Beruflich Dokumente
Kultur Dokumente
PHONE NO:
OWNER:
95020
GENERAL INFORMATION
TYPE OF CONTROL: Church
TYPE OF CARE:
General
LICENSED BEDS*
8
ACUTE
64
6/24/2015
1 OF 5
07/01/2013
06/30/2014
(408)848-8607
DAUGHTERS OF CHARITY HEALTH SYSTEM
COUNTY:
HSA NO:
AVAILABLE BEDS
INTENSIVE
DATE PREPARED:
PAGE:
REPORT PERIOD:
THRU
Santa Clara
07
HFPA NO:
0433
EMERGENCY SERVICES
INTENSIVE
ACUTE
64
EMERGENCY ROOM
TRAUMA CENTER DESIGNATION
LONG-TERM
LONG-TERM
OBSERVATION
OTHER
OTHER
ORTHOPEDIC
72
PSYCHIATRIC
40.10%
HELICOPTER
TOTAL
OCCUPANCY RATE
72
40.10%
TOTAL
OCCUPANCY RATE
NO. BASSINETS
18
TOTAL
MEDICARE
TRADITIONAL
4,776
1,153
4.1
4.1
11,251
2,796
$96,303,850
$60,167,102
$132,650,873
$14,899,587
$8,920,492
$3,120
$12,922
$793
MEDICARE
MANAGED CARE
591
137
4.3
4.3
994
452
$12,075,357
$7,832,534
$17,213,731
$1,634,173
$1,059,987
$2,765
$11,928
$1,066
MEDI-CAL
TRADITIONAL
1,503
498
3
3
7,144
2,894
$29,521,866
$18,307,768
$37,137,587
$6,599,448
$4,092,599
$4,391
$13,252
$573
MEDI-CAL
MANAGED CARE
1,010
412
2.5
2.5
11,453
9,239
$19,640,971
$41,393,750
$54,343,264
$2,153,311
$4,538,146
$2,132
$5,226
$396
CO. INDIGENT
TRADITIONAL
CO. INDIGENT
MANAGED CARE
THIRD PARTY
TRADITIONAL
77
18
4.3
4.3
907
562
$1,488,842
$4,108,562
$4,586,660
$264,115
$746,629
$3,430
$14,673
$823
THIRD PARTY
MANAGED CARE
2,338
OTHER
INDIGENT
OTHER
PAYERS
256
10,551
3,045
3.5
3.5
56,659
24,813
$210,629,453
$220,282,158
$350,675,329
$37,360,673
$42,875,609
$3,541
$12,270
$757
21,586
$3,717
738
3.2
89
2.9
3.2
2.9
21,297
3,613
6,120
2,750
$47,228,580
$4,369,987
$72,345,271
$95,778,606
$16,127,171
$8,964,608
$9,398,507
$2,411,532
$14,396,738
$9,121,018
$4,020
$9,420
$12,735
$27,096
$676
$2,524
FACILITY NO:106434138
ST LOUISE REGIONAL HOPSITAL
LIVE BIRTH SUMMARY
NATURAL BIRTHS
CESAREAN SECTIONS
TOTAL LIVE BIRTHS
$430,911,611
$3,399,094
$132,473,801
$16,924,623
$36,714,212
$52,947,935
$4,507,051
$81,997,186
$9,647,418
$12,064,009
$350,675,329
$80,236,282
$2,030,636
$93,428,345
($11,161,427)
$1,498,788
$784,244
($10,446,883)
$40,587,201
$13,988,300
$4,151,422
$2,418,143
$7,963,640
$9,783,246
$5,641,101
$546,819
$1,984,617
$6,363,856
$93,428,345
$18,468,877
$7,649,597
$21,552,894
$13,910,476
$2,417,561
$20,295,222
$9,133,718
$93,428,345
$85,917,358
$87,920,968
$257,073,285
$430,911,611
PERCENT OF TOTAL
19.9
20.4
59.7
100.0
3 OF 5
$47,158,228
EQUITY
TOTAL LIABILITIES AND EQUITY
$51,165,540
$30,596,239
$81,761,779
($34,603,551)
$47,158,228
FORMULAS
CURRENT RATIO
0.79% (PROVISION FOR BAD DEBTS / TOTAL GROSS PATIENT REVENUE) X 100
PROFITABILITY RATIOS
NET RETURN ON OPERATING ASSETS
( 19.66%) ((NET FROM OPERATIONS + INTEREST-WORKING CAPITAL + INTERESTOTHER) / (TOTAL CURRENT ASSETS + NET PROPERTY, PLANT AND
EQUIPMENT)) X 100
30.19% (NET INCOME / EQUITY) X 100
( 13.57%) (NET FROM OPERATIONS / TOTAL OPERATING REVENUE) X 100
1.76 TOTAL OPERATING REVENUE / (TOTAL CURRENT ASSETS + NET PROPERTY,
PLANT, AMD EQUIPMENT)
UNITS OF
SERVICE
UNIT
CODE
GROSS REV
PER UNIT
1,780
$12,708.51
$2,925.93
$7,019.30
$1,338.05
$4,562.70
$2,489.62
CORONARY CARE
BURN CARE
DEFINITIVE OBSERVATION
MEDICAL/SURGICAL ACUTE
1
1
1
1,324
ADJ DIRECT
EXP PER UNIT
1
7,447
PEDIATRIC ACUTE
OBSTETRICS ACUTE
ADJ REV
PER UNIT
1
10,551
$7,670.83
$1,750.44
1,093
$4,558.53
$0.00
24,813
$3,130.64
$271.61
11,838
$865.05
$76.89
OBSERVATION CARE
ADJ TOTAL
EXP PER UNIT
PROFIT/LOSS
PER UNIT
UNITS OF
SERVICE
UNIT
CODE
GROSS REV
PER UNIT
565
194,994
21,123
186,970
7
8
9
10
11
11
11
11
14
12
11
27
$7,868.43
$213.45
$964.82
$336.72
$3,801.39
$18.90
$139.99
$21.61
$2,038.11
$119.31
$1,437.08
$1,772.00
$98.38
$143.24
$213.32
$22.80
35,219
15,853
13,949
33,136
ADJ REV
PER UNIT
UNITS OF
SERVICE
36,112
ADJ DIRECT
EXP PER UNIT
$48.65
2,893
UNIT
CODE
16
17
18
19
20
21
22
UNITS OF
SERVICE
372
21,586
111
2,893
1,553
430,912
120,619
UNIT
CODE*
23
24
25
22
26
21
20
ADJ DIRECT
EXP PER UNIT
$23,223.87
$66.74
$7,188.65
$643.38
$422.27
$0.72
$16.45
2,129
105,453
120,619
$62.46
$14.62
$31.64
$513.76
DATE PREPARED:
PAGE:
REPORT PERIOD:
THRU
6/24/2015
5 OF 5
07/01/2013
06/30/2014
MANAGEMENT
AND
SUPERVISION
1.39%
4.59%
4.95%
3.41%
TECHNICAL
AND
SPECIALIST
1.24%
8.83%
48.60%
21.64%
REGISTERED
NURSES
74.33%
62.57%
21.07%
50.79%
LICENSED
VOCATIONAL
NURSES
6.08%
%
%
2.53%
AIDES
AND
ORDERLIES
11.18%
%
1.15%
5.10%
%
%
8.07%
3.72%
24.40%
%
%
20.70%
28.88%
30.58%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
7.62%
%
22.42%
%
29.04%
%
1.44%
%
2.92%
%
$0.00
$0.00
$0.00
$0.00
$0.00
ENVIRON.
AND
FOOD SERV.
%
%
%
%
%
%
43.46%
%
0.07%
CLERICAL
AND OTHER
EMPLOYEES
5.34%
23.39%
18.10%
13.77%
%
%
27.76%
67.41%
44.96%
REGISTRY
AND
TEMP HELP
0.43%
0.63%
6.14%
2.76%
%
%
14.30%
%
12.99%
TOTAL
PRODUCTIVE
HOURS
161,841
71,330
156,434
389,605
TOTAL
PAID
HOURS
208,401
86,422
186,816
481,639
108,967
35,169
116,894
142,576
41,440
149,189
6.96%
%
23.50%
%
6.09%
100.00%
681,403
2,883
814,844
2,883
$0.00
$0.00
$0.00
308
5
111
1
8. Street Address:
9400 NO NAME UNO
9. City:
GILROY
10.Zip Code:
95020
12. City:
REDWOOD CITY
15. Title:
CEO
30. State :
CA
37.
Through:
06/30/2014
39.
Through:
06/30/2014
40. Was this disclosure report completed after an independent financial audit ?
__X__
Yes
____
No
41. Are audit adjustments made by the independent auditor reflected in this report ?
__X__
Yes
____
No
HOSPITAL DESCRIPTION
MISC INFORMATION
(1)
TYPE OF CONTROL
(2)
06/30/2014
TYPE OF CARE
72
Church
Available Beds
72
Non-Profit Corporation
Short-Term - Childrens
10
15
31
Non-Profit Other
Short-Term - Psychiatric
15
20
HSA No
Investor - Individual
Short-Term - Specialty
20
25
Investor - Partnership
Long-Term - General
25
30
Investor - Corporation
Long-Term - Childrens
30
35
State
Long-Term - Psychiatric
35
40
County
Long-Term - Specialty
40
45
Regional
City/County
45
50
Community
City
50
55
Intermediate
District
GOVERNMENT PROGRAMS
(1)
Short-Term - General
Line
No
10
Line
No
(3)
55
PREPAID PROGRAMS
(2)
No.of
Each Type
24 HR. ON PREMISES
COVERAGE
(3)
Line
No
60
60
Medicare
HospitalBased
Emergency Services
65
Medi-Cal
Psychiatric ER
70
State Contracts
Physician
70
75
Short-Doyle
Federal Contracts
Pharmacist
75
80
CHAMPUS
Operating Room
80
85
County Indigent
Laboratory Services
85
90
Other (Specify)
Other (Specify)
Radiology Services
90
Anesthesiologist
95
65
95
100
100
105
105
ACTIVE MEDICAL STAFF PROFILE - MD's, DO's, Podiatrists and Dentists (Enter No)
Line
No
CLINICAL SPECIALTY
HOSPITAL BASED
Board
Certified
(1)
Board
Eligible
(2)
Other
(3)
NON-HOSPITAL BASED
Board
Certified
(4)
Other
(6)
Residents
(7)
Line
No
Fellows
(8)
110
Board
Eligible
(5)
RESIDENTS/FELLOWS
(Enter FTEs)
2
10
115
120
125
130
135
140 Dental
140
145 Dermatology
145
10
150
155
160 Gastroenterology
160
10
165
170
175
180
185
190 Neurology
190
195
12
200
205
210 Oncology
210
215 Ophthalmology
215
220
HOSPITAL DESCRIPTION
CLINICAL SPECIALTY
HOSPITAL BASED
Board
Certified
(1)
Board
Eligible
(2)
Other
(3)
NON-HOSPITAL BASED
Board
Certified
(4)
Board
Eligible
(5)
Other
(6)
06/30/2014
RESIDENTS/FELLOWS
(Enter FTEs)
Residents
(7)
Line
No
Fellows
(8)
225
230 Otolaryngology
230
235 Pathology
235
240 Pediatric-Allergy
240
245 Pediatric-Cardiology
245
250 Pediatric-Surgery
250
255 Pediatrics
255
260
265
270 Podiatry
270
275 Psychiatry
275
280
285
290 Radiology
290
295
300
305 Urology
305
310
22
53
315
320 TOTAL
45
141
320
SERVICES INVENTORY
Line
No
(1)Co
de
10
Burn
15
Coronary
20
06/30/2014
(2)
Code
(3)Co
de
Microbiology
Dental
Necropsy
Dermatology
Serology
Diabetes
Medical
Surgical Pathology
Drug Abuse
25
Neonatal
Family Therapy
30
Neurosurgical
Computed Tomography
Group Therapy
35
Pediatric
Cystoscopy
Hypertension
40
Pulmonary
Metabolic
45
Surgical
Neurology
50
Ultrasonography
Neonatal
55
X-Ray - Radiology
Obesity
60
DIAGNOSTIC/THERAPEUTIC
SERVICES
Obstetrics
65
Geriatric
Audiology
Ophthalmology
70
Medical
Biofeedback Therapy
Orthopedic
75
Neonatal
Cardiac Catheterization
Otolaryngology
80
Oncology
Cobalt Therapy
Pediatric
85
Orthopedic
Diagnostic Radioisotope
Pediatric Surgery
90
Pediatric
Echocardiology
Podiatry
95
Physical Rehabilitation
Electrocardiology
Psychiatric
100
Post Partum
Electroencephalography
Renal
105
Surgical
Electromyography
Rheumatic
107
110
Endoscopy
Rural Health
Surgery
115
Gastro-Intestinal Laboratory
120
125
Lithotripsy
130
Hospice Care
Nuclear Medicine
135
Occupational Therapy
140
LONG-TERM CARE
Physical Therapy
145
150
155
Intermediate Care
Radiation Therapy
160
Residential/Self Care
Radium Therapy
165
Self Care
Radioactive Implants
Jail Care
170
Recreational Therapy
175
Sub-Acute Care
177
Sub-Acute Care-Pediatric
179
180
Speech-Language Pathology
AMBULATORY SERVICES
185
Alcohol
Spotcare Medicine
190
Drug
Stress Testing
195
Therapeutic Radioisotope
200
Alcohol
205
Drug
PSYCHIATRIC SERVICES
CODE
1- Service is available at the hospital.
SERVICES INVENTORY
Line
No
(1)Co
de
06/30/2014
(2)
Code
(3)Co
de
210
PSYCHIATRIC SERVICES
215
220
OTHER SERVICES
225
Milieu Therapy
230
Night Care
Dietetic Counseling
Psychiatric Therapy
Psychopharmacological Therapy
Family Planning
Genetic Counseling
235
240
OBSTETRIC SERVICES
245
Abortion Services
Sheltered Workshop
250
RENAL DIALYSIS
Medical Research
255
Hemodialysis
260
Infertility Services
Patient Representative
265
Peritoneal
270
SURGERY SERVICES
Self-Dialysis Training
275
Dental
Organ Acquisition
Toxicology/Antidote Information
280
General
Blood Bank
Vocational Services
285
Gynecological
290
Heart
Pharmacy
295
Kidney
300
Neurosurgical
EMERGENCY SERVICES
305
Open Heart
310
Ophthalmologic
315
Organ Transplant
320
325
Approved Fellowship
Non-Approved Residency
Orthopedic
Otolaryngologic
Heliport
330
Pediatric
Medical Transportation
335
Plastic
340
Podiatry
345
Thoracic
350
Urologic
Nurse Anesthetist
355
Anesthesia Services
Trauma Treatment E. R.
Nurse Practitioner
Nurse Midwife
Occupational Therapist
360
365
LABORATORY SERVICES
CLINIC SERVICES
370
Anatomical Pathology
AIDS
Pharmacy Intern
375
Chemistry
Alcoholism
Physician's Assistant
380
Clinical Pathology
Allergy
Physical Therapist
385
Cytogenetics
Cardiology
Registered Nurse
390
Cytology
Chest Medical
Respiratory Therapist
395
Hematology
Child Diagnosis
400
Histocompatibility
Child Treatment
405
Immunology
Communicable Disease
CODE
1- Service is available at the hospital.
06/30/2014
A. Are any costs included which are a result of transactions with a related organizations as defined in 42 CFR 413.17?
1.
Yes
B. Are any costs included which are a result of transactions with a related organization of which a hospital employee, board member or member of
the which medical staff, or relative of such person is an officer or owner ? (Ignore stock ownership less than 3%)
2.
Yes
C. Complete the following to show the relationships of the hospital with related organizations and with organizations with related personnel from
the hospital obtained services, facilities, or supplies during the reporting period.
Line
No
Code
(1)
Percent
Ownership of
Hospital (3)
Related Organizations
Name
3
(4)
DAUGHTERS OF CHARITY
HEALTH SYSTEM
Percent
Ownership(5)
100
Type of Business
(6)
CORPORATE OFFICE /
PARENT
4
5
6
7
8
9
10
11
12
Expense Included on
Line
Amount
(7)
(8)
No
3
Page
$4,442,108
(9)
Column (10)
18
4
5
6
7
8
9
10
11
12
COMMENTS:
13
14
15
16
Codes
Use Codes A,B, and G to indicate the relationship of the hospital to related organizations and codes C,D,E,F and G to indicate relationship of hospital with organizations
with related personnel.
A. Corporation, partnership or other organization has ownership interest in hospital. [Complete columns (4) through (11).]
B. Hospital has ownership interest (stockholder, partner, etc.) in both related organization and hospital. [Complete columns (4) through (11).]
C. Individual has ownership interest (stockholder, partner, etc.) in both related organization and hospital. (Complete all columns.)
D. Director, officer, administrator or key person or relative of such person has ownership interest in related organization. [Complete columns(2),(4) through (11).]
E. Individual is director, officer, administrator or key person of hospital and related organization. [Complete columns(2), (4) through (11).]
F. Director, officer, administrator or key person or related organization or relative of such person has ownership interest in hospital. [Complete columns(2),(4) through (11).]
G. Other (ownership or non-financial) interest, specify on lines 13-16. (complete columns as applicable.)
NOTE: Relatives are defined as: spouse, son, daughter, grandchild, great grandchild, stepchild, brother, sister, half-brother, half-sister, stepbrother,
stepsister, parent, grandparent, great grandparent, stepmother, stepfather, niece, nephew, aunt, uncle, son-in-law, daughter-in-law,
father-in-law, mother-in-law, brother-in-law, or sister-in-law.
Line (11)
205
06/30/2014
Partners
Corporation Officers
prietorship
Line
No
Name
(1)
Percentage
of
Customary
Work Week
Devoted to
Business
(3)
Percent
Share of
Operation
Profit or
(Loss)
(4)
Percentage
of
Customary
Work Week
Devoted to
Business
(5)
Percent of
Provider's
Stock
Owned
(6)
Percentage
of
Customary
Work Week
Compensation
Devoted to Included in Costs
Business for the Period
(7)
(8) *
17
18
19
20
21
* Compensation as used in this schedule has the same definition as 42CFR 413.102
NOTE: Relatives are defined as: spouse, son, daughter, grandchild, great grandchild, stepchild, brother, sister, half-brother, half-sister, stepbrother,
stepsister, parent, grandparent, great grandparent, stepmother, stepfather, niece, nephew, aunt, uncle, son-in-law, daughter-in-law,
father-in-law, mother-in-law,brother-in-law, or sister-in-law.
E. Are any funds held in trust by an outside party which are not reflected on the Balance Sheet ?
22.
Yes
F. Section 1191 of the Hospital Accounting and Reporting Manual references six general types of financial arrangements which exist between
hospital and hospital-based physicians. Check the appropriate boxes below to indicate the type of financial arrangement which exists in
your hospital for the various hospital cost centers having such arrangements. If none of the six types of financial arrangements described
are appropriate, check the Other column and describe the arrangement in the comment section. For cost centers other than those listed
below, please complete the Other line
Financial Arrangement
Line
No
Joint
(2)
Contracted
(3)
Rental
(4)
Independent
(5)
23
24
25
Nuclear Medicine
26
Cardiology Services
27
Emergency Services
28
Gastro-Intestinal Services
29
30
Psychiatric Therapy
31
Anesthesiology
32
Other (Specify)
COMMENTS:
33
34
35
36
X
X
X
Agency
(6)
Salaried
(7)
Other
(8)
06/30/2014
Line
No
Name
Occupation
(2)
(1)
Check if
Owner
(3)
Percentage of Check if
Hospital
Board
Ownership
Member
(4)
(5)
Compensation*
(6)
37
NUN
$0
38
NUN
$0
39
NUN
$0
40
NUN
$0
41
NUN
$0
42
ROBERT ISSAI
DCHS PRESIDENT
$0
43
MARK AHN
PHYSICIAN
$0
44
GEORGE CHIALA
FARMER
$0
45
SCOTT BENNINGHOVEN
PHYSICIAN
$0
46
GEORGE GREEN
PHYSICIAN
$0
47
ALLEN HAYES
INSURANCE BROKER
$0
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
* Compensation paid to the individual from all sources for services rendered personally to or on behalf of the hospital.
06/30/2014
To be completed by all closely held corporations. If a physician is an owner or an owner of the corporation which owns the hospital,
identify all business relationships between the physician and the hospital. This would include percentage of stock owned by the physician,
all contracts between the physician and the hospital, and all lease arrangements between the physician and the hospital. If more than ten
owners, provide data for the ten with the largest percentage of stock owned.
Line
No
(1)
Physician Name
(2)
Percent of Stock Owned
(3)
Describe Contract, Lease and Other Arrangements
70
71
72
73
74
75
76
77
78
79
J. Is this facility operated by a management firm ?
80.
Yes
84. State:
86. Amount paid to the management firm for the reporting period:
Yes
No
93
89
94
90
95
91
96
92
97
M. Are the amounts paid to the management firm functionally accounted and reported as required ?
98.
Yes
No.
Please explain why amounts paid to the management firm are not functionally accounted and reported.
99
100
101
102
BEDS
Line
No
(1)
Licensed
(End of
Period)
(2)
Available
(Average)
(3)
Staffed
(Average)
(4)
Adult
1,780
(5)
Pediatric
06/30/2014
DISCHARGES
(11)
Service
(12)
Total
216
Line
No
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
45
Medical/Surgical Acute
50
Pediatric Acute
50
55
55
60
65
Obstetrics Acute
70
70
75
75
80
80
85
85
90
40
48
48
22
7,447
2,138
45
60
16
16
1,324
691
65
90
100
101
105
110
115
120
125
145
72
72
31
18
10,551
3,045
150
155
ACCOUNT DESCRIPTION
(7)
Total Inpatient Units
of Service
06/30/2014
(13)
Total Outpatient
Units of Service
Line
No.
24,813
160
AMBULATORY SERVICES
160 Emergency Services
Visits
Occasions of Service
Visits
175 Clinics
Visits
Visits
180
Operating Minutes
185
Visits
190
Observation Hours
195
200
205
Visits
210
Visits
215
ANCILLARY SERVICES
230 Labor and Delivery Services
Deliveries
Operating Minutes
Operating Minutes
245 Anesthesiology
Anesthesia Minutes
Tests
Tests
265
270
275 Echocardiology
Procedures
275
Procedures
280
Procedures
285
290 Electromyography
Procedures
290
295 Electroencephalography
Procedures
Procedures
Procedures
305
Procedures
310
Procedures
315
320 Ultrasonography
Procedures
320
Procedures
15,853
330
13,949
335
Procedures
Hours of Treatment
350 Lithotripsy
Procedures
Procedures
Sessions
Sessions
365
Sessions
370
Treatments
380
Sessions
385
Sessions
390
Organs acquired
395
24,813
165
170
11,838
11,838
565
565
194,994
112,391
175
230
82,603
235
240
245
21,123
250
255
186,970
90,519
96,451
260
295
35,219
7,380
27,839
300
325
340
1,184
1,168
16
345
350
355
33,136
20,938
12,198
360
OTHER STATISTICS
(1)
Total Units of
Service
(7)
Inpatient Units of
Service
1,619
06/30/2014
(13)
Outpatient Units of
Service
Surgeries
1,619
510
Surgeries
515
520
525
530
Surgeries
535
540
505
545
550
18,385
18,385
555
56,659
56,659
560
(1)
Total Births [Sum of
columns (7) and
(13)]
(7)
Natural Births
(13)
Cesarean Sections
566
439
127
600
605
610
615
620
566
439
127
625
06/30/2014
(1)
Medicare Traditional
(2)
Medicare Managed Care
(3)
Medi-Cal Traditional
(4)
Medi-CalManaged Care
4,776
591
1,503
1,010
(5)
County
Indigent
Programs Traditional
(6)
Line
County
No
Indigent
Programs Managed Care
Acute Care
10
Psychiatric Care
10
15
15
20
Rehabilitation Care
20
25
Long-Term Care
25
30
Other Care
35
Total
40
Nursery Acute
45
30
4,776
591
1,503
1,010
35
452
342
40
45
(7)
Other Third
Parties
Traditional
77
(8)
(9)
Other Third
Other Indigent
Parties
Managed Care
2,338
(10)
Other Payors
(11)
Total Patient
Days
256
10,551
Line
No
Acute Care
10
Psychiatric Care
10
15
15
20
Rehabilitation Care
20
25
Long-Term Care
25
30
Other Care
35
Total
40
Nursery Acute
45
30
77
2,338
256
299
10,551
35
1,093
40
45
DISCHARGES
TYPE OF CARE
Line
No
(12)
Medicare Traditional
(13)
Medicare Managed Care
(14)
Medi-Cal Traditional
(15)
Medi-CalManaged Care
1,153
137
498
412
(16)
County
Indigent
Programs Traditional
(17)
County
Line
Indigent
No
Programs Managed Care
Acute Care
10
Psychiatric Care
10
15
15
20
Rehabilitation Care
20
25
Long-Term Care
25
30
Other Care
35
Total
40
Nursery Acute
45
30
1,153
137
498
412
35
219
172
40
45
DISCHARGES
TYPE OF CARE
Line
No
(18)
Other Third
Parties
Traditional
18
(19)
(20)
Other Third
Other Indigent
Parties
Managed Care
738
(21)
Other Payors
89
(22)
Total
Discharges
Line
No
Acute Care
10
Psychiatric Care
3,045
10
15
15
20
Rehabilitation Care
20
25
Long-Term Care
25
30
Other Care
35
Total
40
Nursery Acute
45
30
18
738
140
89
3,045
35
531
40
45
06/30/2014
OUTPATIENT VISITS
TYPE OF OUTPATIENT VISIT
(1)
Medicare Traditional
(2)
Medicare Managed Care
(3)
Medi-Cal Traditional
(4)
Medi-CalManaged Care
(5)
County
Indigent
Programs Traditional
(6)
County
Indigent
Line
Programs No
Managed Care
Line
No
60
2,796
452
2,894
9,239
60
65
1,815
59
3,201
279
65
70
70
75
75
80
80
85
Hospice - Outpatient
90
Outpatient Surgeries
95
Private Referred
85
706
88
18
68
5,934
395
1,031
1,867
90
95
100 Other *
100
105 Total
11,251
994
7,144
11,453
105
OUTPATIENT VISITS
TYPE OF OUTPATIENT VISIT
(7)
Other Third
Parties Traditional
(8)
Other Third
Parties Managed Care
(9)
Other Indigent
(10)
Other Payors
(11)
Total
OutPatient
Visits
Line
No
Line
No
60
562
6,120
2,750
24,813
60
65
115
5,946
423
11,838
65
70
70
75
75
80
80
85
Hospice - Outpatient
90
Outpatient Surgeries
36
698
1,619
95
Private Referred
194
8,529
435
18,385
95
100
56,659
105
85
100 Other *
105 Total
4
907
21,297
Includes Chemical Dependency Services, Adult Day Health Care, & Renal Dialysis Visits
3,613
90
Line
No
ASSETS
06/30/2014
Account No
$2,758,564
$2,533,426
Line
No
CURRENT ASSETS
5
Cash
1000
10
Marketable securities
1010
15
1020
$66,817,916
$60,861,264
15
20
1040
($54,057,581)
($49,662,173)
20
25
1050
25
30
1060
30
35
1070
40
Inventory
1080
$1,229,308
$1,103,753
40
45
Intercompany receivables
1090
$5,693,274
$6,991,137
45
50
1100
$347,041
$3,701,420
50
55
$22,788,522
$25,528,827
55
10
35
1110
65
1120
$43,955
$13,436
60
65
70
1130
$234,015
$235,115
70
75
$277,970
$248,551
75
Land
1200
$6,512,933
$6,511,544
80
85
Land improvements
1210
$4,547,286
$4,547,286
85
90
1220
$28,121,852
$28,121,852
90
95
Leasehold improvements
1230
$12,627,768
$12,627,768
95
1240
$31,930,206
$29,796,927
100
$83,740,045
$81,605,377
105
1260
($59,852,975)
($53,965,746)
195
$23,887,070
$27,639,631
200
$204,666
$317,440
205
100 Equipment
105 TOTAL PROPERTY, PLANT AND EQUIPMENT (Sum of lines 80 through 100)
195 Less accumulated depreciation and amortization
200 NET TOTAL PROPERTY, PLANT AND EQUIPMENT (Sum of lines 105 & 195)
205 Construction in progress
1250
1310
210
1320
215
1330
220
1340
225
1350
230
235 TOTAL INVESTMENTS IN OTHER ASSETS (Sum of lines 210 through 230)
235
INTANGIBLE ASSETS
245 Goodwill
1360
245
1370
250
1380
255
1390
260
265
TOTAL
270 TOTAL ASSETS (Sum of lines 55, 75,200,205,235 , and 265)
Line
No
OTHER INFORMATION
$47,158,228
$53,734,449
270
Line
No
405 Current market value - current assets marketable securities (Line 10)
405
410
415
$204,666
$317,440
420
Line
No
Account No
(4)Prior Year
Line
No
CURRENT LIABILITIES
5
2010
$365,003
$565,030
10
Accounts payable
2020
$2,537,451
$909,120
10
15
2030
$3,830,969
$3,938,438
15
20
2040
$359,998
$390,500
20
25
2050
30
2060
$425,295
$3,890,299
35
2070
40
2080
$758,602
$787,258
40
45
Intercompany payables
2090
$34,252,748
$25,703,223
45
50
55
2100
$8,635,474
$9,583,205
55
60
$51,165,540
$45,767,073
60
25
30
35
50
DEFERRED CREDITS
65
2110
65
70
2120
70
75
2130
75
80
80
Mortgages payable
2210
85
90
Construction loans
2220
90
95
2230
95
2240
100
2250
2260
2270
$30,596,239
$46,465,430
105
110
115
$30,596,239
$46,465,430
$30,596,239
$46,465,430
130
$81,761,779
$92,232,503
135
($34,603,551)
($38,498,054)
140
125 Less amount shown as current maturities (Must agree with line 50)
120
125
2310
2310
145
2320
150
2330
155
2340
160
2350
165
2310
170
2320
175
2710
180
2720
185
2730
190
2740
195
2750
200
($34,603,551)
($38,498,054)
205
$47,158,228
$53,734,449
270
TOTAL
270 TOTAL LIABILITIES AND EQUITY (Sum of lines 135 and 205)
(a) Complete Report Page 5.1 to provide detailed long-term debt information.
Line
No
(6)Date Obligation
Incurred (Year Only*)
105
2006
06/30/2014
Line
No
5
10
10
15
15
20
20
25
25
30
30
35
35
40
40
45
45
50
50
55
55
60
60
65
65
70
70
75
75
80
80
85
85
90
90
95
95
100
100
105
105
110
110
115
115
120
120
125
125
130
130
135
135
140
140
145
145
150
150
155
155
160
160
165
165
170
170
175
175
180
180
185
185
190
190
195
195
200
200
205
205
210
210
215
215
220
220
225
225
230
230
235
235
240
240
245
245
250
250
(6)Date Obligation
Incurred (Year Only*)
06/30/2014
Line
No
255
255
260
260
265
265
270
270
275
275
280
280
285
285
290
290
295
295
300
300
305
305
310
310
315
315
320
320
(2)
(3)
(4)
(5)
06/30/2014
(6)
Additions
Line
Line
No
Description
Beginning
Balance(a)
Purchase
$1,389
Donation
Transfers
Disposals and
Retirements
Ending
Balance (b)
No
Land
$6,511,544
$6,512,933
10
Land Improvements
$4,547,286
$4,547,286
10
15
$28,121,852
$28,121,852
15
20
Leasehold Improvements
$12,627,768
$12,627,768
20
25
Equipment
$29,796,927
$31,930,206
25
30
Construction-in-progress
($112,774)
$204,666
30
35
TOTAL
($112,774)
$83,944,711
35
$2,133,279
$317,440
$81,922,817
$2,134,668
(a) Column(1), line 35 must agree with page 5, column(2), sum of lines 105 and 205.
(b) Column(6), line 35 must agree with page 5, column(1), sum of lines 105 and 205.
Line
No
ASSETS
(1)
Current Year
06/30/2014
(2)
Prior Year
Line
No
Cash
1510
10
1521
10
15
Other Investments
1529
15
20
Receivables
1530
20
25
1540
25
30
Other assets
1550
30
75
75
Cash
1410
105
110
1421
110
115
Mortgages investments
1422
115
120
1423
1424
120
125
Other Investments
1429
125
130
Receivables
1430
130
135
1440
135
140
Other assets
1450
140
170
170
ENDOWMENT FUNDS
205
Cash
1610
205
210
1621
210
215
Mortgages
1622
215
220
1623
1624
220
225
Other investments
1629
225
230
Receivables
1630
230
235
1640
235
240
Other assets
1650
240
275
Line
No
OTHER INFORMATION
275
(1)
Current Year
(2)
Prior Year
Line
No
405
Current market value - specific purpose funds marketable securities (Line 10)
405
410
Current market value - Property Replacement & Exp. funds marketable securities (line
110)
410
415
415
(3)
Current Year
06/30/2014
(4)
Prior Year
Line
No
2510
10
2520
10
15
2530
15
70
Fund balance
2570
70
75
75
2410
105
110
2420
110
115
2430
115
165
Fund balance
2470
165
170
170
ENDOWMENT FUNDS
205
Mortgages
2610
205
210
2620
210
215
2630
215
220
2640
220
225
2650
225
270
Fund balance
2670
270
275
275
06/30/2014
RESTRICTED FUNDS
Line
No
ASSETS
(1) Funds
Unrestricted
(4) Endowment
Line
No
10
10
15
Restatement (describe)
15
($38,498,054)
20
20
25
25
30
30
35
35
40
40
45
45
50
($38,498,054)
50
55
ADDITIONS (DEDUCTIONS):
Net Income (Loss)
($10,446,883)
55
60
60
65
65
70
70
75
75
80
80
85
85
90
Dividends declared
90
95
95
100
Intercompany transfers
100
105
110
105
$14,341,386
110
115
115
120
120
125
130
TRANSFERS:
Property and equipment additions
$3,894,503
125
130
135
135
140
Other (Describe)
140
145
145
150
150
155
155
160
160
165
165
170
170
175
185
175
($34,603,551)
185
Line SECTION I
No
06/30/2014
(2)
Prior Year
Line
No
OPERATING REVENUES:
Daily hospital services
$85,917,358
$87,821,359
10
Ambulatory services
$87,920,968
$90,256,444
10
15
Ancillary services
$257,073,285
$243,379,269
15
30
$430,911,611
$421,457,072
30
105
$350,675,329
$343,084,286
105
107
110
NET PATIENT REVENUE (Line 30 minus line 105 plus line 107)
$80,236,282
$78,372,786
110
135
$2,030,636
$307,498
135
140
$82,266,918
$78,680,284
140
146
OPERATING EXPENSES:
Daily Hospital Services
$18,468,877
$19,661,383
146
151
Ambulatory Services
$7,649,597
$7,761,065
151
156
Ancillary Services
$21,552,894
$21,805,957
156
161
Research Costs
166
Education Costs
171
General Services
$13,910,476
$13,548,272
171
176
Fiscal Services
$2,417,561
$2,943,978
176
181
Administrative Services
$20,295,222
$19,184,366
181
186
Unassigned Costs
$9,133,718
$4,360,876
186
190
195
200
$93,428,345
$89,265,897
200
205
($11,161,427)
($10,585,613)
205
210
$714,544
($3,936,176)
210
215
($10,446,883)
($14,521,789)
215
220
220
225
Deferred
225
230
NET INCOME BEFORE EXTRAORDINARY ITEMS: (Line 215 minus 220 and
225)
107
161
166
190
195
($10,446,883)
($14,521,789)
230
EXTRAORDINARY ITEMS:(Specify)
235
235
240
245
240
NET INCOME (Line 230 minus lines 235 and 240)
($10,446,883)
(a) Report Page 8, Section II must be completed to provide detailed deductions from revenue information.
(b) Report Page 8, Section II must be completed to provide detailed capitation premium revenue information.
(c) Report Page 8, Section III must be completed to provide detailed non-operating revenue and expense information.
($14,521,789)
245
Line SECTION II
No
06/30/2014
(2)
Prior Year
Line
No
300
$3,399,094
$2,208,871
300
305
$132,473,801
$136,303,298
305
310
$16,924,623
$16,363,834
310
315
$36,714,212
$27,202,498
315
320
$52,947,935
$45,854,723
320
325
Disproportionate share payments for Medi-Cal patient days (SB 855) (credit bal)
(d)
325
330
330
335
340
$4,507,051
$4,193,517
340
345
$81,997,186
$82,182,888
345
350
355
$9,647,418
$28,774,657
360
360
365
365
370
370
375
Policy discounts
375
380
Administrative adjustments
385
$12,064,009
395
$350,675,329
430
430
435
435
440
440
445
445
450
450
335
350
355
380
(d) Disproportionate share funds transferred back to a related public entity must be reported on page 7, column(1), line 105.
385
$343,084,286
395
(1)
Current Year
06/30/2014
(2)
Prior Year
Line
No
500
NON-OPERATING REVENUES:
Gains on sale of hospital property
9010
505
9030
510
Unrestricted contributions
9040
515
Donated services
9050
520
9060
525
9070
525
530
9080
530
535
9090
535
540
9100
540
545
9150
545
550
9160
550
555
9170
555
560
9180
560
565
9190
565
570
State appropriation
9200
570
575
9210
575
580
9220
580
585
9230
590
9250
595
9260
595
600
9270
600
605
9280
605
610
9290
615
9400
625
640
NON-OPERATING EXPENSES:
Loses on sale of hospital property
9020
645
9030
650
9510
655
9520
655
660
9530
660
665
9540
665
670
9550
675
9800
685
500
505
$976,789
$883,246
$41,921
$62,370
510
515
520
585
$425,360
$406,411
590
610
$54,718
$83,642
615
$1,498,788
$1,435,669
625
640
645
$915,378
650
670
$784,244
$4,456,467
675
$784,244
$5,371,845
685
700
$714,544
($3,936,176)
700
705
705
Line
No
06/30/2014
Line
No
($10,446,883)
($14,521,789)
$5,887,230
$4,308,777
15
15
Adjustments to reconcile net income to net cash provided by (used for) operating activities and
non-operating revenue :
Depreciation and amortization
17
20
30
Change in accounts and notes receivable, net of allowance for uncollectible receivables and
third-party contractual withholds
35
35
40
40
45
50
Change in inventory
($125,555)
($176,142)
50
55
$1,297,863
$164,107
55
57
$3,354,379
$228,647
57
60
$1,628,331
($432,669)
60
65
($107,469)
$361,478
65
70
($30,502)
($237,800)
70
75
80
($3,465,004)
$268,710
85
87
($28,656)
$92,517
87
90
$8,549,525
$16,555,565
90
95
($947,731)
($1,215,035)
17
20
($1,561,244)
$948,239
30
45
75
80
85
95
100
102
103
104
$14,451,167
$20,866,394
105
115 NET CASH PROVIDED BY (USED FOR) OPERATING ACTIVITIES (Sum of lines 5 and 105)
$4,004,284
$6,344,605
115
($29,419)
($22,203)
130
($2,134,668)
($10,094,041)
135
140
141
142
NET CASH PROVIDED BY (USED FOR) INVESTING ACTIVITIES (Sum of lines 130 through
145 142)
($2,164,087)
($15,869,191)
($200,027)
($10,116,244)
145
160
($565,030)
165
$565,030
170
175
180
185
$14,454,159
$2,889,824
190
191
192
NET CASH PROVIDED BY (USED FOR) FINANCING ACTIVITIES (Sum of lines 160 through
195 192)
($1,615,059)
$2,889,824
195
$225,138
($881,815)
205
$2,533,426
$3,415,238
215
$2,758,564
$2,533,423
225
205 NET INCREASE (DECREASE) IN CASH (Sum of lines 115, 145 and 195)
(1)Units of
Service
from Page 17,
Column (13)
(2)Adjusted
Direct Expenses
from Page 20,
Column (1)
(4)Total Patient
Care Costs from
Page 20, Column
(16),Lines 505 - 915
06/30/2014
(5)Average Unit
Patient Care
Costs, Column
(4) (1)
Line
No
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
40
45
Medical/Surgical Acute
45
50
Pediatric Acute
50
55
55
60
60
65
Obstetrics Acute
65
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
95
100
101
105
110
115
120
125
145
150
AMBULATORY SERVICES:
160 Emergency Services
160
165
170
175 Clinics
175
180
185
190
195
200
205
210
215
220
225
06/30/2014
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
40
45
Medical/Surgical Acute
45
50
Pediatric Acute
50
55
55
60
60
65
Obstetrics Acute
65
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
95
100
101
105
110
115
120
125
145
150
AMBULATORY SERVICES:
160 Emergency Services
160
165
170
175 Clinics
175
180
185
190
195
200
205
210
215
220
225
(11) Gross
Revenue from
Page 12,
Columns (21) +
(22)
(12)Deductions (13)Adjustment
(14)Net Revenue
from Revenue for Professional Column (11) - (12) from Page 12,
Component
(13)
Column 23 Line from Page 15,
455 - 457
Columns (9) &
(13)
06/30/2014
(15)Average Unit Line
Net Revenue
No
Column (14) (1)
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
40
45
Medical/Surgical Acute
45
50
Pediatric Acute
50
55
55
60
60
65
Obstetrics Acute
65
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
95
100
101
105
110
115
120
125
145
150
AMBULATORY SERVICES:
160 Emergency Services
160
165
170
175 Clinics
175
180
185
190
195
200
205
210
215
220
225
(16) Net
(17) Average Line
Revenue Minus
Unit Net
No
Net Costs
Column (16)
Column (14)
(1)
minus (9)
5
10 Coronary Care
10
15
20
25
30 Burn Care
30
35
40 Definitive Observation
40
45 Medical/Surgical Acute
45
50 Pediatric Acute
50
55
60
65 Obstetrics Acute
65
70
75
80
85
90
95 Nursery Acute
95
100
101
105
110
115
120
125
145
150
AMBULATORY SERVICES:
160 Emergency Services
160
165
170
175 Clinics
175
180
185
190
195
200
205
210
215
220
225
06/30/2014
(1)Units of
Service
from Page 17,
Column (13)
(2)Adjusted
Direct Expenses
from Page 20,
Column (1)
06/30/2014
(4)Total Patient
Care Costs from
Page 20, Column
(16),Lines 505 - 915
(5)Average Unit
Patient Care
Costs, Column
(4) (1)
Line
No
ANCILLARY SERVICES:
230 Labor and Delivery Services
230
235
240
245 Anesthesiology
245
250
255
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
295
300
305
310
315
320 Ultrasonography
320
325
330
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
06/30/2014
ANCILLARY SERVICES:
230 Labor and Delivery Services
230
235
240
245 Anesthesiology
245
250
255
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
295
300
305
310
315
320 Ultrasonography
320
325
330
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
(11) Gross
Revenue from
Page 12,
Columns (21) +
(22)
(12)Deductions (13)Adjustment
(14)Net Revenue
from Revenue for Professional Column (11) - (12) from Page 12,
Component
(13)
Column 23 Line from Page 15,
455 - 457
Columns (9) &
(13)
06/30/2014
(15)Average Unit Line
Net Revenue
No
Column (14) (1)
ANCILLARY SERVICES:
230 Labor and Delivery Services
230
235
240
245 Anesthesiology
245
250
255
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
295
300
305
310
315
320 Ultrasonography
320
325
330
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
(16) Net
(17) Average Unit Line
Revenue Minus Net Column (16) No
Net Costs
(1)
Column (14)
minus (9)
ANCILLARY SERVICES:
230 Labor and Delivery Services
230
235
240
245 Anesthesiology
245
250
255
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
295
300
305
310
315
320 Ultrasonography
320
325
330
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
06/30/2014
06/30/2014
MEDICARE
Traditional
(1) Gross
Inpatient Revenue
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Managed Care
(2) Gross
Outpatient
Revenue
(3) Gross
Inpatient Revenue
(4) Gross
Outpatient
Revenue
Account
No
Revenue Subclassifications
Line
No
.04
.44
.14
.54
3010
10
Coronary Care
3030
10
15
3050
15
20
3070
20
25
3090
25
30
Burn Care
3110
30
35
3130
35
40
Definitive Observation
3150
45
Medical/Surgical Acute
3170
50
Pediatric Acute
3290
50
55
3340
55
60
3360
65
Obstetrics Acute
3380
70
3400
70
75
3420
75
80
3440
80
85
3470
85
90
3510
95
Nursery Acute
3530
$11,030,794
$1,257,033
40
$27,874,129
$3,527,489
45
60
$10,248
65
90
$8,453
95
3560
100
3570
101
3580
105
3610
110
3630
115
3680
120
3780
125
3900
145
$38,923,624
$4,784,522
150
AMBULATORY SERVICES:
160 Emergency Services
4010
4040
4060
175 Clinics
4070
4180
180
4200
185
4220
190
4230
195
4260
200
4290
205
4310
210
4320
215
4390
$5,399,861
$9,920,776
$751,567
$1,771,718
160
165
170
$4,354,585
$455,018
175
220
$5,399,861
$14,275,361
$751,567
$2,226,736
225
06/30/2014
MEDI-CAL
Traditional
(5) Gross
Inpatient Revenue
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Managed Care
(6) Gross
Outpatient
Revenue
(7) Gross
Inpatient Revenue
(8) Gross
Outpatient
Revenue
Account
No
Revenue Subclassifications
Line
No
.05
.45
.15
.55
3010
10
Coronary Care
3030
10
15
3050
15
20
3070
20
25
3090
25
30
Burn Care
3110
30
35
3130
35
40
Definitive Observation
3150
45
Medical/Surgical Acute
3170
50
Pediatric Acute
3290
50
55
3340
55
60
3360
65
Obstetrics Acute
3380
70
3400
70
75
3420
75
80
3440
80
85
3470
85
90
3510
95
Nursery Acute
3530
$2,930,132
$1,577,995
40
$5,517,080
$3,116,095
45
60
$2,328,292
$1,854,379
65
90
$1,920,313
$1,529,442
95
3560
100
3570
101
3580
105
3610
110
3630
115
3680
120
3780
125
3900
145
$12,695,817
$8,077,911
150
AMBULATORY SERVICES:
160 Emergency Services
4010
4040
4060
175 Clinics
4070
4180
180
4200
185
4220
190
4230
195
4260
200
4290
205
4310
210
4320
215
4390
$1,474,980
$7,774,955
$1,124,969
$21,204,463
160
165
170
$369,584
$1,111,682
175
220
$1,474,980
$8,144,539
$1,124,969
$22,316,145
225
06/30/2014
PATIENT
REVENUE PRODUCING CENTERS
Managed Care
(10) Gross
Outpatient
Revenue
(11) Gross
Inpatient Revenue
(12) Gross
Outpatient
Revenue
Account
No
Revenue Subclassifications
Line
No
.07
.47
.17
.57
3010
10
Coronary Care
3030
10
15
3050
15
20
3070
20
25
3090
25
30
Burn Care
3110
30
35
3130
35
40
Definitive Observation
3150
40
45
Medical/Surgical Acute
3170
45
50
Pediatric Acute
3290
50
55
3340
55
60
3360
60
65
Obstetrics Acute
3380
65
70
3400
70
75
3420
75
80
3440
80
85
3470
85
90
3510
90
95
Nursery Acute
3530
95
3560
100
3570
101
3580
105
3610
110
3630
115
3680
120
3780
125
3900
145
150
AMBULATORY SERVICES:
160 Emergency Services
4010
160
4040
165
4060
170
175 Clinics
4070
175
4180
180
4200
185
4220
190
4230
195
4260
200
4290
205
4310
210
4320
215
4390
220
225
06/30/2014
PATIENT
REVENUE PRODUCING CENTERS
(14) Gross
Outpatient
Revenue
Managed Care
(15) Gross
Inpatient Revenue
(16) Gross
Outpatient
Revenue
Account
No
Revenue Subclassifications
Line
.02, .03, .06
.12,.13,.16
No
3010
10
Coronary Care
3030
10
15
3050
15
20
3070
20
25
3090
25
30
Burn Care
3110
30
35
3130
35
40
Definitive Observation
3150
45
Medical/Surgical Acute
3170
50
Pediatric Acute
3290
50
55
3340
55
60
3360
65
Obstetrics Acute
3380
70
3400
70
75
3420
75
80
3440
80
85
3470
85
90
3510
95
Nursery Acute
3530
$70,224
$5,240,843
40
$483,540
$10,476,946
45
60
$1,835,561
65
90
$1,513,922
95
3560
100
3570
101
3580
105
3610
110
3630
115
3680
120
3780
125
3900
145
$553,764
$19,067,272
150
AMBULATORY SERVICES:
160 Emergency Services
4010
4040
4060
175 Clinics
4070
4180
180
4200
185
4220
190
4230
195
4260
200
4290
205
4310
210
4320
215
4390
$79,719
$1,325,240
$2,264,612
$17,205,233
160
165
170
$291,361
$3,489,142
175
220
$79,719
$1,616,601
$2,264,612
$20,694,375
225
OTHER INDIGENT
(17) Gross
Inpatient Revenue
Line
No
PATIENT
REVENUE PRODUCING CENTERS
(18) Gross
Outpatient
Revenue
06/30/2014
OTHER PAYORS
(19) Gross
Inpatient Revenue
(20) Gross
Outpatient
Revenue
Account
No
Revenue Subclassifications
Line
.08
.48
.00, .09
.40, .49
No
3010
10
Coronary Care
3030
10
15
3050
15
20
3070
20
25
3090
25
30
Burn Care
3110
30
35
3130
35
40
Definitive Observation
3150
45
Medical/Surgical Acute
3170
50
Pediatric Acute
3290
50
55
3340
55
60
3360
65
Obstetrics Acute
3380
70
3400
70
75
3420
75
80
3440
80
85
3470
85
90
3510
95
Nursery Acute
3530
$514,127
40
$1,277,440
45
60
$12,539
65
90
$10,342
95
3560
100
3570
101
3580
105
3610
110
3630
115
3680
120
3780
125
3900
145
$1,814,448
150
AMBULATORY SERVICES:
160 Emergency Services
4010
4040
4060
175 Clinics
4070
4180
180
4200
185
4220
190
4230
195
4260
200
4290
205
4310
210
4320
215
4390
$360,890
$7,021,468
160
165
170
$169,145
175
220
$360,890
$7,190,613
225
06/30/2014
TOTAL
(21) Gross
Inpatient Revenue
Line
No
PATIENT
REVENUE PRODUCING CENTERS
(22) Gross
Outpatient
Revenue
Account
No
Line
3010
10
Coronary Care
3030
10
15
3050
15
20
3070
20
25
3090
25
30
Burn Care
3110
30
35
3130
35
40
Definitive Observation
3150
45
Medical/Surgical Acute
3170
50
Pediatric Acute
3290
50
55
3340
55
60
3360
65
Obstetrics Acute
3380
70
3400
70
75
3420
75
80
3440
80
85
3470
85
90
3510
95
Nursery Acute
3530
$22,621,148
$22,621,148
40
$52,272,719
$52,272,719
45
60
$6,041,019
$6,041,019
65
90
$4,982,472
$4,982,472
95
3560
100
3570
101
3580
105
3610
110
3630
115
3680
120
3780
125
3900
145
$85,917,358
$85,917,358
150
$77,680,451
160
AMBULATORY SERVICES:
160 Emergency Services
4010
4040
4060
175 Clinics
4070
4180
180
4200
185
4220
190
4230
195
4260
200
4290
205
4310
210
4320
215
4390
$11,456,598
$66,223,853
165
170
$10,240,517
$10,240,517
175
220
$11,456,598
$76,464,370
$87,920,968
225
06/30/2014
MEDICARE
Traditional
Line
No
PATIENT
REVENUE PRODUCING CENTERS
(1) Gross
Inpatient Revenue
Account
No
Revenue Subclassifications
.04
Managed Care
(2) Gross
Outpatient
Revenue
(3) Gross
Inpatient Revenue
(4) Gross
Outpatient
Revenue
.44
.14
.54
$9,571,584
$658,874
$1,029,849
Line
No
ANCILLARY SERVICES:
230 Labor and Delivery Services
4400
$7,542
4420
$6,953,532
4430
245 Anesthesiology
4450
4470
4480
4500
4520
265
4540
270
275 Echocardiology
4560
275
4570
280
4590
285
290 Electromyography
4610
290
295 Electroencephalography
4620
4630
4640
305
4650
310
4660
315
320 Ultrasonography
4670
320
4680
4710
$7,241,430
$3,085,022
$805,228
$312,240
330
4720
$10,280,786
$2,268,547
$1,310,792
$332,043
335
4730
4740
$623,254
$15,650
$94,690
350 Lithotripsy
4750
4760
4770
4780
365
4790
370
4800
375
4820
380
4830
385
4840
390
4860
395
4870
230
240
245
$3,537,788
$2,235,716
$540,986
$330,289
$13,286,142
$10,556,285
$1,735,220
$1,355,699
$16,898,386
$996,553
$2,181,175
300
325
340
345
350
355
$2,791,638
$1,260,551
$396,925
$64,503
360
400
$96,303,850
$60,167,102
MEDICARE
Traditional
Inpatient
Outpatient
260
295
$7,258,253
$51,980,365
250
255
235
$45,891,741
$6,539,268
$5,605,798
405
$12,075,357
MEDICARE
Managed Care
Total
$7,832,534
415
$108,664
$68,408
$289,108
420
$81,295,599
$51,178,202
$16,924,623
425
426
430 Charity
430
435
440
445
450
$81,404,263
$51,246,610
$17,213,731
$14,899,587
$8,920,492
$2,694,160
455
457
460
06/30/2014
MEDI-CAL
Traditional
Line
No
PATIENT
REVENUE PRODUCING CENTERS
(6) Gross
Outpatient
Revenue
(7) Gross
Inpatient Revenue
(8) Gross
Outpatient
Revenue
.05
.45
.15
.55
Account
No
Revenue Subclassifications
Managed Care
(5) Gross
Inpatient Revenue
Line
No
ANCILLARY SERVICES:
230 Labor and Delivery Services
4400
$1,713,420
4420
$1,809,346
4430
245 Anesthesiology
4450
4470
4480
4500
4520
265
4540
270
275 Echocardiology
4560
275
4570
280
4590
285
290 Electromyography
4610
290
295 Electroencephalography
4620
4630
4640
305
4650
310
4660
315
320 Ultrasonography
4670
320
4680
4710
$2,090,382
$348,814
$1,225,564
$681,210
330
4720
$2,230,012
$429,438
$1,056,217
$841,246
335
4730
4740
350 Lithotripsy
4750
4760
4770
4780
365
4790
370
4800
375
4820
380
4830
385
4840
390
4860
395
4870
$1,364,661
$471,253
$1,690,261
230
$1,234,211
235
240
245
$1,664,242
$1,044,064
$1,536,918
$1,940,982
$3,526,717
$3,577,919
$2,270,362
$6,684,177
250
255
260
295
$1,735,310
$4,178,081
$1,053,186
$7,470,582
300
325
340
$247,996
$107,215
345
350
355
$333,644
$113,660
$133,707
$225,197
360
400
$15,351,069
$10,163,229
$10,438,091
$19,077,605
405
$29,521,866
$18,307,768
$19,640,971
$41,393,750
415
MEDI-CAL
Traditional
Total
MEDI-CAL
Managed Care
Total
$853,962
420
$36,714,212
$52,947,935
425
$423,375
$541,367
426
430
435
440
445
450
$37,137,587
$54,343,264
$10,692,047
$6,691,457
455
457
460
06/30/2014
PATIENT
REVENUE PRODUCING CENTERS
Account
No
Revenue Subclassifications
Managed Care
(9) Gross
Inpatient Revenue
(10) Gross
Outpatient
Revenue
(11) Gross
Inpatient Revenue
(12) Gross
Outpatient
Revenue
.07
.47
.17
.57
Line
No
ANCILLARY SERVICES:
230 Labor and Delivery Services
4400
230
4420
235
4430
240
245 Anesthesiology
4450
245
4470
250
4480
255
4500
260
4520
265
4540
270
275 Echocardiology
4560
275
4570
280
4590
285
290 Electromyography
4610
290
295 Electroencephalography
4620
295
4630
300
4640
305
4650
310
4660
315
320 Ultrasonography
4670
320
4680
325
4710
330
4720
335
4730
340
4740
345
350 Lithotripsy
4750
350
4760
355
4770
360
4780
365
4790
370
4800
375
4820
380
4830
385
4840
390
4860
395
4870
400
405
415
COUNTY INDIGENT PROGRAMS
Traditional
Inpatient
Outpatient
CO. INDIGENT
PROGRAMS
Managed Care
Total
420
425
426
430 Charity
430
435
440
445
450
455
457
460
06/30/2014
PATIENT
REVENUE PRODUCING CENTERS
Account
No
Revenue Subclassifications
Managed Care
(13) Gross
Inpatient Revenue
(14) Gross
Outpatient
Revenue
(15) Gross
Inpatient Revenue
(16) Gross
Outpatient
Revenue
.12,.13,.16
$340,225
$769,942
Line
No
ANCILLARY SERVICES:
230 Labor and Delivery Services
4400
4420
4430
245 Anesthesiology
4450
4470
4480
4500
4520
265
4540
270
275 Echocardiology
4560
275
4570
280
4590
285
290 Electromyography
4610
290
295 Electroencephalography
4620
4630
4640
305
4650
310
4660
315
320 Ultrasonography
4670
320
4680
4710
$104,551
$105,512
$3,410,474
$2,749,792
330
4720
$84,111
$43,659
$3,618,365
$1,705,815
335
4730
4740
350 Lithotripsy
4750
4760
4770
4780
365
4790
370
4800
375
4820
380
4830
385
4840
390
4860
395
4870
$1,350,812
230
$11,466,412
235
240
245
$27,483
$129,128
$2,374,254
$3,214,373
$158,660
$214,598
$5,516,407
$10,234,293
250
255
260
295
$115,642
$1,224,752
$3,390,564
$21,265,681
300
325
340
$232,467
345
350
355
$24,687
$4,370
$670,794
$1,014,530
360
400
$855,359
$2,491,961
$1,488,842
$4,108,562
OTHER THIRD PARTIES
Traditional
Inpatient
$5,332,559
Outpatient
$25,896,696
$47,228,580
OTHER THIRD
PARTIES
Managed Care
Total
$51,650,896
405
$72,345,271
415
$21,257
$58,352
$1,717,411
420
$1,203,470
$3,303,581
$81,997,186
425
426
430 Charity
430
435
440
445
$12,064,009
450
455
$1,224,727
$3,361,933
$95,778,606
$264,115
$746,629
$23,795,245
457
460
OTHER INDIGENT
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
Revenue Subclassifications
06/30/2014
OTHER PAYORS
(17) Gross
Inpatient Revenue
(18) Gross
Outpatient
Revenue
(19) Gross
Inpatient Revenue
(20) Gross
Outpatient
Revenue
.08
.48
.00, .09
.40, .49
Line
No
ANCILLARY SERVICES:
230 Labor and Delivery Services
4400
$9,228
4420
$161,425
4430
245 Anesthesiology
4450
4470
4480
4500
4520
265
4540
270
275 Echocardiology
4560
275
4570
280
4590
285
290 Electromyography
4610
290
295 Electroencephalography
4620
4630
4640
305
4650
310
4660
315
320 Ultrasonography
4670
320
4680
4710
$285,080
$336,736
330
4720
$116,185
$400,377
335
4730
340
4740
345
350 Lithotripsy
4750
350
4760
4770
4780
365
4790
370
4800
375
4820
380
4830
385
4840
390
4860
395
4870
230
$132,479
235
240
245
$497,989
$1,305,612
$651,606
$3,188,312
250
255
260
295
$438,923
$3,573,042
300
325
355
$34,213
360
400
$2,194,649
$8,936,558
405
$4,369,987
$16,127,171
OTHER PAYORS
415
OTHER INDIGENT
Inpatient
Outpatient
Inpatient
Outpatient
$61,592
$220,340
425
420
426
$1,896,863
$6,785,813
430
435
440
445
450
$1,958,455
$7,006,153
$2,411,532
$9,121,018
455
457
460
06/30/2014
TOTAL
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(21) Gross
Inpatient Revenue
(22) Gross
Outpatient
Revenue
ANCILLARY SERVICES:
230 Labor and Delivery Services
4400
$4,445,663
4420
$16,946,222
4430
245 Anesthesiology
4450
4470
4480
4500
4520
265
4540
270
275 Echocardiology
4560
275
4570
280
4590
285
290 Electromyography
4610
290
295 Electroencephalography
4620
4630
4640
305
4650
310
4660
315
320 Ultrasonography
4670
320
4680
4710
$15,162,709
$7,619,326
$22,782,035
330
4720
$18,696,468
$6,021,125
$24,717,593
335
4730
4740
$1,305,622
$15,650
$1,321,272
350 Lithotripsy
4750
4760
4770
4780
365
4790
370
4800
375
4820
380
4830
385
4840
390
4860
395
4870
$24,675,730
$4,445,663
230
$41,621,952
235
240
245
$10,179,660
$10,200,164
$20,379,824
$27,145,114
$35,811,283
$62,956,397
250
255
260
295
$14,988,431
$56,791,699
$71,780,130
300
325
340
345
350
355
$4,385,608
$2,682,811
$7,068,419
360
400
$113,255,497
$143,817,788
$257,073,285
405
$210,629,453
$220,282,158
$430,911,611
415
Total Inpatient
Total Outpatient
Total
$3,399,094
420
$325,564,808
425
426
$9,647,418
430
435
440
445
$12,064,009
450
$350,675,329
455
457
$80,236,282
460
(1)
06/30/2014
Other Operating
Revenue
Line
No
5650
10
5660
10
15
5670
20
5680
25
Other Commissions
5710
25
30
5730
30
35
Other (Specify)
15
$689
20
35
40
40
45
45
50
50
65
5470
70
Donated Blood
5750
75
5690
80
Television/Radio Rentals
5720
85
5520
90
5760
95
Other (Specify)
65
70
$1,571
75
80
($21,333)
85
90
95
100
100
105
105
110
110
115
115
120
($19,073)
120
130
5320
135
5340
$149,760
130
135
140
5350
140
145
5370
145
150
5380
150
155
5390
155
160
Parking Revenue
5430
160
165
5440
165
170
5480
175
5700
180
5740
180
185
5790
185
190
5782
190
195
5770
195
196
Reinsurance Recoveries
5781
200
170
$14,190
175
196
$1,885,759
200
205
205
210
210
215
215
220
$2,049,709
225
220
5010
225
230
5220
230
235
5230
235
240
5240
240
245
5250
245
250
5260
250
255
5270
255
260
5280
260
270
5790
270
275
TOTAL PART IV
280
275
$2,030,636
280
06/30/2014
COMPENSATION
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
(1)
Salaries
and Wages
No
.07
(2)
Employee
Benefits
.10-.19
(3)
Professional Fees
(4)
Total
Compensation
Line
No
.20
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
40
45
Medical/Surgical Acute
6170
45
50
Pediatric Acute
6290
50
55
6340
55
60
6360
65
Obstetrics Acute
6380
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
$55,225
$55,225
60
$108,193
$108,193
65
145
$163,418
$163,418
150
$2,263,564
$2,263,564
160
AMBULATORY SERVICES
160 Emergency Services
7010
7040
7060
175 Clinics
7070
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
165
170
$460,163
$460,163
175
220
$2,723,727
$2,723,727
225
06/30/2014
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(5)
Research
Supported by
Hospital
(6)
Medical
Education
Supported by
Hospital (NonInservice)
(7)
General
Administration
and Hospital
Committees
(8)
Nursing and
Paramedical Care Line
of Hospital
No
Patients
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
40
45
Medical/Surgical Acute
6170
45
50
Pediatric Acute
6290
50
55
6340
55
60
6360
65
Obstetrics Acute
6380
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
$55,225
60
$108,193
65
145
$163,418
150
$2,263,564
160
AMBULATORY SERVICES
160 Emergency Services
7010
7040
7060
175 Clinics
7070
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
165
170
$460,163
175
220
$2,723,727
225
06/30/2014
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(9)
Physician and
Intern/Resident
Care of Hospital
Patients
(10)
(13)
Supervision and
Allocation of
Other Functions
Page 16, Column Line
of the Cost Center (9), to Revenue
No
Centers (See
Instructions)
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
40
45
Medical/Surgical Acute
6170
45
50
Pediatric Acute
6290
50
55
6340
55
60
6360
60
65
Obstetrics Acute
6380
65
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
145
150
AMBULATORY SERVICES
160 Emergency Services
7010
160
7040
165
7060
170
175 Clinics
7070
175
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
220
225
06/30/2014
COMPENSATION
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
(1)
Salaries
and Wages
No
.07
(2)
Employee
Benefits
.10-.19
(3)
Professional
Fees
(4)
Total
Compensation
Line
No
.20
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
230
7420
235
7430
245 Anesthesiology
7450
7470
7480
7500
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
7630
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
325
7710
7720
7730
340
7740
345
350 Lithotripsy
7750
350
7760
355
7770
360
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
240
$865,031
$865,031
245
250
255
$95,024
$95,024
260
295
$121,428
$121,428
300
330
$102,261
$102,261
335
400
$1,183,744
$1,183,744
405
06/30/2014
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(5)
Research
Supported by
Hospital
(6)
Medical
Education
Supported by
Hospital (NonInservice)
(7)
General
Administration
and Hospital
Committees
(8)
Nursing and
Paramedical Care Line
of Hospital
No
Patients
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
230
7420
235
7430
245 Anesthesiology
7450
7470
7480
7500
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
7630
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
325
7710
7720
7730
340
7740
345
350 Lithotripsy
7750
350
7760
355
7770
360
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
240
$865,031
245
250
255
$95,024
260
295
$121,428
300
330
$102,261
335
400
$1,183,744
405
06/30/2014
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(9)
Physician and
Intern/Resident
Care of Hospital
Patients
(10)
(13)
Supervision and
Allocation of
Other Functions
Page 16, Column Line
of the Cost Center (9), to Revenue
No
Centers (See
Instructions)
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
230
7420
235
7430
240
245 Anesthesiology
7450
245
7470
250
7480
255
7500
260
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
295
7630
300
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
325
7710
330
7720
335
7730
340
7740
345
350 Lithotripsy
7750
350
7760
355
7770
360
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
400
405
06/30/2014
COMPENSATION
Line
No
Account
No
(1)
Salaries
and Wages
(2)
Employee
Benefits
(3)
Professional
Fees
(4)
Total
Compensation
Line
No
.07,.09
.10-.19
.20
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
205
8620
210
8630
215
8640
220
225 Personnel
8650
8660
8670
235
8680
240
8690
245
8700
8710
8720
260
8730
265
8740
270
8750
275
8760
280
8790
225
$4,013
$4,013
230
250
$76,520
$76,520
255
295
$80,533
$80,533
300
$4,151,422
$4,151,422
305
TOTAL
305 TOTAL PAGES 15 AND 16
06/30/2014
Line
No
(5)
Research
Supported by
Hospital
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(6)
Medical
Education
Supported by
Hospital (NonInservice)
(7)
General
Administration
and Hospital
Committees
(8)
Nursing and
Paramedical Care Line
of Hospital
No
Patients
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
205
8620
210
8630
215
8640
220
225 Personnel
8650
8660
8670
235
8680
240
8690
245
8700
8710
8720
260
8730
265
8740
270
8750
275
8760
280
8790
225
$4,013
230
250
$76,520
255
295
$80,533
300
TOTAL
305 TOTAL PAGES 15 AND 16
$4,151,422
TOTAL LINE 305
LINES 15-50
TOTAL LINE 305
TO PAGE 18,
PAGE 16,TO
TO PAGE 18,
COLUMN(3), LINE SAME LINES ON COLUMN(3) LINE
5
PAGE 18, COL.(3);
295
OTHERS TO
PAGE 18,
COLUMN(3), LINE
15
305
LINE ITEMS TO
PAGE 17,
COLUMN(3)
LINES AS
APPROPRIATE
(SEE
INSTRUCTIONS)
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(9)
Physician and
Intern/Resident
Care of Hospital
Patients
(10)
Supervision and
Other Functions Line
of the Cost Center No
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
205
8620
210
8630
215
8640
220
225 Personnel
8650
225
8660
230
8670
235
8680
240
8690
245
8700
250
8710
255
8720
260
8730
265
8740
270
8750
275
8760
280
8790
295
300
TOTAL
305 TOTAL PAGES 15 AND 16
305
LINE 50 TO PAGE
15, COLUMN(13)
(SEE
INSTRUCTIONS)
LINE ITEMS TO
PAGES 17 & 18,
COLUMN(3),
LINES AS
APPROPRIATE
(SEE
INSTRUCTIONS)
06/30/2014
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(1)
Salaries
and Wages
.00-.06,.08,
.09,.91,.95
.10-.19,.92-.96
$3,749,518
$1,292,264
06/30/2014
(3)
Reclassified
Physician and
Student
Compensation
Pages 15 &16,
Cols. (8) & (10)
(4)
Professional Fees
.07,.10-.19,.20
.21-.29
Line
No
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
45
Medical/Surgical Acute
6170
50
Pediatric Acute
6290
50
55
6340
55
60
6360
65
Obstetrics Acute
6380
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
$3,118
40
$7,039,797
$2,426,252
$38,376
45
60
$2,357,807
$812,614
$11,063
65
145
$13,147,122
$4,531,130
$52,557
150
$4,849,548
$1,671,387
$36,773
160
AMBULATORY SERVICES
160 Emergency Services
7010
7040
7060
175 Clinics
7070
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
165
170
$553,597
$190,796
175
220
$5,403,145
$1,862,183
$36,773
225
Line
No
PATIENT
REVENUE PRODUCING CENTERS
(5)
Supplies
Account
No
.31-.50,.93,.97
.61-.69
$160,127
$1,246
(7)
Depreciation
.71-.74
06/30/2014
(8)
Leases
and Rentals
Line
No
.75-.76
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
45
Medical/Surgical Acute
6170
50
Pediatric Acute
6290
50
55
6340
55
60
6360
65
Obstetrics Acute
6380
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
40
$282,914
$162,459
45
60
$68,228
$39,509
65
145
$511,269
$203,214
150
$70,166
$80,082
160
AMBULATORY SERVICES
160 Emergency Services
7010
7040
7060
175 Clinics
7070
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
165
170
$118,116
$46,301
175
220
$188,282
$126,383
225
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
Natural Classification Code
(11)
Adjustments of
Direct Expenses
from Page 14,
Parts I & II
06/30/2014
(12) (Optional)
Adjusted Direct
Expenses [Cols. Line
(10) minus (11)] to No
Page 20, Column
(1)
.77-.90,.94-.98
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
45
Medical/Surgical Acute
6170
50
Pediatric Acute
6290
50
55
6340
55
60
6360
65
Obstetrics Acute
6380
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
$1,890
$5,208,163
40
$14,654
$9,964,452
45
60
$7,041
$3,296,262
65
145
$23,585
$18,468,877
150
$31,428
$6,739,384
160
AMBULATORY SERVICES
160 Emergency Services
7010
7040
7060
175 Clinics
7070
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
165
170
$1,403
$910,213
175
220
$32,831
$7,649,597
225
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(13) (Optional)
Units of Service
from Page 4,
Columns (4) + (5)
or Col(1)
Line
No
6010
10
Coronary Care
6030
10
15
6050
15
20
6070
20
25
6090
25
30
Burn Care
6110
30
35
6130
35
40
Definitive Observation
6150
40
45
Medical/Surgical Acute
6170
45
50
Pediatric Acute
6290
50
55
6340
55
60
6360
60
65
Obstetrics Acute
6380
65
70
6400
70
75
6420
75
80
6440
80
85
6470
85
90
6510
90
95
Nursery Acute
6530
95
6560
100
6570
101
6580
105
6610
110
6630
115
6680
120
6780
125
6900
145
150
AMBULATORY SERVICES
160 Emergency Services
7010
160
7040
165
7060
170
175 Clinics
7070
175
7180
180
7200
185
7220
190
7230
195
7260
200
7290
205
7310
210
7320
215
7390
220
225
06/30/2014
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(1)
Salaries
and Wages
.00-.06,.08,
.09,.91,.95
.10-.19,.92-.96
06/30/2014
(3)
Reclassified
Physician and
Student
Compensation
Pages 15 &16,
Cols. (8) & (10)
(4)
Professional
Fees
.07,.10-.19,.20
.21-.29
Line
No
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
$1,534,455
$528,847
230
7420
$2,725,342
$939,284
235
7430
240
245 Anesthesiology
7450
245
7470
250
7480
7500
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
7630
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
325
7710
7720
7730
340
7740
345
350 Lithotripsy
7750
350
7760
7770
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
255
$1,933,693
$666,444
260
295
$2,621,727
$903,573
$49,899
300
330
$1,455,325
$501,575
$3,316
335
355
$753,592
360
400
$10,270,542
$3,539,723
$806,807
405
7900
7950
410
411
$28,820,809
$9,933,036
$896,137
415
Line
No
PATIENT
REVENUE PRODUCING CENTERS
(5)
Supplies
Account
No
.31-.50,.93,.97
(6)
Purchased
Services
.61-.69
(7)
Depreciation
.71-.74
06/30/2014
(8)
Leases
and Rentals
Line
No
.75-.76
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
$84,262
$223
7420
($30,272)
$24,312
7430
245 Anesthesiology
7450
7470
7480
7500
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
7630
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
7710
$1,559,653
7720
$24,460
$2,837
7730
7740
$97
$207,682
350 Lithotripsy
7750
7760
7770
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
230
$20,751
235
240
245
$2,956,920
250
255
$1,076,486
$345,712
260
295
$279,497
$72,098
$217,846
300
325
330
335
340
345
350
355
$315
360
400
$5,951,418
$652,864
$238,597
405
7900
7950
410
411
$6,650,969
$982,461
$238,597
415
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
Natural Classification Code
(11)
Adjustments of
Direct Expenses
from Page 14,
Parts I & II
06/30/2014
(12) (Optional)
Adjusted Direct
Expenses [Cols. Line
(10) minus (11)] to No
Page 20, Column
(1)
.77-.90,.94-.98
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
7420
7430
245 Anesthesiology
7450
7470
7480
7500
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
7630
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
7710
7720
7730
7740
350 Lithotripsy
7750
7760
7770
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
$6,150
$2,147,787
230
$3,685,567
235
240
245
$2,956,920
250
255
$17,526
$4,039,861
260
295
$57,218
$4,201,858
300
325
$10,541
$1,559,653
330
$1,998,054
335
340
$207,779
345
350
355
$1,508
$755,415
360
400
$92,943
$21,552,894
405
7900
7950
410
411
$149,359
$47,671,368
415
Line
No
PATIENT
REVENUE PRODUCING CENTERS
Account
No
(13) (Optional)
Units of Service
from Page 4,
Columns (4) + (5)
or Col(1)
Line
No
ANCILLARY SERVICES
230 Labor and Delivery Services
7400
230
7420
235
7430
240
245 Anesthesiology
7450
245
7470
250
7480
255
7500
260
7520
265
7540
270
275 Echocardiology
7560
275
7570
280
7590
285
290 Electromyography
7610
290
295 Electroencephalography
7620
295
7630
300
7640
305
7650
310
7660
315
320 Ultrasonography
7670
320
7680
325
7710
330
7720
335
7730
340
7740
345
350 Lithotripsy
7750
350
7760
355
7770
360
7780
365
7790
370
7800
375
7820
380
7830
385
7840
390
7860
395
7870
400
405
7900
7950
410
411
415
06/30/2014
NON-REVENUE
PRODUCING CENTERS
Line
No
Account
No
(1)
Salaries
and Wages
.00-.06,.08,
.09,.91,.95
.10-.19,.92-.96
06/30/2014
(3)
Reclassified
Physician and
Student
Compensation
Pages 15 &16,
Cols. (5),(6),(7),
(8)& (10)
(4)
Professional
Fees
.07,.10-.19,.20
.21-.29
Line
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
8310
55
60
Kitchen
8320
60
65
8330
70
Dietary
8340
75
8350
80
8360
85
Central Transportation
8370
90
8380
95
Pharmacy
8390
$892,226
$307,504
95
8400
$436,246
$150,351
100
105 Grounds
8410
110 Security
8420
$114,881
$39,594
115 Parking
8430
120 Housekeeping
8440
$804,314
$277,205
8450
8460
$952,859
$328,401
130
135 Communications
8470
$181,797
$62,656
135
8480
$71,956
$24,799
140
8490
$4,643,836
$1,600,488
$360,774
150
$158,147
$54,505
$8,383
155
65
$1,091,152
$376,063
$98,405
$33,915
70
75
80
85
90
105
$360,774
110
115
120
125
145
FISCAL SERVICES
155 General Accounting
8510
8530
8550
170 Admitting
8560
8570
8590
160
165
$1,084,230
$373,678
170
175
195
$1,242,377
$428,183
$8,383
200
NON-REVENUE
PRODUCING CENTERS
Line
No
(5)
Supplies
Account
No
.31-.50,.93,.97
(6)
Purchased
Services
.61-.69
(7)
Depreciation
.71-.74
06/30/2014
(8)
Leases and
Rentals
Line
No
.75-.76
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
8310
55
60
Kitchen
8320
60
65
8330
70
Dietary
8340
75
8350
80
8360
85
Central Transportation
8370
90
8380
$60,040
95
Pharmacy
8390
$220,093
$142,383
95
8400
$193,641
$2,636
100
105 Grounds
8410
110 Security
8420
$8,230
$7,836
110
115 Parking
8430
120 Housekeeping
8440
$180,488
$270,920
120
8450
$3,536
8460
$172,121
$1,548,287
135 Communications
8470
$220
$46,634
8480
$11,125
$2,953,723
$91,013
8490
$28,140
$1,167,098
$4,972,527
$181,005
$123
$548,009
65
$288,881
$108
70
75
$583
80
85
$89,992
90
105
115
125
130
135
140
145
150
FISCAL SERVICES
155 General Accounting
8510
8530
8550
170 Admitting
8560
8570
8590
155
160
165
$21,001
$5,662
170
175
195
$21,124
$553,671
200
Line
No
Account
No
Natural Classification Code
(9)
Other Direct
Expenses
NON REVENUE
PRODUCING CENTERS
(10)
Total Direct
Expenses
Columns (1) thru
(9)
(11)
Adjustments of
Direct Expenses
from Page 14,
Parts I & II
06/30/2014
(12) (Optional)
Adjusted Direct
Expenses [Cols. Line
(10) minus (11)] to No
Page 20, Column
(1)
.77-.90,.94-.98
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
8310
55
60
Kitchen
8320
60
65
8330
70
Dietary
8340
75
8350
80
8360
85
Central Transportation
8370
90
8380
95
Pharmacy
8390
$16,903
$1,579,109
95
8400
$26,113
$808,987
100
105 Grounds
8410
110 Security
8420
$2,614
$533,929
110
115 Parking
8430
120 Housekeeping
8440
$9,321
$1,542,248
120
8450
$3,536
125
8460
$811,254
$3,812,922
130
135 Communications
8470
$116,241
$407,548
135
8480
$3,152,616
140
8490
$28,140
65
$2,231
$1,758,435
$71
$132,974
$1,571
70
75
80
85
$150,032
90
105
115
145
$984,748
$13,910,476
$1,571
150
$162,079
$931,246
($21,333)
155
FISCAL SERVICES
155 General Accounting
8510
8530
8550
170 Admitting
8560
8570
8590
160
165
$1,744
$1,486,315
170
175
195
$163,823
$2,417,561
($21,333)
200
NON REVENUE
PRODUCING CENTERS
Line
No
(13)
Units of Service
Account
No
(14)(Optional)
Adjusted Direct
Expenses Per
Unit Column (12)
(13)
Line
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
8010
5
10
EDUCATION COSTS
15
8210
15
20
School of Nursing
8220
20
25
8230
25
30
8240
30
35
Paramedical Education
8250
35
40
Student Housing
8260
40
45
8290
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
8310
55
60
Kitchen
8320
60
65
8330
70
Dietary
8340
75
8350
80
8360
85
Central Transportation
8370
90
8380
21,123
95
Pharmacy
8390
15,853
95
8400
8,007
100
105 Grounds
8410
110 Security
8420
115 Parking
8430
120 Housekeeping
65
36,112
70
75
2,129
80
85
90
105
372
110
8440
105,453
120
8450
120,619
125
8460
120,619
130
135 Communications
8470
372
135
8480
430,912
140
8490
115
145
150
FISCAL SERVICES
155 General Accounting
8510
8530
8550
170 Admitting
8560
8570
175
8590
195
372
155
160
165
2,893
170
200
06/30/2014
NON REVENUE
PRODUCING CENTERS
Line
No
Account
No
(1)
Salaries
and Wages
.00-.06,.08,
.09,.91,.95
.10-.19,.92-.96
$2,227,235
$767,614
$26,322
$9,072
06/30/2014
(3)
Reclassified
Physician and
Student
Compensation
Pages 15 & 16,
Cols. (5),(6),(7),(8)
& (10)
(4)
Professional
Fees
.07,.10-.19,.20
.21-.29
Line
No
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
8620
8630
8640
225 Personnel
8650
$126,476
$43,590
$51,917
225
8660
$179,113
$61,731
$11,339
230
8670
$31,239
$10,766
235
8680
$115,142
$39,683
240
8690
8700
$816,950
$281,560
$207,244
250
8710
$152,163
$52,443
$232,440
255
8720
$570,924
$196,768
$26,604
260
8730
8740
$77,645
$26,760
8750
$1,152,278
$397,130
8770
$404,692
$139,476
8790
$371,449
205
210
215
220
245
265
270
$251,856
280
$4,151,422
$5,880,179
$2,026,593
275
$4,151,422
295
$1,152,849
300
UNASSIGNED COSTS
305 Depreciation and Amortization
8810
305
8820
310
8830
315
8840
320
8850
325
8860
330
8870
345
8880
350
8890
355
360
TOTAL
365 TOTAL OPERATING COSTS (17 & 18)
$40,587,201
$13,988,300
$4,151,422
$40,587,201
$13,988,300
$4,151,422
$2,418,143
365
$146,926
370
$2,565,069
375
NON REVENUE
PRODUCING CENTERS
Line
No
(5)
Supplies
Account
No
(6)
Purchased
Services
.31-.50,.93,.97
.61-.69
$36,790
$3,056,730
$1,549
$18,774
$11,391
(7)
Depreciation
.71-.74
06/30/2014
(8)
Leases and
Rentals
Line
No
.75-.76
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
8620
8630
8640
225 Personnel
8650
$8,666
8660
$10,846
8670
$10,019
8680
$108
8690
8700
$24,913
$101,023
8710
$4,739
$44,565
255
8720
$2,294
$341
260
8730
8740
$8,406
$56
8750
$5,603
$27,897
8770
$10,516
$418
$49,927
8790
$124,449
$3,274,587
$127,217
($1,770)
205
210
215
220
$47,788
225
$30,775
230
$13,392
235
240
245
$497
250
265
270
275
280
295
300
UNASSIGNED COSTS
305 Depreciation and Amortization
8810
8820
$5,641,101
305
310
8830
315
8840
320
8850
325
8860
330
8870
345
8880
350
8890
355
$5,641,101
360
TOTAL
365 TOTAL OPERATING COSTS (17 & 18)
370 Non-Operating Cost Centers
375 TOTAL COSTS
$7,963,640
$9,783,246
$5,641,101
$546,819
365
$43,660
$192,403
$246,129
($7,109)
370
$8,007,300
$9,975,649
$5,887,230
$539,710
375
NON REVENUE
PRODUCING CENTERS
Line
No
(11)
Adjustments of
Direct Expenses
from Page 14,
Parts I & II
$2,181,919
$8,639,967
$689
$440,820
$496,537
Account
No
Natural Classification Code
06/30/2014
(12) (Optional)
Adjusted Direct
Expenses [Cols. Line
(10) minus (11)] to No
Page 20, Column
(1)
.77-.90,.94-.98
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
8620
8630
8640
225 Personnel
8650
$306,959
$596,787
225
8660
$8,320
$302,124
230
8670
$2,684
$68,100
235
8680
$5,552
$160,485
240
8690
8700
$8,432
$1,440,619
250
8710
$468,300
$954,650
255
8720
$1,009
$797,940
260
8730
8740
$56,640
$169,507
270
8750
$26,538
$1,861,302
275
8770
$50,753
$655,782
280
8790
205
210
215
220
245
265
$4,151,422
$3,557,926
$20,295,222
295
$689
300
UNASSIGNED COSTS
305 Depreciation and Amortization
8810
8820
8830
$310,671
$310,671
315
8840
$168,074
$168,074
320
8850
$284,523
$284,523
325
8860
8870
$1,984,617
$1,984,617
345
8880
$744,732
$744,732
350
8890
$3,492,617
$9,133,718
$8,348,473
$93,428,345
$162,235
$784,244
$8,510,708
$94,212,589
$5,641,101
305
310
330
355
360
TOTAL
365 TOTAL OPERATING COSTS (17 & 18)
370 Non-Operating Cost Centers
375 TOTAL COSTS
($19,073)
365
370
($19,073)
375
NON REVENUE
PRODUCING CENTERS
Line
No
(13)
Units of Service
Account
No
(14)(Optional)
Adjusted Direct
Expenses Per
Unit Column (12)
(13)
Line
No
ADMINISTRATIVE SERVICES
205 Hospital Administration
8610
8620
372
205
8630
8640
225 Personnel
8650
372
225
8660
372
230
8670
11,100
235
8680
10,551
240
8690
8700
21,586
250
8710
186
255
8720
111
260
8730
8740
1,307
270
8750
2,893
275
8770
1,553
280
8790
210
432,942
215
220
245
265
295
300
UNASSIGNED COSTS
305 Depreciation and Amortization
8810
8820
8830
430,912
315
8840
120,619
320
8850
120,619
325
8860
8870
120,619
345
8880
372
350
8890
120,619
305
310
330
355
360
TOTAL
365 TOTAL OPERATING COSTS (17 & 18)
365
370
375
06/30/2014
(5) Hospital
FTE's
Line
No
LINES BEING ALLOCATED
5-25
30-80
85-100
(7) Square
Feet Serviced
105
110
Line
No
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
35
Hospital Administration
40
40
45
Public Relations
45
50
Management Engineering
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
85
Personnel
90
95
30
5,514
35
50
1,400
55
80
1,480
85
943
90
1,761
100
2,194
105
110 Housekeeping
1,686
110
95
115 Grounds
120 Security
115
32
32
2,348
2,348
130
129
129
135
3,332
3,332
125 Parking
130 Plant Operations
135 Plant Maintenance
125
140
155
2,461
2,461
160
165
145
150
120
170
725
725
1,010
1,010
185
391
391
190
97
97
195
712
524
200
609
609
180
175
205
210
215
220
190
190
225
84
84
230
1,778
1,778
235
850
850
240
245
250
255
260
265
270
275
280
145
150
155-215
Line
No
220
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
69
240
245
250
255
260
265
270
275
280
(13)Nursing
FTE's
(14) Central
Service and
Supply Costed
Requisitions
(15) Pharmacy
Costed
Requisitions
225-230
235
240
Line
No
250-255
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
(19) Nursing
Student
Departmental
Assignment
260-265
(21) Medical
PostGraduate
Departmental
Assignment
Line
No
280
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
(5) Hospital
FTE's
Line
No
LINES BEING ALLOCATED
DAILY HOSPITAL SERVICES
505 Medical/Surgical Intensive Care
5-25
4,297
30-80
85-100
(7) Square
Feet Serviced
105
110
Line
No
4,297
505
510
515
520
525
530
535
540
17,735
17,735
545
550
555
560
6,864
6,864
565
570
575
580
585
590
1,579
1,579
595
600
601
605
610
615
620
625
645
AMBULATORY SERVICES
660 Emergency Services
3,399
3,399
665
660
670
5,280
5,280
675
680
685
690
695
700
705
710
715
720
ANCILLARY SERVICES
730 Labor and Delivery Services
2,291
2,291
730
8,053
8,053
735
740
745 Anesthesiology
745
750
755
3,246
3,246
760
765
770
775 Echocardiology
775
780
145
150
3,327
18,873
155-215
Line
No
220
505
510
515
520
525
530
535
540
27,835
108,630
545
550
555
560
4,950
16,032
565
570
575
580
585
590
7,235
595
600
601
605
610
615
620
625
645
AMBULATORY SERVICES
660 Emergency Services
44,700
665
660
670
2,740
675
680
685
690
695
700
705
710
715
720
ANCILLARY SERVICES
730 Labor and Delivery Services
13,982
730
89,176
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
(13)Nursing
FTE's
(14) Central
Service and
Supply Costed
Requisitions
(15) Pharmacy
Costed
Requisitions
225-230
235
240
$150,653
$9,474
Line
No
DAILY HOSPITAL SERVICES
505 Medical/Surgical Intensive Care
250-255
505
510
515
520
525
530
535
540
$264,294
$18,523
545
550
555
560
$67,622
$606
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
AMBULATORY SERVICES
660 Emergency Services
$45,494
$24,672
665
660
670
$93,636
$152
675
680
685
690
695
700
705
710
715
720
ANCILLARY SERVICES
730 Labor and Delivery Services
$78,845
$5,417
730
$219,149
$19,041
735
740
745 Anesthesiology
750 Medical Supplies Sold to Patients
745
$2,956,920
$8
750
755
$1,076,493
760
765
770
775 Echocardiology
775
780
(19) Nursing
Student
Departmental
Assignment
260-265
(21) Medical
PostGraduate
Departmental
Assignment
Line
No
280
505
510
515
520
525
530
535
540
545
550
555
560
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
AMBULATORY SERVICES
660 Emergency Services
660
665
670
675 Clinics
675
680
685
690
695
700
705
710
715
720
ANCILLARY SERVICES
730 Labor and Delivery Services
730
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
(5) Hospital
FTE's
Line
No
LINES BEING ALLOCATED
5-25
30-80
85-100
(7) Square
Feet Serviced
105
110
Line
No
785
790 Electromyography
790
795 Electroencephalography
800 Radiology - Diagnostic
795
7,900
7,900
800
805
810
815
820 Ultrasonography
820
825
830
917
917
835
840
845
850 Lithotripsy
850
855
1,277
1,277
860
865
870
875
880
885
890
895
900
910
911
28,055
28,055
915
120,619
105,453
920
925
930
935
940
145
150
155-215
Line
No
220
785
790 Electromyography
790
795 Electroencephalography
795
17,586
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
221
860
865
870
875
880
885
890
895
900
910
911
915
36,112
319,244
920
925
930
935
940
(13)Nursing
FTE's
(14) Central
Service and
Supply Costed
Requisitions
(15) Pharmacy
Costed
Requisitions
225-230
235
240
Line
No
250-255
785
790 Electromyography
790
795 Electroencephalography
800 Radiology - Diagnostic
795
$278,467
$1,184
800
805
810
815
820 Ultrasonography
820
825
$1,559,653
830
$24,277
$183
835
$3
$94
840
850 Lithotripsy
850
845
855
$315
860
865
870
875
880
885
890
895
900
910
911
915
$5,256,168
$1,639,007
920
925
930
935
940
(19) Nursing
Student
Departmental
Assignment
260-265
(21) Medical
PostGraduate
Departmental
Assignment
Line
No
280
785
790 Electromyography
790
795 Electroencephalography
795
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
860
865
870
875
880
885
890
895
900
910
911
915
920
925
930
935
940
COST ALLOCATION
(2)Square Feet
06/30/2014
(3)Subtotal
Line
No
5-25
Interest - Other
8870
10
Insurance - Other
8840
10
15
8850
15
20
8810
20
25
8820
25
30
8860
30
35
Hospital Administration
8610
35
40
8620
40
45
Public Relations
8630
45
50
Management Engineering
8640
50
55
8770
55
60
8790
60
65
General Accounting
8510
65
70
Communications
8470
70
75
8590
75
80
8310
80
85
Personnel
8650
85
90
8660
90
95
8880
95
8330
100
8400
105
110 Housekeeping
8440
110
115 Grounds
8410
115
120 Security
8420
120
125 Parking
8430
125
8450
130
8460
135
8490
140
145 Dietary
8340
145
8350
150
8530
155
8480
160
8550
165
8670
170
8680
175
8690
180
8700
185
8710
190
8360
195
8750
200
8830
205
210 Admitting
8560
210
8890
215
8570
220
8720
225
8740
230
8380
235
240 Pharmacy
8390
240
8010
245
8210
250
8260
255
8230
260
8220
265
8250
270
8290
275
8260
280
285
COST ALLOCATION
(4)Accumulated
Costs
30-80
105
06/30/2014
(7)Square Feet
Serviced
Line
No
110
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
COST ALLOCATION
(8)Square Feet
from Column (2)
(9)Meals Served
(10)Dry Pounds
Processed
115-140
145
150
06/30/2014
(11)Gross Patient
Line
Revenue from Page No
12, Column 23
155-215
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
COST ALLOCATION
06/30/2014
(12)Gross
Outpatient Revenue
from Page
12,Column 22
(13)Nursing
FTE's
(14)Central Service
and Supply Costed
Requisitions
(15) Pharmacy
Costed
Requisitions
Line
No
220
225-230
235
240
No
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
COST ALLOCATION
06/30/2014
(17)Gross Patient
Revenue from
Column (11)
(18) Students in
All Approved
Programs
(19)Nursing Student
Departmental
Assignment
245
250-255
260-265
Line
No
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
285
COST ALLOCATION
(20)Paramedic Student
Departmental
Assignment
(21)Medical
Postgraduate
Departmental
Assignment
270-275
280
06/30/2014
(22)Transfers
for Operating
Costs
(23)Total
Line
No
Interest - Other
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
255
260
265
270
275
280
COST ALLOCATION
(2)Square Feet
06/30/2014
(3)Subtotal
Line
No
5-25
5320
350
5340
355
5350
360
5370
365
5380
370
5390
375
5430
380
5440
385
5480
390
5700
395
5740
400
5782
405
5770
410
5781
411
5790
415
5780
420
5780
425
5780
430
5780
435
440
445
6010
505
6030
510
6050
515
6070
520
6090
525
6110
530
6130
535
6150
540
6170
545
6290
550
6340
555
6360
560
6380
565
6400
570
6420
575
6440
580
6470
585
6510
590
6530
595
6560
600
6570
601
6580
605
6610
610
6630
615
6680
620
6780
625
6900
645
650
AMBULATORY SERVICES
660 Emergency Services
7010
660
7040
665
7060
670
COST ALLOCATION
(4)Accumulated
Costs
30-80
105
06/30/2014
(7)Square Feet
Serviced
Line
No
110
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
440
445
505
510
515
520
525
530
535
540
545
550
555
560
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
650
AMBULATORY SERVICES
660 Emergency Services
660
665
670
COST ALLOCATION
(8)Square Feet
from Column (2)
(9)Meals Served
(10)Dry Pounds
Processed
115-140
145
150
06/30/2014
(11)Gross Patient
Line
Revenue from Page No
12, Column 23
155-215
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
440
445
505
510
515
520
525
530
535
540
545
550
555
560
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
650
AMBULATORY SERVICES
660 Emergency Services
660
665
670
COST ALLOCATION
06/30/2014
(12)Gross
Outpatient Revenue
from Page
12,Column 22
(13)Nursing
FTE's
(14)Central Service
and Supply Costed
Requisitions
(15) Pharmacy
Costed
Requisitions
Line
No
220
225-230
235
240
No
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
440
445
505
510
515
520
525
530
535
540
545
550
555
560
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
650
AMBULATORY SERVICES
660 Emergency Services
660
665
670
COST ALLOCATION
06/30/2014
(17)Gross Patient
Revenue from
Column (11)
(18) Students in
All Approved
Programs
(19)Nursing Student
Departmental
Assignment
245
250-255
260-265
Line
No
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
440
445
505
510
515
520
525
530
535
540
545
550
555
560
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
650
AMBULATORY SERVICES
660 Emergency Services
660
665
670
COST ALLOCATION
(20)Paramedic Student
Departmental
Assignment
(21)Medical
Postgraduate
Departmental
Assignment
270-275
280
06/30/2014
(22)Transfers
for Operating
Costs
(23)Total
Line
No
350
355
360
365
370
375
380
385
390
395
400
405
410
411
415
420
425
430
435
440
445
505
510
515
520
525
530
535
540
545
550
555
560
565
570
575
580
585
590
595
600
601
605
610
615
620
625
645
650
AMBULATORY SERVICES
660 Emergency Services
660
665
670
COST ALLOCATION
(2)Square Feet
06/30/2014
(3)Subtotal
Line
No
5-25
675 Clinics
7070
675
7180
680
7200
685
7220
690
7230
695
7260
700
7290
705
7310
710
7320
715
7390
720
725
ANCILLARY SERVICES
730 Labor and Delivery Services
7400
7420
735
7430
740
745 Anesthesiology
7450
745
7470
750
7480
755
7500
760
7520
765
7540
770
775 Echocardiology
7560
775
7570
780
7590
785
790 Electromyography
7610
790
795 Electroencephalography
7620
795
7630
800
7640
805
7650
810
7660
815
820 Ultrasonography
7670
820
7680
825
7710
830
7720
835
7730
840
7740
845
850 Lithotripsy
7750
850
7760
855
7770
860
7780
865
7790
870
7800
875
7820
880
7830
885
7840
890
7860
895
7870
900
730
905
7900
7950
910
911
915
-0-
920
COST ALLOCATION
(4)Accumulated
Costs
30-80
105
06/30/2014
(7)Square Feet
Serviced
Line
No
110
675 Clinics
675
680
685
690
695
700
705
710
715
720
725
ANCILLARY SERVICES
730 Labor and Delivery Services
730
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
785
790 Electromyography
790
795 Electroencephalography
795
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
860
865
870
875
880
885
890
895
900
905
910
911
915
920 TOTAL
-0-
-0-
-0-
-0-
920
COST ALLOCATION
(8)Square Feet
from Column (2)
(9)Meals Served
(10)Dry Pounds
Processed
115-140
145
150
06/30/2014
(11)Gross Patient
Line
Revenue from Page No
12, Column 23
155-215
675 Clinics
675
680
685
690
695
700
705
710
715
720
725
ANCILLARY SERVICES
730 Labor and Delivery Services
730
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
785
790 Electromyography
790
795 Electroencephalography
795
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
860
865
870
875
880
885
890
895
900
905
910
911
915
920 TOTAL
-0-
-0-
-0-
-0-
920
COST ALLOCATION
06/30/2014
(12)Gross Patient
Revenue from Page
12,Column 22
(13)Nursing
FTE's
(14)Central Service
and Supply Costed
Requisitions
(15) Pharmacy
Costed
Requisitions
220
225-230
235
240
Line
No
No
675 Clinics
675
680
685
690
695
700
705
710
715
720
725
ANCILLARY SERVICES
730 Labor and Delivery Services
730
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
785
790 Electromyography
790
795 Electroencephalography
795
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
860
865
870
875
880
885
890
895
900
905
910
911
915
920 TOTAL
-0-
-0-
-0-
-0-
920
COST ALLOCATION
06/30/2014
(17)Gross Patient
Revenue from
Column (11)
(18) Students in
All Approved
Programs
(19)Nursing Student
Departmental
Assignment
245
250-255
260-265
Line
No
675 Clinics
675
680
685
690
695
700
705
710
715
720
725
ANCILLARY SERVICES
730 Labor and Delivery Services
730
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
785
790 Electromyography
790
795 Electroencephalography
795
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
860
865
870
875
880
885
890
895
900
905
910
911
915
920 TOTAL
-0-
-0-
-0-
920
COST ALLOCATION
(20)Paramedic Student
Departmental
Assignment
(21)Medical
Postgraduate
Departmental
Assignment
270-275
280
06/30/2014
(22)Transfers
for Operating
Costs
(23)Total
Line
No
675 Clinics
675
680
685
690
695
700
705
710
715
720
725
ANCILLARY SERVICES
730 Labor and Delivery Services
730
735
740
745 Anesthesiology
745
750
755
760
765
770
775 Echocardiology
775
780
785
790 Electromyography
790
795 Electroencephalography
795
800
805
810
815
820 Ultrasonography
820
825
830
835
840
845
850 Lithotripsy
850
855
860
865
870
875
880
885
890
895
900
905
910
911
915
920 TOTAL
-0-
-0-
-0-
920
06/30/2014
(4)Other Operating
Revenue Page 14, Col Line
(1),Line 210
No
Cost Recovery
Interest - Other
1
5
10
Insurance - Other
10
15
15
20
20
25
25
30
35
Hospital Administration
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
30
$1,885,759
35
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
Line
No
06/30/2014
(4)Other Operating
Revenue Page 14, Col Line
(1),Line 210
No
255
260
265
270
275
280
-0-
-0-
-0-
-0-
285
Cost Recovery
Interest - Other
1
5
10
Insurance - Other
10
15
15
20
20
25
25
30
30
35
Hospital Administration
35
40
40
45
Public Relations
45
50
Management Engineering
50
55
55
60
60
65
General Accounting
65
70
Communications
70
75
75
80
80
85
Personnel
85
90
90
95
95
100
105
110 Housekeeping
110
115 Grounds
115
120 Security
120
125 Parking
125
130
135
140
145 Dietary
145
150
155
160
165
170
175
180
185
190
195
200
205
210 Admitting
210
215
220
225
230
235
240 Pharmacy
240
245
250
06/30/2014
Line
No
255
260
265
270
275
280
-0-
-0-
285
06/30/2014
Account No
6010
505
6030
510
6050
515
6070
520
6090
525
6110
530
6130
535
6150
540
6170
545
6290
550
6340
555
6360
560
6380
565
6400
570
6420
575
6440
580
6470
585
6510
590
6530
595
6560
600
6570
601
6580
605
6610
610
6630
615
6680
620
6780
625
6900
645
650
AMBULATORY SERVICES
660 Emergency Services
7010
660
7040
665
7060
670
675 Clinics
7070
675
7180
680
7200
685
7220
690
7230
695
7260
700
7290
705
7310
710
7320
715
7390
720
725
06/30/2014
Account No
Line
No
ANCILLARY SERVICES
730 Labor and Delivery Services
7400
730
7420
735
7430
740
745 Anesthesiology
7450
745
7470
750
7480
755
7500
760
7520
765
7540
770
775 Echocardiology
7560
775
7570
780
7590
785
790 Electromyography
7610
790
795 Electroencephalography
7620
795
7630
800
7640
805
7650
810
7660
815
820 Ultrasonography
7670
820
7680
825
7710
830
7720
835
7730
840
7740
845
850 Lithotripsy
7750
850
7760
855
7770
860
7780
865
7790
870
7800
875
7820
880
7830
885
7840
890
7860
895
7870
900
905
-0-
920
06/30/2014
CLASSIFICATION DESCRIPTION
Line
No
Management and
Supervision
(3)
(4)
Technical and
Specialist
.00
06/30/2014
(5)
(6)
Registered
Nurses
.01
.02
Line
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
$70.02
1,717
$39.46
562
$81.05
36,641
No
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
45
Medical/Surgical Acute
50
Pediatric Acute
50
55
55
60
65
Obstetrics Acute
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
40
$70.80
403
$32.11
1,446
$71.20
64,234
45
60
$83.56
135
$83.22
19,423
65
95
100
101
105
110
115
120
125
145
2,255
2,008
120,298
150
44,310
160
AMBULATORY SERVICES
160 Emergency Services
$78.66
1,229
$51.74
2,948
$79.85
165
170
$73.91
2,044
$31.60
3,349
$77.21
318
175
180
185
190
195
200
205
210
215
220
3,273
6,297
44,628
225
CLASSIFICATION DESCRIPTION
Line
No
Licensed
Vocational Nurses
(9)
(10)
Aides and
Orderlies
.03
Average
Hourly Rate
06/30/2014
(11)
.04
Productive
Hours
(12)
.05
Line
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
$32.01
731
$29.00
1,496
No
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
45
Medical/Surgical Acute
50
Pediatric Acute
50
55
55
60
65
Obstetrics Acute
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
40
$44.55
9,838
$28.21
17,361
$27.20
5,314
45
60
$30.46
1,840
65
95
100
101
105
110
115
120
125
145
9,838
18,092
8,650
150
10,956
160
AMBULATORY SERVICES
160 Emergency Services
$30.51
165
170
$33.12
5,725
175
180
185
190
195
200
205
210
215
220
16,681
225
CLASSIFICATION DESCRIPTION
Line
No
Environmental and
Food Service
(15)
(16)
Productive
Hours
(17)
(18)
Physicians
(Salaried)
Non-Physicians Medical
Practitioners
.07
.08
.06
Average
Hourly Rate
06/30/2014
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Line
Productive
Hours
No
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
40
45
Medical/Surgical Acute
45
50
Pediatric Acute
50
55
55
60
60
65
Obstetrics Acute
65
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
95
100
101
105
110
115
120
125
145
150
AMBULATORY SERVICES
160 Emergency Services
160
165
170
175 Clinics
175
180
185
190
195
200
205
210
215
220
225
Line
No
(19)
CLASSIFICATION DESCRIPTION
(20)
Other Salaries
and Wages
(21)
Cost Center
Average Hourly
Rate
.09
Average Hourly
Rate
Line
Productive
Hours
No
10
Coronary Care
$73.82
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
45
Medical/Surgical Acute
50
Pediatric Acute
50
55
55
60
65
Obstetrics Acute
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
95
100
Sub-Acute Care
100
101
101
105
105
110
110
115
Intermediate Care
115
120
Residential Care
120
125
125
145
145
150
150
40
$56.55
45
60
$72.72
65
AMBULATORY SERVICES
160
Emergency Services
165
$67.01
160
170
175
Clinics
180
Satellite Clinics
180
185
185
190
190
195
Observation Care
195
200
200
205
205
210
210
215
215
220
220
225
225
165
170
$40.70
175
06/30/2014
21
Facility D.B.A. Name :
(24)
HOURS SUMMARY
Productive
Hours
NonProductive
Hours
Total Paid
Hours
41,147
9,649
50,796
06/30/2014
(25)
(Optional)
Full
Time
Equivalent
Employees
Line
No
Line
No
Column (22)
2080
10
Coronary Care
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
45
Medical/Surgical Acute
50
Pediatric Acute
50
55
55
60
65
Obstetrics Acute
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
40
98,596
25,888
124,484
45
60
21,398
11,023
32,421
65
95
100
101
105
110
115
120
125
145
161,141
46,560
207,701
150
59,443
12,925
72,368
160
AMBULATORY SERVICES
160 Emergency Services
165 Medical Transportation Services
165
170
11,436
2,167
13,603
175
180
185
190
195
200
205
210
215
220
70,879
15,092
85,971
225
CLASSIFICATION DESCRIPTION
Line
No
Management and
Supervision
(3)
(4)
Technical and
Specialist
.00
06/30/2014
(5)
(6)
Registered
Nurses
.01
Average
Hourly Rate
Productive
Hours
$72.05
1,558
$72.16
1,452
.02
Line
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
No
$75.84
18,399
230
$80.43
5,525
$101.09
14,557
235
ANCILLARY SERVICES
240
245 Anesthesiology
245
250
255
$64.03
1,805
$56.53
17,801
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
300 Radiology - Diagnostic
295
$67.07
1,438
$64.92
31,357
300
305
310
315
320 Ultrasonography
320
325
330
$57.29
1,493
$52.99
21,337
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
7,746
76,020
32,956
405
CLASSIFICATION DESCRIPTION
Line
No
Licensed
Vocational Nurses
(9)
(10)
Aides and
Orderlies
.03
Average
Hourly Rate
06/30/2014
(11)
.04
Productive
Hours
(12)
.05
Line
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
$25.60
1,795
$33.48
1,734
No
ANCILLARY SERVICES
230 Labor and Delivery Services
235 Surgery and Recovery Services
230
235
240
245 Anesthesiology
245
250
255
$29.69
19,174
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
295
$26.05
7,014
300
305
310
315
320 Ultrasonography
320
325
330
$31.76
389
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
1,795
28,311
405
CLASSIFICATION DESCRIPTION
Line
No
Environmental and
Food Service
(15)
(16)
Productive
Hours
(17)
(18)
Physicians
(Salaried)
Non-Physicians Medical
Practitioners
.07
.08
.06
Average
Hourly Rate
06/30/2014
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Line
Productive
Hours
No
ANCILLARY SERVICES
230 Labor and Delivery Services
230
235
240
245 Anesthesiology
245
250
255
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
295
300
305
310
315
320 Ultrasonography
320
325
330
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
405
Line
No
(19)
CLASSIFICATION DESCRIPTION
(20)
Other Salaries
and Wages
(21)
Cost Center
Average Hourly
Rate
.09
Average Hourly
Rate
Line
Productive
Hours
No
ANCILLARY SERVICES
230
$75.02
230
235
$76.00
235
240
240
245
Anesthesiology
245
250
250
255
260
265
265
270
Blood Bank
270
275
Echocardiology
275
280
280
285
Cardiology Services
285
290
Electromyography
290
295
Electroencephalography
300
Radiology - Diagnostic
305
Radiology - Therapeutic
305
310
Nuclear Medicine
310
315
315
320
Ultrasonography
320
325
325
330
335
Respiratory Therapy
340
340
345
Renal Dialysis
345
350
Lithotripsy
350
355
Gastro-Intestinal Services
355
360
Physical Therapy
360
365
Speech-Language Pathology
365
370
Occupational Therapy
370
375
375
380
Electroconvulsive Therapy
380
385
Psychiatric/Psychological Testing
385
390
390
395
Organ Acquisition
395
400
400
405
405
255
$42.76
260
295
$55.67
300
330
$50.92
335
06/30/2014
(24)
HOURS SUMMARY
Productive
Hours
NonProductive
Hours
Total Paid
Hours
06/30/2014
(25)
(Optional)
Full
Time
Equivalent
Employees
Line
No
Line
No
Column (22)
2080
ANCILLARY SERVICES
230 Labor and Delivery Services
19,957
496
20,453
230
25,063
10,797
35,860
235
240
245 Anesthesiology
245
250
255
38,780
6,439
45,219
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
300 Radiology - Diagnostic
295
39,809
7,287
47,096
300
305
310
315
320 Ultrasonography
320
325
330
23,219
5,363
28,582
335
340
345
350 Lithotripsy
350
355
360
365
370
375
380
385
390
395
400
146,828
30,382
177,210
405
(1)
(2)
(3)
06/30/2014
(4)
CLASSIFICATION DESCRIPTION
Registry Nursing
Personnel
Other Contracted
Services
.25
.21, .26
(5)
Total Contracted
Hours
Line
No
Line
REVENUE PRODUCING CENTERS
Average Hourly
Rate
Productive Hours
$79.95
39
Average Hourly
Rate
Productive Hours
No
10
Coronary Care
39
10
15
15
20
20
25
25
30
Burn Care
30
35
35
40
Definitive Observation
45
Medical/Surgical Acute
50
Pediatric Acute
50
55
55
60
65
Obstetrics Acute
70
70
75
75
80
80
85
85
90
90
95
Nursery Acute
40
$74.52
515
515
45
60
$75.77
146
146
65
95
100
101
105
110
115
120
125
145
700
700
150
451
451
160
AMBULATORY SERVICES
160 Emergency Services
$81.54
165
170
175 Clinics
175
180
185
190
195
200
205
210
215
220
451
451
225
(1)
(2)
(3)
06/30/2014
(4)
CLASSIFICATION DESCRIPTION
Registry Nursing
Personnel
Other Contracted
Services
.25
.21, .26
(5)
Total Contracted
Hours
Line
No
Line
REVENUE PRODUCING CENTERS
Average Hourly
Rate
Productive Hours
Average Hourly
Rate
Productive Hours
No
ANCILLARY SERVICES
230 Labor and Delivery Services
230
235
240
245 Anesthesiology
245
250
255
$69.78
720
720
260
265
270
275 Echocardiology
275
280
285
290 Electromyography
290
295 Electroencephalography
300 Radiology - Diagnostic
295
$75.38
662
662
300
305
310
315
320 Ultrasonography
320
325
330
$82.90
40
40
335
340
345
350 Lithotripsy
350
355
$92.08
8,184
8,184
360
365
370
375
380
385
390
395
400
1,422
8,184
9,606
405
CLASSIFICATION DESCRIPTION
Line
No
Management and
Supervision
(3)
(4)
Technical and
Specialist
.00
Average
Hourly Rate
06/30/2014
(5)
(6)
Registered
Nurses
.01
Productive
Hours
Average
Hourly Rate
.02
Productive
Hours
Average
Hourly Rate
Line
Productive
Hours
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
10
EDUCATION COSTS
15
15
20
School of Nursing
20
25
25
30
30
35
Paramedical Education
35
40
Student Housing
40
45
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
55
60
Kitchen
60
65
70
Dietary
75
80
85
Central Transportation
90
95
Pharmacy
65
$49.56
1,742
$38.90
4,299
$48.60
1,753
75
90
$87.39
1,837
$68.45
6,589
95
$45.90
1,738
$27.54
8,647
100
$52.38
1,876
110
$67.23
1,601
120
105
115 Parking
120 Housekeeping
80
85
105 Grounds
110 Security
70
115
125
130
135 Communications
$55.12
1,272
135
140
145
8,794
22,560
150
3,333
155
FISCAL SERVICES
155 General Accounting
$41.01
160
165
$47.44
1,307
$28.33
6,823
175
170
195
1,307
10,156
200
CLASSIFICATION DESCRIPTION
Line
No
Management and
Supervision
(3)
(4)
Technical and
Specialist
.00
06/30/2014
(5)
(6)
Registered
Nurses
.01
.02
Average
Hourly Rate
Line
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
Productive
Hours
No
$79.60
12,434
$41.21
9,582
$41.66
487
225 Personnel
$40.42
2,128
$30.00
817
225
$67.19
1,372
$33.47
83
230
$23.93
1,227
235
240
ADMINISTRATIVE SERVICES
205 Hospital Administration
210 Governing Board Expense
215 Public Relations
210
215
220
205
$54.73
680
$33.19
2,026
$67.75
1,422
$32.36
10,903
250
$54.23
2,147
$29.74
703
255
$70.41
364
$40.06
186
260
245
265
270
$72.62
3,491
$49.96
8,903
275
$39.98
3,994
$18.15
1,317
280
295
28,519
35,747
300
350
370
CLASSIFICATION DESCRIPTION
Line
No
Licensed
Vocational Nurses
(9)
(10)
Aides and
Orderlies
.03
Average
Hourly Rate
06/30/2014
(11)
.04
Productive
Hours
Average
Hourly Rate
(12)
.05
Productive
Hours
Average
Hourly Rate
Line
Productive
Hours
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
10
EDUCATION COSTS
15
15
20
School of Nursing
20
25
25
30
30
35
Paramedical Education
35
40
Student Housing
40
45
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
55
60
Kitchen
60
65
70
Dietary
75
75
80
80
85
Central Transportation
85
90
95
Pharmacy
65
$29.94
1,625
70
90
$29.66
5,316
95
$29.43
1,531
100
105 Grounds
105
110 Security
110
115 Parking
115
120 Housekeeping
120
125
$31.18
218
130
135 Communications
$27.54
5,704
135
140
145
14,394
150
FISCAL SERVICES
155 General Accounting
155
160
165
$28.10
23,706
175
170
195
23,706
200
CLASSIFICATION DESCRIPTION
Line
No
Licensed
Vocational Nurses
(9)
(10)
Productive
Hours
(11)
(12)
Aides and
Orderlies
.04
.05
.03
Average
Hourly Rate
06/30/2014
Average
Hourly Rate
Productive
Hours
Line
Average
Hourly Rate
Productive
Hours
No
$28.26
16,708
205
ADMINISTRATIVE SERVICES
205 Hospital Administration
210 Governing Board Expense
210
215
220
225 Personnel
230 Employee Health Services
225
$26.17
230
235
240
245
$25.63
8,347
250
255
260
265
270
$37.03
7,713
275
$18.27
10,192
280
295
42,966
300
350
370
(15)
(16)
06/30/2014
(17)
(18)
CLASSIFICATION DESCRIPTION
Environmental and
Food Service
Physicians
(Salaried)
Non-Physician Medical
Practitioners
Line
.06
.07
.08
No
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Productive
Hours
Average
Hourly Rate
Line
Productive
Hours
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
10
EDUCATION COSTS
15
15
20
School of Nursing
20
25
25
30
30
35
Paramedical Education
35
40
Student Housing
40
45
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
55
60
Kitchen
60
65
70
Dietary
75
75
80
80
85
Central Transportation
85
90
90
95
Pharmacy
65
$25.53
24,546
70
95
100
105 Grounds
105
110 Security
110
115 Parking
120 Housekeeping
115
$25.24
22,816
120
125
130
135 Communications
135
140
145
47,362
150
FISCAL SERVICES
155 General Accounting
155
160
165
170 Admitting
170
175
195
200
CLASSIFICATION DESCRIPTION
Line
No
Environmental and
Food Service
(15)
(16)
Physicians
(Salaried)
.06
Average
Hourly Rate
06/30/2014
(17)
.07
Productive
Hours
Average
Hourly Rate
(18)
Non-Physician Medical
Practitioners
.08
Productive
Hours
Average
Hourly Rate
Line
Productive
Hours
No
ADMINISTRATIVE SERVICES
205 Hospital Administration
205
210
215
220
225 Personnel
230 Employee Health Services
225
$23.70
76
230
235
240
245
250
255
260
265
270
275
280
295
76
300
350
370
Line
No
(19)
CLASSIFICATION DESCRIPTION
(20)
Other Salaries
and Wages
(21)
Cost Center
Average Hourly
Rate
.09
Average Hourly
Rate
Line
Productive
Hours
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
10
EDUCATION COSTS
15
15
20
School of Nursing
20
25
25
30
30
35
Paramedical Education
35
40
Student Housing
40
45
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
55
60
Kitchen
60
65
70
Dietary
75
80
85
Central Transportation
90
95
Pharmacy
$55.48
95
100
$31.83
100
105
Grounds
110
Security
115
Parking
120
Housekeeping
125
Plant Operations
130
Plant Maintenance
135
Communications
140
Data Processing
145
150
65
$28.67
70
75
$46.22
80
85
90
105
$55.10
110
$28.40
120
115
125
$49.65
15,857
$50.87
130
$32.18
135
140
145
15,857
150
FISCAL SERVICES
155
General Accounting
160
Patient Accounting
$40.88
155
165
170
Admitting
175
Outpatient Registration
175
195
195
200
200
160
165
$28.86
170
06/30/2014
(19)
(20)
CLASSIFICATION DESCRIPTION
Other Salaries
and Wages
Line
.09
No
Average Hourly
Rate
(21)
Cost Center
Average Hourly
Rate
Line
Productive
Hours
No
ADMINISTRATIVE SERVICES
205
Hospital Administration
210
215
Public Relations
220
Management Engineering
225
Personnel
230
235
$49.25
205
210
$48.74
215
220
$39.57
225
$60.94
230
Auxiliary Groups
$23.88
235
240
Chaplaincy Services
$37.71
240
245
Medical Library
250
Medical Records
$32.38
250
255
$48.94
255
260
Nursing Administration
260
265
270
$57.96
1,072
245
$72.13
6,536
$70.05
$58.48
1,157
$60.95
270
275
Utilization Management
$50.97
821
$49.95
275
280
$23.93
280
295
300
350
350
370
370
265
295
9,586
300
06/30/2014
(24)
HOURS SUMMARY
Productive
Hours
NonProductive
Hours
Total Paid
Hours
06/30/2014
(25)
(Optional)
Full
Time
Equivalent
Employees
Line
No
Line
No
Column (22)
2080
RESEARCH COSTS
5
10
TOTAL RESEARCH
10
EDUCATION COSTS
15
15
20
School of Nursing
20
25
25
30
30
35
Paramedical Education
35
40
Student Housing
40
45
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
55
60
Kitchen
60
65
70
Dietary
75
80
85
Central Transportation
90
95
Pharmacy
65
32,212
5,842
38,054
1,753
376
2,129
70
75
80
85
90
13,742
2,341
16,083
95
11,916
1,788
13,704
100
1,876
209
2,085
110
24,417
3,904
28,321
120
16,075
2,657
18,732
130
135 Communications
6,976
909
7,885
135
105
115 Parking
120 Housekeeping
115
125
140
145
108,967
18,026
126,993
150
3,333
536
3,869
155
FISCAL SERVICES
155 General Accounting
160 Patient Accounting
160
165
31,836
5,735
37,571
175
170
195
35,169
6,271
41,440
200
(24)
HOURS SUMMARY
06/30/2014
(25)
(Optional)
Full
Time
Equivalent
Employees
Line
No
Line
No
Productive
Hours
NonProductive
Hours
Total Paid
Hours
Column (22)
2080
38,724
6,498
45,222
487
53
540
225 Personnel
2,945
251
3,196
225
2,609
330
2,939
230
1,227
81
1,308
235
2,706
347
3,053
240
20,672
4,560
25,232
250
2,850
259
3,109
255
7,086
1,064
8,150
260
1,157
117
1,274
270
20,928
2,142
23,070
275
15,503
1,408
16,911
280
116,894
17,110
134,004
ADMINISTRATIVE SERVICES
205 Hospital Administration
210 Governing Board Expense
215 Public Relations
210
215
220
245
265
205
295
300
350
370
CLASSIFICATION DESCRIPTION
Line
No
Other Contracted
Services
.26
Average
Hourly Rate
Line
Productive
Hours
No
RESEARCH COSTS
5
10
TOTAL RESEARCH
10
EDUCATION COSTS
15
15
20
School of Nursing
20
25
25
30
30
35
Paramedical Education
35
40
Student Housing
40
45
45
50
TOTAL EDUCATION
50
GENERAL SERVICES
55
55
60
Kitchen
60
65
65
70
Dietary
70
75
75
80
80
85
Central Transportation
85
90
90
95
Pharmacy
95
100
105 Grounds
110 Security
105
$23.15
15,583
110
115 Parking
115
120 Housekeeping
120
125
130
135 Communications
135
140
145
15,583
150
FISCAL SERVICES
155 General Accounting
155
160
165
170 Admitting
170
175
195
200
06/30/2014
CLASSIFICATION DESCRIPTION
Line
No
Other Contracted
Services
.26
Line
Average
Hourly Rate
Productive
Hours
No
$41.37
1,777
205
ADMINISTRATIVE SERVICES
205 Hospital Administration
210 Governing Board Expense
210
215
220
225 Personnel
$33.54
676
225
$73.15
155
230
235
240
245
$47.49
4,364
250
$56.20
3,880
255
$77.11
345
260
265
270
$63.15
3,988
295
15,185
275
280
300
350
$50.96
2,883
370
06/30/2014