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Table of Contents

Executive Summary                                                          3-5

Financial and Operational Study                                            6 - 59

    • Total Profit Margin                                                  6 - 14
    •   Total Operating Profit Margin                                      15 - 23
    •   Total Labor Cost as a Percentage of Total Operating Revenues       24 - 32
    •   Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)   33 - 41
    •   Days Net Patient Revenue in Accounts Receivable (AR)               42 - 50
    •   Average Age of Plant and Equipment                                 51 - 59


Introduction to Healthcare Management Partners                             60 - 64

Clients Our Professionals Have Served                                      65 - 66

Firm Leadership                                                            67 - 70

Contact Information                                                        71




                                                October 2010                         2
Executive Summary – Overview
Healthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its senior
executives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignments
across the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools are
necessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMP
MetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparable
facilities and against “1st Quartile” or “High Performing” competitors.

Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive study
comparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groups
selected include the following:

       1.   All General Acute Care Hospitals Regardless of Ownership or Sponsorship
       2.   All Investor Owned General Acute Care Hospitals
       3.   All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations
       4.   All State and Local Government Owned General Acute Care Hospitals
       5.   Free Standing Children’s Hospitals
       6.   All Non-Federal Major Teaching Hospitals

Using proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period or
statistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals,
specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensed
beds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer group
comparisons for dozens of standard industry metrics.

This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustrate
the benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess the
relative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or create
new peer groups and compare them to state, local or national benchmarks.


                                                          October 2010                                                              3
Executive Summary – Key Terms
Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for all not-for-profit
general acute care hospitals within the peer groups.

Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States Regardless of Bed Size
                                               2009                                 2008                          2007
        Quartile Rank
                                   Mean      Median        Count       Mean       Median      Count    Mean     Median    Count
         1st Quartile             11.42%     10.12%          433      10.16%       8.94%       503    13.47%    12.63%     513
         2nd Quartile              4.04%      4.03%          433       3.26%       3.24%       505     6.40%     6.35%     516
         3rd Quartile              0.15%      0.14%          436      (0.73%)     (0.61%)      507     2.29%     2.36%     518
         4th Quartile            (7.04%)     (5.98%)        438       (8.21%)     (7.33%)      510    (4.80%)   (3.68%)    519
        Total Population           2.11%      2.08%         1740       1.08%       1.33%      2025     4.31%     4.19%    2066
    Excluded Cost Reports                                    111                               128                         112
      Total Cost Reports                                    1851                              2153                        2178

As noted above, the first quartile contains the top 25% of the best performing hospitals in an applicable peer group,
the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains those
hospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%.

Mean Value: The mean value is the average of all amounts within a defined quartile or population.

Median Value: The report also contains the median value by quartile or total population.

Count: Actual number of qualified hospitals included in the mean or median calculation.

Excluded Cost Reports: Represents those metrics values not considered normative (i.e., outlier values). For
example, certain metric values that were greater than two standard deviations from the mean of a reported population
would be excluded from the analysis and included in this category.

                                                              October 2010                                                        4
Executive Summary – Hospital Performance Metrics
                                       A measure of overall hospital profitability presented as a percentage. A negative percentage
Total Profit Margin
                                       indicates an overall loss, while a positive percentage indicates profitability.

                                       A measure of operating profitability presented as a percentage. A negative percentage indicates
Total Operating Profit Margin
                                       overall loss, while a positive percentage indicates profitability.

                                    A measure of labor productivity. This metric divides labor costs by operating revenues. A
Total Labor Cost as a Percentage of
                                    higher percentage compared to its peers indicates that a hospital uses more labor to produce its
Total Operating Revenues
                                    revenue.
                                      Measures the number of full-time equivalent (FTE) employees used for each occupied bed.
Full-Time Equivalent Staff (FTEs) per
                                      Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital
Adjusted Occupied Bed (AOB)
                                      uses more labor to treat its patients.
                                       Measures the number of days it typically takes to collect accounts receivable. A higher
Days Net Patient Revenue in
                                       percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as
Accounts Receivable (AR)
                                       its peers.
                                   Measures the average age of the hospital including capital improvements and major equipment
Average Age of Plant and Equipment purchases. A higher age compared to its peers indicates that the hospital has deferred the
                                   replacement of its capital when compared to its peers, which can lead to further distress.


Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal
Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management
when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in
the Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations.
Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, and
hospitals where the computed metric is more than 2 standard deviations from the mean.

                                                             October 2010                                                                    5
Total Profit Margin - Summary
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
                                               2009                               2008                                                                         2007
   Number of Licensed Beds
                                  Mean       Median        Count       Mean      Median      Count                                            Mean            Median              Count
        25 Beds or Less           0.95%       1.06%          338       0.84%     1.14%         383                                            2.84%           3.15%                388
        26 to 100 Beds            2.15%       1.73%          324       1.29%     1.38%         382                                            3.95%           3.44%                389
        101 to 200 Beds           2.10%       2.14%          381       0.95%     0.85%         453                                            3.94%           3.91%                455
        201 to 300 Beds           1.69%       1.60%          254       0.81%     1.19%         293                                            4.40%           4.60%                303
        301 to 400 Beds           3.44%       3.80%          181       1.01%     1.64%         203                                            5.62%           5.32%                214
        401 to 500 Beds           3.13%       3.07%          102       1.40%     1.83%         121                                            6.02%           5.89%                123
        Over 500 Beds             3.05%       3.57%          160       1.78%     3.17%         190                                            6.15%           6.05%                194
       Total All Hospitals        2.11%       2.08%         1740       1.08%     1.33%        2025                                            4.31%           4.19%               2066
     Excluded Cost Reports                                   111                               128                                                                                 112
      Total Cost Reports                                    1851                              2153                                                                                2178
                                               2006                               2005                                                                         2004
   Number of Licensed Beds
                                  Mean       Median        Count       Mean      Median      Count                                            Mean            Median              Count
        25 Beds or Less           2.56%       2.68%          359       1.99%     1.81%         305                                            1.50%           1.99%                249
        26 to 100 Beds            3.98%       3.77%          381       3.68%     3.57%         408                                            2.12%           3.13%                455
        101 to 200 Beds           3.17%       3.33%          467       2.89%     3.18%         470                                            2.42%           2.79%                471
        201 to 300 Beds           3.23%       3.80%          304       3.24%     3.43%         311                                            2.77%           3.09%                309
        301 to 400 Beds           5.19%       5.21%          218       4.51%     4.79%         219                                            4.33%           4.40%                216
        401 to 500 Beds           5.19%       5.07%          122       5.04%     4.96%         123                                            4.79%           4.66%                123
        Over 500 Beds             5.63%       5.43%          193       4.75%     5.02%         197                                            4.39%           4.80%                196
       Total All Hospitals        3.79%       3.96%         2044       3.45%     3.64%        2033                                            2.83%           3.30%               2019
     Excluded Cost Reports                                    96                                83                                                                                 101
      Total Cost Reports                                    2140                              2116                                                                                2120
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.



                                                                                   October 2010                                                                                           6
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
                                               2009                                  2008                                                                       2007
         Quartile Rank
                                   Mean      Median        Count        Mean       Median      Count                                          Mean            Median              Count
          1st Quartile            9.91%       8.39%          84         9.46%       8.32%        95                                          11.35%           10.59%                97
          2nd Quartile            3.00%       2.98%          84         3.02%       2.93%        96                                           4.98%            4.85%                97
          3rd Quartile           (0.92%)     (0.97%)         85       (1.04%)      (1.03%)       96                                           1.14%            1.26%               97
          4th Quartile           (8.06%)     (6.88%)         85       (7.99%)      (6.83%)       96                                          (6.10%)          (4.70%)              97
        Total Population          0.95%       1.06%         338         0.84%       1.14%       383                                           2.84%            3.15%               388
     Excluded Cost Reports                                   23                                  24                                                                                 20
      Total Cost Reports                                    361                                 407                                                                                408
                                               2006                                  2005                                                                       2004
         Quartile Rank
                                   Mean      Median        Count        Mean       Median      Count                                          Mean            Median              Count
          1st Quartile            11.46%     10.82%          89        10.54%       9.66%        76                                           9.30%            8.54%                62
          2nd Quartile            4.74%       4.84%          90         4.20%       4.48%        76                                           3.96%            4.17%                62
          3rd Quartile            0.76%       0.93%          90         0.14%       0.08%        76                                          (0.02%)          (0.15%)              62
          4th Quartile           (6.63%)     (4.93%)         90       (6.81%)      (5.94%)       77                                          (7.11%)          (5.52%)              63
        Total Population          2.56%       2.68%         359         1.99%       1.81%       305                                           1.50%            1.99%               249
     Excluded Cost Reports                                   17                                  15                                                                                 20
      Total Cost Reports                                    376                                 320                                                                                269
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           7
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            12.86%     11.42%          81        12.23%     11.52%         95      14.59%                                               13.25%                97
          2nd Quartile            3.96%       3.97%          81         3.42%      3.20%         95       6.28%                                                6.28%                97
          3rd Quartile           (0.58%)     (0.58%)         81        (1.16%)    (1.16%)        96       1.43%                                                1.67%               97
          4th Quartile           (7.64%)     (6.65%)         81        (9.17%)    (8.21%)        96      (6.40%)                                              (5.37%)              98
        Total Population          2.15%       1.73%         324         1.29%      1.38%        382       3.95%                                                3.44%               389
     Excluded Cost Reports                                   23                                  22                                                                                 25
      Total Cost Reports                                    347                                 404                                                                                414
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            13.77%     12.50%          95        13.22%     11.88%        102      11.27%                                               10.09%               113
          2nd Quartile            5.90%       5.72%          95         5.46%      5.25%        102       4.69%                                                4.63%               114
          3rd Quartile            2.07%       2.12%          95         1.76%      1.80%        102       0.80%                                                0.92%               114
          4th Quartile           (5.72%)     (4.40%)         96        (5.73%)    (4.49%)       102      (8.20%)                                              (6.85%)              114
        Total Population          3.98%       3.77%         381         3.68%      3.57%        408       2.12%                                                3.13%               455
     Excluded Cost Reports                                   19                                  18                                                                                 22
      Total Cost Reports                                    400                                 426                                                                                477
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           8
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            11.37%     10.13%          95         9.83%      7.82%        113      13.09%                                               12.39%               113
          2nd Quartile            3.82%       3.84%          95         2.89%      2.87%        113       5.88%                                                5.96%               114
          3rd Quartile            0.16%       0.17%          95        (0.76%)    (0.71%)       113       2.10%                                                2.22%               114
          4th Quartile           (6.86%)     (5.38%)         96        (8.08%)    (7.33%)       114      (5.21%)                                              (3.49%)              114
        Total Population          2.10%       2.14%         381         0.95%      0.85%        453       3.94%                                                3.91%               455
     Excluded Cost Reports                                   22                                  26                                                                                 29
      Total Cost Reports                                    403                                 479                                                                                484
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            11.81%     10.89%         116        10.92%      9.93%        117      10.42%                                                9.21%               117
          2nd Quartile            4.93%       4.66%         117         5.10%      5.10%        117       4.50%                                                4.41%               118
          3rd Quartile            1.81%       1.83%         117         1.54%      1.69%        118       1.17%                                                1.23%               118
          4th Quartile           (5.78%)     (4.16%)        117        (5.91%)    (4.82%)       118      (6.34%)                                              (4.82%)              118
        Total Population          3.17%       3.33%         467         2.89%      3.18%        470       2.42%                                                2.79%               471
     Excluded Cost Reports                                   18                                  20                                                                                 22
      Total Cost Reports                                    485                                 490                                                                                493
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           9
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            10.26%      9.57%          63         9.31%      8.13%         73      13.37%                                               13.04%                75
          2nd Quartile            3.46%       3.01%          63         2.95%      3.03%         73       6.53%                                                6.42%                76
          3rd Quartile           (0.16%)     (0.23%)         64        (0.95%)    (0.81%)       73        2.48%                                                2.72%               76
          4th Quartile           (6.64%)     (5.27%)         64        (7.94%)    (6.65%)       74       (4.68%)                                              (3.23%)              76
        Total Population          1.69%       1.60%         254         0.81%      1.19%        293       4.40%                                                4.60%               303
     Excluded Cost Reports                                   20                                  22                                                                                 15
      Total Cost Reports                                    274                                 315                                                                                318
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            11.43%     10.09%          76        10.77%      9.69%         77      10.34%                                                9.19%                77
          2nd Quartile            5.57%       5.61%          76         5.03%      5.12%         78       4.84%                                                4.76%                77
          3rd Quartile            1.75%       1.66%          76         1.67%      1.84%         78       1.32%                                                1.45%                77
          4th Quartile           (5.85%)     (4.86%)         76        (4.41%)    (3.43%)       78       (5.32%)                                              (4.22%)              78
        Total Population          3.23%       3.80%         304         3.24%      3.43%        311       2.77%                                                3.09%               309
     Excluded Cost Reports                                   21                                  15                                                                                 16
      Total Cost Reports                                    325                                 326                                                                                325
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           10
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            12.19%     11.24%          45         9.41%      8.65%         50      14.35%                                               13.60%                53
          2nd Quartile            5.50%       5.77%          45         3.43%      3.55%         51       7.50%                                                7.39%                53
          3rd Quartile            1.69%       1.71%          45        (0.58%)    (0.34%)        51       3.42%                                                3.34%                54
          4th Quartile           (5.43%)     (4.48%)         46        (8.04%)    (7.47%)       51       (2.57%)                                              (1.54%)              54
        Total Population          3.44%       3.80%         181         1.01%      1.64%        203       5.62%                                                5.32%               214
     Excluded Cost Reports                                   12                                  20                                                                                 13
      Total Cost Reports                                    193                                 223                                                                                227
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            12.74%     11.83%          54        12.03%     11.20%         54      11.36%                                               10.59%                54
          2nd Quartile            6.76%       6.37%          54         6.33%      6.14%         55       5.41%                                                5.33%                54
          3rd Quartile            3.74%       3.87%          55         3.06%      2.98%         55       2.84%                                                2.86%                54
          4th Quartile           (2.30%)     (0.90%)         55        (3.24%)    (2.17%)       55       (2.28%)                                              (0.92%)              54
        Total Population          5.19%       5.21%         218         4.51%      4.79%        219       4.33%                                                4.40%               216
     Excluded Cost Reports                                   9                                    9                                                                                13
      Total Cost Reports                                    227                                 228                                                                                229
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           11
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            12.82%     11.64%          25         9.57%      8.07%         30      15.28%                                               14.22%                30
          2nd Quartile            5.35%       5.48%          25         3.11%      3.07%         30       7.88%                                                7.69%                31
          3rd Quartile            1.25%       1.26%          26         0.18%      0.25%         30       3.62%                                                3.29%                31
          4th Quartile           (6.44%)     (5.17%)         26        (7.00%)    (6.01%)       31       (2.40%)                                              (1.06%)              31
        Total Population          3.13%       3.07%         102         1.40%      1.83%        121       6.02%                                                5.89%               123
     Excluded Cost Reports                                   6                                   6                                                                                  5
      Total Cost Reports                                    108                                 127                                                                                128
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            13.07%     11.71%          30        13.55%     12.29%         30      12.17%                                               11.43%                30
          2nd Quartile            6.78%       6.70%          30         7.02%      6.72%         31       7.11%                                                6.85%                31
          3rd Quartile            3.78%       3.94%          31         3.56%      3.62%         31       2.84%                                                2.82%                31
          4th Quartile           (2.56%)     (0.88%)         31        (3.71%)    (1.36%)       31       (2.74%)                                              (1.04%)              31
        Total Population          5.19%       5.07%         122         5.04%      4.96%        123       4.79%                                                4.66%               123
     Excluded Cost Reports                                   6                                   4                                                                                  5
      Total Cost Reports                                    128                                 127                                                                                128
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           12
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Over 500 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median      Count                                           Mean            Median              Count
          1st Quartile            11.88%     11.00%          40        10.67%      9.56%        47                                           14.39%           13.20%                48
          2nd Quartile            5.41%       5.36%          40         4.74%      4.90%        47                                            8.36%            8.63%                48
          3rd Quartile            1.89%       2.14%          40         0.40%      0.15%        48                                            4.28%            4.20%                49
          4th Quartile           (6.99%)     (5.50%)         40        (8.44%)    (7.49%)       48                                           (2.22%)          0.06%                49
        Total Population          3.05%       3.57%         160         1.78%      3.17%       190                                            6.15%            6.05%               194
     Excluded Cost Reports                                   5                                   8                                                                                  5
      Total Cost Reports                                    165                                198                                                                                 199
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median      Count                                            Mean           Median              Count
          1st Quartile            12.86%     12.09%          48        11.62%      11.12%       49                                            11.34%          10.37%                49
          2nd Quartile            7.09%       7.15%          48         6.73%      6.70%        49                                             6.44%           6.32%                49
          3rd Quartile            3.98%       3.89%          48         3.51%      3.56%        49                                             3.25%           3.09%                49
          4th Quartile           (1.27%)      0.79%          49        (2.69%)    (0.19%)       50                                            (3.47%)         (0.61%)              49
        Total Population          5.63%       5.43%         193         4.75%      5.02%       197                                             4.39%           4.80%               196
     Excluded Cost Reports                                   6                                   2                                                                                  3
      Total Cost Reports                                    199                                199                                                                                 199
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           13
Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States Regardless of Bed Size
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count       Mean       Median                                       Count           Mean           Median              Count
          1st Quartile            11.42%     10.12%         433       10.16%       8.94%                                        503           13.47%          12.63%               513
          2nd Quartile            4.04%       4.03%          433       3.26%       3.24%                                        505            6.40%           6.35%               516
          3rd Quartile            0.15%       0.14%          436      (0.73%)     (0.61%)                                       507            2.29%           2.36%               518
          4th Quartile           (7.04%)     (5.98%)         438      (8.21%)     (7.33%)                                       510           (4.80%)         (3.68%)              519
        Total Population          2.11%       2.08%         1740       1.08%       1.33%                                       2025            4.31%           4.19%              2066
     Excluded Cost Reports                                   111                                                                128                                                112
      Total Cost Reports                                    1851                                                               2153                                               2178
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count       Mean       Median                                       Count           Mean           Median              Count
          1st Quartile            12.33%     11.46%         508       11.65%      10.83%                                        505           10.76%           9.91%               502
          2nd Quartile            5.68%       5.62%          510       5.43%       5.41%                                        508            4.97%           4.95%               505
          3rd Quartile            2.19%       2.23%          512       1.87%       2.00%                                        509            1.45%           1.65%               505
          4th Quartile           (4.93%)     (3.74%)         514      (5.04%)     (4.07%)                                       511           (5.77%)         (4.63%)              507
        Total Population          3.79%       3.96%         2044       3.45%       3.64%                                       2033            2.83%           3.30%              2019
     Excluded Cost Reports                                    96                                                                83                                                 101
      Total Cost Reports                                    2140                                                               2116                                               2120
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           14
Total Operating Profit Margin - Summary
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
                                               2009                                2008                                                                         2007
   Number of Licensed Beds
                                  Mean       Median        Count       Mean      Median      Count                                             Mean           Median              Count
        25 Beds or Less          (2.20%)     (1.87%)         328      (1.97%)    (1.26%)       368                                            (1.68%)         (0.89%)              379
        26 to 100 Beds           (0.84%)     (1.26%)         324      (1.51%)    (1.16%)       374                                            (0.70%)         (0.28%)              385
        101 to 200 Beds           0.04%      (0.24%)         384      (1.29%)    (1.28%)       454                                            (0.89%)         (0.41%)              456
        201 to 300 Beds          (0.92%)     (0.65%)         252      (1.18%)    (1.25%)       291                                            (0.79%)         (0.69%)              299
        301 to 400 Beds           1.09%       0.89%          181      (0.55%)    (0.23%)       208                                             0.02%          (0.39%)              212
        401 to 500 Beds           0.27%       0.05%          101      (1.14%)    (0.93%)       121                                            (0.90%)         (0.24%)              123
        Over 500 Beds             0.32%       0.75%          160      (0.62%)    (0.03%)       190                                             0.24%           0.20%               188
       Total All Hospitals       (0.54%)     (0.36%)        1730      (1.29%)    (1.04%)      2006                                            (0.79%)         (0.47%)             2042
     Excluded Cost Reports                                   121                               147                                                                                 136
      Total Cost Reports                                    1851                              2153                                                                                2178
                                               2006                                2005                                                                         2004
   Number of Licensed Beds
                                  Mean       Median        Count       Mean      Median      Count                                            Mean            Median              Count
        25 Beds or Less          (2.57%)     (1.58%)         351      (2.42%)    (2.01%)       297                                           (2.69%)          (2.64%)              238
        26 to 100 Beds           (0.28%)     (0.01%)         376      (0.30%)    (0.05%)       403                                           (2.04%)          (0.64%)              451
        101 to 200 Beds          (1.17%)     (0.86%)         463      (0.54%)    (0.44%)       464                                           (1.59%)          (0.82%)              470
        201 to 300 Beds          (1.13%)     (1.14%)         301      (1.17%)    (1.07%)       307                                           (1.57%)          (1.33%)              305
        301 to 400 Beds          (0.15%)      0.14%         215        0.07%      0.52%       217                                            (0.17%)          (0.18%)              218
        401 to 500 Beds          (0.89%)      0.31%         121       (0.14%)     1.11%        119                                           (0.12%)           0.53%               122
        Over 500 Beds            (0.72%)      0.38%         189       (0.36%)     0.33%        189                                           (0.39%)           0.08%               187
       Total All Hospitals       (1.07%)     (0.65%)        2016      (0.76%)    (0.37%)      1996                                           (1.46%)          (0.76%)             1991
     Excluded Cost Reports                                   124                               120                                                                                 129
      Total Cost Reports                                    2140                              2116                                                                                2120
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.



                                                                                   October 2010                                                                                           15
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
                                               2009                                  2008                                                                       2007
         Quartile Rank
                                   Mean      Median        Count        Mean       Median      Count                                           Mean           Median              Count
          1st Quartile             8.56%      6.70%          82         8.15%       6.36%        92                                            8.86%           7.59%                94
          2nd Quartile             0.77%      0.73%          82         0.64%       0.51%        92                                            0.99%           0.75%                95
          3rd Quartile            (4.11%)    (3.89%)         82        (3.88%)     (3.87%)       92                                           (3.30%)         (3.48%)              95
          4th Quartile           (14.02%) (13.43%)           82       (12.81%) (11.59%)          92                                          (13.14%)        (12.32%)               95
        Total Population          (2.20%)    (1.87%)        328        (1.97%)     (1.26%)      368                                           (1.68%)         (0.89%)              379
     Excluded Cost Reports                                   33                                  39                                                                                 29
      Total Cost Reports                                    361                                 407                                                                                408
                                               2006                                  2005                                                                       2004
         Quartile Rank
                                   Mean      Median        Count        Mean       Median      Count                                           Mean           Median              Count
          1st Quartile             7.83%      6.50%          87         7.87%       6.94%        74                                            7.73%           7.08%                59
          2nd Quartile             0.59%      0.55%          88         0.50%       0.47%        74                                            0.28%           0.72%                59
          3rd Quartile            (3.96%)    (3.96%)         88        (4.42%)     (4.13%)       74                                           (4.89%)         (4.72%)              60
          4th Quartile           (14.61%) (13.53%)           88       (13.46%) (12.05%)          75                                          (13.65%)        (12.72%)               60
        Total Population          (2.57%)    (1.58%)        351        (2.42%)     (2.01%)      297                                           (2.69%)         (2.64%)              238
     Excluded Cost Reports                                   25                                  23                                                                                 31
      Total Cost Reports                                    376                                 320                                                                                269
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           16
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            10.96%      9.72%          81        10.34%      9.61%         93      10.58%                                               10.13%                96
          2nd Quartile             1.51%      1.48%          81         1.53%      1.12%         93       2.35%                                                1.88%                96
          3rd Quartile            (3.58%)    (3.59%)         81        (4.00%)    (4.09%)        94      (2.96%)                                              (2.59%)              96
          4th Quartile           (12.27%) (11.10%)           81       (13.74%) (13.13%)          94     (12.65%)                                             (11.12%)               97
        Total Population          (0.84%)    (1.26%)        324        (1.51%)    (1.16%)       374      (0.70%)                                              (0.28%)              385
     Excluded Cost Reports                                   23                                  30                                                                                 29
      Total Cost Reports                                    347                                 404                                                                                414
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            10.75%      9.52%          94        10.63%      9.03%        100       8.65%                                                7.61%               112
          2nd Quartile             2.04%      1.88%          94         1.94%      1.74%        101       1.35%                                                1.35%               113
          3rd Quartile            (2.82%)    (2.89%)         94        (2.03%)    (1.89%)       101      (3.51%)                                              (3.36%)              113
          4th Quartile           (11.11%) (9.25%)            94       (11.63%) (10.50%)         101     (14.56%)                                             (14.53%)              113
        Total Population          (0.28%)    (0.01%)        376        (0.30%)    (0.05%)       403      (2.04%)                                              (0.64%)              451
     Excluded Cost Reports                                   24                                  23                                                                                 26
      Total Cost Reports                                    400                                 426                                                                                477
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           17
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             9.94%      8.66%          96         8.72%      8.07%        113       9.04%                                                8.00%               114
          2nd Quartile             1.87%      2.06%          96         0.67%      0.58%        113       1.86%                                                1.88%               114
          3rd Quartile            (2.15%)    (2.20%)         96        (2.99%)    (2.84%)       114      (2.56%)                                              (2.48%)              114
          4th Quartile            (9.51%)    (7.67%)         96       (11.45%) (9.65%)          114     (11.91%)                                             (10.42%)              114
        Total Population           0.04%     (0.24%)        384        (1.29%)    (1.28%)       454      (0.89%)                                              (0.41%)              456
     Excluded Cost Reports                                   19                                  25                                                                                 28
      Total Cost Reports                                    403                                 479                                                                                484
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             8.67%      7.04%         115         9.12%      7.83%        116       7.98%                                                6.30%               117
          2nd Quartile             1.04%      1.12%         116         1.82%      1.72%        116       0.79%                                                0.61%               117
          3rd Quartile            (2.74%)    (2.79%)        116        (2.32%)    (1.91%)       116      (3.33%)                                              (3.03%)              118
          4th Quartile           (11.58%) (10.02%)          116       (10.78%) (9.05%)          116     (11.70%)                                             (10.32%)              118
        Total Population          (1.17%)    (0.86%)        463        (0.54%)    (0.44%)       464      (1.59%)                                              (0.82%)              470
     Excluded Cost Reports                                   22                                  26                                                                                 23
      Total Cost Reports                                    485                                 490                                                                                493
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           18
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             8.32%      6.83%          63         8.43%      7.42%         72       8.94%                                                7.16%                74
          2nd Quartile             1.34%      1.11%          63         0.81%      0.43%         73       1.11%                                                1.10%                75
          3rd Quartile            (2.49%)    (2.44%)         63        (2.89%)    (2.68%)       73       (2.84%)                                              (2.87%)              75
          4th Quartile           (10.85%) (9.55%)            63       (10.96%) (9.63%)           73     (10.24%)                                              (9.19%)               75
        Total Population          (0.92%)    (0.65%)        252        (1.18%)    (1.25%)       291      (0.79%)                                              (0.69%)              299
     Excluded Cost Reports                                   22                                  24                                                                                 19
      Total Cost Reports                                    274                                 315                                                                                318
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             8.61%      7.00%          75         8.51%      6.58%         76       8.18%                                                6.07%                76
          2nd Quartile             0.93%      0.93%          75         0.81%      0.61%         77       0.66%                                                0.61%                76
          3rd Quartile            (3.17%)    (3.11%)         75        (3.23%)    (3.22%)       77       (3.73%)                                              (3.66%)              76
          4th Quartile           (10.77%) (9.63%)            76       (10.64%) (9.43%)           77     (11.28%)                                             (10.45%)               77
        Total Population          (1.13%)    (1.14%)        301        (1.17%)    (1.07%)       307      (1.57%)                                              (1.33%)              305
     Excluded Cost Reports                                   24                                  19                                                                                 20
      Total Cost Reports                                    325                                 326                                                                                325
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           19
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            10.31%      8.98%          45         9.26%      8.40%         52       9.63%                                                9.02%                53
          2nd Quartile             2.57%      2.72%          45         1.46%      1.27%         52       2.10%                                                2.31%                53
          3rd Quartile            (0.24%)    (0.09%)         45        (2.21%)    (2.40%)       52       (2.16%)                                              (2.05%)              53
          4th Quartile            (8.09%)    (5.03%)         46       (10.72%) (8.50%)          52       (9.50%)                                              (9.19%)              53
        Total Population           1.09%      0.89%         181        (0.55%)    (0.23%)       208       0.02%                                               (0.39%)              212
     Excluded Cost Reports                                   12                                  15                                                                                 15
      Total Cost Reports                                    193                                 223                                                                                227
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             9.49%      8.49%          53         9.23%      8.50%         54       8.58%                                                7.30%                54
          2nd Quartile             2.25%      2.11%          54         2.44%      2.53%         54       1.56%                                                1.37%                54
          3rd Quartile            (1.91%)    (1.73%)         54        (1.48%)    (1.45%)       54       (1.74%)                                              (1.75%)              55
          4th Quartile           (10.24%) (9.25%)            54        (9.72%)    (7.70%)       55       (8.88%)                                              (7.54%)              55
        Total Population          (0.15%)     0.14%         215         0.07%      0.52%        217      (0.17%)                                              (0.18%)              218
     Excluded Cost Reports                                   12                                  11                                                                                 11
      Total Cost Reports                                    227                                 228                                                                                229
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           20
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             8.94%      7.61%          25         8.10%      7.40%         30       9.07%                                                6.96%                30
          2nd Quartile             2.36%      2.39%          25         1.37%      1.70%         30       1.75%                                                1.76%                31
          3rd Quartile            (1.41%)    (1.13%)         25        (2.66%)    (2.57%)       30       (2.20%)                                              (1.66%)              31
          4th Quartile            (8.47%)    (6.72%)         26       (11.02%) (10.45%)          31     (11.92%)                                             (10.88%)               31
        Total Population           0.27%      0.05%         101        (1.14%)    (0.93%)       121      (0.90%)                                              (0.24%)              123
     Excluded Cost Reports                                   7                                   6                                                                                  5
      Total Cost Reports                                    108                                 127                                                                                128
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile             7.90%      6.04%          30         9.41%      8.99%         29       9.44%                                                7.31%                30
          2nd Quartile             1.85%      1.79%          30         2.73%      2.78%         30       2.19%                                                2.21%                30
          3rd Quartile            (2.25%)    (2.42%)         30        (1.01%)    (1.18%)       30       (1.31%)                                              (1.44%)              31
          4th Quartile           (10.71%) (10.01%)           31       (11.36%) (10.88%)          30     (10.43%)                                              (8.99%)               31
        Total Population          (0.89%)     0.31%         121        (0.14%)     1.11%        119      (0.12%)                                               0.53%               122
     Excluded Cost Reports                                   7                                   8                                                                                  6
      Total Cost Reports                                    128                                 127                                                                                128
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           21
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States with Over 500 Licensed Beds
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median      Count                                            Mean           Median              Count
          1st Quartile             9.77%      9.78%          40         8.70%      8.47%        47                                            10.85%           9.77%                47
          2nd Quartile             2.85%      2.68%          40         2.73%      2.98%        47                                             3.07%           2.94%                47
          3rd Quartile            (1.48%)    (1.46%)         40        (2.38%)    (2.26%)       48                                            (1.89%)         (1.56%)              47
          4th Quartile            (9.87%)    (8.13%)         40       (11.29%) (10.47%)         48                                           (11.08%)         (9.42%)              47
        Total Population           0.32%      0.75%         160        (0.62%)    (0.03%)      190                                             0.24%           0.20%               188
     Excluded Cost Reports                                   5                                   8                                                                                 11
      Total Cost Reports                                    165                                198                                                                                 199
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median      Count                                            Mean           Median              Count
          1st Quartile             8.90%      7.82%          47         9.12%      8.37%        47                                             9.45%           8.16%                46
          2nd Quartile             2.04%      1.80%          47         1.98%      1.75%        47                                             2.05%           1.75%                47
          3rd Quartile            (2.24%)    (2.21%)         47        (1.56%)    (1.39%)       47                                            (1.54%)         (1.45%)              47
          4th Quartile           (11.34%) (8.06%)            48       (10.77%) (8.23%)          48                                           (11.33%)         (9.19%)               47
        Total Population          (0.72%)     0.38%         189        (0.36%)     0.33%       189                                            (0.39%)          0.08%               187
     Excluded Cost Reports                                   10                                 10                                                                                  12
      Total Cost Reports                                    199                                199                                                                                 199
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           22
Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Not-For-Profit General Acute Care Hospitals in the United States Regardless of Bed Size
                                               2009                                 2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median                                       Count           Mean           Median              Count
          1st Quartile             9.60%      8.43%          432        8.89%      8.10%                                        499            9.51%           8.49%               508
          2nd Quartile             1.71%      1.81%          432        1.16%      1.01%                                        500            1.81%           1.71%               511
          3rd Quartile            (2.54%)    (2.38%)         432       (3.17%)    (2.99%)                                       503           (2.69%)         (2.57%)              511
          4th Quartile           (10.89%) (9.77%)            434      (11.94%) (10.73%)                                         504          (11.71%)        (10.37%)              512
        Total Population          (0.54%)    (0.36%)        1730       (1.29%)    (1.04%)                                      2006           (0.79%)         (0.47%)             2042
     Excluded Cost Reports                                   121                                                                147                                                136
      Total Cost Reports                                    1851                                                               2153                                               2178
                                               2006                                 2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median                                       Count           Mean           Median              Count
          1st Quartile             8.97%      7.66%          501        9.17%      7.90%                                        496            8.43%           7.08%               494
          2nd Quartile             1.40%      1.40%          504        1.63%      1.57%                                        499            1.12%           1.12%               496
          3rd Quartile            (2.87%)    (2.83%)         504       (2.47%)    (2.27%)                                       499           (3.15%)         (2.90%)              500
          4th Quartile           (11.68%) (10.01%)          507       (11.25%) (10.11%)                                         502          (12.09%)        (10.75%)              501
        Total Population          (1.07%)    (0.65%)        2016       (0.76%)    (0.37%)                                      1996           (1.46%)         (0.76%)             1991
     Excluded Cost Reports                                   124                                                                120                                                129
      Total Cost Reports                                    2140                                                               2116                                               2120
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           23
Total Labor Cost as a Percentage of Total Operating Revenues - Summary
Total Labor Cost as a Percentage of Total Operating Revenues
All Not-For-Profit General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
                                               2009                               2008                                                                         2007
   Number of Licensed Beds
                                   Mean      Median        Count       Mean      Median      Count                                             Mean           Median              Count
        25 Beds or Less           48.66%     48.99%          338      49.05%     49.65%        375                                            49.13%          49.12%               375
        26 to 100 Beds            49.99%     49.98%          329      50.77%     51.01%        379                                            50.83%          50.93%               397
        101 to 200 Beds           50.02%     50.48%          390      51.08%     50.99%        460                                            51.14%          50.83%               465
        201 to 300 Beds           50.43%     49.91%          259      51.15%     50.58%        292                                            51.08%          50.68%               297
        301 to 400 Beds           49.93%     49.64%          181      50.61%     50.58%        203                                            51.22%          50.83%               214
        401 to 500 Beds           49.57%     48.23%          105      51.07%     49.94%        121                                            51.07%          50.77%               122
        Over 500 Beds             48.70%     47.91%          158      49.65%     49.56%        191                                            49.35%          48.60%               193
       Total All Hospitals        49.66%     49.54%         1760      50.47%     50.48%       2021                                            50.54%          50.33%              2063
     Excluded Cost Reports                                    91                               132                                                                                 115
      Total Cost Reports                                    1851                              2153                                                                                2178
                                               2006                               2005                                                                         2004
   Number of Licensed Beds
                                   Mean      Median        Count       Mean      Median      Count                                             Mean           Median              Count
        25 Beds or Less           48.68%     48.35%          346      48.16%     48.16%        294                                            48.89%          48.67%               244
        26 to 100 Beds            51.06%     50.75%          383      51.53%     51.32%        407                                            52.72%          52.83%               449
        101 to 200 Beds           51.42%     51.69%          470      50.76%     50.66%        469                                            51.74%          51.71%               472
        201 to 300 Beds           51.19%     50.90%          300      51.52%     51.60%        306                                            52.30%          51.95%               307
        301 to 400 Beds           50.81%     50.52%          214      50.55%     50.81%        215                                            51.25%          51.13%               216
        401 to 500 Beds           51.15%     50.68%          120      51.04%     50.47%        121                                            51.13%          50.84%               124
        Over 500 Beds             49.57%     49.36%          190      49.48%     48.69%        191                                            50.01%          49.17%               192
       Total All Hospitals        50.59%     50.34%         2023      50.53%     50.45%       2003                                            51.44%          51.29%              2004
     Excluded Cost Reports                                   117                               113                                                                                 116
      Total Cost Reports                                    2140                              2116                                                                                2120
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.



                                                                                   October 2010                                                                                           24
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Total Labor Cost as a Percentage of Total Operating Revenues
All Not-For-Profit General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
                                               2009                                 2008                                                                       2007
         Quartile Rank
                                   Mean      Median        Count        Mean       Median      Count                                           Mean           Median              Count
          1st Quartile            36.52%     37.15%          84        37.76%      38.09%        93                                           37.28%          37.58%                93
          2nd Quartile            45.70%     45.77%          84        46.40%      46.52%        94                                           46.40%          47.00%                94
          3rd Quartile            52.12%     52.31%          85        52.31%      52.46%        94                                           52.61%          53.08%                94
          4th Quartile            60.12%     60.04%          85        59.59%      58.88%        94                                           60.10%          59.36%                94
        Total Population          48.66%     48.99%         338        49.05%      49.65%       375                                           49.13%          49.12%               375
     Excluded Cost Reports                                   23                                  32                                                                                 33
      Total Cost Reports                                    361                                 407                                                                                408
                                               2006                                 2005                                                                       2004
         Quartile Rank
                                   Mean      Median        Count        Mean       Median      Count                                           Mean           Median              Count
          1st Quartile            37.37%     37.61%          86        36.86%      37.30%        73                                           37.87%          38.45%                61
          2nd Quartile            45.28%     45.38%          86        44.28%      43.98%        73                                           44.99%          44.92%                61
          3rd Quartile            51.70%     51.93%          87        51.55%      51.50%        74                                           52.00%          51.98%                61
          4th Quartile            60.18%     59.10%          87        59.76%      59.35%        74                                           60.68%          59.79%                61
        Total Population          48.68%     48.35%         346        48.16%      48.16%       294                                           48.89%          48.67%               244
     Excluded Cost Reports                                   30                                  26                                                                                 25
      Total Cost Reports                                    376                                 320                                                                                269
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           25
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Total Labor Cost as a Percentage of Total Operating Revenues
All Not-For-Profit General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
                                               2009                                2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            39.70%     40.43%          82        40.76%     41.51%         94      40.84%                                               41.07%                99
          2nd Quartile            47.25%     47.27%          82        48.29%     48.46%         95      48.47%                                               48.56%                99
          3rd Quartile            52.91%     52.73%          82        53.22%     53.24%         95      53.04%                                               53.10%                99
          4th Quartile            59.99%     58.78%          83        60.71%     60.20%         95      60.85%                                               60.27%               100
        Total Population          49.99%     49.98%         329        50.77%     51.01%        379      50.83%                                               50.93%               397
     Excluded Cost Reports                                   18                                  25                                                                                 17
      Total Cost Reports                                    347                                 404                                                                                414
                                               2006                                2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            41.56%     42.86%          95        42.10%     43.22%        101      43.82%                                               44.66%               112
          2nd Quartile            48.48%     48.44%          96        49.20%     49.48%        102      50.26%                                               50.24%               112
          3rd Quartile            53.37%     53.21%          96        53.77%     53.69%        102      54.99%                                               54.81%               112
          4th Quartile            60.72%     60.56%          96        60.98%     61.00%        102      61.74%                                               61.51%               113
        Total Population          51.06%     50.75%         383        51.53%     51.32%        407      52.72%                                               52.83%               449
     Excluded Cost Reports                                   17                                  19                                                                                 28
      Total Cost Reports                                    400                                 426                                                                                477
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           26
Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Total Labor Cost as a Percentage of Total Operating Revenues
All Not-For-Profit General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
                                               2009                                2008                                                                        2007
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            40.81%     41.58%          97        41.76%     42.28%        115      42.01%                                               42.68%               116
          2nd Quartile            47.62%     47.67%          97        48.59%     48.54%        115      48.46%                                               48.66%               116
          3rd Quartile            52.49%     52.51%          98        53.36%     53.37%        115      53.61%                                               53.88%               116
          4th Quartile            59.02%     58.04%          98        60.62%     59.96%        115      60.40%                                               60.00%               117
        Total Population          50.02%     50.48%         390        51.08%     50.99%        460      51.14%                                               50.83%               465
     Excluded Cost Reports                                   13                                  19                                                                                 19
      Total Cost Reports                                    403                                 479                                                                                484
                                               2006                                2005                                                                        2004
         Quartile Rank
                                   Mean      Median        Count        Mean      Median       Count      Mean                                                Median              Count
          1st Quartile            41.91%     42.79%         117        41.38%     42.60%        117      42.53%                                               43.50%               118
          2nd Quartile            48.91%     49.06%         117        48.29%     48.42%        117      49.35%                                               49.42%               118
          3rd Quartile            54.17%     54.20%         118        53.32%     53.34%        117      54.21%                                               54.06%               118
          4th Quartile            60.58%     60.04%         118        59.99%     59.99%        118      60.89%                                               60.33%               118
        Total Population          51.42%     51.69%         470        50.76%     50.66%        469      51.74%                                               51.71%               472
     Excluded Cost Reports                                   15                                  21                                                                                 21
      Total Cost Reports                                    485                                 490                                                                                493
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                           27
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010
HMP Metrics™: Not-For-Profit Hospitals October, 2010

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HMP Metrics™: Not-For-Profit Hospitals October, 2010

  • 1. 1
  • 2. Table of Contents Executive Summary 3-5 Financial and Operational Study 6 - 59 • Total Profit Margin 6 - 14 • Total Operating Profit Margin 15 - 23 • Total Labor Cost as a Percentage of Total Operating Revenues 24 - 32 • Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 33 - 41 • Days Net Patient Revenue in Accounts Receivable (AR) 42 - 50 • Average Age of Plant and Equipment 51 - 59 Introduction to Healthcare Management Partners 60 - 64 Clients Our Professionals Have Served 65 - 66 Firm Leadership 67 - 70 Contact Information 71 October 2010 2
  • 3. Executive Summary – Overview Healthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its senior executives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignments across the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools are necessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMP MetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparable facilities and against “1st Quartile” or “High Performing” competitors. Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive study comparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groups selected include the following: 1. All General Acute Care Hospitals Regardless of Ownership or Sponsorship 2. All Investor Owned General Acute Care Hospitals 3. All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations 4. All State and Local Government Owned General Acute Care Hospitals 5. Free Standing Children’s Hospitals 6. All Non-Federal Major Teaching Hospitals Using proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period or statistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals, specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensed beds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer group comparisons for dozens of standard industry metrics. This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustrate the benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess the relative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or create new peer groups and compare them to state, local or national benchmarks. October 2010 3
  • 4. Executive Summary – Key Terms Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for all not-for-profit general acute care hospitals within the peer groups. Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.42% 10.12% 433 10.16% 8.94% 503 13.47% 12.63% 513 2nd Quartile 4.04% 4.03% 433 3.26% 3.24% 505 6.40% 6.35% 516 3rd Quartile 0.15% 0.14% 436 (0.73%) (0.61%) 507 2.29% 2.36% 518 4th Quartile (7.04%) (5.98%) 438 (8.21%) (7.33%) 510 (4.80%) (3.68%) 519 Total Population 2.11% 2.08% 1740 1.08% 1.33% 2025 4.31% 4.19% 2066 Excluded Cost Reports 111 128 112 Total Cost Reports 1851 2153 2178 As noted above, the first quartile contains the top 25% of the best performing hospitals in an applicable peer group, the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains those hospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%. Mean Value: The mean value is the average of all amounts within a defined quartile or population. Median Value: The report also contains the median value by quartile or total population. Count: Actual number of qualified hospitals included in the mean or median calculation. Excluded Cost Reports: Represents those metrics values not considered normative (i.e., outlier values). For example, certain metric values that were greater than two standard deviations from the mean of a reported population would be excluded from the analysis and included in this category. October 2010 4
  • 5. Executive Summary – Hospital Performance Metrics A measure of overall hospital profitability presented as a percentage. A negative percentage Total Profit Margin indicates an overall loss, while a positive percentage indicates profitability. A measure of operating profitability presented as a percentage. A negative percentage indicates Total Operating Profit Margin overall loss, while a positive percentage indicates profitability. A measure of labor productivity. This metric divides labor costs by operating revenues. A Total Labor Cost as a Percentage of higher percentage compared to its peers indicates that a hospital uses more labor to produce its Total Operating Revenues revenue. Measures the number of full-time equivalent (FTE) employees used for each occupied bed. Full-Time Equivalent Staff (FTEs) per Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital Adjusted Occupied Bed (AOB) uses more labor to treat its patients. Measures the number of days it typically takes to collect accounts receivable. A higher Days Net Patient Revenue in percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as Accounts Receivable (AR) its peers. Measures the average age of the hospital including capital improvements and major equipment Average Age of Plant and Equipment purchases. A higher age compared to its peers indicates that the hospital has deferred the replacement of its capital when compared to its peers, which can lead to further distress. Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in the Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations. Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, and hospitals where the computed metric is more than 2 standard deviations from the mean. October 2010 5
  • 6. Total Profit Margin - Summary Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 0.95% 1.06% 338 0.84% 1.14% 383 2.84% 3.15% 388 26 to 100 Beds 2.15% 1.73% 324 1.29% 1.38% 382 3.95% 3.44% 389 101 to 200 Beds 2.10% 2.14% 381 0.95% 0.85% 453 3.94% 3.91% 455 201 to 300 Beds 1.69% 1.60% 254 0.81% 1.19% 293 4.40% 4.60% 303 301 to 400 Beds 3.44% 3.80% 181 1.01% 1.64% 203 5.62% 5.32% 214 401 to 500 Beds 3.13% 3.07% 102 1.40% 1.83% 121 6.02% 5.89% 123 Over 500 Beds 3.05% 3.57% 160 1.78% 3.17% 190 6.15% 6.05% 194 Total All Hospitals 2.11% 2.08% 1740 1.08% 1.33% 2025 4.31% 4.19% 2066 Excluded Cost Reports 111 128 112 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 2.56% 2.68% 359 1.99% 1.81% 305 1.50% 1.99% 249 26 to 100 Beds 3.98% 3.77% 381 3.68% 3.57% 408 2.12% 3.13% 455 101 to 200 Beds 3.17% 3.33% 467 2.89% 3.18% 470 2.42% 2.79% 471 201 to 300 Beds 3.23% 3.80% 304 3.24% 3.43% 311 2.77% 3.09% 309 301 to 400 Beds 5.19% 5.21% 218 4.51% 4.79% 219 4.33% 4.40% 216 401 to 500 Beds 5.19% 5.07% 122 5.04% 4.96% 123 4.79% 4.66% 123 Over 500 Beds 5.63% 5.43% 193 4.75% 5.02% 197 4.39% 4.80% 196 Total All Hospitals 3.79% 3.96% 2044 3.45% 3.64% 2033 2.83% 3.30% 2019 Excluded Cost Reports 96 83 101 Total Cost Reports 2140 2116 2120 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 6
  • 7. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.91% 8.39% 84 9.46% 8.32% 95 11.35% 10.59% 97 2nd Quartile 3.00% 2.98% 84 3.02% 2.93% 96 4.98% 4.85% 97 3rd Quartile (0.92%) (0.97%) 85 (1.04%) (1.03%) 96 1.14% 1.26% 97 4th Quartile (8.06%) (6.88%) 85 (7.99%) (6.83%) 96 (6.10%) (4.70%) 97 Total Population 0.95% 1.06% 338 0.84% 1.14% 383 2.84% 3.15% 388 Excluded Cost Reports 23 24 20 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.46% 10.82% 89 10.54% 9.66% 76 9.30% 8.54% 62 2nd Quartile 4.74% 4.84% 90 4.20% 4.48% 76 3.96% 4.17% 62 3rd Quartile 0.76% 0.93% 90 0.14% 0.08% 76 (0.02%) (0.15%) 62 4th Quartile (6.63%) (4.93%) 90 (6.81%) (5.94%) 77 (7.11%) (5.52%) 63 Total Population 2.56% 2.68% 359 1.99% 1.81% 305 1.50% 1.99% 249 Excluded Cost Reports 17 15 20 Total Cost Reports 376 320 269 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 7
  • 8. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.86% 11.42% 81 12.23% 11.52% 95 14.59% 13.25% 97 2nd Quartile 3.96% 3.97% 81 3.42% 3.20% 95 6.28% 6.28% 97 3rd Quartile (0.58%) (0.58%) 81 (1.16%) (1.16%) 96 1.43% 1.67% 97 4th Quartile (7.64%) (6.65%) 81 (9.17%) (8.21%) 96 (6.40%) (5.37%) 98 Total Population 2.15% 1.73% 324 1.29% 1.38% 382 3.95% 3.44% 389 Excluded Cost Reports 23 22 25 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 13.77% 12.50% 95 13.22% 11.88% 102 11.27% 10.09% 113 2nd Quartile 5.90% 5.72% 95 5.46% 5.25% 102 4.69% 4.63% 114 3rd Quartile 2.07% 2.12% 95 1.76% 1.80% 102 0.80% 0.92% 114 4th Quartile (5.72%) (4.40%) 96 (5.73%) (4.49%) 102 (8.20%) (6.85%) 114 Total Population 3.98% 3.77% 381 3.68% 3.57% 408 2.12% 3.13% 455 Excluded Cost Reports 19 18 22 Total Cost Reports 400 426 477 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 8
  • 9. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.37% 10.13% 95 9.83% 7.82% 113 13.09% 12.39% 113 2nd Quartile 3.82% 3.84% 95 2.89% 2.87% 113 5.88% 5.96% 114 3rd Quartile 0.16% 0.17% 95 (0.76%) (0.71%) 113 2.10% 2.22% 114 4th Quartile (6.86%) (5.38%) 96 (8.08%) (7.33%) 114 (5.21%) (3.49%) 114 Total Population 2.10% 2.14% 381 0.95% 0.85% 453 3.94% 3.91% 455 Excluded Cost Reports 22 26 29 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.81% 10.89% 116 10.92% 9.93% 117 10.42% 9.21% 117 2nd Quartile 4.93% 4.66% 117 5.10% 5.10% 117 4.50% 4.41% 118 3rd Quartile 1.81% 1.83% 117 1.54% 1.69% 118 1.17% 1.23% 118 4th Quartile (5.78%) (4.16%) 117 (5.91%) (4.82%) 118 (6.34%) (4.82%) 118 Total Population 3.17% 3.33% 467 2.89% 3.18% 470 2.42% 2.79% 471 Excluded Cost Reports 18 20 22 Total Cost Reports 485 490 493 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 9
  • 10. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.26% 9.57% 63 9.31% 8.13% 73 13.37% 13.04% 75 2nd Quartile 3.46% 3.01% 63 2.95% 3.03% 73 6.53% 6.42% 76 3rd Quartile (0.16%) (0.23%) 64 (0.95%) (0.81%) 73 2.48% 2.72% 76 4th Quartile (6.64%) (5.27%) 64 (7.94%) (6.65%) 74 (4.68%) (3.23%) 76 Total Population 1.69% 1.60% 254 0.81% 1.19% 293 4.40% 4.60% 303 Excluded Cost Reports 20 22 15 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.43% 10.09% 76 10.77% 9.69% 77 10.34% 9.19% 77 2nd Quartile 5.57% 5.61% 76 5.03% 5.12% 78 4.84% 4.76% 77 3rd Quartile 1.75% 1.66% 76 1.67% 1.84% 78 1.32% 1.45% 77 4th Quartile (5.85%) (4.86%) 76 (4.41%) (3.43%) 78 (5.32%) (4.22%) 78 Total Population 3.23% 3.80% 304 3.24% 3.43% 311 2.77% 3.09% 309 Excluded Cost Reports 21 15 16 Total Cost Reports 325 326 325 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 10
  • 11. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.19% 11.24% 45 9.41% 8.65% 50 14.35% 13.60% 53 2nd Quartile 5.50% 5.77% 45 3.43% 3.55% 51 7.50% 7.39% 53 3rd Quartile 1.69% 1.71% 45 (0.58%) (0.34%) 51 3.42% 3.34% 54 4th Quartile (5.43%) (4.48%) 46 (8.04%) (7.47%) 51 (2.57%) (1.54%) 54 Total Population 3.44% 3.80% 181 1.01% 1.64% 203 5.62% 5.32% 214 Excluded Cost Reports 12 20 13 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.74% 11.83% 54 12.03% 11.20% 54 11.36% 10.59% 54 2nd Quartile 6.76% 6.37% 54 6.33% 6.14% 55 5.41% 5.33% 54 3rd Quartile 3.74% 3.87% 55 3.06% 2.98% 55 2.84% 2.86% 54 4th Quartile (2.30%) (0.90%) 55 (3.24%) (2.17%) 55 (2.28%) (0.92%) 54 Total Population 5.19% 5.21% 218 4.51% 4.79% 219 4.33% 4.40% 216 Excluded Cost Reports 9 9 13 Total Cost Reports 227 228 229 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 11
  • 12. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.82% 11.64% 25 9.57% 8.07% 30 15.28% 14.22% 30 2nd Quartile 5.35% 5.48% 25 3.11% 3.07% 30 7.88% 7.69% 31 3rd Quartile 1.25% 1.26% 26 0.18% 0.25% 30 3.62% 3.29% 31 4th Quartile (6.44%) (5.17%) 26 (7.00%) (6.01%) 31 (2.40%) (1.06%) 31 Total Population 3.13% 3.07% 102 1.40% 1.83% 121 6.02% 5.89% 123 Excluded Cost Reports 6 6 5 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 13.07% 11.71% 30 13.55% 12.29% 30 12.17% 11.43% 30 2nd Quartile 6.78% 6.70% 30 7.02% 6.72% 31 7.11% 6.85% 31 3rd Quartile 3.78% 3.94% 31 3.56% 3.62% 31 2.84% 2.82% 31 4th Quartile (2.56%) (0.88%) 31 (3.71%) (1.36%) 31 (2.74%) (1.04%) 31 Total Population 5.19% 5.07% 122 5.04% 4.96% 123 4.79% 4.66% 123 Excluded Cost Reports 6 4 5 Total Cost Reports 128 127 128 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 12
  • 13. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.88% 11.00% 40 10.67% 9.56% 47 14.39% 13.20% 48 2nd Quartile 5.41% 5.36% 40 4.74% 4.90% 47 8.36% 8.63% 48 3rd Quartile 1.89% 2.14% 40 0.40% 0.15% 48 4.28% 4.20% 49 4th Quartile (6.99%) (5.50%) 40 (8.44%) (7.49%) 48 (2.22%) 0.06% 49 Total Population 3.05% 3.57% 160 1.78% 3.17% 190 6.15% 6.05% 194 Excluded Cost Reports 5 8 5 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.86% 12.09% 48 11.62% 11.12% 49 11.34% 10.37% 49 2nd Quartile 7.09% 7.15% 48 6.73% 6.70% 49 6.44% 6.32% 49 3rd Quartile 3.98% 3.89% 48 3.51% 3.56% 49 3.25% 3.09% 49 4th Quartile (1.27%) 0.79% 49 (2.69%) (0.19%) 50 (3.47%) (0.61%) 49 Total Population 5.63% 5.43% 193 4.75% 5.02% 197 4.39% 4.80% 196 Excluded Cost Reports 6 2 3 Total Cost Reports 199 199 199 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 13
  • 14. Peer Group Comparison – Total Profit Margin Total Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 11.42% 10.12% 433 10.16% 8.94% 503 13.47% 12.63% 513 2nd Quartile 4.04% 4.03% 433 3.26% 3.24% 505 6.40% 6.35% 516 3rd Quartile 0.15% 0.14% 436 (0.73%) (0.61%) 507 2.29% 2.36% 518 4th Quartile (7.04%) (5.98%) 438 (8.21%) (7.33%) 510 (4.80%) (3.68%) 519 Total Population 2.11% 2.08% 1740 1.08% 1.33% 2025 4.31% 4.19% 2066 Excluded Cost Reports 111 128 112 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 12.33% 11.46% 508 11.65% 10.83% 505 10.76% 9.91% 502 2nd Quartile 5.68% 5.62% 510 5.43% 5.41% 508 4.97% 4.95% 505 3rd Quartile 2.19% 2.23% 512 1.87% 2.00% 509 1.45% 1.65% 505 4th Quartile (4.93%) (3.74%) 514 (5.04%) (4.07%) 511 (5.77%) (4.63%) 507 Total Population 3.79% 3.96% 2044 3.45% 3.64% 2033 2.83% 3.30% 2019 Excluded Cost Reports 96 83 101 Total Cost Reports 2140 2116 2120 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 14
  • 15. Total Operating Profit Margin - Summary Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less (2.20%) (1.87%) 328 (1.97%) (1.26%) 368 (1.68%) (0.89%) 379 26 to 100 Beds (0.84%) (1.26%) 324 (1.51%) (1.16%) 374 (0.70%) (0.28%) 385 101 to 200 Beds 0.04% (0.24%) 384 (1.29%) (1.28%) 454 (0.89%) (0.41%) 456 201 to 300 Beds (0.92%) (0.65%) 252 (1.18%) (1.25%) 291 (0.79%) (0.69%) 299 301 to 400 Beds 1.09% 0.89% 181 (0.55%) (0.23%) 208 0.02% (0.39%) 212 401 to 500 Beds 0.27% 0.05% 101 (1.14%) (0.93%) 121 (0.90%) (0.24%) 123 Over 500 Beds 0.32% 0.75% 160 (0.62%) (0.03%) 190 0.24% 0.20% 188 Total All Hospitals (0.54%) (0.36%) 1730 (1.29%) (1.04%) 2006 (0.79%) (0.47%) 2042 Excluded Cost Reports 121 147 136 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less (2.57%) (1.58%) 351 (2.42%) (2.01%) 297 (2.69%) (2.64%) 238 26 to 100 Beds (0.28%) (0.01%) 376 (0.30%) (0.05%) 403 (2.04%) (0.64%) 451 101 to 200 Beds (1.17%) (0.86%) 463 (0.54%) (0.44%) 464 (1.59%) (0.82%) 470 201 to 300 Beds (1.13%) (1.14%) 301 (1.17%) (1.07%) 307 (1.57%) (1.33%) 305 301 to 400 Beds (0.15%) 0.14% 215 0.07% 0.52% 217 (0.17%) (0.18%) 218 401 to 500 Beds (0.89%) 0.31% 121 (0.14%) 1.11% 119 (0.12%) 0.53% 122 Over 500 Beds (0.72%) 0.38% 189 (0.36%) 0.33% 189 (0.39%) 0.08% 187 Total All Hospitals (1.07%) (0.65%) 2016 (0.76%) (0.37%) 1996 (1.46%) (0.76%) 1991 Excluded Cost Reports 124 120 129 Total Cost Reports 2140 2116 2120 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 15
  • 16. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.56% 6.70% 82 8.15% 6.36% 92 8.86% 7.59% 94 2nd Quartile 0.77% 0.73% 82 0.64% 0.51% 92 0.99% 0.75% 95 3rd Quartile (4.11%) (3.89%) 82 (3.88%) (3.87%) 92 (3.30%) (3.48%) 95 4th Quartile (14.02%) (13.43%) 82 (12.81%) (11.59%) 92 (13.14%) (12.32%) 95 Total Population (2.20%) (1.87%) 328 (1.97%) (1.26%) 368 (1.68%) (0.89%) 379 Excluded Cost Reports 33 39 29 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.83% 6.50% 87 7.87% 6.94% 74 7.73% 7.08% 59 2nd Quartile 0.59% 0.55% 88 0.50% 0.47% 74 0.28% 0.72% 59 3rd Quartile (3.96%) (3.96%) 88 (4.42%) (4.13%) 74 (4.89%) (4.72%) 60 4th Quartile (14.61%) (13.53%) 88 (13.46%) (12.05%) 75 (13.65%) (12.72%) 60 Total Population (2.57%) (1.58%) 351 (2.42%) (2.01%) 297 (2.69%) (2.64%) 238 Excluded Cost Reports 25 23 31 Total Cost Reports 376 320 269 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 16
  • 17. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.96% 9.72% 81 10.34% 9.61% 93 10.58% 10.13% 96 2nd Quartile 1.51% 1.48% 81 1.53% 1.12% 93 2.35% 1.88% 96 3rd Quartile (3.58%) (3.59%) 81 (4.00%) (4.09%) 94 (2.96%) (2.59%) 96 4th Quartile (12.27%) (11.10%) 81 (13.74%) (13.13%) 94 (12.65%) (11.12%) 97 Total Population (0.84%) (1.26%) 324 (1.51%) (1.16%) 374 (0.70%) (0.28%) 385 Excluded Cost Reports 23 30 29 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.75% 9.52% 94 10.63% 9.03% 100 8.65% 7.61% 112 2nd Quartile 2.04% 1.88% 94 1.94% 1.74% 101 1.35% 1.35% 113 3rd Quartile (2.82%) (2.89%) 94 (2.03%) (1.89%) 101 (3.51%) (3.36%) 113 4th Quartile (11.11%) (9.25%) 94 (11.63%) (10.50%) 101 (14.56%) (14.53%) 113 Total Population (0.28%) (0.01%) 376 (0.30%) (0.05%) 403 (2.04%) (0.64%) 451 Excluded Cost Reports 24 23 26 Total Cost Reports 400 426 477 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 17
  • 18. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.94% 8.66% 96 8.72% 8.07% 113 9.04% 8.00% 114 2nd Quartile 1.87% 2.06% 96 0.67% 0.58% 113 1.86% 1.88% 114 3rd Quartile (2.15%) (2.20%) 96 (2.99%) (2.84%) 114 (2.56%) (2.48%) 114 4th Quartile (9.51%) (7.67%) 96 (11.45%) (9.65%) 114 (11.91%) (10.42%) 114 Total Population 0.04% (0.24%) 384 (1.29%) (1.28%) 454 (0.89%) (0.41%) 456 Excluded Cost Reports 19 25 28 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.67% 7.04% 115 9.12% 7.83% 116 7.98% 6.30% 117 2nd Quartile 1.04% 1.12% 116 1.82% 1.72% 116 0.79% 0.61% 117 3rd Quartile (2.74%) (2.79%) 116 (2.32%) (1.91%) 116 (3.33%) (3.03%) 118 4th Quartile (11.58%) (10.02%) 116 (10.78%) (9.05%) 116 (11.70%) (10.32%) 118 Total Population (1.17%) (0.86%) 463 (0.54%) (0.44%) 464 (1.59%) (0.82%) 470 Excluded Cost Reports 22 26 23 Total Cost Reports 485 490 493 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 18
  • 19. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.32% 6.83% 63 8.43% 7.42% 72 8.94% 7.16% 74 2nd Quartile 1.34% 1.11% 63 0.81% 0.43% 73 1.11% 1.10% 75 3rd Quartile (2.49%) (2.44%) 63 (2.89%) (2.68%) 73 (2.84%) (2.87%) 75 4th Quartile (10.85%) (9.55%) 63 (10.96%) (9.63%) 73 (10.24%) (9.19%) 75 Total Population (0.92%) (0.65%) 252 (1.18%) (1.25%) 291 (0.79%) (0.69%) 299 Excluded Cost Reports 22 24 19 Total Cost Reports 274 315 318 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.61% 7.00% 75 8.51% 6.58% 76 8.18% 6.07% 76 2nd Quartile 0.93% 0.93% 75 0.81% 0.61% 77 0.66% 0.61% 76 3rd Quartile (3.17%) (3.11%) 75 (3.23%) (3.22%) 77 (3.73%) (3.66%) 76 4th Quartile (10.77%) (9.63%) 76 (10.64%) (9.43%) 77 (11.28%) (10.45%) 77 Total Population (1.13%) (1.14%) 301 (1.17%) (1.07%) 307 (1.57%) (1.33%) 305 Excluded Cost Reports 24 19 20 Total Cost Reports 325 326 325 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 19
  • 20. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 10.31% 8.98% 45 9.26% 8.40% 52 9.63% 9.02% 53 2nd Quartile 2.57% 2.72% 45 1.46% 1.27% 52 2.10% 2.31% 53 3rd Quartile (0.24%) (0.09%) 45 (2.21%) (2.40%) 52 (2.16%) (2.05%) 53 4th Quartile (8.09%) (5.03%) 46 (10.72%) (8.50%) 52 (9.50%) (9.19%) 53 Total Population 1.09% 0.89% 181 (0.55%) (0.23%) 208 0.02% (0.39%) 212 Excluded Cost Reports 12 15 15 Total Cost Reports 193 223 227 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.49% 8.49% 53 9.23% 8.50% 54 8.58% 7.30% 54 2nd Quartile 2.25% 2.11% 54 2.44% 2.53% 54 1.56% 1.37% 54 3rd Quartile (1.91%) (1.73%) 54 (1.48%) (1.45%) 54 (1.74%) (1.75%) 55 4th Quartile (10.24%) (9.25%) 54 (9.72%) (7.70%) 55 (8.88%) (7.54%) 55 Total Population (0.15%) 0.14% 215 0.07% 0.52% 217 (0.17%) (0.18%) 218 Excluded Cost Reports 12 11 11 Total Cost Reports 227 228 229 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 20
  • 21. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.94% 7.61% 25 8.10% 7.40% 30 9.07% 6.96% 30 2nd Quartile 2.36% 2.39% 25 1.37% 1.70% 30 1.75% 1.76% 31 3rd Quartile (1.41%) (1.13%) 25 (2.66%) (2.57%) 30 (2.20%) (1.66%) 31 4th Quartile (8.47%) (6.72%) 26 (11.02%) (10.45%) 31 (11.92%) (10.88%) 31 Total Population 0.27% 0.05% 101 (1.14%) (0.93%) 121 (0.90%) (0.24%) 123 Excluded Cost Reports 7 6 5 Total Cost Reports 108 127 128 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 7.90% 6.04% 30 9.41% 8.99% 29 9.44% 7.31% 30 2nd Quartile 1.85% 1.79% 30 2.73% 2.78% 30 2.19% 2.21% 30 3rd Quartile (2.25%) (2.42%) 30 (1.01%) (1.18%) 30 (1.31%) (1.44%) 31 4th Quartile (10.71%) (10.01%) 31 (11.36%) (10.88%) 30 (10.43%) (8.99%) 31 Total Population (0.89%) 0.31% 121 (0.14%) 1.11% 119 (0.12%) 0.53% 122 Excluded Cost Reports 7 8 6 Total Cost Reports 128 127 128 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 21
  • 22. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States with Over 500 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.77% 9.78% 40 8.70% 8.47% 47 10.85% 9.77% 47 2nd Quartile 2.85% 2.68% 40 2.73% 2.98% 47 3.07% 2.94% 47 3rd Quartile (1.48%) (1.46%) 40 (2.38%) (2.26%) 48 (1.89%) (1.56%) 47 4th Quartile (9.87%) (8.13%) 40 (11.29%) (10.47%) 48 (11.08%) (9.42%) 47 Total Population 0.32% 0.75% 160 (0.62%) (0.03%) 190 0.24% 0.20% 188 Excluded Cost Reports 5 8 11 Total Cost Reports 165 198 199 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.90% 7.82% 47 9.12% 8.37% 47 9.45% 8.16% 46 2nd Quartile 2.04% 1.80% 47 1.98% 1.75% 47 2.05% 1.75% 47 3rd Quartile (2.24%) (2.21%) 47 (1.56%) (1.39%) 47 (1.54%) (1.45%) 47 4th Quartile (11.34%) (8.06%) 48 (10.77%) (8.23%) 48 (11.33%) (9.19%) 47 Total Population (0.72%) 0.38% 189 (0.36%) 0.33% 189 (0.39%) 0.08% 187 Excluded Cost Reports 10 10 12 Total Cost Reports 199 199 199 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 22
  • 23. Peer Group Comparison – Total Operating Profit Margin Total Operating Profit Margin All Not-For-Profit General Acute Care Hospitals in the United States Regardless of Bed Size 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 9.60% 8.43% 432 8.89% 8.10% 499 9.51% 8.49% 508 2nd Quartile 1.71% 1.81% 432 1.16% 1.01% 500 1.81% 1.71% 511 3rd Quartile (2.54%) (2.38%) 432 (3.17%) (2.99%) 503 (2.69%) (2.57%) 511 4th Quartile (10.89%) (9.77%) 434 (11.94%) (10.73%) 504 (11.71%) (10.37%) 512 Total Population (0.54%) (0.36%) 1730 (1.29%) (1.04%) 2006 (0.79%) (0.47%) 2042 Excluded Cost Reports 121 147 136 Total Cost Reports 1851 2153 2178 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 8.97% 7.66% 501 9.17% 7.90% 496 8.43% 7.08% 494 2nd Quartile 1.40% 1.40% 504 1.63% 1.57% 499 1.12% 1.12% 496 3rd Quartile (2.87%) (2.83%) 504 (2.47%) (2.27%) 499 (3.15%) (2.90%) 500 4th Quartile (11.68%) (10.01%) 507 (11.25%) (10.11%) 502 (12.09%) (10.75%) 501 Total Population (1.07%) (0.65%) 2016 (0.76%) (0.37%) 1996 (1.46%) (0.76%) 1991 Excluded Cost Reports 124 120 129 Total Cost Reports 2140 2116 2120 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 23
  • 24. Total Labor Cost as a Percentage of Total Operating Revenues - Summary Total Labor Cost as a Percentage of Total Operating Revenues All Not-For-Profit General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds 2009 2008 2007 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 48.66% 48.99% 338 49.05% 49.65% 375 49.13% 49.12% 375 26 to 100 Beds 49.99% 49.98% 329 50.77% 51.01% 379 50.83% 50.93% 397 101 to 200 Beds 50.02% 50.48% 390 51.08% 50.99% 460 51.14% 50.83% 465 201 to 300 Beds 50.43% 49.91% 259 51.15% 50.58% 292 51.08% 50.68% 297 301 to 400 Beds 49.93% 49.64% 181 50.61% 50.58% 203 51.22% 50.83% 214 401 to 500 Beds 49.57% 48.23% 105 51.07% 49.94% 121 51.07% 50.77% 122 Over 500 Beds 48.70% 47.91% 158 49.65% 49.56% 191 49.35% 48.60% 193 Total All Hospitals 49.66% 49.54% 1760 50.47% 50.48% 2021 50.54% 50.33% 2063 Excluded Cost Reports 91 132 115 Total Cost Reports 1851 2153 2178 2006 2005 2004 Number of Licensed Beds Mean Median Count Mean Median Count Mean Median Count 25 Beds or Less 48.68% 48.35% 346 48.16% 48.16% 294 48.89% 48.67% 244 26 to 100 Beds 51.06% 50.75% 383 51.53% 51.32% 407 52.72% 52.83% 449 101 to 200 Beds 51.42% 51.69% 470 50.76% 50.66% 469 51.74% 51.71% 472 201 to 300 Beds 51.19% 50.90% 300 51.52% 51.60% 306 52.30% 51.95% 307 301 to 400 Beds 50.81% 50.52% 214 50.55% 50.81% 215 51.25% 51.13% 216 401 to 500 Beds 51.15% 50.68% 120 51.04% 50.47% 121 51.13% 50.84% 124 Over 500 Beds 49.57% 49.36% 190 49.48% 48.69% 191 50.01% 49.17% 192 Total All Hospitals 50.59% 50.34% 2023 50.53% 50.45% 2003 51.44% 51.29% 2004 Excluded Cost Reports 117 113 116 Total Cost Reports 2140 2116 2120 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 24
  • 25. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev. Total Labor Cost as a Percentage of Total Operating Revenues All Not-For-Profit General Acute Care Hospitals in the United States with 25 Licensed Beds or Less 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 36.52% 37.15% 84 37.76% 38.09% 93 37.28% 37.58% 93 2nd Quartile 45.70% 45.77% 84 46.40% 46.52% 94 46.40% 47.00% 94 3rd Quartile 52.12% 52.31% 85 52.31% 52.46% 94 52.61% 53.08% 94 4th Quartile 60.12% 60.04% 85 59.59% 58.88% 94 60.10% 59.36% 94 Total Population 48.66% 48.99% 338 49.05% 49.65% 375 49.13% 49.12% 375 Excluded Cost Reports 23 32 33 Total Cost Reports 361 407 408 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 37.37% 37.61% 86 36.86% 37.30% 73 37.87% 38.45% 61 2nd Quartile 45.28% 45.38% 86 44.28% 43.98% 73 44.99% 44.92% 61 3rd Quartile 51.70% 51.93% 87 51.55% 51.50% 74 52.00% 51.98% 61 4th Quartile 60.18% 59.10% 87 59.76% 59.35% 74 60.68% 59.79% 61 Total Population 48.68% 48.35% 346 48.16% 48.16% 294 48.89% 48.67% 244 Excluded Cost Reports 30 26 25 Total Cost Reports 376 320 269 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 25
  • 26. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev. Total Labor Cost as a Percentage of Total Operating Revenues All Not-For-Profit General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 39.70% 40.43% 82 40.76% 41.51% 94 40.84% 41.07% 99 2nd Quartile 47.25% 47.27% 82 48.29% 48.46% 95 48.47% 48.56% 99 3rd Quartile 52.91% 52.73% 82 53.22% 53.24% 95 53.04% 53.10% 99 4th Quartile 59.99% 58.78% 83 60.71% 60.20% 95 60.85% 60.27% 100 Total Population 49.99% 49.98% 329 50.77% 51.01% 379 50.83% 50.93% 397 Excluded Cost Reports 18 25 17 Total Cost Reports 347 404 414 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.56% 42.86% 95 42.10% 43.22% 101 43.82% 44.66% 112 2nd Quartile 48.48% 48.44% 96 49.20% 49.48% 102 50.26% 50.24% 112 3rd Quartile 53.37% 53.21% 96 53.77% 53.69% 102 54.99% 54.81% 112 4th Quartile 60.72% 60.56% 96 60.98% 61.00% 102 61.74% 61.51% 113 Total Population 51.06% 50.75% 383 51.53% 51.32% 407 52.72% 52.83% 449 Excluded Cost Reports 17 19 28 Total Cost Reports 400 426 477 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 26
  • 27. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev. Total Labor Cost as a Percentage of Total Operating Revenues All Not-For-Profit General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds 2009 2008 2007 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 40.81% 41.58% 97 41.76% 42.28% 115 42.01% 42.68% 116 2nd Quartile 47.62% 47.67% 97 48.59% 48.54% 115 48.46% 48.66% 116 3rd Quartile 52.49% 52.51% 98 53.36% 53.37% 115 53.61% 53.88% 116 4th Quartile 59.02% 58.04% 98 60.62% 59.96% 115 60.40% 60.00% 117 Total Population 50.02% 50.48% 390 51.08% 50.99% 460 51.14% 50.83% 465 Excluded Cost Reports 13 19 19 Total Cost Reports 403 479 484 2006 2005 2004 Quartile Rank Mean Median Count Mean Median Count Mean Median Count 1st Quartile 41.91% 42.79% 117 41.38% 42.60% 117 42.53% 43.50% 118 2nd Quartile 48.91% 49.06% 117 48.29% 48.42% 117 49.35% 49.42% 118 3rd Quartile 54.17% 54.20% 118 53.32% 53.34% 117 54.21% 54.06% 118 4th Quartile 60.58% 60.04% 118 59.99% 59.99% 118 60.89% 60.33% 118 Total Population 51.42% 51.69% 470 50.76% 50.66% 469 51.74% 51.71% 472 Excluded Cost Reports 15 21 21 Total Cost Reports 485 490 493 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 27