I. CALL TO ORDER
TEHACHAPI VALLEY HEALTHCARE DISTRICT
FINANCE COMMITTEE MEETING AGENDA
October 9, 2019 12:30 PM
Tehachapi Valley Healthcare District Office 305 S. Robinson St., Tehachapi CA
93581
II.
PUBLIC COMMENTS ON ITEMS NOT APPEARING ON THE AGENDAPOSTED: C. WASIELEWSKI I 0/4/19
This portion of the meeting is reserved for persons desiring to address the Committee
on any matter not on the agenda over which the District has jurisdiction. You may state
your name and address for the record. Time is limited to 3 minutes per speaker. The
Committee can take no action on your presentation, but can seek clarification to points
made in your presentation or comments. Additionally, members can ask staff for
factual information, refer the item to staff and/or calendar the item on a future agenda.
Any person desiring to speak on an agenda item will be given an opportunity to do so
prior to the Committee taking action on the item.
Ill. APPROVAL OF MINUTES
A. Approval of September 11, 2019 Finance Committee Minutes
IV. REPORTS
A. Finance Reports August 2019
1. August 2019 Variance Analysis (Beed le)
2. AH/Tehachapi Collections/Withholds Due Report
3. August 2019 Cash Flow (Beedle)
4. August 2019 Unaudited Financial Statement (Beedle)
5. August 2019 Monthly Deposit Log Averages (Beedle)
6. August 2019 Current Bank Balance Statements (Beedle)
V. OLD BUSINESSNone
VI. NEW BUSINESS
Trunk or Treat
VII.
BOARD COMMENTS ON BUSINESS NOT APPEARING ON THE AGENDAVIII.
ADJOURNMENTTab 1
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TEHACHAPI VALLEY HEALTHCARE DISTRICT FINANCE COMMITTEE MINUTES
September 11, 2019 TVHD District Office 305 S. Robinson Street
12:30pm
Board Members Present: Duane Moats, Sam Conklin
Staff Present: Chet Beedle, CFO; Lisa Hughes, Business Manager; Caroline Wasielewski, Compliance Officer, District Manager
Transcribed by: Recorded and Transcribed by: Caroline Wasielewski, District Manager
Approval:
Date:---Duane Moats, Chair
COMMITTEE ACTIONS AND DIRECTION SHOWN IN CAPS AND BOLD I. Call to Order
Duane Moats called the Finance Committee meeting to order at 12:30 pm. II. Public Comments on Items Not Appearing on the Agenda
None.
Ill. Approval of Minutes
A. Approval of August 14, 2019 Finance Committee Minutes MSA CONKLIN/MOATS; APPROVED
IV. Reports
A. Finance Reports for July 2019 1. July 2019 Variance Analysis
The committee reviewed report. No questions or comments for Mr. Beedle. 2. AH/Tehachapi Collections and Withholds Due Report
Mr. Beedle explained the report as a summary of reconciliation between Adventist Health And TVHD. Current due to Adventist Health by TVHD is $834,204. Dr. Conklin asked if there was any resolution from WIPFLI about withholds. Mr. Beedle responded there was not.
Finance Committee Sept 11,2019 Page 2
3. July 2019 Cash Flow
The committee reviewed the report in packet. It shows the operational cash flow and Projected cash flow for August. Mr. Beedle commented TVHD has two real sources of income: supplemental monies from Medi-Cal and property taxes. Mr. Beedle explained each line of the statement and is not unhappy with the numbers. He is seeking consistency between operating and non-operating. He did not change projections for the new Fiscal Year as they are based on prior year activity.
4. July 2019 Unaudited Financial Statement
CFO Beedle reported on the following financial documents:
Income Statement Summary - The report was in the packet for the committee to review.
Executive Financial Summary - Attached for review.
Statement of Revenue and Expense- The report was in the packet. Mr. Beedle explained all the expenses.
Balance Sheet- Assets- Attached for review. Cash decreased. Mr. Beedle is determined to keep the cash balance constant. Mr. Beedle commented there is an overstatement by Moss Adams for bad debt allowances.
Liabilities- Attached for review.
5. July 2019 Monthly Deposit Log Averages (Beedle)
Committee reviewed report in the packet. Mr. Beedle went over each category. Mr. Moats asked about the $18k in Bad Debt. Mr. Beedle directed Ms. Wasielewski and Ms. Hughes
to research the balance.
6. July 2019 Current Bank Balance Statements (Beedle)
Attached for review. CFO reviewed the balances and explained the sweep account. V. Old Business
None
VI. New Business None
VII. Board Comments on Business Not Appearing on the Agenda None
VIII. Adjournment
Memo
To: Finance Committee From: Chet BeedleDate: 10/5/19
Re: Variance Analysis for August 2019 Executive Summary:
The month of August 2019 generated a net loss for the District. We ended loss with a net profit of ($112,778).This is mainly due to the posting of an internal audit adjustment to reverse an overstatement of Medicare receivable by Moss Adams on their audited financial statements for FY 2016. The operating loss also includes the amortization of the CIP New Hospital Building and Equipment depreciation as well as Capitalized Interest and Deferred Income from the taxpayers for the semi-annual payments to the bondholders of the General Obligation bonds. The operating expenses, because of the addition of the new hospital interest and depreciation, and the new fiscal year 2020 budget were $12,509 over budget. Also, non-operating income was $93,197 over budget due to the posting of $100,000 of IGT income for funds brought into the operations bank account from the Wells Fargo construction account. There was $3,800 in property taxes received in August and also $238,306 in reconciliation settlement payments to Adventist Health. In that regard, it must be understood that most of the Medicare and Medi-Cal cost reports from prior fiscal years have now been settled. Also, the inter-governmental supplemental payments for Medi-Cal patients programs could be cancelled with the current federal Administration's repeal attempts of the provisions of the Affordable Care Act or disallowed due to TVHD no longer operating the Hospital. TVHD continues to qualify for the Medi-Cal rate reconciliation for public hospitals from Kern Health Systems, so an annual consideration based upon AHTV Medi-Cal payments for services rendered in the TVHD boundaries is continuing. There was an adjustment to contractual allowances of ($340,275) from prior periods relating to the adjustment for overstated Medicare receivables by Moss
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Adams. The largest favorable operating variance was $48,565 under budget in depreciation expense due to the interest expense on the GO bonds being shown in the budget with the depreciation expense which allowed the interest expense to be over budget by $59,168. The net effect of these two variance items offset against each other is an unfavorable interest expense variance of $12,603.There was $68,144 in capitalized interest expense amortized for the general obligation bonds for the new Hospital which is close to the accrued monthly interest for the prior months after the new Hospital was opened. We have worked on the effects of the period of not sending any uncollectible accounts for hard collection, but with the absence of any patient revenue generation and the collection or adjustment of most of our collectible accounts receivable having ended, we are at 63.8% of our outstanding accounts receivables as self-pay, including the installment payment accounts. The goal is to continue to identify and progressively send accounts receivable considered uncollectible to an outside collection agency. As well, effective 2/15/19 we discontinued first using HRG for soft collections to maintain the self-pay level of total receivables as low as possible as we wind down the collection process. With less than 50 accounts remaining with HRG, the TVHD Office staff took over the accounts receivable soft collection process including payment plan accounts. This approach will allow us to continue to meet the needs of the District and community for prior period collections while reducing the cost of collection for the District.
Cash collections were $53,380 over budget due to $100,000 in delayed IGT funds being transferred from the Construction account. The level of collections included Medicare payments being $0 as the budget anticipated Medicare withholding 100% for the overpayment of allowable cost for FY 2014 and 2015 through interim reimbursement. Medi-Cal collections were $39,185 due to Medi-Cal claims payments for AHTV that were deposited into the TVHD operations bank account. Insurance collections were $0 due to receiving no old workers' compensation payments. The recovery of bad debts was $1,449 vs a budget of $4,901. Private pay collections were $424 over budget including hard collections from HP Sears, but no collections from HRG, January being their last month working TVHD patients' accounts. Ad Valorem property tax receipts in August were $3,800. TVHD collected $0 for Adventist Health Tehachapi claims in August, but paid $238,306 toward the amount charged as interest or penalties on the Medicare withholds from prior periods. Reconciliation efforts continue on the collection due to the balance remaining from the previous withhold by Adventist Health of TVHD Medi-Cal IGT supplemental payments for claims. There was $100,000 of additional Affordable Care Act outpatient supplemental payments transferred from the construction account during August, and there was receipt of property taxes of $3,800. There were no additional funds from the ACA supplemental outpatient funds deposited into the investment account. Total cash disbursements for old Hospital renovation related items were $0. All construction and renovation at the new Hospital has been turned over to AHTV, but work is progressing on what it will take to renovate the old Hospital for District use including rental.
Total cash disbursements were over budget by $140,959 due to the effect of the reconciliation payments to Adventist Health. Cash disbursements for professional fees were over budget by $399 due to the timing and payment of billings received from Wipfli, LLP for the FY 2017 and FY 2018 audits. Supplies were over budget by $543 due to more supply needs than anticipated. Disbursements for labor expenses were under budget by $5,706 due to fewer hours used by the part-timers than anticipated. At this point, TVHD has taken over all on-going billing and collections service with our in-house employees and is no longer relying on the pre collection service for self-pay patients by HRG, but still hard collection by HP Sears. Also, due
to the small amount of the payroll expense with only 2. 75 FTEs paid, we have not been making and reversing an accrual entry for the third payroll in one month happening every six months when using a bi-weekly payroll system. In addition to these operating residuals, supplemental income sources as allowed by the Affordable Care Act (Obamacare), are positively affecting the cash balance as long as TVHD can qualify and cash receipts are not sent to Adventist Health Tehachapi who will deposit them into their bank account. Care needs to be taken to integrate some of these funds when received to strengthen emergency funds to meet new service or old hospital building repair requirements and negative cost reporting settlements, if any, so that cash reserves for District expenses are properly maintained and disbursement of these reserves follow a Board approval of any request for wellness funds, equipment donation to AHTV or other local charitable healthcare services, as well as old Hospital repair and/or renovation expenses or the sharing of building improvements with a renter.
Cash disbursements for renovation, equipment and legal settlements were $0 in August. The continued receipt of Medi-Cal IGT supplemental payments has allowed the District to transfer funds to the Local Agency Investment Fund (LAIF) with the State Treasurer's office for investment purposes while still maintaining some funded depreciation for potential future new and old Hospital building repairs and improvements if necessary. There was $0 for investment transferred during August. We disbursed $0 for the renovation of the old Hospital building, but there was a payment of $238,306 to reimburse AHTV Medicare withholdings for penalties and interest plus AHTV Medi-Cal claims payments deposited into the TVHD operating account. Through August 31, we have now spent a total of $95,455,394 on the new Hospital construction project, with $87,470,162 of that amount being for construction and $7,985,232 being for equipment and furniture. The total replacement project had a budget of $98,997,860 without phasing and the total available bond funds for the project were $64,851,583 leaving $34,146,277 in additional funds due from grants, operations, borrowing, and/or construction advances from Adventist Health.
The fiscal year to date contractual allowance percentage was 0% of gross revenue vs. a budget of 0.0% and a same month prior year of 0%. This zero percentage is due to the discontinuance of any gross revenue generation by TVHD. The provision for bad debts also no longer exists unless there is some adjustment on the remaining self-pay accounts receivable outstanding. Non-operating revenue was $93,197 over budget due to the accrual of deferred income to be received from property taxes for payment to the bondholders for the New Hospital and $100,000 of IGT funds transferred from the construction account. Prepaid rental income from Adventist Health Tehachapi Valley was right on budget at $75,000 and the property tax accrual for operations for August was $62,333.
The following is a variance analysis by line item of the balance sheet material changes from the end of the prior month and of the income statement from budget.
Balance Sheet:
1) Cash and cash equivalents increased by $114,299 over the end of the prior month.
This is due to the reconciliation effects of a 100% withhold of payments from Medicare due to overpayments on an interim basis during FY 2014 and 2015, the receipt of payments for AHTV
insurance claims, a transfer of $100,000 of IGT supplemental funding, repayments to AHTV for Medicare withholds from their claims payments and the receipt of $3,800 in property taxes. 2) Gross accounts receivable outstanding were $85,192 under the end of the prior month. This reflects the absence of gross patient revenue generation for the last thirty-four months, collections from TVHD office staff and the hard collection of bad debt accounts turned to HP Sears.
3) Bad debt and allowance reserves were $753,582 under the end of the prior month. This is 861.7% of the outstanding gross accounts receivable versus a prior month end of 946.9% and a prior fiscal year end of 1568.7%. The change reflects the mix of patients, the age of the accounts outstanding with no new patient revenue generation, the current collections of self-pay installment accounts, contractual allowance adjustments from prior fiscal years, bad debt recoveries, and the impact of cost-based reimbursement for Medicare and Medi-Cal patients. In the financial statement presentation, some of the IGT supplemental income allocation is being booked to the allowance account rather than non-operating causing it to be overstated for the current level of receivables. The net revenue is correct, but the entry should reflect in the Other Receivables account rather than in the Allowance account. We have met with the new auditor for FY 2017 & 2018, Wipfli, LLP, and have proposed audit adjusting entries to reconcile the balance sheet accounts once they have completed their tie in with the previous audit account balances and the inter-company account due to Adventist Health has been reconciled. However, in anticipation of some of the audit adjustments that are expected, we are making some of our own post-closing internal audit adjustments.
4) Net patient accounts receivable decreased by $838,774 under the end of the prior month.
Medicare accounts outstanding over 90 days were at 100% vs. a prior month of 100% and a goal of less than 15% with new revenue generated. Medi-Cal accounts outstanding over 90 days were at 100% vs. a prior month end of 100% and a goal of less than 20% with new revenue generation. Commercial accounts outstanding over 90 days were 100% vs. a prior month of 100% and a goal of less than 20% with new revenue generation. Blues accounts outstanding over 90 days were 100% vs. a prior month of 100% and a goal of less than 20% with new revenue generation. Self-pay accounts outstanding over 120 days were 100% vs. a prior month of 100% and a goal of less than 30% with new revenue generation.
5) Other Receivables decreased by $2,250,694 under the end of the prior month.
There was an accrual of property taxes for the month and no funds were returned to the investment account which had been withdrawn and sent to the Department of Health Care Services to pay for matching the federal supplemental income portion for inter-governmental transfers related to Medi-Cal managed care claims at Adventist Health Tehachapi Valley during 2017-18. These funds were returned to TVHD along with the Federal matching funds and have become a portion of the affiliation reconciliation with Adventist Health.
This account balance should reflect the accrual and payment of property taxes and inter governmental transfer funds, now including an amortization of the accrued property taxes for
the New Hospital. In the month of August, no payment funds were sent to the Department of Health Care Services for required federal matching. All lGT payments received in prior months were deposited or shared with Adventist Health and are being used to offset their charge against TVHD for interest and penalty charges for prior period Medicare overpayments. That balance due at September 9, 2019 is $834,204 due to Adventist Health at the end of posting business through that date according to Adventist Health and updated with current payments made. However, that includes 100% of all penalty and interest charges from Medicare and charges by Medicare to Adventist for Report Fees? TVHD believes that Adventist should pay a share of the penalty and interest charges especially for their timing differences for the provider number changeover and their assertion that Medicare over-withheld $1,064,585 from them. We are waiting for an opinion from the TVHD external auditors before a final reconciliation balance owing is confirmed.
6) Inventories stayed the same as the end of the prior month at $0.
This lack of change reflects that no supply items are still running through the District's books during the month. The entire inventory balance of $121,963 has now been transferred to the Adventist Health due to account. We are now working with JWT, LLP and Adventist Health to verify this inter-company account balance.
7) Restricted cash in the construction account is at $120,070 which $490,805 less than
the end of the prior month.
The only amounts moving through this account are receipts from Adventist Health for construction, receipts of IGT federal matching funds, the disbursement of these funds for payments for construction or renovation of District buildings and the payment of Adventist affiliation reconciliation funds owed.
8) Bond Reserve funds decreased by $559,398 in August.
The bond reserve accounVdebt retirement fund decreased by $559,398 from the end of the prior month at $2,266,326 reflecting the amount borrowed for this purpose as required by the various bond issues. Should there be no default of payments due to the bondholders over the life of the bonds, this money will come to TVHD to be used for other purposes as necessary.
9) There were no trustee held funds at the end of the month.
This was due to the semi-annual timing of principal and interest payments due to the bondholders and held in case property tax payments are insufficient to fund the principal and interest due and payable at the amortization time of semi-annual disbursement.
10) Investments increased by $189,561 over the end the prior month.
This increase reflects the quarterly interest earned and distributed by the LAIF fund. No receipts or disbursements were set aside for equipment and/or District construction projects less any payments or transfers out for such items and/or projects, investments held for future use and/or payments for other non-guild, foundation, property tax or Adventist funded capital expenditures or required operating disbursement items. The balance in the LAIF account is now up to $3,502,553.
11) Funded Depreciation was the same amount as at the end of the prior month.
This balance reflects the board approved donation of $25,000 to the Tehachapi Parks and Recreation department from the restricted funds set aside for use toward philanthropic Board designated purposes in prior months. The account was down to a balance of $22, but the depreciation expense for November 2016, March 2017 and January 2018 was funded due to a positive net income generated for those months.
12) Net due to/from Third Party Payers decreased by $4,005,639 under the end of the previous month.
This net balance of $3,151,571 due from reflects an overpayment by Medicare for FY 2014 and 2015 interim payments and the amount due from a FY 2015 Medicare settlement appeal and IGT and Medi-Cal settlement payments not yet taken into income or withheld from current claims payments. A review was done and a decision was made to reimburse the interim overpayments from Medicare plus interest through withholdings. The balance above reflects the actual withholding or payments through December 2018, but only the accrued interest through March 2016. There is also a consideration of the initial audit adjustments for FY 2016 and now FY 2017 which was revised to reflect additional settlement information. This has reduced the due from balance. This withholding was averaging about $200,000 per month toward the total amount due of originally close to $5,300,000 before the transition to Adventist Health Tehachapi and the Medicare appeal results. A spreadsheet from the Medicare intermediary has been received and updated and reconciliation is reflected in the FY 2016 audited financial statements. In addition, Adventist Health Tehachapi Valley has developed withholding, interest and penalty worksheets by fiscal year and provider number which they have shared with TVHD. They believe that both AHTV and TVHD have been over-withheld by Medicare and have requested that TVHD allow them to reopen closed cost reports to pursue these over-withholdings. In addition, Adventist corporate reimbursement has developed item by item schedules for all cost report years and provider numbers since 2014. These have been reviewed and discussed, but Adventist is not showing some payments recently made by TVHD on the inter-company reconciliation and also applying all of the Medicare penalties and interest charges to TVHD. Nevertheless, TVHD has noted those payments to reflect on this schedule and updated the amount due AHTV at the end of posting business through 9/9/2019 of $834,204 due to AHTV.
13) Net Property, Plant & Equipment is $4,906,497 over the balance at the end of the prior month.
This new balance of $125,408,146 reflects the additions to and/or deletions from the current property, plant and equipment being used at the existing Hospital and Clinics, plus the construction costs associated with the new Hospital, minus the associated depreciation and amortization of currently depreciable asset cost over the useful life to date of the asset.
14) Construction in Progress decreased by $82,442 in August and capitalized interest increased by $5,027,104 over the end of the prior month due to posting Wipfli, LLP audit adjustments. Capitalized equipment cost increased by $405,482over the end of the prior month.
This reflects the change in the capitalized cost of construction of the new Hospital as well as any other construction projects in progress by the District or purchases of equipment put into service. The balance at the end of August for Construction in Progress was $95,455,394. Now that the new Hospital is open, this account needs to be changed to New Hospital Building & Equipment and should only reflect any additions of equipment or construction paid for by TVHD as changes. The capitalized interest was $27,137,732 and has been modified by amortized interest expense and additional interest accrued on the general obligation bonds for the new Hospital building and equipment.
15) Accounts payable increased by $1,259,963 over the end of the prior month.
The accounts payable outstanding was adjusted for the payment to AHTV for a portion of the amount withheld and interest charges on Medicare amounts outstanding from Adventist Health in the Medicare withhold reconciliation process as well as audit adjustments by Wipfli, LLP. As the reconciliation process proceeds, the accounts payable will be adjusted to reflect the reconciling items. The days outstanding for accounts payable are not a consideration because the payables include the Adventist Health due to/from reconciliation items. The timing of the cash receipts and disbursements of Construction funds from Adventist Health, the strain on cash availability from the depletion of bond funds requiring use of operating funds for construction of the new Hospital and Medicare withholding from overpayments in FY 2014 and FY 2015 have affected the accounts payable. We are seeing the effects of declining operating expenses since the Adventist transition. In addition, there has been a conscientious effort to decrease the accounts payable outstanding to move toward an agency setting rather than one of a hospital operator. Industry standards are that the accounts payable outstanding for hospitals should be at or near 60 days. Also, the accounts payable balance has been progressively decreasing, except for the accrual of AHTV reconciling items, now that the District has no material operating results. However, there remains the timing of the Adventist due to/from reconciliation items flowing through the accounts payable.
Income Statement:
1) No inpatient hospital revenue existed for August 2019. 2) No outpatient revenue existed for August 2019.
3) No emergency department revenue existed for August 2019
4) No clinic revenue existed for August 2019.
5) A contractual allowance adjustment of ($31,162) was posted for a prior period in August 2019.
6) There was $278 in other operating revenue due to minor IGT adjustments to prior postings. 7) Total operating expenses were over budget by $12,508 due to the amortization of long
term interest and depreciation of the New Hospital and Equipment.
Total labor was $20,456 under budget with contract labor being $0 while salaries were $5,123 over and benefits were $15,333 over budget with the timing of some benefit
premiums. Also, we have no accrual reversal from prior pay periods to offset the actual third payroll expense every six months. Repairs and maintenance was $81 under budget due to no repairs on the Guild occupied building. Depreciation and amortization expense was $46,565 under budget due to the posting of the accrued interest expense for the GO bonds in the budget line item along with the depreciation for the Hospital buildings and equipment. Purchased services were $2,848 under budget due to, no janitorial expenses, no collection fees from HRG and the amount of fees for the Healthland software applications. Insurance expense was $3,774 under budget due to the end of an allocation of the large prepaid insurance, benefit expenses not departmentalized and a monthly accrual of liability insurance for the New Hospital. Utilities were $1,536 over budget with the transfer of Hospital usage to Adventist Health and retention of the utilities for the Guild. Professional fees were $5,000 under budget due to no additional audit fees charged during the month.
Conclusions:
For August, the district had a net loss of ($112,778) and for the fiscal year to date a net profit of $30,581. This is less than the fiscal year to date budget by $278,752 or 90.11 %, and over the prior fiscal year to date by $78,610. Administration now has to work to stay focused on the management and clean-up of outstanding receivables, managing any funded depreciation for the new Hospital buildings and equipment, and keeping variable expenses down to a reduced agency level. Some new items of focus have also appeared which are to scrutinize the need for any consulting, legal and third-party fees, and doing improvements on the old Hospital building. TVHD needs to find ways to minimize unrecorded third-party settlements and other extra-ordinary expenses, as well as maximize any remaining Medi-Cal IGT reimbursement. An additional new focus is to strategically plan for how the affiliation with Adventist Health can assist with future District operations and community needs benefit. We also need to carefully plan for the timing of the cash flow requirements, especially insurance payments, withholds by Adventist Health Tehachapi Valley, amounts to pay Adventist Health for Medicare withholds and interest charged for TVHD patient services, reserve cash for funded depreciation and the renovation expenses for the old Hospital building.
Adventist Health Tehachapi Valley
Summary of Amount Due From Tehachapi Valley Healthcare District as of 1/10/2019
Noridian Withholds due from TVHD FOIA Report Fees
Total due for Medicare Cost Reports VA Withholds
Blue Cross Withholds
Total due for VA & Blue Cross Withholds EFT Various Payors & minor adj
Credit Card Payments
AHTV Deposits in the Bank of the Sierra Less: TVHD Payments
Total due for Deposits in the Bank of the Sierra
KHS-14-16 Voluntary Intergovernmental Transfer KHS-7/15-6/16 SB239 Quality Assurance Fee Program Mcal-06-11-18 AB915 Supplemental Payments Waiv ACA Adj/NDPH IGT 13-14
Waiv ACA Adj/07 /14-06/15
Medi-Cal Cost Report Settlement May 2017 THl0/16-12/16
Medi-Cal FQHC Cost Settlement Payment 6/18/18
Total Payments From Other Sources
!Total Due From TVHD
Department ofTreasury Duplicate Withholds !Total Tehachapi Receivable {106700)
3,445,073.36 1,674.25 3,446,747.61 199,800.04 7,199.50 206,999.54 2,020,942.29 1,403,741.35 3,424,683.64 (4,244,937.61) (820,253.97) (1,255,818.24) (417,924.02) (145,375.91) (6,404.00) (17,754.00) (41,437.43) (114,576.00) (1,999,289.60) 834,203.58 1,064,584.58 $ 1,898,788.16
!
Tab 3 - Withholds
Adventist Health Tehachapi Valley
2014 • 2016 Medicare Cost Report Summary Year
2014
Owed toAHTV Owed toAHTV
Description Date Amount Due Total Withheld TVHD FromTVHD From Noridian
lump·Sums (wkst E-1, M-5) 5/20/2014 1,095,000.00 1,095,000.00 1,095,000.00 -Tentative Settlement 2/19/2015 593,644.00 593,644.00 593,644.00 - -NPR 12/12/2016 (1,649,090.00) (1,648,919.25) (1,648,919.25) (170.75) Interest (134,255.05) (134,255.05) (134,255.05) -Dept of Treasury - 41,089.96 - 41,089.96 Grand Total (94,701.05) (53,440.34) 1,688,644.00 (1,783,174.30) 41,089.96 lump-Sums (wkst E-1, M-5) 2/19/15, 6/3/15 (1,414,000.00) (1,414,000.00) (1,414,000.00) - -As�Filed 11/24/2015 (5,069,364.00) (5,069,364.00) (3,185,845.36) (1,883,518.64) -Tentative Settlement 2/19/2015 (834,560.00} (834,560.00) (210,757.99) (623,802.01) -2015 NPR 7/11/2017 1,241,825.00 1,241,825.00 - 1,241,825.00 -Interest (433,209.53) (433,209.53) (376,582.26) (56,627.27} -Dept of Treasury···--···---·-·---: ___________ (638,751.15) ___ • __________ : _________________ .: _________ •• (638,751.15) Grand Total
Lump Sum (wkst E-1, M-5) 4/25/2016
Lump-Sum 3/11/2016 Tentative Settlement 1/18/17,3/8/17 (6,509,308.53) 454,000.00 (451,000.00) {173,017.00) (7,148,059.68) 454,000.00 (451,000.00) (488,034.00} (5,187,185.61) {1,322,122.92) 454,000.00 -- (451,000.00) (488,034.00) 6/30/2016 NPR 6/25/2018 180,216.00 180,216.00 - 180,216.00 Interest (76,653.56) (76,653.56} (7,661.42) {68,992.14) (638,751.15) -Dept of Treasury - (466,923.39} - - (466,923.39} Grand Total (66,454.56) (533,377.95) 273,321.58 (339,776.14) (466,923.39) lump Sum (wkst E-1, M-5) - - - - -As-Filed Tentative Settlement 10/31/2016 NPR 5/18/2017 {99,185.00) {99,185.00) (99,185.00) Interest - -Dept of Treasury·--···: •••••••••••••••••••••••••••••••••••••••• : •••••••••••••••••• ·-···-··---Grand Total {99,185.00) (99,185.00) (99,185.00) - -!Grand Totals (6,670,464.14) (7,734,877.97) (3,225,220.03) (3,445,073.36) (1,064,584.58}!
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so
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Reimbursement by TVHD
Invoice No
TVHD Payment
6/29/2017 453,740.91 7/26/2017 267,449.31 8/1/2017 295,104.70 8/9/2017 136,581.69 8/28/2017 391,738.94 9/6/2017 93,189.95 9/8/2017 800,000.00 3/9/2018 (Feb 2018) 20,000.00 6/7/2018 - CK. 139587 210,338.00 6/14/2018 - Ck. 139592 97,119.37 6/21/2018 - Ck 139600 154,229.86 6/28/2018 - Ck 139609 133,389.01 9/13/2018 - Ck 139710 36,416.59 9/27/2018 - Ck 139727 48,478.19 10/4/2018 - Ck 139741 12,219.18 10/16/2018 - Ck 139757 29,295.79 10/25/2018 - Ck 139765 32,118.96 11/1/2018 - Ck 139776 47,162.77 11/8/2018 - Ck 139786 83,111.60 8/30/2018 - Ck 139689 96,983.73 9/6/2018 - Ck 139699 15,170.26 1/2/2019 - Ck 139849 11,342.74 1/10/2019 - Ck 139863 23,794.95 3/28/2019 - Ck 139962 9,167.42 4/11/19 - Ck 139993 25,453.15 4/24/19 - Ck 140012 20,000.00 4/25/19 - Ck 140015 10,367.12 5/02/19 - Ck 140020 35,096.86 5/09/19 - Ck 140034 20,000.00 5/15/19 - Ck 140043 20,000.00 5/22/19 - Ck 140056 40,000.00Check was for $47,662.77, but $500 was for 'Reim refund to Arthur Vas ... '
55
56
57
58
59
60
61
62
63
63
5/22/19 - Ck 140060 5/30/19 - Ck 140061 6/6/19 - Ck 140073 6/12/19 - Ck 140083 6/19/19 - Ck 140094 7 /10/19 - Ck 140119 7 /16/19 - NP DB-Fees '19 7 /16/19 - Ck 140140 7 /25/19 - Ck 140149 8/1/19 - CK 140164Totals
2,634.36
Ck 140060 for $2,634.36 is for rental of the modular office buildings which AHRV I95,556.55
60,269.80
48,213.92
59,064.57
141,756.07
23.00
71,682.57
48,603.00
48,072.72
4,244,937.61
� 0 .c (/) co () I 'V ..0 co
I-Tehachapi Valley Healthcare Distric
Operational Cash Flow Actual w/Projections Projected 2020
Average Daily Census
Acute Care Swing Beginning Balance Cash Receipts Medicare Medi-Cal Insurance HMO Other Private Pay Rebates/lGT/Reserves
Receipt of AH Claims Payments
Property Taxes Total Cash Received Salaries
Professional Fees Supplies
Other
Pmt to AH/Care/Cal for Reconcil. W/H IGT Matching of Federal Cal Suppl. Purchased Serv/Repairs & Maint.
TOTAL EXPENSE
Return of Medicare/Cal Overpmt. Investment Account
Ad Valorem Tax Reserve Total Payments Cash Over/(Under) Property Tax Fund
Operating Res/Additions/Transfers/Int
Care/lGT/Funded Dep Reserve Add or Transfer Net Cash Balance
Actual Actual Ju/-19 Auq-19 0.00 0.00 0.00 0.00 -22,215 -192,857 0 0 202,552 39,185 0 0 2,050 1,449 0 918 2,260 933 0 100,000 0 0 6,285 3,800 213,148 146,285 19,304 16,284 18,090 4,247 164 563 29,701 29,701 304,720 238,306 11,812 11,812 0 0 383,789 300,912 0 0 0 0 0 0 383,789 300,912 (192,857) (347,483) 1,028,089 1,028,089 (76,340) (147,539) 258,687 179,292 316,547 398,779 1,334,126 1111138
Actual Projected Projected Projected Sep-19 Oct-19 Nov-19 Dec-19
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 -347,484 -160,754 -252,962 -280,698 0 0 0 0 37,748 0 0 0 0 210 20 0 4,000 4,096 1,263 453 0 15 50 311 1,346 2,100 1,893 990 9,869 0 0 342,046 36,869 0 0 0 56,128 22,229 33,117 0 145,959 28,651 36,343 343,800 18,829 19,191 17,492 18,029 0 6,333 7,796 5,000 1,194 7 315 227 7,596 18,246 32,038 3,191 16,240 73,634 0 100,000 3,394 0 0 0 11,975 3,448 6,439 520 59,229 120,858 64,079 126,967 -100,000 0 0 0 0 0 0 200,000 0 0 0 0 -40,771 120,858 64,079 326,967 (160,754) (252,962) (280,698) (263,865) 1,028,089 1,028,089 1,028,089 1,028,089 (99,878) -99,878 -99,878 -99,878 358,102 358,102 358,102 358,102 21,623 0 0 0 1,147,182 1,033,351 1,005,614 1,022 448
Projected Projected Projected Projected Projected Projected FY
Jan-20 Feb-20 Mar-20 Apr-20 Mav-20 Jun-20 TOTAL
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 -263,865 -249,022 -321,953 -397,485 -186,714 -279,487 -22.215 0 0 0 0 7,811 0 7,811 56,173 9,267 0 7,387 42,678 0 394,990 0 61 0 0 0 0 291 3,106 0 2,129 4,148 9,247 0 31,940 568 25 893 58 436 0 3,275 1,690 2,194 701 2,735 8,248 1,680 26,770 0 0 44 39 1,000,000 50,000 1,501,997 0 0 0 0 0 0 36,869 15,429 10,128 8,082 310,064 8,191 0 473,453 76,966 21,676 11,848 324,431 1,076,611 51,680 2,477,396 20,984 18,891 17,461 17,434 19,702 19,266 222,866 5,082 2,186 8,490 6,280 6,054 5,000 74,556 84 173 325 442 31 2,247 5,772 12,177 23,281 11,105 21,905 29,543 35,112 253,594 23,795 50,075 50,000 67,600 210,653 25,000 1,160,023 0 0 600,000 0 0 0 627,018 0 0 0 0 3,401 0 25,783 62,123 94,606 687,380 113,660 269,384 86,625 2,369,612 0 0 0 0 0 0 -100,000 0 0 -600,000 0 900,000 0 500,000 0 0 0 0 0 0 0 62,123 94,606 87,380 113,660 1,169,384 86,625 2,769,612 (249,022) (321,953) (397,485) (186,714) (279,487) (314,432) (314,432) 1,028,089 1,028,089 1,028,089 1,028,089 1,028,089 1,028,089 1,028,089 -99,878 -99,878 -99,878 -99,878 85,516 85,516 85,516 358,102 208,687 208,687 208,687 208,687 208,687 208,687 0 0 0 0 0 0 736,949 1 037 290 814,945 739 413 950,184 1,042,805 1,007,86 0 1,744,809
Tab 5
Unaudited Financials
1
Tehachapr Valley
Healthcare District
Tehachapi Valley Healthcare District
Tehachapi, CA
FY 2020
Unaudited Financial Statements
for
2nd Month Ended August, 2019
Certification Statement:
To the best of my knowledge, I certify for the hospital that the attached financial statements do not contain any untrue statement of a material fact or omit to state a material fact that would make the financial statements misleading. I further certify that the financial statements present in all material respects the financial condition and results of operation of the hospital and all related organizations reported herein. Certified by:
Chet Beedle
Tehachap� Val1ey
IHI aaJrm;ear
e
1
DJ e.
hi
i ct
PG. 2
Tehachapi Valley Healthcare District
Income Statement Summary
2nd Month Ended August, 2019
CURRENT MONTH ,_ YEAR-TO-DATE
Positive
Actual Budget (Negative) Actual Budget
08/31/19 08/31/19 Variance 08/31/19 08/31/19
Total Gross Patient Revenue 0 0 0 0 0
Total Deductions From Revenue (340,275) 0 (340,275) (371,437) 0
% Deductions #DIV/Of #DIV/Of
Net Patient Revenue (340,275) 0 (340,275) (371,437) 0
Other Operating Revenue 278 3,649 (3,371) 278 7,298
Total Operating Revenue (339,997) 3,649 (343,646) (371,159) 7,298
Total Operating Expenses 305,864 293,356 (12,508) 587,544 577,736
Net Operating Surplus/(Loss)I (645,861) ($289,707) ($356,154) (958,703) (570,439)
Non-Operating Revenue 533,083 439,886 93,197 989,284 879,772
!Total Net Surplus/(Loss) ($112,778) 150,179 ($262,957) $30,581 $309,333
Positive (Negative) Variance 0 (371,437) (371,437) (7,020) (378,457) (9,808) (388,265) 109,512 ($278,752)
PG.3
f
l
Tehachapi Valley
\
Healthcare Dislrict
Tehachapi Valley Healthcare District
EXECUTIVE FINANCIAL SUMMARY 2nd Month Ended August, 2019
BALANCE SHEET
8/31/2019 6/30/2019
ASSETS
Current Assets $7,308,459 $8,653,426
Assets Whose Use is Limited 5,479,802 6,545,163
Property, Plant and Equipment (Net) 125,408,146 124,881,700 Other Assets (1,880,852) (2, 142,104)
Total Unrestricted Assets 136,315,555 137,938,185
Restricted Assets 0 0
Total Assets $136,315,555 $137,938,185
LIABILITIES AND NET ASSETS
Current Liabilities $40,096,334 $39,789,871
Long-Term Debt 60,190,254 60,190,254
Other Long-Term Liabilities 0 0
Total Liabilities 100,286,588 99,980,125
Net Assets 36,028,967 37,958,060
Total Liabilities and Net Assets $136,315,555 $137,938,185
STATEMENT OF REVENUE AND EXPENSES • YTD
ACTUAL BUDGET
Revenue:
Gross Patient Revenues $0 $0
Deductions From Revenue (371,437) 0
Net Patient Revenues (371,437) 0
Other Operating Revenue 278 7,298
Total Operating Revenues (371,159) 7,298
Expenses:
Salaries, Benefits & Contract Labor 64,752 45,822
Purchased Services & Physician Fees 7,258 19,178
Supply Expenses 724 338
Other Operating Expenses 145,361 177,101
Bad Debt Expense 0 0
Depreciation & Interest Expense 369,449 335,299 Total Expenses 587,544 577,736 NET OPERATING SURPLUS (958,703) (570,439) Non-Operating Revenue/(Expenses) 989,284 879,772
TOTAL NET SURPLUS $30,581 $309,333
DAYS CASH ON HAND
33o.oo .-----,--:-:29,.,..4.3,..,.4..---, 300.00 t-----r-::26,:-,U3::.- ----:----;:------j 270.00 +---.!i---'--'---:--l 240.00 210.00 180.00 150.00 60.00 30.00
Cash - Short Term Cash - All Sources
SALARY AND BENEFIT EXPENSE AS A PERCENTAGE
OF NET REVENUE 0.8 �---� 0.6 +---0.4 · 0.2 O · -0.2
1---0.4 �---�Statement of Revenue and Expense Tehachapi Valley Healthcare District Tehachapi, CA
2nd Month Ended August, 2019
Gross Patient Revenue Inpatient Revenue ED Revenue Outpatient Revenue
Long Term Care Revenue Clinics Revenue
Total Gross Patient Revenue
Deductions From Revenue Disc but in t
Bad Debt Expense (Governmental P Prior Year Settlements
Charity Care
Total Deductions From Revenu,
Net Patient Revenue Other Operating Revenue
Total Operating Revenue Operating Expenses
Salaries and Wages Fringe Benefits Contract Labor Physicians Fees Purchased Services Supply Expense Utilities
Repairs and Maintenance Insurance Expense All Other Operating Expenses Bad Debt Expense (Non-Governmer Leases and Rentals
Depreciation and Amortization Interest Expense (Non-Government,
Total Operating Expenses
!Net Operating Surplus/(Loss)
Non-Operating Revenue Contributions Investment Income
Income Derived from Property Taxe! Interest Expense (Governmental Pro Other Non-Operating Revenue/(Exp, Total Non Operating Revenue.
!Total Net Surplus/(Loss)
Operating Margin
Total Profit Margin
EBITDA Actual 08/31/19 $0 0 0 0 0 0 (340,275) 0 0 0 (340,275) (340,275) 278 (339,997) 22,371 20,996 0 0 1,741 424 4,837 1,240 52,966 11,836 0 4,713 116,596 68,144 305,864 (646,861) 0 52 62,333 0 470,698 533,083 ($112,778) 189.96% 33.17% 135.62% PG. 4 CURRENT MONTH Positive Prior
Budget (Negative) Percentage Year
08/31/19 Variance Variance 08/31/18 $0 $0 0.00% $0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0 0 (340,275) 0.00% 0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0 0 (340,275) 0.00% 0 0 (340,275) 0.00% 0 3,649 (3,371) -92.38% 2,677 3,649 (343,646) -9417.76% 2,677 17,248 (5,123) -29.70% 25,880 5,663 (15,333) -270.78% 21,209 0 0 0.00% 0 5,000 5,000 100.00% 0 4,589 2,848 62.06% 6,078 169 (255) -151.26% 422 3,301 (1,536) -46.55% 3,469 1,321 81 6.16% 1,209 56,740 3,774 6.65% 52,966 24,836 13,000 52.34% 9,856 0 0 0.00% 0 2,353 (2,360) -100.30% 9,258 163,161 46,565 28.54% 36,425 8,976 (59,168) -659.16% 74 293,356 (12,608) -4.26% 166,846 (289,707) (356,164) 122.94% (164,169) 0 0 0.00% 0 6,688 (6,636) -99.22% 110 62,500 (167) -0.27% 62,333 0 0 0.00% 0 370,698 100,000 26.98% 75,015 439,886 93,197 21.19% 137,458 $150,179 ($262,957) -175.10% ($26,711) -7939.55% -6132.57% 4115.70% -997.80% -3222.05% -4769.14%
PG 5
Statement of Revenue and Expense Tehachapi Valley Healthcare District Tehachapi, CA
2nd Month Ended August, 2019
YEAR-TO-DATE
Positive Prior
Actual Budget (Negative) Percentage Year
08/31/19 08131119 Variance Variance 08/31118
Gross Patient Revenue
Inpatient Revenue 0 0 0 0.00% 0
ED Revenue 0 0 0 0.00% 0
Outpatient Revenue 0 0 0 0.00% 0
Long Term Care Revenue 0 0 0 0.00% 0
Clinics Revenue 0 0 0 0
Total Gross Patient Revent 0 0 0 0.00% 0
Deductions From Revenue
Discounts and Allowances (371,437) 0 (371,437) 0.00% 0
Bad Debt Expense (Governmental Pre 0 0 0 0.00% 0
Prior Year Settlements 0 0 0 0.00% 0
Charity Care 0 0 0 0.00% 0
Total Deductions From Revenue (371,437) 0 (371,437) 0.00% 0
Net Patient Revenue (371,437) 0 (371,437) 0.00% 0
Other Operating Revenue 278 7,298 (7,020) -96.19% 4,948
Total Operating Revenue (371,159) 7,298 (378,457) -5185.88% 4,948
Operating Expenses
Salaries and Wages 35,729 34,497 (1,233) -3.57% 41,667
Fringe Benefits 29,023 11,325 (17,698) -156.27% 29,294 Contract Labor 0 0 0 0.00% 0 Physicians Fees 0 10,000 10,000 100.00% 0 Purchased Services 7,258 9,178 1,920 20.92% 9,256 Supply Expense 724 338 (387) -114.52% 471 Utilities 6,145 6,601 456 6.91% 6,660
Repairs and Maintenance 2,480 2,643 163 6.16% 2,413
Insurance Expense 105,932 113,480 7,548 6.65% 116,880
All Other Operating Expenses 23,762 49,671 25,909 52.16% 36,500
Bad Debt Expense (Non-Government, 0 0 0 0.00% 0
Leases and Rentals 7,042 4,706 (2,336) -49.64% 11,784
Depreciation and Amortization 233,192 326,322 93,130 28.54% 72,850 Interest Expense (Non-Governmental 136,257 8,976 (127,281) -1417.97% 104
Total Operating Expenses 587,544 577,736 (9,808) -1.70% 327,879
!Net Operating Surplus/(Loss) (958,703) (570,439) (388,265) 68.06% (322,931)
Non-Operating Revenue:
Contributions 0 0 0 0.00% 0
Investment Income 19,209 13,376 5,833 43.61% 218
Income Derived from Property Taxes 124,664 125,000 (336) -0.27% 124,669
Interest Expense (Governmental Provi 0 0 0 0.00% 0
Other Non-Operating Revenue/(Exper 845,411 741,396 104,015 14.03% 150,015 Total Non Operating RevE 989,284 879,772 109,512 12.45% 274,902
!Total Net Surplus/(Loss) $30,581 $309,333 ($278,752) -90.11% ($48,029)
Operating Margin 258.30% -7816.55% -6526.50%
Total Profit Margin -8.24% 4238.70% -970.68%
EBITDA 158.76% -3222.05% -5052.08%
Operating Expenses Salaries and Wages Fringe Benefits Con1ract Labor Physicians Fees Purchased Services Supply Expense Utilities
Repairs and Maintenance Insurance Expense
Alf Other Operating Expenses
Bad Debt Expense (Non-Governmenlal Providers) Leases and Rentals
Depreciation and Amortizalion
Interest Expense (Non-Governmental Providers) Total Operating Expenses
All Other Operating Expenses Legal Fees
Consulting
Other Professional Fees
Minor Equipment Freight Licenses & Taxes Dues/Subscriptions Outside Training
Travel
Recruiting
Other Direct Expenses
Admin Yearly Events (Heallh Fair, Guild lunch. Xm
Advertising/Marketing
Software Expense Security
Postage
PG 6
Other Operating Expense Detail
CURRENT MONTH YEAR-TO-DATE
Positive Positive
Actual Budget (Negative) Actual Budget (Negative)
08/31119 08/31119 Variance 08/31/19 08/31119 Variance 22,371 17,248 (5,123) 35,729 34,497 (1,233) 20,996 5,663 (15,333) 29,023 11.325 (17,698) 0 0 0 0 0 0 0 5,000 5,000 0 10,000 10,000 1,741 4,589 2,848 7,258 9,178 1,920 424 169 (255) 724 338 (387) 4,837 3,301 (1,536) 6,145 6,601 456 1,240 1,321 81 2,480 2,643 163 52,966 56,740 3,774 105,932 113,480 7,548 11,836 24.836 13,000 23,762 49,671 25,909 0 0 0 0 0 0 4,713 2,353 (2,360) 7,042 4,706 (2,336) 116,596 163,161 46,565 233.192 326,322 93,130 68,144 8,976 (59,168) 136,257 8,976 (127,281) 305,864 293.356 (12,508) 587.544 577,736 (9,808) 2,188 2,038 (150) 4,032 24,453 20,421 0 0 5,500 9,087 3,587 11,000 109,038 98,038 0 0 373 9,460 9,086 4,792 113,519 108,727 1.129 1.129 13,543 13,543 386 386 4,635 4,635 187 187 2,245 2,245 0 0 1,274 906 (368) 2,608 10,872 8,264 625 185 (441) 698 2,214 1,516 1,750 176 (1,574) 2,115 2,115 899 899 10,792 10,792 35 124 89 507 1,491 984 91 259 168 125 3,110 2,985 11,836 24,836 I 13,000 23,762 ( 298,027 I 274,265
Statement of Revenue and Expense - 13 Mo1ith Trend
Tehachapi Valley Healthcare District
Tehachapi, CA
Actual Actual Actual Actual Actual
6/30/2018 7/31/2019 8/31/2019 9/30/2019 10/31/2019
Gross Patient Revenue
Inpatient Revenue $0 $0 $0 $0 $0
ED Revenue $0 0 0 0 0
Outpatient Revenue $0 $0 $0 $0 $0
Clinic Revenue $0 $0 $0 $0 $0
Long Term Care Revenue $0 $0 $0 $0 $0
Home Health Revenue $0 $0 $0 $0 $0
Total Gross Patient Revenue $0 $0 $0 $0 $0
Deductions From Revenue
Discounts and Allowances $42,678 $31,162 $340,275 $0 $0
Bad Debt Expense (Governmental Providers Only) $0 $0 $0 $0 $0
Prior Year Settlements $0 $0 $0 $0 $0
Charity Care $0 $0 $0 $0 $0
Total Deductions From Revenue $42,678 $31,162 $340,275 $0 $0
Net Patient Revenue ($42,678) ($31,162) ($340,275) $0 $0
Other Operating Revenue ($7,239)1 0 278 0 0
Total Operating Revenue ($49,917) ($31,162) ($339,997) $0 $0
Operating Expenses
Salaries and Wages $14,679 $13,358 $22,371 $0 $0
Fringe Benefits $4,434 $8,027 $20,996 $0 $0 Contract Labor $0 $0 $0 $0 $0 Physicians Fees $0 $0 $0 $0 $0 Purchased Services $2,956 $5,517 $1,741 $0 $0 Supply Expense $376 $300 $424 $0 $0 Utilities $3,120 $1,308 $4,837 $0 $0
Repairs and Maintenance $2,737 $1,240 $1,240 $0 $0
Insurance Expense $53,757 $52,966 $52,966 $0 $0
All Other Operating Expenses $19,980 $11,926 $11,836 $0 $0
Bad Debt Expense (Non-Governmental Providers) $0 $0 $0 $0 $0
Leases and Rentals $1,660 $2,329 $4,713 $0 $0
Depreciation and Amortization $116,596 $116,596 $116,596 $0 $0
Interest Expense (Non-Governmental Providers) $68,109 $68,113 $68,144 $0 $0
Total Operating Expenses $288,404 $281,680 $305,864 $0 $0
INet Operating Surplus/(Loss) ($338,321 )I ($312,842)1 ($645,861
l
l
$0 I $0 INon-Operating Revenue:
Contributions $0 $0 $0 $0 $0
Investment Income $0 $19,157 $52 $0 $0
Income Derived from Property Taxes $62,333 $62,333 $62,333 $0 $0
Interest Expense (Governmental Providers Only) $0 $0 $0 $0 $0
$0 $295,698 $295,698 $0 $0
Other Non-Operating Revenue/(Expenses) $665,340 $79,015 $175,000 $0 $0
Total Non Operating Revenue/(Expense) 727,673 $456,203 $533,083 $0 $0
ITotal Net Surplus/(Loss) $389,3521 $143,361 I ($112, 778)1 $0 I $0 I
Operating Margin 27.42% 1003.92% 189.96% #DIV/01 #DIV/01
Total Profit Margin 30.09% -460.05% 33.17% #DIV/01 #DIV/01
EBITDA 0.33188286 4.111834927 1.356249867 #DIV/01 #DIV/01
PG.8
Actual Actual Actual Actual Actual Actual Actual Actual
11/30/2019 12/31/2019 1/31/2020 2/29/2020 3/31/2020 4/30/2020 5/31/2020 6/30/2020 $0 $0 $0 $0 $0 $0 $0 $0 0 0 0 0 0 0 0 0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0 0 0 0 0 0 0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0
i
$0i
$0i
$0i
$0i
$0i
$0i
$0i
$0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0i
$0i
$0i
$0i
$0i
$0i
$0i
$0i
PG. 9
Balance Sheet - Assets
Tehachapi Valley Healthcare District
Tehachapi, CA
2nd Month Ended August, 2019
ASSETS
Current Prior Positive/ Prior
Month Month (Negative) Percentage Year End
8/31/2019 7/31/2019 Variance Variance 6/30/2019 Current Assets
Cash and Cash Equivalents $1,511,908 $1,397,609 $114,299 8.18% $2,226,891 Gross Patient Accounts Receivable 113,281 198,473 (85,192) -42.92% 109,020 Less: Bad Debt and Allowance Reserves 976,184 1,729,766 (753,582) 43.57% 1,710,164
Net Patient Accounts Receivable 1,089,465 1,928,239 (838,774) -43.50% 1,819,184
Interest Receivable 0 0 0 0.00% 0
Other Receivables 19,597 2,270,291 (2,250,694) -99.14% 15,377
Inventories 0 0 0 0.00% 0
Prepaid Expenses 1,042,019 1,061,166 (19,147) -1.80% 445,609
Due From Third Party Payers 3,645,470 7,669,840 (4,024,370) -52.47% 4,146,365
Due From Affiliates/Related Organizations 0 0 0 0.00% 0
Other Current Assets 0 0 0 0.00% 0
Total Current Assets 7,308,459 14,327,145 (7,018,686) -48.99% 8,653,426 Assets Whose Use is Limited
Cash 120,070 610,875 (490,805) -80.34% 120,070
Investments 3,502,553 3,312,992 189,561 5.72% 3,483,454
Bond Reserve/Debt Retirement Fund 1,806,928 2,366,326 (559,398) -23.64% 2,891,392
Trustee Held Funds 0 0 0 0.00% 0
Funded Depreciation 50,251 50,224 27 0.05% 50,247
Board Designated Funds 0 0 0 0.00% 0
Other Limited Use Assets 0 0 0 0.00% 0
Total Limited Use Assets 5,479,802 6,340,417 (860,615) -13.57% 6,545,163 Property, Plant, and Equipment
Land and Land Improvements 2,161,096 2,161,096 0 0.00% 2,161,096
Building and Building Improvements 1,498,051 1,491,942 6,109 0.41% 1,491,942
Equipment 7,985,232 7,579,750 405,482 5.35% 7,985,232
Construction In Progress 95,455,394 95,537,836 (82,442) -0.09% 95,461,503
Capitalized Interest 27,137,732 22.110,628 5,027,104 22.74% 26,493,222
Gross Property, Plant, and Equipment 134,237,505 128,881,252 5,356,253 4.16% 133,592,995 Less: Accumulated Depreciation {8,829,359) {8,379,603) {449,756) -5.37% {8,711,295)
Net Property, Plant, and Equipment 125,408, 146 120,501,649 4,906,497 4.07% 124,881,700 Other Assets
Unamortized Loan Costs (2,546,329) (2,670,531) 124,202 -4.65% (2,574,818)
Assets Held for Future Use 0 0 0 0.00% 0
Investments in Subsidiary/Affiliated Org. 0 0 0 0.00% 0
Other 665,477 432,714 232,763 -53.79% 432,714
Total Other Assets (1,880,852) (2,237,817) 356,965 -15.95% (2,142,104) TOTAL UNRESTRICTED ASSETS 136,315,555 138,931,394 (2,615,839) -1.88% 137,938,185
Restricted Assets 0 0 0 0.00% 0
PG.10
Balance Sheet - Liabilities and Net Assets
Tehachapi Valley Healthcare District
Tehachapi, CA
2nd Month Ended August, 2019
LIABILITIES AND FUND BALANCE
Current Prior Positive/ Prior
Month Month (Negative) Percentage Year End
8/31/2019 7/31/2019 Variance Variance 6/30/2019
Current Liabilities
Accounts Payable ($1,417,398) ($157,435) $1,259,963 -800.31% ($114,799)
Notes and Loans Payable 28,552,465 31,891,438 3,338,973 10.47% 28,552,465
Accrued Payroll (148,954) 449,845 598,799 133.11% (150,537)
Accrued Payroll Taxes 41,983 41,983 0 0.00% 41,983
Accrued Benefits 147 30,894 30,747 99.52% 35,074
Accrued Pension Expense (Current Portion) 246 0 (246) 0.00% 0
Other Accrued Expenses 13,561,744 11,472,646 (2,089,098) -18.21% 11,918,563
Patient Refunds Payable 0 3,031 3,031 100.00% 1,021
Property Tax Payable 0 0 0 0.00% 0
Due to Third Party Payers (493,899) (475,168) 18,731 -3.94% (493,899)
Advances From Third Party Payers 0 0 0 0.00% 0
Current Portion of LTD (Bonds/Mortgages) 0 0 0 0.00% 0
Current Portion of LTD (Leases) 0 0 0 0.00% 0
Other Current Liabilities 0 0 0 0.00% 0
Total Current Liabilities 40,096,334 43,257,234 3,160,900 7.31% 39,789,871
Long Term Debt
Bonds/Mortgages Payable 60,190,254 61,894,072 1,703,818 2.75% 60,190,254
Leases Payable 0 0 0 0.00% 0
Less: Current Portion Of Long Term Debt 0 0 0 0.00% 0
Total Long Term Debt (Net of Current) 60,190,254 61,894,072 1,703,818 2.75% 60,190,254 Other Long Term Liabilities
Deferred Revenue 0 0 0 0.00% 0
Accrued Pension Expense (Net of Current) 0 0 0 0.00% 0
Other 0 0 0 0.00% 0
Total Other Long Term Liabilities 0 0 0 0.00% 0
TOT AL LIABILITIES 100,286,588 105,151,306 4,864,718 4.63% 99,980,125
Net Assets:
Unrestricted Fund Balance 35,998,386 33,801,407 (2,196,979) -6.50% 37,238,586
Temporarily Restricted Fund Balance 0 0 0 0.00% 0
Restricted Fund Balance 0 0 0 0.00% 0
Net Revenue/(Expenses) 30,581 (21,319) NIA NIA 719,474
TOT AL NET ASSETS 36,028,967 33,780,088 (2,248,879) -6.66% 37,958,060 TOTAL LIABILITIES
TEHACHAPI VALLEY HEALTHCARE DISTRICT Aging Analysis Report - as of 10/3/2019
Summarized by Financial Class
Application Code:AR User Login Name: cbeedle
Financial Class O - 30 Days 31 - 60 Days 61 - 90 Days 91 - 120 Days Over 120 Days Balance
EMPLOYER BILLS 0.00 0.00% 0.00 0.00 % 0.00 0.00 % 0.00 0.00% 475.03 100.00% 475.03 MEDI-CAL 0.00 0.00% 0.00 0.00 % 0.00 0.00 % 0.00 0.00% 2,656.82 100.00% 2,656.82 MEDICARE 0.00 0.00% 0.00 0.00 % 0.00 0.00 % 0.00 0.00% 837.02 100.00% 837.02 ADVANTAGE PAYMENT PLAN 0.00 0.00 % 0.00 0.00 % 0.00 0.00 % 0.00 0.00% 47,879.28 100.00% 47,879.28 SELF PAY 0.00 0.00 % 0.00 0.00 % 0.00 0.00% 0.00 0.00% 26,504.96 100.00% 26,504.96 WORKERS COMP 0.00 0.00 % 0.00 0.00 % 0.00 0.00% 0.00 0.00 % 37,119.57 100.00% 37,119.57 Totals: 0.00 0.00% 0.00 0.00% 0.00 0.00 % 0.00 0.00% 115,472.68 100.00 % 115,472.68
Days in Accounts Receivables
Hospital Billing Last Period: 0.000 Last 6 Period: 0.000 Last 12 Period: 0.000
Clinic Billing Last Period: 0.000 Last 6 Period: 0.000 Last 12 Period: 0.000
Home Health Billing Last Period: 0.000 Last 6 Period: 0.000 Last 12 Period: 0.000
Long Term Care Billing Last Period: 0.000 Last 6 Period: 0.000 Last 12 Period: 0.000
ALL Last Period: 0.000 Last 6 Period: 0.000 Last 12 Period: 0.000
Number of Bills Processed : 84
Bill Status All bills excluding bad debt, Patient Bills, Nondischarged Episodes Include Bills Older Than O Days
Aging Date Used Admission Date Balance To Include Minimum -9999999.99 To Maximum
Account Listing: Banlc of the Sierra
BANKrWESIERRA
Welcome TEHACHAPI VALLEY HEALTHCARE DISTRICT! � You have 1 new message ...Account (Click for Details) Available Bal.
General Chk 8569 50,000.00
Sweep 8599 44,854.31
Payroll Acct 8577 5,000.00
Prop Tax Fund 5470 928,210.95
McareMcal Ovrp 2670 31,224.66
!GT Grants 6217 37,198.78
Funded Depree 8670 50,258.42
EAC 434.93
8 Deposit accounts with a total balance of 1,147,182.05
You last accessed your Sierra Online Banking account on Wednesday, October 2, 2019 3:27: 16 PM Pacific Time
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