Hospitals' financial metrics improved year-over-year from 2010 to 2011, but Moody's said the stable medians are not likely to last given the lower inpatient volumes and impending decreases to federal healthcare programs like Medicare. The following 118 median statistics compare several financial metrics from FY 2010 to FY 2011.
Note: The following data are based on audited financial statements for 400 hospitals and single-state health systems within Moody's database. Utilization and liquidity statistics are based on a smaller sample size where five years of consistent data are available.
Utilization
|
Category |
FY 2010 |
FY 2011 |
|
Maintained beds |
403 |
406 |
|
Admissions |
22,267 |
22,180 |
|
Patient days |
103,838 |
103,089 |
|
Average length of stay |
4.6 days |
4.7 days |
|
Maintained bed occupancy |
65.5 percent |
65.1 percent |
|
Emergency room visits |
71,645 |
73,909 |
|
Outpatient visits |
282,136 |
276,284 |
|
Outpatient surgeries |
9,784 |
10,157 |
|
Medicare case mix index |
1.59 |
1.58 |
|
Observation stays |
4,073 |
4,593 |
Financial performance
|
Category |
FY 2010 |
FY 2011 |
|
Net patient revenues |
$469.9 million |
$504 million |
|
Total operating revenue |
$501.7 million |
$522.5 million |
|
Interest expense |
$7.6 million |
$7.5 million |
|
Depreciation and amortization expense |
$26.5 million |
$27 million |
|
Total operating expenses |
$484.2 million |
$504 million |
|
Income from operations |
$10.4 million |
$12.8 million |
|
Excess of revenue over expenses |
$24.4 million |
$27 million |
|
Net revenue available for debt service |
$62.4 million |
$62.3 million |
|
Operating cash flow |
$46.3 million |
$47.4 million |
|
Debt service |
$14.4 million |
$15.4 million |
|
Additions to property, plan & equipment |
$31.6 million |
$33.8 million |
Balance sheet
|
Category |
FY 2010 |
FY 2011 |
|
Unrestricted cash and investments |
$202.2 million |
$225.8 million |
|
Net fixed assets |
$258.5 million |
$266.7 million |
|
Total debt |
$189.3 million |
$191.9 million |
|
Unrestricted net assets |
$278.8 million |
$301.1 million |
|
Total comprehensive debt |
$248.1 million |
$259.4 million |
|
Monthly liquidity |
$207.6 million |
$225.8 million |
|
Annual liquidity |
$217.1 million |
$234.9 million |
Key ratios
|
Category |
FY 2010 |
FY 2011 |
|
Operating margin |
2.4 percent |
2.5 percent |
|
Excess margin |
4.7 percent |
4.9 percent |
|
Operating cash flow margin |
9.3 percent |
9.3 percent |
|
Return on assets |
4.5 percent |
4.5 percent |
|
Annual debt service coverage |
4.3x |
4.4x |
|
Maximum annual debt service coverage |
4.1x |
4.2x |
|
Current ratio |
1.9x |
1.9x |
|
Cash on hand |
159.8 days |
165 days |
|
Cushion ratio |
14.3x |
14.9x |
|
Cash-to-debt ratio |
110.8 percent |
117.7 percent |
|
Accounts receivable |
44.3 days |
45.1 days |
|
Average payment period |
56.9 days |
58.6 days |
|
Debt-to-capitalization ratio |
41.6 percent |
40.4 percent |
|
Debt-to-cash flow |
3.6x |
3.5x |
|
Bad debt as a percent of net patient revenue |
6.1 percent |
6.1 percent |
|
Average age of plant |
10.2 years |
10.5 years |
|
Capital spending ratio |
1.1x |
1.2x |
|
Debt-to-total revenue |
36.2 percent |
36.1 percent |
|
Three-year operating revenue CAGR |
6.1 percent |
5.4 percent |
|
Cash-to-total comprehensive debt |
84.4 percent |
88 percent |
|
Monthly liquidity to demand debt |
311.3 percent |
340.4 percent |
|
Annual liquidity to demand debt |
342.8 percent |
373.7 percent |
|
Puttable debt as a percent of total debt |
38.1 percent |
35.1 percent |
|
Cash-to-demand debt |
347.9 percent |
384 percent |
|
Monthly liquidity to total cash/investments |
99.6 percent |
98 percent |
Patient revenue sources by gross revenue
|
Category |
FY 2010 |
FY 2011 |
|
Medicare |
43.4 percent |
43.7 percent |
|
Medicaid |
12.4 percent |
13 percent |
|
Blue Cross |
15.7 percent |
15.6 percent |
|
Commercial |
4.9 percent |
4.6 percent |
|
Managed care |
20 percent |
19 percent |
|
Self-pay and other |
7.6 percent |
7.9 percent |
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