any other info needed is here at this document https://www.coursehero.com/u/file/57084089/County-Revisedpdf/#question

14} For 2018, develop a statistical budget; then develop a revenue budget [using a financial model, determine whether to increase rates and if so, how much} and then develop an expense budget, in statement of operations format including detailed footnotes explaining any changes in the numbers. I would like to see at least four different expense scenarios: 1) maintain expenses at 2017 levels after adjusting for volumes and mandated expenditures identified in earlier steps; 2) maintain expenses at 201? levels after adjusting for volumes and mandated expenditures identified in earlier steps and honoring all requests (i.e., raises, additional personnel, etc); 3) cut expenses (from expense scenario #1) in order to break-even in 2018; 4) cut expenses (from expense scenario #1) in order to break- even in 2013 and recover PI 2011 losses. Tablo I Hays County IDS Balance Sheet as of Docombor 31, 2016 Assets 2016 Current Assets Cash and cash equivalents 016,875 Marketable securities 8, 100,500 Accounts receivable less allowances 17,250,000 Inventories at cost 2, 368,000 Other current assets 8, 992,500 Total Current Assets 537,527,875 Land and improvements 11, 250,000 Buildings 50,509,500 Long-term investment 20,000,000 Fixed equipment 5,063,250 Moveable equipment 4,466,750 Property, Plant & Equipment 91,289,500 Less accumulated depreciation (38,376,231) Total Property, Plant & Equipment 52,913,269 TOTAL ASSETS 90, 441,144 Current Liabilities Current portion of long-term debt $ 10, 151,000 Accounts payable & accrued expenses 8, 400,000 Estimated amounts due to third-party payors 8, 423,750 Other current liabilities 10,500,000 Total Current Liabilities 37,474, 750 Long-term debt, net of current portion 25,000,000 TOTAL LIABILITIES 62,474,750 Net Assets Unrestricted 742, 625 Temporarily restricted 16,000,000 Permanently restricted 11,223, 769 TOTAL NET ASSETS 27,966,394 TOTAL LIABILITIES AND NET ASSETS $ 90,441,144Table II Hays County IDS Actual Expenses through Docombor 31, 2017 Wages, Taxes, Benefits 76,725, 792 Professional Fees & Commissions 7,000,000 Drugs 8,000,000 Medical and Other Supplies 8,500,000 Food 7,500,000 Purchased Services 6,500,000 Repairs & Maintenance 8,000,000 Utilities 9,000,000 Interest 8, 021, 440 Depreciation 3,000,000 TOTAL EXPENSES 142,247,232Table III Solocted Industry Financial & Productivity Ratios for Urban Hospital (175-400 million revenue) with 200-299 Beds Financial Ratios Optum 2015* Hays Liquidity Ratios Current ratio 1. 87 Collection period ratio 47.60 Days Cash-on-hand, short-term sources 18.80 Days Cash-on-hand, all sources 32. 70 Capital Structure Ratios Net asset financing ratio 56.30 Debt service coverage ratio 4.09 Efficiency Ratios Total asset turnover ratio 0.87 Age of plant ratio 11.47 Fixed asset turnover ratio 2.59 Current asset turnover ratio 4.22 Inventory turnover ratio 51.38 Profitability Ratios Excess margin 5. 10 Operating margin 4 . 14 Return on net assets 9.50 Operating Indicators Length of stay-acute 4 . 10 Occupancy rate-acute 52.30 Productivity Ratios Cost adjusted per acute discharge 11, 076* * (use discharge equivalents) Salaries adjusted per acute discharge 4,270* * (use discharge equivalents) Nursing service RN's as a percent of total nursing 1. 10*#* LPN's as a percent of total nursing 11.38* *# Full-time equivalent employees Per occupied bed 4 .86 Salary per FTE 62,306 See Optum 2017 for 2015 data Optum number is adjusted for inpatient day equivalents See AHA hospital statistics for nursing personnel dataTable IV-A Hays County IDS Discharges Service (LOS) 2013 2014 2015 2016 2017 Acute (4) 6,777 6,354 5,931 5,931 5,931 SNF (30) 239 243 247 251 255 Rehab (20) 155 157 159 162 164 Home Health 7,298 6,082 4,866 3,650 3,650 Emergency 27,915 30,062 32, 207 34,354 36,500 Outpatient 16,826 10,355 19,804 22,942 26,000 Table IV-B Porcontage of Discharges by Payor 2013 2014 2015 2016 2017 Medicare 24 25 26 27 28 Medicaid 22 24 26 28 30 Commercial 3 2 NC--dis 39 39 39 33 32 NC--cap 0 Bad Debt WU NN NN NN Charity Tablo IV-C 2017 Charges per Discharge/Visit Hays St. Teresa Acute $40,000 538, 200 SNF 30,000 28, 000 Rehab 40,000 38, 000 Home Health 400 300 Emergency 1, 600 1, 500 Outpatient 600 500Table V Radiology Department Procedures Tech Supply Machine 2017 Procedure Minutoo Expense Minutes Volume Radiology Chest 2-view 14 10 10 20,000 Chest 4-view 28 20 10 15,000 Hand 05 05 05 7,000 Arm 10 10 05 4,000 Foot 05 05 05 1,000 Log 10 10 05 6,000 Flouroscopy 30 30 15 3,000 Ultrasound Abdomen 15 10 10 5,000 Other 10 10 10 5, 622 Nuclear Medicine 6can 60 30 30 2,000 CT Head w/o contrast 30 50 30 200 Head w contrast 60 75 45 300 Body w/o contrast 30 75 30 400 Body w contrast 60 100 45 500Tablo VI-A Salary Survey of Aroa Hospitals Average Hourly Rates (without benefits), December, 2017 Position Hays St. Teresa Chief Executive Officer $ 595.00 5 595.00 Chief Operating Officer 390.00 386.00 Chief Nursing Officer 175.00 172.00 Director Clinical Services 230.00 226.00 Director Support Services 150.00 149.00 Chief Medical Officer 295.00 291.00 Chief Financial Officer 312.00 280.00 Chief compliance Officer 140.00 135.00 Chief Information Officer 225.00 222.00 Head Nurse 43.00 38.00 Staff RN 37.40 33.00 Staff LPN 24. 70 21.00 Nursing Assistant 14.80 11.00 Lab Tech 31.68 28.00 Rad Tech 29.72 26.00 Food Server 12.45 9.45 Housekeeper 12.41 9.00 Administrators Below Chief's 40.73 37.00 Clerk 20.23 17.00 Respiratory Therapist 30.14 27.25 Table VI-B Hays County IDS Staffing as of December 31, 2017 Department FTE'S Chief Executives 9 Administrators Below Chief's 50 Medical Records 10 Dietary 35 Housekeeping 25 Laundry Physical Plant Nursing* 500 Laboratory 20 Radiology 10 Respiratory Therapy UT Physical Therapy Emergency Department Physicians *contract **84e RN's, 109 Nursing Assistant, 50 Head Nurse, 10 clerksTable VII San Marcos City and County Ad Valorem/Property Tax Schedule per $100 assessed value Aquifer .00981 County .35510 city . 47000 ISD 1.23954 Special Roads Project .06010 Upper Kays River Watershed . 02000 state sales tax 8.254