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HOSPITAL SUMMARY INDIVIDUAL DISCLOSURE REPORTUSING DATA AUDITED BY OSHPDFACILITY NO:106191228LAC/USC MEDICAL CENTER

PAGE: 1 OF 5REPORT PERIOD: 07/01/2013 THRU 06/30/2014

DATE PREPARED: 11/16/2015

1200 NORTH STATE STREETLOS ANGELES CA 90033

PHONE NO: (323)409-6871OWNER: COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

TYPE OF CONTROL: CountyTYPE OF CARE: General

INTENSIVE 190ACUTE 486LONG-TERMOTHER TOTAL 676OCCUPANCY RATE 78.70%*EXCLUDES BEDS IN SUSPENSE

LICENSED BEDS* INTENSIVE 188ACUTE 476LONG-TERMOTHER TOTAL 664OCCUPANCY RATE 80.10%NO. BASSINETS 20

AVAILABLE BEDS X EMERGENCY ROOM1 TRAUMA CENTER DESIGNATIONX OBSERVATIONX ORTHOPEDICX PSYCHIATRICX HELICOPTER

EMERGENCY SERVICES

FINANCIAL AND UTILIZATION DATA BY PAYER TOTAL MEDICARETRADITIONAL

MEDICAREMANAGED CARE

MEDI-CALTRADITIONAL

Patient (Census) Days 194,088 15,607 3,298 79,046 Hospital Discharges (Excluding Nursery) 31,067 2,142 471 10,994 Average Length of Stay (Including L-T Care) 6.2 7.3 7 7.2 Average Length of Stay (Excluding L-T Care) 6.2 7.3 7 7.2 Outpatient Visits (Incl. ER Visits) 576,298 32,156 1,190 174,756 Outpatient Emergency Services Visits 114,658 4,619 597 31,552 Gross Inpatient Revenue $1,353,047,314 $107,919,718 $19,434,889 $562,433,416 Gross Outpatient Revenue $923,854,015 $49,156,805 $1,659,065 $236,628,170 Deductions From Revenue $1,395,706,124 $94,282,937 $14,737,982 $367,483,367 Net Inpatient Revenue $688,508,493 $58,995,153 $5,856,067 $303,773,847 Net Outpatient Revenue $313,647,558 $3,798,433 $499,905 $127,804,372 Net Inpatient Revenue Per Day $3,547 $3,780 $1,776 $3,843 Net Inpatient Revenue Per Discharge $22,162 $27,542 $12,433 $27,631 Net Outpatient Revenue Per Visit $544 $118 $420 $731

Adjusted Patient Days 326,610 Net Revenue Per Adj Patient Day $3,068 Purchased Inpatient Days

FINANCIAL AND UTILIZATION DATA BY PAYER THIRD PARTYMANAGED CARE

OTHERINDIGENT

OTHERPAYERS

Patient (Census) Days 2,037 274 Hospital Discharges (Excluding Nursery) 431 64 Average Length of Stay (Including L-T Care) 4.7 4.3 Average Length of Stay (Excluding L-T Care) 4.7 4.3 Outpatient Visits (Incl. ER Visits) 10,845 2,279 Outpatient Emergency Services Visits 1,664 1,073 Gross Inpatient Revenue $22,315,830 $2,311,132 Gross Outpatient Revenue $19,353,440 $4,647,761 Deductions From Revenue $30,944,772 $816,100 Net Inpatient Revenue $9,951,803 $1,737,043 Net Outpatient Revenue $8,630,718 $4,405,750 Net Inpatient Revenue Per Day $4,886 $6,340 Net Inpatient Revenue Per Discharge $23,090 $27,141 Net Outpatient Revenue Per Visit $796 $1,933

Adjusted Patient Days Net Revenue Per Adj Patient Day Purchased Inpatient Days

FINANCIAL AND UTILIZATION DATA BY PAYER MEDI-CALMANAGED CARE

CO. INDIGENTTRADITIONAL

CO. INDIGENTMANAGED CARE

THIRD PARTYTRADITIONAL

Patient (Census) Days 36,054 27,731 13,168 16,873 Hospital Discharges (Excluding Nursery) 6,705 5,500 2,632 2,128 Average Length of Stay (Including L-T Care) 5.4 5 5 7.9 Average Length of Stay (Excluding L-T Care) 5.4 5 5 7.9 Outpatient Visits (Incl. ER Visits) 139,112 119,105 42,069 54,786 Outpatient Emergency Services Visits 28,360 28,118 5,993 12,682 Gross Inpatient Revenue $275,899,563 $151,626,159 $89,423,328 $121,683,279 Gross Outpatient Revenue $201,113,565 $221,332,579 $83,841,135 $106,121,495 Deductions From Revenue $304,623,322 $302,931,927 $112,211,636 $167,674,081 Net Inpatient Revenue $165,126,046 $70,026,811 $31,509,906 $41,531,817 Net Outpatient Revenue $120,366,583 $29,542,921 $18,598,876 Net Inpatient Revenue Per Day $4,580 $2,525 $2,393 $2,461 Net Inpatient Revenue Per Discharge $24,627 $12,732 $11,972 $19,517 Net Outpatient Revenue Per Visit $865 $702 $339

Adjusted Patient Days Net Revenue Per Adj Patient Day Purchased Inpatient Days

COUNTY: Los AngelesHSA NO: 11 HFPA NO: 0925

GENERAL INFORMATION

HOSPITAL SUMMARY INDIVIDUAL DISCLOSURE REPORT

GROSS PATIENT REVENUE BY REVENUE CENTER PERCENT OF TOTAL DAILY HOSPITAL SERVICES $936,856,876 41.2 AMBULATORY SERVICES $465,030,056 20.4 ANCILLARY SERVICES $875,014,397 38.4 TOTAL GROSS PATIENT REVENUE $2,276,901,329 100.0

LIVE BIRTH SUMMARY NATURAL BIRTHS 559 CESAREAN SECTIONS 428 TOTAL LIVE BIRTHS 987

SUMMARY STATEMENT OF INCOME GROSS PATIENT REVENUE $2,276,901,329 PROVISION FOR BAD DEBT $816,100 MEDICARE TRAD. CONTRACTUAL ADJ $94,282,937 MEDICARE MANAGED CONTRACTUAL ADJ $14,737,982 MEDI-CAL TRAD. CONTRACTUAL ADJ $609,651,373 MEDI-CAL MANAGED CONTRACTUAL ADJ $304,623,322 DISPROPORTIONATE SHARE FUNDS REC'D ($242,168,006) CO. INDIGENT TRAD. CONTRACTUAL ADJ $302,931,927 CO. INDIGENT MANAGED CONTRACTUAL ADJ $112,211,636 THIRD PARTY TRAD. CONTRACTUAL ADJ $167,674,081 THIRD PARTY MANAGED CONTRACTUAL ADJ $30,944,772 CHARITY OTHER ALL OTHER DEDUCTIONS TOTAL DEDUCTIONS FROM REVENUE $1,395,706,124 CAPITATION PREMIUM REVENUE $120,960,846 NET PATIENT REVENUE $1,002,156,051

OTHER OPERATING REVENUE $167,622,415 TOTAL OPERATING EXPENSES $1,375,844,399 NET FROM OPERATIONS ($206,065,933)

NON-OPERATING REVENUE + $283,593,675 NON-OPERATING EXPENSES - $688,694 PROVISION FOR INCOME TAXES - EXTRAORDINARY ITEMS - NET INCOME $76,839,048

OPERATING EXPENSES BY CLASSIFICATION SALARIES AND WAGES $397,692,227 EMPLOYEE BENEFITS $409,660,838 PHYSICIANS PROFESSIONAL FEES $110,743,781 OTHER PROFESSIONAL FEES $63,936,975 SUPPLIES $155,194,258 PURCHASED SERVICES $165,511,397 DEPRECIATION $23,543,629 LEASES AND RENTALS $10,749,897 INTEREST $529,778 ALL OTHER EXPENSES $38,281,619 TOTAL OPERATING EXPENSES $1,375,844,399

ADJUSTED PATIENT REVENUE ADJUSTED INPATIENT REVENUE $500,493,278 REVENUE PER DAY $2,579 REVENUE PER DISCHARGE $16,110

ADJUSTED OUTPATIENT REVENUE $329,752,436 REVENUE PER VISIT $572

ADJUSTED PATIENT EXPENSES ADJUSTED INPATIENT EXPENSES $587,340,749 EXPENSES PER DAY $3,026 EXPENSES PER DISCHARGE $18,906

ADJUSTED OUTPATIENT EXPENSES $447,081,386 EXPENSES PER VISIT $776


DATE PREPARED: 11/16/2015USING DATA AUDITED BY OSHPDFACILITY NO:106191228LAC/USC MEDICAL CENTER

OPERATING EXPENSES BY COST CENTER GROUP DAILY HOSPITAL SERVICES $253,927,186 AMBULATORY SERVICES $170,411,353 ANCILLARY SERVICES $331,511,592 PURCHASED INPATIENT SERVICES PURCHASED OUTPATIENT SERVICES $9,417 RESEARCH EDUCATION $113,670,847 GENERAL SERVICES $173,783,789 FISCAL SERVICES $57,258,149 ADMINISTRATIVE SERVICES $226,446,338 UNASSIGNED COSTS $48,825,728 TOTAL OPERATING EXPENSES $1,375,844,399



TOTAL CURRENT ASSETS $703,493,811LIMITED USE ASSETSNET PROPERTY, PLANT, AND EQUIPMENT $859,319,516CONSTRUCTION-IN-PROGRESSOTHER ASSETS $70,342,149INTANGIBLE ASSETS $12,460,000TOTAL ASSETS $1,645,615,476

TOTAL CURRENT LIABILITIES $462,191,449DEFERRED INCOME $204,246NET LONG-TERM DEBT $1,156,636,383TOTAL LIABILITIES $1,619,032,078

EQUITY $26,583,398TOTAL LIABILITIES AND EQUITY $1,645,615,476

BALANCE SHEET SUMMARY

FINANCIAL RATIO FORMULAS

LIQUIDITY RATIOS FORMULAS

CURRENT RATIO 1.52 (TOTAL CURRENT ASSETS + BOARD DESIG. CASH + BOARD DESIG. INVESTMENTS) / TOTAL CURRENT LIABILITIES

ACID TEST RATIO .04 (CASH + MARKETABLE SECURITIES + BOARD DESIG. CASH + BOARD DESIG. INVESTMENTS) / TOTAL CURRENT LIABILITIES

DAYS IN ACCOUNTS RECEIVABLE 219.97 NET ACCOUNTS RECEIVABLE / (NET PATIENT REVENUE / DAYS IN REPORT PERIOD)

BAD DEBT RATE 0.04% (PROVISION FOR BAD DEBTS / TOTAL GROSS PATIENT REVENUE) X 100

DEBT, RISK, AND LEVERAGE RATIOS

LONG-TERM DEBT TO ASSETS RATE 70.29% (NET LONG-TERM DEBT / TOTAL ASSETS) X 100

DEBT SERVICE COVERAGE RATIO 190.48 (NET INCOME + INTEREST-WORKING CAPITAL + INTEREST-OTHER + DEPRECIATION EXPENSE) / PRINCIPAL PAYMENTS ON SHORT-TERM AND LONG-TERM DEBT, NOTES, AND LOANS + INTEREST-WORKING CAPITAL + INTEREST-OTHER)

INTEREST EXPENSE AS A PERCENTAGE OF OPERATING EXPENSE

0.04% ((INTEREST-WORKING CAPITAL + INTEREST-OTHER) / TOTAL OPERATING EXPENSE) X 100

PROFITABILITY RATIOS

NET RETURN ON OPERATING ASSETS ( 13.15%) ((NET FROM OPERATIONS + INTEREST-WORKING CAPITAL + INTEREST-OTHER) / (TOTAL CURRENT ASSETS + NET PROPERTY, PLANT AND EQUIPMENT)) X 100

NET RETURN ON EQUITY 289.05% (NET INCOME / EQUITY) X 100

OPERATING MARGIN ( 17.62%) (NET FROM OPERATIONS / TOTAL OPERATING REVENUE) X 100

TURNOVER ON OPERATING ASSETS .75 TOTAL OPERATING REVENUE / (TOTAL CURRENT ASSETS + NET PROPERTY, PLANT, AMD EQUIPMENT)

FIXED ASSET RATIOS

FIXED ASSET GROWTH RATE ( .38%) ((CURRENT YEAR GROSS PROPERTY, PLANT AND EQUIPMENT + CONSTRUCTION-IN-PROGRESS) - (PRIOR YEAR GROSS PROPERTY, PLANT, AND EQUIPMENT + CONSTRUCTION-IN-PROGRESS)) / (PRIOR YEAR NET PROPERTY, PLANT, AND EQUIPMENT + CONSTRUCTION-IN-PROGRESS) X 100

AVERAGE AGE OF PLANT 10.95 ACCUMULATED DEPRECIATION / DEPRECIATION EXPENSE

NET PPE ASSETS PER BED 1,271,183 (NET PROPERTY, PLANT, AND EQUIPMENT + CONSTRUCTION-IN-PROGRESS) / LICENSED BEDS (END OF PERIOD)

REVENUE-PRODUCING COST CENTERS UNITS OFSERVICE

UNITCODE

GROSS REVPER UNIT

ADJ REVPER UNIT

ADJ DIRECTEXP PER UNIT

ADJ TOTALEXP PER UNIT

PROFIT/LOSSPER UNIT

DAILY HOSPITAL SERVICESMEDICAL/SURGICAL INTENSIVE CARE 28,956 1 $4,479.60 $1,664.81 $1,854.65 $2,712.23 ($1,047.42)

CORONARY CARE 3,175 1 $3,478.48 $997.78 $1,452.95 $2,167.21 ($1,169.44)

BURN CARE 3,890 1 $5,937.12 $2,376.66 $2,112.57 $3,240.24 ($863.58)

DEFINITIVE OBSERVATION 1

MEDICAL/SURGICAL ACUTE 103,263 1 $5,670.78 $2,150.73 $902.33 $1,582.05 $568.68

PEDIATRIC ACUTE 5,066 1 $4,675.94 $1,450.97 $1,419.92 $2,785.71 ($1,334.74)

PSYCHIATRIC ACUTE - ADULT 18,496 1 $3,193.69 $1,251.56 $1,061.61 $1,559.76 ($308.20)

OBSTETRICS ACUTE 4,097 1 $1,841.29 $607.63 $671.88 $1,107.55 ($499.92)

ALTERNATE BIRTHING CENTER 1

CHEMICAL DEPENDENCY SERVICES 1

SKILLED NURSING CARE 1

TOTAL PATIENT CARE SERVICES 194,088 2 $4,796.10 $1,801.13 $1,151.44 $1,861.69 ($60.56)

NURSERY ACUTE 1,892 3 $3,166.32 $1,218.07 $1,264.59 $1,893.25 ($675.18)

AMBULATORY SERVICESEMERGENCY SERVICES 124,667 4 $1,280.26 $429.17 $402.61 $611.55 ($182.39)

CLINICS 473,615 4 $576.21 $175.93 $158.92 $269.96 ($94.03)

OBSERVATION CARE 5

HOME HEALTH CARE SERVICES 6

SUMMARY OF FINANCIAL AND UTILIZATION DATA FOR SELECTED COST CENTERS





REVENUE-PRODUCING COST CENTERS UNITS OFSERVICE

UNITCODE

GROSS REVPER UNIT

ADJ REVPER UNIT


ADJ TOTALEXP PER UNIT

PROFIT/LOSSPER UNIT

ANCILLARY SERVICESLABOR AND DELIVERY SERVICES 972 7 $31,426.95 $12,768.10 $13,271.95 $18,972.31 ($6,204.21)SURGERY AND RECOVERY SERVICES 2,804,220 8 $35.98 $9.23 $13.22 $20.53 ($11.30)MEDICAL SUPPLIES SOLD TO PATIENTS 894,192 9 $61.63 $27.13 $20.25 $29.78 ($2.65)CLINICAL LABORATORY SERVICES 2,672,956 10 $34.99 $14.80 $13.95 $18.75 ($3.95)CARDIAC CATHETERIZATION SERVICES 4,200 11 $3,875.18 $1,492.02 $1,518.00 $2,240.34 ($748.33)RADIOLOGY - DIAGNOSTIC 226,858 11 $281.92 $88.64 $87.84 $135.21 ($46.57)MAGNETIC RESONANCE IMAGING 12,944 11 $766.56 $251.87 $251.91 $360.81 ($108.94)COMPUTED TOMOGRAPHIC SCANNER 77,682 11 $170.34 $47.25 $55.67 $81.58 ($34.32)DRUGS SOLD TO PATIENTS 894,192 14 $270.22 $118.94 $64.39 $130.27 ($11.34)RESPIRATORY THERAPY 199,710 12 $166.14 $73.13 $76.14 $96.39 ($23.26)LITHOTRIPSY SERVICES 11PHYSICAL THERAPY 278,662 27 $50.06 $22.03 $21.46 $28.85 ($6.82)

COST CENTER UNITS OFSERVICE

UNITCODE


DIETARY 538,650 16 $10.28 LAUNDRY AND LINEN 4,698,912 17 $0.83 SOCIAL WORK SERVICES 155,427 18 $40.76 HOUSEKEEPING 1,586,645 19 $12.34 PLANT OPERATIONS & MAINTENANCE 4,294,509 20 $9.32 PATIENT ACCOUNTING 2,276,901 21 $7.08 ADMITTING 30,923 22 $302.45

NON-REVENUE PRODUCING COST CENTERS

COST CENTER UNITS OFSERVICE

UNITCODE*


HOSPITAL ADMINISTRATION 7,054 23 $15,959.63 MEDICAL RECORDS 326,610 24 $73.78 NURSING ADMINISTRATION 2,366 25 $13,272.41 UTILIZATION MANAGEMENT 30,923 22 $720.67 COMMUNITY HEALTH EDUCATION 26 INSURANCE - MALPRACTICE 2,276,901 21 $4.90 INTEREST - OTHER 20

UNIT CODE DESCRIPTIONS

UNIT CODE <-----------------STANDARD UNIT OF MEASURE ------------------>1 NUMBER OF PATIENT DAYS2 TOTAL PATIENT DAYS (EXCLUDING NEWBORN)3 NUMBER OF NEWBORN DAYS4 NUMBER OF VISITS5 NUMBER OF OBSERVATION HOURS6 NUMBER OF HOME HEALTH CARE VISITS7 NUMBER OF DELIVERIES8 NUMBER OF OPERATING MINUTES9 NUMBER OF CS & S ADJUSTED INPATIENT DAYS10 NUMBER OF TESTS11 NUMBER OF PROCEDURES12 NUMBER OF RESPIRATORY THERAPY ADJUSTED INPATIENT DAYS14 NUMBER OF PHARMACY ADJUSTED INPATIENT DAYS16 NUMBER OF PATIENT MEALS17 NUMBER OF DRY AND CLEAN POUNDS PROCESSED18 NUMBER OF PERSONAL CONTACTS19 NUMBER OF SQUARE FEET SERVICED20 NUMBER OF GROSS SQUARE FEET21 $ 1,000 OF GROSS PATIENT REVENUE22 NUMBER OF ADMISSIONS23 NUMBER OF HOSPITAL FULL-TIME EQUIVALENT (FTE) EMPLOYEES24 NUMBER OF ADJUSTED INPATIENT DAYS25 NUMBER OF NURSING SERVICE FULL-TIME EQUIVALENT PERSONNEL26 NUMBER OF PARTICIPANTS27 NUMBER OF SESSIONS




PERCENTAGE OF HOURS AND AVERAGE HOURLY RATE BY EMPLOYEE CLASSIFICATION

COST CENTER GROUP MANAGEMENT ANDSUPERVISION

TECHNICAL ANDSPECIALIST

REGISTERED NURSES

LICENSEDVOCATIONAL NURSES

AIDES ANDORDERLIES

DAILY HOSPITAL SERVICES 4.28% 1.77% 54.20% 1.62% 19.05% AMBULATORY SERVICES 4.13% 1.72% 36.62% 6.92% 15.75% ANCILLARY SERVICES 8.85% 42.97% 17.40% 0.47% 3.76% TOTAL PATIENT CARE SERVICES 5.59% 13.96% 38.44% 2.74% 13.61%

COST CENTER GROUP ENVIRON. AND FOOD SERV.

CLERICALAND OTHEREMPLOYEES

REGISTRY ANDTEMP HELP

TOTALPRODUCTIVE HOURS

TOTAL PAIDHOURS

DAILY HOSPITAL SERVICES % 7.01% 12.07% 3,197,777 3,837,168 AMBULATORY SERVICES % 18.59% 16.27% 2,066,937 2,399,046 ANCILLARY SERVICES % 13.39% 13.16% 2,215,989 2,655,790 TOTAL PATIENT CARE SERVICES % 12.10% 13.55% 7,480,703 8,892,004

RESEARCH % % % % % EDUCATION 0.90% 3.45% % % % GENERAL SERVICES 11.18% 29.96% % % % FISCAL SERVICES 16.46% 6.02% % % % ADMINISTRATIVE SERVICES 42.78% 16.81% % % %

RESEARCH % % % EDUCATION % 95.66% % 1,806,451 2,021,018 GENERAL SERVICES 45.74% 13.12% 6.92% 1,819,243 2,327,324 FISCAL SERVICES % 77.52% 0.57% 779,013 983,817 ADMINISTRATIVE SERVICES 0.40% 40.01% 9.25% 1,280,888 1,703,733

TOTAL OPERATING COST CTRS 9.80% 14.27% 21.44% 1.53% 7.59% NON-OPERATING COST CENTERS 0.42% 41.32% % % %

AVERAGE HOURLY RATE $45.76 $34.14 $42.74 $21.14 $15.07

TOTAL OPERATING COST CTRS 6.24% 29.73% 9.41% 13,415,010 15,927,896 NON-OPERATING COST CENTERS % 0.61% 57.65% 13,518 14,238

AVERAGE HOURLY RATE $20.30 $27.02 $36.55

HOSPITAL PERSONNEL PROFILE

TOTAL NUMBER OF PRODUCTIVE HOSPITAL FTE'S* 5,845 NUMBER OF NURSING REGISTRY AND TEMP HELP FTE'S 490

TOTAL NUMBER OF NURSING FTE'S** 2,366NUMBER OF NURSING REGISTRY FTE'S 395

* EXCLUDES REGISTRY NURSES AND TEMPORARY HELP**INCLUDES NURSING REGISTRY

GENERAL INFORMATION AND CERTIFICATION

12. City:

13. Zip Code:

1.Health Care Institution(Legal Name): LOS ANGELES COUNTY + USC MEDICAL CENTER

2. OSHPD Facility Number: 106191228

3. D. B.A. (Doing Business As) Name: LAC/USC MEDICAL CENTER

4. Hospital Business Phone: (323) 409-6871

5.Medi-Cal Contract Provider Number: HSC30373W

6. Medi-Cal Non-Contract Provider Number: ZZT30373W

7.Medicare Provider Number: 05-0373

8. Street Address: 1200 NORTH STATE STREET

9. City: LOS ANGELES

10.Zip Code: 90033

14. Chief Executive Officer: DAN CASTILLO, MHA

15. Title: CHIEF EXEC. OFFICER

16. Hospital Web Site Address: WWW.DHS.LACOUNTY.GOV

17. Name of Owner: COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

18.Previous Name of Institution if Changed Since Previous Report:

23. Person Completing Report: RUSTY THOMSEN

11. Mailing Address (if different) - Street or P.O. Box:

24. Organization Name: LAC+USC EXPENDITURE MANAGEMENT

25. Phone Number: (323) 226-6531 Ext: -

26. FAX Phone Number: (323) 226-2446

28. Mailing Address - Street or P.O. Box: 1200 N. STATE ST. - TRAILER 15

29. City: LOS ANGELES

30. State : CA

31. Zip Code: 90033

36. Report Period: From: 07/01/2013

37. Through: 06/30/2014

38. Medi-Cal Contract Period: From: 07/01/2013

39. Through: 06/30/2014

40. Was this disclosure report completed after an independent financial audit ?

41. Are audit adjustments made by the independent auditor reflected in this report ?

____ Yes __X__ No

____ Yes __X__ No

( Page 0 Audited Data )

Date Prepared: 11/16/2015 HOSPITAL DISCLOSURE REPORT FACSIMILE

Line No MISC INFORMATION (1)

5 Licensed Beds (End of Period) 676

10 Available Beds 664

15 Staffed Beds (Average) 533

20 HSA No 11

25 If Designated Trauma Center

30 Indicate Level (1,2 or 3) 1

35 If CCS approved NICU,

40 indicate the standard below:

45 Regional

50 Community

55 Intermediate

TYPE OF CONTROL (2)

Church

Non-Profit Corporation

Non-Profit Other

Investor - Individual

Investor - Partnership

Investor - Corporation

State

County X

City/County

City

District

TYPE OF CARE (3) Line No

Short-Term - General X 5

Short-Term - Childrens 10

Short-Term - Psychiatric 15

Short-Term - Specialty 20

Long-Term - General 25

Long-Term - Childrens 30

Long-Term - Psychiatric 35

Long-Term - Specialty 40

45

50

55

Line No GOVERNMENT PROGRAMS (1)

60 Medicare X

65 Medi-Cal X

70 Children's Medical Services X

75 Short-Doyle X

80 CHAMPUS X

85 County Indigent X

90 Other (Specify)

95

100

105

PREPAID PROGRAMS (2) No.of

Each Type

HospitalBased

Parent Organization Based

State Contracts

Federal Contracts

Medical Foundation Contracts

Commercial Plan Contracts 1

Other (Specify)

24 HR. ON PREMISES COVERAGE (3) Line

No

Emergency Services X 60

Psychiatric ER X 65

Physician X 70

Pharmacist X 75

Operating Room X 80

Laboratory Services X 85

Radiology Services X 90

Anesthesiologist X 95

100

105

Line No

CLINICAL SPECIALTY HOSPITAL BASED NON-HOSPITAL BASED RESIDENTS/FELLOWS(Enter FTEs)

Line No

Board Certified

(1)

Board Eligible

(2) Other

(3)

Board Certified

(4)

Board Eligible

(5) Other

(6) Residents

(7)Fellows

(8)

110 Aerospace Medicine 110

115 Allergy and Immunology 115

120 Anesthesiology 46 13 38.93 3.67 120

125 Cardiovascular Diseases 35 2 10.28 125

130 Child Psychiatry 18 4 9.55 130

135 Colon and Rectal Surgery 4 1 0.73 135

140 Dental 3 2 2.20 140

145 Dermatology 10 2 7.35 145

150 Diagnostic Radiology 77 3 31.58 5.88 150

155 Forensic Pathology 155

160 Gastroenterology 39 9.55 160

165 General/Family Practice 3 1 165

170 General Preventive Medicine 170

175 General Surgery 39.66 175

180 Internal Medicine 58 4 124.87 25.71 180

185 Neurological Surgery 11 2 9.55 185

190 Neurology 35 2 12.49 2.20 190

195 Nuclear Medicine 1.47 195

200 Obstetrics and Gynecology 36 6 24.24 7.35 200

205 Occupational Medicine 205

210 Oncology 35 3 5.88 210

215 Ophthalmology 17 13.22 215

220 Oral Surgery 3 2 10.28 220

ACTIVE MEDICAL STAFF PROFILE - MD's, DO's, Podiatrists and Dentists (Enter No)

1. HOSPITAL DESCRIPTION

LAC/USC MEDICAL CENTER 06/30/2014Facility D.B.A. Name : Report Period End:

( Page 1 (1 of 2) Audited Data )


Line No

CLINICAL SPECIALTY HOSPITAL BASED NON-HOSPITAL BASED RESIDENTS/FELLOWS(Enter FTEs)

Line No

Board Certified

(1)

Board Eligible

(2) Other

(3)

Board Certified

(4)

Board Eligible

(5) Other

(6) Residents

(7)Fellows

(8)

225 Orthopaedic Surgery 17 4 36.73 1.47 225

230 Otolaryngology 12 1 14.69 230

235 Pathology 40 2 18.36 10.28 235

240 Pediatric-Allergy 7 1 1.47 240

245 Pediatric-Cardiology 245

250 Pediatric-Surgery 250

255 Pediatrics 79 11 47.01 13.22 255

260 Physical Medicine/Rehabilitation 260

265 Plastic Surgery 6 1 16.89 265

270 Podiatry 2 270

275 Psychiatry 32 4 52.84 275

280 Public Health 280

285 Pulmonary Disease 58 1 15.43 285

290 Radiology 290

295 Therapeutic Radiology 5 4.41 295

300 Thoracic Surgery 4 3 7.35 300

305 Urology 8 8.81 305

310 Vascular Surgery 6 1 2.94 310

315 Other Specialties 70 2 49.95 4.41 315

320 TOTAL 774 80 580.96 121.94 320

1. HOSPITAL DESCRIPTION




CODE

1- Service is available at the hospital. 3 - Service not available.

2- Service is available through arrangement at 4 - Clinic services are commonly provided in the emergency suite to another health care entity. non-emergency outpatients by hospital-based physicians or residents. *

* Code 4 used only for Clinic Services.

Line No

(1)Code

(2) Code

(3)Code

5 INTENSIVE CARE SERVICES Microbiology 1 Dental 1

10 Burn 1 Necropsy 1 Dermatology 1

15 Coronary 1 Serology 1 Diabetes 1

20 Medical 1 Surgical Pathology 1 Drug Abuse 3

25 Neonatal 1 DIAGNOSTIC IMAGING SERVICES Family Therapy 1

30 Neurosurgical 1 Computed Tomography 1 Group Therapy 1

35 Pediatric 1 Cystoscopy 1 Hypertension 1

40 Pulmonary 1 Magnetic Resonance Imaging 1 Metabolic 1

45 Surgical 1 Positron Emission Tomography 2 Neurology 1

50 Definitive Observation Care 1 Ultrasonography 1 Neonatal 1

55 ACUTE CARE SERVICES X-Ray - Radiology 1 Obesity 3

60 Alternate Birthing Center (Licensed Beds) 3 DIAGNOSTIC/THERAPEUTIC SERVICES

Obstetrics 1

65 Geriatric 1 Audiology 1 Ophthalmology 1

70 Medical 1 Biofeedback Therapy 3 Orthopedic 1

75 Neonatal 1 Cardiac Catheterization 1 Otolaryngology 1

80 Oncology 1 Cobalt Therapy 1 Pediatric 1

85 Orthopedic 1 Diagnostic Radioisotope 1 Pediatric Surgery 1

90 Pediatric 1 Echocardiology 1 Podiatry 1

95 Physical Rehabilitation 3 Electrocardiology 1 Psychiatric 1

100 Post Partum 1 Electroencephalography 1 Renal 1

105 Surgical 1 Electromyography 1 Rheumatic 1

107 Transitional Inpatient Care (Acute Beds) 1

110 NEWBORN CARE SERVICES Endoscopy 1 Rural Health 3

115 Developmentally Disabled Nursery Care 1 Gastro-Intestinal Laboratory 1 Surgery 1

120 Newborn Nursery Care 1 Hyperbaric Chamber Services 1

125 Premature Nursery Care 1 Lithotripsy 1 HOME CARE SERVICES

130 Hospice Care 3 Nuclear Medicine 1 Home Health Aide Services 2

135 Inpatient Care Under Custody (Jail) 1 Occupational Therapy 1 Home Nursing Care (Visiting Nurse) 2

140 LONG-TERM CARE Physical Therapy 1 Home Physical Medicine Care 2

145 Behavioral Disorder Care 3 Peripheral Vascular Laboratory 1 Home Social Service Care 2

150 Developmentally Disabled Care 3 Pulmonary Function Services 1 Home Dialysis Training 3

155 Intermediate Care 3 Radiation Therapy 1 Home Hospice Care 2

160 Residential/Self Care 3 Radium Therapy 1 Home IV Therapy Services 2

165 Self Care 3 Radioactive Implants 1 Jail Care 2

170 Skilled Nursing Care 3 Recreational Therapy 1 Psychiatric Foster Home Care 3

175 Sub-Acute Care 3 Respiratory Therapy Services 1

177 Sub-Acute Care-Pediatric 3

179 Transitional Inpatient Care (SNF Beds) 3

180 CHEMICAL DEPENDENCY - DETOX Speech-Language Pathology 1 AMBULATORY SERVICES

185 Alcohol 3 Spotcare Medicine 1 Adult Day Health Care Center 3

190 Drug 3 Stress Testing 1 Ambulatory Surgery Services 1

195 CHEMICAL DEPENDENCY - REHAB Therapeutic Radioisotope 1 Comprehensive Outpatient Rehab Facility

3

200 Alcohol 3 X-Ray Radiology Therapy 1 Observation (Short Stay) Care 1

205 Drug 3 PSYCHIATRIC SERVICES Satellite Ambulatory Surgery Center 1

2. SERVICES INVENTORY




CODE

1- Service is available at the hospital. 3 - Service not available.

2- Service is available through arrangement at 4 - Clinic services are commonly provided in the emergency suite to another health care entity. non-emergency outpatients by hospital-based physicians or residents. *

* Code 4 used only for Clinic Services.

Line No

(1)Code

(2) Code

(3)Code

210 PSYCHIATRIC SERVICES Clinic Psychologist Services 1 Satellite Clinic Services 1

215 Psychiatric Acute- Adult 1 Child Care Services 1

220 Psychiatric - Adolescent and Child 1 Electroconvulsive Therapy (Shock) 1 OTHER SERVICES

225 Psychiatric Intensive (Isolation) Care 3 Milieu Therapy 1 Diabetic Training class 1

230 Psychiatric Long-Term Care 3 Night Care 3 Dietetic Counseling 1

235 Psychiatric Therapy 1 Drug Reaction Information 1

240 OBSTETRIC SERVICES Psychopharmacological Therapy 1 Family Planning 1

245 Abortion Services 1 Sheltered Workshop 3 Genetic Counseling 1

250 Combined Labor/Delivery Birthing Room 1 RENAL DIALYSIS Medical Research 1

255 Delivery Room Services 1 Hemodialysis 1 Parent Training Class 1

260 Infertility Services 1 Home Dialysis Support Services 1 Patient Representative 1

265 Labor Room Services 1 Peritoneal 1 Public Health Class 3

270 SURGERY SERVICES Self-Dialysis Training 1 Social Work Services 1

275 Dental 1 Organ Acquisition 1 Toxicology/Antidote Information 1

280 General 1 Blood Bank 1 Vocational Services 1

285 Gynecological 1 Extracorporeal Membrane Oxygenation 1

290 Heart 1 Pharmacy 1 MEDICAL EDUCATION PROGRAMS

295 Kidney 1 Approved Residency 1

300 Neurosurgical 1 EMERGENCY SERVICES Approved Fellowship 1

305 Open Heart 1 Emergency Communications Systems 1 Non-Approved Residency 1

310 Ophthalmologic 1 Emergency Helicopter Service 1 Associate Records Technician 3

315 Organ Transplant 3 Emergency Observation Service 1 Diagnostic Radiologic Technologist 3

320 Orthopedic 1 Emergency Room Service 1 Dietetic Intern Program 1

325 Otolaryngologic 1 Heliport 1 Hospital Administration Program 3

330 Pediatric 1 Medical Transportation 1 Hospital Administration Program 3

335 Plastic 1 Mobile Cardiac Care Services 1 Licensed Vocational Nurse 3

340 Podiatry 1 Orthopedic Emergency Services 1 Medical Technologist Program 1

345 Thoracic 1 Psychiatric Emergency Services 1 Medical Records Administrator 3

350 Urologic 1 Radioisotope Decontamination Room 3 Nurse Anesthetist 3

355 Anesthesia Services 1 Trauma Treatment E. R. 1 Nurse Practitioner 3

360 Nurse Midwife 3

365 LABORATORY SERVICES CLINIC SERVICES Occupational Therapist 3

370 Anatomical Pathology 1 AIDS 1 Pharmacy Intern 2

375 Chemistry 1 Alcoholism 3 Physician's Assistant 3

380 Clinical Pathology 1 Allergy 1 Physical Therapist 3

385 Cytogenetics 2 Cardiology 1 Registered Nurse 1

390 Cytology 1 Chest Medical 1 Respiratory Therapist 3

395 Hematology 1 Child Diagnosis 1 Social Worker Program 3

400 Histocompatibility 1 Child Treatment 1

405 Immunology 1 Communicable Disease 1

2. SERVICES INVENTORY




Codes

Use Codes A,B, and G to indicate the relationship of the hospital to related organizations and codes C,D,E,F and G to indicate relationship of hospital with organizations with related personnel.

A. Corporation, partnership or other organization has ownership interest in hospital. [Complete columns (4) through (11).]

B. Hospital has ownership interest (stockholder, partner, etc.) in both related organization and hospital. [Complete columns (4) through (11).]

C. Individual has ownership interest (stockholder, partner, etc.) in both related organization and hospital. (Complete all columns.)

D. Director, officer, administrator or key person or relative of such person has ownership interest in related organization. [Complete columns(2),(4) through (11).]

E. Individual is director, officer, administrator or key person of hospital and related organization. [Complete columns(2), (4) through (11).]

F. Director, officer, administrator or key person or related organization or relative of such person has ownership interest in hospital. [Complete columns(2),(4) through (11).]

G. Other (ownership or non-financial) interest, specify on lines 13-16. (complete columns as applicable.)

NOTE: Relatives are defined as: spouse, son, daughter, grandchild, great grandchild, stepchild, brother, sister, half-brother, half-sister, stepbrother, stepsister, parent, grandparent, great grandparent, stepmother, stepfather, niece, nephew, aunt, uncle, son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law.

A. Are any costs included which are a result of transactions with a related organizations as defined in 42 CFR 413.17?

1.

B. Are any costs included which are a result of transactions with a related organization of which a hospital employee, board member or member of the which medical staff, or relative of such person is an officer or owner ? (Ignore stock ownership less than 3%)

2.

Yes No (If "Yes", complete item C.)X

Yes No (If "Yes", complete item C.)X

Line No

Code(1)

Name of Individual - (Complete for Codes C- G)

(2)

Percent Ownership of

Hospital (3)

Related Organizations

Name (4) Percent Ownership(5)

Type of Business (6)

3

4

5

6

7

8

9

10

11

12

Line Nature of Service or Supply Amount Expense Included on

No (7) (8) Page (9) Column (10) Line (11)

3

4

5

6

7

8

9

10

11

12

COMMENTS:

13

14

15

16

3.1 RELATED HOSPITAL INFORMATION

C. Complete the following to show the relationships of the hospital with related organizations and with organizations with related personnel from the hospital obtained services, facilities, or supplies during the reporting period.


( Page 3.1 Audited Data )


Sole Pro-

prietorship

Partners Corporation Officers

Line No

Name (1)

Title and Function (2)

Percentage of

Customary Work Week Devoted to Business

(3)

Percent Share of

Operation Profit or

(Loss)

(4)

Percentage of


(5)

Percent of Provider's

Stock Owned

(6)

Percentage of


(7)

Compensation Included in Costs for the Period

(8) *

17

18

19

20

21

E. Are any funds held in trust by an outside party which are not reflected on the Balance Sheet ?

22. Yes No If "Yes", what is the total amount ?X

Financial Arrangement

Line No

Hospital Cost Center (1)

Joint (2)

Contracted (3)

Rental (4)

Independent (5)

Agency (6)

Salaried (7)

Other (8)

23 Clinical and Pathological Laboratory Services X X

24 Radiology - Diagnostic and Therapeutic X X

25 Nuclear Medicine X

26 Cardiology Services

27 Emergency Services X X

28 Gastro-Intestinal Services

29 Pulmonary Function Services X X

30 Psychiatric Therapy

31 Anesthesiology X X

32 Other (Specify)

F. Section 1191 of the Hospital Accounting and Reporting Manual references six general types of financial arrangements which exist between hospital and hospital-based physicians. Check the appropriate boxes below to indicate the type of financial arrangement which exists in your hospital for the various hospital cost centers having such arrangements. If none of the six types of financial arrangements described are appropriate, check the Other column and describe the arrangement in the comment section. For cost centers other than those listed below, please complete the Other line

COMMENTS:

33

34

35

36


* Compensation as used in this schedule has the same definition as 42CFR 413.102

NOTE: Relatives are defined as: spouse, son, daughter, grandchild, great grandchild, stepchild, brother, sister, half-brother, half-sister, stepbrother, stepsister, parent, grandparent, great grandparent, stepmother, stepfather, niece, nephew, aunt, uncle, son-in-law, daughter-in-law, father-in-law, mother-in-law,brother-in-law, or sister-in-law.


D. STATEMENT OF COMPENSATION OF OWNERS AND THEIR RELATIVES



* Compensation paid to the individual from all sources for services rendered personally to or on behalf of the hospital.

Line No Name (1)

Occupation (2)

Check if Owner

(3)

Percentage of Hospital

Ownership (4)

Check if Board Member

(5) Compensation*

(6)

37 GLORIA MOLINA SUPERVISOR, FIRST DISTRICT X $0

38 MARK RIDLEY-THOMAS SUPERVISOR, SECOND DISTRICT X $0

39 ZEV YAROSLAVSKY SUPERVISOR, THIRD DISTRICT X $0

40 DON KNABE SUPERVISOR, FORTH DISTRICT X $0

41 MICHAEL D. ANTONOVICH SUPERVISOR, FIFTH DISTRICT X $0

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66


G. HOSPITAL OWNERS AND GOVERNMENT BOARD MEMBERS




Facility D.B.A. Name :

Line No

(1) Physician Name

(2) Percent of Stock Owned

(3) Describe Contract, Lease and Other Arrangements

70

71

72

73

74

75

76

77

78

79

J. Is this facility operated by a management firm ? (This excludes related parties, e.g, management by a parent corporation.)

Yes X No. (If "Yes", complete lines 81 through 102.)

81. Name of the management firm:

82. Address:

83. City: 84. State: 85. ZIP Code:

86. Amount paid to the management firm for the reporting period:

K. Does the hospital administrator work for the management firm ?

87. Yes No

L. List the services provided by the management firm.

80.

88

89

90

91

92

M. Are the amounts paid to the management firm functionally accounted and reported as required ?

Yes No. (If "No", complete lines 99 through 102.)98.

Please explain why amounts paid to the management firm are not functionally accounted and reported.

99

100

101

102

I. To be completed by all closely held corporations. If a physician is an owner or an owner of the corporation which owns the hospital, identify all business relationships between the physician and the hospital. This would include percentage of stock owned by the physician, all contracts between the physician and the hospital, and all lease arrangements between the physician and the hospital. If more than ten owners, provide data for the ten with the largest percentage of stock owned.


LAC/USC MEDICAL CENTER 06/30/2014Report Period End:

93

94

95

96

97



BEDS PATIENT (CENSUS) DAYS DISCHARGES

Line No

DAILY HOSPITAL SERVICES (1) Licensed (End of Period)

(2) Available

(Average)

(3) Staffed

(Average)

(4) Adult

(5) Pediatric

(11) Service

(12) Total

Line No

5 Medical/Surgical Intensive Care 110 108 79 28,956 5,670 1,809 5

10 Coronary Care 10 10 9 3,175 547 437 10

15 Pediatric Intensive Care 10 10 5 1,648 265 358 15

20 Neonatal Intensive Care 40 40 18 6,461 61 470 20

25 Psychiatric Intensive ( Isolation ) Care 25

30 Burn Care 20 20 11 3,890 179 292 30

35 Other Intensive Care 35

40 Definitive Observation 40

45 Medical/Surgical Acute 310 310 283 103,263 8,528 20,791 45

50 Pediatric Acute 32 28 14 5,066 165 1,637 50

55 Psychiatric Acute - Adult 65 59 51 18,496 22 804 55

60 Psychiatric Acute - Adolescent & Child 11 11 9 3,191 19 206 60

65 Obstetrics Acute 12 12 11 4,097 1,445 1,272 65

70 Alternate Birthing Center 70

75 Chemical Dependency Services 75

80 Physical Rehabilitation Care 80

85 Hospice - Inpatient Care 85

90 Other Acute Care 56 56 43 15,845 308 2,991 90

100 Sub-Acute Care 100

101 Sub-Acute Care - Pediatric 101

105 Skilled Nursing Care 105

110 Psychiatric Long-Term Care 110

115 Intermediate Care 115

120 Residential Care 120

125 Other Long-Term Care Services 125

145 Other Daily Hospital Services 145

150 Total 676 664 533 177,722 16,366 17,209 31,067 150

155 Nursery Acute 20 5 155

4 PATIENT UTILIZATION STATISTICS

Facility D.B.A. Name : LAC/USC MEDICAL CENTER 06/30/2014Report Period End:



Line No

ACCOUNT DESCRIPTION STANDARD UNIT OF MEASURE (1) Total Units of

Service [Sum of columns (7) and

(13)]

(7) Total Inpatient Units

of Service

(13) Total Outpatient Units of Service

Line No.

160AMBULATORY SERVICES Emergency Services Visits 124,667 19,665 105,002 160

165 Medical Transportation Services Occasions of Service 5,736 1,380 4,356 165

170 Psychiatric Emergency Rooms Visits 10,596 940 9,656 170

175 Clinics Visits 473,615 17,326 456,289 175

180 Satellite Clinics Visits 180

185 Satellite Ambulatory Surgery Center Operating Minutes 185

190 Outpatient Chemical Dependency Svcs Visits 190

195 Observation Care Observation Hours 195

200 Partial Hospitalization - Psychiatric Day-Night Care Days 200

205 Home Health Care Services Home Health Visits 205

210 Hospice - Outpatient Visits 210

215 Adult Day Health Care Visits 215

230ANCILLARY SERVICESLabor and Delivery Services Deliveries 972 972 230

235 Surgery and Recovery Services Operating Minutes 2,804,220 2,038,441 765,779 235

240 Ambulatory Surgery Services Operating Minutes 240

245 Anesthesiology Anesthesia Minutes 2,804,220 2,038,441 765,779 245

250 Medical Supplies Sold to Patients CS & S Adj. Inpatient Days 894,192 250

255 Durable Medical Equipment Adjusted Inpatient Days 255

260 Clinical Laboratory Services Tests 2,672,956 1,643,219 1,029,737 260

265 Pathological Laboratory Services Tests 67,731 25,243 42,488 265

270 Blood Bank Units of Blood Issued 181,091 109,545 71,546 270

275 Echocardiology Procedures 19,288 14,829 4,459 275

280 Cardiac Catheterization Services Procedures 4,200 3,369 831 280

285 Cardiology Services Procedures 48,216 28,004 20,212 285

290 Electromyography Procedures 290

295 Electroencephalography Procedures 22,148 8,542 13,606 295

300 Radiology - Diagnostic Procedures 226,858 87,155 139,703 300

305 Radiology - Therapeutic Procedures 86,405 3,672 82,733 305

310 Nuclear Medicine Procedures 27,148 5,132 22,016 310

315 Magnetic Resonance Imaging Procedures 12,944 5,731 7,213 315

320 Ultrasonography Procedures 72,388 24,898 47,490 320

325 Computed Tomographic Scanner Procedures 77,682 30,946 46,736 325

330 Drugs Sold to Patients Pharmacy Adj. Inpatient Days 894,192 330

335 Respiratory Therapy Respiratory Therapy Adj. Inpatient Days

199,710 335

340 Pulmonary Function Services Procedures 6,722 1,644 5,078 340

345 Renal Dialysis Hours of Treatment 39,457 39,457 345

350 Lithotripsy Procedures 350

355 Gastro-Intestinal Services Procedures 355

360 Physical Therapy Sessions 278,662 278,662 360

365 Speech-Language Pathology Sessions 2,820 1,667 1,153 365

370 Occupational Therapy Sessions 77,421 42,226 35,195 370

380 Electroconvulsive Therapy Treatments 380

385 Psychiatric/Psychological Testing Sessions 385

390 Psychiatric Individual/Group Therapy Sessions 390

395 Organ Acquisition Organs acquired 395





(a) Sum of column 13, lines 160,170,175,180,190,200,205,210,215,505,515,535,545,550, and 555.

OTHER STATISTICS (1) Total Units of

Service

(7) Inpatient Units of

Service

(13) Outpatient Units of

Service

505 Satellite Ambulatory Surgery Center Surgeries 505

510 Satellite Ambulatory Surgery Center Satellite Operating Rooms 510

515 Surgery and Recovery Services Surgeries 14,645 9,294 5,351 515

520 Surgery and Recovery Services Open Heart Surgery Minutes 99,509 99,509 520

525 Surgery and Recovery Services Open Heart Surgeries 254 254 525

530 Surgery and Recovery Services Inpatient Operating Rooms 25 530

535 Ambulatory Surgery Services Surgeries 535

540 Ambulatory Surgery Services Outpatient Operating Rooms 540

545 Observation Care Days 545

550 Renal Dialysis Care Visits 550

555 Referred Visits 555

560 Total Outpatient Visits(a) 576,298 576,298 560

LIVE BIRTH SUMMARY (1) Total Births [Sum of

columns (7) and (13)]

(7) Natural Births

(13) Cesarean Sections

600 Labor and Delivery Services 987 559 428 600

605 Surgery and Recovery Services 605

610 Alternate Birthing Services 610

615 Obstetrics Acute 615

620 Emergency Services and other areas within the hospital 620

625 Total Births (Sum of Lines 600 through 620) 987 559 428 625





PATIENT (CENSUS ) DAYS

Line No

TYPE OF CARE (1) Medicare -Traditional

(2) Medicare -

Managed Care

(3) Medi-Cal -Traditional

(4) Medi-Cal-

Managed Care

(5) County Indigent

Programs - Traditional

(6) County Indigent

Programs -Managed Care

Line No

5 Acute Care 13,254 2,886 70,694 35,629 27,263 12,048 5

10 Psychiatric Care 2,353 412 8,352 425 468 1,120 10

15 Chemical Dependency Care 15

20 Rehabilitation Care 20

25 Long-Term Care 25

30 Other Care 30

35 Total 15,607 3,298 79,046 36,054 27,731 13,168 35

40 Nursery Acute 1,092 539 195 2 40

45 Purchased Inpatient Services 45

DISCHARGES

Line No

TYPE OF CARE (12) Medicare - Traditional

(13) Medicare -

Managed Care


(15) Medi-Cal-

Managed Care

(16) County Indigent


(17) County Indigent


Line

No

5 Acute Care 2,072 456 10,885 6,686 5,462 2,548 5

10 Psychiatric Care 70 15 109 19 38 84 10




30 Other Care 30

35 Total 2,142 471 10,994 6,705 5,500 2,632 35

40 Nursery Acute 425 210 74 1 40


4.1 PATIENT UTILIZATION STATISTICS BY PAYER

PATIENT (CENSUS ) DAYS

Line No

TYPE OF CARE (7) Other Third

Parties Traditional

(8) Other Third

Parties Managed Care

(9) Other Indigent

(10) Other Payors

(11) Total Patient

Days

Line No

5 Acute Care 8,330 2,037 260 172,401 5

10 Psychiatric Care 8,543 14 21,687 10




30 Other Care 30

35 Total 16,873 2,037 274 194,088 35

40 Nursery Acute 41 21 2 1,892 40


DISCHARGES

Line No

TYPE OF CARE (18) Other Third

Parties Traditional

(19) Other Third

Parties Managed Care

(20) Other Indigent

(21) Other Payors

(22) Total Discharges

Line

No

5 Acute Care 1,454 431 63 30,057 5

10 Psychiatric Care 674 1 1,010 10




30 Other Care 30

35 Total 2,128 431 64 31,067 35

40 Nursery Acute 15 8 1 734 40



( Page 4.1 (1 of 2) Audited Data )


OUTPATIENT VISITS

Line No

TYPE OF OUTPATIENT VISIT (1) Medicare - Traditional

(2) Medicare -

Managed Care


(4) Medi-Cal-

Managed Care

(5) County Indigent


(6) County Indigent


Line No

60 Emergency Svcs. (incl. Psych ER) 4,619 597 31,552 28,360 28,118 5,993 60

65 Clinic (incl. Satellite Clinics) 27,341 586 141,177 109,627 89,817 35,473 65


75 Psychiatric Day-Night Care Days 75

80 Home Health Care Services 80

85 Hospice - Outpatient 85

90 Outpatient Surgeries 196 7 2,027 1,125 1,170 603 90

95 Private Referred 95

100 Other * 100

105 Total 32,156 1,190 174,756 139,112 119,105 42,069 105

4.1 PATIENT UTILIZATION STATISTICS BY PAYER


OUTPATIENT VISITS

Line No

TYPE OF OUTPATIENT VISIT (7) Other Third

Parties -Traditional

(8) Other Third

Parties -Managed Care

(9) Other Indigent

(10) Other Payors

(11) Total

OutPatient Visits

Line No

60 Emergency Svcs. (incl. Psych ER) 12,682 1,664 1,073 114,658 60

65 Clinic (incl. Satellite Clinics) 42,006 9,072 1,190 456,289 65


75 Psychiatric Day-Night Care Days 75


85 Hospice - Outpatient 85

90 Outpatient Surgeries 98 109 16 5,351 90

95 Private Referred 95

100 Other * 100

105 Total 54,786 10,845 2,279 576,298 105

Includes Chemical Dependency Services, Adult Day Health Care, & Renal Dialysis Visits



Line No

ASSETS Account No (1) Current Year (2) Prior Year Line No

CURRENT ASSETS

5 Cash 1000 $17,132,088 $13,779,546 5

10 Marketable securities 1010 10

15 Accounts and notes receivable 1020 $2,369,964,367 $2,369,964,367 15

20 Less allowance for uncollectible receivables and thrid-party contractual withholds 1040 ($1,766,014,715) ($1,809,357,206) 20

25 Receivables from third-party payors 1050 25

30 Pledges and other receivables 1060 $26,811,481 $25,190,060 30

35 Due from restricted funds 1070 35

40 Inventory 1080 $8,853,036 $7,223,554 40

45 Intercompany receivables 1090 $46,747,554 $108,326,607 45

50 Prepaid expenses and other current assets 1100 50

55 TOTAL CURRENT ASSETS (Sum of lines 5 through 50) $703,493,811 $715,126,928 55

ASSETS WHOSE USE IS LIMITED

60 Limited use cash 1110 60

65 Limited use investments 1120 65

70 Limited use other assets 1130 70

75 TOTAL ASSETS WHOSE USE IS LIMITED (Sum of lines 60 through 70) 75

PROPERTY, PLANT AND EQUIPMENT - AT COST

80 Land 1200 $15,433,178 $15,433,178 80

85 Land improvements 1210 85

90 Buildings and improvements 1220 $1,014,083,446 $1,013,183,917 90

95 Leasehold improvements 1230 95

100 Equipment 1240 $87,659,706 $91,894,671 100

105 TOTAL PROPERTY, PLANT AND EQUIPMENT (Sum of lines 80 through 100) $1,117,176,330 $1,120,511,766 105

195 Less accumulated depreciation and amortization 1260 ($257,856,814) ($244,209,167) 195

200 NET TOTAL PROPERTY, PLANT AND EQUIPMENT (Sum of lines 105 & 195) $859,319,516 $876,302,599 200

205 Construction in progress 1250 205

INVESTMENTS AND OTHER ASSETS

210 Investments in property, plant and equipment 1310 210

215 Less accumulated depreciation - investments in plant and equipment 1320 215

220 Other Investments 1330 220

225 Intercompany receivables 1340 225

230 Other Assets 1350 $70,342,149 $73,341,035 230

235 TOTAL INVESTMENTS IN OTHER ASSETS (Sum of lines 210 through 230) $70,342,149 $73,341,035 235

INTANGIBLE ASSETS

245 Goodwill 1360 245

250 Unamortized loan costs 1370 250

255 Preopening and other organization costs 1380 255

260 Other Intangible assets 1390 $12,460,000 $14,230,000 260

265 TOTAL INTANGIBLE ASSETS (Sum of lines 245 through 260) $12,460,000 $14,230,000 265

TOTAL

270 TOTAL ASSETS (Sum of lines 55, 75,200,205,235 , and 265) $1,645,615,476 $1,679,000,562 270

Line No

OTHER INFORMATION (1) Current Year (2) Prior Year Line No

405 Current market value - current assets marketable securities (Line 10) 405

410 Current market value - limited use investments (Line 65) 410

415 Current market value - other investments (Line 220) 415

420 Total cost to complete construction in progress (Line 205) $34,524,000 $41,124,000 420

5 BALANCE SHEET - UNRESTRICTED FUND




5 BALANCE SHEET - UNRESTRICTED FUND

Line No

LIABILITIES AND EQUITY Account No (3) Current Year (4)Prior Year Line No

CURRENT LIABILITIES

5 Notes and loans payable 2010 5

10 Accounts payable 2020 $91,915,892 $111,499,575 10

15 Accrued compensation and related liabilities 2030 $31,076,346 $28,712,502 15

20 Other accrued expenses 2040 20

25 Advances from third-party payors 2050 $315,000 $476,000 25

30 Payable to third-party payors 2060 30

35 Due to restricted funds 2070 35

40 Income Taxes payable 2080 40

45 Intercompany payables 2090 $250,965,862 $305,654,953 45

50 Current maturities of long-term debt (Must agree with line 125) $84,408,349 $46,534,401 50

55 Other current liabilities 2100 $3,510,000 $3,629,000 55

60 TOTAL CURRENT LIABILITIES (Sum of lines 5 through 55) $462,191,449 $496,506,431 60

DEFERRED CREDITS

65 Deferred income taxes 2110 65

70 Deferred third-party income 2120 70

75 Other deferred credits 2130 $204,246 $190,047 75

80 TOTAL DEFERRED CREDITS (Sum of lines 65 through 75) $204,246 $190,047 80

LONG-TERM DEBT Unpaid Principal(a)

85 Mortgages payable 2210 85

90 Construction loans 2220 90

95 Notes under revolving credit 2230 95

100 Capital lease obligations 2240 100

105 Bonds payable 2250 105

110 Intercompany payables 2260 $1,241,044,732 $1,127,597,940 110

115 Other non-current liabilities 2270 115

120 TOTAL LONG-TERM DEBT (Sum of lines 85 through 115) $1,241,044,732 $1,127,597,940 120

125 Less amount shown as current maturities (Must agree with line 50) ($84,408,349) ($46,534,401) 125

130 NET TOTAL LONG-TERM DEBT(Sum of lines 120 and 125) $1,156,636,383 $1,081,063,539 130

135 TOTAL LIABILITIES (Sum of lines 60,80 and 130) $1,619,032,078 $1,577,760,017 135

EQUITY (Non Profit)

140 Unrestricted Fund Balance 2310 $26,583,398 $101,240,545 140

EQUITY (Investor-Owned - Corporation)

145 Preferred stock 2310 145

150 Common stock 2320 150

155 Additional paid-in-capital 2330 155

160 Retained earnings 2340 160

165 Less Treasury stock 2350 165

EQUITY (Investor-Owned - Partnership)

170 Capital - unrestricted 2310 170

175 Less Partner's draw 2320 175

EQUITY (Investor-Owned - Division of a Corporation)

180 Preferred Stock 2710 180

185 Common Stock 2720 185

190 Additional paid-in-capital 2730 190

195 Division equity - unrestricted 2740 195

200 Less Treasury stock 2750 200

205 TOTAL EQUITY(Sum of lines 140 through 200) $26,583,398 $101,240,545 205

TOTAL

270 TOTAL LIABILITIES AND EQUITY (Sum of lines 135 and 205) $1,645,615,476 $1,679,000,562 270

(a) Complete Report Page 5.1 to provide detailed long-term debt information.



Line No

(5) Detail For Page 5, column(3), Line No

(6)Date Obligation Incurred (Year Only*)

(7) Due Date (Year Only*)

(8) Interest Rate (a)

(9) Unpaid Principal Balance at Year End

Line No

5 110 1994 2015 5.95 $1,241,044,732 5

10 10

15 15

20 20

25 25

30 30

35 35

40 40

45 45

50 50

55 55

60 60

65 65

70 70

75 75

80 80

85 85

90 90

95 95

100 100

105 105

110 110

115 115

120 120

125 125

130 130

135 135

140 140

145 145

150 150

155 155

160 160

165 165

170 170

175 175

180 180

185 185

190 190

195 195

200 200

205 205

210 210

215 215

220 220

225 225

230 230

235 235

240 240

245 245

250 250

5.1 SUPPLEMENTAL LONG - TERM DEBT INFORMATION


*Do not report month and day. Report year only.(a) If more than one due date or interest rate, list each with related unpaid principal amount.



*Do not report month and day. Report year only.(a) If more than one due date or interest rate, list each with related unpaid principal amount.

Line No

(5) Detail For Page 5, column(3), Line No

(6)Date Obligation Incurred (Year Only*)

(7) Due Date (Year Only*)

(8) Interest Rate (a)

(9) Unpaid Principal Balance at Year End

Line No

255 255

260 260

265 265

270 270

275 275

280 280

285 285

290 290

295 295

300 300

305 305

310 310

315 315

320 320

5.1 SUPPLEMENTAL LONG - TERM DEBT INFORMATION




Line

(1) (2) (3)

Additions

(4) (5) (6)

Line

No Description Beginning Balance(a)

Purchase Donation Transfers Disposals and Retirements

Ending Balance (b)

No

5 Land $15,433,178 $15,433,178 5

10 Land Improvements 10

15 Buildings and Improvements $1,013,183,917 $899,529 $1,014,083,446 15

20 Leasehold Improvements 20

25 Equipment $91,894,671 ($4,234,965) $87,659,706 25

30 Construction-in-progress 30

35 TOTAL $1,120,511,766 $899,529 ($4,234,965) $1,117,176,330 35

5.2 STATEMENT OF CHANGES IN PROPERTY, PLANT AND EQUIPMENT


(a) Column(1), line 35 must agree with page 5, column(2), sum of lines 105 and 205.(b) Column(6), line 35 must agree with page 5, column(1), sum of lines 105 and 205.



Line No

ASSETS Account No

(1) Current Year

(2) Prior Year

Line No

SPECIFIC PURPOSE FUNDS

5 Cash 1510 5

10 Investments Marketable Securities 1521 10


20 Receivables 1530 20

25 Due from other funds 1540 25

30 Other assets 1550 30

75 TOTAL SPECIFIC PURPOSE FUND ASSETS (Sum of lines 5 through 30) 75

PLANT REPLACEMENT AND EXPANSION FUNDS

105 Cash 1410 105


115 Mortgages investments 1422 115

120 Real property (net of accumulated depreciation) 1423 1424

120





170 TOTAL PLANT REPLACEMENT AND EXPANSION FUND ASSETS (Sum of lines 105 through 140)

170

ENDOWMENT FUNDS

205 Cash 1610 205


215 Mortgages 1622 215

220 Real property (net of accumulated depreciation) 1623 1624

220

225 Other investments 1629 225




275 TOTAL ENDOWMENT FUND ASSETS (Sum of lines 205 through 240) 275

Line No

OTHER INFORMATION (1) Current Year

(2) Prior Year

Line No

405 Current market value - specific purpose funds marketable securities (Line 10) 405

410 Current market value - Property Replacement & Exp. funds marketable securities (line 110)

410

415 Current market value - endowment funds marketable securities (line 210) 415

6 BALANCE SHEET - RESTRICTED FUND




6 BALANCE SHEET - RESTRICTED FUND

Line No

LIABILITIES AND FUND BALANCES Account No

(3) Current Year

(4) Prior Year

Line No

SPECIFIC PURPOSE FUNDS

5 Due to unrestricted fund 2510 5

10 Due to plant replacement and expansion fund 2520 10

15 Due to endowment fund 2530 15

70 Fund balance 2570 70

75 TOTAL SPECIFIC PURPOSE FUND LIABILITIES AND FUND BALANCE (Sum of lines 5 through 70)

75

PLANT REPLACEMENT AND EXPANSION FUNDS


110 Due to specific purpose fund 2420 110

115 Due to endowment fund 2430 115


170 TOTAL PLANT REPLACEMENT AND EXPANSION FUND LIABILITIES AND FUND BALANCE (Sum of lines 105 through 165)

170

ENDOWMENT FUNDS

205 Mortgages 2610 205

210 Other non-current liabilities 2620 210


220 Due to plant replacement and expansion fund 2640 220

225 Due to specific purpose fund 2650 225


275 TOTAL ENDOWMENT FUND LIABILITIES AND FUND BALANCE (Sum of lines 205 through 270)

275




(a) District Hospitals. Include bond interest and redemption.

RESTRICTED FUNDS

Line No

ASSETS (1) Funds Unrestricted

(2) Specific Purpose (a)

(3) Plant Replacement and Expansion

(4) Endowment Line No

5BALANCE AT BEGINNING OF YEAR, AS PREVIOUSLY REPORTED $101,240,545 5

10 Prior period audit adjustment 10

15 Restatement (describe) 15

20 20

25 25

30 30

35 35

40 40

45 45

50BALANCE AT BEGINNING OF YEAR, AS RESTATED $101,240,545 50

55ADDITIONS (DEDUCTIONS):Net Income (Loss) $76,839,048 55

60 Acquisitions of pooled companies 60

65 Proceeds from sale of stock 65

70 Stock options exercised 70

75 Restricted contributions and grants 75

80 Restricted investment income 80

85 Expenditures for specific purposes 85

90 Dividends declared 90

95 Donated property, plant and equipment 95

100 Intercompany transfers 100

105 Dispo. Share funds transferred to public entity ($888,039) 105

110 Other (Describe) MANAGED CARE SUPPLEMENT IGT

($155,935,855) 110

115 OTHER-RECONCILIATION ADJ $5,327,699 115

120 120

125 TOTAL ADDITIONS (DEDUCTIONS) ($74,657,147) 125

130TRANSFERS:Property and equipment additions 130

135 Principal payments on long-term debt 135

140 Other (Describe) 140

145 145

150 150

155 155

160 160

165 165

170 170

175TOTAL TRANSFERS (Sum of columns (1) through (4) must equal 0) 175

185BALANCE AT END OF YEAR (Sum of lines 50,125 and 175) $26,583,398 185

7 STATEMENT OF CHANGES IN EQUITY




(a) Report Page 8, Section II must be completed to provide detailed deductions from revenue information.(b) Report Page 8, Section II must be completed to provide detailed capitation premium revenue information.(c) Report Page 8, Section III must be completed to provide detailed non-operating revenue and expense information.

Line No

SECTION I (1) Current Year

(2) Prior Year

Line No

5OPERATING REVENUES:Daily hospital services $936,856,876 $877,722,463 5

10 Ambulatory services $465,030,056 $433,550,762 10

15 Ancillary services $875,014,397 $954,727,050 15

30 GROSS PATIENT REVENUE (Sum of lines 5 through 15) $2,276,901,329 $2,266,000,275 30

105 DEDUCTIONS FROM REVENUE (From line 395) (a) $1,395,706,124 $1,398,394,050 105

107 CAPITATION PREMIUM REVENUE (From line 450) (b) $120,960,846 ($7,967,623) 107

110 NET PATIENT REVENUE (Line 30 minus line 105 plus line 107) $1,002,156,051 $859,638,602 110

135 TOTAL OTHER OPERATING REVENUE $167,622,415 $188,334,860 135

140 TOTAL OPERATING REVENUE (Sum of lines 110 and 135) $1,169,778,466 $1,047,973,462 140

146OPERATING EXPENSES:Daily Hospital Services $253,927,186 $243,557,179 146

151 Ambulatory Services $170,411,353 $162,458,216 151

156 Ancillary Services $331,511,592 $308,708,683 156

161 Research Costs 161

166 Education Costs $113,670,847 $104,581,628 166

171 General Services $173,783,789 $157,579,011 171

176 Fiscal Services $57,258,149 $52,169,987 176

181 Administrative Services $226,446,338 $222,130,084 181

186 Unassigned Costs $48,825,728 $35,810,719 186

190 Purchased Inpatient Services $151,215 190

195 Purchased Outpatient Services $9,417 195

200 TOTAL OPERATING EXPENSES (Sum of Lines 146 through 195) $1,375,844,399 $1,287,146,722 200

205 NET FROM OPERATIONS (Line 140 minus line 200) ($206,065,933) ($239,173,260) 205

210 NET NON-OPERATING REVENUE AND EXPENSE (From Line 700) (c) $282,904,981 $345,700,497 210

215NET INCOME BEFORE TAXES AND EXTRAORDINARY ITEMS: (Sum of lines 205 and 210) $76,839,048 $106,527,237 215

220PROVISION FOR INCOME TAXES:Current 220

225 Deferred 225

230NET INCOME BEFORE EXTRAORDINARY ITEMS: (Line 215 minus 220 and 225) $76,839,048 $106,527,237 230

235EXTRAORDINARY ITEMS:(Specify)

235

240 240

245 NET INCOME (Line 230 minus lines 235 and 240) $76,839,048 $106,527,237 245

8 STATEMENT OF INCOME- UNRESTRICTED FUND




8 STATEMENT OF INCOME- UNRESTRICTED FUND (DEDUCTIONS FROM REVENUE AND CAPITATION PREMIUM REVENUE)

Line No

SECTION II (1) Current Year

(2) Prior Year

Line No

300DEDUCTIONS FROM REVENUE:Provision for bad debt $816,100 $2,578,497 300

305 Contractual adjustments - Medicare - traditional $94,282,937 $67,765,530 305

310 Contractual adjustments - Medicare - managed care $14,737,982 $10,839,194 310

315 Contractual adjustments - Medi-Cal - traditional $609,651,373 $630,709,132 315

320 Contractual adjustments - Medi-Cal - managed care $304,623,322 $38,960,987 320

325 Disproportionate share payments for Medi-Cal patient days (SB 855) (credit bal) (d)

($242,168,006) ($98,673,484) 325

330 Contractual adjustments - County indigent programs - traditional $302,931,927 $426,743,249 330

335 Contractual adjustments - County indigent programs - managed care $112,211,636 $190,288,668 335

340 Contractual adjustments - Other third parties - traditional $167,674,081 $104,555,803 340

345 Contractual adjustments - Other third parties - managed care $30,944,772 $24,626,474 345

350 Charity discounts - Hill Burton 350

355 Charity discounts - other 355

360 Restricted donations and subsidies for indigent care (credit balance) 360

365 Teaching allowances (Teaching Hospitals only) 365

370 Support for clinical teaching (credit balance (Teaching Hospitals only) 370

375 Policy discounts 375

380 Administrative adjustments 380

385 Other deductions from revenue 385

395 TOTAL DEDUCTIONS FROM REVENUE (Sum of lines 300 thru 385) $1,395,706,124 $1,398,394,050 395

430CAPITATION PREMIUM REVENUE:Capitation Premium Revenue - Medicare 430

435 Capitation Premium Revenue - Medi-Cal $113,102,823 ($15,501,136) 435

440 Capitation Premium Revenue - County indigent programs 440

445 Capitation Premium Revenue - Other third parties $7,858,023 $7,533,513 445

450 TOTAL CAPITATION PREMIUM REVENUE (Sum of lines 430 thru 445) $120,960,846 ($7,967,623) 450

Facility D.B.A. Name : LAC/USC MEDICAL CENTER Report Period End: 06/30/2014

(d) Disproportionate share funds transferred back to a related public entity must be reported on page 7, column(1), line 105.



Line No

SECTION III Account No

(1) Current Year

(2) Prior Year

Line No

500NON-OPERATING REVENUES:Gains on sale of hospital property 9010 500

505 Maintenance of restricted funds revenue 9030 505

510 Unrestricted contributions 9040 $13,532,490 510

515 Donated services 9050 515

520 Income, gains and losses from unrestricted investments 9060 520

525 Unrestricted income from endowment funds 9070 525

530 Unrestricted income from other restricted funds 9080 530

535 Term endowment funds becoming unrestricted 9090 535

540 Transfers from restricted funds for non-operating expenses 9100 540

545 Assessment revenue (e) 9150 545

550 County allocation of taxes revenue (e) 9160 550

555 Special district augmentation revenue (e) 9170 555

560 Debt service taxes revenue (e) 9180 560

565 State homeowner's property tax relief (e) 9190 565

570 State appropriation 9200 570

575 County appropriation - Realignment funds 9210 $115,456,504 $133,387,486 575

580 County appropriation - County general funds 9220 $168,137,171 $199,280,431 580

585 County appropriation - Other county funds 9230 585

590 Physician's offices and other rentals - revenue 9250 590

595 Medical office building revenue 9260 595

600 Child care services revenue (non-employee) 9270 600

605 Family housing revenue 9280 605

610 Retail operations revenue 9290 610

615 Other non-operating revenue 9400 615

625 TOTAL NON-OPERATING REVENUE (Sum of lines 500 thru 615) $283,593,675 $346,200,407 625

640NON-OPERATING EXPENSES:Loses on sale of hospital property 9020 640

645 Maintenance of restricted funds expense 9030 645

650 Physician's offices and other rentals expense 9510 650

655 Medical office building expense 9520 655

660 Child care services expense (non-employee) 9530 660

665 Family housing expense 9540 665

670 Retail operations expense 9550 670

675 Other non-operating expense 9800 $688,694 $499,910 675

685 TOTAL NON-OPERATING EXPENSE (Sum of lines 640 thru 675) $688,694 $499,910 685

700NET NON-OPERATING REVENUE AND EXPENSE (Line 625 minus line 685) $282,904,981 $345,700,497 700

705 Interest on long-term debt (e) 705

8 STATEMENT OF INCOME- UNRESTRICTED FUND (NON-OPERATING REVENUE AND EXPENSE)

06/30/2014Facility D.B.A. Name : LAC/USC MEDICAL CENTER Report Period End:

(e) District Hospital only.



Line No

(1) Current Year (2) Prior Year Line No

5CASH FLOW FROM OPERATING ACTIVITIES AND NON-OPERATING REVENUE:Net income (loss) $76,839,048 $106,527,237 5

15

Adjustments to reconcile net income to net cash provided by (used for) operating activities and non-operating revenue :Depreciation and amortization $23,547,517 $24,654,040 15

17 Amortization of intangible assets $1,770,000 $1,087,000 17

20 Change in marketable securities 20

30 Change in accounts and notes receivable, net of allowance for uncollectible receivables and third-party contractual withholds

($43,342,491) ($162,324,625) 30

35 Change in receivables from third-party payors 35

40 Change in pledges and other receivables ($1,621,421) ($284,060) 40

45 Change in due from restricted funds 45

50 Change in inventory ($1,629,482) ($1,481,178) 50

55 Change in intercompany receivables $61,579,053 ($82,046,943) 55

57 Change in Prepaid expenses and other current assets 57

60 Change in accounts payable ($19,583,683) $50,393,571 60

65 Change in accrued compensation and related liabilities $2,363,844 $628,900 65

70 Change in other accrued expenses 70

75 Change in advances from third-party payors ($161,000) $476,000 75

80 Change in payable to third-party payors ($290,000) 80

85 Change in due to restricted funds 85

87 Change in income taxes payable 87

90 Change in intercompany payables ($54,689,091) $45,397,884 90

95 Change in other current liabilities ($119,000) ($97,000) 95

100 Change in deferred credits $14,199 ($1,103,372) 100

102 Other (Describe): OTHER - CURRENT MATURITIES OF $37,873,948 $89,852,765 102

103 Other (Describe): 103


105 TOTAL ADJUSTMENTS (Sum of lines 15 through 104) $6,002,393 ($35,137,018) 105

115 NET CASH PROVIDED BY (USED FOR) OPERATING ACTIVITIES (Sum of lines 5 and 105) $82,841,441 $71,390,219 115

130CASH FLOW FROM INVESTING ACTIVITIES: Change in assets whose use is limited $20,719,676 130

135 Purchase of plant, property and equipment and construction-in-progress ($899,529) 135

140 Other (Describe): RECONCILING ADJUSTMENT ($43,538,852) ($45,051,940) 140

141 Other (Describe): CHANGES IN OTHER ASSETS $2,998,886 ($11,156,801) 141


145NET CASH PROVIDED BY (USED FOR) INVESTING ACTIVITIES (Sum of lines 130 through 142) ($41,439,495) ($35,489,065) 145

160CASH FLOW FROM FINANCING ACTIVITIES:Proceeds from issuance of long-term debt $113,446,792 $86,078,493 160

165 Principal payments on long-term debt 165

170 Proceeds from issuance of short-term notes and loans 170

175 Principal payments on short-term notes and loans 175

180 Dividends paid 180

185 Proceeds from issuance of common stock 185

190 Other (Describe): OTHER: INTERCOMPANY TRANSFERS ($888,039) ($111,710,250) 190

191 Other (Describe): OTHER: INTERCOMPANY TRANSFERS ($155,935,855) ($200,678,840) 191

192 Other (Describe): OHTER: ADJUSTMENTS $5,327,698 $187,112,395 192

195NET CASH PROVIDED BY (USED FOR) FINANCING ACTIVITIES (Sum of lines 160 through 192) ($38,049,404) ($39,198,202) 195

205 NET INCREASE (DECREASE) IN CASH (Sum of lines 115, 145 and 195) $3,352,542 ($3,297,048) 205

215 CASH AT BEGINNING OF YEAR $13,779,546 $17,076,594 215

225 CASH AT END OF YEAR (Sum of lines 205 and 215) $17,132,088 $13,779,546 225

9 STATEMENT OF CASH FLOWS - UNRESTRICTED FUND




Line No

REVENUE PRODUCING CENTERS (1)Units ofService

from Page 17,Column (13)

(2)AdjustedDirect Expenses


(3)AllocatedCosts

Column(4) minus (2)

(4)Total PatientCare Costs fromPage 20, Column

(16),Lines 505 - 915

(5)Average UnitPatient Care

Costs, Column (4) ÷ (1)

Line No

5DAILY HOSPITAL SERVICES:Medical/Surgical Intensive Care 28,956 $53,703,177 $23,121,907 $76,825,084 $2,653.17 5

10 Coronary Care 3,175 $4,613,119 $2,108,571 $6,721,690 $2,117.07 10

15 Pediatric Intensive Care 1,648 $4,540,444 $2,072,078 $6,612,522 $4,012.45 15

20 Neonatal Intensive Care 6,461 $13,245,480 $5,265,543 $18,511,023 $2,865.04 20

25 Psychiatric Intensive (Isolation) Care 25

30 Burn Care 3,890 $8,217,891 $4,169,918 $12,387,809 $3,184.53 30



45 Medical/Surgical Acute 103,263 $93,177,240 $54,047,922 $147,225,162 $1,425.73 45

50 Pediatric Acute 5,066 $7,193,326 $5,419,040 $12,612,366 $2,489.61 50

55 Psychiatric Acute - Adult 18,496 $19,635,570 $6,561,579 $26,197,149 $1,416.37 55

60 Psychiatric Acute - Adol & Child 3,191 $3,153,147 $1,193,372 $4,346,519 $1,362.12 60

65 Obstetrics Acute 4,097 $2,752,685 $1,476,439 $4,229,124 $1,032.25 65





90 Other Acute Care 15,845 $13,297,942 $7,394,855 $20,692,797 $1,305.95 90

95 Nursery Acute 1,892 $2,392,609 $1,028,329 $3,420,938 $1,808.11 95









150 TOTAL DAILY HOSPITAL SERVICES $225,922,630 $113,859,555 $339,782,185 150

160AMBULATORY SERVICES:Emergency Services 124,667 $50,192,299 $24,213,977 $74,406,276 $596.84 160

165 Medical Transportation Services 5,736 $1,078,691 $226,695 $1,305,386 $227.58 165

170 Psychiatric Emergency Rooms 10,596 $8,201,190 $4,263,145 $12,464,335 $1,176.32 170

175 Clinics 473,615 $75,267,796 $47,754,805 $123,022,601 $259.75 175

180 Satellite Clinics 180

185 Satellite Ambulatory Surgery Center 185

190 Outpatient Chemical Dependency Svcs 190

195 Observation Care 195

200 Partial Hospitalization - Psychiatric 200


210 Hospice - Outpatient Services 210

215 Adult Day Health Care Services 215

220 Other Ambulatory Services 220

225 TOTAL AMBULATORY SERVICES $134,739,976 $76,458,622 $211,198,598 225

10 (OPTIONAL) SUMMARY OF REVENUES AND COSTS




Line No

REVENUE PRODUCING CENTERS (6) Reallocated Net Research Costs from

Page 20, Col.(17), Lines 505-

915

(7) Reallocated Net Education

Costs from Page 20, Cols.

(18) + (19) + (20) +(21), Lines 505

- 915

(8) Transfers for Operating Costs from

Page 20, Column (22),

Lines 505 - 915

(9) Net Costs as Reallocated Column

(4) + (6) +(7) - (8)

(10) Average Unit Cost Column (9)

÷ (1)

Line No

5DAILY HOSPITAL SERVICES:Medical/Surgical Intensive Care $126,553 $1,583,576 $78,535,213 $2,712.23 5

10 Coronary Care $10,775 $148,433 $6,880,899 $2,167.21 10

15 Pediatric Intensive Care $10,996 $65,092 $6,688,609 $4,058.62 15

20 Neonatal Intensive Care $29,515 $139,004 $18,679,542 $2,891.12 20


30 Burn Care $22,533 $194,188 $12,604,530 $3,240.24 30



45 Medical/Surgical Acute $571,326 $15,570,558 $163,367,046 $1,582.05 45

50 Pediatric Acute $23,112 $1,476,935 $14,112,412 $2,785.71 50

55 Psychiatric Acute - Adult $57,632 $2,594,486 $28,849,268 $1,559.76 55

60 Psychiatric Acute - Adol & Child $10,040 $338,537 $4,695,097 $1,471.36 60

65 Obstetrics Acute $7,360 $301,153 $4,537,637 $1,107.55 65





90 Other Acute Care $38,362 $1,650,573 $22,381,732 $1,412.54 90

95 Nursery Acute $5,845 $155,245 $3,582,028 $1,893.25 95









150 TOTAL DAILY HOSPITAL SERVICES $914,049 $24,217,780 $364,914,014 150

160AMBULATORY SERVICES:Emergency Services $155,720 $1,678,696 $76,240,692 $611.55 160

165 Medical Transportation Services $2,798 $1,308,183 $228.07 165

170 Psychiatric Emergency Rooms $28,931 $109,804 $12,603,071 $1,189.42 170

175 Clinics $266,259 $4,566,732 $127,855,592 $269.96 175










225 TOTAL AMBULATORY SERVICES $453,709 $6,355,231 $218,007,538 225






Line No

REVENUE PRODUCING CENTERS (11) Gross Revenue from Page 12, Columns (21) + (22)

(12)Deductions from Revenue from Page 12,

Column 23 Line 455 - 457

(13)Adjustment for Professional

Component from Page 15, Columns (9) &

(13)

(14)Net Revenue Column (11) - (12) -

(13)

(15)Average Unit Net Revenue

Column (14) ÷ (1)

Line No

5DAILY HOSPITAL SERVICES:Medical/Surgical Intensive Care $129,711,224 $72,620,086 $8,884,878 $48,206,260 $1,664.81 5

10 Coronary Care $11,044,179 $6,183,191 $1,693,051 $3,167,937 $997.78 10

15 Pediatric Intensive Care $11,269,920 $6,309,574 $870,745 $4,089,601 $2,481.55 15

20 Neonatal Intensive Care $30,251,162 $16,936,406 $1,474,069 $11,840,687 $1,832.64 20


30 Burn Care $23,095,402 $12,930,185 $919,998 $9,245,219 $2,376.66 30



45 Medical/Surgical Acute $585,582,144 $327,843,839 $35,647,699 $222,090,606 $2,150.73 45

50 Pediatric Acute $23,688,289 $13,262,118 $3,075,575 $7,350,596 $1,450.97 50

55 Psychiatric Acute - Adult $59,070,401 $33,071,137 $2,850,440 $23,148,824 $1,251.56 55

60 Psychiatric Acute - Adol & Child $10,290,388 $5,761,173 $650,185 $3,879,030 $1,215.62 60

65 Obstetrics Acute $7,543,749 $4,223,441 $830,842 $2,489,466 $607.63 65





90 Other Acute Care $39,319,348 $22,013,318 $3,237,058 $14,068,972 $887.91 90

95 Nursery Acute $5,990,670 $3,353,935 $332,144 $2,304,591 $1,218.07 95









150 TOTAL DAILY HOSPITAL SERVICES $936,856,876 $524,508,403 $60,466,684 $351,881,789 150

160AMBULATORY SERVICES:Emergency Services $159,606,033 $89,356,985 $16,745,993 $53,503,055 $429.17 160

165 Medical Transportation Services $2,867,485 $1,605,389 $1,262,096 $220.03 165

170 Psychiatric Emergency Rooms $29,653,227 $16,601,647 $2,838,815 $10,212,765 $963.83 170

175 Clinics $272,903,311 $152,787,564 $36,792,859 $83,322,888 $175.93 175










225 TOTAL AMBULATORY SERVICES $465,030,056 $260,351,584 $56,377,667 $148,300,805 225





Line No

REVENUE PRODUCING CENTERS (16) Net Revenue Minus

Net Costs Column (14)

minus (9)

(17) Average Unit Net

Column (16) ÷ (1)

Line No

5DAILY HOSPITAL SERVICES:Medical/Surgical Intensive Care ($30,328,953) ($1,047.42) 5

10 Coronary Care ($3,712,961) ($1,169.44) 10

15 Pediatric Intensive Care ($2,599,008) ($1,577.07) 15

20 Neonatal Intensive Care ($6,838,856) ($1,058.48) 20


30 Burn Care ($3,359,311) ($863.58) 30



45 Medical/Surgical Acute $58,723,559 $568.68 45

50 Pediatric Acute ($6,761,817) ($1,334.74) 50

55 Psychiatric Acute - Adult ($5,700,443) ($308.20) 55

60 Psychiatric Acute - Adol & Child ($816,067) ($255.74) 60

65 Obstetrics Acute ($2,048,171) ($499.92) 65





90 Other Acute Care ($8,312,760) ($524.63) 90

95 Nursery Acute ($1,277,436) ($675.18) 95









150 TOTAL DAILY HOSPITAL SERVICES ($13,032,224) 150

160AMBULATORY SERVICES:Emergency Services ($22,737,636) ($182.39) 160

165 Medical Transportation Services ($46,088) ($8.03) 165

170 Psychiatric Emergency Rooms ($2,390,305) ($225.59) 170

175 Clinics ($44,532,703) ($94.03) 175










225 TOTAL AMBULATORY SERVICES ($69,706,733) 225




Line No

REVENUE PRODUCING CENTERS (1)Units ofService


(2)AdjustedDirect Expenses


(3)AllocatedCosts

Column(4) minus (2)

(4)Total PatientCare Costs fromPage 20, Column

(16),Lines 505 - 915

(5)Average UnitPatient Care

Costs, Column (4) ÷ (1)

Line No

230ANCILLARY SERVICES:Labor and Delivery Services 972 $12,900,332 $4,985,790 $17,886,122 $18,401.36 230

235 Surgery and Recovery Services 2,804,220 $37,078,355 $17,575,330 $54,653,685 $19.49 235

240 Ambulatory Surgery Services 240

245 Anesthesiology 2,804,220 $10,210,721 $3,823,034 $14,033,755 $5.00 245

250 Medical Supplies Sold to Patients 894,192 $18,111,298 $8,464,732 $26,576,030 $29.72 250

255 Durable Medical Equipment 255

260 Clinical Laboratory Services 2,672,956 $37,297,768 $12,495,632 $49,793,400 $18.63 260

265 Pathological Laboratory Services 67,731 $4,868,244 $3,499,552 $8,367,796 $123.54 265

270 Blood Bank 181,091 $11,808,023 $3,425,277 $15,233,300 $84.12 270

275 Echocardiology 19,288 $1,707,775 $725,803 $2,433,578 $126.17 275

280 Cardiac Catheterization Services 4,200 $6,375,580 $2,904,231 $9,279,811 $2,209.48 280

285 Cardiology Services 48,216 $1,628,709 $606,578 $2,235,287 $46.36 285

290 Electromyography 290

295 Electroencephalography 22,148 $445,074 $485,965 $931,039 $42.04 295

300 Radiology - Diagnostic 226,858 $19,926,954 $10,136,773 $30,063,727 $132.52 300

305 Radiology - Therapeutic 86,405 $4,158,608 $1,456,187 $5,614,795 $64.98 305

310 Nuclear Medicine 27,148 $2,671,906 $1,341,422 $4,013,328 $147.83 310

315 Magnetic Resonance Imaging 12,944 $3,260,777 $1,381,645 $4,642,422 $358.65 315

320 Ultrasonography 72,388 $2,827,939 $1,425,509 $4,253,448 $58.76 320

325 Computed Tomographic Scanner 77,682 $4,324,486 $1,901,673 $6,226,159 $80.15 325

330 Drugs Sold to Patients 894,192 $57,578,688 $58,674,957 $116,253,645 $130.01 330

335 Respiratory Therapy 199,710 $15,204,993 $3,641,187 $18,846,180 $94.37 335

340 Pulmonary Function Services 6,722 $2,383,267 $944,392 $3,327,659 $495.04 340

345 Renal Dialysis 39,457 $4,863,638 $1,574,239 $6,437,877 $163.16 345

350 Lithotripsy 350

355 Gastro-Intestinal Services 355

360 Physical Therapy 278,662 $5,980,013 $1,999,431 $7,979,444 $28.63 360

365 Speech-Language Pathology 2,820 $642,771 $209,533 $852,304 $302.24 365

370 Occupational Therapy 77,421 $2,574,096 $1,113,092 $3,687,188 $47.63 370

375 Other Physical Medicine $2,778,049 $763,560 $3,541,609 375

380 Electroconvulsive Therapy 380

385 Psychiatric/Psychological Testing 385

390 Psychiatric Individual/Group Therapy 390

395 Organ Acquisition 395

400 Other Ancillary Services $20,644,908 $6,254,271 $26,899,179 400

405 TOTAL ANCILLARY SERVICES $292,252,972 $151,809,792 $444,062,764 405


411 Purchased Outpatient Services $9,417 $1,630 $11,047 411

415 TOTAL OPERATING REV. & EXP. (A) $652,924,995 $342,129,599 $995,054,594 415

420 Non-Operating Cost Centers/Revenue $688,694 $1,878,464 $2,567,158 420

425 Provision for Income Taxes 425

430 Extraordinary Items 430

435 TOTALS/NET PROFIT (LOSS) (B) $653,613,689 $344,008,063 $997,621,752 435



(A) Sum of lines 150, 225, 405, and 410. (B) Column (16), Line 435 must agree with Page 8, Column 1, Line 245.



Line No

REVENUE PRODUCING CENTERS (6) Reallocated Net Research Costs from

Page 20, Col.(17), Lines 505-

915

(7) Reallocated Net Education

Costs from Page 20, Cols.

(18) + (19) + (20) +(21), Lines 505

- 915

(8) Transfers for Operating Costs from

Page 20, Column (22),

Lines 505 - 915

(9) Net Costs as Reallocated Column

(4) + (6) +(7) - (8)

(10) Average Unit Cost Column (9)

÷ (1)

Line No

230ANCILLARY SERVICES:Labor and Delivery Services $29,803 $525,161 $18,441,087 $18,972.31 230

235 Surgery and Recovery Services $98,437 $2,816,054 $57,568,176 $20.53 235


245 Anesthesiology $27,399 $1,029,300 $15,090,453 $5.38 245

250 Medical Supplies Sold to Patients $53,768 $26,629,798 $29.78 250


260 Clinical Laboratory Services $91,253 $243,333 $50,127,986 $18.75 260

265 Pathological Laboratory Services $16,613 $322,417 $8,706,826 $128.55 265

270 Blood Bank $27,919 $15,261,219 $84.27 270

275 Echocardiology $4,264 $2,437,842 $126.39 275

280 Cardiac Catheterization Services $15,880 $113,758 $9,409,449 $2,240.34 280

285 Cardiology Services $4,100 $2,239,387 $46.44 285


295 Electroencephalography $1,853 $23,725 $956,617 $43.19 295

300 Radiology - Diagnostic $62,399 $547,196 $30,673,321 $135.21 300

305 Radiology - Therapeutic $11,381 $5,626,175 $65.11 305

310 Nuclear Medicine $8,072 $52,012 $4,073,412 $150.04 310

315 Magnetic Resonance Imaging $9,681 $18,250 $4,670,353 $360.81 315

320 Ultrasonography $8,497 $97,942 $4,359,887 $60.23 320

325 Computed Tomographic Scanner $12,911 $97,942 $6,337,011 $81.58 325

330 Drugs Sold to Patients $235,749 $116,489,395 $130.27 330

335 Respiratory Therapy $32,373 $371,743 $19,250,295 $96.39 335

340 Pulmonary Function Services $6,688 $3,334,346 $496.03 340

345 Renal Dialysis $10,259 $6,448,136 $163.42 345

350 Lithotripsy 350


360 Physical Therapy $13,611 $46,468 $8,039,523 $28.85 360

365 Speech-Language Pathology $1,544 $853,848 $302.78 365

370 Occupational Therapy $7,391 $92,936 $3,787,515 $48.92 370

375 Other Physical Medicine $7,925 $185,871 $3,735,406 375





400 Other Ancillary Services $53,942 $26,953,120 400

405 TOTAL ANCILLARY SERVICES $853,712 $6,584,107 $451,500,584 405



415 TOTAL OPERATING REV. & EXP. (A) $2,221,469 $37,157,119 $1,034,433,182 415

420 Non-Operating Cost Centers/Revenue $2,567,158 420



435 TOTALS/NET PROFIT (LOSS) (B) $2,221,469 $37,157,119 $1,037,000,340 435







Line No

REVENUE PRODUCING CENTERS (11) Gross Revenue from Page 12, Columns (21) + (22)

(12)Deductions from Revenue from Page 12,

Column 23 Line 455 - 457

(13)Adjustment for Professional

Component from Page 15, Columns (9) &

(13)

(14)Net Revenue Column (11) - (12) -

(13)

(15)Average Unit Net Revenue Column (14) ÷ (1)

Line No

230ANCILLARY SERVICES:Labor and Delivery Services $30,546,993 $17,102,030 $1,034,368 $12,410,595 $12,768.10 230

235 Surgery and Recovery Services $100,893,335 $56,486,112 $18,534,963 $25,872,260 $9.23 235


245 Anesthesiology $28,082,377 $15,722,191 $14,421,945 ($2,061,759) ($0.74) 245

250 Medical Supplies Sold to Patients $55,110,062 $30,853,902 $24,256,160 $27.13 250


260 Clinical Laboratory Services $93,529,942 $52,363,645 $1,595,798 $39,570,499 $14.80 260

265 Pathological Laboratory Services $17,027,851 $9,533,207 $3,036,812 $4,457,832 $65.82 265

270 Blood Bank $28,615,442 $16,020,633 $136,845 $12,457,964 $68.79 270

275 Echocardiology $4,370,349 $2,446,782 $519,351 $1,404,216 $72.80 275

280 Cardiac Catheterization Services $16,275,745 $9,112,134 $897,128 $6,266,483 $1,492.02 280

285 Cardiology Services $4,202,503 $2,352,812 $1,849,691 $38.36 285


295 Electroencephalography $1,899,741 $1,063,588 $299,836 $536,317 $24.22 295

300 Radiology - Diagnostic $63,955,705 $35,806,221 $8,040,125 $20,109,359 $88.64 300

305 Radiology - Therapeutic $11,664,501 $6,530,484 $5,134,017 $59.42 305

310 Nuclear Medicine $8,273,487 $4,631,992 $785,334 $2,856,161 $105.21 310

315 Magnetic Resonance Imaging $9,922,296 $5,555,094 $1,107,025 $3,260,177 $251.87 315

320 Ultrasonography $8,709,533 $4,876,116 $1,447,681 $2,385,736 $32.96 320

325 Computed Tomographic Scanner $13,232,716 $7,408,464 $2,153,640 $3,670,612 $47.25 325

330 Drugs Sold to Patients $241,631,793 $135,279,901 $106,351,892 $118.94 330

335 Respiratory Therapy $33,180,647 $18,576,507 $14,604,140 $73.13 335

340 Pulmonary Function Services $6,854,629 $3,837,630 $380,811 $2,636,188 $392.17 340

345 Renal Dialysis $10,514,852 $5,886,842 $4,628,010 $117.29 345

350 Lithotripsy 350


360 Physical Therapy $13,950,464 $7,810,302 $6,140,162 $22.03 360

365 Speech-Language Pathology $1,582,845 $886,171 $696,674 $247.05 365

370 Occupational Therapy $7,575,809 $4,241,390 $3,334,419 $43.07 370

375 Other Physical Medicine $8,123,176 $4,547,839 $3,575,337 375





400 Other Ancillary Services $55,287,604 $30,953,301 $674,325 $23,659,978 400

405 TOTAL ANCILLARY SERVICES $875,014,397 $489,885,291 $55,065,987 $330,063,119 405


411 Purchased Outpatient Services 411

415 TOTAL OPERATING REV. & EXP. (A) $2,276,901,329 $1,274,745,278 $171,910,338 $830,245,713 415

420 Non-Operating Cost Centers/Revenue $283,593,675 420



435 TOTALS/NET PROFIT (LOSS) (B) $1,113,839,388 435






Line No

REVENUE PRODUCING CENTERS (16) Net Revenue Minus

Net Costs Column (14)

minus (9)

(17) Average Unit Net Column (16) ÷

(1)

Line No

230ANCILLARY SERVICES:Labor and Delivery Services ($6,030,492) ($6,204.21) 230

235 Surgery and Recovery Services ($31,695,915) ($11.30) 235


245 Anesthesiology ($17,152,212) ($6.12) 245

250 Medical Supplies Sold to Patients ($2,373,639) ($2.65) 250


260 Clinical Laboratory Services ($10,557,486) ($3.95) 260

265 Pathological Laboratory Services ($4,248,994) ($62.73) 265

270 Blood Bank ($2,803,255) ($15.48) 270

275 Echocardiology ($1,033,626) ($53.59) 275

280 Cardiac Catheterization Services ($3,142,965) ($748.33) 280

285 Cardiology Services ($389,696) ($8.08) 285


295 Electroencephalography ($420,301) ($18.98) 295

300 Radiology - Diagnostic ($10,563,963) ($46.57) 300

305 Radiology - Therapeutic ($492,158) ($5.70) 305

310 Nuclear Medicine ($1,217,251) ($44.84) 310

315 Magnetic Resonance Imaging ($1,410,175) ($108.94) 315

320 Ultrasonography ($1,974,152) ($27.27) 320

325 Computed Tomographic Scanner ($2,666,399) ($34.32) 325

330 Drugs Sold to Patients ($10,137,503) ($11.34) 330

335 Respiratory Therapy ($4,646,155) ($23.26) 335

340 Pulmonary Function Services ($698,159) ($103.86) 340

345 Renal Dialysis ($1,820,126) ($46.13) 345

350 Lithotripsy 350


360 Physical Therapy ($1,899,361) ($6.82) 360

365 Speech-Language Pathology ($157,174) ($55.74) 365

370 Occupational Therapy ($453,096) ($5.85) 370

375 Other Physical Medicine ($160,069) 375





400 Other Ancillary Services ($3,293,142) 400

405 TOTAL ANCILLARY SERVICES ($121,437,465) 405


411 Purchased Outpatient Services ($11,047) 411

415 TOTAL OPERATING REV. & EXP. (A) ($204,187,469) 415

420 Non-Operating Cost Centers/Revenue 420



435 TOTALS/NET PROFIT (LOSS) (B) $76,839,048 435





MEDICARE

Traditional Managed Care

Line No

PATIENT REVENUE PRODUCING CENTERS Account

No

(1) Gross Inpatient Revenue

(2) Gross Outpatient Revenue



Line No

Revenue Subclassifications .04 .44 .14 .54

5DAILY HOSPITAL SERVICES:Medical/Surgical Intensive Care 3010 $13,027,454 $3,442,012 5

10 Coronary Care 3030 $1,609,196 $191,623 10

15 Pediatric Intensive Care 3050 15

20 Neonatal Intensive Care 3070 20

25 Psychiatric Intensive (Isolation) Care 3090 25

30 Burn Care 3110 $911,242 $956,958 30

35 Other Intensive Care 3130 35

40 Definitive Observation 3150 40

45 Medical/Surgical Acute 3170 $50,173,839 $8,180,322 45

50 Pediatric Acute 3290 $52,278 50

55 Psychiatric Acute - Adult 3340 $6,343,545 $994,619 55

60 Psychiatric Acute - Adolescent and Child 3360 $40,909 60

65 Obstetrics Acute 3380 $118,435 $19,846 65

70 Alternate Birthing Center 3400 70

75 Chemical Dependency Services 3420 75

80 Physical Rehabilitation Care 3440 80

85 Hospice - Inpatient Services 3470 85

90 Other Acute Care 3510 $891,426 $61,458 90

95 Nursery Acute 3530 95

100 Sub-Acute Care 3560 100

101 Sub-Acute Care - Pediatric 3570 101

105 Skilled Nursing Care 3580 105

110 Psychiatric - Long Term Care 3610 110

115 Intermediate Care 3630 115

120 Residential Care 3680 120

125 Other Long-Term Care Services 3780 125

145 Other Daily Hospital Services 3900 145

150 TOTAL DAILY HOSPITAL SERVICES $73,168,324 $13,846,838 150

160AMBULATORY SERVICES:Emergency Services 4010 $1,731,392 $5,226,838 $374,201 $504,365 160

165 Medical Transportation Services 4040 165

170 Psychiatric Emergency Rooms 4060 $156,777 $1,511,322 $35,300 $88,703 170

175 Clinics 4070 $555,281 $15,624,144 $106,277 $237,458 175

180 Satellite Clinics 4180 180

185 Satellite Ambulatory Surgery Center 4200 185

190 Outpatient Chemical Dependency Services 4220 190

195 Observation Care 4230 195

200 Partial Hospitalization - Psychiatric 4260 200

205 Home Health Care Services 4290 205

210 Hospice - Outpatient Services 4310 210

215 Adult Day Health Care Services 4320 215

220 Other Ambulatory Services 4390 220

225 TOTAL AMBULATORY SERVICES $2,443,450 $22,362,304 $515,778 $830,526 225

12 SUPPLEMENTAL PATIENT REVENUE INFORMATION




Report Period End: 06/30/2014


Facility D.B.A. Name : LAC/USC MEDICAL CENTER

MEDI-CAL


Line No


No





Line No



10 Coronary Care 3030 $3,918,689 $2,463,510 10

15 Pediatric Intensive Care 3050 $7,077,859 $1,965,261 15

20 Neonatal Intensive Care 3070 $24,275,525 $2,948,971 20


30 Burn Care 3110 $7,641,615 $2,459,944 30




50 Pediatric Acute 3290 $12,221,120 $7,579,284 50

55 Psychiatric Acute - Adult 3340 $21,002,779 $734,662 55

60 Psychiatric Acute - Adolescent and Child 3360 $3,168,446 $518,281 60

65 Obstetrics Acute 3380 $3,872,364 $2,443,269 65





90 Other Acute Care 3510 $14,792,562 $8,140,521 90

95 Nursery Acute 3530 $3,490,157 $1,785,204 95










160AMBULATORY SERVICES:Emergency Services 4010 $8,824,169 $36,500,967 $4,650,252 $34,785,700 160


170 Psychiatric Emergency Rooms 4060 $279,421 $497,179 $108,308 $427,105 170

175 Clinics 4070 $3,297,314 $72,404,034 $1,846,510 $59,550,543 175
















COUNTY INDIGENT PROGRAMS


Line No


No





Line No



10 Coronary Care 3030 $1,170,872 $992,028 10

15 Pediatric Intensive Care 3050 $762,541 $6,471 15

20 Neonatal Intensive Care 3070 $2,657,063 20


30 Burn Care 3110 $1,245,946 $576,166 30




50 Pediatric Acute 3290 $1,734,015 $263,907 50

55 Psychiatric Acute - Adult 3340 $846,972 $3,121,418 55







90 Other Acute Care 3510 $3,970,583 $4,292,510 90

95 Nursery Acute 3530 $441,304 $6,106 95










160AMBULATORY SERVICES:Emergency Services 4010 $1,942,723 $43,020,562 $1,536,315 $8,703,806 160

165 Medical Transportation Services 4040 $392,000 $2,475,485 165

170 Psychiatric Emergency Rooms 4060 $75,516 $344,461 $193,572 $144,030 170

175 Clinics 4070 $529,426 $60,748,945 $749,833 $22,873,132 175













OTHER THIRD PARTIES


Line No


No





Line

Revenue Subclassifications .02, .03, .06 .42, .43, .46 .12,.13,.16 .52, .53, .56 No


10 Coronary Care 3030 $557,889 $122,116 10

15 Pediatric Intensive Care 3050 $1,160,320 $292,585 15

20 Neonatal Intensive Care 3070 $241,531 $110,689 20


30 Burn Care 3110 $6,015,814 $3,271,763 30




50 Pediatric Acute 3290 $1,678,372 $139,062 50

55 Psychiatric Acute - Adult 3340 $26,001,171 55

60 Psychiatric Acute - Adolescent and Child 3360 $6,445,935 60






90 Other Acute Care 3510 $6,198,806 $935,792 90

95 Nursery Acute 3530 $172,686 $90,606 95










160AMBULATORY SERVICES:Emergency Services 4010 $1,359,059 $6,231,763 $364,524 $2,260,822 160


170 Psychiatric Emergency Rooms 4060 $1,447,583 $24,249,425 $84,416 170

175 Clinics 4070 $629,821 $27,067,030 $135,352 $5,529,778 175










225 TOTAL AMBULATORY SERVICES $3,436,463 $57,548,218 $499,876 $7,875,016 225





OTHER INDIGENT OTHER PAYORS

Line No


No





Line

Revenue Subclassifications .08 .48 .00, .09 .40, .49 No

5DAILY HOSPITAL SERVICES:Medical/Surgical Intensive Care 3010 $155,884 5

10 Coronary Care 3030 $18,256 10

15 Pediatric Intensive Care 3050 $4,883 15

20 Neonatal Intensive Care 3070 $17,383 20


30 Burn Care 3110 $15,954 30



45 Medical/Surgical Acute 3170 $714,284 45

50 Pediatric Acute 3290 $20,251 50

55 Psychiatric Acute - Adult 3340 $25,235 55


65 Obstetrics Acute 3380 $5,319 65





90 Other Acute Care 3510 $35,690 90

95 Nursery Acute 3530 $4,607 95









150 TOTAL DAILY HOSPITAL SERVICES $1,021,707 150

160AMBULATORY SERVICES:Emergency Services 4010 $34,391 $1,554,184 160


170 Psychiatric Emergency Rooms 4060 $1,538 $8,571 170

175 Clinics 4070 $257,424 $761,009 175










225 TOTAL AMBULATORY SERVICES $293,353 $2,323,764 225





TOTAL

Line No


No



(23) Gross Patient Revenue

Line


10 Coronary Care 3030 $11,044,179 $11,044,179 10

15 Pediatric Intensive Care 3050 $11,269,920 $11,269,920 15

20 Neonatal Intensive Care 3070 $30,251,162 $30,251,162 20


30 Burn Care 3110 $23,095,402 $23,095,402 30




50 Pediatric Acute 3290 $23,688,289 $23,688,289 50

55 Psychiatric Acute - Adult 3340 $59,070,401 $59,070,401 55

60 Psychiatric Acute - Adolescent and Child 3360 $10,290,388 $10,290,388 60

65 Obstetrics Acute 3380 $7,543,749 $7,543,749 65





90 Other Acute Care 3510 $39,319,348 $39,319,348 90

95 Nursery Acute 3530 $5,990,670 $5,990,670 95










160AMBULATORY SERVICES:Emergency Services 4010 $20,817,026 $138,789,007 $159,606,033 160

165 Medical Transportation Services 4040 $392,000 $2,475,485 $2,867,485 165

170 Psychiatric Emergency Rooms 4060 $2,298,015 $27,355,212 $29,653,227 170

175 Clinics 4070 $8,107,238 $264,796,073 $272,903,311 175
















DEDUCTIONS FROM REVENUE MEDICARE

Traditional MEDICARE

Managed CareInpatient Outpatient Total

420 Provision for Bad Debts 420

425 Contractual Adjustments (exclude capitation revenue) $48,924,565 $45,358,372 $14,737,982 425

426Disproportionate share payments for Medi-Cal patient days (SB 855) (Credit Balance) 426

430 Charity 430

435 Restricted Donations and Subsidies for Indigent Care (Credit Balance)

435

440 Teaching Allowances 440

445 Support for Clinical Teaching (Credit Balance) 445

450 Other Deductions 450

455 TOTAL DEDUCTIONS FROM REVENUE $48,924,565 $45,358,372 $14,737,982 455

457 CAPITATION PREMIUM REVENUE 457

460 NET PATIENT REVENUE (Line 415 - 455 + 457) $58,995,153 $3,798,433 $6,355,972 460


MEDICARE


Line No


No




(4) Gross Outpatient Revenue Line

No


230ANCILLARY SERVICES:Labor and Delivery Services 4400 230

235 Surgery and Recovery Services 4420 $3,364,384 $1,179,389 $489,650 $31,302 235

240 Ambulatory Surgery Services 4430 240

245 Anesthesiology 4450 $936,434 $328,268 $136,287 $8,712 245

250 Medical Supplies sold to Patients 4470 $900,302 $2,371,896 $169,202 $62,250 250

255 Durable Medical Equipment 4480 255

260 Clinical Laboratory Services 4500 $4,136,460 $2,640,026 $877,959 $109,782 260

265 Pathological Laboratory Services 4520 $114,560 $163,419 $10,356 $948 265

270 Blood Bank 4540 $1,197,940 $655,369 $270,655 $50,152 270

275 Echocardiology 4560 $385,057 $98,166 $91,347 $1,128 275

280 Cardiac Catheterization Services 4570 $1,131,047 $363,749 $143,250 280

285 Cardiology Services 4590 $215,115 $106,798 $47,595 $9,749 285

290 Electromyography 4610 290

295 Electroencephalography 4620 $45,891 $38,482 $10,140 $128 295

300 Radiology - Diagnostic 4630 $1,841,971 $1,916,069 $470,466 $162,459 300

305 Radiology - Therapeutic 4640 $11,882 $872,969 $5,712 $4,687 305

310 Nuclear Medicine 4650 $128,245 $519,343 $16,232 $6,215 310

315 Magnetic Resonance Imaging 4660 $302,983 $319,420 $82,385 $16,430 315

320 Ultrasonography 4670 $173,371 $214,901 $30,453 $3,781 320

325 Computed Tomographic Scanner 4680 $427,057 $532,393 $135,968 $61,596 325

330 Drugs Sold to Patients 4710 $3,947,403 $10,399,656 $741,872 $272,936 330

335 Respiratory Therapy 4720 $72,385 $42,550 $557,576 $3,469 335

340 Pulmonary Function Services 4730 $98,929 $337,298 $12,876 $733 340

345 Renal Dialysis 4740 $1,509,761 $222,109 345

350 Lithotripsy 4750 350

355 Gastro-Intestinal Services 4760 355

360 Physical Therapy 4770 $1,296,620 $341,993 360

365 Speech- Language Pathology 4780 $90,502 $71,254 $27,710 $903 365

370 Occupational Therapy 4790 $302,304 $138,339 $67,445 $872 370

375 Other Physical Medicine 4800 $152,038 $7,535 $18,889 $2,425 375

380 Electroconvulsive Therapy 4820 380

385 Psychiatric/Psychological Testing 4830 385

390 Psychiatric Individual/Group Therapy 4840 390

395 Organ Acquisition 4860 395

400 Other Ancillary Services 4870 $9,525,303 $3,477,212 $94,146 $17,882 400

405 TOTAL ANCILLARY SERVICES $32,307,944 $26,794,501 $5,072,273 $828,539 405

415 TOTAL PATIENT REVENUE $107,919,718 $49,156,805 $19,434,889 $1,659,065 415



DEDUCTIONS FROM REVENUE

MEDI-CAL Traditional

Total

MEDI-CAL Managed Care

Total


425 Contractual Adjustments (exclude capitation revenue) $609,651,373 $304,623,322 425

426Disproportionate share payments for Medi-Cal patient days (SB 855) (Credit Balance) ($242,168,006) 426

430 Charity 430


435




455 TOTAL DEDUCTIONS FROM REVENUE $367,483,367 $304,623,322 455

457 CAPITATION PREMIUM REVENUE $113,102,823 457

460 NET PATIENT REVENUE (Line 415 - 455 + 457) $431,578,219 $285,492,629 460




MEDI-CAL


Line No


No





Line No


230ANCILLARY SERVICES:Labor and Delivery Services 4400 $16,610,605 $8,365,303 230

235 Surgery and Recovery Services 4420 $25,070,057 $10,924,467 $13,436,176 $6,424,473 235


245 Anesthesiology 4450 $6,977,932 $3,040,687 $3,739,789 $1,788,170 245

250 Medical Supplies sold to Patients 4470 $4,968,653 $11,516,102 $2,351,119 $9,744,518 250


260 Clinical Laboratory Services 4500 $21,799,635 $11,166,736 $11,144,453 $9,224,767 260

265 Pathological Laboratory Services 4520 $2,555,797 $3,305,318 $1,055,980 $2,149,116 265

270 Blood Bank 4540 $6,339,492 $4,278,267 $3,256,122 $2,469,275 270

275 Echocardiology 4560 $1,156,023 $266,684 $697,644 $284,988 275

280 Cardiac Catheterization Services 4570 $4,466,397 $1,095,055 $2,156,747 $770,323 280



295 Electroencephalography 4620 $265,157 $248,170 $142,053 $326,807 295

300 Radiology - Diagnostic 4630 $8,098,328 $10,634,976 $4,361,239 $7,980,346 300

305 Radiology - Therapeutic 4640 $192,152 $3,877,865 $91,215 $2,952,617 305

310 Nuclear Medicine 4650 $538,277 $1,734,852 $275,651 $1,831,269 310

315 Magnetic Resonance Imaging 4660 $1,572,240 $1,535,091 $747,290 $1,390,739 315

320 Ultrasonography 4670 $1,093,756 $1,756,306 $520,614 $1,118,777 320

325 Computed Tomographic Scanner 4680 $1,617,678 $2,060,489 $868,128 $1,677,034 325

330 Drugs Sold to Patients 4710 $21,785,211 $50,492,707 $10,308,559 $42,725,148 330

335 Respiratory Therapy 4720 $18,372,466 $176,048 $5,687,684 $333,225 335

340 Pulmonary Function Services 4730 $631,925 $879,352 $327,873 $1,357,255 340

345 Renal Dialysis 4740 $4,652,025 $2,414,893 345



360 Physical Therapy 4770 $5,254,128 $2,908,757 360

365 Speech- Language Pathology 4780 $359,856 $286,051 $193,340 $152,396 365

370 Occupational Therapy 4790 $1,258,323 $967,116 $274,599 $725,597 370

375 Other Physical Medicine 4800 $636,251 $891,461 $41,916 $528,784 375





400 Other Ancillary Services 4870 $961,673 $5,613,040 $412,245 $10,022,477 400






COUNTY INDIGENT PROGRAMS Traditional

CO. INDIGENT PROGRAMS





430 Charity 430


435










COUNTY INDIGENT PROGRAMS


Line No

PATIENT REVENUE PRODUCING CENTERS

Account No





Line No


230ANCILLARY SERVICES:Labor and Delivery Services 4400 $2,682,083 $88,978 230

235 Surgery and Recovery Services 4420 $11,325,344 $8,307,926 $6,889,105 $4,089,137 235


245 Anesthesiology 4450 $3,152,266 $2,312,406 $1,917,495 $1,138,158 245

250 Medical Supplies sold to Patients 4470 $1,225,997 $10,362,625 $780,037 $3,472,136 250


260 Clinical Laboratory Services 4500 $6,008,585 $11,060,836 $3,583,752 $3,133,345 260

265 Pathological Laboratory Services 4520 $874,866 $3,306,190 $463,451 $1,504,133 265

270 Blood Bank 4540 $1,936,603 $2,990,418 $963,895 $952,433 270

275 Echocardiology 4560 $348,611 $349,190 $270,204 $137,409 275

280 Cardiac Catheterization Services 4570 $1,795,110 $812,002 $1,488,365 $716,966 280




300 Radiology - Diagnostic 4630 $2,244,788 $11,915,930 $1,495,145 $3,648,721 300

305 Radiology - Therapeutic 4640 $38,292 $1,586,276 $38,141 $1,269,072 305

310 Nuclear Medicine 4650 $157,420 $1,781,440 $100,192 $673,957 310

315 Magnetic Resonance Imaging 4660 $479,772 $1,627,820 $266,832 $588,251 315

320 Ultrasonography 4670 $345,741 $1,879,636 $204,043 $534,099 320

325 Computed Tomographic Scanner 4680 $525,016 $2,295,876 $322,442 $551,008 325

330 Drugs Sold to Patients 4710 $5,375,423 $45,435,252 $3,420,097 $15,223,692 330

335 Respiratory Therapy 4720 $3,423,052 $219,917 $703,974 $50,654 335

340 Pulmonary Function Services 4730 $155,476 $1,911,602 $79,278 $640,936 340

345 Renal Dialysis 4740 $739,700 $139,861 345





370 Occupational Therapy 4790 $219,943 $1,059,431 $180,343 $414,868 370

375 Other Physical Medicine 4800 $92,008 $2,712,064 $97,806 $1,287,449 375





400 Other Ancillary Services 4870 $127,716 $1,862,574 $152,168 $11,676,107 400






OTHER THIRD PARTIES Traditional

OTHER THIRD PARTIES





430 Charity 430


435






460 NET PATIENT REVENUE (Line 415 - 455 + 457) $41,531,817 $18,598,876 $18,582,521 460

OTHER THIRD PARTIES


Line No


Account No





Line No

Revenue Subclassifications .02, .03, .06 .42, .43, .46 .12,.13,.16 .52, .53, .56

230ANCILLARY SERVICES:Labor and Delivery Services 4400 $2,168,486 $586,780 230

235 Surgery and Recovery Services 4420 $5,785,989 $661,238 $2,011,809 $696,987 235


245 Anesthesiology 4450 $1,610,456 $184,047 $559,961 $193,998 245

250 Medical Supplies sold to Patients 4470 $1,381,961 $4,580,873 $172,251 $849,793 250



265 Pathological Laboratory Services 4520 $141,353 $823,630 $123,987 $385,711 265

270 Blood Bank 4540 $1,386,818 $937,954 $450,566 $378,904 270

275 Echocardiology 4560 $167,969 $53,250 $35,011 $19,243 275

280 Cardiac Catheterization Services 4570 $902,390 $10,384 $296,017 $98,227 280




300 Radiology - Diagnostic 4630 $2,149,900 $5,004,249 $513,133 $1,159,135 300

305 Radiology - Therapeutic 4640 $37,453 $410,725 $265,875 305



320 Ultrasonography 4670 $128,161 $445,707 $22,764 $195,105 320

325 Computed Tomographic Scanner 4680 $504,658 $1,127,528 $159,898 $283,168 325

330 Drugs Sold to Patients 4710 $6,059,246 $20,084,976 $755,241 $3,725,947 330

335 Respiratory Therapy 4720 $2,215,628 $76,128 $646,308 $23,450 335

340 Pulmonary Function Services 4730 $51,263 $150,499 $10,502 $134,640 340

345 Renal Dialysis 4740 $737,095 $98,822 345





370 Occupational Therapy 4790 $1,487,960 $286,903 $72,582 $100,669 370

375 Other Physical Medicine 4800 $1,060,822 $420,564 $135,195 375





400 Other Ancillary Services 4870 $158,829 $9,642,265 $1,397,728 400







DEDUCTIONS FROM REVENUE OTHER INDIGENT OTHER PAYORS

Inpatient Outpatient Inpatient Outpatient

420 Provision for Bad Debts $574,089 $242,011 420

425 Contractual Adjustments (exclude capitation revenue) 425


430 Charity 430


435




455 TOTAL DEDUCTIONS FROM REVENUE $574,089 $242,011 455



OTHER INDIGENT OTHER PAYORS

Line No


Account No





Line No

Revenue Subclassifications .08 .48 .00, .09 .40, .49

230ANCILLARY SERVICES:Labor and Delivery Services 4400 $44,758 230

235 Surgery and Recovery Services 4420 $98,507 $107,395 235


245 Anesthesiology 4450 $27,418 $29,893 245

250 Medical Supplies sold to Patients 4470 $12,334 $188,013 250


260 Clinical Laboratory Services 4500 $64,676 $232,576 260

265 Pathological Laboratory Services 4520 $7,732 $41,304 265

270 Blood Bank 4540 $27,397 $73,182 270

275 Echocardiology 4560 $3,675 $4,750 275

280 Cardiac Catheterization Services 4570 $19,411 $10,305 280

285 Cardiology Services 4590 $2,974 $9,536 285


295 Electroencephalography 4620 $818 $3,851 295

300 Radiology - Diagnostic 4630 $26,307 $332,543 300

305 Radiology - Therapeutic 4640 $166 $9,402 305

310 Nuclear Medicine 4650 $1,696 $28,027 310

315 Magnetic Resonance Imaging 4660 $4,983 $33,339 315

320 Ultrasonography 4670 $3,822 $38,496 320

325 Computed Tomographic Scanner 4680 $7,395 $75,384 325

330 Drugs Sold to Patients 4710 $54,082 $824,345 330

335 Respiratory Therapy 4720 $567,482 $8,651 335

340 Pulmonary Function Services 4730 $1,247 $72,945 340

345 Renal Dialysis 4740 $586 345



360 Physical Therapy 4770 $13,751 360

365 Speech- Language Pathology 4780 $767 $1,425 365

370 Occupational Therapy 4790 $2,345 $16,170 370

375 Other Physical Medicine 4800 $1,130 $36,839 375





400 Other Ancillary Services 4870 $613 $145,626 400

405 TOTAL ANCILLARY SERVICES $996,072 $2,323,997 405

415 TOTAL PATIENT REVENUE $2,311,132 $4,647,761 415





DEDUCTIONS FROM REVENUETotal Inpatient Total Outpatient Total

420 Provision for Bad Debts $816,100 420

425 Contractual Adjustments (exclude capitation revenue) $1,637,058,030 425

426Disproportionate share payments for Medi-Cal patient days (SB 855) (Credit Balance) ($242,168,006) 426

430 Charity 430


435




455 TOTAL DEDUCTIONS FROM REVENUE $1,395,706,124 455


460 NET PATIENT REVENUE (Line 415 - 455 + 457) $1,002,156,051 460

TOTAL

Line No


Account No



(23) Gross patient Revenue Line

No

230ANCILLARY SERVICES:Labor and Delivery Services 4400 $30,546,993 $30,546,993 230

235 Surgery and Recovery Services 4420 $68,471,021 $32,422,314 $100,893,335 235


245 Anesthesiology 4450 $19,058,038 $9,024,339 $28,082,377 245

250 Medical Supplies sold to Patients 4470 $11,961,856 $43,148,206 $55,110,062 250


260 Clinical Laboratory Services 4500 $52,384,706 $41,145,236 $93,529,942 260

265 Pathological Laboratory Services 4520 $5,348,082 $11,679,769 $17,027,851 265

270 Blood Bank 4540 $15,829,488 $12,785,954 $28,615,442 270

275 Echocardiology 4560 $3,155,541 $1,214,808 $4,370,349 275

280 Cardiac Catheterization Services 4570 $12,398,734 $3,877,011 $16,275,745 280

285 Cardiology Services 4590 $2,186,430 $2,016,073 $4,202,503 285


295 Electroencephalography 4620 $625,813 $1,273,928 $1,899,741 295

300 Radiology - Diagnostic 4630 $21,201,277 $42,754,428 $63,955,705 300

305 Radiology - Therapeutic 4640 $415,013 $11,249,488 $11,664,501 305

310 Nuclear Medicine 4650 $1,285,177 $6,988,310 $8,273,487 310

315 Magnetic Resonance Imaging 4660 $3,826,936 $6,095,360 $9,922,296 315

320 Ultrasonography 4670 $2,522,725 $6,186,808 $8,709,533 320

325 Computed Tomographic Scanner 4680 $4,568,240 $8,664,476 $13,232,716 325

330 Drugs Sold to Patients 4710 $52,447,134 $189,184,659 $241,631,793 330

335 Respiratory Therapy 4720 $32,246,555 $934,092 $33,180,647 335

340 Pulmonary Function Services 4730 $1,369,369 $5,485,260 $6,854,629 340

345 Renal Dialysis 4740 $10,514,852 $10,514,852 345



360 Physical Therapy 4770 $13,950,464 $13,950,464 360

365 Speech- Language Pathology 4780 $862,318 $720,527 $1,582,845 365

370 Occupational Therapy 4790 $3,865,844 $3,709,965 $7,575,809 370

375 Other Physical Medicine 4800 $2,100,860 $6,022,316 $8,123,176 375





400 Other Ancillary Services 4870 $11,432,693 $43,854,911 $55,287,604 400


415 TOTAL PATIENT REVENUE $1,353,047,314 $923,854,015 $2,276,901,329 415





Line No

SUPPLEMENTAL OTHER OPERATING REVENUE INFORMATION Account No.

(1) Other Operating Revenue

Line No

5PART I: COST REDUCTIONS DISTRIBUTED TO SEVERAL COST CENTERSDonated Commodities 5650 5

10 Cash Discounts of Purchases 5660 10

15 Sale of Scrap and Waste 5670 $585,143 15

20 Rebates and Refunds 5680 20

25 Other Commissions 5710 25

30 Non-Patient Room Rentals 5730 30

35 Other (Specify) VARIOUS DEPT NONPATIENT REV $18,869,086 35

40 40

45 45

50 50

65PART II: MINOR RECOVERIES DISTRIBUTED TO ONE COST CENTERTelephone and Telegraph Revenue 5470 $10,478 65

70 Donated Blood 5750 70

75 Vending Machine Commissions 5690 75

80 Television/Radio Rentals 5720 80

85 Finance Charges on Patient Accounts Receivable 5520 $1,791 85

90 Child Care Services Revenue - Employees 5760 90

95 Other (Specify) 95

100 100

105 105

110 110

115 115

120 TOTAL PARTS I AND II $19,466,498 120

130PART III: OTHER OPERATING REVENUE ALLOCATEDNon-Patient Food Sales 5320 $176,131 130

135 Laundry and Linen Revenue 5340 $348 135

140 Social Work Services Revenue 5350 140

145 Supplies sold to Non-Patients Revenue 5370 145

150 Drugs Sold to Non-Patients Revenue 5380 $2,260,214 150

155 Purchasing Services Revenue 5390 155

160 Parking Revenue 5430 160

165 Housekeeping & Maintenance Services Revenue 5440 165

170 Data Processing Services Revenue 5480 $65 170

175 Medical Records Abstracts Sales 5700 $255,465 175

180 Management Services Revenue 5740 $20 180

185 Transfers from Restricted Funds for Operations (Non-Revenue Centers) 5790 185

190 Worker's Compensation Refunds 5782 190

195 Community Health Education Revenue 5770 195

196 Reinsurance Recoveries 5781 196

200 Other (Specify) OTHER - DSRIP REVENUE $138,296,128 200

205 ELECTRONIC HEALTH RECORDS $6,077,500 205

210 210

215 HOUSEKEEPING $1,794 215

220 TOTAL PART III $147,067,665 220

225PART IV: RESEARCH & EDUCATION REVENUES AND TRANSFERSTransfers from Restricted Funds for Research Expense 5010 225

230 School of Nursing Tuition 5220 $1,088,252 230

235 Licensed Vocational Nurse Program Tuition 5230 235

240 Medical Postgraduate Education Tuition 5240 240

245 Paramedical Education Tuition 5250 245

250 Student Housing Revenue 5260 250

255 Other Health Profession Education Revenue 5270 255

260 Transfers from Restricted Funds for Education Expense 5280 260

270 Transfers from Restricted Funds for Operations (Revenue Centers) 5790 270

275 TOTAL PART IV $1,088,252 275

280 TOTAL OTHER OPERATING REVENUE (Sum of Lines 120,220 and 275) $167,622,415 280

14 SUPPLEMENTAL OTHER OPERATING REVENUE INFORMATION




COMPENSATION

Line No


(1) Salaries

and Wages

(2) Employee

Benefits

(3) Professional Fees

(4) Total

Compensation Line No

Natural Classification Code No .07 .10-.19 .20

DAILY HOSPITAL SERVICES

5 Medical/Surgical Intensive Care 6010 $390,110 $447,449 $3,101,689 $3,939,248 5

10 Coronary Care 6030 $77,207 $77,329 $1,140,832 $1,295,368 10

15 Pediatric Intensive Care 6050 $52,139 $45,292 $652,303 $749,734 15

20 Neonatal Intensive Care 6070 $303,599 $254,249 $1,353,107 $1,910,955 20


30 Burn Care 6110 $690,384 $690,384 30



45 Medical/Surgical Acute 6170 $1,649,468 $1,611,881 $19,946,749 $23,208,098 45

50 Pediatric Acute 6290 $556,339 $511,899 $2,789,437 $3,857,675 50

55 Psychiatric Acute - Adult 6340 $494,981 $483,380 $1,073,285 $2,051,646 55

60 Psychiatric Acute - Adolescent & Child 6360 $147,227 $158,319 $146,686 $452,232 60

65 Obstetrics Acute 6380 $25,161 $21,985 $754,731 $801,877 65




85 Hospice - Inpatient Care 6470 85

90 Other Acute Care 6510 $368,422 $667,402 $2,980,759 $4,016,583 90

95 Nursery Acute 6530 $9,518 $9,080 $63,085 $81,683 95




110 Psychiatric Long-Term Care 6610 110






AMBULATORY SERVICES

160 Emergency Services 7010 $2,213,708 $2,125,687 $11,533,002 $15,872,397 160


170 Psychiatric Emergency Rooms 7060 $293,812 $254,104 $1,895,439 $2,443,355 170

175 Clinics 7070 $2,210,827 $2,256,449 $17,157,689 $21,624,965 175



190 Outpatient Chemical Dependency Svcs. 7220 190








15 RECLASSIFICATION WORKSHEET- PHYSICIAN AND STUDENT COMPENSATION -PATIENT REVENUE PRODUCING CENTERS




PERCENT OF TIME SPENT BY FUNCTION

Line No


No

(5) Research

Supported by Hospital

(6) Medical

Education Supported by Hospital (Non-

Inservice)

(7) General

Administration and Hospital Committees

(8) Nursing and

Paramedical Care of Hospital

Patients

Line No


5 Medical/Surgical Intensive Care 6010 $353,143 $116,420 5

10 Coronary Care 6030 $71,913 $165,501 10

15 Pediatric Intensive Care 6050 $23,658 $82,618 15

20 Neonatal Intensive Care 6070 $279,737 $284,821 20


30 Burn Care 6110 $77,935 $49,935 30




50 Pediatric Acute 6290 $810,278 $1,174,888 50

55 Psychiatric Acute - Adult 6340 $58,213 $39,676 55

60 Psychiatric Acute - Adolescent & Child 6360 $6,700 $3,386 60






90 Other Acute Care 6510 $1,000,367 $1,782,998 90

95 Nursery Acute 6530 $6,825 $3,524 95










AMBULATORY SERVICES

160 Emergency Services 7010 $1,874,788 $3,562,463 160


170 Psychiatric Emergency Rooms 7060 $18,027 $26,399 170

175 Clinics 7070 $622,986 $1,353,355 175










225 TOTAL AMBULATORY SERVICES $2,515,801 $4,942,217 225






Line No


No

(9) Physician and Intern/Resident Care of Hospital

Patients

(10) Supervision and Other Functions

of the Cost Center

(13) Allocation of

Page 16, Column(9), to Revenue Centers (See Instructions)

Line No


5 Medical/Surgical Intensive Care 6010 $3,203,332 $266,353 $5,681,546 5

10 Coronary Care 6030 $1,057,954 $635,097 10

15 Pediatric Intensive Care 6050 $596,108 $47,350 $274,637 15

20 Neonatal Intensive Care 6070 $881,884 $464,513 $592,185 20


30 Burn Care 6110 $447,966 $114,548 $472,032 30



45 Medical/Surgical Acute 6170 $9,239,663 $3,304,870 $26,408,036 45

50 Pediatric Acute 6290 $1,324,766 $547,743 $1,750,809 50

55 Psychiatric Acute - Adult 6340 $1,726,146 $227,611 $1,124,294 55

60 Psychiatric Acute - Adolescent & Child 6360 $349,801 $92,345 $300,384 60

65 Obstetrics Acute 6380 $187,162 $90,118 $643,680 65





90 Other Acute Care 6510 $799,657 $433,561 $2,437,401 90

95 Nursery Acute 6530 $66,090 $5,244 $266,054 95










AMBULATORY SERVICES

160 Emergency Services 7010 $9,605,439 $829,707 $7,140,554 160


170 Psychiatric Emergency Rooms 7060 $2,375,366 $23,563 $463,449 170

175 Clinics 7070 $18,855,651 $792,973 $17,937,208 175















COMPENSATION

Line No


(1) Salaries

and Wages

(2) Employee

Benefits

(3) Professional

Fees

(4) Total


Natural Classification Code No .07 .10-.19 .20

ANCILLARY SERVICES

230 Labor and Delivery Services 7400 $16,225 $21,536 $917,733 $955,494 230

235 Surgery and Recovery Services 7420 $368,788 $346,912 $9,846,393 $10,562,093 235


245 Anesthesiology 7450 $2,029,271 $1,972,048 $7,269,283 $11,270,602 245

250 Medical Supplies Sold to Patients 7470 250


260 Clinical Laboratory Services 7500 $11,078 $21,591 $1,700,672 $1,733,341 260

265 Pathological Laboratory Services 7520 $418,304 $402,737 $1,690,564 $2,511,605 265

270 Blood Bank 7540 $290,259 $290,259 270

275 Echocardiology 7560 $16,086 $13,572 $489,693 $519,351 275

280 Cardiac Catheterization Services 7570 $11,526 $9,724 $395,264 $416,514 280

285 Cardiology Services 7590 285



300 Radiology - Diagnostic 7630 $623,054 $555,867 $8,587,878 $9,766,799 300

305 Radiology - Therapeutic 7640 $29,990 $29,990 305

310 Nuclear Medicine 7650 $1,081,516 $1,081,516 310

315 Magnetic Resonance Imaging 7660 $238 $218 $1,104,506 $1,104,962 315

320 Ultrasonography 7670 $114,750 $122,461 $842,087 $1,079,298 320

325 Computed Tomographic Scanner 7680 $156,843 $157,778 $1,525,872 $1,840,493 325

330 Drugs Sold to Patients 7710 330

335 Respiratory Therapy 7720 335

340 Pulmonary Function Services 7730 $507 $24,526 $355,778 $380,811 340

345 Renal Dialysis 7740 345



360 Physical Therapy 7770 360

365 Speech-Language Pathology 7780 365

370 Occupational Therapy 7790 370

375 Other Physical Medicine 7800 375





400 Other Ancillary Services 7870 $88,926 $95,392 $637,099 $821,417 400







Line No


No

(5) Research


(6) Medical


Inservice)

(7) General


(8) Nursing and


Patients

Line No

ANCILLARY SERVICES

230 Labor and Delivery Services 7400 $5,399 $5,857 230

235 Surgery and Recovery Services 7420 $267,191 $45,635 235


245 Anesthesiology 7450 $653,316 $5,615 245



260 Clinical Laboratory Services 7500 $113,588 $858,162 260

265 Pathological Laboratory Services 7520 $257,849 $250,295 265

270 Blood Bank 7540 $55,254 $76,244 270

275 Echocardiology 7560 275

280 Cardiac Catheterization Services 7570 280



295 Electroencephalography 7620 $13,446 $45,636 295

300 Radiology - Diagnostic 7630 $2,030,788 $1,549,854 300

305 Radiology - Therapeutic 7640 $1,523 $18,697 305

310 Nuclear Medicine 7650 $197,196 $186,082 310

315 Magnetic Resonance Imaging 7660 $49,060 $14,142 315

320 Ultrasonography 7670 $1,147 $14,074 320

325 Computed Tomographic Scanner 7680 $64,842 $15,819 325



340 Pulmonary Function Services 7730 340












400 Other Ancillary Services 7870 $41,049 $34,567 400

405 TOTAL ANCILLARY SERVICES $3,751,648 $3,120,679 405






Line No


No


Patients


of the Cost Center

(13) Allocation of

Page 16, Column(9), to Revenue Centers (See Instructions)

Line No

ANCILLARY SERVICES

230 Labor and Delivery Services 7400 $914,214 $30,024 $120,154 230

235 Surgery and Recovery Services 7420 $10,081,303 $167,964 $8,453,660 235


245 Anesthesiology 7450 $10,044,923 $566,748 $4,377,022 245



260 Clinical Laboratory Services 7500 $557,328 $204,263 $1,038,470 260

265 Pathological Laboratory Services 7520 $1,663,629 $339,832 $1,373,183 265

270 Blood Bank 7540 $136,845 $21,916 270

275 Echocardiology 7560 $519,351 275

280 Cardiac Catheterization Services 7570 $416,514 $480,614 280



295 Electroencephalography 7620 $205,430 $10,866 $94,406 295

300 Radiology - Diagnostic 7630 $5,714,296 $471,861 $2,325,829 300

305 Radiology - Therapeutic 7640 $9,770 305

310 Nuclear Medicine 7650 $562,192 $136,046 $223,142 310

315 Magnetic Resonance Imaging 7660 $1,029,783 $11,977 $77,242 315

320 Ultrasonography 7670 $1,027,144 $36,933 $420,537 320

325 Computed Tomographic Scanner 7680 $1,733,103 $26,729 $420,537 325



340 Pulmonary Function Services 7730 $380,811 340












400 Other Ancillary Services 7870 $674,325 $71,476 400






COMPENSATION

Line No

NON-REVENUE PRODUCING CENTERS Account No

(1) Salaries

and Wages

(2) Employee

Benefits


(4) Total


Natural Classification Code .07,.09 .10-.19 .20

RESEARCH COSTS

5 Research Projects and Administration 8010 5

10 TOTAL RESEARCH 10

EDUCATION COSTS

15 Education Administration Office 8210 15

20 School of Nursing 8220 $3,994 $2,978 $6,972 20

25 Licensed Vocational Nurse Program 8230 25

30 Medical Postgraduate Education 8240 $48,649,529 $36,277,953 $1,652,295 $86,579,777 30

35 Paramedical Education 8250 $207,221 $154,525 $361,746 35

40 Student Housing 8260 40

45 Other Health Profession Education 8290 45

50 TOTAL EDUCATION $48,860,744 $36,435,456 $1,652,295 $86,948,495 50

ADMINISTRATIVE SERVICES

205 Hospital Administration 8610 $1,206,186 $1,174,426 $6,366,581 $8,747,193 205

210 Governing Board Expense 8620 210

215 Public Relations 8630 215

220 Management Engineering 8640 220

225 Personnel 8650 225

230 Employee Health Services 8660 $265,021 $265,021 230

235 Auxiliary Groups 8670 235

240 Chaplaincy Services 8680 240

245 Medical Library 8690 245

250 Medical Records 8700 250

255 Medical Staff Administration 8710 255

260 Nursing Administration 8720 260

265 Nursing Float Personnel 8730 265

270 Inservice Education - Nursing 8740 270

275 Utilization Management 8750 $164,857 $166,641 $263,861 $595,359 275

280 Community Health Education 8760 280

295 Other Administrative Services 8790 295

300 TOTAL ADMINISTRATIVE SERVICES $1,371,043 $1,341,067 $6,895,463 $9,607,573 300

TOTAL

305 TOTAL PAGES 15 AND 16 $62,949,095 $50,499,315 $110,743,781 $224,192,191 305

DO NOT INCLUDE ANY COMPENSATION LISTED ABOVE ON PAGE 17 OR 18, COLUMNS (1), (2) OR (4).

16 RECLASSIFICATION WORKSHEET - PHYSICIAN AND STUDENT COMPENSATION - NON-REVENUE PRODUCING CENTERS






Line No


Account No

(5) Research


(6) Medical


Inservice)

(7) General


(8) Nursing and


Patients

Line No

RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing 8220 20


30 Medical Postgraduate Education 8240 $1,047,615 30

35 Paramedical Education 8250 35



50 TOTAL EDUCATION $1,047,615 50


205 Hospital Administration 8610 $499,888 $7,224,794 205





230 Employee Health Services 8660 $265,021 230









275 Utilization Management 8750 $11,944 $578,360 275



300 TOTAL ADMINISTRATIVE SERVICES $511,832 $8,068,175 300

TOTAL

305 TOTAL PAGES 15 AND 16 $14,715,261 $26,823,404 305

TOTAL LINE 305 TO PAGE 18,

COLUMN(3), LINE 5

LINES 15-50 PAGE 16,TO

SAME LINES ON PAGE 18, COL.(3);

OTHERS TO PAGE 18,

COLUMN(3), LINE 15

TOTAL LINE 305 TO PAGE 18,

COLUMN(3) LINE 295

LINE ITEMS TO PAGE 17,

COLUMN(3) LINES AS

APPROPRIATE (SEE

INSTRUCTIONS)





Line No


No


Patients


of the Cost CenterLine No

RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing 8220 $6,972 20


30 Medical Postgraduate Education 8240 $85,532,162 30

35 Paramedical Education 8250 $361,746 35



50 TOTAL EDUCATION $85,532,162 $368,718 50


205 Hospital Administration 8610 $1,022,511 205





230 Employee Health Services 8660 230









275 Utilization Management 8750 $5,055 275



300 TOTAL ADMINISTRATIVE SERVICES $1,027,566 300

TOTAL

305 TOTAL PAGES 15 AND 16 $171,910,338 $10,743,188 305

LINE 50 TO PAGE 15, COLUMN(13)

(SEE INSTRUCTIONS)

LINE ITEMS TO PAGES 17 & 18,

COLUMN(3), LINES AS

APPROPRIATE (SEE

INSTRUCTIONS)





Line No

PATIENTREVENUE PRODUCING CENTERS Account

No

(1) Salaries

and Wages

(2) Employee

Benefits

(3) Reclassified

Physician and Student

Compensation Pages 15 &16, Cols. (8) & (10)


Line No

Natural Classification Code .00-.06,.08, .09,.91,.95

.10-.19,.92-.96 .07,.10-.19,.20 .21-.29


5 Medical/Surgical Intensive Care 6010 $24,028,639 $25,627,778 $266,353 $2,693,362 5

10 Coronary Care 6030 $2,181,554 $2,408,340 $48,904 10

15 Pediatric Intensive Care 6050 $1,876,750 $2,549,258 $47,350 $8,863 15

20 Neonatal Intensive Care 6070 $5,434,897 $7,059,578 $464,513 $1,477 20


30 Burn Care 6110 $3,404,872 $3,737,807 $114,548 $257,324 30



45 Medical/Surgical Acute 6170 $41,559,211 $43,484,818 $3,304,870 $6,646,726 45

50 Pediatric Acute 6290 $3,217,658 $3,494,245 $547,743 $40,017 50

55 Psychiatric Acute - Adult 6340 $7,419,775 $7,448,124 $227,611 $2,296,264 55

60 Psychiatric Acute - Adolescent & Child 6360 $1,182,747 $1,115,189 $92,345 $405,996 60

65 Obstetrics Acute 6380 $1,230,033 $1,379,063 $90,118 $18,032 65





90 Other Acute Care 6510 $5,662,446 $6,142,405 $433,561 $982,312 90

95 Nursery Acute 6530 $1,147,069 $1,250,330 $5,244 $10,729 95










AMBULATORY SERVICES

160 Emergency Services 7010 $20,943,820 $21,862,186 $829,707 $5,128,101 160


170 Psychiatric Emergency Rooms 7060 $3,654,016 $3,517,547 $23,563 $930,388 170

175 Clinics 7070 $32,141,652 $32,801,981 $792,973 $7,190,902 175











17 TRIAL BALANCE WORKSHEET AND SUPPLEMENTAL EXPENSE INFORMATION -PATIENT REVENUE PRODUCING CENTERS




Line No


No

(5) Supplies

(6) Purchased

Services

(7) Depreciation

(8) Leases

and Rentals Line No

Natural Classification Code .31-.50,.93,.97 .61-.69 .71-.74 .75-.76


5 Medical/Surgical Intensive Care 6010 $2,606,712 $2,844 $67,028 $30,251 5

10 Coronary Care 6030 $90,270 $303 10

15 Pediatric Intensive Care 6050 $112,533 $174 15

20 Neonatal Intensive Care 6070 $393,155 $412 20


30 Burn Care 6110 $707,603 $4,746 $53,455 $24,125 30



45 Medical/Surgical Acute 6170 $2,083,084 $5,370 $656,322 $302,188 45

50 Pediatric Acute 6290 $171,252 $837 $34,546 $9,612 50

55 Psychiatric Acute - Adult 6340 $86,271 $2,375,038 $32,886 $14,842 55

60 Psychiatric Acute - Adolescent & Child 6360 $6,553 $405,741 60

65 Obstetrics Acute 6380 $123,295 $192 $21,064 $9,506 65





90 Other Acute Care 6510 $459,947 $880 $45,304 $20,447 90

95 Nursery Acute 6530 $17,662 $18 $7,555 $3,410 95









150 TOTAL DAILY HOSPITAL SERVICES $6,858,337 $2,796,555 $918,160 $414,381 150

AMBULATORY SERVICES

160 Emergency Services 7010 $2,672,192 $30,024 $26,860 $12,122 160

165 Medical Transportation Services 7040 $1,078,691 165

170 Psychiatric Emergency Rooms 7060 $155,588 $544 $3,587 $1,619 170

175 Clinics 7070 $4,307,681 $950,572 $323,912 $146,187 175










225 TOTAL AMBULATORY SERVICES $7,135,461 $2,059,831 $354,359 $159,928 225





Line No

PATIENTREVENUE PRODUCING CENTERS

Account No

(9) Other Direct

Expenses

(10) Total Direct Expenses

Columns (1) thru (9)

(11) Adjustments of Direct Expenses

from Page 14, Parts I & II

(12) (Optional) Adjusted Direct Expenses [Cols.

(10) minus (11)] to Page 20, Column

(1)

Line No

Natural Classification Code .77-.90,.94-.98


5 Medical/Surgical Intensive Care 6010 $2,003 $55,324,970 $1,621,793 $53,703,177 5

10 Coronary Care 6030 $238 $4,729,609 $116,490 $4,613,119 10

15 Pediatric Intensive Care 6050 $797 $4,595,725 $55,281 $4,540,444 15

20 Neonatal Intensive Care 6070 $546 $13,354,578 $109,098 $13,245,480 20


30 Burn Care 6110 $690 $8,305,170 $87,279 $8,217,891 30



45 Medical/Surgical Acute 6170 $5,300 $98,047,889 $4,870,649 $93,177,240 45

50 Pediatric Acute 6290 $957 $7,516,867 $323,541 $7,193,326 50

55 Psychiatric Acute - Adult 6340 $879 $19,901,690 $266,120 $19,635,570 55

60 Psychiatric Acute - Adolescent & Child 6360 $77 $3,208,648 $55,501 $3,153,147 60

65 Obstetrics Acute 6380 $2,871,303 $118,618 $2,752,685 65





90 Other Acute Care 6510 $629 $13,747,931 $449,989 $13,297,942 90

95 Nursery Acute 6530 $260 $2,442,277 $49,668 $2,392,609 95









150 TOTAL DAILY HOSPITAL SERVICES $12,376 $234,046,657 $8,124,027 $225,922,630 150

AMBULATORY SERVICES

160 Emergency Services 7010 $4,707 $51,509,719 $1,317,420 $50,192,299 160

165 Medical Transportation Services 7040 $1,078,691 $1,078,691 165

170 Psychiatric Emergency Rooms 7060 $561 $8,287,413 $86,223 $8,201,190 170

175 Clinics 7070 $43,214 $78,699,074 $3,431,278 $75,267,796 175










225 TOTAL AMBULATORY SERVICES $48,482 $139,574,897 $4,834,921 $134,739,976 225





Report Period End: LAC/USC MEDICAL CENTERFacility D.B.A. Name :


Line No


No

(13) (Optional) Units of Service

from Page 4, Columns (4) + (5)

or Col(1)

(14)(Optional) Adjusted Direct Expenses Per

Unit Column (12) ÷ (13)

Line No


5 Medical/Surgical Intensive Care 6010 28,956 $1,854.65 5

10 Coronary Care 6030 3,175 $1,452.95 10

15 Pediatric Intensive Care 6050 1,648 $2,755.12 15

20 Neonatal Intensive Care 6070 6,461 $2,050.07 20


30 Burn Care 6110 3,890 $2,112.57 30



45 Medical/Surgical Acute 6170 103,263 $902.33 45

50 Pediatric Acute 6290 5,066 $1,419.92 50

55 Psychiatric Acute - Adult 6340 18,496 $1,061.61 55

60 Psychiatric Acute - Adolescent & Child 6360 3,191 $988.14 60

65 Obstetrics Acute 6380 4,097 $671.88 65





90 Other Acute Care 6510 15,845 $839.25 90

95 Nursery Acute 6530 1,892 $1,264.59 95









150 TOTAL DAILY HOSPITAL SERVICES 150

AMBULATORY SERVICES

160 Emergency Services 7010 124,667 $402.61 160

165 Medical Transportation Services 7040 5,736 $188.06 165

170 Psychiatric Emergency Rooms 7060 10,596 $773.99 170

175 Clinics 7070 473,615 $158.92 175










225 TOTAL AMBULATORY SERVICES 225

06/30/2014



Line No


No

(1) Salaries

and Wages

(2) Employee

Benefits

(3) Reclassified


Compensation Pages 15 &16, Cols. (8) & (10)

(4) Professional

Fees

Line No


.10-.19,.92-.96 .07,.10-.19,.20 .21-.29

ANCILLARY SERVICES

230 Labor and Delivery Services 7400 $5,979,920 $6,581,810 $30,024 $1,888 230

235 Surgery and Recovery Services 7420 $12,902,806 $13,311,829 $167,964 $893,308 235


245 Anesthesiology 7450 $4,214,151 $4,402,618 $566,748 $1,253,602 245




265 Pathological Laboratory Services 7520 $1,819,502 $2,023,636 $339,832 $1,908 265

270 Blood Bank 7540 $1,577,993 $1,727,042 $21,916 $256 270

275 Echocardiology 7560 $647,113 $757,106 $57,954 275

280 Cardiac Catheterization Services 7570 $1,688,257 $2,094,009 $44,278 280

285 Cardiology Services 7590 $664,425 $800,600 $82,837 285


295 Electroencephalography 7620 $182,135 $206,567 $10,866 $197 295

300 Radiology - Diagnostic 7630 $5,811,457 $6,058,842 $471,861 $1,643,244 300

305 Radiology - Therapeutic 7640 $1,062,663 $1,090,751 $9,770 $631,628 305



320 Ultrasonography 7670 $505,967 $529,968 $36,933 $1,027,682 320

325 Computed Tomographic Scanner 7680 $1,455,457 $1,692,944 $26,729 $544,466 325


335 Respiratory Therapy 7720 $3,995,895 $4,509,764 $4,241,006 335

340 Pulmonary Function Services 7730 $1,042,643 $1,256,813 340

345 Renal Dialysis 7740 $1,986,411 $2,323,892 345



360 Physical Therapy 7770 $2,065,371 $2,266,862 $927,064 360

365 Speech-Language Pathology 7780 $250,905 $247,012 $131,333 365

370 Occupational Therapy 7790 $995,932 $1,116,473 $447,034 370

375 Other Physical Medicine 7800 $1,108,728 $1,464,702 $161,372 375





400 Other Ancillary Services 7870 $426,652 $465,175 $71,476 $656 400


PATIENT CARE SERVICES

410 Purchased Inpatient Services 7900 410

411 Purchased Outpatient Services 7950 411

415 TOTAL PATIENT CARE SERVICES $219,997,756 $234,328,609 $9,346,904 $40,248,047 415





Line No


No

(5) Supplies

(6) Purchased Services

(7) Depreciation

(8) Leases

and Rentals Line No


ANCILLARY SERVICES

230 Labor and Delivery Services 7400 $322,367 $231 $3,977 $1,795 230

235 Surgery and Recovery Services 7420 $10,055,419 $713,665 $397,215 $179,269 235


245 Anesthesiology 7450 $402,161 $151,314 $16,777 $7,572 245

250 Medical Supplies Sold to Patients 7470 $18,111,298 250



265 Pathological Laboratory Services 7520 $581,260 $179,185 $119,428 $53,900 265

270 Blood Bank 7540 $8,211,541 $265,932 $1,476 $666 270

275 Echocardiology 7560 $245,480 275

280 Cardiac Catheterization Services 7570 $2,449,460 $76,356 $83,808 $37,824 280

285 Cardiology Services 7590 $55,706 $25,141 285



300 Radiology - Diagnostic 7630 $2,002,472 $4,224,968 $76,605 $66,401 300

305 Radiology - Therapeutic 7640 $48,687 $1,296,778 $17,582 305


315 Magnetic Resonance Imaging 7660 $29,149 $507,406 $13,039 315

320 Ultrasonography 7670 $429,513 $360,787 $12,452 320

325 Computed Tomographic Scanner 7680 $182,157 $485,300 $13,339 325

330 Drugs Sold to Patients 7710 $57,578,688 330

335 Respiratory Therapy 7720 $469,380 $23,279 $1,353,865 $611,021 335

340 Pulmonary Function Services 7730 $57,016 $22,334 $3,003 $1,355 340

345 Renal Dialysis 7740 $426,546 $126,446 345



360 Physical Therapy 7770 $96,472 $430,084 $194,104 360

365 Speech-Language Pathology 7780 $13,466 365

370 Occupational Therapy 7790 $14,618 370

375 Other Physical Medicine 7800 $43,189 375





400 Other Ancillary Services 7870 $19,577,348 $94,143 $6,279 $2,834 400




411 Purchased Outpatient Services 7950 $9,417 411

415 TOTAL PATIENT CARE SERVICES $140,981,316 $18,599,020 $4,043,497 $1,826,959 415





Line No

PATIENTREVENUE PRODUCING CENTERS

Account No

(9) Other Direct

Expenses







(1)

Line No


ANCILLARY SERVICES

230 Labor and Delivery Services 7400 $372 $12,922,384 $22,052 $12,900,332 230

235 Surgery and Recovery Services 7420 $21,461 $38,642,936 $1,564,581 $37,078,355 235


245 Anesthesiology 7450 $3,503 $11,018,446 $807,725 $10,210,721 245

250 Medical Supplies Sold to Patients 7470 $18,111,298 $18,111,298 250


260 Clinical Laboratory Services 7500 $9,677 $37,489,880 $192,112 $37,297,768 260

265 Pathological Laboratory Services 7520 $2,550 $5,121,201 $252,957 $4,868,244 265

270 Blood Bank 7540 $1,201 $11,808,023 $11,808,023 270

275 Echocardiology 7560 $122 $1,707,775 $1,707,775 275

280 Cardiac Catheterization Services 7570 $1,205 $6,475,197 $99,617 $6,375,580 280

285 Cardiology Services 7590 $1,628,709 $1,628,709 285


295 Electroencephalography 7620 $112 $463,768 $18,694 $445,074 295

300 Radiology - Diagnostic 7630 $1,884 $20,357,734 $430,780 $19,926,954 300

305 Radiology - Therapeutic 7640 $749 $4,158,608 $4,158,608 305

310 Nuclear Medicine 7650 $599 $2,712,688 $40,782 $2,671,906 310

315 Magnetic Resonance Imaging 7660 $704 $3,275,152 $14,375 $3,260,777 315

320 Ultrasonography 7670 $1,514 $2,904,816 $76,877 $2,827,939 320

325 Computed Tomographic Scanner 7680 $971 $4,401,363 $76,877 $4,324,486 325

330 Drugs Sold to Patients 7710 $57,578,688 $57,578,688 330

335 Respiratory Therapy 7720 $783 $15,204,993 $15,204,993 335

340 Pulmonary Function Services 7730 $103 $2,383,267 $2,383,267 340

345 Renal Dialysis 7740 $343 $4,863,638 $4,863,638 345



360 Physical Therapy 7770 $56 $5,980,013 $5,980,013 360

365 Speech-Language Pathology 7780 $55 $642,771 $642,771 365

370 Occupational Therapy 7790 $39 $2,574,096 $2,574,096 370

375 Other Physical Medicine 7800 $58 $2,778,049 $2,778,049 375





400 Other Ancillary Services 7870 $345 $20,644,908 $20,644,908 400

405 TOTAL ANCILLARY SERVICES $48,406 $295,850,401 $3,597,429 $292,252,972 405



411 Purchased Outpatient Services 7950 $9,417 $9,417 411

415 TOTAL PATIENT CARE SERVICES $109,264 $669,481,372 $16,556,377 $652,924,995 415







Line No


No

(13) (Optional) Units of Service

from Page 4, Columns (4) + (5)

or Col(1)



Line No

ANCILLARY SERVICES

230 Labor and Delivery Services 7400 972 $13,271.95 230

235 Surgery and Recovery Services 7420 2,804,220 $13.22 235


245 Anesthesiology 7450 2,804,220 $3.64 245

250 Medical Supplies Sold to Patients 7470 894,192 $20.25 250


260 Clinical Laboratory Services 7500 2,672,956 $13.95 260

265 Pathological Laboratory Services 7520 67,731 $71.88 265

270 Blood Bank 7540 181,091 $65.20 270

275 Echocardiology 7560 19,288 $88.54 275

280 Cardiac Catheterization Services 7570 4,200 $1,518.00 280

285 Cardiology Services 7590 48,216 $33.78 285


295 Electroencephalography 7620 22,148 $20.10 295

300 Radiology - Diagnostic 7630 226,858 $87.84 300

305 Radiology - Therapeutic 7640 86,405 $48.13 305

310 Nuclear Medicine 7650 27,148 $98.42 310

315 Magnetic Resonance Imaging 7660 12,944 $251.91 315

320 Ultrasonography 7670 72,388 $39.07 320

325 Computed Tomographic Scanner 7680 77,682 $55.67 325

330 Drugs Sold to Patients 7710 894,192 $64.39 330

335 Respiratory Therapy 7720 199,710 $76.14 335

340 Pulmonary Function Services 7730 6,722 $354.55 340

345 Renal Dialysis 7740 39,457 $123.26 345



360 Physical Therapy 7770 278,662 $21.46 360

365 Speech-Language Pathology 7780 2,820 $227.93 365

370 Occupational Therapy 7790 77,421 $33.25 370






400 Other Ancillary Services 7870 400

405 TOTAL ANCILLARY SERVICES 405



411 Purchased Outpatient Services 7950 411

415 TOTAL PATIENT CARE SERVICES 415

06/30/2014



Line No

NON-REVENUEPRODUCING CENTERS Account

No

(1) Salaries

and Wages

(2) Employee

Benefits

(3) Reclassified


Compensation Pages 15 &16, Cols. (5),(6),(7),

(8)& (10)

(4) Professional

Fees

Line No


.10-.19,.92-.96 .07,.10-.19,.20 .21-.29

RESEARCH COSTS



EDUCATION COSTS

15 Education Administration Office 8210 $13,667,646 15

20 School of Nursing 8220 $3,823,321 $4,220,528 $6,972 20


30 Medical Postgraduate Education 8240 $2,267,338 $2,333,682 $1,047,615 $170,585 30

35 Paramedical Education 8250 $361,746 35



50 TOTAL EDUCATION $6,090,659 $6,554,210 $15,083,979 $170,585 50

GENERAL SERVICES

55 Printing and Duplicating 8310 55

60 Kitchen 8320 60

65 Non-Patient Food Services 8330 65

70 Dietary 8340 70

75 Laundry and Linen 8350 $573,986 $638,801 75

80 Social Work Services 8360 $3,039,640 $3,245,895 80

85 Central Transportation 8370 85

90 Central Services and Supplies 8380 $1,351,392 $1,416,697 $541,230 90

95 Pharmacy 8390 $12,599,930 $13,446,303 $4,086,174 95

100 Purchasing and Stores 8400 $3,598,891 $3,719,347 100

105 Grounds 8410 105

110 Security 8420 110

115 Parking 8430 $150,859 $217,149 115

120 Housekeeping 8440 $7,431,057 $7,910,949 120

125 Plant Operations 8450 $2,412,113 $2,432,091 125

130 Plant Maintenance 8460 $12,089,606 $12,997,353 $31,331 130

135 Communications 8470 $505,773 $561,801 135

140 Data Processing 8480 $5,295,592 $5,317,423 $62,657 140

145 Other General Services 8490 145

150 TOTAL GENERAL SERVICES $49,048,839 $51,903,809 $4,721,392 150

FISCAL SERVICES

155 General Accounting 8510 $2,361,636 $2,433,998 155

160 Patient Accounting 8530 $730,319 $755,608 160

165 Credit and Collection 8550 $370,666 $395,826 165

170 Admitting 8560 $4,293,569 $5,034,971 $12,912 170

175 Outpatient Registration 8570 175

195 Other Fiscal Services 8590 $10,956,915 $12,305,275 $93,471 195

200 TOTAL FISCAL SERVICES $18,713,105 $20,925,678 $106,383 200


18 TRIAL BALANCE WORKSHEET AND SUPPLEMENTAL EXPENSE INFORMATION NON-REVENUE PRODUCING CENTERS



Line No

NON-REVENUEPRODUCING CENTERS Account

No

(5) Supplies


(7) Depreciation

(8) Leases and

Rentals Line No


RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing 8220 $85,252 $3,623 $20,587 $9,291 20


30 Medical Postgraduate Education 8240 $64,607 $598 $7,711 $3,480 30




50 TOTAL EDUCATION $149,859 $4,221 $28,298 $12,771 50

GENERAL SERVICES


60 Kitchen 8320 60

65 Non-Patient Food Services 8330 $5,550,502 65

70 Dietary 8340 $13,366 $5,521,546 70

75 Laundry and Linen 8350 $1,108,417 $1,328,908 $168,357 $75,982 75

80 Social Work Services 8360 $18,701 $6,433 $7,888 $3,560 80


90 Central Services and Supplies 8380 $1,729,354 $77,902 $7,799 $6,627 90

95 Pharmacy 8390 $498,566 $304,345 $87,058 $39,291 95

100 Purchasing and Stores 8400 $934,816 $1,742,110 $14,199 $3,302 100

105 Grounds 8410 105

110 Security 8420 $418 $14,597,916 110

115 Parking 8430 $14,104 $16,600 $37,228 $4,921,826 115

120 Housekeeping 8440 $1,938,148 $2,304,604 120

125 Plant Operations 8450 $658,847 $625,857 $3,875 $1,749 125

130 Plant Maintenance 8460 $3,822,502 $4,430,516 $249,246 $112,489 130

135 Communications 8470 $183,904 $150,854 $6,876 $3,103 135

140 Data Processing 8480 $1,106,093 $9,338,332 $107,377 $1,229,501 140


150 TOTAL GENERAL SERVICES $12,027,236 $45,996,425 $689,903 $6,397,430 150

FISCAL SERVICES

155 General Accounting 8510 $16,154 $13,266 $9,284 $3,847 155

160 Patient Accounting 8530 $14,639,149 160

165 Credit and Collection 8550 $110 $2,289,075 $4,798 $2,166 165

170 Admitting 8560 $6,953 $3,001 $1,354 170


195 Other Fiscal Services 8590 $302,198 $8,204 $142,623 $64,368 195

200 TOTAL FISCAL SERVICES $325,415 $16,949,694 $159,706 $71,735 200





Line No

NON REVENUEPRODUCING CENTERS

Account No

(9) Other Direct

Expenses







(1)

Line No


RESEARCH COSTS



EDUCATION COSTS

15 Education Administration Office 8210 $13,667,646 $13,667,646 15

20 School of Nursing 8220 $44,056 $8,213,630 $8,213,630 20


30 Medical Postgraduate Education 8240 $47 $5,895,663 $5,895,663 30

35 Paramedical Education 8250 $361,746 $361,746 35



50 TOTAL EDUCATION $44,103 $28,138,685 $28,138,685 50

GENERAL SERVICES


60 Kitchen 8320 60

65 Non-Patient Food Services 8330 $5,550,502 $5,550,502 65

70 Dietary 8340 $5,534,912 $5,534,912 70

75 Laundry and Linen 8350 $151 $3,894,602 $3,894,602 75

80 Social Work Services 8360 $13,823 $6,335,940 $6,335,940 80


90 Central Services and Supplies 8380 $1,502 $5,132,503 $5,132,503 90

95 Pharmacy 8390 $1,472 $31,063,139 $31,063,139 95

100 Purchasing and Stores 8400 $7,469 $10,020,134 $585,143 $9,434,991 100

105 Grounds 8410 105

110 Security 8420 $14,598,334 $14,598,334 110

115 Parking 8430 $5 $5,357,771 $5,357,771 115

120 Housekeeping 8440 $449 $19,585,207 $19,585,207 120

125 Plant Operations 8450 $2,054,410 $8,188,942 $8,188,942 125

130 Plant Maintenance 8460 $48,424 $33,781,467 $1,930,563 $31,850,904 130

135 Communications 8470 $756,281 $2,168,592 $10,478 $2,158,114 135

140 Data Processing 8480 $114,769 $22,571,744 $22,571,744 140


150 TOTAL GENERAL SERVICES $2,998,755 $173,783,789 $2,526,184 $171,257,605 150

FISCAL SERVICES

155 General Accounting 8510 $2,975 $4,841,160 $49,399 $4,791,761 155

160 Patient Accounting 8530 $16,125,076 $16,125,076 160

165 Credit and Collection 8550 $7 $3,062,648 $1,791 $3,060,857 165

170 Admitting 8560 $9,352,760 $9,352,760 170


195 Other Fiscal Services 8590 $3,451 $23,876,505 $23,876,505 195

200 TOTAL FISCAL SERVICES $6,433 $57,258,149 $51,190 $57,206,959 200







Line No

NON REVENUEPRODUCING CENTERS Account

No

(13) Units of Service



Line No

RESEARCH COSTS



EDUCATION COSTS

15 Education Administration Office 8210 900 $15,186.27 15

20 School of Nursing 8220 182 $45,129.84 20


30 Medical Postgraduate Education 8240 703 $8,386.43 30

35 Paramedical Education 8250 15 $24,116.40 35



50 TOTAL EDUCATION 50

GENERAL SERVICES


60 Kitchen 8320 60

65 Non-Patient Food Services 8330 565,131 $9.82 65

70 Dietary 8340 538,650 $10.28 70

75 Laundry and Linen 8350 4,698,912 $0.83 75

80 Social Work Services 8360 155,427 $40.76 80


90 Central Services and Supplies 8380 894,192 $5.74 90

95 Pharmacy 8390 894,192 $34.74 95

100 Purchasing and Stores 8400 155,311 $60.75 100

105 Grounds 8410 105

110 Security 8420 7,054 $2,069.51 110

115 Parking 8430 1,445,500 $3.71 115

120 Housekeeping 8440 1,586,645 $12.34 120

125 Plant Operations 8450 4,294,509 $1.91 125

130 Plant Maintenance 8460 4,294,509 $7.42 130

135 Communications 8470 7,054 $305.94 135

140 Data Processing 8480 2,276,901 $9.91 140


150 TOTAL GENERAL SERVICES 150

FISCAL SERVICES

155 General Accounting 8510 7,054 $679.30 155

160 Patient Accounting 8530 2,276,901 $7.08 160

165 Credit and Collection 8550 2,276,901 $1.34 165

170 Admitting 8560 30,923 $302.45 170


195 Other Fiscal Services 8590 195

200 TOTAL FISCAL SERVICES 200

06/30/2014




Line No


No

(1) Salaries

and Wages

(2) Employee

Benefits

(3) Reclassified


Compensation Pages 15 & 16,

Cols. (5),(6),(7),(8) & (10)

(4) Professional

Fees

Line No


.10-.19,.92-.96 .07,.10-.19,.20 .21-.29


205 Hospital Administration 8610 $5,130,091 $5,963,120 $1,022,511 $13,165,246 205


215 Public Relations 8630 $42,280 $46,766 215


225 Personnel 8650 $261 $195 225

230 Employee Health Services 8660 $1,344,833 $1,373,097 $234 230

235 Auxiliary Groups 8670 $502,801 $514,448 $105 235

240 Chaplaincy Services 8680 $50,622 $60,558 240

245 Medical Library 8690 $143,382 $153,372 245

250 Medical Records 8700 $7,992,176 $9,295,313 $3,809,048 250

255 Medical Staff Administration 8710 $221,053 $234,436 255

260 Nursing Administration 8720 $14,382,125 $15,718,058 $637,709 260


270 Inservice Education - Nursing 8740 $1,003,185 $1,094,295 270

275 Utilization Management 8750 $9,387,855 $10,181,057 $5,055 $1,078,226 275


295 Other Administrative Services 8790 $692,109 $814,502 $26,823,404 295

300 TOTAL ADMINISTRATIVE SERVICES $40,892,773 $45,449,217 $27,850,970 $18,690,568 300

UNASSIGNED COSTS

305 Depreciation and Amortization 8810 305

310 Leases and Rentals 8820 310

315 Insurance - Hosp and Prof. Malpractice 8830 315

320 Insurance - Other 8840 320

325 Lic. & Other Taxes (Other than income) 8850 325

330 Interest - Working Capital 8860 330

345 Interest - Other 8870 345

350 Employee Benefits (Non-Payroll Related) 8880 350

355 Other Unassigned costs 8890 355

360 TOTAL UNASSIGNED COSTS 360

TOTAL

365 TOTAL OPERATING COSTS (17 & 18) $334,743,132 $359,161,523 $52,281,853 $63,936,975 365

370 Non-Operating Cost Centers $138,964 $130,046 $212,054 370

375 TOTAL COSTS $334,882,096 $359,291,569 $52,281,853 $64,149,029 375




06/30/2014Facility D.B.A. Name : Report Period End: LAC/USC MEDICAL CENTER

Line No


No

(5) Supplies


(7) Depreciation

(8) Leases and

Rentals Line No



205 Hospital Administration 8610 $390,668 $80,152,006 $99,694 $1,804,257 205




225 Personnel 8650 $17,124 $20,304 $9,163 225

230 Employee Health Services 8660 $16,953 $65 $10,122 $4,568 230

235 Auxiliary Groups 8670 $15,128 $15,491 $17,773 $8,021 235

240 Chaplaincy Services 8680 $4,603 $2,399 $1,083 240

245 Medical Library 8690 $60,724 $2,525 $8,989 $4,057 245

250 Medical Records 8700 $318,872 $2,016,722 $94,462 $569,213 250

255 Medical Staff Administration 8710 $28,613 $1,062 $2,399 $1,083 255

260 Nursing Administration 8720 $621,474 $26,370 $12,459 $5,623 260


270 Inservice Education - Nursing 8740 $8,337 270

275 Utilization Management 8750 $163,315 $1,367,780 $69,517 $31,374 275


295 Other Administrative Services 8790 $64,621 $380,016 $5,672 $2,560 295

300 TOTAL ADMINISTRATIVE SERVICES $1,710,432 $83,962,037 $343,790 $2,441,002 300

UNASSIGNED COSTS

305 Depreciation and Amortization 8810 $18,278,435 305


315 Insurance - Hosp and Prof. Malpractice 8830 315


325 Lic. & Other Taxes (Other than income) 8850 325

330 Interest - Working Capital 8860 330




360 TOTAL UNASSIGNED COSTS $18,278,435 360

TOTAL

365 TOTAL OPERATING COSTS (17 & 18) $155,194,258 $165,511,397 $23,543,629 $10,749,897 365

370 Non-Operating Cost Centers $116,273 $85,700 $3,888 $1,755 370

375 TOTAL COSTS $155,310,531 $165,597,097 $23,547,517 $10,751,652 375

18 TRIAL BALANCE WORKSHEET AND SUPPLEMENTAL EXPENSE INFORMATION -NON-REVENUE PRODUCING CENTERS




Line No

NON REVENUE PRODUCING CENTERS

Account No

(9) Other Direct

Expenses







(1)

Line No



205 Hospital Administration 8610 $5,087,551 $112,815,144 $235,896 $112,579,248 205




225 Personnel 8650 $16 $47,063 $47,063 225

230 Employee Health Services 8660 $261 $2,750,133 $2,750,133 230

235 Auxiliary Groups 8670 $1 $1,073,768 $1,073,768 235

240 Chaplaincy Services 8680 $17 $119,282 $119,282 240

245 Medical Library 8690 $14,443 $387,492 $1,090 $386,402 245

250 Medical Records 8700 $1,175 $24,096,981 $24,096,981 250

255 Medical Staff Administration 8710 $488,646 $91,931 $396,715 255

260 Nursing Administration 8720 $650 $31,404,468 $1,950 $31,402,518 260


270 Inservice Education - Nursing 8740 $100 $2,105,917 $2,105,917 270

275 Utilization Management 8750 $962 $22,285,141 $22,285,141 275


295 Other Administrative Services 8790 $373 $28,783,257 $28,783,257 295

300 TOTAL ADMINISTRATIVE SERVICES $5,105,549 $226,446,338 $330,867 $226,115,471 300

UNASSIGNED COSTS

305 Depreciation and Amortization 8810 $18,278,435 $18,278,435 305


315 Insurance - Hosp and Prof. Malpractice 8830 $11,166,531 $11,166,531 $11,166,531 315


325 Lic. & Other Taxes (Other than income) 8850 $1,450,410 $1,450,410 $1,450,410 325

330 Interest - Working Capital 8860 $529,778 $529,778 $529,778 330


350 Employee Benefits (Non-Payroll Related) 8880 $1,880 ($1,880) 350

355 Other Unassigned costs 8890 $17,400,574 $17,400,574 $17,400,574 355

360 TOTAL UNASSIGNED COSTS $30,547,293 $48,825,728 $1,880 $48,823,848 360

TOTAL

365 TOTAL OPERATING COSTS (17 & 18) $38,811,397 $1,203,934,061 $19,466,498 $1,184,467,563 365

370 Non-Operating Cost Centers $14 $688,694 $688,694 370

375 TOTAL COSTS $38,811,411 $1,204,622,755 $19,466,498 $1,185,156,257 375






Line No


No

(13) Units of Service



Line No


205 Hospital Administration 8610 7,054 $15,959.63 205


215 Public Relations 8630 2,444,524 $0.04 215


225 Personnel 8650 7,054 $6.67 225

230 Employee Health Services 8660 7,054 $389.87 230

235 Auxiliary Groups 8670 63,487 $16.91 235

240 Chaplaincy Services 8680 194,088 $0.61 240

245 Medical Library 8690 854 $452.46 245

250 Medical Records 8700 326,610 $73.78 250

255 Medical Staff Administration 8710 854 $464.54 255

260 Nursing Administration 8720 2,366 $13,272.41 260


270 Inservice Education - Nursing 8740 104,590 $20.13 270

275 Utilization Management 8750 30,923 $720.67 275



300 TOTAL ADMINISTRATIVE SERVICES 300

UNASSIGNED COSTS

305 Depreciation and Amortization 8810 4,294,509 $4.26 305


315 Insurance - Hosp and Prof. Malpractice 8830 2,276,901 $4.90 315


325 Lic. & Other Taxes (Other than income) 8850 4,294,509 $0.34 325

330 Interest - Working Capital 8860 2,276,901 $0.23 330




360 TOTAL UNASSIGNED COSTS 360

TOTAL

365 TOTAL OPERATING COSTS (17 & 18) 365

370 Non-Operating Cost Centers 370

375 TOTAL COSTS 375

06/30/2014



Line No

NON-REVENUE PRODUCING CENTERSBASIS OF ALLOCATION

(2) Square Feet (4) Accumulated Costs

(5) Hospital FTE's

(6) Supplies from Pages 17 & 18

column (5)

(7) Square Feet Serviced

Line No

LINES BEING ALLOCATED 5-25 30-80 85-100 105 110

5 Interest - Other 5

10 Insurance - Other 10

15 Licenses and Taxes (Other than on income) 15

20 Depreciation and Amortization 20

25 Leases and Rentals 25

30 Interest - Working Capital 30

35 Hospital Administration 96,163 35

40 Governing Board Expense 40

45 Public Relations 45

50 Management Engineering 50

55 Community Health Education 55

60 Other Administrative Services 2,065 60

65 General Accounting 8,379 65

70 Communications 14,607 70

75 Other Fiscal Services 45,423 75

80 Printing and Duplicating 80

85 Personnel 2,345 $76,221 85

90 Employee Health Services 7,682 $2,845,653 90

95 Employee Benefits (Non-Payroll Related) ($1,880) 95

100 Non-Patient Food Services 25,105 $5,862,665 100

105 Purchasing and Stores 79,379 $10,422,015 77.22 105

110 Housekeeping 17,742 $19,805,817 237.64 $1,938,148 110

115 Grounds 115

120 Security 5,615 $14,668,153 $418 5,615 120

125 Parking $5,357,771 4.09 $14,104 125

130 Plant Operations 106,612 $9,514,589 35.14 $658,847 106,612 130

135 Plant Maintenance 32,986 $32,261,062 198.28 $3,822,502 32,986 135

140 Other General Services 140

145 Dietary 11,492 $5,677,807 $13,366 11,492 145

150 Laundry and Linen 15,897 $4,092,270 17.85 $1,108,417 15,897 150

155 Patient Accounting 980 $16,137,262 16.06 980 155

160 Data Processing 22,910 $22,856,614 65.92 $1,106,093 22,910 160

165 Credit and Collection 1,461 $3,079,024 9.32 $110 1,461 165

170 Auxiliary Groups 14,496 $1,254,016 10.04 $15,128 14,496 170

175 Chaplaincy Services 1,249 $134,812 1.20 $4,603 1,249 175

180 Medical Library 3,154 $425,620 3.11 $60,724 3,154 180

185 Medical Records 104,612 $25,397,760 173.79 $318,872 104,612 185

190 Medical Staff Administration $396,715 3.79 $28,613 190

195 Social Work Services 7,812 $6,433,077 46.70 $18,701 7,812 195

200 Utilization Management 16,570 $22,491,178 111.03 $163,315 16,570 200

205 Insurance - Hospital and Professional Malpractice $11,166,531 205

210 Admitting 2,060 $9,378,375 98.95 $6,953 2,060 210

215 Other Unassigned Costs $17,400,574 215

220 Outpatient Registration 220

225 Nursing Administration 14,896 $31,587,740 190.03 $621,474 14,896 225

230 Inservice Education-Nursing $2,105,917 8.99 $8,337 230

235 Central Services and Supplies 11,369 $5,273,869 35.77 $1,729,354 11,369 235

240 Pharmacy 61,847 $31,832,164 142.34 $498,566 61,847 240

245 Research Projects and Administration 22,304 $277,335 22,304 245

250 Education Administration Office $13,667,646 250

255 Student Housing 255

260 Licensed Vocational Nurse Program 260

265 School of Nursing 32,243 $8,614,550 38.46 $85,252 32,243 265

270 Paramedical Education $361,746 2.93 270

275 Other Health Profession Education 275

280 Medical Postgraduate Education 4,042 $5,945,923 827.10 $64,607 4,042 280

19 COST ALLOCATION - STATISTICAL BASIS

LAC/USC MEDICAL CENTERFacility D.B.A. Name : Report Period End: 06/30/2014



Line No


(8) Square Feet from Column

(2)

(9)Meals Served (10)Dry Pounds Processed

(11)Gross Patient Revenue from

Page 12,Column (23)

(12)Gross Outpatient

Revenue from Pg 12,Col(22)

Line No

LINES BEING ALLOCATED 115-140 145 150 155-215 220







35 Hospital Administration 35





60 Other Administrative Services 60

65 General Accounting 65

70 Communications 70

75 Other Fiscal Services 75


85 Personnel 85

90 Employee Health Services 90

95 Employee Benefits (Non-Payroll Related) 95

100 Non-Patient Food Services 100

105 Purchasing and Stores 105

110 Housekeeping 110

115 Grounds 115

120 Security 120

125 Parking 125

130 Plant Operations 130

135 Plant Maintenance 135


145 Dietary 11,492 145

150 Laundry and Linen 15,897 150

155 Patient Accounting 980 155

160 Data Processing 22,910 160

165 Credit and Collection 1,461 165

170 Auxiliary Groups 14,496 103,452 170

175 Chaplaincy Services 1,249 175

180 Medical Library 3,154 180

185 Medical Records 104,612 185

190 Medical Staff Administration 190

195 Social Work Services 7,812 195

200 Utilization Management 16,570 200

205 Insurance - Hospital and Professional Malpractice 205

210 Admitting 2,060 210

215 Other Unassigned Costs 215


225 Nursing Administration 14,896 225

230 Inservice Education-Nursing 230

235 Central Services and Supplies 11,369 123,425 $55,110,062 $43,148,206 235

240 Pharmacy 61,847 $241,631,793 $189,184,659 240

245 Research Projects and Administration 22,304 245

250 Education Administration Office 250



265 School of Nursing 32,243 265

270 Paramedical Education 270


280 Medical Postgraduate Education 4,042 280





Line No


(13)Nursing FTE's

(14) Central Service and

Supply Costed Requisitions

(15) Pharmacy Costed

Requisitions


Column (11)

(18) Students in All Approved

Programs Line No

LINES BEING ALLOCATED 225-230 235 240 245 250-255

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145

150 Laundry and Linen 150

155 Patient Accounting 155

160 Data Processing 160

165 Credit and Collection 165

170 Auxiliary Groups 170

175 Chaplaincy Services 175

180 Medical Library 180

185 Medical Records 185


195 Social Work Services 195

200 Utilization Management 200


210 Admitting 210



225 Nursing Administration 225


235 Central Services and Supplies 235

240 Pharmacy $246,851 240

245 Research Projects and Administration 245




265 School of Nursing $5,790 182 265



280 Medical Postgraduate Education 703 280





Line No


(19) Nursing Student

Departmental Assignment

(20) Paramedic Student Departmental Assignment

(21) Medical PostGraduate Departmental Assignment

Line No

LINES BEING ALLOCATED 260-265 270-275 280

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145













210 Admitting 210






240 Pharmacy 240





265 School of Nursing 265



280 Medical Postgraduate Education 280





Line No



(5) Hospital FTE's


column (5)


Line No


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care 47,426 $54,292,887 292.67 $2,606,712 47,426 505

510 Coronary Care 5,071 $4,676,173 26.14 $90,270 5,071 510

515 Pediatric Intensive Care 5,394 $4,607,515 22.59 $112,533 5,394 515

520 Neonatal Intensive Care 10,875 $13,380,703 64.51 $393,155 10,875 520


530 Burn Care 12,178 $8,369,316 41.34 $707,603 12,178 530



545 Medical/Surgical Acute 118,204 $94,647,026 611.93 $2,083,084 118,204 545

550 Pediatric Acute 27,233 $7,531,950 47.81 $171,252 27,233 550

555 Psychiatric Acute - Adult $19,635,570 115.20 $86,271 555

560 Psychiatric Acute - Adolescent & Child $3,153,147 21.15 $6,553 560

565 Obstetrics Acute 3,974 $2,802,099 16.83 $123,295 3,974 565





590 Other Acute Care 20,622 $13,554,362 78.33 $459,947 20,622 590

595 Nursery Acute 2,898 $2,428,644 13.36 $17,662 2,898 595









660AMBULATORY SERVICES Emergency Services 58,553 $50,920,365 299.44 $2,672,192 58,553 660

665 Medical Transportation Services $1,078,691 665

670 Psychiatric Emergency Rooms 6,597 $8,283,219 54.17 $155,588 6,597 670

675 Clinics 213,856 $77,926,949 478.47 $4,307,681 213,856 675



690 Outpatient Chemical Dependency Services 690







730ANCILLARY SERVICES Labor and Delivery Services 9,036 $13,012,688 68.56 $322,367 9,036 730

735 Surgery and Recovery Services 45,016 $37,638,098 183.31 $10,055,419 45,016 735


745 Anesthesiology 13,470 $10,378,211 43.60 $402,161 13,470 745

750 Medical Supplies Sold to Patients $18,111,298 $18,111,298 750


760 Clinical Laboratory Services 38,628 $37,778,081 203.06 $5,822,236 38,628 760

765 Pathological Laboratory Services 22,922 $5,153,263 36.17 $581,260 22,922 765

770 Blood Bank 2,817 $11,843,050 20.45 $8,211,541 2,817 770

775 Echocardiology 3,369 $1,749,666 9.21 3,369 775

780 Cardiac Catheterization Services 6,048 $6,450,783 21.21 $2,449,460 6,048 780





Line No



(2)



Page 12,Column (23)

(12)Gross Outpatient


Line No


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care 47,426 53,359 406,190 $129,711,224 505

510 Coronary Care 5,071 10,136 36,729 $11,044,179 510

515 Pediatric Intensive Care 5,394 4,946 83,505 $11,269,920 515

520 Neonatal Intensive Care 10,875 240,727 $30,251,162 520


530 Burn Care 12,178 12,245 111,794 $23,095,402 530



545 Medical/Surgical Acute 118,204 297,643 909,739 $585,582,144 545

550 Pediatric Acute 27,233 15,682 105,802 $23,688,289 550

555 Psychiatric Acute - Adult $59,070,401 555

560 Psychiatric Acute - Adolescent & Child $10,290,388 560

565 Obstetrics Acute 3,974 11,639 23,188 $7,543,749 565





590 Other Acute Care 20,622 50,229 135,435 $39,319,348 590

595 Nursery Acute 2,898 42,048 $5,990,670 595









660AMBULATORY SERVICES Emergency Services 58,553 49,894 821,922 $159,606,033 $138,789,007 660

665 Medical Transportation Services $2,867,485 $2,475,485 665

670 Psychiatric Emergency Rooms 6,597 32,877 102,971 $29,653,227 $27,355,212 670

675 Clinics 213,856 282,472 $272,903,311 $264,796,073 675










730ANCILLARY SERVICES Labor and Delivery Services 9,036 214,434 $30,546,993 730

735 Surgery and Recovery Services 45,016 270,546 $100,893,335 $32,422,314 735


745 Anesthesiology 13,470 7,143 $28,082,377 $9,024,339 745

750 Medical Supplies Sold to Patients 750


760 Clinical Laboratory Services 38,628 1,002 $93,529,942 $41,145,236 760

765 Pathological Laboratory Services 22,922 $17,027,851 $11,679,769 765

770 Blood Bank 2,817 $28,615,442 $12,785,954 770

775 Echocardiology 3,369 11,242 $4,370,349 $1,214,808 775

780 Cardiac Catheterization Services 6,048 42,057 $16,275,745 $3,877,011 780





Line No


(13)Nursing FTE's




Requisitions


Column (11)


Programs Line No


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care 280.82 $1,640,591 $129,711,224 505

510 Coronary Care 22.75 $29,270 $11,044,179 510

515 Pediatric Intensive Care 19.86 $61,941 $11,269,920 515

520 Neonatal Intensive Care 54.27 $233,281 $30,251,162 520


530 Burn Care 37.02 $519,708 $23,095,402 530



545 Medical/Surgical Acute 634.32 $914,189 $585,582,144 545

550 Pediatric Acute 36.74 $117,762 $23,688,289 550

555 Psychiatric Acute - Adult 121.30 $26,883 $59,070,401 555

560 Psychiatric Acute - Adolescent & Child 26.62 $3,028 $10,290,388 560

565 Obstetrics Acute 14.69 $28,094 $7,543,749 565





590 Other Acute Care 79.24 $164,849 $39,319,348 590

595 Nursery Acute 8.96 $17,275 $5,990,670 595









660AMBULATORY SERVICES Emergency Services 261.96 $1,545,321 $159,606,033 660


670 Psychiatric Emergency Rooms 60.46 $14,803 $29,653,227 670

675 Clinics 428.42 $2,562,229 $272,903,311 675










730ANCILLARY SERVICES Labor and Delivery Services 54.92 $144,607 $30,546,993 730

735 Surgery and Recovery Services 129.22 $7,041,456 $100,893,335 735


745 Anesthesiology 8.50 $242,083 $28,082,377 745



760 Clinical Laboratory Services .32 $167,207 $93,529,942 760

765 Pathological Laboratory Services 1.20 $8,258 $17,027,851 765

770 Blood Bank .05 $3,927 $28,615,442 770

775 Echocardiology .09 $49 $4,370,349 775

780 Cardiac Catheterization Services 15.72 $1,893,698 $16,275,745 780





Line No




(20) Paramedic Student

Department Assignment


Line No


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care 3.00 43.89 505

510 Coronary Care 4.88 510

515 Pediatric Intensive Care 2.14 515

520 Neonatal Intensive Care 4.57 520


530 Burn Care 1.00 3.66 530



545 Medical/Surgical Acute 113.01 204.04 545

550 Pediatric Acute 12.85 13.55 550

555 Psychiatric Acute - Adult 16.00 41.71 555

560 Psychiatric Acute - Adolescent & Child 11.13 560

565 Obstetrics Acute 1.81 4.97 565





590 Other Acute Care 13.00 18.85 590

595 Nursery Acute 1.11 2.08 595









660AMBULATORY SERVICES Emergency Services 55.19 660

665 Medical Transportation Services 665

670 Psychiatric Emergency Rooms 3.61 670

675 Clinics 4.21 138.67 675










730ANCILLARY SERVICES Labor and Delivery Services 6.00 .92 730

735 Surgery and Recovery Services 10.00 65.34 735


745 Anesthesiology 33.84 745



760 Clinical Laboratory Services 8.00 760

765 Pathological Laboratory Services 10.60 765

770 Blood Bank 770

775 Echocardiology 775

780 Cardiac Catheterization Services 3.74 780





Line No



(5) Hospital FTE's


column (5)


Line No


ANCILLARY SERVICES (Continued)

785 Cardiology Services 2,062 $1,654,349 16.13 2,062 785


795 Electroencephalography 3,598 $489,813 4.15 $11,390 3,598 795

800 Radiology - Diagnostic 43,491 $20,467,735 90.60 $2,002,472 43,491 800

805 Radiology - Therapeutic 4,955 $4,220,220 15.04 $48,687 4,955 805

810 Nuclear Medicine 7,052 $2,759,593 11.11 $51,685 7,052 810

815 Magnetic Resonance Imaging 4,769 $3,320,076 14.49 $29,149 4,769 815

820 Ultrasonography 4,346 $2,881,979 8.00 $429,513 4,346 820

825 Computed Tomographic Scanner 6,567 $4,406,142 22.44 $182,157 6,567 825

830 Drugs Sold to Patients $57,578,688 $57,578,688 830

835 Respiratory Therapy 3,607 $15,249,844 54.65 $469,380 3,607 835

840 Pulmonary Function Services 3,698 $2,429,249 17.19 $57,016 3,698 840

845 Renal Dialysis 1,068 $4,876,918 21.71 $426,546 1,068 845

850 Lithotripsy 850


860 Physical Therapy 6,453 $6,060,252 26.47 $96,472 6,453 860

865 Speech - Language Pathology 675 $651,164 2.76 $13,466 675 865

870 Occupational Therapy 4,923 $2,635,310 12.35 $14,618 4,923 870

875 Other Physical Medicine 1,385 $2,795,271 14.54 $43,189 1,385 875





900 Other Ancillary Services 3,010 $20,682,335 7.97 $19,577,348 3,010 900



915 Non-Operating Cost Centers 17,302 $903,833 2.75 $116,273 17,302 915

920 Total Statistical Units (Lines 5-915) 1,586,645 $1,010,276,531 5,467.61 $153,384,093 1,287,755 920



925 Operating costs Being Allocated (Page 20) $19,728,845 $174,879,726 $10,302,946 $12,369,090 $23,830,650 925

930 Cost Recoveries (Page 20, Lines 440 and 445) $20 $176,131 $1,794 930

935 Net Cost (Line 925 minus 930) $19,728,845 $174,879,706 $10,126,815 $12,369,090 $23,828,856 935

940 Unit Multiplier (Line 935 ÷ Line 920) $12.4343 $0.1731 $1,852.1459 $0.0806 $18.5042 940



Line No



(2)



Page 12,Column (23)

(12)Gross OutPatient


Line No



785 Cardiology Services 2,062 23,076 $4,202,503 $2,016,073 785


795 Electroencephalography 3,598 9,740 $1,899,741 $1,273,928 795

800 Radiology - Diagnostic 43,491 202,698 $63,955,705 $42,754,428 800

805 Radiology - Therapeutic 4,955 $11,664,501 $11,249,488 805

810 Nuclear Medicine 7,052 8,330 $8,273,487 $6,988,310 810

815 Magnetic Resonance Imaging 4,769 26,491 $9,922,296 $6,095,360 815

820 Ultrasonography 4,346 161,520 $8,709,533 $6,186,808 820

825 Computed Tomographic Scanner 6,567 82,958 $13,232,716 $8,664,476 825

830 Drugs Sold to Patients 830

835 Respiratory Therapy 3,607 $33,180,647 $934,092 835

840 Pulmonary Function Services 3,698 19,649 $6,854,629 $5,485,260 840

845 Renal Dialysis 1,068 $10,514,852 845

850 Lithotripsy 850


860 Physical Therapy 6,453 40,102 $13,950,464 860

865 Speech - Language Pathology 675 $1,582,845 $720,527 865

870 Occupational Therapy 4,923 32,420 $7,575,809 $3,709,965 870

875 Other Physical Medicine 1,385 $8,123,176 $6,022,316 875





900 Other Ancillary Services 3,010 $55,287,604 $43,854,911 900



915 Non-Operating Cost Centers 17,302 16,105 915

920 Total Statistical Units (Lines 5-915) 1,142,542 538,650 4,698,912 $2,276,901,329 $923,854,015 920



925 Operating costs Being Allocated (Page 20) $75,988,989.00 $7,638,686.00 $6,274,547.00 $176,368,965.00 925

930 Cost Recoveries (Page 20, Lines 440 and 445) $348.00 $144,629,158.00 930

935 Net Cost (Line 925 minus 930) $75,988,989.00 $7,638,686.00 $6,274,199.00 $31,739,807.00 935

940 Unit Multiplier (Line 935 ÷ Line 920) 67 14 1 $0.0139 940



Line No


(13)Nursing FTE's




Requisitions


Column (11)


Programs Line No



785 Cardiology Services $4,202,503 785


795 Electroencephalography .04 $8,200 $1,899,741 795

800 Radiology - Diagnostic 31.22 $1,499,900 $63,955,705 800

805 Radiology - Therapeutic 1.98 $65,358 $11,664,501 805

810 Nuclear Medicine .81 $52,185 $8,273,487 810

815 Magnetic Resonance Imaging 7.50 $40,314 $9,922,296 815

820 Ultrasonography 1.61 $414,750 $8,709,533 820

825 Computed Tomographic Scanner 6.29 $177,598 $13,232,716 825


835 Respiratory Therapy $226,254 $33,180,647 835

840 Pulmonary Function Services .07 $19,215 $6,854,629 840

845 Renal Dialysis 18.46 $389,675 $10,514,852 845

850 Lithotripsy 850


860 Physical Therapy $78,390 $13,950,464 860

865 Speech - Language Pathology $12,957 $1,582,845 865

870 Occupational Therapy .07 $13,829 $7,575,809 870

875 Other Physical Medicine $5,073 $8,123,176 875





900 Other Ancillary Services .14 $66,609 $55,287,604 900




920 Total Statistical Units (Lines 5-915) 2,365.63 $38,814,755 $57,578,688 $2,276,901,329 900 920



925 Operating costs Being Allocated (Page 20) $41,211,821 $8,292,031 $46,325,034 $2,221,469 $16,033,527 925

930 Cost Recoveries (Page 20, Lines 440 and 445) $2,260,214 930

935 Net Cost (Line 925 minus 930) $41,211,821 $8,292,031 $44,064,820 $2,221,469 $16,033,527 935

940 Unit Multiplier (Line 935 ÷ Line 920) $17,421.1024 $0.2136 $0.7653 $0.0010 $17,815.0299 940



Line No




(20) Paramedic Student Departmental Assignment


Line No



785 Cardiology Services 785


795 Electroencephalography .78 795

800 Radiology - Diagnostic 17.99 800

805 Radiology - Therapeutic 805

810 Nuclear Medicine 1.71 810

815 Magnetic Resonance Imaging .60 815

820 Ultrasonography 3.22 820

825 Computed Tomographic Scanner 3.22 825


835 Respiratory Therapy 8.00 835

840 Pulmonary Function Services 840

845 Renal Dialysis 845

850 Lithotripsy 850


860 Physical Therapy 1.00 860

865 Speech - Language Pathology 865

870 Occupational Therapy 2.00 870

875 Other Physical Medicine 4.00 875





900 Other Ancillary Services 900




920 Total Statistical Units (Lines 5-915) 181.99 15.00 702.90 920



925 Operating costs Being Allocated (Page 20) $16,168,481 $697,017 $21,379,872 925

930 Cost Recoveries (Page 20, Lines 440 and 445) $1,088,252 930

935 Net Cost (Line 925 minus 930) $15,080,229 $697,017 $21,379,872 935

940 Unit Multiplier (Line 935 ÷ Line 920) $82,862.9566 $46,467.8202 $30,416.6623 940



Line No


Account No (1)Adjusted Direct Costs from Page 17 & 18,Column (12)

(2)Square Feet (3)Subtotal Line No

LINES BEING ALLOCATED 5-25



15 Licenses and Taxes (Other than on income) 8850 $1,450,410 15

20 Depreciation and Amortization 8810 $18,278,435 20

25 Leases and Rentals 8820 ($19,728,845) 25

30 Interest - Working Capital 8860 $529,778 $529,778 30

35 Hospital Administration 8610 $112,579,248 $1,195,721 $113,774,969 35





60 Other Administrative Services 8790 $28,783,257 $25,677 $28,808,934 60

65 General Accounting 8510 $4,791,761 $104,187 $4,895,948 65

70 Communications 8470 $2,158,114 $181,628 $2,339,742 70

75 Other Fiscal Services 8590 $23,876,505 $564,804 $24,441,309 75


85 Personnel 8650 $47,063 $29,158 $76,221 85

90 Employee Health Services 8660 $2,750,133 $95,520 $2,845,653 90

95 Employee Benefits (Non-Payroll Related) 8880 ($1,880) ($1,880) 95

100 Non-Patient Food Services 8330 $5,550,502 $312,163 $5,862,665 100

105 Purchasing and Stores 8400 $9,434,991 $987,024 $10,422,015 105

110 Housekeeping 8440 $19,585,207 $220,610 $19,805,817 110

115 Grounds 8410 115

120 Security 8420 $14,598,334 $69,819 $14,668,153 120

125 Parking 8430 $5,357,771 $5,357,771 125

130 Plant Operations 8450 $8,188,942 $1,325,647 $9,514,589 130

135 Plant Maintenance 8460 $31,850,904 $410,158 $32,261,062 135


145 Dietary 8340 $5,534,912 $142,895 $5,677,807 145

150 Laundry and Linen 8350 $3,894,602 $197,668 $4,092,270 150

155 Patient Accounting 8530 $16,125,076 $12,186 $16,137,262 155

160 Data Processing 8480 $22,571,744 $284,870 $22,856,614 160

165 Credit and Collection 8550 $3,060,857 $18,167 $3,079,024 165

170 Auxiliary Groups 8670 $1,073,768 $180,248 $1,254,016 170

175 Chaplaincy Services 8680 $119,282 $15,530 $134,812 175

180 Medical Library 8690 $386,402 $39,218 $425,620 180

185 Medical Records 8700 $24,096,981 $1,300,779 $25,397,760 185

190 Medical Staff Administration 8710 $396,715 $396,715 190

195 Social Work Services 8360 $6,335,940 $97,137 $6,433,077 195

200 Utilization Management 8750 $22,285,141 $206,037 $22,491,178 200

205 Insurance - Hospital and Professional Malpractice 8830 $11,166,531 $11,166,531 205

210 Admitting 8560 $9,352,760 $25,615 $9,378,375 210

215 Other Unassigned Costs 8890 $17,400,574 $17,400,574 215


225 Nursing Administration 8720 $31,402,518 $185,222 $31,587,740 225

230 Inservice Education-Nursing 8740 $2,105,917 $2,105,917 230

235 Central Services and Supplies 8380 $5,132,503 $141,366 $5,273,869 235

240 Pharmacy 8390 $31,063,139 $769,025 $31,832,164 240

245 Research Projects and Administration 8010 $277,335 $277,335 245

250 Education Administration Office 8210 $13,667,646 $13,667,646 250



265 School of Nursing 8220 $8,213,630 $400,920 $8,614,550 265

270 Paramedical Education 8250 $361,746 $361,746 270


280 Medical Postgraduate Education 8260 $5,895,663 $50,260 $5,945,923 280

285 TOTAL NON-REVENUE PRODUCING CENTERS $531,542,568 $521,680,315 285

20 COST ALLOCATION




20 COST ALLOCATION

Line No


(4)Accumulated Costs

(5)Hospital FTE's (6) Supplies from Pages 17 & 18,

Column (5)

(7)Square Feet Serviced

Line No

LINES BEING ALLOCATED 30-80 85-100 105 110
















80 Printing and Duplicating ($174,879,726) 80

85 Personnel $13,194 85

90 Employee Health Services $492,585 90

95 Employee Benefits (Non-Payroll Related) ($325) 95

100 Non-Patient Food Services $1,014,832 ($10,302,946) 100

105 Purchasing and Stores $1,804,059 $143,016 ($12,369,090) 105

110 Housekeeping $3,428,403 $440,135 $156,295 ($23,830,650) 110

115 Grounds 115

120 Security $2,539,069 $34 $103,901 120

125 Parking $927,435 $7,582 $1,137 125

130 Plant Operations $1,646,983 $65,092 $53,130 $1,972,768 130

135 Plant Maintenance $5,584,417 $367,234 $308,251 $610,379 135


145 Dietary $982,833 $1,078 $212,650 145

150 Laundry and Linen $708,375 $33,067 $89,384 $294,161 150

155 Patient Accounting $2,793,373 $29,754 $18,134 155

160 Data Processing $3,956,499 $122,088 $89,197 $423,931 160

165 Credit and Collection $532,982 $17,266 $9 $27,035 165

170 Auxiliary Groups $217,071 $18,596 $1,220 $268,237 170

175 Chaplaincy Services $23,336 $2,231 $371 $23,112 175

180 Medical Library $73,675 $5,763 $4,897 $58,362 180

185 Medical Records $4,396,373 $321,888 $25,714 $1,935,760 185

190 Medical Staff Administration $68,672 $7,027 $2,307 190

195 Social Work Services $1,113,571 $86,501 $1,508 $144,555 195

200 Utilization Management $3,893,242 $205,650 $13,170 $306,614 200

205 Insurance - Hospital and Professional Malpractice $1,932,936 205

210 Admitting $1,623,404 $183,271 $561 $38,119 210

215 Other Unassigned Costs $3,012,054 215


225 Nursing Administration $5,467,864 $351,969 $50,116 $275,638 225

230 Inservice Education-Nursing $364,536 $16,654 $672 230

235 Central Services and Supplies $912,911 $66,251 $139,457 $210,374 235

240 Pharmacy $5,510,174 $263,637 $40,205 $1,144,428 240

245 Research Projects and Administration $48,007 $412,717 245




265 School of Nursing $1,491,186 $71,228 $6,875 $596,630 265

270 Paramedical Education $62,619 $5,427 270


280 Medical Postgraduate Education $1,029,244 $1,531,907 $5,210 $74,794 280




20 COST ALLOCATION

Line No


(8)Square Feet from Column (2)


(11)Gross Patient Revenue from Page

12, Column 23

Line No

LINES BEING ALLOCATED 115-140 145 150 155-215

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125



140 Other General Services ($75,988,989) 140

145 Dietary $764,318 ($7,638,686) 145

150 Laundry and Linen $1,057,289 ($6,274,547) 150

155 Patient Accounting $65,179 155

160 Data Processing $1,523,714 160

165 Credit and Collection $97,169 165

170 Auxiliary Groups $964,110 $138,134 170

175 Chaplaincy Services $83,069 175

180 Medical Library $209,768 180

185 Medical Records $6,957,609 185


195 Social Work Services $519,566 195

200 Utilization Management $1,102,049 200


210 Admitting $137,008 210

215 Other Unassigned Costs ($176,368,965) 215


225 Nursing Administration $990,714 225


235 Central Services and Supplies $756,137 $164,803 $768,229 235

240 Pharmacy $4,113,364 $3,368,326 240

245 Research Projects and Administration $1,483,410 245




265 School of Nursing $2,144,440 265



280 Medical Postgraduate Education $268,828 280




20 COST ALLOCATION

Line No


(12)Gross Outpatient Revenue

from Page 12,Column 22

(13)Nursing FTE's

(14)Central Service and Supply Costed

Requisitions


Requisitions

Line No

LINES BEING ALLOCATED 220 225-230 235 240 No

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145













210 Admitting 210




230 Inservice Education-Nursing ($41,211,821) 230

235 Central Services and Supplies ($8,292,031) 235

240 Pharmacy $52,735 ($46,325,034) 240





265 School of Nursing $1,237 265







Line No


(16)Subtotal (17)Gross Patient Revenue from

Column (11)


Programs

(19)Nursing Student Departmental Assignment

Line No

LINES BEING ALLOCATED 245 250-255 260-265

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145













210 Admitting 210






240 Pharmacy 240

245 Research Projects and Administration $2,221,469 ($2,221,469) 245


255 Student Housing ($16,033,527) 255


265 School of Nursing $12,926,146 $3,242,335 ($16,168,481) 265

270 Paramedical Education $429,792 $267,225 270


280 Medical Postgraduate Education $8,855,906 $12,523,966 280

285 TOTAL NON-REVENUE PRODUCING CENTERS $40,466,840 285

20 COST ALLOCATION

LAC/USC MEDICAL CENTER 06/30/2014Report Period End: Facility D.B.A. Name :



Line No


(20)Paramedic Student Departmental Assignment

(21)Medical Postgraduate Departmental Assignment

(22)Transfers for Operating

Costs

(23)Total

Line

LINES BEING ALLOCATED 270-275 280 No

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145













210 Admitting 210






240 Pharmacy 240







275 Other Health Profession Education ($697,017) 275

280 Medical Postgraduate Education ($21,379,872) 280

20 COST ALLOCATION




Line No

REVENUE PRODUCING CENTERSBASIS OF ALLOCATION




350COST RECOVERIES (Page 14, Part III) Non-Patient Food Sales 5320 ($176,131) ($176,131) 350

355 Laundry and Linen Revenue 5340 ($348) ($348) 355

360 Social Work Services Revenue 5350 360

365 Supplies Sold to Non-Patients Revenue 5370 365

370 Drugs Sold to Non-Patients Revenue 5380 ($2,260,214) ($2,260,214) 370

375 Purchasing Services Revenue 5390 375

380 Parking Revenue 5430 380

385 Housekeeping and Maintenance Services Revenue 5440 385

390 Data Processing Services Revenue 5480 ($65) ($65) 390

395 Medical Records Abstracts Sales 5700 ($255,465) ($255,465) 395

400 Management Services Revenue 5740 ($20) ($20) 400

405 Worker's Compensation Refunds 5782 405

410 Community Health Education Revenue 5770 410

411 Reinsurance Recoveries 5781 411

415 Transfers from Restricted Funds for Operations (Non-Revenue Centers)

5790 415

420 Other (Specify) 5780 ($138,296,128) ($138,296,128) 420

425 Other (Specify) 5780 ($6,077,500) ($6,077,500) 425

430 Other (Specify) 5780 430

435 Other (Specify) 5780 ($1,794) ($1,794) 435

440 TOTAL COST RECOVERIES ($147,067,665) ($147,067,665) 440

445 Research & Education Revenue and Transfers ($1,088,252) ($1,088,252) 445

505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care 6010 $53,703,177 $589,710 $54,292,887 505

510 Coronary Care 6030 $4,613,119 $63,054 $4,676,173 510

515 Pediatric Intensive Care 6050 $4,540,444 $67,071 $4,607,515 515

520 Neonatal Intensive Care 6070 $13,245,480 $135,223 $13,380,703 520


530 Burn Care 6110 $8,217,891 $151,425 $8,369,316 530



545 Medical/Surgical Acute 6170 $93,177,240 $1,469,786 $94,647,026 545

550 Pediatric Acute 6290 $7,193,326 $338,624 $7,531,950 550

555 Psychiatric Acute - Adult 6340 $19,635,570 $19,635,570 555

560 Psychiatric Acute - Adolescent & Child 6360 $3,153,147 $3,153,147 560

565 Obstetrics Acute 6380 $2,752,685 $49,414 $2,802,099 565





590 Other Acute Care 6510 $13,297,942 $256,420 $13,554,362 590

595 Nursery Acute 6530 $2,392,609 $36,035 $2,428,644 595


601 Sub-Acute Care Pediatric 6570 601








660AMBULATORY SERVICES Emergency Services 7010 $50,192,299 $728,066 $50,920,365 660

665 Medical Transportation Services 7040 $1,078,691 $1,078,691 665

670 Psychiatric Emergency Rooms 7060 $8,201,190 $82,029 $8,283,219 670

20 COST ALLOCATION




20 COST ALLOCATION

Line No




Column (5)


Line No


350COST RECOVERIES (Page 14, Part III) Non-Patient Food Sales $176,131 350

355 Laundry and Linen Revenue 355

360 Social Work Services Revenue 360

365 Supplies Sold to Non-Patients Revenue 365

370 Drugs Sold to Non-Patients Revenue 370

375 Purchasing Services Revenue 375

380 Parking Revenue 380

385 Housekeeping and Maintenance Services Revenue 385

390 Data Processing Services Revenue 390

395 Medical Records Abstracts Sales 395

400 Management Services Revenue $20 400

405 Worker's Compensation Refunds 405

410 Community Health Education Revenue 410

411 Reinsurance Recoveries 411


415




435 Other (Specify) $1,794 435

440 TOTAL COST RECOVERIES $20 $176,131 $1,794 440

445 Research & Education Revenue and Transfers 445

505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care $9,398,144 $542,067 $210,209 $877,579 505

510 Coronary Care $809,449 $48,409 $7,279 $93,835 510

515 Pediatric Intensive Care $797,565 $41,842 $9,075 $99,812 515

520 Neonatal Intensive Care $2,316,211 $119,487 $31,705 $201,233 520


530 Burn Care $1,448,736 $76,565 $57,062 $225,344 530



545 Medical/Surgical Acute $16,383,479 $1,133,374 $167,983 $2,187,269 545

550 Pediatric Acute $1,303,787 $88,549 $13,810 $503,924 550

555 Psychiatric Acute - Adult $3,398,933 $213,372 $6,957 555

560 Psychiatric Acute - Adolescent & Child $545,812 $39,168 $528 560

565 Obstetrics Acute $485,046 $31,162 $9,943 $73,536 565





590 Other Acute Care $2,346,271 $145,079 $37,091 $381,593 590

595 Nursery Acute $420,400 $24,748 $1,424 $53,625 595


601 Sub-Acute Care Pediatric 601







650 TOTAL DAILY HOSPITAL SERVICES $39,653,833 $2,503,822 $553,065 $4,697,750 650

660AMBULATORY SERVICES Emergency Services $8,814,358 $554,600 $215,489 $1,083,475 660

665 Medical Transportation Services $186,722 665

670 Psychiatric Emergency Rooms $1,433,832 $100,324 $12,547 $122,072 670




20 COST ALLOCATION

Line No





12, Column 23

Line No


350COST RECOVERIES (Page 14, Part III) Non-Patient Food Sales 350

355 Laundry and Linen Revenue $348 355







390 Data Processing Services Revenue $65 390

395 Medical Records Abstracts Sales $255,465 395

400 Management Services Revenue 400





415

420 Other (Specify) $138,296,128 420

425 Other (Specify) $6,077,500 425



440 TOTAL COST RECOVERIES $348 $144,629,158 440


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care $3,154,242 $756,693 $542,363 $1,808,163 505

510 Coronary Care $337,266 $143,740 $49,042 $153,955 510

515 Pediatric Intensive Care $358,748 $70,140 $111,500 $157,102 515

520 Neonatal Intensive Care $723,282 $321,430 $421,699 520


530 Burn Care $809,943 $173,648 $149,272 $321,948 530



545 Medical/Surgical Acute $7,861,595 $4,220,925 $1,214,724 $8,162,964 545

550 Pediatric Acute $1,811,232 $222,389 $141,272 $330,213 550

555 Psychiatric Acute - Adult $823,436 555

560 Psychiatric Acute - Adolescent & Child $143,447 560

565 Obstetrics Acute $264,306 $165,055 $30,962 $105,159 565





590 Other Acute Care $1,371,543 $712,306 $180,839 $548,108 590

595 Nursery Acute $192,742 $56,144 $83,509 595










660AMBULATORY SERVICES Emergency Services $3,894,284 $707,555 $1,097,467 $2,224,894 660

665 Medical Transportation Services $39,972 665

670 Psychiatric Emergency Rooms $438,758 $466,234 $137,492 $413,363 670




20 COST ALLOCATION

Line No


(12)Gross Outpatient Revenue

from Page 12,Column 22

(13)Nursing FTE's


Requisitions


Requisitions

Line No






370 Drugs Sold to Non-Patients Revenue $2,260,214 370











415





440 TOTAL COST RECOVERIES $2,260,214 440


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care $4,892,256 $350,481 505

510 Coronary Care $396,288 $6,253 510

515 Pediatric Intensive Care $345,993 $13,233 515

520 Neonatal Intensive Care $945,438 $49,836 520


530 Burn Care $644,949 $111,026 530



545 Medical/Surgical Acute $11,050,524 $195,299 545

550 Pediatric Acute $640,083 $25,158 550

555 Psychiatric Acute - Adult $2,113,138 $5,743 555

560 Psychiatric Acute - Adolescent & Child $463,770 $647 560

565 Obstetrics Acute $255,856 $6,002 565





590 Other Acute Care $1,380,388 $35,217 590

595 Nursery Acute $156,011 $3,690 595









650 TOTAL DAILY HOSPITAL SERVICES $23,284,694 $802,584 650

660AMBULATORY SERVICES Emergency Services $4,563,659 $330,128 660


670 Psychiatric Emergency Rooms $1,053,332 $3,162 670




Line No



Column (11)


Programs


Line No

















415





440 TOTAL COST RECOVERIES 440

445 Research & Education Revenue and Transfers ($1,088,252) $1,088,252 445

505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care $76,825,084 $126,553 $248,589 505

510 Coronary Care $6,721,690 $10,775 510

515 Pediatric Intensive Care $6,612,522 $10,996 515

520 Neonatal Intensive Care $18,511,023 $29,515 520


530 Burn Care $12,387,809 $22,533 $82,863 530



545 Medical/Surgical Acute $147,225,162 $571,326 $9,364,343 545

550 Pediatric Acute $12,612,366 $23,112 $1,064,789 550

555 Psychiatric Acute - Adult $26,197,149 $57,632 $1,325,807 555

560 Psychiatric Acute - Adolescent & Child $4,346,519 $10,040 560

565 Obstetrics Acute $4,229,124 $7,360 $149,982 565





590 Other Acute Care $20,692,797 $38,362 $1,077,218 590

595 Nursery Acute $3,420,938 $5,845 $91,978 595









650 TOTAL DAILY HOSPITAL SERVICES $339,782,185 $914,049 $13,405,569 650

660AMBULATORY SERVICES Emergency Services $74,406,276 $155,720 660

665 Medical Transportation Services $1,305,386 $2,798 665

670 Psychiatric Emergency Rooms $12,464,335 $28,931 670

20 COST ALLOCATION




Line No





Costs

(23)Total

Line

















415





440 TOTAL COST RECOVERIES 440


505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care $1,334,987 $78,535,213 505

510 Coronary Care $148,433 $6,880,899 510

515 Pediatric Intensive Care $65,092 $6,688,609 515

520 Neonatal Intensive Care $139,004 $18,679,542 520


530 Burn Care $111,325 $12,604,530 530



545 Medical/Surgical Acute $6,206,216 $163,367,046 545

550 Pediatric Acute $412,146 $14,112,412 550

555 Psychiatric Acute - Adult $1,268,679 $28,849,268 555

560 Psychiatric Acute - Adolescent & Child $338,537 $4,695,097 560

565 Obstetrics Acute $151,171 $4,537,637 565





590 Other Acute Care $573,354 $22,381,732 590

595 Nursery Acute $63,267 $3,582,028 595










660AMBULATORY SERVICES Emergency Services $1,678,696 $76,240,692 660


670 Psychiatric Emergency Rooms $109,804 $12,603,071 670

20 COST ALLOCATION




Line No





675 Clinics 7070 $75,267,796 $2,659,153 $77,926,949 675











730ANCILLARY SERVICES Labor and Delivery Services

7400$12,900,332 $112,356 $13,012,688 730

735 Surgery and Recovery Services 7420 $37,078,355 $559,743 $37,638,098 735


745 Anesthesiology 7450 $10,210,721 $167,490 $10,378,211 745

750 Medical Supplies Sold to Patients 7470 $18,111,298 $18,111,298 750


760 Clinical Laboratory Services 7500 $37,297,768 $480,313 $37,778,081 760

765 Pathological Laboratory Services 7520 $4,868,244 $285,019 $5,153,263 765

770 Blood Bank 7540 $11,808,023 $35,027 $11,843,050 770

775 Echocardiology 7560 $1,707,775 $41,891 $1,749,666 775

780 Cardiac Catheterization Services 7570 $6,375,580 $75,203 $6,450,783 780

785 Cardiology Services 7590 $1,628,709 $25,640 $1,654,349 785


795 Electroencephalography 7620 $445,074 $44,739 $489,813 795

800 Radiology - Diagnostic 7630 $19,926,954 $540,781 $20,467,735 800

805 Radiology - Therapeutic 7640 $4,158,608 $61,612 $4,220,220 805

810 Nuclear Medicine 7650 $2,671,906 $87,687 $2,759,593 810

815 Magnetic Resonance Imaging 7660 $3,260,777 $59,299 $3,320,076 815

820 Ultrasonography 7670 $2,827,939 $54,040 $2,881,979 820

825 Computed Tomographic Scanner 7680 $4,324,486 $81,656 $4,406,142 825

830 Drugs Sold to Patients 7710 $57,578,688 $57,578,688 830

835 Respiratory Therapy 7720 $15,204,993 $44,851 $15,249,844 835

840 Pulmonary Function Services 7730 $2,383,267 $45,982 $2,429,249 840

845 Renal Dialysis 7740 $4,863,638 $13,280 $4,876,918 845



860 Physical Therapy 7770 $5,980,013 $80,239 $6,060,252 860

865 Speech - Language Pathology 7780 $642,771 $8,393 $651,164 865

870 Occupational Therapy 7790 $2,574,096 $61,214 $2,635,310 870

875 Other Physical Medicine 7800 $2,778,049 $17,222 $2,795,271 875





900 Other Ancillary Services 7870 $20,644,908 $37,427 $20,682,335 900



911 Purchased Outpatient Services 7950 $9,417 $9,417 911

915 Non-Operating Cost Centers $688,694 $215,139 $903,833 915

920 TOTAL $1,037,000,340 -0- $1,037,000,340 920

20 COST ALLOCATION




20 COST ALLOCATION

Line No




Column (5)


Line No


675 Clinics $13,489,220 $886,197 $347,377 $3,957,231 675










725 TOTAL AMBULATORY SERVICES $23,924,132 $1,541,122 $575,413 $5,162,778 725

730ANCILLARY SERVICES Labor and Delivery Services $2,252,507 $126,989 $25,996 $167,204 730

735 Surgery and Recovery Services $6,515,186 $339,508 $810,882 $832,984 735


745 Anesthesiology $1,796,477 $80,746 $32,431 $249,251 745



760 Clinical Laboratory Services $6,539,417 $376,100 $469,513 $714,780 760

765 Pathological Laboratory Services $892,034 $66,990 $46,874 $424,153 765

770 Blood Bank $2,050,042 $37,872 $662,189 $52,126 770

775 Echocardiology $302,869 $17,058 $62,341 775

780 Cardiac Catheterization Services $1,116,636 $39,286 $197,528 $111,913 780

785 Cardiology Services $286,369 $29,878 $38,156 785


795 Electroencephalography $84,787 $7,685 $919 $66,578 795

800 Radiology - Diagnostic $3,542,982 $167,804 $161,482 $804,765 800

805 Radiology - Therapeutic $730,524 $27,856 $3,926 $91,688 805

810 Nuclear Medicine $477,688 $20,578 $4,168 $130,492 810

815 Magnetic Resonance Imaging $574,708 $26,844 $2,351 $88,246 815

820 Ultrasonography $498,873 $14,821 $34,636 $80,419 820

825 Computed Tomographic Scanner $762,707 $41,558 $14,689 $121,517 825


835 Respiratory Therapy $2,639,761 $101,213 $37,851 $66,745 835

840 Pulmonary Function Services $420,505 $31,837 $4,598 $68,428 840

845 Renal Dialysis $844,199 $40,210 $34,397 $19,762 845

850 Lithotripsy 850


860 Physical Therapy $1,049,035 $49,029 $7,780 $119,407 860

865 Speech - Language Pathology $112,717 $5,120 $1,086 $12,490 865

870 Occupational Therapy $456,174 $22,876 $1,179 $91,096 870

875 Other Physical Medicine $483,864 $26,929 $3,483 $25,628 875





900 Other Ancillary Services $3,580,129 $14,753 $1,578,742 $55,698 900




915 Non-Operating Cost Centers $156,454 $5,098 $9,376 $320,159 915

920 TOTAL -0- -0- -0- -0- 920




20 COST ALLOCATION

Line No





12, Column 23

Line No


675 Clinics $14,223,286 $377,169 $3,804,249 675











730ANCILLARY SERVICES Labor and Delivery Services $600,973 $286,322 $425,822 730

735 Surgery and Recovery Services $2,993,956 $361,245 $1,406,444 735


745 Anesthesiology $895,872 $9,538 $391,466 745



760 Clinical Laboratory Services $2,569,098 $1,338 $1,303,799 760

765 Pathological Laboratory Services $1,524,513 $237,367 765

770 Blood Bank $187,355 $398,897 770

775 Echocardiology $224,068 $15,011 $60,922 775

780 Cardiac Catheterization Services $402,245 $56,156 $226,882 780

785 Cardiology Services $137,141 $30,812 $58,583 785


795 Electroencephalography $239,298 $13,005 $26,482 795

800 Radiology - Diagnostic $2,892,530 $270,651 $891,537 800

805 Radiology - Therapeutic $329,551 $162,602 805

810 Nuclear Medicine $469,019 $11,123 $115,332 810

815 Magnetic Resonance Imaging $317,180 $35,372 $138,316 815

820 Ultrasonography $289,047 $215,669 $121,410 820

825 Computed Tomographic Scanner $436,763 $110,769 $184,463 825


835 Respiratory Therapy $239,897 $462,535 835

840 Pulmonary Function Services $245,949 $26,236 $95,553 840

845 Renal Dialysis $71,031 $146,576 845

850 Lithotripsy 850


860 Physical Therapy $429,181 $53,546 $194,468 860

865 Speech - Language Pathology $44,893 $22,065 865

870 Occupational Therapy $327,422 $43,289 $105,606 870

875 Other Physical Medicine $92,115 $113,236 875





900 Other Ancillary Services $200,191 $770,704 900




915 Non-Operating Cost Centers $1,150,734 $21,504 915

920 TOTAL -0- -0- -0- -0- 920




20 COST ALLOCATION

Line No



12,Column 22

(13)Nursing FTE's


Requisitions


Requisitions

Line No


675 Clinics $7,463,552 $547,371 675










725 TOTAL AMBULATORY SERVICES $13,080,543 $880,662 725

730ANCILLARY SERVICES Labor and Delivery Services $956,728 $30,893 730

735 Surgery and Recovery Services $2,251,108 $1,504,273 735


745 Anesthesiology $148,046 $51,716 745

750 Medical Supplies Sold to Patients $3,869,133 750


760 Clinical Laboratory Services $5,553 $35,721 760

765 Pathological Laboratory Services $20,838 $1,764 765

770 Blood Bank $930 $839 770

775 Echocardiology $1,633 $10 775

780 Cardiac Catheterization Services $273,830 $404,552 780



795 Electroencephalography $720 $1,752 795

800 Radiology - Diagnostic $543,815 $320,425 800

805 Radiology - Therapeutic $34,465 $13,962 805

810 Nuclear Medicine $14,188 $11,148 810

815 Magnetic Resonance Imaging $130,717 $8,612 815

820 Ultrasonography $27,991 $88,603 820

825 Computed Tomographic Scanner $109,611 $37,940 825

830 Drugs Sold to Patients $44,064,820 830

835 Respiratory Therapy $48,335 835

840 Pulmonary Function Services $1,198 $4,105 840

845 Renal Dialysis $321,537 $83,247 845

850 Lithotripsy 850


860 Physical Therapy $16,747 860

865 Speech - Language Pathology $2,768 865

870 Occupational Therapy $1,281 $2,954 870

875 Other Physical Medicine $1,084 875





900 Other Ancillary Services $2,395 $14,230 900





920 TOTAL -0- -0- -0- -0- 920




Line No



Column (11)


Programs


Line No


675 Clinics $123,022,601 $266,259 $348,853 675










725 TOTAL AMBULATORY SERVICES $211,198,598 $453,709 $348,853 725

730ANCILLARY SERVICES Labor and Delivery Services $17,886,122 $29,803 $497,178 730

735 Surgery and Recovery Services $54,653,685 $98,437 $828,630 735


745 Anesthesiology $14,033,755 $27,399 745

750 Medical Supplies Sold to Patients $26,576,030 $53,768 750


760 Clinical Laboratory Services $49,793,400 $91,253 760

765 Pathological Laboratory Services $8,367,796 $16,613 765

770 Blood Bank $15,233,300 $27,919 770

775 Echocardiology $2,433,578 $4,264 775

780 Cardiac Catheterization Services $9,279,811 $15,880 780

785 Cardiology Services $2,235,287 $4,100 785


795 Electroencephalography $931,039 $1,853 795

800 Radiology - Diagnostic $30,063,727 $62,399 800

805 Radiology - Therapeutic $5,614,795 $11,381 805

810 Nuclear Medicine $4,013,328 $8,072 810

815 Magnetic Resonance Imaging $4,642,422 $9,681 815

820 Ultrasonography $4,253,448 $8,497 820

825 Computed Tomographic Scanner $6,226,159 $12,911 825

830 Drugs Sold to Patients $116,253,645 $235,749 830

835 Respiratory Therapy $18,846,180 $32,373 835

840 Pulmonary Function Services $3,327,659 $6,688 840

845 Renal Dialysis $6,437,877 $10,259 845

850 Lithotripsy 850


860 Physical Therapy $7,979,444 $13,611 860

865 Speech - Language Pathology $852,304 $1,544 865

870 Occupational Therapy $3,687,188 $7,391 870

875 Other Physical Medicine $3,541,609 $7,925 875





900 Other Ancillary Services $26,899,179 $53,942 900

905 TOTAL ANCILLARY SERVICES $444,062,764 $853,712 $1,325,807 905



915 Non-Operating Cost Centers $2,567,158 915

920 TOTAL $1,037,000,340 -0- -0- -0- 920

20 COST ALLOCATION




Line No





Costs

(23)Total

Line


675 Clinics $4,217,879 $127,855,592 675










725 TOTAL AMBULATORY SERVICES $6,006,378 $218,007,538 725

730ANCILLARY SERVICES Labor and Delivery Services $27,983 $18,441,087 730

735 Surgery and Recovery Services $1,987,425 $57,568,176 735


745 Anesthesiology $1,029,300 $15,090,453 745

750 Medical Supplies Sold to Patients $26,629,798 750


760 Clinical Laboratory Services $243,333 $50,127,986 760

765 Pathological Laboratory Services $322,417 $8,706,826 765

770 Blood Bank $15,261,219 770

775 Echocardiology $2,437,842 775

780 Cardiac Catheterization Services $113,758 $9,409,449 780

785 Cardiology Services $2,239,387 785


795 Electroencephalography $23,725 $956,617 795

800 Radiology - Diagnostic $547,196 $30,673,321 800

805 Radiology - Therapeutic $5,626,175 805

810 Nuclear Medicine $52,012 $4,073,412 810

815 Magnetic Resonance Imaging $18,250 $4,670,353 815

820 Ultrasonography $97,942 $4,359,887 820

825 Computed Tomographic Scanner $97,942 $6,337,011 825

830 Drugs Sold to Patients $116,489,395 830

835 Respiratory Therapy $371,743 $19,250,295 835

840 Pulmonary Function Services $3,334,346 840

845 Renal Dialysis $6,448,136 845

850 Lithotripsy 850


860 Physical Therapy $46,468 $8,039,523 860

865 Speech - Language Pathology $853,848 865

870 Occupational Therapy $92,936 $3,787,515 870

875 Other Physical Medicine $185,871 $3,735,406 875





900 Other Ancillary Services $26,953,120 900

905 TOTAL ANCILLARY SERVICES $697,017 $4,561,283 $451,500,584 905



915 Non-Operating Cost Centers $2,567,158 915

920 TOTAL -0- -0- -0- $1,037,000,340

920

20 COST ALLOCATION




Line No

COST RECOVERY INFORMATION(1) Transfers for Operations Non-

Revenue Centers Page 14, Col(1), Line 185

(2)Other Operating Revenue Page

14,Col(1), Line 200

(3) Other Operating Revenue Page 14, Col (1), Line 205

(4)Other Operating Revenue Page 14, Col

(1),Line 210Line No

1 Cost Recovery ($138,296,128) ($6,077,500) 1

















85 Personnel 85






115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145












205 Insurance - Hospital and Professional Malpractice $138,296,128 $6,077,500 205

210 Admitting 210






240 Pharmacy 240



20a. COST ALLOCATION SHORT FORM


( Page 20a (1 of 6) Audited Data )


Line No

COST RECOVERY INFORMATION(1) Transfers for Operations Non-

Revenue Centers Page 14, Col(1), Line 185

(2)Other Operating Revenue Page

14,Col(1), Line 200

(3) Other Operating Revenue Page 14, Col (1), Line 205

(4)Other Operating Revenue Page 14, Col

(1),Line 210Line No







285 TOTAL NON-REVENUE PRODUCING CENTERS -0- -0- -0- -0- 285





Line No

COST RECOVERY INFORMATION(5)Other Operating Revenue

Page 14, Column (1), Line 215

(6)Transfers for Education Page 14,Column (1), Line

260Line No

1 Cost Recovery ($1,794) 1

















85 Personnel 85





110 Housekeeping $1,794 110

115 Grounds 115

120 Security 120

125 Parking 125




145 Dietary 145













210 Admitting 210






240 Pharmacy 240







Line No

COST RECOVERY INFORMATION(5)Other Operating Revenue

Page 14, Column (1), Line 215

(6)Transfers for Education Page 14,Column (1), Line

260Line No







285 TOTAL NON-REVENUE PRODUCING CENTERS -0- -0- 285





Line No

COST RECOVERY INFORMATION Account No(7)Transfers for

Operations (Revenue Centers) Page

14,Column (1), Line 270

Line No

500 Transfers for Operations(Revenue Centers) [Page 14, Column(1), Line 270]

500

505DAILY HOSPITAL SERVICES Medical/Surgical Intensive Care 6010 505

510 Coronary Care 6030 510

515 Pediatric Intensive Care 6050 515

520 Neonatal Intensive Care 6070 520


530 Burn Care 6110 530



545 Medical/Surgical Acute 6170 545

550 Pediatric Acute 6290 550

555 Psychiatric Acute - Adult 6340 555

560 Psychiatric Acute - Adolescent & Child 6360 560

565 Obstetrics Acute 6380 565





590 Other Acute Care 6510 590

595 Nursery Acute 6530 595


601 Sub-Acute Care Pediatric 6570 601







650 TOTAL DAILY HOSPITAL SERVICES 650

660AMBULATORY SERVICES Emergency Services 7010 660


670 Psychiatric Emergency Rooms 7060 670

675 Clinics 7070 675










725 TOTAL AMBULATORY SERVICES 725





Line No

COST RECOVERY INFORMATION Account No(7)Transfers for

Operations (Revenue

Centers) Page 14,Column (1),

Line 270

Line No

730ANCILLARY SERVICES Labor and Delivery Services 7400 730

735 Surgery and Recovery Services 7420 735


745 Anesthesiology 7450 745



760 Clinical Laboratory Services 7500 760

765 Pathological Laboratory Services 7520 765

770 Blood Bank 7540 770

775 Echocardiology 7560 775

780 Cardiac Catheterization Services 7570 780



795 Electroencephalography 7620 795

800 Radiology - Diagnostic 7630 800

805 Radiology - Therapeutic 7640 805

810 Nuclear Medicine 7650 810

815 Magnetic Resonance Imaging 7660 815

820 Ultrasonography 7670 820

825 Computed Tomographic Scanner 7680 825



840 Pulmonary Function Services 7730 840





865 Speech - Language Pathology 7780 865







900 Other Ancillary Services 7870 900

905 TOTAL ANCILLARY SERVICES 905

920 TOTAL -0- 920





(1) (2) (3) (4) (5) (6)

CLASSIFICATION DESCRIPTION Management and

Supervision Technical and

Specialist Registered

Nurses

Line Natural Classification Code .00 .01 .02 Line

No REVENUE PRODUCING CENTERS Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No


5 Medical/Surgical Intensive Care $59.50 35,504 $35.20 1,263 $43.22 462,485 5

10 Coronary Care $59.93 2,537 $29.92 374 $44.75 40,514 10

15 Pediatric Intensive Care $54.72 3,082 $29.84 216 $43.74 36,217 15

20 Neonatal Intensive Care $58.35 8,919 $42.90 106,921 20


30 Burn Care $58.93 7,823 $29.93 210 $44.64 57,371 30



45 Medical/Surgical Acute $57.73 53,588 $30.01 6,651 $41.35 728,857 45

50 Pediatric Acute $58.06 5,919 $29.89 1,043 $41.19 54,858 50

55 Psychiatric Acute - Adult $43.68 6,694 $28.23 45,356 $44.89 94,902 55

60 Psychiatric Acute - Adolescent & Child $12.15 1,419 $29.89 98 $43.85 17,383 60

65 Obstetrics Acute $63.86 1,545 $29.90 238 $42.32 21,413 65





90 Other Acute Care $61.08 9,009 $29.90 1,088 $42.08 99,273 90

95 Nursery Acute $66.24 868 $30.50 22 $42.27 13,049 95









150 TOTAL DAILY HOSPITAL SERVICES $57.47 136,907 $28.69 56,559 $42.46 1,733,243 150

AMBULATORY SERVICES

160 Emergency Services $54.37 34,477 $41.98 10,023 $41.11 283,877 160


170 Psychiatric Emergency Rooms $52.72 4,301 $27.49 4,092 $43.38 57,493 170

175 Clinics $54.40 46,652 $27.51 21,427 $43.44 415,547 175



190 Outpatient Chemical Dependency Svcs. 190







225 TOTAL AMBULATORY SERVICES $54.30 85,430 $31.59 35,542 $42.56 756,917 225

21 DETAIL OF DIRECT PAYROLL COSTS PATIENT REVENUE PRODUCING CENTERS




(7) (8) (9) (10) (11) (12)

CLASSIFICATION DESCRIPTION Licensed

Vocational Nurses Aides and Orderlies

Clerical and Other Administrative



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No


5 Medical/Surgical Intensive Care $21.13 933 $15.63 74,795 $19.03 27,798 5

10 Coronary Care $19.67 18 $15.63 5,543 $18.64 3,306 10

15 Pediatric Intensive Care $18.55 11 $13.10 4,739 $16.96 1,326 15

20 Neonatal Intensive Care $19.28 25 $16.64 5,935 $17.88 6,438 20


30 Burn Care $22.28 888 $15.36 12,115 $19.98 6,958 30



45 Medical/Surgical Acute $20.56 31,620 $15.14 356,768 $17.92 59,626 45

50 Pediatric Acute $19.22 51 $14.26 19,991 $17.04 8,247 50

55 Psychiatric Acute - Adult $22.02 7,457 $15.83 66,779 $18.95 10,799 55

60 Psychiatric Acute - Adolescent & Child $22.85 4,182 $14.61 17,559 $18.33 1,824 60

65 Obstetrics Acute $21.35 2,075 $15.15 6,358 $17.28 2,399 65





90 Other Acute Care $21.93 3,183 $14.86 34,740 $18.32 8,297 90

95 Nursery Acute $21.36 1,270 $15.13 3,877 $16.82 1,283 95









150 TOTAL DAILY HOSPITAL SERVICES $21.13 51,713 $15.22 609,199 $18.29 138,301 150

AMBULATORY SERVICES

160 Emergency Services $21.70 26,282 $15.04 117,589 $19.46 50,012 160


170 Psychiatric Emergency Rooms $19.73 2,812 $15.32 36,541 $21.18 1,326 170

175 Clinics $21.02 113,950 $14.70 171,442 $19.03 131,855 175










225 TOTAL AMBULATORY SERVICES $21.12 143,044 $14.89 325,572 $19.16 183,193 225





(13) (14) (15) (16) (17) (18)

CLASSIFICATION DESCRIPTION Environmental and

Food Service Physicians (Salaried)

Non-Physicians Medical Practitioners


No "REVENUE PRODUCING CENTERS Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No


5 Medical/Surgical Intensive Care $141.24 2,762 $51.59 3,061 5

10 Coronary Care $79.68 969 $51.58 1,051 10

15 Pediatric Intensive Care $68.33 763 $51.61 605 15

20 Neonatal Intensive Care $68.24 4,449 $51.61 1,429 20


30 Burn Care $51.60 590 30



45 Medical/Surgical Acute $102.29 16,126 $51.60 18,643 45

50 Pediatric Acute $88.55 6,283 $51.59 2,907 50

55 Psychiatric Acute - Adult $113.76 4,351 $51.60 1,396 55

60 Psychiatric Acute - Adolescent & Child $119.50 1,232 $51.59 275 60

65 Obstetrics Acute $94.24 267 $51.60 668 65





90 Other Acute Care $89.18 4,131 $51.61 3,054 90

95 Nursery Acute $84.23 113 $58.82 7,307 95









150 TOTAL DAILY HOSPITAL SERVICES $98.30 41,446 $52.89 40,986 150

AMBULATORY SERVICES

160 Emergency Services $99.58 22,230 $46.79 77,744 160


170 Psychiatric Emergency Rooms $115.36 2,547 $51.60 1,888 170

175 Clinics $86.80 25,471 $56.65 56,925 175










225 TOTAL AMBULATORY SERVICES $93.90 50,248 $50.97 136,557 225





(19) (20) (21)

CLASSIFICATION DESCRIPTION Other Salaries

and Wages Cost Center

Average Hourly Rate

Line Natural Classification Code .09 Line


Productive Hours

No


5 Medical/Surgical Intensive Care $47.11 152 $38.65 5

10 Coronary Care $47.27 52 $39.38 10

15 Pediatric Intensive Care $47.20 30 $38.87 15

20 Neonatal Intensive Care $47.10 71 $40.30 20


30 Burn Care $47.59 29 $37.68 30



45 Medical/Surgical Acute $47.15 925 $32.91 45

50 Pediatric Acute $47.23 144 $36.38 50

55 Psychiatric Acute - Adult $47.29 1,887 $32.46 55

60 Psychiatric Acute - Adolescent & Child $45.93 14 $30.08 60

65 Obstetrics Acute $47.36 33 $35.04 65





90 Other Acute Care $47.01 152 $35.68 90

95 Nursery Acute $49.00 3 $40.69 95









150 TOTAL DAILY HOSPITAL SERVICES $47.22 3,492 $35.18 150

AMBULATORY SERVICES

160 Emergency Services $47.19 594 $35.84 160


170 Psychiatric Emergency Rooms $47.84 1,666 $33.91 170

175 Clinics $26.10 11,950 $33.74 175










225 TOTAL AMBULATORY SERVICES $29.53 14,210 $34.51 225





(22) (23) (24) (25)

Line No

HOURS SUMMARY (Optional) Full Time

Equivalent Employees

Line No

REVENUE PRODUCING CENTERS Productive Hours

Non-Productive

Hours

Total Paid Hours

Column (22) ÷ 2080


5 Medical/Surgical Intensive Care 608,753 139,711 748,464 292.67 5

10 Coronary Care 54,364 14,673 69,037 26.14 10

15 Pediatric Intensive Care 46,989 19,690 66,679 22.59 15

20 Neonatal Intensive Care 134,187 51,381 185,568 64.51 20


30 Burn Care 85,984 22,630 108,614 41.34 30



45 Medical/Surgical Acute 1,272,804 264,534 1,537,338 611.93 45

50 Pediatric Acute 99,443 23,097 122,540 47.81 50

55 Psychiatric Acute - Adult 239,621 40,116 279,737 115.20 55

60 Psychiatric Acute - Adolescent & Child 43,986 5,603 49,589 21.15 60

65 Obstetrics Acute 34,996 8,437 43,433 16.83 65





90 Other Acute Care 162,927 43,291 206,218 78.33 90

95 Nursery Acute 27,792 6,228 34,020 13.36 95









150 TOTAL DAILY HOSPITAL SERVICES 2,811,846 639,391 3,451,237 1,351.85 150

AMBULATORY SERVICES

160 Emergency Services 622,828 130,795 753,623 299.44 160


170 Psychiatric Emergency Rooms 112,666 17,772 130,438 54.17 170

175 Clinics 995,219 183,542 1,178,761 478.47 175










225 TOTAL AMBULATORY SERVICES 1,730,713 332,109 2,062,822 832.07 225



( Page 21 (5 of 10) Audited Data )Date Prepared: 11/16/2015 HOSPITAL DISCLOSURE REPORT FACSIMILE

(1) (2) (3) (4) (5) (6)




Nurses



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No

ANCILLARY SERVICES

230 Labor and Delivery Services $59.91 10,847 $30.05 12,600 $50.93 85,496 230

235 Surgery and Recovery Services $57.88 23,052 $20.61 82,115 $41.12 207,186 235


245 Anesthesiology $66.88 5,694 $68.01 44,860 $47.25 2,779 245



260 Clinical Laboratory Services $39.96 46,463 $32.93 277,925 $47.22 500 260

265 Pathological Laboratory Services $33.60 5,941 $26.97 33,748 $47.88 2,284 265

270 Blood Bank $41.82 7,000 $38.79 31,137 $47.45 84 270

275 Echocardiology $38.44 103 $27.91 14,813 $47.33 147 275

280 Cardiac Catheterization Services $56.04 3,709 $28.35 7,697 $42.52 27,733 280

285 Cardiology Services $25.72 1,903 $19.60 28,577 285


295 Electroencephalography $17.85 110 $22.87 7,185 $47.06 65 295

300 Radiology - Diagnostic $37.88 17,693 $32.11 102,729 $43.90 15,744 300

305 Radiology - Therapeutic $39.64 2,696 $35.42 22,910 $43.23 1,630 305

310 Nuclear Medicine $45.35 5,133 $33.60 12,049 $44.31 1,165 310

315 Magnetic Resonance Imaging $35.54 2,909 $32.26 20,065 $44.06 1,547 315

320 Ultrasonography $36.55 1,224 $32.00 9,479 $43.96 1,505 320

325 Computed Tomographic Scanner $37.68 4,339 $32.77 31,398 $44.27 1,868 325


335 Respiratory Therapy $40.58 27,334 $33.81 84,144 335

340 Pulmonary Function Services $36.85 3,379 $29.11 28,121 $47.06 108 340

345 Renal Dialysis $59.08 2,132 $23.50 4,635 $48.25 35,431 345

350 Lithotripsy 350


360 Physical Therapy $50.22 12,876 $36.64 35,196 360

365 Speech-Language Pathology $43.64 5,750 365

370 Occupational Therapy $48.22 5,354 $36.35 20,183 370

375 Other Physical Medicine $44.40 4,486 $36.60 23,976 375





400 Other Ancillary Services $24.88 1,830 $22.16 10,897 $47.21 216 400

405 TOTAL ANCILLARY SERVICES $44.89 196,207 $32.99 952,189 $44.32 385,488 405





(7) (8) (9) (10) (11) (12)






Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No

ANCILLARY SERVICES

230 Labor and Delivery Services $21.47 7,003 $15.26 21,690 $18.20 3,983 230

235 Surgery and Recovery Services $21.50 1,959 $14.41 41,426 $18.85 13,004 235


245 Anesthesiology $19.39 142 $17.10 762 $19.37 8,236 245



260 Clinical Laboratory Services $19.04 26 $17.10 137 $22.08 12,302 260

265 Pathological Laboratory Services $19.44 32 $17.12 172 $20.36 15,037 265

270 Blood Bank $21.00 4 $17.22 23 $20.37 137 270

275 Echocardiology $18.25 8 $17.28 40 $20.38 239 275

280 Cardiac Catheterization Services $20.32 22 $14.24 3,148 $14.51 1,304 280

285 Cardiology Services $17.98 3,074 285


295 Electroencephalography $21.33 3 $16.89 18 $20.40 105 295

300 Radiology - Diagnostic $21.35 819 $14.73 6,605 $18.93 26,396 300

305 Radiology - Therapeutic $21.75 85 $14.44 731 $17.24 2,689 305

310 Nuclear Medicine $21.30 60 $14.91 469 $18.22 2,993 310

315 Magnetic Resonance Imaging $21.38 80 $12.53 2,653 $17.79 1,507 315

320 Ultrasonography $21.37 78 $14.75 627 $17.70 1,442 320

325 Computed Tomographic Scanner $21.12 97 $14.32 1,570 $18.19 3,615 325


335 Respiratory Therapy $18.93 2,186 335

340 Pulmonary Function Services $21.40 5 $16.80 30 $20.35 3,773 340

345 Renal Dialysis $14.14 2,959 345

350 Lithotripsy 350


360 Physical Therapy $18.47 6,989 360

365 Speech-Language Pathology 365

370 Occupational Therapy $26.50 153 370

375 Other Physical Medicine $17.97 1,780 375





400 Other Ancillary Services $19.45 11 $17.15 59 $20.40 350 400

405 TOTAL ANCILLARY SERVICES $21.41 10,434 $14.65 83,272 $19.29 111,141 405


06/30/2014Facility D.B.A. Name : Report Period End: LAC/USC MEDICAL CENTER




(13) (14) (15) (16) (17) (18)



Non-Physicians Medical Practitioners



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No

ANCILLARY SERVICES

230 Labor and Delivery Services $108.89 149 $51.58 803 230

235 Surgery and Recovery Services $110.65 3,333 $51.60 8,765 235


245 Anesthesiology $107.16 18,936 $51.51 8,866 245



260 Clinical Laboratory Services $66.34 167 $51.61 1,469 260

265 Pathological Laboratory Services $111.31 3,758 $51.59 1,847 265

270 Blood Bank $51.61 248 270

275 Echocardiology $82.07 196 $60.18 3,589 275

280 Cardiac Catheterization Services $81.74 141 $51.63 348 280



295 Electroencephalography $73.22 945 $51.71 190 295

300 Radiology - Diagnostic $103.76 6,005 $51.33 9,064 300

305 Radiology - Therapeutic $49.86 168 305

310 Nuclear Medicine $51.44 999 310

315 Magnetic Resonance Imaging $59.50 4 $51.38 1,052 315

320 Ultrasonography $112.06 1,024 $51.36 943 320

325 Computed Tomographic Scanner $86.37 1,816 $51.42 1,579 325


335 Respiratory Therapy 335

340 Pulmonary Function Services $84.50 6 $51.65 316 340


350 Lithotripsy 350


360 Physical Therapy 360

365 Speech-Language Pathology 365

370 Occupational Therapy 370

375 Other Physical Medicine 375





400 Other Ancillary Services $117.94 754 $49.42 2,420 400

405 TOTAL ANCILLARY SERVICES $105.41 37,234 $52.09 42,666 405

Facility D.B.A. Name : Report Period End: 06/30/2014LAC/USC MEDICAL CENTER




(19) (20) (21)

CLASSIFICATION DESCRIPTION Other Salaries

and Wages Cost Center

Average Hourly Rate



Productive Hours

No

ANCILLARY SERVICES

230 Labor and Delivery Services $46.95 40 $40.56 230

235 Surgery and Recovery Services $47.14 435 $34.08 235


245 Anesthesiology $47.20 405 $64.80 245



260 Clinical Laboratory Services $16.71 83,380 $29.30 260

265 Pathological Laboratory Services $15.73 12,412 $28.53 265

270 Blood Bank $14.76 3,898 $36.69 270

275 Echocardiology $48.24 21 $34.15 275

280 Cardiac Catheterization Services $47.94 17 $37.74 280

285 Cardiology Services $19.10 285


295 Electroencephalography $49.44 9 $27.72 295

300 Radiology - Diagnostic $21.12 3,393 $33.30 300

305 Radiology - Therapeutic $17.81 374 $33.21 305

310 Nuclear Medicine $23.34 241 $34.57 310

315 Magnetic Resonance Imaging $21.89 329 $30.86 315

320 Ultrasonography $21.50 322 $36.67 320

325 Computed Tomographic Scanner $23.18 388 $32.88 325


335 Respiratory Therapy $33.77 335

340 Pulmonary Function Services $46.25 16 $28.36 340

345 Renal Dialysis $41.76 345

350 Lithotripsy 350


360 Physical Therapy $36.77 360

365 Speech-Language Pathology $42.86 365

370 Occupational Therapy $37.85 370

375 Other Physical Medicine $34.63 375





400 Other Ancillary Services $47.90 31 $30.75 400

405 TOTAL ANCILLARY SERVICES $17.02 105,711 $34.64 405




(22) (23) (24) (25)

Line No



Line No


Non-Productive

Hours

Total Paid Hours

Column (22) ÷ 2080

ANCILLARY SERVICES

230 Labor and Delivery Services 142,611 35,387 177,998 68.56 230

235 Surgery and Recovery Services 381,275 71,443 452,718 183.31 235


245 Anesthesiology 90,680 20,890 111,570 43.60 245



260 Clinical Laboratory Services 422,369 97,146 519,515 203.06 260

265 Pathological Laboratory Services 75,231 18,440 93,671 36.17 265

270 Blood Bank 42,531 9,078 51,609 20.45 270

275 Echocardiology 19,156 4,898 24,054 9.21 275

280 Cardiac Catheterization Services 44,119 13,621 57,740 21.21 280

285 Cardiology Services 33,554 10,383 43,937 16.13 285


295 Electroencephalography 8,630 1,950 10,580 4.15 295

300 Radiology - Diagnostic 188,448 36,061 224,509 90.60 300

305 Radiology - Therapeutic 31,283 5,871 37,154 15.04 305

310 Nuclear Medicine 23,109 4,197 27,306 11.11 310

315 Magnetic Resonance Imaging 30,146 4,599 34,745 14.49 315

320 Ultrasonography 16,644 3,247 19,891 8.00 320

325 Computed Tomographic Scanner 46,670 13,669 60,339 22.44 325


335 Respiratory Therapy 113,664 30,445 144,109 54.65 335

340 Pulmonary Function Services 35,754 11,203 46,957 17.19 340

345 Renal Dialysis 45,157 13,983 59,140 21.71 345

350 Lithotripsy 350


360 Physical Therapy 55,061 12,255 67,316 26.47 360

365 Speech-Language Pathology 5,750 907 6,657 2.76 365

370 Occupational Therapy 25,690 5,925 31,615 12.35 370

375 Other Physical Medicine 30,242 10,722 40,964 14.54 375





400 Other Ancillary Services 16,568 3,481 20,049 7.97 400

405 TOTAL ANCILLARY SERVICES 1,924,342 439,801 2,364,143 925.16 405


Report Period End: LAC/USC MEDICAL CENTER 06/30/2014Facility D.B.A. Name :



(1) (2) (3) (4) (5)

CLASSIFICATION DESCRIPTION Registry Nursing

Personnel Other Contracted

Services Total Contracted

Hours

LineNatural Classification Code .25 .21, .26

Line


Productive Hours Average Hourly Rate

Productive Hours No


5 Medical/Surgical Intensive Care $58.61 45,900 45,900 5

10 Coronary Care $38.56 1,240 1,240 10

15 Pediatric Intensive Care $24.02 343 343 15

20 Neonatal Intensive Care 20


30 Burn Care $38.72 6,630 6,630 30



45 Medical/Surgical Acute $27.98 202,137 202,137 45

50 Pediatric Acute $24.30 1,523 1,523 50

55 Psychiatric Acute - Adult $27.59 83,161 83,161 55

60 Psychiatric Acute - Adolescent & Child $24.97 16,248 16,248 60

65 Obstetrics Acute $24.70 702 702 65





90 Other Acute Care $35.46 27,616 27,616 90

95 Nursery Acute $24.74 431 431 95









150 TOTAL DAILY HOSPITAL SERVICES $32.14 385,931 385,931 150

AMBULATORY SERVICES

160 Emergency Services $43.67 117,132 117,132 160


170 Psychiatric Emergency Rooms $32.11 28,917 28,917 170

175 Clinics $32.75 190,175 190,175 175










225 TOTAL AMBULATORY SERVICES $36.50 336,224 336,224 225

21.1 DETAIL OF DIRECT CONTRACTED COSTS PATIENT REVENUE PRODUCING CENTERS




21.1 DETAIL OF DIRECT CONTRACTED COSTS PATIENT REVENUE PRODUCING CENTERS

(1) (2) (3) (4) (5)

CLASSIFICATION DESCRIPTION Registry Nursing

Personnel Other Contracted

Services Total Contracted

Hours

LineNatural Classification Code .25 .21, .26

Line


Productive Hours Average Hourly Rate

Productive Hours No

ANCILLARY SERVICES

230 Labor and Delivery Services $24.00 40 40 230

235 Surgery and Recovery Services $32.94 18,201 $51.50 5,481 23,682 235


245 Anesthesiology $47.52 13,993 13,993 245



260 Clinical Laboratory Services 260

265 Pathological Laboratory Services 265

270 Blood Bank 270

275 Echocardiology $51.53 1,116 1,116 275

280 Cardiac Catheterization Services $24.52 1,791 1,791 280

285 Cardiology Services $26.82 3,089 3,089 285


295 Electroencephalography $18.39 3,967 3,967 295

300 Radiology - Diagnostic $24.05 41,761 $37.83 24,715 66,476 300

305 Radiology - Therapeutic $24.00 1,669 $60.39 7,146 8,815 305

310 Nuclear Medicine $54.93 7,965 7,965 310

315 Magnetic Resonance Imaging $24.06 11,327 $61.30 8,215 19,542 315

320 Ultrasonography $30.77 1,132 $51.58 17,929 19,061 320

325 Computed Tomographic Scanner $24.18 9,552 $50.18 3,519 13,071 325


335 Respiratory Therapy $52.16 81,199 81,199 335

340 Pulmonary Function Services 340


350 Lithotripsy 350


360 Physical Therapy $60.91 15,219 15,219 360

365 Speech-Language Pathology $44.50 2,951 2,951 365

370 Occupational Therapy $61.85 7,228 7,228 370

375 Other Physical Medicine $66.08 2,442 2,442 375





400 Other Ancillary Services 400

405 TOTAL ANCILLARY SERVICES $29.08 99,466 $51.03 192,181 291,647 405




(1) (2) (3) (4) (5) (6)




Nurses



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No

RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing $65.99 9,386 $53.82 53,048 20


30 Medical Postgraduate Education $39.02 6,834 $25.01 9,207 30




50 TOTAL EDUCATION $54.63 16,220 $49.56 62,255 50

GENERAL SERVICES


60 Kitchen 60


70 Dietary 70

75 Laundry and Linen $16.65 10,379 $32.96 1,843 75

80 Social Work Services $53.50 7,976 $30.24 81,984 80

85 Central Transportation 85

90 Central Services and Supplies $24.88 6,922 $16.54 43,654 90

95 Pharmacy $61.41 18,905 $43.20 255,267 95

100 Purchasing and Stores $32.97 26,462 $40.33 4,378 100

105 Grounds 105

110 Security 110

115 Parking 115

120 Housekeeping $17.53 32,949 120

125 Plant Operations $37.81 6,917 $40.39 4,556 125

130 Plant Maintenance $39.15 59,258 $34.39 47,747 130

135 Communications $21.57 5,205 135

140 Data Processing $50.50 28,367 $35.91 105,592 140


150 TOTAL GENERAL SERVICES $36.93 203,340 $36.85 545,021 150

FISCAL SERVICES

155 General Accounting $41.72 23,508 $29.46 33,032 155

160 Patient Accounting $28.68 5,672 160

165 Credit and Collection $23.59 3,917 165

170 Admitting $26.61 19,727 170


195 Other Fiscal Services $36.47 75,383 $30.91 13,860 195

200 TOTAL FISCAL SERVICES $35.18 128,207 $29.89 46,892 200

22 DETAIL OF DIRECT PAYROLL COSTS NON-REVENUE PRODUCING CENTERS




(1) (2) (3) (4) (5) (6)




Nurses



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No


205 Hospital Administration $56.42 67,176 $27.01 23,751 205


215 Public Relations $22.59 1,872 215


225 Personnel $43.50 6 225

230 Employee Health Services $44.44 24,394 $25.92 3,246 230

235 Auxiliary Groups $51.01 3,655 $24.68 6,853 235

240 Chaplaincy Services $19.89 996 240

245 Medical Library $35.04 1,671 245

250 Medical Records $25.56 33,867 $27.30 126,731 250

255 Medical Staff Administration $42.25 1,824 $27.49 1,974 255

260 Nursing Administration $46.59 247,802 $42.06 14,862 260

265 Nursing Float Personnel 265

270 Inservice Education - Nursing $53.64 18,703 270

275 Utilization Management $49.93 163,461 $29.86 13,019 275


295 Other Administrative Services $42.84 3,906 $27.25 3,571 295

300 TOTAL ADMINISTRATIVE SERVICES $47.30 547,963 $30.65 215,377 300


370 Non-Operating Cost Centers $52.82 57 $24.08 5,585 370





(7) (8) (9) (10) (11) (12)






Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No

RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing $20.21 17,259 20


30 Medical Postgraduate Education $22.82 3,523 30




50 TOTAL EDUCATION $20.65 20,782 50

GENERAL SERVICES


60 Kitchen 60


70 Dietary 70


80 Social Work Services $20.09 5,481 80


90 Central Services and Supplies $20.22 19,524 90

95 Pharmacy $18.86 9,837 95

100 Purchasing and Stores $19.91 123,163 100

105 Grounds 105

110 Security 110

115 Parking $18.34 2,455 115



130 Plant Maintenance $18.88 19,598 130

135 Communications $16.91 23,264 135

140 Data Processing $22.79 3,149 140


150 TOTAL GENERAL SERVICES $19.48 206,471 150

FISCAL SERVICES

155 General Accounting $21.14 19,289 155

160 Patient Accounting $20.46 27,742 160

165 Credit and Collection $17.98 15,473 165

170 Admitting $20.41 176,450 170


195 Other Fiscal Services $21.91 354,860 195

200 TOTAL FISCAL SERVICES $21.27 593,814 200





(7) (8) (9) (10) (11) (12)






Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No


205 Hospital Administration $22.31 63,660 205




225 Personnel 225

230 Employee Health Services $19.31 6,998 230

235 Auxiliary Groups $16.52 6,642 235

240 Chaplaincy Services $20.42 1,509 240

245 Medical Library $17.67 4,801 245

250 Medical Records $18.29 199,252 250

255 Medical Staff Administration $19.35 2,391 255

260 Nursing Administration $19.20 43,686 260


270 Inservice Education - Nursing 270

275 Utilization Management $18.16 54,026 275


295 Other Administrative Services $17.13 14,288 295

300 TOTAL ADMINISTRATIVE SERVICES $18.97 397,253 300


370 Non-Operating Cost Centers $20.26 27 370





(13) (14) (15) (16) (17) (18)



Non-Physician Medical Practitioners



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No

RESEARCH COSTS



EDUCATION COSTS









GENERAL SERVICES


60 Kitchen 60


70 Dietary 70

75 Laundry and Linen $13.66 24,913 75



90 Central Services and Supplies $13.96 650 90

95 Pharmacy 95

100 Purchasing and Stores $13.95 2,657 100

105 Grounds 105

110 Security 110

115 Parking $20.69 2,471 115

120 Housekeeping $14.86 461,332 120

125 Plant Operations $31.91 61,627 125

130 Plant Maintenance $27.37 278,558 130





FISCAL SERVICES




170 Admitting 170



200 TOTAL FISCAL SERVICES 200





(13) (14) (15) (16) (17) (18)



Non-Physician Medical Practitioners



Productive Hours

Average Hourly Rate

Productive Hours

Average Hourly Rate

Productive Hours

No






225 Personnel 225












295 Other Administrative Services $22.63 5,097 295








(19) (20) (21)

CLASSIFICATION DESCRIPTION Other Salaries and Wages

Cost Center Average Hourly

Rate



Productive Hours

No

RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing $13.40 298 $47.09 20


30 Medical Postgraduate Education $26.74 1,700,801 $26.75 30

35 Paramedical Education $34.00 6,095 $34.00 35



50 TOTAL EDUCATION $26.76 1,707,194 $27.76 50

GENERAL SERVICES


60 Kitchen 60


70 Dietary 70

75 Laundry and Linen $15.12 75

80 Social Work Services $13.78 1,701 $30.46 80


90 Central Services and Supplies $14.62 3,651 $17.85 90

95 Pharmacy $18.81 12,061 $41.80 95

100 Purchasing and Stores $15.32 3,950 $21.85 100

105 Grounds 105

110 Security 110

115 Parking $15.25 3,589 $17.21 115

120 Housekeeping $14.84 120

125 Plant Operations $32.44 125

130 Plant Maintenance $18.24 7,251 $27.88 130

135 Communications $17.66 135

140 Data Processing $38.19 140


150 TOTAL GENERAL SERVICES $17.12 32,203 $26.27 150

FISCAL SERVICES

155 General Accounting $30.15 155

160 Patient Accounting $21.46 160

165 Credit and Collection $18.95 165

170 Admitting $17.39 9,640 $19.95 170


195 Other Fiscal Services $12.90 460 $23.90 195

200 TOTAL FISCAL SERVICES $17.19 10,100 $23.19 200





(19) (20) (21)

CLASSIFICATION DESCRIPTION Other Salaries and Wages

Cost Center Average Hourly

Rate



Productive Hours

No


205 Hospital Administration $47.78 10,121 $36.98 205


215 Public Relations $22.61 215


225 Personnel $43.50 225

230 Employee Health Services $17.51 2,376 $34.76 230

235 Auxiliary Groups $10.04 3,734 $24.23 235

240 Chaplaincy Services $19.99 240

245 Medical Library $22.65 245

250 Medical Records $13.76 1,637 $21.55 250

255 Medical Staff Administration $25.51 1,703 $27.50 255

260 Nursing Administration $15.46 88,919 $35.80 260


270 Inservice Education - Nursing $53.74 270

275 Utilization Management $48.61 443 $40.58 275


295 Other Administrative Services $10.75 6,265 $21.26 295

300 TOTAL ADMINISTRATIVE SERVICES $18.16 115,198 $32.18 300


370 Non-Operating Cost Centers $48.18 56 $24.21 370





(22) (23) (24) (25)

Line No



Line No


Non-Productive

Hours

Total Paid Hours

Column (22) ÷ 2080

RESEARCH COSTS



EDUCATION COSTS


20 School of Nursing 79,991 17,973 97,964 38.46 20


30 Medical Postgraduate Education 1,720,365 196,594 1,916,959 827.10 30

35 Paramedical Education 6,095 6,095 2.93 35



50 TOTAL EDUCATION 1,806,451 214,567 2,021,018 868.49 50

GENERAL SERVICES


60 Kitchen 60


70 Dietary 70

75 Laundry and Linen 37,135 8,814 45,949 17.85 75

80 Social Work Services 97,142 21,095 118,237 46.70 80


90 Central Services and Supplies 74,401 14,468 88,869 35.77 90

95 Pharmacy 296,070 60,972 357,042 142.34 95

100 Purchasing and Stores 160,610 31,259 191,869 77.22 100

105 Grounds 105

110 Security 110

115 Parking 8,515 3,737 12,252 4.09 115

120 Housekeeping 494,281 97,936 592,217 237.64 120

125 Plant Operations 73,100 12,456 85,556 35.14 125

130 Plant Maintenance 412,412 103,226 515,638 198.28 130

135 Communications 28,469 6,165 34,634 13.69 135

140 Data Processing 137,108 22,108 159,216 65.92 140


150 TOTAL GENERAL SERVICES 1,819,243 382,236 2,201,479 874.64 150

FISCAL SERVICES

155 General Accounting 75,829 15,306 91,135 36.46 155

160 Patient Accounting 33,414 6,258 39,672 16.06 160

165 Credit and Collection 19,390 3,781 23,171 9.32 165

170 Admitting 205,817 61,922 267,739 98.95 170


195 Other Fiscal Services 444,563 113,122 557,685 213.73 195

200 TOTAL FISCAL SERVICES 779,013 200,389 979,402 374.53 200





(22) (23) (24) (25)

Line No



Line No


Non-Productive

Hours

Total Paid Hours

Column (22) ÷ 2080


205 Hospital Administration 164,708 44,063 208,771 79.19 205


215 Public Relations 1,872 385 2,257 .90 215


225 Personnel 6 6 225

230 Employee Health Services 37,014 7,789 44,803 17.80 230

235 Auxiliary Groups 20,884 3,171 24,055 10.04 235

240 Chaplaincy Services 2,505 681 3,186 1.20 240

245 Medical Library 6,472 1,034 7,506 3.11 245

250 Medical Records 361,487 98,120 459,607 173.79 250

255 Medical Staff Administration 7,892 1,599 9,491 3.79 255

260 Nursing Administration 395,269 86,409 481,678 190.03 260


270 Inservice Education - Nursing 18,703 3,660 22,363 8.99 270

275 Utilization Management 230,949 50,008 280,957 111.03 275


295 Other Administrative Services 33,127 7,474 40,601 15.93 295

300 TOTAL ADMINISTRATIVE SERVICES 1,280,888 304,393 1,585,281 615.81 300


370 Non-Operating Cost Centers 5,725 720 6,445 2.75 370





22.1 DETAIL OF DIRECT CONTRACTED COSTS NON-REVENUE PRODUCING CENTERS


(3) (4)

CLASSIFICATION DESCRIPTION Other Contracted

Services


No NON-REVENUE PRODUCING CENTERS Average Hourly Rate

Productive Hours

No

RESEARCH COSTS



EDUCATION COSTS









GENERAL SERVICES


60 Kitchen 60


70 Dietary 70




90 Central Services and Supplies $39.84 13,583 90

95 Pharmacy $30.72 109,506 95


105 Grounds 105

110 Security 110

115 Parking 115





140 Data Processing $53.68 2,756 140



FISCAL SERVICES




170 Admitting $24.00 538 170


195 Other Fiscal Services $24.11 3,877 195

200 TOTAL FISCAL SERVICES $24.10 4,415 200



(3) (4)

CLASSIFICATION DESCRIPTION Other Contracted

Services


No NON-REVENUE PRODUCING CENTERS Average Hourly Rate

Productive Hours

No






225 Personnel 225





250 Medical Records $42.28 83,917 250


260 Nursing Administration $24.27 26,276 260



275 Utilization Management $51.07 8,259 275





370 Non-Operating Cost Centers $27.20 7,793 370

22.1 DETAIL OF DIRECT CONTRACTED COSTS NON-REVENUE PRODUCING CENTERS




using data audited by oshpd hospital summary...

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