hmp metrics™: investor owned hospitals october, 2010
DESCRIPTION
TRANSCRIPT
1
October 2010 2
Table of Contents
Executive Summary 3 - 5
Financial and Operational Study 6 - 59
• Total Profit Margin 6 - 14• Total Operating Profit Margin 15 - 23• Total Labor Cost as a Percentage of Total Operating Revenues 24 - 32• Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 33 - 41• Days Net Patient Revenue in Accounts Receivable (AR) 42 - 50• Average Age of Plant and Equipment 51 - 59
Introduction to Healthcare Management Partners 60 - 64
Clients Our Professionals Have Served 65 - 66
Firm Leadership 67 - 70
Contact Information 71
October 2010 3
Healthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its seniorexecutives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignmentsacross the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools arenecessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMPMetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparablefacilities and against “1st Quartile” or “High Performing” competitors.
Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive studycomparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groupsselected include the following:
1. All General Acute Care Hospitals Regardless of Ownership or Sponsorship2. All Investor Owned General Acute Care Hospitals3. All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations4. All State and Local Government Owned General Acute Care Hospitals5. Free Standing Children’s Hospitals6. All Non-Federal Major Teaching Hospitals
Using proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period orstatistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals,specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensedbeds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer groupcomparisons for dozens of standard industry metrics.
This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustratethe benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess therelative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or createnew peer groups and compare them to state, local or national benchmarks.
Executive Summary – Overview
October 2010 4
Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for all investor owned general acute care hospitals within the peer groups.
As noted above, the first quartile contains the top 25% of the best performing hospitals in an applicable peer group, the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains those hospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%.
Mean Value: The mean value is the average of all amounts within a defined quartile or population.
Median Value: The report also contains the median value by quartile or total population.
Count: Actual number of qualified hospitals included in the mean or median calculation.
Excluded Cost Reports: Represents those metrics values not considered normative (i.e., outlier values). For example, certain metric values that were greater than two standard deviations from the mean of a reported population would be excluded from the analysis and included in this category.
Executive Summary – Key Terms
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Mean Median Count1st Quartile 19.14% 18.86% 1482nd Quartile 10.53% 10.84% 1503rd Quartile 4.37% 4.15% 1534th Quartile (4.50%) (3.63%) 155
Total Population 7.23% 7.48% 606Excluded Cost Reports 94
Total Cost Reports 700
Quartile Rank2009
October 2010 5
Executive Summary – Hospital Performance Metrics
Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in the Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations. Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, and hospitals where the computed metric is more than 2 standard deviations from the mean.
Total Profit Margin A measure of overall hospital profitability presented as a percentage. A negative percentage indicates an overall loss, while a positive percentage indicates profitability.
Total Operating Profit Margin A measure of operating profitability presented as a percentage. A negative percentage indicates overall loss, while a positive percentage indicates profitability.
Total Labor Cost as a Percentage of Total Operating Revenues
A measure of labor productivity. This metric divides labor costs by operating revenues. A higher percentage compared to its peers indicates that a hospital uses more labor to produce its revenue.
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)
Measures the number of full-time equivalent (FTE) employees used for each occupied bed. Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital uses more labor to treat its patients.
Average Days Net Patient Revenue in Accounts Receivable (AR)
Measures the number of days it typically takes to collect accounts receivable. A higher percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as its peers.
Average Age of PlantMeasures the average age of the hospital including capital improvements and major equipment purchases. A higher age compared to its peers indicates that the hospital has deferred the replacement of its capital when compared to its peers, which can lead to further distress.
October 2010 6
Total Profit Margin - Summary
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 6.17% 5.52% 75 5.93% 7.16% 89 5.79% 8.16% 8926 to 100 Beds 5.39% 5.08% 166 5.38% 6.28% 187 6.08% 5.50% 196
101 to 200 Beds 7.54% 7.59% 197 6.00% 6.07% 221 6.27% 6.26% 226201 to 300 Beds 9.90% 10.98% 86 7.65% 8.41% 89 8.39% 8.84% 92301 to 400 Beds 8.29% 8.95% 43 6.97% 7.10% 47 7.16% 8.39% 49401 to 500 Beds 7.61% 6.98% 21 6.48% 4.88% 24 7.85% 8.74% 23Over 500 Beds 9.59% 9.36% 18 8.52% 8.05% 18 9.80% 8.99% 18
Total All Hospitals 7.23% 7.48% 606 6.19% 6.71% 675 6.64% 7.06% 693Excluded Cost Reports 94 89 100
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 4.76% 3.80% 92 5.62% 4.56% 69 4.98% 5.75% 5726 to 100 Beds 6.50% 6.10% 195 6.52% 6.70% 193 4.87% 5.23% 199
101 to 200 Beds 5.67% 5.61% 218 5.81% 6.27% 215 5.55% 6.21% 216201 to 300 Beds 8.71% 9.20% 96 8.05% 8.35% 92 7.52% 7.30% 98301 to 400 Beds 7.85% 6.52% 46 5.96% 6.47% 48 7.88% 8.17% 50401 to 500 Beds 4.16% 6.48% 23 6.00% 5.59% 21 6.87% 7.58% 24Over 500 Beds 8.56% 8.91% 20 10.03% 7.16% 20 9.64% 9.39% 19
Total All Hospitals 6.39% 6.48% 690 6.46% 6.63% 658 5.93% 6.16% 663Excluded Cost Reports 107 106 87
Total Cost Reports 797 764 750
Number of Licensed Beds2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
Number of Licensed Beds2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 7
Peer Group Comparison – Total Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.40% 20.53% 18 20.28% 19.39% 22 19.42% 19.31% 222nd Quartile 10.13% 9.73% 19 11.46% 11.66% 22 10.48% 9.93% 223rd Quartile 2.41% 2.31% 19 2.39% 2.48% 22 3.70% 4.22% 224th Quartile (7.53%) (6.49%) 19 (9.71%) (9.71%) 23 (9.73%) (9.63%) 23
Total Population 6.17% 5.52% 75 5.93% 7.16% 89 5.79% 8.16% 89Excluded Cost Reports 21 29 33
Total Cost Reports 96 118 122
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.37% 20.09% 23 21.69% 21.72% 17 19.89% 19.48% 142nd Quartile 9.39% 9.05% 23 10.33% 11.41% 17 9.73% 9.03% 143rd Quartile 0.32% 0.26% 23 1.26% 1.99% 17 0.88% 0.10% 144th Quartile (11.05%) (9.87%) 23 (9.88%) (9.33%) 18 (9.55%) (9.28%) 15
Total Population 4.76% 3.80% 92 5.62% 4.56% 69 4.98% 5.75% 57Excluded Cost Reports 35 25 23
Total Cost Reports 127 94 80
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 8
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.60% 18.98% 41 19.56% 19.39% 46 19.49% 19.09% 492nd Quartile 9.06% 8.32% 41 9.74% 9.79% 47 9.67% 10.11% 493rd Quartile 1.62% 1.26% 42 2.22% 2.27% 47 2.60% 2.49% 494th Quartile (8.27%) (7.64%) 42 (9.68%) (8.87%) 47 (7.46%) (6.22%) 49
Total Population 5.39% 5.08% 166 5.38% 6.28% 187 6.08% 5.50% 196Excluded Cost Reports 34 33 34
Total Cost Reports 200 220 230
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.73% 20.82% 48 19.19% 18.75% 48 19.18% 18.55% 492nd Quartile 11.14% 11.40% 49 10.51% 10.46% 48 8.86% 9.19% 503rd Quartile 2.68% 2.68% 49 3.75% 4.15% 48 1.21% 0.95% 504th Quartile (8.25%) (7.17%) 49 (7.08%) (5.26%) 49 (9.49%) (9.55%) 50
Total Population 6.50% 6.10% 195 6.52% 6.70% 193 4.87% 5.23% 199Excluded Cost Reports 34 36 28
Total Cost Reports 229 229 227
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 9
Mean Median Count Mean Median Count Mean Median Count1st Quartile 18.75% 18.90% 49 17.96% 17.41% 55 18.11% 17.48% 562nd Quartile 10.58% 10.50% 49 9.44% 9.74% 55 9.52% 9.42% 563rd Quartile 4.42% 4.24% 49 2.88% 3.09% 55 3.14% 3.07% 574th Quartile (3.38%) (2.43%) 50 (6.07%) (5.10%) 56 (5.45%) (3.76%) 57
Total Population 7.54% 7.59% 197 6.00% 6.07% 221 6.27% 6.26% 226Excluded Cost Reports 25 16 23
Total Cost Reports 222 237 249
Mean Median Count Mean Median Count Mean Median Count1st Quartile 17.58% 17.32% 54 17.53% 17.42% 53 17.95% 16.71% 542nd Quartile 9.35% 9.45% 54 9.37% 9.17% 54 9.13% 9.19% 543rd Quartile 2.51% 2.33% 55 3.43% 3.59% 54 2.97% 3.17% 544th Quartile (6.47%) (5.79%) 55 (6.89%) (5.44%) 54 (7.84%) (6.94%) 54
Total Population 5.67% 5.61% 218 5.81% 6.27% 215 5.55% 6.21% 216Excluded Cost Reports 30 34 27
Total Cost Reports 248 249 243
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 10
Mean Median Count Mean Median Count Mean Median Count1st Quartile 18.89% 17.62% 21 16.84% 16.09% 22 17.97% 17.33% 232nd Quartile 12.72% 12.34% 21 10.51% 10.49% 22 11.32% 11.34% 233rd Quartile 8.85% 8.77% 22 6.17% 6.40% 22 6.40% 6.25% 234th Quartile (0.34%) 3.19% 22 (2.47%) (0.63%) 23 (2.15%) (0.75%) 23
Total Population 9.90% 10.98% 86 7.65% 8.41% 89 8.39% 8.84% 92Excluded Cost Reports 9 9 8
Total Cost Reports 95 98 100
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.05% 18.01% 24 18.78% 18.66% 23 19.07% 19.56% 242nd Quartile 11.86% 11.69% 24 10.86% 10.55% 23 10.33% 10.19% 243rd Quartile 6.52% 6.79% 24 5.52% 5.03% 23 4.56% 4.47% 254th Quartile (2.58%) (0.00%) 24 (2.98%) (0.42%) 23 (3.31%) (2.77%) 25
Total Population 8.71% 9.20% 96 8.05% 8.35% 92 7.52% 7.30% 98Excluded Cost Reports 5 8 4
Total Cost Reports 101 100 102
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 11
Mean Median Count Mean Median Count Mean Median Count1st Quartile 18.00% 18.06% 10 18.17% 18.27% 11 18.16% 18.13% 122nd Quartile 11.39% 10.83% 11 9.76% 9.52% 12 10.97% 10.61% 123rd Quartile 7.14% 7.04% 11 4.07% 4.09% 12 4.91% 5.02% 124th Quartile (2.48%) (1.89%) 11 (3.21%) (3.22%) 12 (4.42%) (3.72%) 13
Total Population 8.29% 8.95% 43 6.97% 7.10% 47 7.16% 8.39% 49Excluded Cost Reports 3 2 1
Total Cost Reports 46 49 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.21% 18.69% 11 18.52% 17.76% 12 19.91% 18.58% 122nd Quartile 10.38% 10.05% 11 10.21% 10.23% 12 11.00% 10.32% 123rd Quartile 5.05% 5.30% 12 3.19% 3.01% 12 5.37% 5.11% 134th Quartile (2.06%) (1.63%) 12 (8.06%) (5.65%) 12 (3.58%) (2.43%) 13
Total Population 7.85% 6.52% 46 5.96% 6.47% 48 7.88% 8.17% 50Excluded Cost Reports 2 2 4
Total Cost Reports 48 50 54
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 12
Mean Median Count Mean Median Count Mean Median Count1st Quartile 16.77% 14.17% 5 16.44% 16.28% 6 18.55% 18.44% 52nd Quartile 9.53% 9.36% 5 7.33% 7.77% 6 10.16% 9.85% 63rd Quartile 5.33% 6.33% 5 2.79% 2.23% 6 6.47% 7.21% 64th Quartile 0.28% 1.17% 6 (0.63%) (0.35%) 6 (1.97%) (1.29%) 6
Total Population 7.61% 6.98% 21 6.48% 4.88% 24 7.85% 8.74% 23Excluded Cost Reports 2 0 1
Total Cost Reports 23 24 24
Mean Median Count Mean Median Count Mean Median Count1st Quartile 16.34% 16.22% 5 15.29% 14.17% 5 18.97% 17.64% 62nd Quartile 9.48% 9.03% 6 10.58% 11.34% 5 10.53% 10.66% 63rd Quartile 2.57% 2.59% 6 2.73% 2.58% 5 3.55% 3.29% 64th Quartile (9.71%) (9.63%) 6 (2.84%) (1.33%) 6 (5.58%) (4.02%) 6
Total Population 4.16% 6.48% 23 6.00% 5.59% 21 6.87% 7.58% 24Excluded Cost Reports 1 1 0
Total Cost Reports 24 22 24
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 13
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.75% 20.88% 4 20.60% 20.10% 4 19.43% 19.55% 42nd Quartile 14.12% 14.09% 4 12.43% 12.18% 4 12.30% 12.26% 43rd Quartile 7.58% 6.83% 5 6.47% 6.74% 5 8.12% 8.87% 54th Quartile (0.94%) (1.64%) 5 (2.21%) (2.07%) 5 1.80% 2.09% 5
Total Population 9.59% 9.36% 18 8.52% 8.05% 18 9.80% 8.99% 18Excluded Cost Reports 0 0 0
Total Cost Reports 18 18 18
Mean Median Count Mean Median Count Mean Median Count1st Quartile 17.56% 16.91% 5 21.03% 22.05% 5 16.98% 16.00% 42nd Quartile 10.53% 10.49% 5 11.28% 11.46% 5 11.38% 10.77% 53rd Quartile 7.26% 7.79% 5 6.07% 5.72% 5 7.62% 8.24% 54th Quartile (1.11%) (0.58%) 5 1.76% 2.51% 5 4.06% 4.06% 5
Total Population 8.56% 8.91% 20 10.03% 7.16% 20 9.64% 9.39% 19Excluded Cost Reports 0 0 1
Total Cost Reports 20 20 20
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 14
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.14% 18.86% 148 18.59% 18.38% 166 18.70% 18.21% 1712nd Quartile 10.53% 10.84% 150 9.95% 10.11% 168 10.11% 10.29% 1723rd Quartile 4.37% 4.15% 153 3.25% 3.14% 169 3.87% 3.85% 1744th Quartile (4.50%) (3.63%) 155 (6.56%) (6.31%) 172 (5.74%) (4.72%) 176
Total Population 7.23% 7.48% 606 6.19% 6.71% 675 6.64% 7.06% 693Excluded Cost Reports 94 89 100
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.12% 18.57% 170 18.74% 18.56% 163 18.81% 17.89% 1632nd Quartile 10.32% 10.57% 172 10.17% 10.28% 164 9.53% 9.66% 1653rd Quartile 3.14% 3.16% 174 3.64% 3.99% 164 2.85% 3.08% 1674th Quartile (6.70%) (6.20%) 174 (6.41%) (5.17%) 167 (7.04%) (6.36%) 168
Total Population 6.39% 6.48% 690 6.46% 6.63% 658 5.93% 6.16% 663Excluded Cost Reports 107 106 87
Total Cost Reports 797 764 750
Quartile Rank2006 2005 2004
Total Profit MarginAll Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Quartile Rank2009 2008 2007
Peer Group Comparison – Total Profit Margin
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 15
Total Operating Profit Margin - Summary
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 3.21% 2.36% 76 3.64% 3.19% 85 2.27% 4.65% 9426 to 100 Beds 5.46% 4.61% 166 5.10% 5.69% 187 5.03% 5.05% 199
101 to 200 Beds 6.59% 6.55% 196 6.01% 6.25% 210 4.98% 5.70% 217201 to 300 Beds 8.51% 9.65% 85 7.33% 8.32% 87 7.54% 9.38% 86301 to 400 Beds 7.77% 8.46% 42 6.38% 6.06% 46 6.88% 8.20% 48401 to 500 Beds 6.38% 5.50% 21 6.37% 5.66% 24 6.29% 6.29% 24Over 500 Beds 8.55% 8.84% 18 6.58% 6.61% 17 6.64% 7.89% 17
Total All Hospitals 6.26% 6.52% 604 5.67% 6.18% 656 5.16% 5.76% 685Excluded Cost Reports 96 108 108
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 1.23% 0.89% 94 0.45% 0.46% 74 1.14% (1.71%) 5826 to 100 Beds 5.14% 6.15% 201 5.35% 6.55% 200 3.62% 4.26% 197
101 to 200 Beds 4.42% 4.99% 216 4.59% 4.91% 208 4.66% 5.56% 216201 to 300 Beds 7.90% 9.65% 90 7.15% 7.50% 90 6.51% 6.31% 94301 to 400 Beds 6.48% 5.46% 45 5.69% 5.91% 49 5.73% 8.62% 53401 to 500 Beds 4.88% 4.31% 23 4.10% 4.21% 19 4.42% 5.34% 22Over 500 Beds 6.69% 7.59% 20 7.42% 4.97% 20 6.42% 7.96% 18
Total All Hospitals 4.87% 5.82% 689 4.86% 5.22% 660 4.43% 5.21% 658Excluded Cost Reports 108 104 92
Total Cost Reports 797 764 750
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
Number of Licensed Beds2009 2008 2007
Number of Licensed Beds2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 16
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.04% 20.39% 19 20.25% 19.38% 21 19.57% 18.97% 232nd Quartile 8.57% 8.94% 19 9.69% 10.02% 21 9.53% 9.92% 233rd Quartile (1.36%) (0.53%) 19 0.21% 0.27% 21 (1.64%) (1.13%) 244th Quartile (14.41%) (13.46%) 19 (14.72%) (15.96%) 22 (17.35%) (17.54%) 24
Total Population 3.21% 2.36% 76 3.64% 3.19% 85 2.27% 4.65% 94Excluded Cost Reports 20 33 28
Total Cost Reports 96 118 122
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.01% 19.02% 23 19.46% 19.29% 18 18.72% 17.35% 142nd Quartile 7.41% 7.03% 23 7.04% 7.40% 18 7.06% 5.69% 143rd Quartile (3.89%) (3.09%) 24 (4.49%) (3.38%) 19 (4.52%) (5.03%) 154th Quartile (16.62%) (16.99%) 24 (18.86%) (20.35%) 19 (15.11%) (12.75%) 15
Total Population 1.23% 0.89% 94 0.45% 0.46% 74 1.14% (1.71%) 58Excluded Cost Reports 33 20 22
Total Cost Reports 127 94 80
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 17
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.44% 20.61% 41 20.28% 20.86% 46 19.18% 18.48% 492nd Quartile 10.05% 9.47% 41 9.91% 9.85% 47 9.89% 10.13% 503rd Quartile 0.86% 0.53% 42 2.01% 2.42% 47 1.69% 1.95% 504th Quartile (9.04%) (8.35%) 42 (11.49%) (10.15%) 47 (10.36%) (8.44%) 50
Total Population 5.46% 4.61% 166 5.10% 5.69% 187 5.03% 5.05% 199Excluded Cost Reports 34 33 31
Total Cost Reports 200 220 230
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.78% 20.69% 50 18.88% 18.54% 50 18.21% 16.97% 492nd Quartile 10.95% 11.03% 50 10.58% 10.22% 50 8.40% 8.73% 493rd Quartile 1.68% 2.37% 50 2.46% 2.63% 50 (0.00%) (0.31%) 494th Quartile (12.49%) (12.04%) 51 (10.51%) (8.96%) 50 (11.83%) (11.68%) 50
Total Population 5.14% 6.15% 201 5.35% 6.55% 200 3.62% 4.26% 197Excluded Cost Reports 28 29 30
Total Cost Reports 229 229 227
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 18
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.26% 20.33% 49 18.76% 18.29% 52 18.59% 17.98% 542nd Quartile 10.44% 11.01% 49 10.04% 10.07% 52 9.18% 9.40% 543rd Quartile 3.33% 3.28% 49 2.46% 2.20% 53 1.50% 1.27% 544th Quartile (7.67%) (5.95%) 49 (6.89%) (5.58%) 53 (9.10%) (7.33%) 55
Total Population 6.59% 6.55% 196 6.01% 6.25% 210 4.98% 5.70% 217Excluded Cost Reports 26 27 32
Total Cost Reports 222 237 249
Mean Median Count Mean Median Count Mean Median Count1st Quartile 18.63% 18.50% 54 18.63% 18.36% 52 18.78% 18.60% 542nd Quartile 9.37% 9.28% 54 8.47% 8.52% 52 9.14% 8.90% 543rd Quartile 0.22% (0.29%) 54 1.21% 0.98% 52 1.52% 1.94% 544th Quartile (10.53%) (8.34%) 54 (9.96%) (9.12%) 52 (10.79%) (9.46%) 54
Total Population 4.42% 4.99% 216 4.59% 4.91% 208 4.66% 5.56% 216Excluded Cost Reports 32 41 27
Total Cost Reports 248 249 243
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 19
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.33% 19.96% 21 18.88% 19.93% 21 19.05% 17.59% 212nd Quartile 12.14% 11.25% 21 10.97% 11.01% 22 11.82% 11.80% 213rd Quartile 7.05% 6.50% 21 5.34% 5.22% 22 5.27% 5.15% 224th Quartile (3.87%) (0.79%) 22 (5.33%) (4.48%) 22 (5.27%) (3.95%) 22
Total Population 8.51% 9.65% 85 7.33% 8.32% 87 7.54% 9.38% 86Excluded Cost Reports 10 11 14
Total Cost Reports 95 98 100
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.33% 20.38% 22 20.11% 19.02% 22 19.40% 19.43% 232nd Quartile 12.72% 12.78% 22 10.80% 10.77% 22 10.93% 11.16% 233rd Quartile 5.71% 5.74% 23 4.02% 3.75% 23 2.97% 2.53% 244th Quartile (6.40%) (2.89%) 23 (5.62%) (3.14%) 23 (6.55%) (4.71%) 24
Total Population 7.90% 9.65% 90 7.15% 7.50% 90 6.51% 6.31% 94Excluded Cost Reports 11 10 8
Total Cost Reports 101 100 102
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 20
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 18.63% 17.94% 10 19.17% 17.90% 11 18.40% 18.47% 122nd Quartile 12.07% 13.05% 10 9.60% 9.36% 11 10.45% 10.24% 123rd Quartile 6.16% 6.28% 11 3.83% 4.69% 12 4.44% 3.90% 124th Quartile (4.41%) (4.28%) 11 (5.74%) (4.58%) 12 (5.74%) (5.58%) 12
Total Population 7.77% 8.46% 42 6.38% 6.06% 46 6.88% 8.20% 48Excluded Cost Reports 4 3 2
Total Cost Reports 46 49 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.23% 19.22% 11 19.84% 19.98% 12 19.04% 19.44% 132nd Quartile 10.11% 10.68% 11 11.04% 10.11% 12 10.64% 10.09% 133rd Quartile 3.57% 3.98% 11 1.98% 2.22% 12 3.87% 3.30% 134th Quartile (5.85%) (4.55%) 12 (8.88%) (5.80%) 13 (9.47%) (6.70%) 14
Total Population 6.48% 5.46% 45 5.69% 5.91% 49 5.73% 8.62% 53Excluded Cost Reports 3 1 1
Total Cost Reports 48 50 54
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 21
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.01% 22.28% 5 18.29% 18.57% 6 20.63% 19.76% 62nd Quartile 8.98% 9.47% 5 8.24% 7.26% 6 9.41% 8.27% 63rd Quartile 2.81% 2.35% 5 3.06% 4.31% 6 1.25% 0.56% 64th Quartile (3.34%) (2.36%) 6 (4.11%) (3.58%) 6 (6.14%) (3.88%) 6
Total Population 6.38% 5.50% 21 6.37% 5.66% 24 6.29% 6.29% 24Excluded Cost Reports 2 0 0
Total Cost Reports 23 24 24
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.26% 19.52% 5 17.66% 16.31% 4 17.67% 17.14% 52nd Quartile 9.92% 9.18% 6 8.65% 10.28% 5 9.14% 9.43% 53rd Quartile 1.21% 1.55% 6 0.13% (0.38%) 5 1.92% 2.07% 64th Quartile (9.31%) (8.28%) 6 (7.33%) (7.05%) 5 (8.06%) (6.69%) 6
Total Population 4.88% 4.31% 23 4.10% 4.21% 19 4.42% 5.34% 22Excluded Cost Reports 1 3 2
Total Cost Reports 24 22 24
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 22
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 21.36% 20.61% 4 18.49% 18.70% 4 17.85% 17.27% 42nd Quartile 13.72% 13.70% 4 10.12% 10.51% 4 10.83% 10.78% 43rd Quartile 6.08% 6.32% 5 4.33% 5.40% 4 3.32% 2.41% 44th Quartile (3.35%) (2.96%) 5 (4.00%) (5.07%) 5 (3.01%) (3.53%) 5
Total Population 8.55% 8.84% 18 6.58% 6.61% 17 6.64% 7.89% 17Excluded Cost Reports 0 1 1
Total Cost Reports 18 18 18
Mean Median Count Mean Median Count Mean Median Count1st Quartile 18.33% 16.43% 5 20.81% 21.23% 5 14.12% 14.10% 42nd Quartile 10.53% 9.26% 5 10.98% 10.90% 5 10.06% 10.13% 43rd Quartile 2.72% 0.36% 5 1.71% 1.13% 5 6.17% 7.50% 54th Quartile (4.82%) (3.07%) 5 (3.81%) (2.77%) 5 (2.42%) (0.92%) 5
Total Population 6.69% 7.59% 20 7.42% 4.97% 20 6.42% 7.96% 18Excluded Cost Reports 0 0 2
Total Cost Reports 20 20 20
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 23
Peer Group Comparison – Total Operating Profit Margin
Mean Median Count Mean Median Count Mean Median Count1st Quartile 20.03% 20.12% 149 19.41% 19.38% 161 18.99% 18.47% 1692nd Quartile 10.48% 10.51% 149 9.99% 10.06% 163 9.90% 9.93% 1703rd Quartile 2.85% 2.98% 152 2.60% 2.67% 165 1.84% 2.02% 1724th Quartile (7.79%) (6.44%) 154 (8.74%) (7.47%) 167 (9.60%) (8.04%) 174
Total Population 6.26% 6.52% 604 5.67% 6.18% 656 5.16% 5.76% 685Excluded Cost Reports 96 108 108
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count1st Quartile 19.61% 19.54% 170 19.13% 18.78% 163 18.56% 17.76% 1622nd Quartile 10.10% 10.35% 171 9.54% 9.78% 164 9.13% 9.49% 1623rd Quartile 1.12% 1.22% 173 1.36% 1.44% 166 1.07% 1.54% 1664th Quartile (10.87%) (9.50%) 175 (10.19%) (8.83%) 167 (10.42%) (9.27%) 168
Total Population 4.87% 5.82% 689 4.86% 5.22% 660 4.43% 5.21% 658Excluded Cost Reports 108 104 92
Total Cost Reports 797 764 750
Quartile Rank2006 2005 2004
Total Operating Profit MarginAll Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 24
Total Labor Cost as a Percentage of Total Operating Revenues - Summary
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 42.84% 40.62% 61 43.59% 40.46% 71 44.48% 43.43% 6926 to 100 Beds 42.90% 40.77% 170 44.35% 42.50% 186 43.58% 43.19% 197
101 to 200 Beds 42.98% 41.94% 207 43.92% 42.54% 224 44.79% 44.16% 239201 to 300 Beds 41.55% 40.13% 91 42.64% 41.13% 96 43.00% 41.72% 97301 to 400 Beds 44.24% 43.69% 45 44.72% 45.15% 49 44.29% 44.25% 50401 to 500 Beds 46.17% 44.86% 22 45.87% 45.51% 24 46.40% 45.08% 24Over 500 Beds 42.66% 41.55% 18 44.51% 43.71% 18 44.24% 43.32% 18
Total All Hospitals 42.93% 41.49% 614 43.97% 42.45% 668 44.17% 43.56% 694Excluded Cost Reports 86 96 99
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 44.99% 43.57% 79 44.79% 42.61% 62 48.59% 48.40% 5126 to 100 Beds 43.55% 42.35% 191 44.58% 43.27% 200 44.89% 43.99% 201
101 to 200 Beds 45.39% 44.09% 234 45.44% 44.44% 239 45.45% 44.16% 233201 to 300 Beds 42.90% 41.46% 98 43.81% 42.31% 98 44.12% 42.39% 100301 to 400 Beds 44.53% 44.73% 48 45.32% 44.68% 50 44.52% 44.03% 52401 to 500 Beds 46.14% 43.95% 24 45.71% 45.71% 22 46.29% 46.06% 24Over 500 Beds 44.36% 42.57% 20 43.56% 42.36% 20 44.30% 43.43% 19
Total All Hospitals 44.42% 42.83% 694 44.85% 43.55% 691 45.25% 43.92% 680Excluded Cost Reports 103 73 70
Total Cost Reports 797 764 750
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
Number of Licensed Beds2009 2008 2007
Number of Licensed Beds2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 25
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 32.04% 32.42% 15 31.61% 31.62% 17 31.67% 31.84% 172nd Quartile 36.44% 36.21% 15 36.56% 36.19% 18 38.40% 38.15% 173rd Quartile 45.63% 46.09% 15 46.84% 48.48% 18 47.34% 48.25% 174th Quartile 56.35% 53.92% 16 58.69% 57.30% 18 59.62% 58.07% 18
Total Population 42.84% 40.62% 61 43.59% 40.46% 71 44.48% 43.43% 69Excluded Cost Reports 35 47 53
Total Cost Reports 96 118 122
Mean Median Count Mean Median Count Mean Median Count1st Quartile 31.89% 32.07% 19 31.16% 31.17% 15 34.14% 34.32% 122nd Quartile 39.01% 39.35% 20 37.77% 37.65% 15 40.21% 39.23% 133rd Quartile 48.31% 48.33% 20 48.63% 49.79% 16 53.99% 56.28% 134th Quartile 60.12% 58.73% 20 60.31% 61.29% 16 64.89% 64.29% 13
Total Population 44.99% 43.57% 79 44.79% 42.61% 62 48.59% 48.40% 51Excluded Cost Reports 48 32 29
Total Cost Reports 127 94 80
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 26
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 33.61% 33.93% 42 33.81% 34.29% 46 33.77% 34.27% 492nd Quartile 38.70% 39.05% 42 39.98% 39.76% 46 39.62% 39.72% 493rd Quartile 44.01% 43.60% 43 45.64% 45.52% 47 45.67% 45.35% 494th Quartile 54.98% 53.17% 43 57.65% 56.33% 47 55.01% 54.82% 50
Total Population 42.90% 40.77% 170 44.35% 42.50% 186 43.58% 43.19% 197Excluded Cost Reports 30 34 33
Total Cost Reports 200 220 230
Mean Median Count Mean Median Count Mean Median Count1st Quartile 33.59% 33.67% 47 34.00% 34.28% 50 34.41% 35.02% 502nd Quartile 39.27% 39.20% 48 40.28% 40.24% 50 40.71% 40.99% 503rd Quartile 45.36% 45.40% 48 46.60% 46.78% 50 47.36% 47.18% 504th Quartile 55.78% 54.42% 48 57.44% 56.48% 50 56.84% 55.55% 51
Total Population 43.55% 42.35% 191 44.58% 43.27% 200 44.89% 43.99% 201Excluded Cost Reports 38 29 26
Total Cost Reports 229 229 227
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 27
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.21% 34.38% 51 34.54% 34.67% 56 34.77% 35.11% 592nd Quartile 39.72% 39.80% 52 40.43% 40.54% 56 40.97% 40.96% 603rd Quartile 44.04% 43.89% 52 45.47% 45.76% 56 46.92% 46.42% 604th Quartile 53.78% 52.99% 52 55.25% 53.90% 56 56.34% 55.19% 60
Total Population 42.98% 41.94% 207 43.92% 42.54% 224 44.79% 44.16% 239Excluded Cost Reports 15 13 10
Total Cost Reports 222 237 249
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.78% 35.29% 58 35.11% 35.48% 59 35.84% 36.52% 582nd Quartile 41.05% 40.80% 58 41.00% 41.22% 60 41.86% 42.27% 583rd Quartile 47.27% 47.21% 59 47.47% 47.42% 60 47.03% 47.00% 584th Quartile 58.21% 57.35% 59 58.03% 56.32% 60 56.86% 55.62% 59
Total Population 45.39% 44.09% 234 45.44% 44.44% 239 45.45% 44.16% 233Excluded Cost Reports 14 10 10
Total Cost Reports 248 249 243
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 28
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 33.25% 33.72% 22 35.02% 35.24% 24 34.52% 35.21% 242nd Quartile 37.70% 37.77% 23 39.68% 39.79% 24 39.48% 39.55% 243rd Quartile 43.13% 42.99% 23 43.52% 43.53% 24 44.49% 43.90% 244th Quartile 51.73% 49.98% 23 52.35% 50.51% 24 53.09% 53.41% 25
Total Population 41.55% 40.13% 91 42.64% 41.13% 96 43.00% 41.72% 97Excluded Cost Reports 4 2 3
Total Cost Reports 95 98 100
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.46% 34.74% 24 34.23% 33.86% 24 34.62% 34.79% 252nd Quartile 39.09% 38.98% 24 38.93% 38.71% 24 39.84% 39.92% 253rd Quartile 43.63% 42.75% 25 45.47% 45.62% 25 45.72% 45.25% 254th Quartile 53.94% 53.50% 25 56.05% 54.83% 25 56.29% 55.43% 25
Total Population 42.90% 41.46% 98 43.81% 42.31% 98 44.12% 42.39% 100Excluded Cost Reports 3 2 2
Total Cost Reports 101 100 102
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 29
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.36% 36.06% 11 34.82% 35.57% 12 35.06% 35.87% 122nd Quartile 41.41% 40.88% 11 41.26% 41.30% 12 40.70% 39.74% 123rd Quartile 46.25% 46.62% 11 48.10% 48.49% 12 46.95% 46.73% 134th Quartile 52.24% 51.29% 12 53.94% 53.69% 13 53.46% 52.16% 13
Total Population 44.24% 43.69% 45 44.72% 45.15% 49 44.29% 44.25% 50Excluded Cost Reports 1 0 0
Total Cost Reports 46 49 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 35.52% 36.36% 12 35.14% 35.36% 12 36.18% 36.58% 132nd Quartile 41.15% 40.48% 12 40.70% 40.23% 12 40.38% 39.92% 133rd Quartile 46.90% 46.92% 12 47.92% 47.19% 13 47.05% 46.69% 134th Quartile 54.57% 52.78% 12 56.39% 56.20% 13 54.49% 54.31% 13
Total Population 44.53% 44.73% 48 45.32% 44.68% 50 44.52% 44.03% 52Excluded Cost Reports 0 0 2
Total Cost Reports 48 50 54
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 30
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 38.71% 39.42% 5 37.94% 38.28% 6 37.24% 37.24% 62nd Quartile 43.09% 43.74% 5 43.60% 43.20% 6 42.71% 43.51% 63rd Quartile 46.27% 45.92% 6 47.76% 47.53% 6 48.51% 49.28% 64th Quartile 54.86% 54.08% 6 54.19% 54.52% 6 57.17% 58.50% 6
Total Population 46.17% 44.86% 22 45.87% 45.51% 24 46.40% 45.08% 24Excluded Cost Reports 1 0 0
Total Cost Reports 23 24 24
Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.52% 36.16% 6 35.09% 34.79% 5 35.64% 35.47% 62nd Quartile 41.90% 41.52% 6 41.57% 42.87% 5 43.18% 42.96% 63rd Quartile 49.57% 50.45% 6 47.43% 46.97% 6 49.15% 49.64% 64th Quartile 56.59% 55.79% 6 56.30% 54.62% 6 57.19% 56.20% 6
Total Population 46.14% 43.95% 24 45.71% 45.71% 22 46.29% 46.06% 24Excluded Cost Reports 0 0 0
Total Cost Reports 24 22 24
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 31
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.50% 36.64% 4 37.17% 36.92% 4 36.82% 36.55% 42nd Quartile 39.52% 39.46% 4 42.14% 42.10% 4 41.63% 41.63% 43rd Quartile 43.01% 43.33% 5 45.12% 45.99% 5 45.00% 44.16% 54th Quartile 49.75% 47.64% 5 51.65% 52.11% 5 51.52% 51.83% 5
Total Population 42.66% 41.55% 18 44.51% 43.71% 18 44.24% 43.32% 18Excluded Cost Reports 0 0 0
Total Cost Reports 18 18 18
Mean Median Count Mean Median Count Mean Median Count1st Quartile 38.01% 36.86% 5 35.96% 36.65% 5 37.79% 37.81% 42nd Quartile 41.63% 41.43% 5 40.96% 41.23% 5 41.06% 41.07% 53rd Quartile 45.01% 44.35% 5 44.48% 44.41% 5 45.58% 45.95% 54th Quartile 52.78% 52.76% 5 52.82% 51.89% 5 51.46% 50.14% 5
Total Population 44.36% 42.57% 20 43.56% 42.36% 20 44.30% 43.43% 19Excluded Cost Reports 0 0 1
Total Cost Reports 20 20 20
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 32
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.05% 34.06% 150 34.31% 34.53% 165 34.29% 34.60% 1712nd Quartile 39.04% 39.16% 152 39.99% 40.19% 166 40.18% 40.34% 1723rd Quartile 44.26% 44.21% 155 45.65% 45.71% 168 46.28% 45.91% 1744th Quartile 53.87% 52.87% 157 55.63% 53.93% 169 55.52% 54.74% 177
Total Population 42.93% 41.49% 614 43.97% 42.45% 668 44.17% 43.56% 694Excluded Cost Reports 86 96 99
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.29% 34.63% 171 34.34% 34.61% 170 35.18% 35.62% 1682nd Quartile 40.10% 40.18% 173 40.21% 40.21% 171 41.01% 40.99% 1703rd Quartile 46.33% 46.11% 175 46.99% 46.72% 175 47.50% 47.20% 1704th Quartile 56.69% 55.95% 175 57.45% 56.26% 175 57.05% 55.75% 172
Total Population 44.42% 42.83% 694 44.85% 43.55% 691 45.25% 43.92% 680Excluded Cost Reports 103 73 70
Total Cost Reports 797 764 750
Quartile Rank2006 2005 2004
Total Labor Cost as a Percentage of Total Operating RevenuesAll Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 33
Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (A0B) - Summary
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 5.09 5.02 70 5.14 5.05 86 4.98 4.74 8826 to 100 Beds 4.51 4.15 188 4.56 4.22 208 4.50 4.14 213
101 to 200 Beds 4.13 4.04 222 4.16 4.03 234 4.17 4.03 247201 to 300 Beds 4.19 4.12 94 4.24 4.19 98 4.22 4.15 100301 to 400 Beds 4.28 4.27 46 4.36 4.30 49 4.39 4.28 50401 to 500 Beds 4.12 4.24 23 4.12 4.15 24 4.11 4.17 24Over 500 Beds 4.47 4.32 18 4.65 4.66 18 4.63 4.61 18
Total All Hospitals 4.37 4.16 661 4.43 4.20 717 4.39 4.16 740Excluded Cost Reports 39 47 53
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 5.03 4.93 92 5.02 4.90 72 5.03 4.89 6426 to 100 Beds 4.50 4.24 215 4.36 4.12 210 4.42 4.22 210
101 to 200 Beds 4.14 4.02 247 4.05 3.90 247 3.99 3.89 241201 to 300 Beds 4.20 4.18 100 4.16 4.09 98 4.19 4.16 101301 to 400 Beds 4.49 4.42 48 4.37 4.31 50 4.36 4.27 54401 to 500 Beds 4.09 4.12 24 4.08 4.12 22 4.04 4.14 24Over 500 Beds 4.59 4.61 20 4.53 4.56 20 4.36 4.32 19
Total All Hospitals 4.40 4.21 746 4.29 4.09 719 4.28 4.14 713Excluded Cost Reports 51 45 37
Total Cost Reports 797 764 750
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
Number of Licensed Beds2009 2008 2007
Number of Licensed Beds2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 34
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.02 3.22 17 2.97 3.13 21 3.04 3.15 222nd Quartile 4.32 4.40 17 4.28 4.20 21 4.19 4.27 223rd Quartile 5.43 5.49 18 5.50 5.46 22 5.44 5.55 224th Quartile 7.43 7.49 18 7.68 7.72 22 7.24 7.14 22
Total Population 5.09 5.02 70 5.14 5.05 86 4.98 4.74 88Excluded Cost Reports 26 32 34
Total Cost Reports 96 118 122
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.05 3.20 23 3.12 3.17 18 3.24 3.24 162nd Quartile 4.36 4.46 23 4.38 4.46 18 4.49 4.51 163rd Quartile 5.44 5.38 23 5.44 5.34 18 5.27 5.31 164th Quartile 7.27 7.44 23 7.14 7.20 18 7.12 7.24 16
Total Population 5.03 4.93 92 5.02 4.90 72 5.03 4.89 64Excluded Cost Reports 35 22 16
Total Cost Reports 127 94 80
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 35
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.13 3.29 47 3.14 3.14 52 3.10 3.21 532nd Quartile 3.87 3.85 47 3.92 3.93 52 3.88 3.86 533rd Quartile 4.59 4.59 47 4.61 4.55 52 4.59 4.61 534th Quartile 6.46 6.26 47 6.55 6.43 52 6.41 6.30 54
Total Population 4.51 4.15 188 4.56 4.22 208 4.50 4.14 213Excluded Cost Reports 12 12 17
Total Cost Reports 200 220 230
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.14 3.22 53 3.12 3.22 52 3.10 3.20 522nd Quartile 3.95 3.94 54 3.80 3.78 52 3.88 3.89 523rd Quartile 4.62 4.57 54 4.42 4.38 53 4.49 4.46 534th Quartile 6.28 6.19 54 6.05 6.16 53 6.19 6.20 53
Total Population 4.50 4.24 215 4.36 4.12 210 4.42 4.22 210Excluded Cost Reports 14 19 17
Total Cost Reports 229 229 227
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 36
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.13 3.26 55 3.16 3.26 58 3.17 3.26 612nd Quartile 3.83 3.83 55 3.82 3.82 58 3.84 3.86 623rd Quartile 4.30 4.27 56 4.27 4.29 59 4.28 4.28 624th Quartile 5.25 4.88 56 5.36 5.02 59 5.37 4.92 62
Total Population 4.13 4.04 222 4.16 4.03 234 4.17 4.03 247Excluded Cost Reports 0 3 2
Total Cost Reports 222 237 249
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.23 3.36 61 3.14 3.27 61 3.18 3.33 602nd Quartile 3.80 3.80 62 3.72 3.73 62 3.71 3.70 603rd Quartile 4.27 4.29 62 4.16 4.19 62 4.13 4.12 604th Quartile 5.24 4.89 62 5.14 4.97 62 4.94 4.69 61
Total Population 4.14 4.02 247 4.05 3.90 247 3.99 3.89 241Excluded Cost Reports 1 2 2
Total Cost Reports 248 249 243
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 37
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.42 3.46 23 3.50 3.61 24 3.46 3.57 252nd Quartile 3.96 3.94 23 4.02 4.00 24 4.01 4.00 253rd Quartile 4.29 4.31 24 4.36 4.35 25 4.37 4.36 254th Quartile 5.04 4.97 24 5.05 4.92 25 5.04 4.78 25
Total Population 4.19 4.12 94 4.24 4.19 98 4.22 4.15 100Excluded Cost Reports 1 0 0
Total Cost Reports 95 98 100
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.37 3.48 25 3.37 3.47 24 3.33 3.40 252nd Quartile 4.02 4.03 25 3.94 3.97 24 3.92 3.90 253rd Quartile 4.33 4.32 25 4.27 4.25 25 4.30 4.28 254th Quartile 5.10 4.89 25 5.00 4.78 25 5.14 4.96 26
Total Population 4.20 4.18 100 4.16 4.09 98 4.19 4.16 101Excluded Cost Reports 1 2 1
Total Cost Reports 101 100 102
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 38
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.58 3.63 11 3.53 3.57 12 3.59 3.69 122nd Quartile 4.03 4.02 11 4.13 4.19 12 4.08 4.05 123rd Quartile 4.38 4.36 12 4.49 4.50 12 4.52 4.49 134th Quartile 5.06 4.86 12 5.21 4.86 13 5.30 5.02 13
Total Population 4.28 4.27 46 4.36 4.30 49 4.39 4.28 50Excluded Cost Reports 0 0 0
Total Cost Reports 46 49 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.62 3.70 12 3.44 3.55 12 3.49 3.54 132nd Quartile 4.24 4.29 12 4.07 4.07 12 4.07 4.08 133rd Quartile 4.61 4.62 12 4.46 4.44 13 4.39 4.32 144th Quartile 5.51 5.18 12 5.41 5.15 13 5.42 5.05 14
Total Population 4.49 4.42 48 4.37 4.31 50 4.36 4.27 54Excluded Cost Reports 0 0 0
Total Cost Reports 48 50 54
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 39
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 40
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.46 3.48 4 3.53 3.54 4 3.53 3.59 42nd Quartile 4.02 4.08 4 4.05 4.03 4 4.10 4.05 43rd Quartile 4.54 4.54 5 4.81 4.78 5 4.76 4.65 54th Quartile 5.56 5.49 5 5.87 5.89 5 5.82 5.81 5
Total Population 4.47 4.32 18 4.65 4.66 18 4.63 4.61 18Excluded Cost Reports 0 0 0
Total Cost Reports 18 18 18
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.63 3.70 5 3.44 3.61 5 3.18 3.20 42nd Quartile 4.25 4.10 5 4.25 4.14 5 3.88 3.98 53rd Quartile 4.77 4.78 5 4.70 4.71 5 4.56 4.58 54th Quartile 5.72 5.69 5 5.73 5.74 5 5.58 5.56 5
Total Population 4.59 4.61 20 4.53 4.56 20 4.36 4.32 19Excluded Cost Reports 0 0 1
Total Cost Reports 20 20 20
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 41
Peer Group Comparison -Full-Time Equivalent (FTE) Staff Per Adjusted Occupied Bed (AOB)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.21 3.32 162 3.23 3.34 177 3.22 3.29 1832nd Quartile 3.93 3.90 163 3.96 3.92 177 3.94 3.94 1843rd Quartile 4.51 4.37 168 4.56 4.44 181 4.54 4.43 1864th Quartile 5.76 5.38 168 5.91 5.67 182 5.83 5.56 187
Total Population 4.37 4.16 661 4.43 4.20 717 4.39 4.16 740Excluded Cost Reports 39 47 53
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.25 3.34 185 3.20 3.28 177 3.21 3.29 1762nd Quartile 3.99 3.94 187 3.89 3.83 178 3.90 3.83 1773rd Quartile 4.56 4.41 187 4.41 4.30 182 4.40 4.31 1794th Quartile 5.78 5.54 187 5.60 5.37 182 5.58 5.25 181
Total Population 4.40 4.21 746 4.29 4.09 719 4.28 4.14 713Excluded Cost Reports 51 45 37
Total Cost Reports 797 764 750
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)All Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 42
Days Net Patient Revenue in Accounts Receivable (AR) - Summary
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 49.71 46.91 89 55.51 52.70 108 54.85 54.62 10526 to 100 Beds 50.55 47.79 183 53.73 52.53 202 55.53 54.45 213
101 to 200 Beds 53.15 50.93 205 54.17 52.19 217 56.12 54.92 226201 to 300 Beds 49.69 48.21 79 54.09 53.66 81 54.79 54.38 85301 to 400 Beds 50.46 49.69 41 57.06 56.06 44 55.53 56.15 47401 to 500 Beds 54.40 50.06 18 52.35 52.98 19 58.90 55.74 20Over 500 Beds 47.90 49.19 15 53.31 55.24 16 55.08 56.00 16
Total All Hospitals 51.21 49.02 630 54.36 53.05 687 55.61 54.65 712Excluded Cost Reports 70 77 81
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 56.09 53.32 105 55.39 53.23 81 54.01 55.00 6826 to 100 Beds 56.23 55.35 210 56.15 56.62 209 57.95 58.12 207
101 to 200 Beds 60.87 58.88 231 59.30 57.56 229 58.99 57.89 221201 to 300 Beds 55.57 55.64 89 55.96 55.69 95 56.69 55.70 98301 to 400 Beds 58.21 57.05 48 58.22 58.25 48 60.62 60.73 49401 to 500 Beds 55.04 51.83 20 53.37 51.57 21 57.18 55.58 24Over 500 Beds 58.47 55.74 17 54.29 52.26 18 59.22 56.61 20
Total All Hospitals 57.77 55.93 720 57.08 56.23 701 57.91 56.99 687Excluded Cost Reports 77 63 63
Total Cost Reports 797 764 750
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
Number of Licensed Beds2009 2008 2007
Number of Licensed Beds2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 43
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.06 35.71 22 35.25 39.56 27 33.85 36.21 262nd Quartile 43.30 43.31 22 48.50 48.57 27 47.66 46.96 263rd Quartile 51.15 51.63 22 58.25 58.65 27 58.80 57.71 264th Quartile 69.42 67.58 23 80.01 78.03 27 78.19 75.88 27
Total Population 49.71 46.91 89 55.51 52.70 108 54.85 54.62 105Excluded Cost Reports 7 10 17
Total Cost Reports 96 118 122
Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.13 37.56 26 36.92 36.85 20 28.91 29.46 172nd Quartile 48.76 49.58 26 48.46 48.40 20 48.45 48.19 173rd Quartile 59.33 58.47 26 59.31 59.02 20 59.55 59.03 174th Quartile 79.26 78.08 27 75.85 70.95 21 79.14 78.87 17
Total Population 56.09 53.32 105 55.39 53.23 81 54.01 55.00 68Excluded Cost Reports 22 13 12
Total Cost Reports 127 94 80
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 44
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.89 36.93 45 36.08 38.20 50 35.68 38.60 532nd Quartile 43.89 44.06 46 47.90 47.84 50 49.86 49.70 533rd Quartile 52.64 52.29 46 57.35 57.52 51 58.46 57.03 534th Quartile 70.41 67.55 46 73.15 70.32 51 77.72 76.22 54
Total Population 50.55 47.79 183 53.73 52.53 202 55.53 54.45 213Excluded Cost Reports 17 18 17
Total Cost Reports 200 220 230
Mean Median Count Mean Median Count Mean Median Count1st Quartile 37.17 39.35 52 35.34 37.77 52 35.50 36.99 512nd Quartile 50.49 50.61 52 50.61 50.27 52 52.51 52.94 523rd Quartile 59.45 58.97 53 60.12 60.23 52 62.75 62.78 524th Quartile 77.34 74.23 53 78.10 75.83 53 80.61 78.54 52
Total Population 56.23 55.35 210 56.15 56.62 209 57.95 58.12 207Excluded Cost Reports 19 20 20
Total Cost Reports 229 229 227
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 45
Mean Median Count Mean Median Count Mean Median Count1st Quartile 35.80 37.19 51 38.85 40.42 54 39.74 42.23 562nd Quartile 47.35 47.28 51 49.27 49.52 54 50.53 50.47 563rd Quartile 55.06 54.28 51 56.54 56.40 54 58.90 59.44 574th Quartile 73.98 70.53 52 71.70 68.16 55 74.91 70.03 57
Total Population 53.15 50.93 205 54.17 52.19 217 56.12 54.92 226Excluded Cost Reports 17 20 23
Total Cost Reports 222 237 249
Mean Median Count Mean Median Count Mean Median Count1st Quartile 41.57 43.24 57 39.89 41.17 57 39.05 41.43 552nd Quartile 54.20 54.16 58 53.62 53.80 57 53.28 53.85 553rd Quartile 64.71 64.58 58 62.62 62.73 57 62.79 62.73 554th Quartile 82.66 79.07 58 80.68 79.27 58 80.43 79.96 56
Total Population 60.87 58.88 231 59.30 57.56 229 58.99 57.89 221Excluded Cost Reports 17 20 22
Total Cost Reports 248 249 243
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 46
Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.11 36.08 19 40.08 41.41 20 40.19 43.37 212nd Quartile 45.10 45.35 20 50.25 50.57 20 50.59 50.08 213rd Quartile 51.98 52.34 20 56.23 55.64 20 57.99 58.05 214th Quartile 64.89 60.10 20 69.07 63.88 21 69.69 66.95 22
Total Population 49.69 48.21 79 54.09 53.66 81 54.79 54.38 85Excluded Cost Reports 16 17 15
Total Cost Reports 95 98 100
Mean Median Count Mean Median Count Mean Median Count1st Quartile 40.31 41.98 22 40.23 40.27 23 39.46 42.82 242nd Quartile 51.45 51.61 22 51.25 51.10 24 51.50 52.24 243rd Quartile 59.20 58.91 22 59.34 59.09 24 59.78 59.63 254th Quartile 70.62 69.98 23 72.37 69.69 24 75.12 71.61 25
Total Population 55.57 55.64 89 55.96 55.69 95 56.69 55.70 98Excluded Cost Reports 12 5 4
Total Cost Reports 101 100 102
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 47
Mean Median Count Mean Median Count Mean Median Count1st Quartile 34.28 37.61 10 42.70 46.01 11 39.16 41.94 112nd Quartile 47.01 46.97 10 52.79 53.17 11 49.79 49.53 123rd Quartile 54.51 54.61 10 58.79 58.49 11 60.16 60.02 124th Quartile 64.63 62.32 11 73.96 70.73 11 71.65 70.58 12
Total Population 50.46 49.69 41 57.06 56.06 44 55.53 56.15 47Excluded Cost Reports 5 5 3
Total Cost Reports 46 49 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 39.25 43.56 12 43.14 44.27 12 44.17 45.78 122nd Quartile 53.41 53.32 12 52.80 52.51 12 55.36 54.90 123rd Quartile 60.59 61.40 12 61.00 60.48 12 63.76 63.41 124th Quartile 79.59 76.21 12 75.93 70.94 12 77.76 74.65 13
Total Population 58.21 57.05 48 58.22 58.25 48 60.62 60.73 49Excluded Cost Reports 0 2 5
Total Cost Reports 48 50 54
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 48
Mean Median Count Mean Median Count Mean Median Count1st Quartile 39.08 37.95 4 33.68 39.36 4 43.75 43.08 52nd Quartile 47.81 47.69 4 47.26 47.62 5 51.49 50.87 53rd Quartile 53.65 51.45 5 55.48 54.89 5 61.06 62.24 54th Quartile 72.69 69.63 5 69.24 69.10 5 79.31 79.18 5
Total Population 54.40 50.06 18 52.35 52.98 19 58.90 55.74 20Excluded Cost Reports 5 5 4
Total Cost Reports 23 24 24
Mean Median Count Mean Median Count Mean Median Count1st Quartile 40.51 40.50 5 42.19 42.41 5 43.53 42.20 62nd Quartile 49.79 50.39 5 48.06 46.95 5 53.46 53.66 63rd Quartile 55.38 54.79 5 53.92 54.03 5 57.97 58.24 64th Quartile 74.47 74.43 5 66.64 59.23 6 73.77 70.02 6
Total Population 55.04 51.83 20 53.37 51.57 21 57.18 55.58 24Excluded Cost Reports 4 1 0
Total Cost Reports 24 22 24
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 49
Mean Median Count Mean Median Count Mean Median Count1st Quartile 36.00 37.71 3 40.69 39.80 4 41.18 42.20 42nd Quartile 45.29 46.04 4 50.37 49.89 4 50.92 51.14 43rd Quartile 50.02 49.89 4 58.14 58.22 4 60.79 60.61 44th Quartile 57.30 56.82 4 64.03 63.48 4 67.44 65.92 4
Total Population 47.90 49.19 15 53.31 55.24 16 55.08 56.00 16Excluded Cost Reports 3 2 2
Total Cost Reports 18 18 18
Mean Median Count Mean Median Count Mean Median Count1st Quartile 48.01 47.28 4 43.54 42.03 4 45.78 45.40 52nd Quartile 55.06 55.14 4 50.53 50.55 4 51.65 50.57 53rd Quartile 57.11 56.84 4 54.15 54.17 5 59.27 59.57 54th Quartile 70.64 74.71 5 66.06 68.68 5 80.16 84.07 5
Total Population 58.47 55.74 17 54.29 52.26 18 59.22 56.61 20Excluded Cost Reports 3 2 0
Total Cost Reports 20 20 20
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 35.31 36.89 154 37.78 40.03 170 37.81 40.07 1762nd Quartile 45.42 45.54 157 49.06 49.36 171 49.90 49.74 1773rd Quartile 53.21 52.92 158 57.16 57.17 172 58.84 58.64 1784th Quartile 70.09 67.03 161 72.99 69.34 174 75.34 72.81 181
Total Population 51.21 49.02 630 54.36 53.05 687 55.61 54.65 712Excluded Cost Reports 70 77 81
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count1st Quartile 39.29 41.06 178 38.60 40.27 173 37.75 40.68 1702nd Quartile 51.84 51.90 179 51.51 51.38 174 52.42 52.85 1713rd Quartile 61.01 60.70 180 60.45 60.15 175 61.81 61.78 1724th Quartile 78.35 75.76 183 77.04 74.84 179 79.16 77.37 174
Total Population 57.77 55.93 720 57.08 56.23 701 57.91 56.99 687Excluded Cost Reports 77 63 63
Total Cost Reports 797 764 750
Quartile Rank2006 2005 2004
Days Net Patient Revenue in Accounts Receivable (AR)All Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Quartile Rank2009 2008 2007
Peer Group Comparison – Days Net Patient Revenue in Accounts Receivable (AR)
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 51
Average Age of Plant and Equipment - Summary
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 6.76 5.43 86 5.50 4.24 106 5.30 3.85 11026 to 100 Beds 6.52 5.87 182 5.90 5.02 200 5.86 4.96 207
101 to 200 Beds 7.13 6.44 202 6.74 6.51 209 6.86 6.36 221201 to 300 Beds 7.63 8.10 85 7.10 7.20 86 6.81 6.82 88301 to 400 Beds 7.95 7.81 42 6.92 6.33 47 6.27 5.91 48401 to 500 Beds 8.24 9.31 22 7.25 8.49 24 6.36 6.95 24Over 500 Beds 9.27 9.13 14 8.61 8.63 15 7.84 7.72 15
Total All Hospitals 7.11 6.48 633 6.42 5.84 687 6.29 5.83 713Excluded Cost Reports 67 77 80
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count25 Beds or Less 5.08 3.46 112 5.07 3.16 86 4.27 2.97 5326 to 100 Beds 5.62 4.21 202 5.89 4.81 194 6.18 4.63 54
101 to 200 Beds 6.47 5.68 219 6.57 6.08 204 5.47 4.18 40201 to 300 Beds 6.75 6.85 89 6.60 6.40 81 7.77 6.32 14301 to 400 Beds 6.70 6.09 46 6.64 6.07 41 6.90 4.23 7401 to 500 Beds 5.66 5.91 24 5.64 5.47 19 6.72 5.73 3Over 500 Beds 7.70 7.26 19 8.21 6.95 14 3.40 3.40 1
Total All Hospitals 6.06 5.37 711 6.18 5.69 639 5.58 4.27 172Excluded Cost Reports 86 125 578
Total Cost Reports 797 764 750
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
Number of Licensed Beds2009 2008 2007
Number of Licensed Beds2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 52
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 2.25 1.93 21 1.30 1.33 26 1.32 1.40 272nd Quartile 4.55 4.54 21 3.37 3.26 26 2.81 2.70 273rd Quartile 7.07 7.11 22 5.48 5.23 27 5.20 5.10 284th Quartile 12.88 11.22 22 11.60 9.61 27 11.65 11.47 28
Total Population 6.76 5.43 86 5.50 4.24 106 5.30 3.85 110Excluded Cost Reports 10 12 12
Total Cost Reports 96 118 122
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.07 1.17 28 1.01 1.09 21 0.59 0.66 132nd Quartile 2.43 2.36 28 2.25 2.12 21 1.95 2.08 133rd Quartile 4.90 4.58 28 4.71 4.34 22 4.58 4.27 134th Quartile 11.92 12.71 28 11.99 11.12 22 9.55 9.65 14
Total Population 5.08 3.46 112 5.07 3.16 86 4.27 2.97 53Excluded Cost Reports 15 8 27
Total Cost Reports 127 94 80
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
Quartile Rank2009 2008 2007
Quartile Rank2006 2005 2004
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 53
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.88 1.90 45 1.44 1.49 50 1.40 1.47 512nd Quartile 4.19 4.09 45 3.56 3.46 50 3.41 3.23 523rd Quartile 7.54 7.40 46 7.04 7.22 50 6.71 6.70 524th Quartile 12.34 11.24 46 11.57 10.60 50 11.84 10.91 52
Total Population 6.52 5.87 182 5.90 5.02 200 5.86 4.96 207Excluded Cost Reports 18 20 23
Total Cost Reports 200 220 230
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.22 1.18 50 1.35 1.56 48 1.25 1.30 132nd Quartile 3.17 3.16 50 3.24 3.20 48 2.93 2.79 133rd Quartile 6.27 6.37 51 6.90 6.92 49 6.40 6.21 144th Quartile 11.67 10.59 51 11.92 11.41 49 13.55 13.37 14
Total Population 5.62 4.21 202 5.89 4.81 194 6.18 4.63 54Excluded Cost Reports 27 35 173
Total Cost Reports 229 229 227
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 54
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.90 1.94 50 1.60 1.65 52 1.76 1.70 552nd Quartile 4.49 4.56 50 4.13 3.69 52 4.53 4.40 553rd Quartile 8.35 8.15 51 8.24 8.46 52 8.04 7.97 554th Quartile 13.61 12.67 51 12.86 11.79 53 12.99 12.09 56
Total Population 7.13 6.44 202 6.74 6.51 209 6.86 6.36 221Excluded Cost Reports 20 28 28
Total Cost Reports 222 237 249
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.42 1.40 54 1.47 1.47 51 1.52 1.53 102nd Quartile 4.05 3.94 55 4.44 4.41 51 2.91 2.78 103rd Quartile 7.89 7.84 55 7.91 8.09 51 6.39 6.48 104th Quartile 12.40 11.73 55 12.45 11.64 51 11.07 10.34 10
Total Population 6.47 5.68 219 6.57 6.08 204 5.47 4.18 40Excluded Cost Reports 29 45 203
Total Cost Reports 248 249 243
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 55
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 2.17 2.14 21 2.20 2.01 21 2.27 2.28 222nd Quartile 5.67 5.36 21 5.55 5.58 21 5.71 6.11 223rd Quartile 9.20 9.24 21 8.54 8.80 22 7.91 7.81 224th Quartile 13.20 12.17 22 11.84 11.27 22 11.36 11.27 22
Total Population 7.63 8.10 85 7.10 7.20 86 6.81 6.82 88Excluded Cost Reports 10 12 12
Total Cost Reports 95 98 100
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.87 1.79 22 2.10 1.94 20 2.79 1.78 32nd Quartile 5.46 5.60 22 5.25 5.14 20 5.81 5.87 33rd Quartile 7.92 7.99 22 7.45 7.50 20 6.72 6.57 44th Quartile 11.54 10.62 23 11.35 9.87 21 14.04 12.64 4
Total Population 6.75 6.85 89 6.60 6.40 81 7.77 6.32 14Excluded Cost Reports 12 19 88
Total Cost Reports 101 100 102
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 56
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 2.53 2.19 10 2.01 1.93 11 2.19 2.10 122nd Quartile 6.06 6.28 10 5.14 5.23 12 4.81 4.60 123rd Quartile 9.68 9.83 11 8.06 8.21 12 7.01 6.87 124th Quartile 12.86 12.84 11 12.07 11.57 12 11.06 10.61 12
Total Population 7.95 7.81 42 6.92 6.33 47 6.27 5.91 48Excluded Cost Reports 4 2 2
Total Cost Reports 46 49 50
Mean Median Count Mean Median Count Mean Median Count1st Quartile 2.05 2.47 11 2.30 2.24 10 1.17 1.17 12nd Quartile 5.33 5.57 11 5.53 5.62 10 2.35 2.35 23rd Quartile 7.34 7.08 12 7.07 6.87 10 7.35 7.35 24th Quartile 11.57 10.52 12 11.21 10.14 11 13.87 13.87 2
Total Population 6.70 6.09 46 6.64 6.07 41 6.90 4.23 7Excluded Cost Reports 2 9 47
Total Cost Reports 48 50 54
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 57
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 3.09 3.09 5 2.19 2.14 6 1.95 2.07 62nd Quartile 7.02 6.26 5 5.98 5.75 6 5.41 5.69 63rd Quartile 9.61 9.67 6 9.40 9.50 6 7.87 7.65 64th Quartile 12.19 11.47 6 11.44 11.00 6 10.21 10.13 6
Total Population 8.24 9.31 22 7.25 8.49 24 6.36 6.95 24Excluded Cost Reports 1 0 0
Total Cost Reports 23 24 24
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.48 1.41 6 1.64 1.56 4 4.71 4.71 12nd Quartile 4.99 5.23 6 4.49 4.22 5 5.73 5.73 13rd Quartile 6.94 6.83 6 6.23 6.46 5 9.72 9.72 14th Quartile 9.23 8.74 6 9.41 9.74 5 0.00 0.00 0
Total Population 5.66 5.91 24 5.64 5.47 19 6.72 5.73 3Excluded Cost Reports 0 3 21
Total Cost Reports 24 22 24
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 58
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 5.34 5.88 3 4.78 5.23 3 3.63 3.96 32nd Quartile 8.40 8.71 3 7.89 7.97 4 6.51 6.82 43rd Quartile 9.84 10.00 4 9.13 9.14 4 8.34 8.19 44th Quartile 12.31 11.81 4 11.68 11.71 4 11.82 11.54 4
Total Population 9.27 9.13 14 8.61 8.63 15 7.84 7.72 15Excluded Cost Reports 4 3 3
Total Cost Reports 18 18 18
Mean Median Count Mean Median Count Mean Median Count1st Quartile 4.09 4.77 4 4.89 4.55 3 3.40 3.40 12nd Quartile 6.62 6.97 5 6.30 6.35 3 0.00 0.00 03rd Quartile 8.16 8.06 5 7.80 8.01 4 0.00 0.00 04th Quartile 11.20 11.16 5 12.54 10.60 4 0.00 0.00 0
Total Population 7.70 7.26 19 8.21 6.95 14 3.40 3.40 1Excluded Cost Reports 1 6 19
Total Cost Reports 20 20 20
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 59
Peer Group Comparison - Average Age of Plant and Equipment
Mean Median Count Mean Median Count Mean Median Count1st Quartile 2.12 2.01 155 1.69 1.64 169 1.72 1.68 1762nd Quartile 4.83 4.56 155 4.25 4.01 171 4.18 4.04 1783rd Quartile 8.23 8.33 161 7.55 7.71 173 7.13 7.20 1794th Quartile 12.96 11.93 162 12.03 11.42 174 12.00 11.44 180
Total Population 7.11 6.48 633 6.42 5.84 687 6.29 5.83 713Excluded Cost Reports 67 77 80
Total Cost Reports 700 764 793
Mean Median Count Mean Median Count Mean Median Count1st Quartile 1.47 1.37 175 1.57 1.51 157 1.35 1.13 422nd Quartile 3.90 3.75 177 3.99 3.72 158 2.86 2.54 423rd Quartile 6.91 7.08 179 7.00 7.10 161 6.01 5.89 444th Quartile 11.81 11.09 180 11.91 11.29 163 11.77 11.71 44
Total Population 6.06 5.37 711 6.18 5.69 639 5.58 4.27 172Excluded Cost Reports 86 125 578
Total Cost Reports 797 764 750
Quartile Rank2006 2005 2004
Average Age of Plant and EquipmentAll Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
Quartile Rank2009 2008 2007
Notes:• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 60
Introduction to Healthcare Management Partners
Who We Are
HMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experienceincluding CEO, COO and CFO assignments across the spectrum of healthcare service providers.
HMP’s senior management has deep experience in building and operating thriving healthcare organizations. Part of that experienceincludes taking decisive action in crises or turnaround situations. This knowledge base gives HMP a unique perspective and all the toolsnecessary to handle the issues facing any healthcare provider organization. HMP provides Hospital Contract Management, TurnaroundManagement and Interim or Crisis Management services.
Our Approach
Our approach to every assignment is built upon the straightforward application of three simple steps or guiding principles.
Listen – We listen carefully to our clients, their key stakeholders and the marketplace throughout each assignment.
Evaluate – We employ detailed, fact-based analysis to evaluate and validate assumptions, findings and recommended actions.
Implement – We have a bias toward “getting it done.” We take decisive action to quickly convert opportunities or solve problems .
The HMP Difference
• Total commitment to providing C-Level attention throughout each assignment by experienced healthcare executives• Small, dedicated teams of operating professionals for each assignment• Absolute integrity of our fact-based approach• Action-oriented diagnostic and business planning processes• Proven ability to drive positive outcomes in all sectors of healthcare• Depth of HMP network, providing critical access to key resources and people• Commitment to the highest professional standards
October 2010 61
Introduction to Healthcare Management Partners (continued)
Management Services
HMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experienceincluding CEO, COO and CFO assignments across the spectrum of health services. Examples of specific assignments include serving asthe Chief Executive Officer (CEO) of the following types of healthcare organizations:
• Religious affiliated or sponsored multihospital systems• Free standing not-for-profit or government owned community hospitals• University and major teaching hospitals• Single site and multihospital regional operations for investor owned hospital management companies• De Novo organizations (start-up) planning, construction and operation of new general acute care hospitals, free-standing heart
and cancer hospitals, a continuing care retirement community and many other related facilities• Hospitals that are in bankruptcy or for sale• Financially distressed skilled nursing facilities• Home health, hospice and physician practices
“HMP’s senior staff members are professional healthcare service executives who also possess consulting skills, not professional consultants. We understand and are committed to the provision of quality healthcare services
at every provider organization where we have a management role.”
October 2010
Hospital Contract Management
HMP is positioned to undertake the long-term (3 to 5 years) contract management of hospitals of all sizes and stages ofdevelopment. Our executives are experienced in leading the development of new or replacement general acute care or specialtyhospitals or the turnaround and repositioning of existing hospitals. They can effectively lead initiatives in the following areas:
62
Introduction to Healthcare Management Partners
Strategic Leadership Clinical Excellence Operational Excellence Financial Performance
Market Positioning Clinical Process Redesign Patient Throughput Revenue Cycle
Brand Development Evidence‐Based Care Emergency Department Clinical Efficiency
Business Office Consolidation
Service Line Development Resource Utilization and Cost of Quality
Surgical Services Clinical Efficiency
Managed Care Contracting
Capital Planning and Investment Pay for Performance Inpatient Length of Stay and Level of Care
Risk Management and Insurance
Physician Relations Care and Case Management Processes
Human Resources Management Budgeting / Financial Planning
Physician Integration Quality and Safety Indicators Ambulatory Care Capital Programs
Continuum of Care Design and Implementation Strategic Plans
Hospice and Home Care Supply Chain
Corporate and Medical Staff Governance
Mission and Vision Best Practices and Operating Metrics
Financial Reporting and Accounting
We will be directly accountable to the board of directors and will assume full responsibility to plan, organize, staff, direct andcontrol the successful and cost effective operations of the hospital.
Because HMP is not a management consulting firm, our contract management executives are free to always bring the best and mostcost-effective solution, from whatever source, to the hospital should outside assistance prove necessary to implement a givenstrategic or tactical initiative.
October 2010
Turnaround Management
HMP’s executives have served as chief restructuring officers of healthcare companies through bankruptcies, crisis situations and in theearly stages of high-profile criminal and civil fraud investigations. In each of these situations, their leadership helped theseorganizations bolster performance through discipline and carefully planned action.
Some consultants assess your problems and provide a recommended course of action. But HMP executives take the helm of failingorganizations and assume direct responsibility for transforming them. Time and again, they have succeeded in revitalizing providers ofall kinds, from a rural nursing home chain to a 1,000 bed teaching hospital or a 179 bed county owned community hospital.
There are no quick fixes in turnaround management, but HMP has developed a highly effective, streamlined approach for achievinglasting improvements as soon as possible. We begin by developing a strong knowledge base of your organization. Individuals fromevery level of the organization are interviewed: management, medical and nursing staff members, board of directors, employees,patients and their families. Their input, combined with a depth of healthcare industry knowledge, allows HMP to:
• Stabilize the crises,• Identify immediate opportunities and challenges,• Develop a strategic plan, including milestones and deadlines,• Define expected outcomes,• Build consensus with all constituents – medical and nursing staffs, management, unions, and the local community,• Change cultures, and• Optimize performance.
In all of its healthcare provider turnaround assignments, HMP has successfully designed and executed plans that simultaneously addedpatient volume and revenues, reduced costs and improved profitability and cash flow.
From the outset, HMP builds on each organization’s strengths, working side‐by‐side with management, directors and other keystakeholders to drive desired results. HMP also focuses on winning the support and active participation of the medical and nursingstaffs, which is fundamental for delivering quality healthcare services and improving financial results.
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Introduction to Healthcare Management Partners
October 2010
Interim and Crisis Management
HMP serves in interim and crisis management roles when required to help guide providers through periods of crisis or change.Companies that are underperforming and in crisis, or healthy but in transition, may need additional experienced healthcare industryleaders to stabilize operations and improve financial performance or maintain continuity in the rapid implementation of critical strategicinitiatives.
Our professionals can offer critical advice or step into key leadership positions such as Chief Restructuring Officer, Chief FinancialOfficer, or Chief Executive Officer to provide needed stability during periods of change. Our proven interim management capabilitiesadd valuable support in crisis situations. We immediately fill critical leadership vacancies and shorten the lead‐time for implementingspecific initiatives. HMP provides much needed leadership and speed to create value in executing crisis management and restructuringplans.
Our crisis and interim management services include:
•Immediate staffing of critical senior management positions•Reducing lead‐time for implementing strategic initiatives•Managing communications processes with Members of the medical and nursing staffs, board members, employees andregulators, and if required•Bankruptcy process planning and administration
64
Introduction to Healthcare Management Partners (continued)
October 2010
Clients Our Professionals Have Served
65
Investor Owned Hospitals or Health SystemsAmeris Health Systems Health South Corporation Integrated Healthcare
Holdings, Inc.Shasta Regional Medical Center
Doctors Hospital, Houston Hospital Corporation of America
Lakeside Hospital at Bastrop St. Joseph Hospital, Houston
Doctors Hospital, Los Angeles Hugh Chatham Memorial Hospital
LifePoint Hospitals Tenet Healthcare Corporation
HealthPlus Hughston Hospital and Clinic Monroe Hospital, LLC Vanguard Health Systems
Hospital Partners of America Integra Healthcare Promise Healthcare
Not-For-Profit or Governmental Hospitals or SystemsBaylor College of Medicine Hahnemann University
HospitalNew York United Hospital Medical Center
Southern Chester County Medical Center
The Brooklyn Hospital Center Health Alliance of Cincinnati Nyack Hospital St Vincent’s Catholic Medical Centers, New York
Devereux Foundation National Health Service, United Kingdom
Rahway Hospital Temple Health System
Franciscan Health System Legacy Health System Raritan Bay Health System Tri‐Lakes Medical Center
General Health System Mercy Health System Robert Wood Johnson Health Network
University Hospital Consortium of Pennsylvania
Good Samaritan Hospital Natchez Regional Medical Center
Sisters of Mercy Health System
October 2010 66
Law and Accounting FirmsBird Marella LLP Deloitte Kantrow, Spaht, Weaver & Blitzer Patton Boggs
Bradley Arant Boult Cummings LLP
Gearhiser, Peters, Lockaby, Cavett & Elliott, PLLC
KPMG Ramirez International, Inc.
Brown McCarroll LLP Hogan & Hartson LLP Latham & Watkins Whiteford Taylor Preston, LLP
Fulbright & Jaworski LLP Hooper, Lundy & Bookman Mancuso & Franco PC Schiavetti, Corgan, Soscia, DiEdwards and Nicholson, LLP
Decosimo Jones Day Milbank, Tweed, Hadley and McCloy LLP
Waller Lansden Dortch & Davis
Clients Our Professionals Have Served (continued)
Senior Care and/or Continuing Care Retirement CommunitiesGrace Care of Texas Monarch Landing, Inc.
Jenner’s Pond Continuing Care Retirement Community National Senior Campuses (Erickson Retirement Communities)
Life Care Centers of America Sedgebrook, Inc.
Linden Ponds, Inc. St. Edward Mercy Health Systems (Ft. Smith, AR)
Mercy Hospitals of Texas St. Johns Nursing Home (St. Louis, MO)
Other Providers / PayorsBlue Cross of Tennessee Best Choice Home Health Community Behavioral Health
Network of PAColumbia Home Care
October 2010 67
Firm Leadership
Scott PhillipsTitle Managing Director
Education B.S. from University of FloridaCPA
Boards & Organizations American Bankruptcy Institute Healthcare Subcommittee Chair
Telephone 267.207.2929
Mobile 267.804.3885
E-Mail [email protected]
Scott has more than 30 years of healthcare industry management and consulting experience. Prior to founding HMP in 1997, he served as thepresident and chief executive officer of a 636-bed academic medical center, as national partner and regional healthcare practice director for ToucheRoss & Co., and as the chief financial officer of a faith-based multihospital system operating 12 hospitals across seven states.
Scott has significant management and consulting experience with government, tax-exempt and investor owned healthcare service providers. Heunderstands the organization and delivery of high-quality health services, including the role of corporate and medical staff governance duringdifficult periods of transition. Scott has executive level experience with mergers, acquisitions and turnaround situations, including restructuring inbankruptcy. In all of his many healthcare provider turnaround assignments, he has successfully designed and implemented plans that simultaneouslyadded patient volume and revenues while conserving cash and reducing unit costs. He understands this approach builds on the organization’sstrengths and attracts the support of the local community and medical and nursing staffs, which is essential for the long-term provision of qualityhealthcare services.
Over the past several years, Scott has served as the chairman and CEO of an investor owned healthcare provider with operations in 15 states andchief executive officer of a publicly traded medical staffing company with more than 2,000 employees. Both turnaround assignments included thecrises management of complex organizations in the early stages of high-profile criminal and civil fraud investigations by multiple federal agencies.
Scott has expert knowledge of the bankruptcy process as well as its implications and obligations on an operating provider of healthcare services. Herecently led the successful financial turnaround and Chapter 9 reorganization of a 179-bed county-owned hospital.
Recently he was the financial advisor to 18 tax-exempt continuing care retirement communities with more than 20,000 residents in twelve states,affected by the bankruptcy and sale of Erickson Retirement Communities.
Scott graduated from the University of Florida with a Bachelor of Science in accounting. He is a licensed certified public accountant and member ofnumerous professional organizations. He is currently serving Leader Special Projects, Healthcare Committee, American Bankruptcy Institute.
October 2010 68
Firm Leadership
Michael MorganTitle Managing Director
Education MBA from University of Central OklahomaB.S. from University of Science and Arts of Oklahoma
Boards & Organizations Fellow of American College of Healthcare Executives
Telephone 713.968.6521
Mobile 214.701.9990
E-Mail [email protected]
Michael is a former hospital chief executive officer with more than 30 years of experience in healthcare management. He brings expertise and talentfor turning around ailing healthcare providers and optimizing healthy organizations.
In his 25-year career at the Sisters of Mercy Health System, Michael was responsible for turning around five of the system’s 19 hospitals. He servedas president and chief executive officer for several Sisters of Mercy hospitals, including St. John’s Mercy Health Care, which has over $800 millionin operating revenues, employs more than 8,000 individuals and includes the system’s flagship 957-bed teaching hospital. As the CEO, he has setsuccessful new strategies, improved clinical and administrative operations and changed organizational cultures. His trademark is developing capablemanagement teams that in turn increase service quality, employee and medical staff satisfaction, patient volume, profitability and maximize cashflow.
After leaving the Sisters of Mercy system, Michael served as the chief restructuring officer and CEO for a two-hospital, investor owned system inTexas. In eight months, he led the successful turnaround, emergence from bankruptcy and recapitalization of the hospitals by a physician-led limitedpartnership. He led the turnaround of a chain of five nursing homes in Texas and the bankruptcy turnaround of a two-campus, acute-care hospital inMississippi. He was the oversight Managing Director for a two-campus rehab and specialty hospital chapter 11 bankruptcy. He also recently servedas the CRO for three individual CCRC’s under a large CCRC management company bankruptcy, and provided financial advisory services for a largeinvestment banking group on a 500-bed hospital system.
Michael holds a Bachelor of Science in business administration from the University of Science and Arts of Oklahoma and a Master of Science inbusiness administration from the University of Central Oklahoma. He is a fellow of the American College of Healthcare Executives and has servedas an officer or director of numerous hospitals and business organizations, including a 280,000-member for-profit health insurance plan.
October 2010 69
Firm Leadership
Bruce BuchananTitle Managing Director
Education MBA from George Mason UniversityMHSA from University of MichiganB.A. from Princeton University
Boards & Organizations Fellow of American College of Healthcare Executives
Telephone 713.968.6521
Mobile 602.363.1140
E-Mail [email protected]
Bruce has more than 30 years of experience in the healthcare field and is a senior healthcare executive with a successful track record in both the not-for-profit and investor owned sectors. He possesses multimarket experience at the hospital and health system chief executive officer level. He hasdeep experience and expertise in revenue growth, physician collaboration/integration, organizational development, productivity improvement andquality enhancement.
Before joining HMP, Bruce served as CEO of Phoenix Baptist Hospital, where he turned around the distressed 236-bed teaching hospital by reducingoperating costs while enhancing the quality of care. Bruce led a similar turnaround of Northeast Baptist Hospital in San Antonio, including recruitingnew physicians, doubling the hospital’s physical space and growing market share. He also served as president and CEO of Atlanta Medical Centerand Mercy Health System Oklahoma and its Mercy Health Center in Oklahoma City. Bruce also held senior management positions with HillcrestHealthcare System and Saint Joseph Hospital and worked for Invalesco Group as an operations consultant to healthcare organizations.
Most recently with HMP, Bruce served as Chief Restructuring Officer for a rehabilitation hospital company with two facilities. He successfully ledthe company through a Chapter 11 bankruptcy process and a Section 363 sale to a new, privately held owner. He also served as CEO of a countyhospital and guided it through a Chapter 9 bankruptcy, which resulted in all unsecured creditors receiving three year notes for full payment plusinterest.
Bruce has a Bachelor of Arts in sociology from Princeton University, a Master of Health Services Administration from University of Michigan, and aMaster of Business Administration from George Mason University. He is board-certified in healthcare management and a Fellow in the AmericanCollege of Healthcare Executives. He also is a member of the Turnaround Management Association.
October 2010 70
Firm Leadership
Derek PierceTitle Managing Director
Education B.S. from Samford University
Telephone 205.202.0459
Mobile 615.584.0719
E-Mail [email protected]
Derek has over 20 years of professional experience focused solely in the healthcare industry, having served as chief financial officer, chiefrestructuring officer, director of reimbursement, court-appointed examiner, Medicare auditor, Medicare cost report preparer, forensic accountant,compliance consultant, financial auditor, and financial advisor. He has audited, managed and consulted with all types of healthcare providers,including government owned, community not-for-profit, academic, and investor owned entities.
Most recently, Derek served as the restructuring chief financial officer of a two-campus, not-for-profit hospital in Chapter 11 bankruptcy. In additionto his CFO responsibilities, he led the Section 363 sale process and conducted a forensic review into the circumstances that led to the hospital’sbankruptcy filing. Throughout the project, Derek worked closely with senior lenders, debtor-in-possession lenders and the applicable federal loanprogram to a successful plan of reorganization.
Starting his career with the Medicare fiscal intermediary as a Medicare auditor, Derek developed deep expert knowledge of the patient revenue cycle,third-party contracting, and Medicare and Medicaid rules and regulations. He is expert in the areas of corporate and regulatory compliance andforensic accounting in conjunction with the defense of civil and criminal fraud claims or allegations. He led teams conducting forensic analysis insupport of settlement negotiations with the government at both Hospital Corporation of America (HCA) and HealthSouth Corporation, two of thelargest and most complex civil fraud settlements in history.
In his career, Derek has led or participated in interim management and consulting assignments for more than 40 healthcare providers, includingBaptist Memorial Health Care, National Health Service (United Kingdom) Washington Hospital Center, Lifepoint Hospitals, Tampa GeneralHospital, Legacy Health System and IASIS Healthcare.
Prior to joining HMP as a managing director, Derek was a Director with Alvarez & Marsal in its New York-based healthcare practice. Before that,he was a senior manager with Arthur Andersen in its Atlanta-based healthcare consulting practice.
Derek is a graduate of Samford University with a Bachelor of Science in accounting and is a member of numerous professional associations.
October 2010
Contact Information
Philadelphia• Contact: Scott Phillips
Managing Director• Address:
One Liberty Place1650 Market Street36th FloorPhiladelphia, PA 19103
• Phone: 267.804.3885• Fax: 215.689.4386
New York• Contact: Nihal Shah
Director• Address:
Healthcare Management Partners LLC1185 Avenue of the Americas30th FloorNew York, NY 10036
• Phone: 212.461.4243• Fax: 212.461.4252
Houston• Contact: Mike Morgan
Managing Director• Address:
Healthcare Management Partners LLC5100 WestheimerSuite 200Houston, TX 77056
• Phone: 713.968.6521• Fax: 866.422.6176
Birmingham• Contact: Derek Pierce
Managing Director• Address:
Healthcare Management Partners LLC402 Office Park Drive, Suite 108Birmingham, AL 35223
• Phone: 205.202.0459• Fax: 615.523.1835
Phoenix• Contact: Bruce Buchanan
Managing Director• Address:
Healthcare Management Partners LLC243 E. Glenn DrivePhoenix, AZ 85020
• Phone: 602.363.1140 • Fax: 866.794.9501
London, UK• Contact: Tim Bolot
Founder and Managing Director• Address:
Bolt Partners LLP 192 Haverstock Hill,Belsize Park,London NW3 2AJ
• Phone: +44 (0)20 7435 7349
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