Need Assistance 5 paper

Financial Analysis

Using the financial statements from the Major Medical Center Case Study below, analyze the following:

x Review the auditor’s opinion letter and analyze any concerns.

x Review the financial statements. Analyze any unusual items and examine the balance sheet,

operating statement, and cash flow statement.

x Review the notes and analyze any causes for concern.

x Calculate the following ratios using Excel: common size, current, quick, days of cash on hand, receivables turnover, average collection period, fixed asset turnover, total asset turnover, debt, debt to equity, timesͲinterestͲearned, operating margin, total margin, Return On Assets (ROA), and Return On Net Assets (RONA).

x Evaluate Major Medical Center’s financial status.

Submit fourͲpage Word document (not including the title and reference pages) and an Excel worksheet.

Paper need to be formatted to APA style, and must cite at least four scholarly sources.

552 Part VI • Financial Analysis

Case Study Problem

15-12. For the Major Medical Center financial statements on the following pages, complete the following:

a. Read the auditor's opinion letter. Are any flags

raised?

b. Review the financial statements. Search for un­

usual items. What things catch your eye on the balance sheet, operating statement, and cash flow statement?

c. Review the notes. Do any of them raise cause for

concern?

d. Calculate the following ratios: common size, cur­ rent, quick, days of cash on hand, receivables turnover, average collection period, fixed asset turnover, total asset turnover. debt, debt to equity. times-interest-earned, operating ma rgin, total mar­ gin, ROA, and RONA.

e. What do you think of Major Medical Center's

financial sta t us?

CASE STUDY

Major Medical Center8

I.N. SINGER AND OW, GPAs

2650 East 38th Street

New York, New York 10089

Report of Independent Auditors

Board of Trustees

Major Medical Center

We have audited the accompanying statements of financial position of Major Medical Center (the "Medical Center") as of December 31, 2014 and 2013, and the related statements of operations, changes in net assets, and cash flows for the years then ended. These financial statements are the responsibility of the Medical Center's management. Our responsi bility is to express an opinion on tl1ese financial state­ ments based on our audits.

We conducted our a udits in accordance with generally accepted aud iting stan­

dards. Those standards require that we plan and perform the audit to obtain rea­ sonable assurance about whether t11e financial statements are f ree of material mis­ statement. An audit includes examining, on a test basis, evidence suppotting the amounts and disclosures i n the financial statements. An audit also includes assess­ ing the accounting principles used and significant estimates made by management, as well as evaluating the overall fina ncial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the financial statements referred to above present fairly, in all

material respects, the financial position of Major Medical Center at December 31,

2014 and 2013, and tl1e results of its operations, changes in net assets, and cash flows for the years then ended, in conformity with generally accepted accounting principles.

April 30, 2015

i.N. SINGER AND OLD, CPAS

RMajor MedicalCenter and Ho pital Support, Inc. are llctional organizations. Any similarity to r al organizations is purely coincidental.

Chapter 1'5 • Financial Statement Analysis 553

Major Medical Center

Statements of Financial Position

Assets

Current Assets

Cash and cash equivalents

Assets limited as to use-compensating balance for letters of credit

Short-term investments

Receivables for patient care, net of allowance

for doubtful accounts (2014-$27,232; 2013-$31,934)

Pledges receivable

Inventories, at average cost

Due from third-party reimbursement programs

Receivables for government grants

Other

Total Current Assets

Assets Limited as to Use

Sinking fund

Compensating balance for standby letters of credit

Long-term investments

Due from affiliates, net

Pledges receivable, net of allowance for uncollectible pledges (2014-$2,218; 2013-$4,453)

Property, plant, and equipment net

Deferred financing costs

Other

Liabilities and Net Assets

Current Liabilities

Current portion of long-term debt Accounts payable and accrued expenses Accrued salaries and related liabilities

Due to third-party reimbursement programs, net

Advances on government grants

Total Current Liabilities

Long-term debt, less current portion Accrued post-retirement benefits Other noncurrent liabilities

Total Liabilities

Commitments and contingencies

Net Assets Unrestricted Temporarily restricted Permanently restricted

TotalNet Assets

Total Liabilities and Net Assets

Scl' an'Ompanying note .

December 31

2014 2013 (In Thousands)

$ 8,065 $ 9,005

1,000

1,387 1,283

49,719 47,614

1,814 2,205

1,690 2,326

6,539

467

2,234 3,415

$ 72,448 $ 66,315

14,487 13,410

923

1,132 618

3,417 3,543

1,889 1,468

98,555 89,777

1,323

2,065 1,043

$196,239 $176,174

$ 11,608 $ 11,488

29,489 25,311

25,572 20,096

1 ,874

1,587

$ 68,256 $ 58,769

55,539 47,709

6,023 6,017

16,445 17,014

$146,263 $129,509

$ 40,582 $ 38,014

8,262 7,519

1'132 1 '132

$ 49,976 $ 46,665

$196,239 $176,174

554 Part VI • Finandal Analysis

Major Medical Center

Statements of Operations

Year ended December 31

2014 2013 (In Thousands)

Operating Revenue Net patient service revenue	$402,921		$369,512
Other revenue	13,356		13,850
Net assets released from restrictions	4,708		2,863
Total Operating Revenue	$420,985		$386,225
Operating Expenses
Salaries and wages	$207,141		$196,453
Employee benefits	44,456		44,860
Supplies and expenses	137,505		117,838
Depreciation and amortization	22,541		18,856
Research	2,457		2,214
Interest	4.456		5,253
Total Operating Expenses	$418,556		$385,474
Operating Income	$ 2,429		$ 751
Net assets released from restrictions used for capital acquisitions	139		146
Increase in unrestricted net assets	$ 2,568		$ 897
Sec accompanying notes.

Major Medical Center

Statements of Changes in Net Assets

Net Assets

Temporarily Permanently

Unrestricted Restricted Restricted

(In Thousands)

Net Assets at December 31, 2012

Increase in unrestricted net assets

Restricted contributions, grants, and other receipts

Investment income restricted for specific purposes

Net assets released from restrictions for: Operating expenses

Capital asset acquisitions

Change in net assets

Net Assets at December 37, 2013

$37,117

$ 897

$ 897

$38,014

$3,023

-$-

7,253

252

(2,863) (146)

$4,496

$7,519

$1,132

-$-

-$­

$1,132

Increase in unrestricted net assets

Restricted contributions, grants, and other receipts

Investment income restricted for specific purposes

Net assets released from restrictions for: Operating expenses

Capital asset acquisitions

$ 2,568

-$--$ -

5,421

169

(4,708) (139)

Change in net assets

Net Assets on December 31, 2014

$ 2,568

$40,582

$ 743

$8,262

$

$1,132

See accompanying notes.

Chapter 15 • Financial Statement Analysis 555

Major Medical Center

Statements of Cash Flows

Year Ended December 31

( Operatin g Activities Operatin g income $ 2,429 $ 751 Change in temporaril y restricte d ne t assets 743 4,496 $ 3,172 $ 5,247 Adjustment s t o recon c i le change in ne t asset s t o cash pro v i ded by operations: Depreciatio n and amortiza t i on 22,541 18,856 Investment income earned on asset s limite d as t o use (774) (698) Changes in operatin g asset s and lia b i litie s : ( Increase ) decrease in receiva b l es fo r pa t i en t care (2 , 105) 7,589 ( Increase ) decrease in due fro m thir d - part y reimbursemen t programs ( 8,413 ) 4 , 500 Increas e in account s payable and accrued expenses and accrued salaries and relate d liabi l ities 9,654 1,412 Ne t effect o f increases and de c r eases in othe r asset s and liabili t i es 2,286 ( 8,707 ) Cash provided by operations Investin g Activities $ 26,361 $ 28,199 Acquisition s o f property, plant, and eq u i pment, net $( 10,043 ) $( 12,998 ) Less amount s provided by restricte d f unds 139 146 Increas e in investments (618) (70) Cash used in investin g activities Financin g Activities $( 10,522 ) $( 12,922 ) Ne t paymen t fro m ( to ) aff i l iates $ 126 $ (1 , 773) I ncrease in deferre d financin g costs (1 ,323 ) Repayment s o f lon g - ter m debt ( 13,326 ) ( 9,5 1 0) Deposit s int o sinking fund, as required by mortgag e loan agreeme n t (303) Increas e in compensatin g balances fo r standb y letter s o f credit (1 ,923 ) ( Increase ) decrease in pledges receivable Cash used in finan c i ng activities (30) $( 16,779 ) (3 , 190) $( 14,473 ) Ne t (decrease) increase in cash and cash e q u iv a l ents $ (940) $ 804 Cash and cash equiv a l ent s a t beginning o f year 9,005 8,201 Cash and cash equivalent s a t end o f year $ 8,065 $ 9,005 See accompanyin g notes. )2014 2013 (In Thousands)

Notes to Financial Statements

1. Organization and Summaty of Significant Accou nti ng Policies

Orgattizatiotz

Major Medical Center (the "Medical Center") is a not-for-profit corporation. The Medical Center provides health care and related services. The accompanying financial statements do not include the accounts of the Research Foundation, a not-for-profit corporation that solicits funds and awards grants to the Medica l Center for research purposes, nor for Hospital Support, Inc., which provides certain su pport services.

Temporarily and Permanently Restricted Net Assets

Temporarily restricted net assets are those whose use by the Medical Center has been limited by donors to a speci fic time period or purpose. Permanently restricted net assets

556 Part Vl • Financial Analysis

have been restricted by donors to be maintained by the Medical Center in perpetuity. When a donor restriction expires (i.e., when a stipulated time restriction ends or pur­ pose restriction is accomplished), temporarily restricted net assets are reclassified as un­ restricted net assets and reponed in the statements of operations as net assets released from restrictions. Donor-restricted contributions whose restrictions are met within the same year as received arc reflected as tempora rily restricted contributions and net asset<; released from restrictions in the accompanying financial statements.

Receivables for Patiettt Care

Patient accounts receivable from th i rd-pa rt y programs for which the Medical Center receives payment under reimbursement formulas or negotiated rates are stated at the estimated net amounts receivable from such payors, which are generally less than the established charges of the Medical Center.

Investments

Investments consist of U.S. Treaswy bonds and notes, certificates of deposit, and money mar­ ket funds. Investments arc carried at fair value. Amounts classilled as long-term investments, consisting primarily of money market funds, represent pem1anently n:suicted net assets.

lnvestmetzt Gains, Losses, and Income

Investment income, which includes real gains and losses, earned on permanently re­ stricted and temporarily restricted funds upon which restrictions have been placed by donors, is added to temporarily restricted funds. All other investment income is ret1ectecl in the accompanying statement'> of operations.

Property, Plant, and Equipment

Propetty, plant, and equipment purchased are canied at cost, and mose acquired by gifts and bequests are carried at appr'dised or fair ma rket value established at the date of acquisition. Capitalized leases are recorded at the fair market value at the inception of the leases. l11e canying amounts of assel<; and the related accumulated depreciation are removed from the accounts when such assets are disposed of, and any resulting gain or loss is included in oper­ ations. Depreciation of assets used in operations is recorded on me stra ight-line method over the estimated useful lives of tl1e asset<;. Capit.'llized leases are amortized over the lease tem1.

Pledges

Unconditional promises to give cash and other assets are repotted at their net present value at the date the promise is received. The gifts are reported as either temporarily or permanently restricted support if they are received with donor stipulations that limit the use of the donated assets. Pledges receivable, discounted at 10 percent, are expected to be paid as follows (in thousands):

Less than one year	$ 1,814
One year to five years	3,145
In excess of five years	962
	$ 5,921
Less allowance for
uncollectible pledges receivable	(2,218)
	$ 3,703

Assets Limited as to Use

Assets classified as limited as to use represent assets whose use is restricted for specific purposes under terms of agreement'S.

---- ----- - - ---

Accrued Post-Reliremellt Benefit s

Chapter 15 • Financial Statement Analysis 557

The i\tedical Center account<> for post-retirement health care and life insurance benefits on the accrual basis of accounting.

Uucompe11sated Care

As a matter of policy, the Medical Center provides significant amounts of partially or totally uncompensated patient care. For accounting purposes, such uncompensated care is treated either as charity care or bad debt expense. The Medical Center has defined char­ ity care for accounting and disclosure purposes as the difference between its customary charges and the sliding scale rates given to patients in need of financial assistance. Since payment of this difference is not sought, charity care allowances are not repotted as reve­ nue. Patients who do not qualify for sliding scale fees and all uninsured inpatient<; who do not qualify for Medicaid assistance arc bi lled at the Medical Center's full rates. Uncollected balances for these patients are categorized as bad debts. Total uncompensated care for all patient services approximated $22 million and $20 million in 2011 and 2013, respectively.

Use of Estimates

The preparation of financial statements in conformity with generally accepted account­ ing principles requires management to m:.tke estimates and assumptions that affect the reported amount of assets and liabilities and the d isclosure of contingent assets and liabilities at the date of the financial statements. Estimates also affect the reported amoums of revenue and expenses during the reponing period. Actual results could differ from these estimates. Management believes that the amounts recorded based on estimates and assumptions are reasonable, and any differences between estimates and actual should not ha\ e a material impact on the Medical Center's financial position.

Operatbzg Income

Transactions deemed hy management to he ongoing, major, or central to the provision of health care services are reported as operating revenue and expenses, and arc included in operating income. Operating income also includes investment income and realized gains

and lossl's from the sale of investments.

Tax Status

The tvll'dical Center is exempt from federal income taxes under Section '501(c)(3) of the Intl'rnal Revenue Code. The Medical Center has been classified as an organization that is not a private foundation under Section 509(a)(1 ). Contributions received by the Medical Cl'nter qualify as tax-deductible charitable contributions.

2. Third-Party Reimbursement Programs

Tlw t\ledical Center has agreements with third-party payers that provide for payments to tlw Medical Center at amounts different from its established charges. Payment ar­ rangements include prospectively determined rates per discharge, reimbursement of costs, discounted charges, and per diem payments. Patient service revenue is recorded at the Medical Center's established charges when patient services are performed. Adjustments for differences between established charges and payment amounts are

deducted directly from receivables for patient care and patient service revenue in the year incurred.

Federal and state regulations provide for certain retrospective adjustments to cun·ent and ptior years' payment rates based on industrywide and hospital-specific data. The Medical Center has estimared the potential impa<.1of such retrospective adjustments based on infOtma­ rion presently available, and adjustments are accrued on an estimated basis in the period the setvices are rendered and are adjusted in future peti<xls as final seulements are determined.

558 Part VI • Financial Analysis

Management believes that amounts recorded in the accompanying financial statements will not be materially affected upon the final settlement of such retrospective adjustments.

Hospitals are reimbursed for Medicare inpatient services under the national pro­

spective payment system ("PPS") and other methodologies of the Medicare program for patient services. Such Medicare payments are based on a blend of national industry and hospital-specific data. The Medicaid program pays rates determined by the state, primar­ ily on a basis of prospectively determined rates per discharge. The Medical Center is paid by non-Medicare/Medicaid payers based on negotiated contract amounts or, if such contracts do not exist, at the Medical Center's established charges. In addition, the state has requested a waiver from the federal government that will allow it to enroll substan­ tially all of its Medicaid patticipants into Medicaid managed care programs. The ultimate outcome and effect of these changes and proposals on the Medical Center's future op­ erations cannot presently be determined. In 2014, net revenue from the Medicare and Medicaid programs accounted for 44 percent and 23 percent, respectively, of total net patient service revenue.

3. Assets Limited as to Usc

A summary of assets limited as to use is as follows at December 31:

2014 2013

Sinking Funds:

(In Thousands)

Cash and cash equivalents

U.S. government and agency obligations

Total Sinking Funds

Collateral for Standby Letters of Credit:

Cash and cash equivalents

Corporate bonds

Total Collateral for Standby Letters of Credit

Total Assets Limited as to Use

$ 276

14,211

$14,487

$ 582

1,341

$ 1,923

$16,410

$ 249

13,161

$13,410

$

$

$13,410

4. Property, Plant, and Equipment

A summary of property, plant, and equipment is as follows at December 31:

2014 2013

(In Thousands)

Land	$ 4,980	$ 4,980
Buildings	58,827	58,827
Equipment	164,592	140,707
	$228,399	$204,514
Less accumulated depreciation	141,502	125,148
	$ 86,897	$ 79,366
Projects in progress	11,658	10,411
	$ 98,555	$ 89,777

Approximately $45,673,000 and $45,706,000 of fully depreciated asseL'i are included in buildings and equipment at December 31, 2014 and 2013, respectively. Substantially all prop­ erty, plant, and equipment is pledged as collateral under various loan agreements. Capitalized equipment leases, included in property, plant, and equipment, are as follows at December 31:

--- --- -- ----- -- -

Chapter 15 • Financial Statement Analysis 559

2014 2013

Assets recorded under capital leases

(In Thousands)

$67,434 $51,695

Less accumulated amortization

35,911

$31,523

27,108

$24,587

5. Long-Term Debt

A summary of long-term debt is as follows at December 31:

2014 2013

FHA Section 242 insured mortgage loan (a)

FHA Section 241

(In Thousands)

$20,865 $

mortgage loan (a)	10,941	12,125
2005 mortgage loan (b)	2,216	2,758

1998 insured mortgage loan (a)

Various mortgages, having

interest rates ranging from 3.5% to 10.0%, maturing at various dates through 2021

Capitalized leases (c)

Less current portion

2,020

31,105

$67,147

11,608

$55,539

15,492

2,892

25,930

$59,197

11,488

$47,709

a. As a condition of these borrowings, the Medica l Center is required to establish and maintain a sink ing fund. Amounts deposited into the sinking fund, to­ gether with investment earnings therein, arc ava ilable for principal payments and purchases of specified levels of capita l assets. Assets on deposit in the sinking fund at December 31, 2014 and 201.3, are in compliance with there­ quired amounts.

b. Annual principal payments for all long-term debt, excluding capital leases and requi red sinking fund balances for the next five yea rs, are as follows:

Principal

Payments

Required

Sinking Fund

Balance

(In Thousands)

2015	$2,789	$15,461
2016	4,688	14,937
2017	4,157	14,162
2018	4,089	13,129
2019	3,746	11,831

c. Future minimum payments, by year and in the aggregate, under capitalized leases consisted of the following at December 31, 201 4 (in thousands):

560 Pan VI • financial Analysis

2015	$11,102
2016	9,852
2017	8,204
2018	4,744
2019	1,518
Thereafter	850
Total minimum lease payments	$36,270
Less amounts representing interest	(5,165)
Present value of lease payments	$31,105

6. Retirement and Similar Benefits

The Medical Center provides retirement and similar benefits to its union employees through several defined benefit multi-employer pension plans and to its nonunion em­ ployees through a noncontributoty defined benefit pension plan and tax-deferred annuity plans. Payments to the defined benefit multi-employer union plans arc made in accor­ dance with contractual arrangements under which contributions are generally based on gross salaries and arc funded on a current basis. The Medical Center contributes amounts to the nonunion plan sufficient to meet the minimum funding requirements set fotth in the Employee Retirement Income Security Act of 1974. The Medical Center's pension ex­ pense under all existing plans aggregated approximately 510,202.000 and S10,6R:),OOO for the years ended December 31, 201"1 and 2013, respectively.

7. Other Post-Retirement Benefits

In addition to the pension plans and the tax-sheltered annuity plans described in "\ote 6, the Medical Center sponsors a defined benefit health care plan that provides post-retirement medical, dental, and life insurance benefits to cettain full-time employees hired prior to July I, 200!, and who have worked 10 years and attained age 65 while in service with the Medical Center. The plan contains cost-shating features such as deductibles and coinsurance.

Effective in May 2014, the Medical Center changed the type of the plan from basic hos­ pital plus major medical to a point-of-service plan for nonunion employees. ·n1e effects of this change have been reflected in the actuary's calculation for the plan year ended December 31.

2014. At the end of 201·1 and 2013, the accrued post-retirement benefit cost was $6,02:).000

and $6,017,000, respectively. As of December 31, 201"1 and 2013. the plan was unfunded.

8. Government Crants

The Medical Center receives grants from various government agencies. For the contract years ending June 30 , 2015, 2016, and 2017, these grant awards are as follows:

Contract Year

Ending June 30:

2015

2016

2017

Amount

(In Thousands)

$3.791

3,513

3.765

Advances on government grants of $1,587,000 at December 31, 2011, as reflected in the accompanying statement of finaacial position, represent amounts received from the granting agencies in excess of claims made at that date. The receivable amount of

$467,000 at December 31, 2013, represents claims made in excess of advances recei\'ed from the granting agencies at that date.

9. Professional Liabil ity Insurance

The Medical Center patticipates in a pooled program with cettain other health care facili­

ties (principally medical centers) for professional liability insurance. This p uticipation is

Chapter 15 • Financial Statement Analysis 561

with captive insurance companies and, with the other health care facilities, in a pooled layer for additional insurance with commercial insurance companies.

During 2013, the Medical Center had an aggregate deposit of $2,000,000 with two of the captive insurance companies. During 2014, these deposits were replaced with two letters of credit of $1,000,000 each. The deposits were included in other current assets in the accompanying 2013 statement of financial position.

Malpractice claims in excess of insurance coverage have been asserted against the

Medical Center by various claimants. The claims arc in various stages of processing, and some may ultimately be brought to trial. Medical Center management and counsel arc unable to conclude about the ultimate outcome of the actions. There are known inci­ dents occurring through December 31, 2014, that may result in the assertion of additional claims, and other claims may be asserted arising from services provided to patients in the past. It is the opinion of Medical Center management, based on prior experience, that adequate insurance is maintained to cover all significant professional liability losses.

10. Transactions with Affiliates

The amounts due from affiliates in the accompanying statements of financial position at D<.:cemher 31, 2014 and 2013, include a $1,900,000 loan receivable and accrued interest thereon from Hospital Support, Inc. The loan, which does not have specified repayment terms, bears interest at the prime rate, which approximated 7.7) percent at December 31,

2011 and 2013.

11. Tempor..trily and Permanently Hestricted Net Assets

TL·mporarily restricted net assets are available for the following purposes at December 31:

	2014 2013
	(In Thousands)
Research and education	$2,502
Plant replacement and expansion	5,017
	$7,519

Permanently restricted net assets at both December 31, 2014 and 2013, consist of investments to be held in perpetuity and whose income is restricted as to use.

12. Other Operating Revenue

Other operating revenue consisted of the following for the year ended December 31:

2014 2013

(In Thousands)

Government grant income

Real estate rentals

Investment income and gains on sale of investments

Faculty practice and research

overhead

Dining room and parking

$ 1,668

2,838

1,077

5,703

$ 5,053

2,651

1,044

2,079

lot income	996	958
Grants and contributions	343	499
Other	731	1,566
	$13,356	$13,850

562 Part VI • Financial Analysis

13. Concentration of Credit Risk

Significant concentrations of patients accounts receivable include .0 percent and 37 percent from government-related programs, 6 percent and H percent from Empire Blue Cross and I31ue Shield, and 27 percent and 23 percent from Cambridge I Iealth Plans at

December 31, 201tl and 2013, respectively.

At December .:31, 201'1, 9'> percent of the Medical Center's cash and cash equivalents balance was held at one financial institution.

14. Fair Value of Financial Instruments

The following methods and assumptions were used by the Medical Center in estimating its fair value disclosures for financial instruments: The carrying amount reported in the statements of financial position for cash and cash equivalents approximates its fair value. Short-term investments consist primarily of government and other debt securities. Fair values are based on quoted market prices. Long-term investments consist primarily of money market funds. Fair values are based on quoted market prices. Assets limited as to use consist primarily of government securities. Fair values are based on quoted market prices. Most of the long-term debt of the Medical Center was refinanced during 2006. The canying value of the Medical Center's long-term debt at December :31, 201'1, approxi­ mates it<; fair value.

15. Contingencies

The Medical Center is a defendant in various legal actions ansrng out of the normal course of its operations, the final outcome of which cannot presently be determined. The amounts claimed would be material to the financial position of the Medical Center. Medical Center management is of the opinion that ultimate liability, if any, with respect to all of these matters will not have a material adverse effect on the Medical Center's financial position.

Approximately 67 percent of the Medical Center's employees are members of vari­

ous unions. Of these employees, approximately 70 percent are covered by contracts expiring during 201'5.

Suggested Readings

Emery, Douglas R., john D. Finnerty, and John D. Stowe.

Corporate Financial Mana emenl, ,ird ed. Upper Saddle

River, N.J.: Prentice Hall, 2007.

Finkler, Steven A. Finance & Accountin for Nonjlnancial

Managers, .3rd ed. New York, N.Y.: Aspen Publishers,

2003.

Fraser, Lyn M., and Aileen Ormiston. Unden;tmulinR Financial Statemellls. 9th ed. Upper Saddle River, 1\'.j.: Prentice Hall, 2009.

lngcnix St. Anthony. 'IZ1e 2008Aimanac c>/llospital Filial/Cia/ ('.Operating I11dicators. United States: lngenix, 200H.

Rcvsinc, Lawrence, Daniel W. Collins. W. Bruce Johnson,

and Fred Mittelstaedt. Fil/(mcia/ Reporting ('. Ana vsis,

5th ed. 'ew York: McGra\\ I!ill Irwin, 20 II.

Werner, Michael L., and Kumen II. jones. 111/roduction to Financial Accounting: A User Perspectil'£', jrd ed. 'ppt:r Saddle Rin:r, N.J.: l'renricc Hall, 200 1.