Pungo District Business Plan

Rural Community Hospitals of America LLC

Report Overview

• RCHA System• Feasibility Key Assumptions• Feasibility Study

Income Statement Sources and Uses Balance Sheet

• Community Next Step• Attachments

1. Detailed Feasibility Model2. Market Study

Primary Service Area Patient Destination Medical Staff Competitor Comparison Utilization Data

3. Letter from National Rural Health Association regarding the OIG report4. Stroudwater Replacement Hospital Study 2011

RCHA System

1

Feasibility Key Assumptions

• A cash infusion of $3,000,000 is received in the latter half of FY 2014 and used for Working Capital

• A new hospital will be built during FY 2017 and opening its doors on the first day of FY 2018

• A Surgical program is built to start in FY 2018 with the opening of the new facility. It is projected to ramp up through FY2020

• Inpatient days are kept flat at an ADC of 5 through FY 2017. With the opening of the new facility, inpatient volumes are projected to grow

• Outpatient volumes are kept flat from FY 2014 through FY2017. With the opening of the new facility, outpatient volumes are projected to grow

• No rate increases are added to revenue. While rates are expected to increase, we want to keep everything in FY 2014 dollars. No rate increases are added to expenses as well for the same reason

• Realization rates are kept consistent with FY 2014 through the construction period. Realization increases in FY 2018 as a result of the cost reimbursement on additional expense related to the construction, namely depreciation and Interest on the loan

• An FTE reduction is assumed in the latter half of FY 2014; FTEs reduce to 55 for the hospital. Wage rates are kept flat

2

Feasibility Key Assumptions (Continued)

• Benefits are kept flat at 18% of salaries, which is consistent with our other hospitals

• Supplies and other operating expenses are projected as a percentage of net revenue

• Management fees are added in the latter half of FY2014. They project at 11% of net revenue

• The construction loan on the new facility is assumed to be $9,250,000 at 6.8% over 25 years

• Interest is capitalized during the construction period and expensed starting in FY 2018.

3

Feasibility Study: Income Statement

4

Belhaven Community HospitalPro Forma Operating Results Internal

FY 2013 FY2014 FY 2015 FY 2016 FY 2017 FY2018 FY2019 FY2020Income Statement:Income:

Gross Revenue:Inpatient $6,372,322 $3,743,360 $2,513,940 $2,513,940 $2,513,940 $3,443,754 $3,788,129 $4,525,092Outpatient 9,318,918 $6,977,860 6,158,674 6,158,674 6,158,674 6,738,272 7,284,029 7,888,413Total 15,691,240 10,721,220 8,672,614 8,672,614 8,672,614 10,182,026 11,072,159 12,413,505

Deductions 5,268,878 $4,404,368 3,408,337 3,408,337 3,408,337 3,319,340 3,758,998 4,381,967

Net Patient Service Revenue 10,422,362 6,316,853 5,264,277 5,264,277 5,264,277 6,862,685 7,313,161 8,031,538Realization Rate 66.42% 60.70% 60.70% 60.70% 67.40% 66.05% 64.70%

Other Revenue 454,713 418,750 180,514 180,514 180,514 180,514 180,514 181,236

Total Operating Revenues 10,877,075 6,735,603 5,444,791 5,444,791 5,444,791 7,043,199 7,493,675 8,212,774

Expenses:Salaries 5,070,760 3,091,128 2,383,691 2,383,691 2,383,691 2,470,370 2,643,730 2,903,769Benefits 1,505,124 774,520 429,064 429,064 429,064 444,667 475,871 522,678Supplies & Other 1,086,264 942,984 762,271 762,271 762,271 986,048 1,049,114 1,149,788Management Expense 0 347,279 598,927 598,927 598,927 774,752 824,304 903,405Other 3,380,379 1,707,401 898,390 816,719 762,271 915,616 917,975 1,010,171

Total Operating Expense 11,042,527 6,863,312 5,072,343 4,990,671 4,936,223 5,591,453 5,910,995 6,489,812

EBITDA (165,452) (127,709) 372,448 454,120 508,567 1,451,747 1,582,680 1,722,962EBITDA % -1.52% -1.90% 6.84% 8.34% 9.34% 20.61% 21.12% 20.98%

Other Revenue (Expense)Depreciation/Amortization (915,473) (2,931,824) (563,104) (563,104) (563,104) (771,225) (741,225) (711,225)Interest Expense (5,118) (1,110) 0 0 0 (614,271) (603,316) (591,591)Interest/ Investment Income 6,595 8,250 4,125 4,125 4,125 4,125 4,125 4,125Other Revenue (6,948) 1,000 0 0 0 0 0 1Contributions 0 0 0 0 0 0 0

Total Other Revenue (Expense) (920,944) (2,923,684) (558,979) (558,979) (558,979) (1,381,371) (1,340,416) (1,298,691)

Total Net Gain/(Loss) ($1,086,396) ($3,051,393) ($186,531) ($104,860) ($50,412) $70,375 $242,264 $424,272Margin % -9.99% -45.30% -3.43% -1.93% -0.93% 1.00% 3.23% 5.17%

Projected

Feasibility Study: Sources and Uses of Cash

5


FY 2013 FY2014 FY 2015 FY 2016 FY 2017 FY2018 FY2019 FY2020Sources & Uses of Cash:

Sources:Total Net Gain/(Loss) ($1,086,396) ($3,051,393) ($186,531) ($104,860) ($50,412) $70,375 $242,264 $424,272Add Non-Cash Expenses 915,473 2,931,824 563,104 563,104 563,104 771,225 741,225 711,225

Cash from Operations (170,923) (119,569) 376,573 458,245 512,692 841,601 983,490 1,135,497

Increase in Current Liabilities 0 0 32,741 33,723 34,735 35,777 36,850 37,956Increase in Equity 2,452,669 4,096,293Decrease in Non-Cash Current Assets 1,356,700 0 908,207 0 0 0 0 0Decrease in Other Assets 0 0 0 0 0 0 0 0Decrease in restricted cash 0 0 0 0 0 0 0 0New Long-Term Debt 0 24,228 0 0 9,250,000 0 0 0Decrease in PP&E 0 0Increase in Restricted Net Assets 0 0

Total 3,638,446 4,000,952 1,317,521 491,968 9,797,427 877,377 1,020,340 1,173,453

Uses:Capital Expenditures 980,278 658,964 0 0 12,124,508 0 0 0Principle Payments on Debt 39,721 0 0 0 145,912 156,149 167,105Increase in Non-Cash Current Assets 0 62,318 0 20,703 21,324 262,820 90,502 131,550Increase in PP&E 0 0 0 0 0 0 0 1Increase in Restricted Cash 1,171,854 0 0 0 0 0 0 0Increase in Other Assets 0 0 0 0 0 0 0 0Decrease in Current Liabilities 332,419 98,171 0 0 0 0 0 0Decrease in Restricted Net Assets 0 0 0 0 0 0 0 1Decrease in Long-Term Debt 92,264 0Decrease in Equity 0 0 0

Total 2,576,815 859,174 0 20,703 12,145,832 408,732 246,651 298,656

Net Source or Use of Cash 1,061,631 3,141,778 1,317,521 471,265 (2,348,405) 468,646 773,688 874,796Beginning Cash 551,476 1,613,107 4,754,885 6,072,406 6,543,671 4,195,266 4,663,912 5,437,600Ending Cash $1,613,107 $4,754,885 $6,072,406 $6,543,671 $4,195,266 $4,663,912 $5,437,600 $6,312,396

Projected

Feasibility Study: Balance Sheet (Assets)

6


FY 2013 FY2014 FY 2015 FY 2016 FY 2017 FY2018 FY2019 FY2020Balance Sheet:

Current AssetsCash $1,613,107 $4,754,885 $6,072,406 $6,543,671 $4,195,266 $4,663,912 $5,437,600 $6,312,396Short-term Investments 0 $0 0 0 0 0 0 0Restricted Cash-Current $0 0 0 0 0 0 0Patient Accounts Receivable 1,670,568 $1,721,554 793,247 793,247 793,247 1,034,103 1,101,983 1,210,232County Appropriations Rec $0 0 0 0 0 0 0Other Receivables 138,892 $162,690 167,571 172,598 177,776 183,109 188,602 194,260Estimated 3rd Party Rec 357,417 $351,726 351,726 351,726 351,726 351,726 351,726 351,726Supplies Inventory 389,939 $387,348 398,968 410,937 423,266 435,964 449,042 462,514Prepaid Expenses 124,137 $119,953 123,552 127,258 131,076 135,008 139,058 143,230

Total 4,294,060 $7,498,156 7,907,470 8,399,437 6,072,356 6,803,822 7,668,012 8,674,358

Restricted CashInternally Designated 10,217 $10,217 10,217 10,217 10,217 10,217 10,217 10,217

Total 10,217 $10,217 10,217 10,217 10,217 10,217 10,217 10,217

Fixed Assets, Net 6,511,219 $4,238,359 3,675,255 3,112,151 14,673,555 13,902,330 13,161,104 12,449,879

Other Assets 0 $0 0 0 0 0 0 0Due from Parent 0 $0 0 0 0 0 0 0

Total Assets $10,815,496 $11,746,733 $11,592,942 $11,521,805 $20,756,128 $20,716,368 $20,839,334 $21,134,454

Projected

Feasibility Study: Balance Sheet (Liabilities)

7


FY 2013 FY2014 FY 2015 FY 2016 FY 2017 FY2018 FY2019 FY2020Balance Sheet (Cont.):Liabilities and Net Assets

Current LiabilitiesCurrent Portion Long-term Debt 39,721 24,228 0 0 156,149 167,105 178,829 191,375Accounts Payable 423,837 342,280 352,548 363,125 374,019 385,239 396,796 408,700Accrued Payroll 0 0 0 0 0 0 0 0Short-Term Payables 0 0 0 0 0 0 0 0Estimated Third Party Payor Settlement 477,704 503,624 503,624 503,624 503,624 503,624 503,624 503,624Payroll Taxes & Other Accrued Exp 791,615 749,081 771,553 794,700 818,541 843,097 868,390 894,442

Total 1,732,877 1,619,213 1,627,726 1,661,449 1,852,333 1,899,065 1,947,639 1,998,141

Long-term Debt 0 0 24,228 24,228 9,118,079 8,961,212 8,793,338 8,613,687

Total Liabilities 1,732,877 1,619,213 1,651,954 1,685,677 10,970,412 10,860,276 10,740,977 10,611,829

Net AssetsBeginning Net Assets 10,169,015 10,178,912 10,127,520 9,940,988 9,836,128 9,785,717 9,856,092 10,098,356Community Working Capital Infusion 3,000,000Donor Restricted 0 0 0 0 0 0 0Net Income/(Loss) Current (1,086,396) (3,051,393) (186,531) (104,860) (50,412) 70,375 242,264 424,272

Ending Net Assets 9,082,619 10,127,520 9,940,988 9,836,128 9,785,717 9,856,092 10,098,356 10,522,628

Total Liabilities and Net Assets $10,815,496 $11,746,733 $11,592,942 $11,521,805 $20,756,128 $20,716,368 $20,839,334 $21,134,456

Projected

Community Next Steps

• Determine the Board Members who will become the new board of Pungo District Hospital

• Negotiate a change in control divestiture of Pungo District Hospital from Vidant back to the community. The corporation would stay intact with all assets, liabilities and net worth as it currently exists including cash, accounts receivable and accounts payable. Once the Vidant board resigns and the new board is in place, the community now governs its hospital.

• File the Medicare Form 855 change in control

• Develop staffing plans and hire necessary employees

• Review and revise existing human resource policies

• Define and arrange for employee benefit programs

• Designate a CEO and CNO

• Establish vendor relationships for supplies and services

• Review and revise operating policies and procedures for the new operating environment

8

Community Next Steps (continued)

• Review and revise medical staff bylaws for the new operating environment

• Review and revise corporate articles and bylaws

• Purchase an information technology system to support the revenue cycle, accounts payable, payroll and general ledger

• Develop a Rural Health Clinic (RHC) to recruit new physicians into and provide a practice location for local physicians that wish to participate

• Develop new facility plans and obtain a Certificate of Need (CON) from the State for construction

• Complete architectural work, acquire a site, obtain financing, contract for and build a new facility

• Move into the new facility and have a community celebration

9

Community Steps (continued)New Facilities: I-70 Community Hospital

10

Community Steps (continued)New Facilities: Drumright Regional Hospital

Drumright Regional Hospital (acquired) Drumright is a new 15-bed CAH facility located in Drumright, Oklahoma. HMC was involved in the planning and development of the new 36,000 ft. facility which began in CY2002 , which opened for business in March 2005.

11

Community Next Steps (continued): Sample New Facility Drumright

12

Drumright Regional Hospital City of DrumrightFinancial Trend

2008 2009 Annualized 2010 2011 2012 2013 FYTD January 2014FYTD January Annualized

Net Patient Services Revenue 6,974,206 6,238,788 7,119,612 7,708,303 8,194,364 9,203,688 3,156,604 9,469,81242.57% 41.27% 45.03% 44.19% 44.19%

Other Revenue 17,084 335,910 37,081 793,010 606,318 207,672 13,432 40,296

Total Operating Revenues 6,991,290 6,574,698 7,156,693 8,501,313 8,800,682 9,411,360 3,170,036 9,510,108

Operating Expenses:Salaries and Wages 2,511,525 2,948,710 3,047,666 3,683,214 3,989,824 3,941,896 1,313,500 3,940,500Benefits 620,628 388,714 695,235 662,639 544,116 531,886 182,764 548,292Supplies 1,725,644 967,728 1,673,729 819,575 876,074 786,248 294,297 882,891Medical Specialist Fees 305,734 139,932 36,250 6,100 300 900Purchased Services 1,528,728 921,600 1,250,026 645,258 682,393 870,163 249,890 749,670Management Fees 276,000 394,873 1,014,682 345,000 1,035,000Other Operating Expenses 764,864 683,057 806,236 760,692 241,606 724,818

Total Operating Expenses 6,386,525 6,297,350 6,666,656 6,909,675 7,329,766 7,911,667 2,627,357 7,882,071

E.B.I.T.D.A. 604,765 277,348 490,037 1,591,638 1,470,916 1,499,693 542,679 1,628,037

Chapter 11 Entries 195,754 0Depreciation and Amortization (761,229) (859,084) (883,009) (854,891) (776,477) (736,347) (237,609) (712,827)Interest Expense (576,315) (514,211) (504,328) (455,243) (445,338) (493,862) (183,091) (549,273)Interest Income 40,424 18,962 1,299 7,699 2,612 14 42

Net Income Before Taxes (692,355) (1,095,947) (878,338) 282,803 256,800 467,850 121,993 365,979

Change in Ownership RCHA

Community Next Steps (continued): Sample New Facility Drumright Volumes

12

Drumright Regional Hospital Volume Trend

2010 2011 2012 2013 FYTD January 2014FYTD January Annualized

Patient Days 2,829 3,524 3,867 3,870 1,349 4,047

Discharges 645 693 737 691 230 690

ER Visits 3,143 2,886 3,037 3,027 983 2,949Surgeries 368 378 361 298 105 315Outpatient Visits 5,058 4,159 5,553 4,911 1,664 4,992Clinic Visits 3,861 5,988 7,828 7,340 2,419 7,257

Avg Length of Stay 4.39 5.09 5.25 5.60 5.87 5.87Avg Daily Census 7.75 9.65 10.59 10.60 10.97 11.09

FTEs 66 69 71 67 66 66FTEs per Adjusted Occupied Bed 2.92 3.25 2.73 2.82 2.83 2.80

ATTACHMENT ONEDetailed Feasibility Study

ATTACHMENT TWOMarket Study

Pungo HospitalMarket Study

February 2014

Primary Service AreaMapDemographic SummaryPopulation by Age trendPopulation by Race EducationHealth Expenditures Household DebtOccupationHousehold Status

Patient DestinationDischarges by hospitalDischarges by patient zip codeMedicare IP discharges and charges

Medical StaffPrimary Care physicians

Financial InfoBalance SheetIncome Statement

Competitor ComparisonUtilization Data

Table of Contents

Pungo HospitalPrimary Service Area

Pungo Hospital - Primary Service Area: Map

I-1

ZIP Area NamePopulation

(2013)27826 Fairfield 1,307

27885 Swanquarter 954

27824 Engelhard 1,577

27875 Scranton 1,036

27810 Belhaven 3,724

27860 Pantego 1,910

Totals 10,508

PSA Population

makes up 79% of

total Medicare

discharges

I-2

Pungo Hospital – Primary Service Area: Demographic Summary

Source: Tactician

2010 CENSUS

2013 ESTIMATE

2018 FORECAST

Population 10,507 10,508 10,510

Households 4,114 4,121 4,181

Families 2,686 2,689 2,730

Median Age 44.3 44.7 45.3

Median Household Income $37,508 $38,952 $41,818

Average Household Income $43,812 $46,913 $49,602

Average Household Size 2.55 2.55 2.51

65+ Population 1,939 2,070 2,445

% 65+ Population 18.50% 19.80% 23.30%

2010 CENSUS

2013 ESTIMATE

2018 FORECAST

Population 9,535,475 9,777,283 10,381,767

Households 3,745,160 3,842,476 4,081,047

Families 2,499,177 2,564,117 2,723,305

Median Age 37.3 37.7 38.7

Median Household Income $43,643 $45,679 $47,967

Average Household Income $59,053 $62,238 $64,961

Average Household Size 2.55 2.54 2.54

65+ Population 1,234,049 1,346,725 1,668,340

% 65+ Population 12.80% 13.70% 16.10%

PSA Demographics

North Carolina Demographics

Pungo Hospital – Primary Service Area: Population by Age

Source: Tactician I-3

US Area

Number Percent Number Percent Number Percent Percent Index*Age 0-4 505 4.80% 491 4.70% 498 4.70% 6.50% 73.44

Age 5-9 567 5.40% 550 5.20% 524 5.00% 6.60% 81.86

Age 10-14 593 5.60% 582 5.50% 568 5.40% 6.70% 84.26

Age 15-19 625 5.90% 626 6.00% 624 5.90% 7.10% 83.31

Age 20-24 507 4.80% 533 5.10% 638 6.10% 7.00% 69

Age 25-29 580 5.50% 547 5.20% 529 5.00% 6.80% 80.75

Age 30-34 628 6.00% 632 6.00% 575 5.50% 6.50% 92.43

Age 35-39 672 6.40% 652 6.20% 611 5.80% 6.50% 97.84

Age 40-44 672 6.40% 672 6.40% 644 6.10% 6.80% 94.5

Age 45-49 745 7.10% 701 6.70% 647 6.20% 7.40% 96.38

Age 50-54 832 7.90% 778 7.40% 638 6.10% 7.20% 109.62

Age 55-59 879 8.40% 871 8.30% 762 7.20% 6.40% 131.32

Age 60-64 765 7.30% 795 7.60% 808 7.70% 5.40% 133.64

Age 65-69 637 6.10% 680 6.50% 801 7.60% 4.00% 150.5

Age 70-74 461 4.40% 490 4.70% 584 5.60% 3.00% 145.97

Age 75-79 378 3.60% 399 3.80% 471 4.50% 2.40% 151.76

Age 80-84 221 2.10% 243 2.30% 281 2.70% 1.90% 113.05

Age 85+ 242 2.30% 258 2.50% 308 2.90% 1.80% 129.42

Total 10,509 100.00% 10,500 100.00% 10,511 100.00% 100.00%

Median 44.3 44.7 45.3

PSA Population by Age

2010 CENSUS 2013 ESTIMATE 2018 FORECAST

Pungo Hospital - Primary Service Area: Population by Race

Source: Tactician I-4

Number Percent Number Percent Number Percent

White 5,949 56.62% 5,921 56.34% 5,847 55.63%Hispanic 529 5.04% 564 5.37% 656 6.24%Black 3,555 33.84% 3,551 33.79% 3,538 33.66%Native American 83 0.79% 83 0.79% 84 0.80%Asian 25 0.24% 25 0.24% 23 0.22%Hawaiian / Pacific Islander 0 0.00% 0 0.00% 0 0.00%Two or More 118 1.12% 118 1.12% 117 1.11%Other Race 247 2.35% 247 2.35% 245 2.33%Total 10,506 100.00% 10,509 100.00% 10,510 100.00%

Population by Race Trends

2010 CENSUS 2013 ESTIMATE 2018 FORECAST

Pungo Hospital – Primary Service Area: Educational Attainment

Source: Tactician

I-5

US Area

Description Number Percent Percent Index*No schooling completed 114 1.50% 1.30% 112.18

Nursery-4th grade 108 1.40% 0.80% 165.21

5th-6th grade 47 0.60% 1.80% 34.5

7th-8th grade 267 3.50% 2.20% 160.7

9th grade 246 3.20% 1.80% 174.17

10th grade 421 5.50% 2.20% 243.56

11th grade 276 3.60% 2.50% 144.53

12th grade no diploma 94 1.20% 1.80% 69

High school graduate, GED, or alternative 2,813 36.50% 28.50% 128.14

Some college, < 1 year 553 7.20% 6.30% 114.2

Some college, 1+ years, no degree 1,105 14.30% 15.00% 95.73

Associate's degree 596 7.70% 7.60% 101.66

Bachelor's degree 777 10.10% 17.70% 56.87

Master's degree 222 2.90% 7.30% 39.37

Professional school degree 47 0.60% 1.90% 31.89

Doctorate degree 15 0.20% 1.20% 16.15

Total 7,701 100.00% 100.00%

Educational Attainment Age 25+ (2010)

PSA

Pungo Hospital – Primary Service Area: Personal Healthcare Expenditure

Source: Tactician

I-6

Area Exp / Hhld $

US Exp / Hhld $

Expenditure Index*

Area Exp Allocation %

US Exp Allocation %

Allocation Index**

Total Health Care $2,701 $3,380 79.9 6.50% 6.20% 105.68

Health Care Insurance $1,303 $1,632 79.87 3.10% 3.00% 105.63

Health Care Services $646 $813 79.48 1.60% 1.50% 105.13

Hospital Services $106 $133 79.21 0.30% 0.20% 104.77

Physician Services $171 $215 79.61 0.40% 0.40% 105.29

Dental Services $246 $309 79.56 0.60% 0.60% 105.22

Eyecare Services $30 $38 79.28 0.10% 0.10% 104.86

Other Medical Services $92 $116 79.42 0.20% 0.20% 105.05

Health Care Supplies & Equipment $751 $936 80.31 1.80% 1.70% 106.23

PSA Personal Healthcare Expenditures

Pungo Hospital – Primary Service Area: Households with Debt

Source: Tactician

I-7

US Area

Description NumberPercent of

Households Percent of

Households Index*

Households Having A Mortgage Debt 1,988 48.20% 46.70% 103.25

Installment Payment Debt 1,866 45.30% 46.70% 97

Other Lines of Credit Debt 64 1.60% 1.40% 112.18

Credit Card Debt 1,838 44.60% 45.10% 98.95

Investment Real Estate Debt 225 5.50% 7.20% 75.98

Other Debt 281 6.80% 7.00% 97.28

Hhlds with Any Debt 3,148 76.40% 77.80% 98.15

Debts

PSA

Pungo Hospital - Primary Service Area: 2010 Occupation

Source: Tactician

I-8

* Area Index is '100' based. An Area Index value of 100 for a particular variable indicates that, for the area, the relative concentration of the variable is consistent with the average concentration of that variable across the US. Accordingly, an index value of 200 indicates that the relative concentration of the variable is twice the national average, while an index value of 50 indicates that the relative concentration of the variable is half the national average.

US Area

Description Number Percent Percent Index*Management occupations 456 11.70% 9.70% 120.65

Business and financial operations occupations 111 2.80% 4.70% 60.53

Computer and mathematical occupations 20 0.50% 2.50% 20.7

Architecture and engineering occupations 26 0.70% 1.80% 36.91

Life, physical, and social science occupations 13 0.30% 0.90% 37.98

Community and social service occupations 85 2.20% 1.70% 128.66

Legal occupations 34 0.90% 1.20% 74.23

Education, training, and library occupations 175 4.50% 6.20% 72.24

Arts, design, entertainment, sports, and media occupations 15 0.40% 1.90% 20.44

Health diagnosing and treating practitioners and other technical occupations160 4.10% 3.80% 109.08

Health technologists and technicians 26 0.70% 1.70% 38.31

Healthcare support occupations 212 5.40% 2.50% 216.61

Fire fighting and prevention, and other protective service workers including supervisors20 0.50% 1.20% 41.9

Law enforcement workers including supervisors 176 4.50% 1.00% 443.51

Food preparation and serving related occupations 103 2.60% 5.70% 46.28

Building and grounds cleaning and maintenance occupations 182 4.70% 4.00% 116.21

Personal care and service occupations 52 1.30% 3.60% 37.17

Sales and related occupations 367 9.40% 11.10% 84.82

Office and administrative support occupations 489 12.50% 13.90% 90.07

Farming, fishing, and forestry occupations 245 6.30% 0.80% 832.87

Construction and extraction occupations 332 8.50% 5.10% 167.05

Installation, maintenance, and repair occupations 114 2.90% 3.30% 88.52

Production occupations 256 6.60% 5.90% 110.76

Transportation occupations 130 3.30% 3.50% 94.82

Material moving occupations 109 2.80% 2.50% 111

Total 3,908 100.00% 100.00%

Occupation (2010)

PSA

Pungo Hospital – Primary Service Area: Household

Source: Tactician

I-9

US Area

Description Number Percent Percent Index*Married Couple Family with Children 669 24.90% 32.70% 76.09

Lone Parent Male with Children 88 3.30% 4.30% 76.39

Lone Parent Female with Children 352 13.10% 12.80% 102.07

Married Couple Family No Children 1,252 46.60% 40.20% 115.94

Lone Parent Male No Children 101 3.80% 3.20% 118.62

Lone Parent Female No Children 226 8.40% 6.80% 122.96

Total 2,688 100.00% 100.00%

Household Structure (2013)

PSA

PUNGO HOSPITALPatient Destination Data

Pungo Hospital – Medicare IP Market Share and Charges – 27810 Belhaven

II-1

2012 2012 2012 2012 2012

M edicare M edicare M edicare M edicare M edicare

Discharges M arket Share Patient Total Charges Average Charge

Days Per patient Day

-- ZIP Total -- 323 100.00% 1,493 4.6 $9,016,626 $6,039.27

VIDANT BEAUFT HSP WA 46 14.20% 200 4.3 $796,288 3,981$ VIDANT MC GREENVILLE 95 29.40% 710 7.5 $5,765,120 8,120$ VIDANT PUNGO HSP BELHAVEN 151 46.70% 435 2.9 $1,182,976 2,719$ ALL OTHER HOSPITALS 31 9.60% 148 4.8 $1,272,242 8,596$

Hospital ALOS

27810 Belhaven

Pungo Hospital – Medicare IP Market Share and Charges – 27860 Pantego

II-2

2012 2012 2012 2012 2012




-- ZIP Total -- 143 100.00% 590 4.1 $3,592,892 6,090$

VIDANT BEAUFT HSP WA 27 18.90% 126 4.7 $396,800 3,149$ VIDANT MC GREENVILLE 47 32.90% 253 5.4 $2,430,976 9,609$ VIDANT PUNGO HSP BELHAVEN 58 40.60% 148 2.6 $376,448 2,544$ ALL OTHER HOSPITALS 11 7.70% 63 5.7 $388,668 6,169$

27860 Pantego

Hospital ALOS

Pungo Hospital – Medicare IP Market Share and Charges – 27824 Engelhard

II-3

2012 2012 2012 2012 2012


Discharges M arket Share

Patient Total Charges Average Charge


-- ZIP Total -- 93 100.00% 458 4.9 $2,997,928 6,546$ JOHNSTON MEM HSP SMITHFIELD 2 2.20% 9 4.5 $42,976 4,775$ THE OUTER BANKS HSP NAGS HEAD 2 2.20% 5 2.5 $29,380 5,876$ UNIV HSP BROOKLYN DOWNSTATE 2 2.20% 35 17.5 $198,528 5,672$ VIDANT BEAUFT HSP WA 8 8.60% 41 5.1 $95,072 2,319$ VIDANT MC GREENVILLE 33 35.50% 214 6.5 $2,205,184 10,305$ VIDANT PUNGO HSP BELHAVEN 44 47.30% 141 3.2 $368,832 2,616$ ALL OTHER HOSPITALS 2 2.20% 13 6.5 $57,956 4,458$

27824 Engelhard

Hospital ALOS

Pungo Hospital – Medicare IP Market Share and Charges – 27826 Fairfield

II-4

2012 2012 2012 2012 2012




-- ZIP Total -- 43 100.00% 164 3.8 $1,111,545 6,778$

VIDANT BEAUFT HSP WA 6 14.00% 22 3.7 $81,888 3,722$ VIDANT MC GREENVILLE 9 20.90% 43 4.8 $546,688 12,714$ VIDANT PUNGO HSP BELHAVEN 21 48.80% 62 3 $165,632 2,671$ ALL OTHER HOSPITALS 7 16.30% 37 5.3 $317,337 8,577$

27826 Fairfield

Hospital ALOS

Pungo Hospital – Medicare IP Market Share and Charges – 27875 Scranton

II-5

2012 2012 2012 2012 2012




-- ZIP Total -- 25 100.00% 99 4 $499,212 5,043$ VIDANT BEAUFT HSP WA 4 16.00% 22 5.5 $51,560 2,344$ VIDANT MC GREENVILLE 5 20.00% 21 4.2 $282,496 13,452$ VIDANT PUNGO HSP BELHAVEN 14 56.00% 48 3.4 $114,800 2,392$ ALL OTHER HOSPITALS 2 8.00% 8 4 $50,356 6,295$

27875 Scranton

Hospital ALOS

Pungo Hospital – Medicare IP Market Share and Charges – 27885 Swanquarter

II-6

2012 2012 2012 2012 2012




-- ZIP Total -- 89 100.00% 371 4.2 $2,307,271 6,219$ UNIV N CAROLINA HSP CHAPEL HIL 5 5.60% 56 11.2 $535,168 9,557$ VIDANT BEAUFT HSP WA 12 13.50% 40 3.3 $131,968 3,299$ VIDANT MC GREENVILLE 30 33.70% 154 5.1 $1,298,688 8,433$ VIDANT PUNGO HSP BELHAVEN 40 44.90% 118 3 $321,152 2,722$ ALL OTHER HOSPITALS 2 2.20% 3 1.5 $20,295 6,765$

27885 Swanquarter

Hospital ALOS

PUNGO HOSPITALPrimary Care Needs

Pungo Hospital – Medical Staff : Need for Primary Care Physicians

III-1

Medical Journal LiftonPhysician Type GMENAC Economics Solucient AMA Associates MeanFamily Practice 2.65 5.23 2.37 1.08 4.02 2.31 2.65Internal Medicine 3.03 2.08 2.00 3.00 4.01 2.64 3.00Obstetrics/gynecology 1.04 0.96 1.07 1.12 1.54 1.12 1.07Pediatrics 1.35 1.05 1.46 1.56 1.93 1.41 1.46

TOTAL 8.06 9.32 6.89 6.75 11.52 7.47 8.17

Median

Pungo Primary Service Area - 20132013 Population to Physician Need

Year 2013Population 10,508

PUNGO HOSPITALFinancial Info

Pungo Hospital - Financial Info: Balance Sheet

IV-1

Belhaven Community HospitalPro Forma Operating Results Audited Audited Internal Internal

FY2010 FY2011 FY2012 FY 2013Balance Sheet:Current AssetsCash $2,011,810 $1,316,050 $551,476 $1,613,107Short-term Investments 0 0 0Restricted Cash-CurrentPatient Accounts Receivable 1,877,982 1,259,808 2,912,557 1,670,568County Appropriations RecOther Receivables 90,391 99,838 559,486 138,892Estimated 3rd Party Rec 0 0 357,417Supplies Inventory 382,098 334,634 347,548 389,939Prepaid Expenses 43,477 281,229 218,062 124,137

Total 4,405,758 3,291,559 4,589,129 4,294,060

Restricted CashRestricted for Debt ServiceHeld by Trustee for CapitalRestricted by Donors

Less Current Portion 0 0 0 0

Internally Designated 0 1,771,483 (1,161,637) 10,217

Total 0 1,771,483 (1,161,637) 10,217

Fixed Assets, Net 5,265,868 4,827,765 6,446,414 6,511,219

Other Assets 614,928 47,452 0 0Due from Parent 0 0 0

Total Assets $10,286,554 $9,938,259 $9,873,906 $10,815,496


FY2010 FY2011 FY2012 FY 2013

Liabilities and Net AssetsCurrent LiabilitiesCurrent Portion Long-term Debt 323,181 287,926 92,264 39,721Accounts Payable 258,188 293,745 525,426 423,837Accrued Payroll 222,059 746,159 0 0Short-Term Payables 0 1,785,760 0 0Estimated Third Party Payor Settlement 925,794 508,000 852,509 477,704Payroll Taxes & Other Accrued Exp 3,110 0 647,640 791,615

Total 1,732,332 3,621,590 2,117,839 1,732,877

Long-term Debt 2,538,057 1,531,984 39,721 0

Total Liabilities 4,270,389 5,153,574 2,157,560 1,732,877

Net AssetsBeginning Net Assets 6,834,605 6,016,165 9,517,362 10,169,015Community Working Capital InfusionDonor Restricted 12,000Net Income/(Loss) Current (818,440) (1,243,480) (1,801,016) (1,086,396)

Ending Net Assets 6,016,165 4,784,685 7,716,346 9,082,619

Total Liabilities and Net Assets $10,286,554 $9,938,259 $9,873,906 $10,815,496

Pungo Hospital - Financial Info: Income Statement

IV-1


FY2010 FY2011 FY2012 FY 2013Income Statement:Income:

Net Patient Service Revenue 9,627,814 11,093,827 9,777,922 10,422,362Realization Rate 61.18% 64.67% 66.42%

Other Revenue 410,691 213,737 150,208 454,713

Total Operating Revenues 10,038,505 11,307,564 9,928,130 10,877,075

Expenses:Salaries 5,587,566 5,199,819 5,070,760Benefits 427,951 1,429,002 1,505,124Supplies & Other 4,285,555 1,447,682 1,086,264Management Expense 0Other 10,351,188 1,671,641 2,873,562 3,380,379

Total Operating Expense 10,351,188 11,972,713 10,950,065 11,042,527

EBITDA (312,683) (665,149) (1,021,935) (165,452)EBITDA % -3.11% -5.88% -10.29% -1.52%

Other Revenue (Expense)Depreciation/Amortization (643,025) (619,547) (645,125) (915,473)Interest Expense (61,638) (47,501) (5,118)Interest/ Investment Income 32,068 14,404 6,595Other Revenue 166,838 74,313 (133,956) (6,948)Contributions 0 0

Total Other Revenue (Expense) (505,757) (578,331) (779,081) (920,944)

Total Net Gain/(Loss) ($818,440) ($1,243,480) ($1,801,016) ($1,086,396)Margin % -8.15% -11.00% -18.14% -9.99%

IV-2

PUNGO HOSPITALCompetitor Comparison

Pungo Hospital– Competitor Comparison: surrounding facilities map

V-1

Pungo Hospital – Competitor Comparison: Profitability Ratios

Source: Ingenix (CHIPS)

2010 2011 2012 2010 2011 2012Number of Months 12 12 12 12. 12 11 13

Total Margin % -3.9 -12.7 -18.4 -7.7 -7.8 -3.8 -12.3

Operating Margin -5.7 -13.4 -18.4 -8.6 -7.9 -7.7 -12.3

Nonoperating Margin 1.8 0.7 0.0 0.9 0.2 3.9 0.0

Deductible Ratio 38.8 37.4 35.3 57.3 59.1 60.6 63.9

Markup Ratio 1.5 1.4 1.3 2.6 2.3 2.3 2.4

Return on Total Assets -4.0 -12.5 -18.2 -0.8 -11.9 -5.1 -14.4

Return on Equity -6.9 -25.9 -23.3 1.4 -31.7 -26.1 -45.1

Return on Investment (PLA) 0.0 -0.1 -0.1 0.1 0.0 0.0 -0.1

Liquidity RatiosCurrent Ratio 2.5 1.0 1.6 6.5 2.5 1.0 1.6

Average Payment Period 60.7 127.5 70.6 54.9 60.7 127.5 70.6

Days Cash on Hand - Short-Term Sources 70.5 59.0 18.4 48.0 70.5 59.0 18.4

Days Cash On Hand - All Sources 92.1 59.0 18.4 94.2 92.1 59.0 18.4

Days in Accounts Receivable 74.6 52.6 86.1 65.3 74.6 52.6 86.1

Pungo BeaufortState AverageProfitability Ratios

V-2

Pungo Hospital – Competitor Comparison: Profitability Ratios (Continued)


2010 2011 2012 2010 2011 2012Capital Structure RatiosEquity Financing 48.2 37.0 45.9 74.9 92.1 90.9

Long-Term Debt to Equity 79.4 124.5 85.9 18.9 0.5 0.5

Fixed Asset Financing 90.9 95.7 92.5 57.0 1.8 2.1

Cash Flow to Debt 23.4 24.7 33.5 70.5 252.6 208.2

Capital Expense 9.5 7.1 6.6 7.0 5.5 4.6

Long-Term Debt per Bed 334,152.4 334,355.9 328,494.6 86,102.4 2,730.5 3,208.6

Times Interest Earned 0.0 0.0 0.0 12.7 47.8 0.0

Asset EfficiencyTotal Asset Turnover 0.89 1.12 1.10 0.82 0.86 0.86

Fixed Asset Turnover 2.12 2.33 2.59 3.30 3.66 4.15

Fixed Asset Turnover (PLA) 0.97 1.04 1.12 1.51 1.63 1.81

Current Asset Turnover 1.72 2.53 2.11 1.24 1.27 1.21

Net Fixed Assets per Bed 367,654 349,222 355,285 151,177 150,107 153,412

Average Age of Plant 6.5 9.2 9.9 7.2 8.1 9.3

Capital & Asset RatiosGreenville Outerbanks

V-3

Pungo Hospital – Competitor Comparison: Capital & Asset Ratios


2010 2011 2012 2010 2011 2012Capital Structure RatiosEquity Financing 58.5 48.1 78.1 71.1 37.6 19.7 31.9

Long-Term Debt to Equity 42.2 32.0 0.5 63.9 73.7 0.0 158.1

Fixed Asset Financing 48.2 31.7 0.6 32.7 52.7 0.0 85.3

Cash Flow to Debt 5.3 -12.1 -53.6 30.3 -9.2 1.1 -14.5

Capital Expense 6.8 6.5 6.1 6.3 4.8 5.5 4.1

Long-Term Debt per Bed 32,818.9 20,586.3 0.0 82,463.3 25,193.2 0.0 64,673.1

Times Interest Earned -5.8 -25.1 -102.6 12.1 -7.6 -2.8 -22.1

Asset EfficiencyTotal Asset Turnover 1.03 0.98 0.99 1.30 1.53 1.36 1.17

Fixed Asset Turnover 2.02 2.02 1.52 4.42 2.91 2.54 1.97

Fixed Asset Turnover (PLA) 0.92 0.90 0.66 1.92 1.33 1.13 0.86

Current Asset Turnover 2.41 2.67 2.86 4.52 3.68 4.59 3.24

Net Fixed Assets per Bed 68,091 64,874 0 169,040 47,781 59,255 75,819

Average Age of Plant 12.5 13.9 13.3 11.6 11.7 11.5 1.0

Capital & Asset RatiosPungo State

AverageBeaufort

V-4

Pungo Hospital – Competitor Comparison: Capital & Asset Ratios (Continued)


2010 2011 2012 2010 2011 2012Capital Structure RatiosEquity Financing 48.2 37.0 45.9 74.9 92.1 90.9

Long-Term Debt to Equity 79.4 124.5 85.9 18.9 0.5 0.5

Fixed Asset Financing 90.9 95.7 92.5 57.0 1.8 2.1

Cash Flow to Debt 23.4 24.7 33.5 70.5 252.6 208.2

Capital Expense 9.5 7.1 6.6 7.0 5.5 4.6

Long-Term Debt per Bed 334,152.4 334,355.9 328,494.6 86,102.4 2,730.5 3,208.6

Times Interest Earned 0.0 0.0 0.0 12.7 47.8 0.0

Asset EfficiencyTotal Asset Turnover 0.89 1.12 1.10 0.82 0.86 0.86

Fixed Asset Turnover 2.12 2.33 2.59 3.30 3.66 4.15

Fixed Asset Turnover (PLA) 0.97 1.04 1.12 1.51 1.63 1.81

Current Asset Turnover 1.72 2.53 2.11 1.24 1.27 1.21

Net Fixed Assets per Bed 367,654 349,222 355,285 151,177 150,107 153,412

Average Age of Plant 6.5 9.2 9.9 7.2 8.1 9.3

Capital & Asset RatiosGreenville Outerbanks

V-5

Pungo Hospital – Competitor Comparison: Volume Indicators


2010 2011 2012 2010 2011 2012Hospital Beds 25.0 25.0 25.0 170.3 96.0 81.0 100.0

Facility Beds 35.0 35.0 35.0 198.6 115.0 100.0 100.0

General Services Beds Percentage 100.0 100.0 100.0 90.4 87.5 85.2 88.0

Hospital Discharges 659 672 548 7,939 2,877 2,782 3,281

Hospital Discharges per Bed 26.4 26.9 21.9 40.7 30.0 34.3 32.8

Hospital Patient Days 3,252 2,962 2,338 38,973 9,940 8,017 13,534

Facility Patient Days 5,928 5,738 5,586 47,073 13,567 11,471 13,534

Occupancy - Hospital 35.6 32.5 25.6 53.5 28.4 29.5 35.4

Occupancy - Facility 46.4 44.9 43.6 59.2 32.3 34.2 35.4

2010 2011 2012 2010 2011 2012Hospital Beds 718.0 718.0 718.0 21.0 21.0 21.0

Facility Beds 845.0 845.0 845.0 21.0 21.0 21.0

General Services Beds Percentage 76.3 76.3 76.3 100.0 100.0 100.0

Hospital Discharges 39,053 40,518 43,129 1,235 1,295 1,393

Hospital Discharges per Bed 54.4 56.4 60.1 58.8 61.7 66.3

Hospital Patient Days 209,578 212,580 222,027 2,926 2,948 3,199

Facility Patient Days 245,072 247,810 255,603 2,926 2,948 3,199

Occupancy - Hospital 80.0 81.1 84.5 38.2 38.5 41.6

Occupancy - Facility 79.5 80.3 82.6 38.2 38.5 41.6

Volume IndicatorsPungo State

AverageBeaufort

Volume IndicatorsGreenville Outerbanks

V-6

Pungo Hospital – Competitor Comparison: LOS


2010 2011 2012 2010 2011 2012Hospital Length of Stay 4.9 4.4 4.3 8.9 3.5 2.9 4.1

Hospital Length of Stay (CMA) 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Medicare Length of Stay 3.3 3.2 3.0 7.0 3.8 3.8 4.3

Medicare Length of Stay (CMA) 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Medicaid Length of Stay 2.6 3.2 2.9 7.0 1.8 1.0 2.5

2010 2011 2012 2010 2011 2012Hospital Length of Stay 5.4 5.2 5.1 2.4 2.3 2.3

Hospital Length of Stay (CMA) 0.0 0.0 0.0 0.0 0.0 0.0

Medicare Length of Stay 6.2 6.1 5.9 2.8 2.7 2.7

Medicare Length of Stay (CMA) 0.0 0.0 0.0 0.0 0.0 0.0

Medicaid Length of Stay 5.3 5.3 5.5 1.9 2.0 2.0

OuterbanksLength of Stay

Greenville

Length of StayPungo State

AverageBeaufort

V-7

Pungo Hospital – Competitor Comparison: Payor Mix


2010 2011 2012 2010 2011 2012Medicare Percentage - Discharges 70.4 68.2 72.6 45.9 52.2 48.7 45.7

Medicare Percentage - Days 47.0 49.2 50.9 46.1 57.8 63.5 47.9

Medicaid Percentage - Discharges 10.8 9.2 8.2 18.5 31.5 26.1 24.7

Medicaid Percentage - Days 5.7 6.6 5.5 12.6 16.5 9.3 14.9

Medicare Outlier Payment Percentage 0.0 0.0 0.0 2.0 0.2 0.2 0.1

Mediare Case Mix Index 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000

Outpatient Revenue Percentage 54.7 53.0 100.0 58.2 78.0 77.8 73.5

Inpatient Revenue Percentage 45.3 47.0 0.0 47.6 22.0 22.2 26.5

Routine Days Percentage 62.5 70.6 66.7 83.4 89.5 91.4 92.3

Intensive Care Unit Days Percentage 0.0 6.0 10.9 8.4 10.5 3.1 2.1

Coronary Care Unit Days Percentage 0.0 0.0 0.0 0.0 0.0 0.0 0.0

2010 2011 2012 2010 2011 2012Medicare Percentage - Discharges 38.0 38.8 40.0 38.2 40.7 41.9

Medicare Percentage - Days 44.2 44.9 46.2 44.4 48.1 49.4

Medicaid Percentage - Discharges 24.8 25.6 23.5 21.0 20.0 18.6

Medicaid Percentage - Days 24.5 25.8 25.1 16.9 17.8 16.5

Medicare Outlier Payment Percentage 9.9 9.1 8.1 0.0 0.0 0.0

Mediare Case Mix Index 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000

Outpatient Revenue Percentage 27.8 28.5 28.5 80.5 79.4 76.8

Inpatient Revenue Percentage 72.2 71.5 71.5 19.5 20.6 23.2

Routine Days Percentage 78.4 80.0 80.4 100.0 100.0 100.0

Intensive Care Unit Days Percentage 21.6 0.6 2.6 0.0 13.3 15.1

Coronary Care Unit Days Percentage 0.0 0.0 0.0 0.0 0.0 0.0

Payer MixPungo State

AverageBeaufort

Payer MixGreenville Outerbanks

V-8

Pungo Hospital – Competitor Comparison: Pricing Indicators


2010 2011 2012 2010 2011 2012Hospital Gross Price per Discharge $10,079 $9,889 $0 $29,194 $11,520 $10,900 $11,089

Hospital Gross Price per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital Net Price per Discharge $6,170 $6,186 $0 $11,373 $4,714 $4,297 $4,005

Hospital Net Price per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

2010 2011 2012 2010 2011 2012Hospital Gross Price per Discharge $39,196 $39,925 $41,202 $13,887 $14,598 $15,538

Hospital Gross Price per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital Net Price per Discharge $15,246 $15,080 $16,234 $7,878 $8,349 $8,696

Hospital Net Price per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Pricing IndicatorsPungo State

AverageBeaufort

Pricing IndicatorsGreenville Outerbanks

V-9

Pungo Hospital – Competitor Comparison: Cost Indicators


2010 2011 2012 2010 2011 2012Hospital Cost per Discharge $7,081 $7,195 $0 $11,967 $5,103 $4,695 $4,632

Hospital Cost per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital Salaries per Discharge $3,645 $3,469 $0 $4,951 $1,866 $1,634 $1,725

Hospital Salaries per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital Capital Costs per Discharge $450 $436 $0 $567 $233 $246 $181

Hospital Capital Costs per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital General Service Cost per Discharge $3,352 $3,419 $0 $4,951 $1,311 $1,254 $1,979

Hospital General Service Cost per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital FTEs per Occupied Bed 6 7 0 5 4 5 3

Hospital FTEs per Occupied Bed (CMA) 0 0 0 0 0 0

Hospital Manhours per Discharge 181 185 0 201 86 90 79

Hospital Manhours per Discharge (CMA) 0 0 0 0 0 0

Facility Salary per FTE $41,838 $39,031 $38,805 $53,538 $45,236 $37,819 $45,526

Facility Salary per FTE (WIA) $0 $0 $0 $0 $0 $0

Facility Wage Index $0 $0 $0 $59,252 $0 $0 $0

Facility Wage Index 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000

Cost IndicatorsPungo State

AverageBeaufort

V-10

Pungo Hospital – Competitor Comparison: Pricing Indicators


2010 2011 2012 2010 2011 2012Hospital Cost per Discharge $14,930 $14,712 $15,098 $6,645 $6,859 $7,240

Hospital Cost per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital Salaries per Discharge $5,501 $5,340 $5,409 $2,093 $2,221 $2,319

Hospital Salaries per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital Capital Costs per Discharge $1,311 $981 $939 $436 $357 $316

Hospital Capital Costs per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital General Service Cost per Discharge $6,688 $6,164 $6,587 $2,002 $2,196 $2,339

Hospital General Service Cost per Discharge (CMA,WIA) $0 $0 $0 $0 $0 $0

Hospital FTEs per Occupied Bed 7 7 7 6 6 5

Hospital FTEs per Occupied Bed (CMA) 0 0 0 0 0 0

Hospital Manhours per Discharge 218 206 203 78 72 72

Hospital Manhours per Discharge (CMA) 0 0 0 0 0 0

Facility Salary per FTE $52,451 $53,934 $55,332 $55,879 $64,150 $67,244

Facility Salary per FTE (WIA) $0 $0 $0 $0 $0 $0

Facility Wage Index $61,074 $65,867 $70,063 $0 $0 $0

Facility Wage Index 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000

Cost IndicatorsGreenville Outerbanks

V-11

PUNGO HOSPITALUtilization Data

Pungo Hospital – Utilization Data:

VI-1

FY 2011 FY 2012 FY 2013ACUTE ADMISSIONS 667 557 507SWING BED ADMISSIONS 64 86 95ACUTE DAYS 2,089 1,594 1,482SWING BED DAYS 871 4,008 3,144ACUTE ALOS 3.13 2.86 2.92SWING BED ALOS 13.61 46.60 33.09INPATIENT SURGERY 45 34 0

FY 2011 FY 2012 FY 2013Lab Tests 30,615 28,196 24,118OP Visits 5,067 5,316 4,960OUTPATIENT SURGERY 215 209 0ER Visits 5,488 5,412 5,928

RADIOLOGY FY 2011 FY 2012 FY 2013Radiograph 6,985 5,160 4,254Ultrasound 359 87 312CT Scans 1,142 1,056 1,534MRI 269 239 202

Payor Mix FY 2011 FY 2012 FY 2013Medicare 49.4% 50.0% 55.3%Medicaid 22.6% 21.9% 18.0%Commercial 21.4% 19.8% 17.7%Self Pay 6.7% 8.3% 9.0%

Ratios FY 2011 FY 2012 FY 2013FTEs Per AOB n/a 3.6 3.8Bad Debt % of Pat Rev n/a 9.6% 4.8%Contractual as % of Pat Rev n/a 35.3% 33.6%

Pungo Hospital – Utilization Data: Graphs

VI-2

FY 2011 FY 2012 FY 20130

100

200

300

400

500

600

700

800

667557 507

ACUTE ADMISSIONS

FY 2011 FY 2012 FY 20130

102030405060708090

100

6486 95

SWING BED ADMISSIONS

FY 2011 FY 2012 FY 20130

500

1,000

1,500

2,000

2,500

2,0891,594 1,482

ACUTE DAYS

FY 2011 FY 2012 FY 20130

5001,0001,5002,0002,5003,0003,5004,0004,500

871

4,0083,144

SWING BED DAYS

Pungo Hospital – Utilization Data: Graphs (Continued)

VI-3

FY 2011 FY 2012 FY 201305

101520253035404550

4534

0

INPATIENT SURGERY

FY 2011 FY 2012 FY 20130

5,000

10,000

15,000

20,000

25,000

30,000

35,000

30,615 28,19624,118

Lab Tests

FY 2011 FY 2012 FY 20130

1,000

2,000

3,000

4,000

5,000

6,000

5,067 5,316 4,960

OP Visits

FY 2011 FY 2012 FY 20130

50

100

150

200

250

215 209

0

OUTPATIENT SURGERY


VI-4

FY 2011 FY 2012 FY 20130

1,000

2,000

3,000

4,000

5,000

6,000

7,000

5,488 5,412 5,928

ER Visits

FY 2011 FY 2012 FY 20130

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

6,9855,160

4,254

Radiograph

FY 2011 FY 2012 FY 20130

50

100

150

200

250

300

350

400

359

87

312

Ultrasound

FY 2011 FY 2012 FY 20130

200400600800

1,0001,2001,4001,6001,800

1,142 1,056

1,534

CT Scans


VI-5

FY 2011 FY 2012 FY 20130

50

100

150

200

250

300

269239

202

MRI

FY 2011 FY 2012 FY 20130

0.5

1

1.5

2

2.5

3

3.5

4

0

3.6 3.8

FTEs Per AOB

FY 2011 FY 2012 FY 20130.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

0.0%

9.6%

4.8%

Bad Debt % of Pat Rev

FY 2011 FY 2012 FY 20130.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

0.0%

35.3% 33.6%

Contractual as % of Pat Rev


VI-6

FY 2011 FY 2012 FY 20130

50

100

150

200

250

300

269239

202

MRI

ATTACHMENT THREELetter from the National Rural Health Association

National Rural Health Letter regarding OIG

ATTACHMENT FOURStroudwater Replacement Hospital Study 2011

Pungo District Business Plan

Documents

Transcript of Pungo District Business Plan