3 2013|555,000 5.000% 100.794%|339511DT1
3 2015|1,235,000 5.000% 105.314%|339511DV6
3 2018|5,150,000 3.750% 101.785%|339511DY0
3 2019|2,350,000 4.000% 101.655%|339511EA1
3 2019|3,000,000 5.000% 107.186%|339511DZ7
test row 2013|555,000 5.000% 100.794%|339511DT1 ) against types ( integer|complex|other ) has 0.000000 unmatching types
4 5,580,000|5.000|Term Bonds due July 1, 2023 Price 104.077% to Yield 4.500%|CUSIP†: 339510BQ1
4 8,355,000|5.250|Term Bonds due July 1, 2028 Price 102.796%* to Yield 4.900%|CUSIP†: 339510BR9
4 8,005,000|5.250|Term Bonds due July 1, 2039 Price 99.286% to Yield 5.300%|CUSIP†: 339510BT5
test row 5,580,000|5.000|Term Bonds due July 1, 2023 Price 104.077% to Yield 4.500%|CUSIP†: 339510BQ1 ) against types ( large_num|small_float|complex|other ) has 0.000000 unmatching types
5 2013|555,000|5.000|100.794|339511DT1
5 2015|1,235,000|5.000|105.314|339511DV6
5 2018|5,150,000|3.750|101.785|339511DY0
5 2019|2,350,000|4.000|101.655|339511DZ7
5 2019|3,000,000|5.000|107.186|339511EA1
5 9,790,000|3.500|Term Bonds due July 1, 2017|Price 101.976% to Yield 3.000%|CUSIP†: 339511DX2
5 8,560,000|4.750|Term Bonds due July 1, 2023|Price 102.027% to Yield 4.500%|CUSIP†: 339511EC7
5 5,950,000|4.750|Term Bonds due July 1, 2028|Price 97.347% to Yield 5.000%|CUSIP†: 339511ED5
test row 2013|555,000|5.000|100.794|339511DT1 ) against types ( integer|large_num|small_float|small_float|other ) has 0.000000 unmatching types
2 INTRODUCTION|1
2 THE SERIES 2013 BONDS|3
2 General|3
2 Discontinuation of Book-Entry System|3
2 Form and Denomination of and Payments on the Series 2013 Bonds|3
2 Redemption|4
2 BOOK-ENTRY SYSTEM|7
2 SECURITY FOR THE SERIES 2013 BONDS|9
2 General|9
2 Designated Affiliates|10
2 RATE AND LIQUIDITY COVENANTS|10
2 PARITY BONDS|11
2 PLAN OF FINANCE|12
2 THE AUTHORITY|12
2 Powers|12
2 Members of the Authority|12
2 ESTIMATED SOURCES AND USES OF FUNDS|13
2 ESTIMATED ANNUAL DEBT SERVICE REQUIREMENTS|14
2 HISTORICAL AND HISTORICAL PRO-FORMA DEBT SERVICE REQUIREMENTS|15
2 BONDHOLDERS’ RISKS|16
2 Introduction|16
2 Concerning the Medical Center’s Operations|16
2 Impact of Recent Economic Recession and Disruption of Credit Markets|17
2 Health Care Reform|18
2 Other Federal and State Regulations|21
2 Medicare|21
2 Medicaid|22
2 Private Health Plans and Insurers|23
2 Blue Cross and Blue Shield of Michigan|24
2 Factors Concerning Enforceability Generally|24
2 Changes in Health Care Delivery|24
2 Audits, Exclusions, Fines, Enforcement and Other Action|25
2 Malpractice Claims and General Liability Insurance|29
2 Workers’ Compensation|29
2 Failure to Obtain Certificates of Need|29
2 Licensing, Surveys, Investigations and Audits|30
2 Antitrust|30
2 Environmental Laws and Regulations|31
2 Certain Matters Relating to Security for the Series 2013 Bonds|31
2 Bankruptcy Filing|32
2 Additional Indebtedness|33
2 Tax-Exempt Status; Continuing Legal Requirements|33
2 Bond Ratings|33
2 Lack of Secondary Market for the Series 2013 Bonds|34
2 Other Risk Factors|34
2 LITIGATION|35
2 The Authority|35
test row INTRODUCTION|1 ) against types ( other|integer ) has 0.000000 unmatching types
2 The Medical Center|35
2 LEGAL MATTERS|36
2 TAX MATTERS|36
2 General|36
2 Tax Treatment of Accruals on Original Issue Discount Bonds|37
2 Amortizable Bond Premium|37
2 Future Developments|37
2 RATINGS|38
2 VERIFICATION OF MATHEMATICAL ACCURACY|38
2 FINANCIAL ADVISOR|39
2 FINANCIAL STATEMENTS|39
2 UNDERWRITING|39
2 CONTINUING DISCLOSURE|39
2 The Medical Center|39
2 The Authority|41
2 MISCELLANEOUS|41
test row The Medical Center|35 ) against types ( other|integer ) has 0.000000 unmatching types
4 2018|15,000|2021|1,300,000
4 2019|530,000|2022|1,365,000
4 2020|935,000|2023|1,435,000
test row 2018|15,000|2021|1,300,000 ) against types ( integer|large_num|integer|large_num ) has 0.000000 unmatching types
4 2024|1,505,000|2027|1,755,000
4 2025|1,580,000|2028|1,850,000
test row 2024|1,505,000|2027|1,755,000 ) against types ( integer|large_num|integer|large_num ) has 0.000000 unmatching types
4 2029|560,000|2035|755,000
4 2030|585,000|2036|795,000
4 2031|615,000|2037|840,000
4 2032|645,000|2038|880,000
4 2033|685,000|2039|930,000
test row 2029|560,000|2035|755,000 ) against types ( integer|large_num|integer|large_num ) has 0.000000 unmatching types
4 2024|1,085,000|2027|1,245,000
4 2025|1,130,000|2028|1,305,000
test row 2024|1,085,000|2027|1,245,000 ) against types ( integer|large_num|integer|large_num ) has 0.000000 unmatching types
4 Series 2013 Bond Proceeds|21,940,000|36,590,000|58,530,000
4 Net Original Issue Premium|403,947|625,543|1,029,489
4 TOTAL SOURCES OF FUNDS|22,343,947|40,697,444|63,041,391
test row Series 2013 Bond Proceeds|21,940,000|36,590,000|58,530,000 ) against types ( other|large_num|large_num|large_num ) has 0.000000 unmatching types
4 Debt Service Reserve Fund|1,873,159|3,659,000|5,532,159
4 Costs of Issuance (1)|484,451|734,762|1,219,213
4 TOTAL USES OF FUNDS|22,343,947|40,697,444|63,041,391
test row Bonds To Be Refunded|36,303,682|36,303,682 ) against types ( other|large_num|large_num|large_num ) has 0.000000 unmatching types
8 2018|15,000|1,137,900|5,150,000|1,126,350|1,304,904|2,343,084|11,077,237
8 2019|530,000|1,137,150|5,350,000|933,225|845,441|2,284,652|11,080,468
8 2020|935,000|1,110,650|5,590,000|689,225|500,000|2,251,825|11,076,700
8 2021|1,300,000|1,063,900|945,000|423,700|210,000|2,222,625|6,165,225
8 2022|1,365,000|998,900|990,000|378,813|225,000|2,207,925|6,165,638
8 2023|1,435,000|930,650|1,035,000|331,788|240,000|2,192,175|6,164,613
8 2024|1,505,000|858,900|1,085,000|282,625|260,000|2,175,375|6,166,900
8 2025|1,580,000|779,888|1,130,000|231,088|280,000|2,157,175|6,158,150
8 2026|1,665,000|696,938|1,185,000|177,413|300,000|2,137,575|6,161,925
8 2027|1,755,000|609,525|1,245,000|121,125|320,000|2,116,575|6,167,225
8 2028|1,850,000|517,388|1,305,000|61,988|335,000|2,094,175|6,163,550
8 TOTAL|21,940,000|17,467,109|36,590,000|10,973,783|50,216,476|51,754,195|188,941,563
test row 2013|338,209|555,000|385,296|5,028,007|2,966,827|9,273,339 ) against types ( integer|large_num|large_num|large_num|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 (Dollars in Thousands)|2010|2011|2012|(Annualized)
5 Expenses|5,150|4,607|4,230|774
5 Depreciation and Amortization|11,115|10,813|13,425|16,600
5 Interest Expense|3,713|3,840|4,441|5,682
5 Income Available for Debt Service|19,978|19,260|22,096|23,056
5 Historical Maximum Annual Debt Service Requirement|9,548|9,548|10,329|10,329
5 Maximum Annual Debt Service Coverage Ratio (x)|2.09|2.02|2.14|2.23
5 Requirement(2)|11,154|11,154|11,154|11,154
5 Pro-Forma Maximum Annual Debt Service Coverage Ratio (x)|1.79|1.73|1.98|2.07
test row (Dollars in Thousands)|2010|2011|2012|(Annualized) ) against types ( other|large_num|large_num|large_num|large_num ) has 0.800000 unmatching types
test row Revenues, Gains and Other Support in Excess of ) against types ( other|large_num|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Depreciation and Amortization|11,115|10,813|13,425|16,600 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
2 GENERAL BACKGROUND|1
2 Introduction|1
2 Historical Background and Facilities|1
2 MEDICAL CENTER AFFILIATES|2
2 Hurley Health Services|2
2 The Hurley Clinics|3
2 Hurley Practice Management Services|3
2 The Hurley Foundation|3
2 Genesys Hurley Cancer Institute|3
2 SERVICES AND PROGRAMS|4
2 Commitment to Community and Community Involvement|5
2 HONORS AND AWARDS|7
2 EDUCATIONAL PROGRAMS AND ACCREDITATIONS|8
2 STRATEGIC INITIATIVES|8
2 Innovative Access to Health Care|8
2 Community Health|9
2 Clinical Excellence|10
2 Academic Excellence|10
2 Physician Alignment|11
2 GOVERNANCE AND MANAGEMENT|12
2 Corporate Governance|12
2 Executive Management|14
2 SERVICE AREA|18
2 Population|20
2 Economic Activity|20
2 COMPETITION|23
2 MEDICAL STAFF|25
2 EMPLOYEES|30
2 Nursing Staff|30
test row GENERAL BACKGROUND|1 ) against types ( other|integer ) has 0.000000 unmatching types
2 HISTORICAL OPERATIONS|31
2 Licensed and Staffed Beds|31
2 Utilization|31
2 Sources of Patient Service Revenue|32
2 SUMMARY FINANCIAL INFORMATION|32
2 MANAGEMENT’S DISCUSSION OF FINANCIAL PERFORMANCE|35
2 Statement of Net Assets|35
2 Operating Income|35
2 Non-operating Revenues and Expenses|36
2 Capital Asset and Debt Administration|36
2 Historical and Pro Forma Maximum Annual Debt Service Coverage|37
2 Historical and Pro Forma Capitalization|38
2 Historical and Pro Forma Liquidity|39
2 LICENSES, ACCREDITATIONS AND MEMBERSHIPS|39
2 MALPRACTICE AND LIABILITY INSURANCE|40
test row HISTORICAL OPERATIONS|31 ) against types ( other|integer ) has 0.000000 unmatching types
2 Genesee County|88.9
2 Lapeer County|2.8
2 Shiawassee County|1.6
2 Oakland County|1.2
2 Saginaw County|1.1
2 Tuscola County|1.0
2 Other Counties|3.4
2 Total|100.0
test row Genesee County|88.9 ) against types ( other|small_float ) has 0.000000 unmatching types
4 Primary Service Area|124,943|112,900|-9.6%
4 Secondary Service Area|311,198|315,890|1.5
4 Genesee County|436,141|422,080|-3.2%
test row 2011|Percent Change ) against types ( other|large_num|large_num|complex ) has 1.000000 unmatching types
test row Estimate|2000-2011 ) against types ( other|large_num|large_num|complex ) has 1.000000 unmatching types
test row Secondary Service Area|311,198|315,890|1.5 ) against types ( other|large_num|large_num|complex ) has 0.250000 unmatching types
5 Hospital|2009|2010|2011|November 2012
5 City of Flint*|14.5|13.8|10.9|7.8
5 Michigan|13.4|12.6|10.3|8.9
5 National|9.3|9.6|8.9|7.8
test row Hospital|2009|2010|2011|November 2012 ) against types ( other|small_float|small_float|small_float|small_float ) has 0.800000 unmatching types
test row Michigan|13.4|12.6|10.3|8.9 ) against types ( other|small_float|small_float|small_float|small_float ) has 0.000000 unmatching types
4 Population|436,141|422,080|-3.22%
4 Households|170,030|164,683|-3.14%
4 Average Household Income|41,951|43,307|3.23
test row 2000|2011 Estimate|% Change ) against types ( other|large_num|large_num|complex ) has 1.000000 unmatching types
test row Population|436,141|422,080|-3.22% ) against types ( other|large_num|large_num|complex ) has 0.000000 unmatching types
3 Health Care & Social Assistance|22,132|19.89
3 Retail Trade|19,348|17.39
3 Accommodation & Food Services|11,895|10.69
3 Manufacturing|10,413|9.36
3 Administration & Support|8,895|8.00
3 Professional, Scientific & Technical|4,978|4.47
3 Wholesale Trade|4,765|4.28
3 Finance & Insurance|4,590|4.13
3 Public Administration|4,188|3.76
3 Other|3,975|3.57
3 Construction|3,385|3.04
3 Transportation & Warehousing|3,263|2.93
3 Information|3,263|2.93
3 Educational Services|2,700|2.43
3 Arts, Entertainment & Recreation|1,688|1.52
3 Real Estate, Rental & Leasing|1,335|1.20
3 Natural Resources & Mining|238|0.21
3 Management|222|0.20
3 TOTAL|111,273|100.00
test row Health Care & Social Assistance|22,132|19.89 ) against types ( other|large_num|small_float ) has 0.000000 unmatching types
3 General Motors|7,000|Automotive
3 Genesys Health System|3,000|Healthcare
3 Hurley Medical Center|2,500|Healthcare
3 McLaren Medical Center|1,500|Healthcare
3 US Post Office|800|Government
3 Charles Stewart Mott College|750|Colleges & Universities
3 University of Michigan - Flint|750|Colleges & Universities
3 Meijer|700|Retail
3 Citizens Banking Corporation|600|Banking
test row General Motors|7,000|Automotive ) against types ( other|integer|other ) has 0.333333 unmatching types
4 Genesys Health System|31.5|30.4|30.2
4 Hurley Medical Center|28.5|28.0|27.4
4 McLaren Regional Medical Center|29.0|29.9|30.0
4 All Others|11.0|11.7|12.4
test row 2009|2010|2011 ) against types ( other|small_float|small_float|small_float ) has 1.000000 unmatching types
test row Hurley Medical Center|28.5|28.0|27.4 ) against types ( other|small_float|small_float|small_float ) has 0.000000 unmatching types
4 Hurley Medical Center|Flint|414|-
4 McLaren Regional Medical Center|Flint|335|2 miles (8 min)
4 Genesys Regional Medical Center|Grand Blanc|410|13 miles (18 min)
test row Hurley Medical Center|Flint|414|- ) against types ( other|other|integer|other ) has 0.000000 unmatching types
6 General Medicine|40%|36%|17%|5%|6,627
6 Cardiac Services|31%|47%|17%|5%|2,973
6 OB/GYN|64%|12%|22%|1%|2,406
6 Psychiatry|52%|41%|0%|6%|1,368
6 General Surgery|46%|29%|16%|9%|1,241
6 Neurosciences|41%|36%|15%|10%|1,236
6 Orthopedics|40%|28%|20%|11%|902
6 Neonatology - NICU|72%|5%|20%|4%|572
6 Oncology/Hematology|49%|24%|16%|11%|547
6 Vascular Services|29%|37%|22%|11%|476
6 Spine|28%|33%|26%|14%|316
6 Rehabilitation|47%|28%|20%|6%|305
6 ENT|57%|26%|10%|6%|259
6 Urology|23%|47%|12%|20%|230
6 Other Trauma|70%|19%|8%|4%|197
6 Other|27%|38%|16%|21%|139
test row Hurley|Genesys|2011 ) against types ( other|other|other|other|other|integer ) has 0.000000 unmatching types
2 Active|284
2 Courtesy|96
2 Consulting|38
2 Emeritus|2
2 Provisional|92
2 Leave of Absence|3
2 TOTAL|515
test row Active|284 ) against types ( other|integer ) has 0.000000 unmatching types
3 Medicine|138|26.8
3 Surgery|134|26.0
3 Pediatrics|87|16.9
3 Family Practice|43|8.4
3 Obstetrics/Gynecology|29|5.6
3 Emergency Medicine|28|5.4
3 Radiology|22|4.3
3 Psychiatry|9|1.7
3 Psychology|9|1.7
3 Anesthesiology|6|1.2
3 Pathology|5|1.0
3 Radiation Oncology|4|0.8
3 Pediatric Emergency Medicine|1|0.2
3 Total|515|100%
test row Medicine|138|26.8 ) against types ( other|integer|small_float ) has 0.000000 unmatching types
4 1. Internal Medicine|54|614|3.2(1)
4 2. Internal Medicine|61|598|3.1
4 3. OB/Gyn|55|405|2.1(2)
4 4. Internal Medicine/Peds|57|404|2.1
4 5. OB/Gyn|41|394|2.1(2)
4 6. Internal Medicine/Peds|54|385|2.0(1)
4 7. Psychiatry|70|361|1.9(3)
4 8. Pediatric Critical Care Medicine|53|358|1.9(4)
4 9. Pediatric Critical Care Medicine|61|348|1.8(4)
4 10. Neonatology|67|336|1.8
4 11. Geriatric Medicine|54|312|1.6
4 12. Pediatric Medicine|44|294|1.5
4 13. Surgical Critical Care|45|292|1.5
4 14. Internal Medicine Hospitalist|30|280|1.5
4 15. Obstetrics|39|276|1.5
4 16. Pediatric Medicine|71|273|1.4
4 17. Internal Medicine/Peds|39|268|1.4
4 18. Internal Medicine Hospitalist|35|266|1.4
4 19. Psychiatry|38|240|1.3(3)
4 20. Surgery, General|51|236|1.2
test row 1. Internal Medicine|54|614|3.2(1) ) against types ( other|integer|integer|small_float ) has 0.250000 unmatching types
6 Allergy / Immunology|6|68|0.0|-|1
6 Anesthesiology|6|54|0.0|-|-
6 Cardiology|22|52|0.4|5|4
6 Cardiothoracic Surgery|2|58|0.0|1|-
6 Clinical Psychology|1|60|0.0|-|-
6 Critical Care Medicine|1|35|0.0|1|-
6 Dentistry|1|32|0.0|-|-
6 Dermatology|3|55|0.0|-|1
6 Diagnostic Radiology|16|53|0.0|4|6
6 Emergency Medicine|29|43|0.4|5|11
6 Endocrinology|3|55|0.4|-|1
6 Family Practice|26|56|1.6|4|8
6 Gastroenterology|8|58|0.0|1|-
6 General Surgery|11|59|5.1|3|6
6 Geriatric Medicine|3|53|2.6|-|-
6 Hematology/Oncology|7|57|0.2|-|5
6 Infectious Disease|3|59|0.1|1|1
6 Internal Medicine|44|52|23.0|8|26
6 Internal Medicine / Pediatrics|16|51|9.7|-|1
6 Interventional Radiology|3|59|0.0|-|3
6 Maternal / Fetal Medicine|3|56|0.2|2|1
6 Neonatology|6|59|5.3|1|-
6 Nephrology|16|49|0.6|5|2
6 Neurological Surgery|3|55|0.4|-|1
6 Neurology|8|51|0.0|-|3
6 Neuropsychology|1|45|0.0|-|-
6 Neuroradiology|1|45|0.0|-|1
6 Obstetrics / Gynecology|25|54|16.2|2|5
6 Ophthalmic Plastic/Reconstructive Surgery|2|41|0.0|1|-
6 Ophthalmology|16|49|0.0|2|1
6 Oral & Maxillofacial Surgery|4|56|0.0|-|1
6 Orthopedic Surgery|14|50|2.9|5|1
6 Otolaryngology|9|60|0.3|-|-
6 Pathology|5|54|0.0|-|-
6 Pediatric Cardiology|3|52|0.0|-|3
6 Pediatric Critical Care Medicine|4|56|4.7|1|4
6 Pediatric Dentistry|11|49|0.0|2|-
6 Pediatric Endocrinology|4|63|0.1|-|-
6 Pediatric Gastroenterology|1|48|0.1|-|3
6 Pediatric Hematology / Oncology|4|59|1.5|-|-
6 Pediatric Infectious Disease|-|-|0.2|-|1
6 Pediatric Nephrology|5|47|0.0|2|1
test row Allergy / Immunology|6|68|0.0|-|1 ) against types ( other|integer|integer|small_float|other|integer ) has 0.000000 unmatching types
6 Pediatric Neurology|5|56|0.0|-|-
6 Psych|1|40|0.0|-|-
6 Pediatric Ophthalmology|4|52|0.0|4|-
6 Pediatric Psychology|-|-|0.0|-|1
6 Pediatric Pulmonology|5|49|0.0|2|1
6 Pediatric Surgery|9|50|0.0|8|6
6 Pediatrics|45|53|11.1|7|5
6 Physical Medicine & Rehabilitation|8|53|0.0|-|2
6 Plastic Surgery|5|58|0.4|2|-
6 Podiatry|14|48|0.0|1|1
6 Psychiatry|9|62|6.3|-|5
6 Psychology|6|47|0.0|3|5
6 Pulmonary Medicine|9|54|0.8|-|-
6 Pulmonary/Critical Care Medicine|1|41|0.0|1|2
6 Radiation Oncology|4|61|0.0|1|1
6 Reproductive Endocrinology|1|61|0.0|-|-
6 Rheumatology|3|62|0.3|-|1
6 Surgical Critical Care|4|47|3.7|1|1
6 Surgical Oncology|1|59|0.0|1|-
6 Telemedicine|-|-|0.0|-|3
6 Teleradiology|2|43|0.0|2|1
6 Thoracic Surgery|1|63|0.0|-|-
6 Trauma|2|49|0.7|3|1
6 Urology|9|57|0.1|-|-
6 Vascular Surgery|11|51|0.3|3|1
test row Pediatric Neurology|5|56|0.0|-|- ) against types ( other|integer|integer|small_float|integer|integer ) has 0.333333 unmatching types
3 CRNA|9|10
3 Nurse Practitioners|14|16
3 Physician Assistants|14|14
3 Prosthesis|6|3
test row CRNA|9|10 ) against types ( other|integer|integer ) has 0.000000 unmatching types
4 Type of Beds|2010|2011|2012
4 Behavioral Health|60|60|60
4 Burn Care|13|13|13
4 Coronary Care|13|13|13
4 General Medical/Surgical|171|171|171
4 Intensive Care|15|15|15
4 Neonatal Intensive Care|44|44|44
4 Neurotrama|18|18|18
4 Obstetrics|46|46|46
4 Pediatric|28|28|28
4 Pediatric Intensive Care|13|13|13
4 Physical Rehabilitation|22|22|22
4 Total Licensed Beds|443|443|443
4 Total Staffed Beds|414|414|414
test row Type of Beds|2010|2011|2012 ) against types ( other|integer|integer|integer ) has 0.000000 unmatching types
6 Licensed Beds|443|443|443|443|443
6 Discharges|21,438|19,956|19,083|9,428|9,281
6 Patient Days|107,366|106,863|99,822|49,346|49,010
6 Average Length of Stay (days)|5.01|5.35|5.23|5.23|5.28
6 Inpatient Surgeries|4,050|4,214|3,742|1,943|1,953
6 Observations|2,345|2,805|2,971|1,539|1,555
6 Emergency Room Visits|82,631|88,584|94,244|45,543|49,330
6 Other Outpatient Visits|296,735|300,993|310,539|148,677|156,525
6 Ambulatory Surgery Cases|6,735|6,553|6,557|3,216|2,930
6 Medicare Case Mix Index|1.61|1.61|1.56|1.60|1.61
test row 2010|2011|2012|2011|2012 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Licensed Beds|443|443|443|443|443 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.833333 unmatching types
test row Patient Days|107,366|106,863|99,822|49,346|49,010 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
6 Medicare|24.2|23.2|22.4|22.3|22.3
6 Medicare HMO|4.0|3.8|5.0|5.1|4.7
6 Medicaid|9.8|10.2|9.9|10.2|10.1
6 Medicaid HMO|27.4|29.1|29.5|29.7|29.6
6 Blue Cross|12.2|12.4|11.7|11.7|11.5
6 Commercial HMOs|6.7|6.4|6.1|5.9|5.5
6 All Others|15.7|14.9|15.4|15.1|16.3
6 Total Gross Revenue|100.0|100.0|100.0|100.0|100.0
test row 2010|2011|2012|2011|2012 ) against types ( other|small_float|small_float|small_float|small_float|small_float ) has 1.000000 unmatching types
test row Medicare HMO|4.0|3.8|5.0|5.1|4.7 ) against types ( other|small_float|small_float|small_float|small_float|small_float ) has 0.000000 unmatching types
6 Net Patient Service Revenue|330,600|319,875|326,353|160,854|165,729
6 Other Operating Revenue|28,332|31,331|33,152|18,483|17,745
6 Total Operating Revenue|358,932|351,206|359,505|179,337|183,474
6 Amortization|11,115|10,813|13,425|6,765|8,300
6 Interest|3,713|3,840|4,441|1,819|2,841
6 All Other|340,480|335,573|345,074|172,716|172,636
6 Total Operating Expenses|355,308|350,226|362,940|181,300|183,777
6 Operations|3,624|980|(3,435)|(1,963)|(303)
6 Non-Operating Revenues|1,526|3,627|7,665|4,134|690
6 Expenses|5,150|4,607|4,230|2,171|387
test row 2010|2011|2012|2011|2012 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Other Operating Revenue|28,332|31,331|33,152|18,483|17,745 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
6 Assets|2010|2011|2012|2011|2012
6 Cash|25,373|7,129|2,601|14,486|6,384
6 Patient Accounts Receivables, Net|29,963|32,846|44,776|34,506|56,481
6 Other Receivables|12,983|11,975|13,394|14,476|9,687
6 Other Assets|9,601|11,899|12,172|11,931|11,901
6 Total Current Assets|77,920|63,849|72,943|75,399|84,453
6 Investments|67,689|77,561|67,381|75,350|57,883
6 Restricted|59,405|44,327|33,577|37,262|26,405
6 Total Other Assets|9,000|6,319|7,857|7,137|8,413
6 Property, Plant and Equipment, Net|73,245|95,341|114,337|100,331|113,940
6 Total Assets|287,259|287,397|296,095|295,479|291,094
test row Assets|2010|2011|2012|2011|2012 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.833333 unmatching types
test row Cash|25,373|7,129|2,601|14,486|6,384 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
6 Liabilities and Fund Net Assets|2010|2011|2012|2011|2012
6 Current Portion of Long-term Debt|3,285|3,965|4,823|4,170|4,649
6 Accounts Payable and Other|18,356|18,889|21,412|15,332|15,139
6 Accrued Expenses|54,255|53,065|50,605|62,168|57,605
6 Total Current Liabilities|75,896|75,919|76,840|81,670|77,393
6 Other Liabilities|32,421|31,085|35,245|29,457|32,368
6 Long-term Debt, Less Current Portion|86,918|83,179|83,276|84,137|79,000
6 Total Liabilities|195,235|190,183|195,361|195,264|188,761
6 Fund Net Assets|92,024|97,214|100,734|100,215|102,333
6 Total Liabilities and Fund Net Assets|287,259|287,397|296,095|295,479|291,094
test row Liabilities and Fund Net Assets|2010|2011|2012|2011|2012 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.833333 unmatching types
test row Current Portion of Long-term Debt|3,285|3,965|4,823|4,170|4,649 ) against types ( other|large_num|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 (Dollars in Thousands)|2010|2011|2012|2012
5 Expenses|5,150|4,607|4,230|774
5 Depreciation and Amortization|11,115|10,813|13,425|16,600
5 Interest Expense|3,713|3,840|4,441|5,682
5 Income Available for Debt Service|19,978|19,260|22,096|23,056
5 Historical Maximum Annual Debt Service Requirement|9,548|9,548|10,329|10,329
5 Maximum Annual Debt Service Coverage Ratio (x)|2.09|2.02|2.14|2.23
5 Pro-Forma Maximum Annual Debt Service Requirement|11,154|11,154|11,154|11,154
5 Pro-Forma Maximum Annual Debt Service Coverage Ratio (x)|1.79|1.73|1.98|2.07
test row (Dollars in Thousands)|2010|2011|2012|2012 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.800000 unmatching types
test row Revenues, Gains and Other Support in Excess of ) against types ( other|large_num|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Depreciation and Amortization|11,115|10,813|13,425|16,600 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 (Dollars in Thousands)|2010|2011|2012|2012
5 Outstanding Long-Term Debt|86,918|83,179|83,276|106,241
5 Unrestricted Net Assets|87,022|91,629|95,859|95,859
5 Total Capitalization|173,940|174,808|179,135|202,100
5 Long-Term Debt to Capitalization|50.0|47.6|46.5|52.6
test row (Dollars in Thousands)|2010|2011|2012|2012 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.800000 unmatching types
test row Outstanding Long-Term Debt|86,918|83,179|83,276|106,241 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 Cash and Cash Equivalents|2,601|6,384|10,101|13,884
5 Investments|67,381|57,883|67,381|57,883
5 Total|69,982|64,267|77,482|71,767
5 Total Operating Expenses|362,940|367,554|362,940|367,554
5 plus Bad Debt Expense|48,168|46,154|48,168|46,154
5 less Depreciation & Amortization|13,425|16,600|13,425|16,600
5 Total|397,683|397,108|397,683|397,108
5 Days Cash on Hand|64|59|71|66
5 Total Long Term Debt|83,276|79,000|106,241|101,965
5 Long Term Debt|84.04|81.35|72.9 %|70.4 %
test row 2012|2012|2012|2012 ) against types ( other|large_num|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Cash and Cash Equivalents|2,601|6,384|10,101|13,884 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
2 Assets (Deficit)|8
2 Statement of Cash Flows|9-10
2 Statement of Net Assets|11
2 Statement of Changes in Net Assets|12
2 Notes to Financial Statements|13-41
2 Required Supplemental Information|42
2 Retirement System - Analysis of Funding Progress|43
2 Additional Information|44
2 Report Letter|45
2 Consolidating Balance Sheet|46-47
2 Consolidating Statement of Operations|48
test row Assets (Deficit)|8 ) against types ( other|integer ) has 0.000000 unmatching types
4 Current assets|72,943|63,848|77,919
4 Assets limited as to use|100,958|121,889|127,094
4 Capital assets|114,337|95,341|73,245
4 Other assets|7,857|6,319|9,001
4 Total assets|296,095|287,397|287,259
4 Current liabilities|76,840|75,919|75,896
4 Long-term debt|83,276|83,179|86,918
4 Accrued expenses|35,245|31,085|32,421
4 Total liabilities|195,361|190,183|195,235
4 related debt|44,058|36,750|27,185
4 operating activities|4,875|5,585|5,002
4 Unrestricted|51,801|54,879|59,837
4 Total net assets|100,734|97,214|92,024
test row 2012|2011|2010 ) against types ( other|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Current assets|72,943|63,848|77,919 ) against types ( other|large_num|large_num|large_num ) has 0.000000 unmatching types
4 Net patient service revenue|326,353|319,875|330,600
4 Other operating revenue|33,152|31,331|28,332
4 Total operating revenues|359,505|351,206|358,932
4 Salaries and wages|155,886|150,174|147,091
4 Employee benefits and payroll taxes|59,117|55,342|60,670
4 Operating supplies and expenses|42,256|42,703|44,073
4 Professional services|40,535|38,869|38,769
4 Purchased services and other|47,281|48,485|49,877
4 Depreciation and amortization|13,425|10,813|11,115
4 Total operating expenses|358,500|346,386|351,595
4 Nonoperating Revenues (Expenses)|2,094|(351)|(2,190)
4 Before Other Activity|3,099|4,469|5,147
4 unrestricted|421|721|(25)
4 Increase in Net Assets|3,520|5,190|5,122
4 Net Assets - End of year|100,734|97,214|92,024
test row 2012|2011|2010 ) against types ( other|large_num|large_num|large_num ) has 1.000000 unmatching types
test row Net patient service revenue|326,353|319,875|330,600 ) against types ( other|large_num|large_num|large_num ) has 0.000000 unmatching types
5 Cash and cash equivalents|2,601,048|458,913|7,128,815|474,720
5 (Note 4)|44,776,227|203,121|32,845,914|291,519
5 Other receivables|6,134,811|668,016|5,274,848|396,707
5 settlements (Note 3)|7,259,116|-|6,700,021|-
5 Assets limited as to use (Note 5)|5,330,565|154,084|5,232,583|153,303
5 Prepaid expenses and other|2,336,387|140,495|2,441,796|551,506
5 Inventory|4,504,727|10,734|4,224,152|20,750
5 Total current assets|72,942,881|1,635,363|63,848,129|1,888,505
5 By the board|67,381,409|154,084|77,561,128|153,303
5 Held by trustee - Bond|18,020,907|-|29,540,804|-
5 Restricted and held in trust - Other|20,886,656|-|20,019,106|-
5 Total assets limited as to use|106,288,972|154,084|127,121,038|153,303
test row Cash and cash equivalents|2,601,048|458,913|7,128,815|474,720 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 use is limited|100,958,407|-|121,888,455|-
5 Capital Assets - Net (Note 18)|114,336,841|205,733|95,341,253|257,290
5 Investment in joint ventures (Note 15)|6,776,600|6,000|5,175,260|6,000
5 Deferred defeasance loss - Net|336,567|-|414,052|-
5 Bond issue costs - Net|744,070|-|729,810|-
5 Other|-|150,000|-|150,000
5 Total assets|296,095,366|1,997,096|287,396,959|2,301,795
test row use is limited|100,958,407|-|121,888,455|- ) against types ( other|large_num|large_num|large_num|large_num ) has 0.400000 unmatching types
5 (Note 6)|4,823,007|-|3,965,000|-
5 Accounts payable and taxes withheld|21,412,199|1,183,059|18,889,233|289,213
5 settlements (Note 3)|16,555,939|-|18,994,846|-
5 Accrued expenses|34,048,769|930,953|34,069,497|745,068
5 Total current liabilities|76,839,914|2,114,012|75,918,576|1,034,281
5 portion (Note 6)|83,275,749|-|83,179,382|-
5 Accrued Expenses (Note 14)|35,245,413|-|31,084,862|-
5 Total liabilities|195,361,076|2,114,012|190,182,820|1,034,281
5 related debt|44,057,866|205,733|36,750,429|257,290
5 activities|4,874,957|-|5,584,506|-
5 Unrestricted|51,801,467|(322,649)|54,879,204|1,010,224
5 Total fund net assets|100,734,290|(116,916)|97,214,139|1,267,514
5 assets|296,095,366|1,997,096|287,396,959|2,301,795
test row (Note 6)|4,823,007|-|3,965,000|- ) against types ( other|large_num|large_num|large_num|large_num ) has 0.400000 unmatching types
5 Net patient service revenue|326,352,745|2,405,846|319,874,843|2,419,985
5 Other operating revenue|33,151,925|17,830,696|31,331,148|17,910,196
5 Total operating revenues|359,504,670|20,236,542|351,205,991|20,330,181
5 Salaries and wages|155,886,264|14,427,961|150,174,351|14,466,600
5 Employee benefits and payroll taxes|59,116,728|2,813,027|55,342,212|2,693,142
5 Operating supplies and expenses|42,255,917|-|42,702,389|-
5 Professional services|40,535,293|817,500|38,868,577|838,711
5 Purchased services and other|47,280,666|3,520,351|48,484,736|3,295,405
5 Depreciation and amortization|13,424,621|22,613|10,813,334|25,961
5 Total operating expenses|358,499,489|21,601,452|346,385,599|21,319,819
5 Net Operating Income (Loss)|1,005,181|(1,364,910)|4,820,392|(989,638)
5 Investment income (Note 5)|4,251,069|884|2,010,987|3,912
5 Joint venture income|2,281,471|-|1,469,880|-
5 Other income (expense)|2,000|(20,404)|8,302|(9,742)
5 Interest expense|(4,440,616)|-|(3,840,106)|-
5 (expenses)|2,093,924|(19,520)|(350,937)|(5,830)
test row Net patient service revenue|326,352,745|2,405,846|319,874,843|2,419,985 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 and Transfer of Funds|3,099,105|(1,384,430)|4,469,455|(995,468)
5 for the purchase of capital assets|1,130,591|-|137,734|-
5 Activity and Transfer of Funds|4,229,696|(1,384,430)|4,607,189|(995,468)
5 Restricted gifts and bequests|1,163,808|-|1,464,010|-
test row and Transfer of Funds|3,099,105|(1,384,430)|4,469,455|(995,468) ) against types ( other|large_num|complex|large_num|complex ) has 0.000000 unmatching types
5 Increase (Decrease) in Net Assets|3,520,151|(1,384,430)|5,190,414|(995,468)
5 Fund Net Assets - Beginning of year|97,214,139|1,267,514|92,023,725|2,262,982
5 Fund Net Assets (Deficit) - End of year|100,734,290|(116,916)|97,214,139|1,267,514
test row Increase (Decrease) in Net Assets|3,520,151|(1,384,430)|5,190,414|(995,468) ) against types ( other|large_num|complex|large_num|large_num ) has 0.200000 unmatching types
5 activities|5,204,981|(24,449)|10,817,102|(625,108)
5 Capital contributed to joint ventures|(5,000)|-|(800,000)|-
5 Distributions from joint ventures|600,000|-|950,000|-
5 Proceeds on dissolution of joint venture|-|-|3,843,079|-
5 Sale of assets whose use is limited|43,501,473|-|37,206,086|-
5 Purchases of assets whose use is limited|(17,625,319)|(781)|(34,248,707)|(1,824)
5 Investment interest and realized (losses) gains|(718,036)|884|2,299,565|3,912
5 Net cash provided by investing activities|25,753,118|103|9,250,023|2,088
5 specific purposes|1,163,808|-|1,464,010|-
5 Proceeds from issuance of long-term debt|5,074,383|-|-|-
test row activities|5,204,981|(24,449)|10,817,102|(625,108) ) against types ( other|large_num|other|large_num|other ) has 0.400000 unmatching types
5 Proceeds from sale of capital assets|39,246|10,000|65,862|5,600
5 related financing activities|(36,649,674)|8,539|(39,774,932)|2,973
5 Net Decrease in Cash and Cash Equivalents|(4,527,767)|(15,807)|(18,243,797)|(620,047)
5 Cash and Cash Equivalents - Beginning of year|7,128,815|474,720|25,372,612|1,094,767
5 Cash and Cash Equivalents - End of year|2,601,048|458,913|7,128,815|474,720
test row Proceeds from sale of capital assets|39,246|10,000|65,862|5,600 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 Operating income (loss)|1,005,181|(1,364,910)|4,820,392|(989,638)
5 Depreciation|13,424,621|22,613|10,813,334|25,961
5 Provision for bad debt|49,646,480|101,332|45,363,520|62,686
5 deferred defeasance gain|276,123|-|384,144|-
5 Loss on investment in assets|416,555|-|233,002|-
5 Contribution released from restrictions|(735,614)|-|(722,836)|-
5 settlements|(65,434,758)|(284,243)|(45,568,269)|275,979
5 Inventories|(280,575)|10,016|(107,741)|(8,593)
5 Prepaid expenses and other|110,409|411,011|(242,227)|18,055
5 Accounts payable and taxes withheld|2,522,966|893,847|533,166|62,320
5 Accrued expenses|4,253,593|185,885|(4,689,383)|(71,878)
5 joint venture|2,201,340|-|1,469,880|-
test row Operating income (loss)|1,005,181|(1,364,910)|4,820,392|(989,638) ) against types ( other|large_num|large_num|large_num|large_num ) has 0.400000 unmatching types
3 Cash and cash equivalents|6,560,791|10,705,507
3 Investment in common stock|8,759,309|17,481,605
3 Investment in corporate bonds|11,273,327|-
3 Investment in U.S. government or agency bonds|5,987,098|-
3 Investment in U.S. government CMOs|2,009,049|-
3 Total investments|28,028,783|17,481,605
3 Interest receivable|132,703|51
3 Total assets|34,722,277|28,187,163
3 Liabilities - Accrued expenses|3,286|4,397
3 Net Assets - Held in trust for retiree health benefits|34,718,991|28,182,766
test row Cash and cash equivalents|6,560,791|10,705,507 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
3 Interest|99|606
3 Dividends|657,529|323,648
3 Realized loss on sale of investment|(820,545)|-
3 Net increase in fair value of investments|1,167,951|3,839,790
3 Less investment expense|(114,389)|(52,767)
3 Net investment income|890,645|4,111,277
3 Employer contributions|7,071,235|7,426,382
3 Retiree contributions|2,202,655|2,083,249
3 Total contributions|9,273,890|9,509,631
3 Total additions|10,164,535|13,620,908
3 Deductions - Benefits payments|3,628,310|6,968,249
3 Net Increase in Net Assets Held in Trust|6,536,225|6,652,659
3 Beginning of year|28,182,766|21,530,107
3 End of year|34,718,991|28,182,766
test row Interest|99|606 ) against types ( other|large_num|large_num ) has 0.666667 unmatching types
test row Realized loss on sale of investment|(820,545)|- ) against types ( other|large_num|large_num ) has 0.666667 unmatching types
test row Less investment expense|(114,389)|(52,767) ) against types ( other|large_num|large_num ) has 0.666667 unmatching types
test row Net investment income|890,645|4,111,277 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
3 charity care|7,743,423|7,441,341
3 patients served|2.16|2.15
test row 2012|2011 ) against types ( other|large_num|large_num ) has 1.000000 unmatching types
test row Charges foregone, based on established rates|23,603,003 $ 22,485,822 ) against types ( other|large_num|large_num ) has 0.500000 unmatching types
test row charity care|7,743,423|7,441,341 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
3 Medicare|17|18
3 Blue Cross/Blue Shield of Michigan|7|6
3 Medicaid|40|40
3 Other third-party payors and patients|36|36
3 Total|100|100
test row 2012|2011 ) against types ( other|integer|integer ) has 0.000000 unmatching types
3 Cash and cash equivalents|2,010,836|3,051,354
3 2011, respectively)|38,839,534|35,728,011
3 Accrued interest receivable|176,849|191,722
3 Cash and cash equivalents|394,833|3,426,385
3 respectively)|25,811,363|34,979,927
3 Accrued interest receivable|147,994|183,729
test row 2012|2011 ) against types ( other|large_num|large_num ) has 1.000000 unmatching types
test row improvements: ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
3 Cash and cash equivalents|18,020,760|20,541,254
3 9,085,000 in 2012 and 2011, respectively)|-|8,934,180
3 Accrued interest receivable|147|65,370
3 Total - Held by trustee - Bond|18,020,907|29,540,804
3 Restricted - Cash and cash equivalents|365,314|376,694
3 Cash and cash equivalents|1,486,881|1,678,011
3 2011, respectively)|18,578,932|17,524,653
3 Accrued interest receivable|142,322|137,707
3 Total - Held in trust - Self-insurance|20,208,135|19,340,371
3 Cash and cash equivalents|74,801|71,207
3 2012 and 2011)|238,406|230,933
3 Total - Held in trust - Retirement|313,207|302,140
3 trust - Other|20,886,656|20,019,106
test row 2012|2011 ) against types ( other|large_num|large_num ) has 1.000000 unmatching types
test row Cash and cash equivalents|18,020,760|20,541,254 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
5 Series 1998B|15,775,000|-|(540,000) 15,235,000|570,000
5 Series 2010|35,215,000|-|(500,000) 34,715,000|500,000
5 Unamortized bond discount (2,065,618)|212,898|-|(1,852,720)|-
test row 2011|Additions|Reductions 2012|Year ) against types ( other|large_num|other|complex|large_num ) has 0.750000 unmatching types
test row Series 1998A|10,530,000|- $ (825,000) $ 9,705,000|870,000 ) against types ( other|large_num|other|complex|large_num ) has 0.250000 unmatching types
5 2010|Additions|Reductions|2011|Year
5 Series 1998B|16,290,000|-|(515,000) 15,775,000|540,000
5 Unamortized bond discount (2,291,650)|226,032|-|(2,065,618)|-
test row 2010|Additions|Reductions|2011|Year ) against types ( integer|large_num|other|complex|other ) has 0.600000 unmatching types
test row Series 1998A|11,315,000|- $ (785,000) $ 10,530,000|825,000 ) against types ( integer|large_num|other|complex|other ) has 0.750000 unmatching types
test row Series 2003|29,675,000|- (1,985,000) 27,690,000|2,100,000 ) against types ( integer|large_num|other|complex|other ) has 0.750000 unmatching types
test row Unamortized bond discount (2,291,650)|226,032|-|(2,065,618)|- ) against types ( integer|large_num|other|complex|other ) has 0.400000 unmatching types
3 2016|5,575,310 4,420,881|9,996,191
3 2017|5,851,931 4,097,643|9,949,574
3 2018-2022|25,400,345 15,548,831|40,949,176
3 2023-2027|6,665,000 12,075,326|18,740,326
3 2038-2040|9,940,000|781,500 10,721,500
test row 2013|4,823,007 $ 5,300,755 $ 10,123,762 ) against types ( other|complex|large_num ) has 0.500000 unmatching types
test row 2015|5,309,983 4,728,698 10,038,681 ) against types ( other|complex|large_num ) has 0.500000 unmatching types
test row 2017|5,851,931 4,097,643|9,949,574 ) against types ( other|complex|large_num ) has 0.333333 unmatching types
3 OCPP|3.75|5.75
3 Exempt|4.50|6.50
3 Others|7.00|7.00
test row OCPP|3.75|5.75 ) against types ( other|small_float|small_float ) has 0.000000 unmatching types
6 6/30/10|6/30/08|13,041,452|90.7|8,896,382|11.45
6 6/30/11|6/30/09|9,450,745|100.0|5,505,003|8.41
test row 6/30/10|6/30/08|13,041,452|90.7|8,896,382|11.45 ) against types ( other|other|large_num|small_float|large_num|small_float ) has 0.000000 unmatching types
2 Annual required contribution|11,734,785
2 Interest on net pension obligation|384,594
2 Adjustment to annual required contribution|(310,504)
2 Annual pension cost|11,808,875
2 Contributions made|10,809,936
2 Increase in net pension obligation|998,939
2 Net pension obligation - Beginning of year|5,505,003
2 Net pension obligation - End of year|6,503,942
test row Annual required contribution|11,734,785 ) against types ( other|large_num ) has 0.000000 unmatching types
3 2013|1,582,368|275,300
3 2014|1,567,395|270,798
3 2015|1,521,009|246,703
3 2016|1,521,009|239,265
3 2017|1,455,821|239,265
3 Thereafter|2,812,468|618,102
3 required|10,460,070|1,889,433
test row 2013|1,582,368|275,300 ) against types ( integer|large_num|large_num ) has 0.000000 unmatching types
3 Corporate bonds|12,180,908|1,844,211 Counterparty trust dept.
3 Repurchase agreement|10,017|1,176,174 Counterparty
3 Mutual funds|238,406|230,933 Counterparty
test row Investment Type|2012|2011|How Held ) against types ( other|large_num|complex ) has 0.750000 unmatching types
test row Corporate stocks|8,759,309 17,481,605 Counterparty trust dept. ) against types ( other|large_num|complex ) has 0.500000 unmatching types
test row Repurchase agreement|10,017|1,176,174 Counterparty ) against types ( other|large_num|complex ) has 0.000000 unmatching types
3 GNMA pool|39,341|42,903 8.9 years
3 Corporate bonds|12,180,908|1,844,211 6.7 years
3 Repurchase agreement|10,017|1,176,174 Less than one year
test row Investment|2012|2011|Maturity ) against types ( other|large_num|complex ) has 0.750000 unmatching types
test row GNMA pool|39,341|42,903 8.9 years ) against types ( other|large_num|complex ) has 0.000000 unmatching types
4 Corporate bonds|1,854,305|1,844,211 AAA|S&P
4 Corporate bonds|4,552,095|- AA+ - A-|S&P
4 Corporate bonds|5,218,339|- BBB+ - B-|S&P
4 Corporate bonds|556,169|-|Not rated
4 Repurchase agreement|10,017|1,176,174|Not rated
test row Investment|2012|2011|Rating|Rating Organization ) against types ( other|large_num|other|other ) has 0.400000 unmatching types
3 Total assets|23,164|22,279
3 Total liabilities|9,946|11,404
3 Net assets|13,218|10,875
3 Operating revenue|10,429|10,531
3 Operating expenses|6,972|6,798
3 Operating income|3,457|3,733
3 Nonoperating income|61|96
3 Excess of revenues over expenses|3,518|3,829
test row 2012|2012 ) against types ( other|large_num|large_num ) has 1.000000 unmatching types
test row Total liabilities|9,946|11,404 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
2 2013|2,655,991
2 2014|104,640
2 2015|96,506
2 2016|87,183
2 2017|58,328
2 Total|3,002,648
test row 2013|2,655,991 ) against types ( integer|large_num ) has 0.000000 unmatching types
5 Land|4,460,723|32,219|-|4,492,942
5 Land improvements|1,660,968|425,000|(152,917)|1,933,051
5 Medical Center building|122,790,462|28,931,234|(1,161,626)|150,560,070
5 Parking structure|5,336,068|108,597|(424,087)|5,020,578
5 Nurses' residence|1,828,336|-|-|1,828,336
5 Interns' apartment|292,494|-|-|292,494
5 Prospect Street apartments|1,472,538|-|(11,132)|1,461,406
5 Power plant|3,884,377|-|(28,886)|3,855,491
5 Rental property|222,047|-|(20,592)|201,455
5 Health and fitness center|4,624,505|-|(10,556)|4,613,949
5 Park Plaza|1,254,271|3,771|-|1,258,042
5 Physicians' office building|340,691|-|-|340,691
5 Davison Clinic|1,956,771|-|-|1,956,771
5 Longway Eastside Campus building|3,643,756|-|-|3,643,756
5 MOB building|167,167|-|(14,365)|152,802
5 Fenton Medical Center|199,941|-|-|199,941
5 Machinery and equipment|78,067,161|33,946,932|(8,253,040)|103,761,053
5 Automotive equipment|374,762|-|(20,407)|354,355
5 Construction in progress|38,185,748|32,834,770|(63,406,513)|7,614,005
5 Total|270,762,786|96,282,523|(73,504,121)|293,541,188
test row 2011|Additions|Transfers|2012 ) against types ( other|large_num|other|complex|large_num ) has 0.750000 unmatching types
test row Land|4,460,723|32,219|-|4,492,942 ) against types ( other|large_num|other|complex|large_num ) has 0.400000 unmatching types
5 Land improvements|1,185,706|75,402|(128,319)|1,132,789
5 Medical Center building|95,310,026|4,034,251|(1,077,584)|98,266,693
5 Parking structure|4,740,547|93,816|(422,489)|4,411,874
5 Nurses' residence|1,601,110|55,976|-|1,657,086
5 Interns' apartment|288,418|2,582|-|291,000
5 Prospect Street apartments|1,234,282|20,634|(11,132)|1,243,784
5 Power plant|2,456,670|113,277|(28,886)|2,541,061
5 Rental property|220,325|689|(20,592)|200,422
5 Health and fitness center|4,557,266|7,362|(10,556)|4,554,072
5 Park Plaza|1,146,365|27,352|-|1,173,717
5 Physicians' office building|309,997|11,223|-|321,220
5 Davison Clinic|779,508|56,765|-|836,273
5 Longway Eastside Campus building|1,344,953|135,859|-|1,480,812
5 MOB building|35,662|19,506|(3,830)|51,338
5 Fenton Medical Center|56,200|22,121|-|78,321
5 Machinery and equipment|59,916,986|8,702,639|(7,918,013)|60,701,612
5 Automotive equipment|237,512|45,167|(20,406)|262,273
5 Total|175,421,533|13,424,621|(9,641,807)|179,204,347
5 Net carrying amount|95,341,253|82,857,902|(63,862,314)|114,336,841
test row 2011|Additions|Transfers|2012 ) against types ( other|large_num|large_num|complex|large_num ) has 1.000000 unmatching types
test row Less accumulated depreciation: ) against types ( other|large_num|large_num|complex|large_num ) has 0.000000 unmatching types
5 Land|4,460,723|-|-|4,460,723
5 Land improvements|1,648,758|78,480|(66,270)|1,660,968
5 Medical Center building|121,550,600|5,767,427|(4,527,565)|122,790,462
5 Parking structure|5,451,002|-|(114,934)|5,336,068
5 Nurses' residence|1,766,711|78,171|(16,546)|1,828,336
5 Interns' apartment|297,961|-|(5,467)|292,494
5 Prospect Street apartments|1,516,629|-|(44,091)|1,472,538
5 Power plant|3,902,678|26,710|(45,011)|3,884,377
5 Rental property|279,550|-|(57,503)|222,047
5 Health and fitness center|4,657,375|-|(32,870)|4,624,505
5 Park Plaza|1,272,534|-|(18,263)|1,254,271
5 Physicians' office building|347,603|-|(6,912)|340,691
5 Davison Clinic|1,956,771|-|-|1,956,771
5 Longway Eastside Campus building|3,643,756|-|-|3,643,756
5 MOB Building|167,167|-|-|167,167
5 Fenton Medical Center|183,090|16,851|-|199,941
5 Machinery and equipment|89,301,839|2,608,676|(13,843,354)|78,067,161
5 Automotive equipment|376,699|12,529|(14,466)|374,762
5 Construction in progress|13,566,515|33,184,576|(8,565,343)|38,185,748
5 Total|256,347,961|41,773,420|(27,358,595)|270,762,786
5 Land improvements|1,204,068|47,909|(66,271)|1,185,706
5 Medical Center building|96,266,464|3,451,134|(4,407,572)|95,310,026
5 Parking structure|4,755,702|99,780|(114,935)|4,740,547
5 Nurses' residence|1,566,643|51,014|(16,547)|1,601,110
5 Interns' apartment|291,303|2,582|(5,467)|288,418
5 Prospect Street apartments|1,257,739|20,634|(44,091)|1,234,282
5 Power plant|2,376,079|124,652|(44,061)|2,456,670
5 Rental property|277,138|689|(57,502)|220,325
5 Health and fitness center|4,473,859|107,577|(24,170)|4,557,266
5 Park Plaza|1,119,014|27,351|-|1,146,365
5 Physicians' office building|304,291|12,618|(6,912)|309,997
5 Davison Clinic|722,272|57,236|-|779,508
5 building|1,208,888|136,065|-|1,344,953
5 MOB building|15,678|19,984|-|35,662
5 Fenton Medical Center|34,641|21,559|-|56,200
5 Machinery and equipment|67,029,051|6,581,641|(13,693,706)|59,916,986
5 Automotive equipment|200,117|50,909|(13,514)|237,512
5 Total|183,102,947|10,813,334|(18,494,748)|175,421,533
5 Net carrying amount|73,245,014|30,960,086|(8,863,847)|95,341,253
test row 2010|Additions|Transfers|2011 ) against types ( other|large_num|large_num|complex|large_num ) has 1.000000 unmatching types
test row Land improvements|1,648,758|78,480|(66,270)|1,660,968 ) against types ( other|large_num|large_num|complex|large_num ) has 0.000000 unmatching types
5 Total|1,111,979|1,461|(122,021)|991,419
5 Leasehold improvements|159,423|7,980|(23,567)|143,836
5 Equipment and furnishings|695,266|14,633|(68,049)|641,850
5 Total|854,689|22,613|(91,616)|785,686
test row 2011|Additions|Transfers|2012 ) against types ( other|large_num|large_num|complex|large_num ) has 1.000000 unmatching types
test row Equipment and furnishings|790,252|1,461 (68,630) 723,083 ) against types ( other|large_num|large_num|complex|large_num ) has 0.333333 unmatching types
5 Total|1,280,505|2,627|(171,153)|1,111,979
5 Leasehold improvements|152,687|8,162|(1,426)|159,423
5 Equipment and furnishings|831,852|17,799|(154,385)|695,266
5 Total|984,539|25,961|(155,811)|854,689
test row 2010|Additions|Transfers|2011 ) against types ( other|large_num|large_num|complex|large_num ) has 1.000000 unmatching types
test row Equipment and furnishings|955,872|2,627 (168,247) 790,252 ) against types ( other|large_num|large_num|complex|large_num ) has 0.333333 unmatching types
8 6/30/99|12/31/97|301,060,938|259,985,429|41,075,509|115.8|87,651,874|-
8 6/30/00|12/31/98|322,497,186|281,563,941|40,933,245|114.5|96,417,303|-
8 6/30/01|12/31/99|340,608,779|306,134,487|34,474,292|111.3|107,246,608|-
8 6/30/02|12/31/00|354,306,658|328,489,881|25,816,777|107.9|105,102,019|-
8 6/30/03|12/31/01|367,058,240|333,802,804|33,255,436|110.0|103,411,340|-
8 6/30/04|12/31/02|357,836,531|399,476,922|(41,640,391)|89.6|103,802,756|40.1
8 6/30/05|12/31/03|357,836,531|399,476,922|(41,640,391)|89.6|103,802,756|40.1
8 6/30/06|6/30/04|338,311,878|430,746,829|(92,434,951)|78.5|110,096,227|84.0
8 6/30/07|6/30/05|341,965,387|431,927,509|(89,962,122)|79.2|108,969,869|82.6
8 6/30/08|6/30/06|345,781,209|459,693,895|(113,912,686)|75.2|104,097,308|109.4
8 6/30/10|6/30/07|358,057,840|497,351,883|(139,294,043)|72.0|111,456,399|125.0
8 6/30/2011|6/30/09|400,567,741|505,722,287|(105,154,546)|79.2|123,943,771|84.8
test row 6/30/99|12/31/97|301,060,938|259,985,429|41,075,509|115.8|87,651,874|- ) against types ( other|other|large_num|large_num|complex|small_float|large_num|small_float ) has 0.250000 unmatching types
6 Cash and cash equivalents|2,601,048|458,913|-|3,059,961|7,603,535
6 Patient accounts receivable - Net|44,776,227|203,121|-|44,979,348|33,137,433
6 Other receivables|6,134,811|668,016|(1,465,122)|5,337,705|5,157,182
6 settlements|7,259,116|-|-|7,259,116|6,700,021
6 Assets limited as to use|5,330,565|154,084|-|5,484,649|5,385,886
6 Prepaid expenses and other|2,336,387|140,495|-|2,476,882|2,993,302
6 Inventory|4,504,727|10,734|-|4,515,461|4,244,902
6 Total current assets|72,942,881|1,635,363|(1,465,122)|73,113,122|65,222,261
6 By the board|67,381,409|154,084|-|67,535,493|77,714,431
6 Held by trustee - Bond|18,020,907|-|-|18,020,907|29,540,804
6 Other|20,886,656|-|-|20,886,656|20,019,106
6 use|106,288,972|154,084|-|106,443,056|127,274,341
test row Cash and cash equivalents|2,601,048|458,913|-|3,059,961|7,603,535 ) against types ( other|large_num|large_num|other|large_num|large_num ) has 0.000000 unmatching types
6 whose use is limited|100,958,407|-|-|100,958,407|121,888,455
6 Capital Assets - Net|114,336,841|205,733|-|114,542,574|95,598,543
6 Investment in joint ventures|6,776,600|6,000|-|6,782,600|5,181,260
6 Services|(116,916)|-|116,916|-|-
6 Deferred defeasance loss - Net|336,567|-|-|336,567|414,052
6 Bond issue costs - Net|744,070|-|-|744,070|729,810
6 Other|-|150,000|-|150,000|150,000
test row whose use is limited|100,958,407|-|-|100,958,407|121,888,455 ) against types ( other|large_num|other|other|large_num|large_num ) has 0.000000 unmatching types
6 debt|4,823,007|-|-|4,823,007|3,965,000
6 withheld|21,412,199|1,183,059|(1,465,122)|21,130,136|18,664,073
6 settlements|16,555,939|-|-|16,555,939|18,994,846
6 Accrued expenses|34,048,769|930,953|-|34,979,722|34,814,565
6 liabilities|76,839,914|2,114,012|(1,465,122)|77,488,804|76,438,484
6 portion|83,275,749|-|-|83,275,749|83,179,382
6 Accrued Expenses|35,245,413|-|-|35,245,413|31,084,862
6 Total liabilities|195,361,076|2,114,012|(1,465,122)|196,009,966|190,702,728
6 related debt|44,057,866|205,733|-|44,263,599|37,007,719
6 operating activities|4,874,957|-|-|4,874,957|5,584,506
6 Unrestricted|51,684,551|(322,649)|116,916|51,478,818|55,889,428
test row debt|4,823,007|-|-|4,823,007|3,965,000 ) against types ( other|large_num|large_num|other|large_num|large_num ) has 0.166667 unmatching types
6 allowances and discounts|374,520,869|2,405,846|-|376,926,715|367,930,032
6 Provision for bad debt|(48,168,124)|-|-|(48,168,124)|(43,210,387)
6 provision for bad debt|326,352,745|2,405,846|-|328,758,591|324,719,645
6 Other operating revenue|33,151,925|17,830,696|(17,291,641)|33,690,980|29,421,476
6 Total operating revenues|359,504,670|22,642,388|(17,291,641)|364,855,417|354,141,121
6 Salaries and wages|155,886,264|14,427,961|-|170,314,225|164,640,951
6 Employee benefits and payroll taxes|59,116,728|2,813,027|-|61,929,755|58,035,354
6 Operating supplies and expenses|42,255,917|-|-|42,255,917|42,702,389
6 Professional services|40,535,293|817,500|(12,274,986)|29,077,807|26,980,493
6 Purchased services and other|47,280,666|3,520,351|(5,016,655)|45,784,362|47,111,885
6 Depreciation and amortization|13,424,621|22,613|-|13,447,234|10,839,295
6 Interest expense|4,440,616|-|-|4,440,616|3,840,106
6 Total operating expenses|362,940,105|21,601,452|(17,291,641)|367,249,916|354,150,473
6 Net Operating Loss|(3,435,435)|1,040,936|-|(2,394,499)|(9,352)
6 Investment income|4,251,069|884|-|4,251,953|2,014,899
6 income|2,281,471|-|-|2,281,471|1,469,880
6 Other expense|2,000|(20,404)|-|(18,404)|(1,440)
6 (expense)|6,534,540|(19,520)|-|6,515,020|3,483,339
6 Activity and Transfer of Funds|3,099,105|1,021,416|-|4,120,521|3,473,987
6 Decrease in investment in Hurley Health Services|(1,384,430)|-|1,384,430|-|-
6 of capital assets|1,130,591|-|-|1,130,591|137,734
6 Transfer of Funds|2,845,266|(1,384,430)|1,384,430|2,845,266|3,611,721
6 Restricted gifts and bequests|1,163,808|-|-|1,163,808|1,464,010
test row Center|Services|Entries|Totals|2011 ) against types ( other|large_num|large_num|other|large_num|large_num ) has 0.800000 unmatching types
test row Patient service revenue - Net of contractual ) against types ( other|large_num|large_num|other|large_num|large_num ) has 1.000000 unmatching types
test row Provision for bad debt|(48,168,124)|-|-|(48,168,124)|(43,210,387) ) against types ( other|large_num|large_num|other|large_num|large_num ) has 0.666667 unmatching types
test row Net patient service revenue less ) against types ( other|large_num|large_num|other|large_num|large_num ) has 0.000000 unmatching types
6 Increase (Decrease) in Fund Net Assets|2,135,721|(1,384,430)|1,384,430|2,135,721|4,194,946
6 Fund Net Assets - Beginning of year|98,481,653|1,267,514|(1,267,514)|98,481,653|94,286,707
6 Fund Net Assets - End of year|100,617,374|(116,916)|116,916|100,617,374|98,481,653
test row Increase (Decrease) in Fund Net Assets|2,135,721|(1,384,430)|1,384,430|2,135,721|4,194,946 ) against types ( other|large_num|complex|large_num|large_num|large_num ) has 0.000000 unmatching types
5 Cash Equivalents|6,383,758|2,601,049|3,782,709|14,485,931
5 Receivable, net|56,481,149|44,776,227|11,704,922|34,505,934
5 Settlements Receivable|3,368,338|7,259,116|(3,890,778)|9,535,248
5 Receivable-Other|6,318,584|6,134,810|183,774|4,940,558
5 Expense|2,689,130|2,331,387|357,743|2,383,413
5 of Assets Whose Use is Limited|4,696,107|5,330,565|{634,458!|5,138,892
5 Current Assets|84,452,743|72,937,882|11,514,861|75,399,169
5 Assets Whose Use is Limited|84,288,534|100,958,406|(16,669,872}|112,611,571
5 and Equipment|301,444,755|293,541 '191|7,903,564|282,517,907
5 Plant and Equipment|113,940,407|114,336,843|(396,436)|100,331 ,273
5 Defeasance, net|301,298|336,567|(35,269)|375,310
5 Cost, net|791,525|744,070|47,455|796,721
5 lrm,m::t!TI<>ntc in Joint Ventures|7,319,819|6,781,600|538,219|5,965,260
5 Total Other Assets|8,412,642|7,862,237|550,405|7,137,291
test row Cash Equivalents|6,383,758|2,601,049|3,782,709|14,485,931 ) against types ( other|large_num|large_num|large_num|large_num ) has 0.000000 unmatching types
5 Portion of Debt|4,648,945|4,823,007|(174,062)|4,170,000
5 Payable|15,139,025|21,412,199|(6,273, 174)|15,331,633
5 Settlements Payable|16,555,939|16,555,939|0|18,994,846
5 Pension|8,370,001|6,821,509|1,548,492|9, 152,192
5 Expenses|32,679,190|27,227,259|5,451,931|34,021,041
5 Current Liabilities|77,393,100|76,839,913|553 187|81,669,712
5 Expenses|32,367,913|35,245,413|(2,877,500)|29,456,862
5 Current Portion|79,000,252|83,275,748|(4,275,496)|84,137,655
5 Noncurrent Liabilities|111,368,165|118,521 '161|(7, 152,996)|113,594,517
5 Total Net Assets|102,333,061|100,734,294|1,598,767|100,215,075
test row Portion of Debt|4,648,945|4,823,007|(174,062)|4,170,000 ) against types ( other|large_num|large_num|complex|large_num ) has 0.000000 unmatching types
3 59.6|64.4|84.1
3 71.3|75.7|66.3
3 45.0|46.8|47.1
3 11.3|13.3|13.5
test row 59.6|64.4|84.1 ) against types ( small_float|small_float|small_float ) has 0.000000 unmatching types
8 13,057,060|-0.2%|Salaries and Wages|77,473,244|75,081,713|(2,391,531)|-3.2%|77,305,729
8 2,966,852|5.1|ProfesslonaJ Salaries|18,554,805|17,708,066|(846,739)|-4.8%|15,945,267
8 385,128|-23.6%|Agency|3,003,673|2,263,480|(720,193)|-31.5%|3,532,457
8 4,927.447|12.0|Payroll Taxes and Fringes|28,859,632|29,239,591|379,959|1.3|31,132,110
8 3,214,707|-5.3%|Medical Supplies|19,831,152|19,587,396|(243,756)|-1.2%|19,580,819
8 218,636|5.8|Supptles - Non-Clinical|1,313,764|1,340,496|26,732|2.0|1,448.46
8 298,498|23.3|Maintenance and Repairs|1,582,927|1,994,745|411,818|20.S%|1,634,'771
8 579,967|12.6|Utilities|3,222,117|3,688,550|466,443|12.6|2,999,226
8 3,174,990|0.8|Other Purchased Services|18,794,026|18,904,588|110,562|0.6|19,037,091
test row Inpatient Revenue|319,365,311|319,296,749|68,562|0.0|295,648,771 ) against types ( complex|small_float|other|large_num|large_num|large_num|complex|large_num ) has 0.166667 unmatching types
3 at the Beginning of the Year|95,859,334|91,629,638
3 of Revenue over Expense|387.454|2,170,960
test row at the Beginning of the Year|95,859,334|91,629,638 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
3 at the Beginning of the Year|4,874,960|5,584,502
3 :·,:|1,452,507|1,167,680
test row at the Beginning of the Year|4,874,960|5,584,502 ) against types ( other|large_num|large_num ) has 0.000000 unmatching types
4 (357,743)|58,307|finance activities|(4,449,558}
4 Accrued Expenses|2,574,431|4,012,567|Cash at the beginning of year
test row (357,743)|58,307|finance activities|(4,449,558} ) against types ( complex|large_num|large_num|complex ) has 0.500000 unmatching types
test row Payable|(6,273,174)|(3,557,600)|Net Increase (decrease) in cash|3,782,709|7,357,117 ) against types ( complex|large_num|large_num|complex ) has 0.833333 unmatching types
test row Accrued Expenses|2,574,431|4,012,567|Cash at the beginning of year ) against types ( complex|large_num|large_num|complex ) has 0.500000 unmatching types
test row Cash at the end of the period ) against types ( complex|large_num|large_num|complex ) has 1.000000 unmatching types
test row 12,487,008|11,996,624 ) against types ( complex|large_num|large_num|complex ) has 0.500000 unmatching types
2 DEFINITIONS|1
2 SUMMARY OF CERTAIN PROVISIONS OF THE 2013 RESTATED CONTRACT OF LEASE|12
2 Term of Lease|12
2 Payment of Cash Rentals|12
2 Expenses and Fees|18
2 Acceleration|18
2 Maintenance of Hurley Medical Center|18
2 Insurance|18
2 Damage or Destruction|19
2 Condemnation; Title Insurance|20
2 General Conditions|21
2 Inspections|21
2 Covenant with Bondholders|21
2 Sale, Lease or Other Disposition of Property|21
2 Sale or Assignment of Leasehold|22
2 Release of Unimproved Property|23
2 Affiliate Guaranties|24
2 Affiliate Leases|26
2 Prevention of Affiliate Bankruptcies|29
2 Hurley Medical Center Rates|29
2 Liquidity Covenant|30
2 SUMMARY OF CERTAIN PROVISIONS OF THE INDENTURE|30
2 Application of Series 2013 Bond Proceeds|30
2 Indenture Funds|31
2 Redemption Fund|31
2 Debt Service Reserve Fund (Series 2013A)|31
2 Debt Service Reserve Fund (Series 2013B)|32
test row DEFINITIONS|1 ) against types ( other|integer ) has 0.000000 unmatching types
2 Authority Expense Fund|33
2 Series 2013A Special Fund|33
2 Series 2013B Special Fund|33
2 Series 2013A Rebate Fund|34
2 Series 2013B Rebate Fund|34
2 Acquisition Fund (2013 Project)|35
2 Deposit of Funds with Trustee|35
2 Nonarbitrage and Tax Covenants|35
2 Additional Bonds|36
2 Lien of Indenture|42
2 Default Provisions and Remedies of Trustee and Bondholders|43
2 Protection of Security|43
2 Trustee Remedies|43
2 Bondholder Remedies|44
2 Application of Funds|44
2 Action by Trustee|45
2 Rights of Bondholders|46
2 Supplemental Indentures|46
2 Bondholder Approval|47
2 Defeasance|47
test row Authority Expense Fund|33 ) against types ( other|integer ) has 0.000000 unmatching types