Total Assets $ 548,019, 606 $ 541, 932, 159 Total Liabilities and Net Assets $ 548,019, 606 $ 541, 932, 159 NCMC, Inc Statement of Operations & Change in Net Assets Periods Ended June 30, 2019 & 2018 Month Month Budget Variance June YTD YTD Budget Variance June Actual Budget Pos/( Neg) 2018 Actual Budget Pos/( Neg) 2018 Revenue: Basic Rent ( Depreciation ) $ 1,945,862 $ 1, 937, 820 $ 8,042 $ 2,001, 850 $ 11, 675, 174 $ 11, 626,920 $ 48, 254 $ 12, 011, 102 Additional Rent ( ROA) 1, 114, 166 1,021,324 92, 842 1, 141, 557 6, 684,094 6, 127,944 556, 150 6, 922, 618 Section 6.03 Accrued Rent - - - - - - - ( 1 ) Deferred Rent - - - - - - - - Charity Care Subsidy ( 1, 250,000) ( 1, 250,000) - ( 1, 250,000) ( 2,500,000) ( 2, 500,000) - ( 2, 500,000) Net Banner Rent Income 1,810,029 1, 709, 144 100,885 1,893,407 15, 859, 268 15, 254, 864 604,404 16,433, 719 Other Rental Income 18, 696 14, 167 4,529 16,013 100,028 84,998 15, 030 151, 650 Other Income - 542 ( 542 ) 5,088 408,076 3, 248 404,828 12, 362 Total Operating Revenue $ 1,828,724 $ 1,723,853 $ 104,871 $ 1,914,508 $ 16,367,372 $ 15,343, 110 $ 1,024,262 $ 16,597, 732 Expense: Interest Expense $ 525,951 $ 525, 952 1 $ 548,949 $ 3, 175, 508 $ 3, 175, 912 404 $ 3,310,426 Depreciation Expense 1,939, 122 1, 996, 714 57, 592 1, 993,948 11, 836,042 11, 980, 284 144, 242 12,085, 979 Amortization Expense 32, 536 32, 536 0 32, 536 195, 215 195, 213 ( 2 ) 195, 215 Bond Maintenance Fees 15, 000 8,000 ( 7,000) 11,486 63,002 48, 000 ( 15,002 ) 31, 619 Administration Expense 34, 826 20, 001 ( 14,825 ) 25, 559 179,461 173 , 872 ( 5,589) 163,986 Pension Cost - Periodic 76, 000 76, 000 - 76,000 456,000 456,000 - 456,000 Consulting & Professional Fees 8, 293 7, 337 ( 956 ) 11, 965 45, 374 44, 022 ( 1,352 ) 46, 019 Education, Travel & Meetings 1, 280 - ( 1, 280) - 1, 619 10,000 8,381 8, 692 Grants - - - - 790,000 790,000 - 540,000 Rental Property Expenses (4, 302 ) 16, 667 20, 969 ( 20, 205 ) 150, 951 99, 998 (50,953 ) 77, 430 Environmental Remediation Expense - - - - - - - - Other Expense 429 1,063 634 - 2, 343 6, 378 4,035 1, 596 Total Operating Expense $ 2, 629, 135 $ 2,684,270 $ 55, 135 $ 2,680,237 $ 16,895, 513 $ 16,979, 679 $ 84, 166 $ 16,916,961 Operating Income $ (800,410) $ (960,417) $ 160,007 $ (765,729) $ (528, 141) $ (1,636,569) $ 1, 108,428 $ (319,229) Interest/Dividend Income - Portfolio 795, 968 586, 370 209,598 688,492 4, 295, 846 4,036,025 259,821 3,587,929 Interest/Dividend Income - Other 12, 554 8, 350 4, 204 11, 563 75, 073 50, 100 24, 973 34, 803 Realized Gain ( Loss) on Investments 8, 346, 824 - 8, 346,824 ( 108,817 ) 8, 254, 202 - 8, 254, 202 5,444,903 Unrealized Gain ( Loss) On Investments 4,916, 253 - 4,916, 253 ( 274, 726) 24, 753, 601 - 24, 753, 601 ( 8, 390, 100) Realized Gain ( Loss) on Swaps ( 212 ,086) - ( 212,086) 64, 581 ( 1, 202, 670) - ( 1, 202, 670) 515, 781 Realized Gain ( Loss) on Refinancing - - - - - - - - Investment Advisor Fees ( 81, 292 ) ( 110,417 ) 29, 125 ( 75, 258) ( 717,958) ( 662,498) ( 55,460) ( 680,588) Investment Income 13, 778, 220 484, 303 13, 293, 917 305,834 35, 458,093 3,423, 627 32, 034,466 512, 728 Revenue in Excess of Expenses $ 12,977, 810 $ (476, 114) $ 13,453,924 $ (459,895) $ 34,929,952 $ 1, 787,058 $ 33, 142,894 $ 193,499 Increase ( Decrease) FMV of Int Rate Swaps ( 163, 119) - ( 163, 119) 174, 127 ( 636,093 ) ( 636,093 ) 925, 945 Pension Costs - Non - Periodic 76,000 - 76,000 76,000 456,000 456,000 456,000 Contributions for Long- Lived Assets 51, 414 - 51,414 61, 787 147,996 - 147, 996 321 , 319 Increase (Decrease) Net Assets $ 12,942, 105 $ (476, 114) $ 13,418, 219 $ ( 147,981) $ 34,897, 854 $ 1,787,058 $ 33, 110, 796 $ 1,896,763 CONTINUING DISCLOSURE COMPLIANCE ATTACHMENT 3 North Colorado Medical Center Statement of Operations For the Quarter ended June 30, 2019 Company Group Greeley Community Pane: 1 Run Dates 07/09/19 Consolidated Income Statement Report: GLCCOIS Run Time; 04:33 June 2019 --------------------- Month-To-Date -------------------------- -___-___------------.. Year-To-Date ----------------_-_--- ACTUAL BUDGET VARIANCE PRIOR YEAR ACTUAL BUDGET VARIANCE PRIOR YEAR GROSS HEALTHCARE REVENUE Hospital Inpatient 45,786,380 46,090,274 (303,894) 41,574,491 292,316,053 283,428,403 8,887,650 273,382,719 Hospital Outpatient 50,025,177 50,854,594 (829,417) 48,104,495 304,464,132 306,860,474 (2,396,342) 294,566,833 Clinic 8,107,756 8,483,124 (375,368) 7,851,601 51,300,645 51,733,173 (432,528) 54,523,967 Other Healthcare Revenue 457,461 433,461 24,000 296,257 2,745,569 2,600,769 144,800 2,720,882 TOTAL GROSS HEALTHCARE REV 104,376,774 105,861,453 (1,484,679) 97,826,844 650,826,398 644,622,819 6,203,579 625,194,401 REDUCTIONS OF REVENUE Hospital Inpatient 29,907,632 30,761,043 853,411 26,651,998 193,031,786 188,798,276 (4,233,510) 180,758,197 Hospital Outpatient 36,530,396 35,958,682 (571,714) 33,849,156 215,400,888 219,064,013 3,663,125 206,979,482 Clinic 4,352,796 4,104,018 (248,778) 4,090,913 26,754,838 25,080,961 (1,673,877) 28,204,375 Other Healthcare Reductions 0 0 0 0 0 0 0 0 !'' -' - TOTAL REDUCTIONS OF REVENUE 70,790,824 70,823,743 32,920 64,592,066 435,187,512 132,943,250 (2,244,262) 415,942,055 NET HEALTHCARE REVENUE 33,585,951 35,037,710 (1,451,759) 33,234,778 215,638,886 211,679,570 3,959,317 209,252,346 Medical Insurance Premiums 0 0 0 0 0 0 0 0 Other Operating Revenue 1,746,214 1,682,317 63,897 1,576,034 9,824,567 10,073,218 (248,651) 10,009,905 TOTAL OPERATING REVENUE 35,332,165 36,720,027 (1,387,862) 34,810,813 225,463,454 221,752,788 3,710,666 219,262,251 EXPENSES Salaries 13,921,650 13,341,190 (580,460) 12,546,914 83,765,974 80,802,979 (2,962,995) 80,956,144 Contract Labor 284,919 51,151 (233,768) 78,308 1,599,183 306,018 (1,293,165) 650,248 Benefits 2,082,243 2,697,698 615,455 2,017,768 14,570,125 16,922,313 2,352,188 16,512,604 Physician & Prof. Fees 1,977,222 1,470,705 (506,517) 1,645,627 11,321,446 9,362,073 ( ,959,373) 8,596,729 Supplies 5,670,168 5,328,191 (341,977) 5,483,110 32,939,595 31,763,842 (1,175,753) 30,953,258 Purchased Services 827,228 953,430 126,202 920,862 5,836,813 5,608,028 (228,785) 5,640,522 Medical Claims Expense 0 0 0 0 0 0 0 0 Other Operating Expenses 4,410,001 4,741,817 331,816 4,276,541 28,597,569 28,859,430 261,861 26,164,057 TOTAL CONTROLLABLE EXPENSES 29,173,432 28,584,184 (589,249) 26,969,130 178,630,705 173,624,683 (5,006,022) 169,473,563 Depreciation & Amortization 2,433,864 2,203,135 (230,729) 2,488,615 14,819,855 12,958,398 (1,861,457) 13,659,856 Facility Leases 161,435 156,398 (5,037) 68,534 846,568 938,385 9'.,817 566,376 Interest 346,245 1,060,657 714,412 1,134,542 2,146,541 6,363,693 4,217,152 6,339,576 TOTAL EXPENSES 32,114,977 32,004,373 (110,603) 30,660,821 196,443,669 193,885,159 (2,558,510) 190,039,371 CONTRIBUTION MARGIN 3,217,189 4,715,654 (1,498,465) 4,149,992 29,019,785 27,867,629 1,152,155 29,222,880 Allocations 4,100,384 4,100,384 0 4,082,821 24,602,2C5 24,602,305 0 23,918,880 NET INCOME FROM OPERATIONS (883,196) 615,270 (1,498.465) 67,171 4,417,480 3,265,324 1.152,156 5,303,999 Investment Income-Realized 0 C 0 0 0 0 0 0 Investment Income-Unrealized 0 0 0 0 0 0 0 0 Int Rate Swaps Unrlzd G/L 0 0 0 0 0 0 0 0 Other Non-Operating Inc(Exp) (51,949) 0 (51,949) 0 (51,949) 0 (51,949) 0 NET INCOME (935,145) 615,270 (1,550,415) 67,171 4,365,531 3,265 324 1,100,206 5,303,999 ====... MEMO: PT BAD DEBT & CHARITY Patient Bad Debt 3,227,260 1,421,326 (1,805,934) 2,529,278 11,593,752 8,659,472 (2,934,280) 8,320,052 Charity 2,892,858 3,178,425 285,567 1,843,927 14,749,538 19,350,895 4,601,357 18,621,842 Company Group Greeley Community Page: 1 Run Date: 07/09/19 Detailed Balance Sheet Report: GLCCGBS2 Run Time: 04:33 06/30/19 Current Year Prior Year ASSETS CURRENT ASSETS: Cash and Cash Equivalents 236,699 704,901 Short Term Investments 0 0 Security Lending Collateral 0 0 C/P Assets Whose Use is Ltd 0 0 PATIENT RECEIVABLES: Gross Patient Receivables 154,956,180 147,997,943 Bad Debt Allowance (18,817,248) (13,229,068) Contractual & Reg Allowance (82,087,431) (83,079,183) NET PATIENT RECEIVABLES 54,051,502 51,689,691 OTHER RECEIVABLES: Other NonPatient Receivables 231,809 1,260,411 Due From Affiliates 11,639 3,077 TOTAL OTHER RECEIVABLES 243,448 1,263,488 Inventories 10,220,121 10,131,166 Securities Under Repurch Prgm 0 0 Intercompany Receivables (392,974) (272,228) Other Current Assets 1,215,203 1,889,132 TOTAL CURRENT ASSETS 65,573,998 65,406,151 NON-CURRENT ASSETS: ASSETS WHOSE USE IS LIMITED: Indenture 0 0 Self Insurance 0 0 Board Designated 0 0 Funded Reserves 0 0 Other Limited Use Assets 0 0 TOTAL LIMITED USE ASSETS 0 0 Property,Plant & Equip S Cost 2,424,573 340,143,454 Less: Accumulated Depreciatn (840,734) (149,569,940) PROPERTY, PLANT & EQUIP, NET 1,583,838 190,573,515 Right of Use Assets 175,425,943 0 Less: Amtzn of RCU Assets (15,092,876) 0 RIGHT OF USE ASSETS, NET 160,333,067 0 Long Term Investments 0 0 Other Investments 0 0 Assets Held for Sale 0 0 Long Term Receivables 0 0 Restricted Assets (13,690) 568,433 Invstmnts/Advances to Affil 0 0 Company Group Greeley Community Page: 2 Run Date: 07/09/19 Detailed Balance Sheet Report: GLCCG952 Run Time: 04:33 06/30/19 Current Year Prior Year Deferred Financing Charges 0 0 Other Deferred Charges 104,444 242,500 Intangibles 0 0 Other Non-Current Assets 0 0 TOTAL ASSETS 227,581,658 256,790,599 Company Group Greeley Community Page: 3 Run Data: 07/09/19 Detailed Balance Sheet Report: GLCCGBS2 Run Time: 04:33 06/30/19 Current Year Prior Year ----LIABILITIES AND EQUITY---- LIABILITIES: CURRENT LIABILITIES: CURRENT MATURITIES OF LTD: Bonds 0 0 Leases 0 0 Other 0 0 TOTAL CURR MATURITIES OF LTD 0 0 Cap Fac Lease Oblig, Curr 36,072,697 22,729,922 Accounts Payable 3,884,584 3,517,170 Securities Lending Payable 0 0 ACCRUED SALARY AND BENEFITS: Compensation 15,012,010 13,612,981 Taxes (18,241) 1,017 Benefits 154,733 128,705 Payroll Deductions 825 4,328 TOTAL ACCRD SALARY & BENEFIT 15,149,328 13,747,032 Securities Repurchase Oblig 0 0 Estd 3rd Prty Payor Settimnt 119,300 (105,208) Reserves for & Claims Payble 0 0 Other Curr Liab & Accrd Exps 4,505,495 5,527,299 TOTAL CURRENT LIABILITIES 59,731,404 45,416,214 LONG TERM LIABILITIES: LTD, NET OF CURR MATURITIES Bonds 0 0 Leases 0 0 Other 0 0 TOTAL LTD, NET OF CURR MATUR 0 0 Cap Fac Lease Obligation, LT 123,836,987 188,967,170 Eetd 3rd PPS, Net of CP 6,075,775 11,732,157 Estd Self Insurance Liab 0 0 Other NonCurrent Liabilities 72,784 68,859 TOTAL LONG TERM LIABILITIES 129,985,546 200,768,186 MINORITY INTEREST 0 0 SUSPENSE 0 0 TOTAL LIABILITIES 189,716,950 246,184,400 Compan,' Group Greeley Community Page: 4 Run Daze: 01/09/19 Detailed Balance Sheet Report: GLCCGBS2 Run Time: 04:33 06/30/19 Current Year Prior Year EQUITY: --- UNRESTRICTED NET ASSETS: Donated Fixed Assets 0 41,104 Capital Stock & APIC 0 0 Unrealized Gains/cLosses› 0 151,490 Unrestricted Equity 33,423,271 4,844,252 YTD Net Income ‹Loss› 4,365,531 5,303,999 TOT UNRESTRICTED NET ASSETS 37,788,802 10,340,845 TEMP RESTRICTED NET ASSETS: Temp Restricted Net Assets 75,907 265,353 Unrealized Gains/Losses 0 0 TOTAL TEMP REST NET ASSETS 75,907 265,353 PERM RESTRICTED NET ASSETS: Perm Restricted Net Assets 0 0 TOTAL PERM REST NET ASSETS 0 0 TOTAL EQUITY 37,864,708 10,606,199 TOTAL LIABILITIES & EQUITY 227,581,658 256,790,599 Hello