Wednesday, December 4, 2013

South Carolina Smaller Non-Profit Hospital Bottom Line Losses Show Need For Medicaid Expansion

From a review of audited financial statements in the Electronic Municipal Market Access (EMMA), I found 19 Non-Profit Hospital Organizations headquartered in the State of South Carolina with Total Operating Revenues of more than $10 mil each in the most recent fiscal year.

To understand what is going on with South Carolina Non-Profit Hospital Organization Earnings, it is helpful to break them down by how financially strong the Hospitals are.....or by their Net Assets.

When this breakdown is done, there is a crystal-clear conclusion.....the weaker the financial strength of the Hospital Organization, the lower the earnings.

Bottom Line Earnings is a combination of Operating Income and Non-Operating Income, with the latter being due predominantly to Investment Returns.  And for Governmental Hospitals, Interest Expense is also a Non-Operating item.

On a Bottom Line Profits basis, here is a summary of the most recent audited annual earnings results of these Hospital Organizations by Net Asset size:

Net Assets > $600 Mil.......Total Bottom Line Income as % of Total Revenues..8.1%
Net Assets $100-600 Mil...Total Bottom Line Income as % of Total Revenues..7.0%
Net Assets < $100 Mil.......Total Bottom Line Loss as % of Total Revenues......(1.8)%

Six of these Seven Smallest South Carolina Hospital Organizations with Net Assets of less than $100 mil each posted Bottom Line Losses in the most recent audited fiscal year.

When the 7 South Carolina Hospital Organizations with Net Assets of less than $100 mil are generating Total Bottom Line Losses of a very dismal negative (1.8)% of their Total Operating Revenues, then they are struggling and need financial help.  This compares to a substantially higher positive 8.1% for the 3 largest South Carolina Non-Profit Hospital Organizations with Net Assets above $600 mil and also a much higher 7.0% for the 9 larger South Carolina Hospitals with Net Assets of $100-600 mil.

The main driver of these dismal Total Bottom Line Losses of $7.9 mil for these 7 smaller South Carolina Hospital Organizations in the most recent audited fiscal year were Total Bad Debt Earnings Charges of $83 mil.

Uncompensated Charity Care Earnings Charges were also very high.

The best way to provide this needed financial boost is to simply Expand Medicaid in South Carolina.  This will substantially reduce two Hospital Operating Statement Earnings Charges.....Provisions for Bad Debts and Uncompensated Charity Care Costs.

The larger South Carolina Hospitals are doing just fine.....but clearly not the smallest ones.

From a review of audited financial statements in the Electronic Municipal Market Access (EMMA), below here are the Bottom Line Profits and Operating Revenues of the 19 Non-Profit Hospital Organizations headquartered in the State of South Carolina with Total Operating Revenues of more than $10 mil each in the most recent fiscal year, stratified by Net Asset size:

`
Most




Recent Bottom
Bottom


Annual Line
Line

Fiscal Net Total Profit

City Year Income Operating Margin

HQs End (Loss) Revenues %



mils $s mils $s
South Carolina Non-Profit Hospital Organizations









Net Assets > $600 mil




Greenville Hospital System Greenville Sep 2012          56       1,443 3.9%
McLeod Health Florence Sep 2012        120          708 16.9%
Palmetto Health Columbia Sep 2012          86       1,074 8.0%






Total 3 With Net Assets > $600 mil

       262       3,225 8.1%






Net Assets $100-$600 mil




Lexington County Health Services West Columbia Sep 2012          42          671 6.3%
Spartanburg Regional Healthcare Spartanburg Sep 2012          21          747 2.8%
Self Regional Healthcare Greenwood Sep 2012          43          356 12.1%
St Francis Downtown & Eastside Greenville Aug 2013          68          457 14.9%
Care Alliance Health Charlestown Sep 2012          32          730 4.3%
Anmed Anderson Dec 2012          65          533 12.2%
Georgetown Hospital System Georgetown Sep 2012          10          253 4.0%
Conway Hospital Conway Sep 2012            8          158 4.8%
Tuomey Healthcare Sumter Sep 2012           (3)          192 -1.3%






Total 9 With Net Assets $100-600 mil

       286       4,097 7.0%






Net Assets < $100 mil




Kershawhealth Camden Sep 2012        (1.6)          106 -1.5%
Oconee Medical Center Seneca Sep 2012        (2.8)          136 -2.1%
Newberry County Memorial Hosp Newberry Jun 2013         2.2            47 4.7%
Laurens County Health Care Clinton Sep 2012        (0.7)            60 -1.2%
Clarendon Hospital District Manning Sep 2012        (3.6)            60 -6.0%
Hampton Regional Medical Center Varnville Sep 2012        (1.0)            21 -4.8%
Williamsburg Regional Hospital Kingstree Sep 2012        (0.4)            17 -2.4%






Total 7 With Net Assets<$100 mil

       (7.9)          447 -1.8%