VOLUNTARY EVENT DISCLOSURE COVER SHEET

Transcription

1 VOLUNTARY EVENT DISCLOSURE COVER SHEET This cover sheet and accompanying voluntary event disclosure will be sent to the MSRB, pursuant to the Disclosure Dissemination Agent Agreement dated as of January 7, 2013 between the Issuer and DAC. Issuer s and/or Other Obligated Person s Name: NYU Hospitals Center ("NYUHC") Nine-Digit CUSIP Number(s) of the bonds to which this notice relates: Dormitory Authority of the State of New York NYU Hospitals Center Revenue Bonds, Series 2011A, $130,930,000, Dated: January 25, 2011: S9, T7, U4, V2, W0, X8, Y6, Z3, A7, B5, C3, D1, E9, F6, G4, H2, J8, K5, L3 Dormitory Authority of the State of New York NYU Hospitals Center Revenue Bonds, Series 2007B, $94,150,000, Dated: December 5, 2007: WR8, WS6 Dormitory Authority of the State of New York NYU Hospitals Center Revenue Bonds, Series 2007A, $165,300,000, Dated: February 6, 2007: CU3, CV1, CW9, CX7, CY5, CZ2, DA6 Dormitory Authority of the State of New York, NYU Hospitals Center Revenue Bonds, Series 2006A, $94,590,000, Dated: October 4, 2006: 64983QY37, 64983QY45, 64983QY52, 64983QY60, 64983QY78, 64983QY86 NYU Hospitals Center Revenue Bonds, $52,200,000, Series 2000D (Auction Rate Securities), Dated: April 15, 2000: 64983WV37 NYU Hospitals Center Taxable Bonds, $250,000,000, Series 2012A, Dated July 31, 2012: 62952EAA5 1

2 Number of pages attached: 26 Description of Voluntary Event Disclosure (Check One): X "amendment to continuing disclosure undertaking;" "change in obligated person;" "notice to investors pursuant to bond documents;" "certain communications from the Internal Revenue Service;" "secondary market purchases;" "bid for auction rate or other securities;" "capital or other financing plan;" "litigationlenforcement action;" "change of tender agent, remarketing agent, or other on-going party;" "derivative or other similar transaction;" and " other event-based disclosures." I hereby represent that I am autj[horized by the issuer or iÿts2agent to distribute this information publicly: Signature:,,ÿÿÿ/,ÿÿ.ÿÿ / Name: Michael T. Bu/rke Date: January 7, 2013 U Langone MEDICAL CEN11:II _ Title: Senior Vice President and Vice Dean, Chief Financial Officer Digital Assurance Certification, L.L.C. 390 N. Orange Avenue Suite 1750 Orlando, FL

3 This document is dated as of January 7, 2013 SPECIAL NOTE CONCERNING FORWARD-LOOKING STATEMENTS. Certain of the discussions included in the following document may include certain forward-looking statements which involve known and unknown risks and uncertainties inherent in the operation of healthcare facilities. Actual actions or results may differ materially from those discussed below. Specific factors that might cause such differences include competition from other healthcare facilities in the service area of NYU Hospitals Center facilities, federal and state regulation of healthcare providers, and reimbursement policies of the state and federal governments and managed care organizations. In particular, statements preceded by, followed by or that include the words believes, estimates, expects, anticipates, plans, intends, scheduled or other similar expressions are or may constitute forward-looking statements. J.P. Morgan Healthcare Conference Presentation January 7, 2013 Concerning NYU Hospitals Center The information in this report has been provided by NYU Hospitals Center 3

4 NYU Hospitals Center Michael T. Burke, Senior Vice President and Vice Dean, Chief Financial Officer J.P. Morgan Healthcare Conference Monday, January 7, 2013

5 Table of Contents Section 1: Organizational Initiatives Section 2: Financial Performance Section 3: Superstorm Sandy Section 4: Future Strategic Focus Presentation Title Goes Here 2

6 NYU Hospitals Center ( NYUHC ) At A Glance NYUHC is a 1,069 licensed bed tertiary care teaching hospital located in midtown Manhattan NYUHC is the principal teaching hospital of the New York University School of Medicine ( NYUSM ) Currently a network of more than 1,050 physicians and 85 medical practices Recognized Leader in Quality Ranked #11 in the nation on U.S. News & World Report s Best Hospitals Honor Roll with 13 nationally ranked specialties ( ) Ranked #2 by U.S. News & World Report in New York State Clinical transformation has driven operational improvements Expanded ambulatory facilities Large growth in outpatient revenue Additional physician recruitment in tandem with NYUSM Successive Rating Increases (2008-Present) (2) Significant investment in information technology Improved balance sheet and financial performance built on strategic focus and discipline Ba2 Baa2 Baa1 Baa1 A3 BB BB+ BBB/BBB+ BBB+ A- BBB- BBB- BBB/BBB+ A- A- Net patient service revenue increased 42% to $1.83 billion in 2012 from $1.29 billion in 2009 As of August 31, 2012, Operating margin was 12.3% (1) Days cash on hand improved to 135 days ($564.9 million of cash & marketable securities) as of August 31, 2012 As of December 31, 2012, NYUHC s liquidity level is approximately $785.9 million (inclusive of cash & marketable securities); and in addition NYUHC has $260.0 million in undrawn lines of credit (1) Operating margin excludes mission payments to NYUSM. (2) Refer to slide 21 for rating agency updates related to Superstorm Sandy. 3

7 NYU Hospitals Center Corporate Organization NYUHC is the acute care delivery component of NYU Langone Medical Center ( NYULMC ). NYUHC and NYU School of Medicine together form one of the nation s premier centers for excellence in clinical care, biomedical research and medical education. NYUHC and the NYU School of Medicine are led by a common management team and governance structure. New York University NYU Langone Medical Center Key: School of Medicine (including Faculty Group Practice) Member of the Obligated Group Sole member Unincorporated division of New York University NYU Hospitals Center CCC550 Note: Neither New York University nor its School of Medicine are obligated with respect to the NYUHC s Bonds. No assets or revenues of New York University or its School of Medicine are pledged to secure or available to pay debt service with respect to the NYUHC s Bonds. CCC550, NYU Hospitals Center s wholly owned captive insurance company, is also not obligated with respect to the NYUHC s Bonds and no assets or revenues of CCC550 are pledged to secure or available to pay debt service with respect to the NYUHC s Bonds. 4

8 NYU Hospitals Center s Facilities Ambulatory Care Center 240 East 38 th Street Clinical Cancer Center 160 East 34 th Street Hospital for Joint Diseases 301 East 17 th Street Tisch Center for Women s Health rd Avenue Ambulatory Surgery Center 333 East 38 th Street Center for Musculoskeletal Care 333 East 38 th Street Rusk Institute 550 First Avenue Tisch Hospital/HCC 550 First Avenue Source: Microsoft MapPoint 5

9 Section 1: Organizational Initiatives Presentation Title Goes Here 6

10 NYUHC s Strategic Goals NYU Langone Medical Center a world-class, patient-centered, integrated academic medical center, pursuing excellence while fulfilling our tri-partite mission in patient care, research and education. NYU Hospitals Center providing excellent quality care and patient experience, by talented people Quality NYUHC is a leader in the national movement focused on quality and patient safety; our continuing achievements in quality are broadly recognized by organizations such as: University HealthSystem Consortium, US News and World Reports, the Leapfrog Group, and Thomson Reuters; Patient Experience focused on transforming the patient experience, both inpatient and outpatient, through such initiatives as the creation of a Patient Experience Office, the 7-Day Hospital initiative and our expanded ambulatory and outpatients, to make our specialized care available to patients whenever and wherever needed People with a distinguished Medical Staff, 116 of whom were recently named Best Doctors by New York magazine, we are committed to attracting and recruiting the best physicians and practices, including over 371 new recruits in the last 5 years; in conjunction with the NYU School of Medicine, these physicians are conducting groundbreaking research Campus Transformation NYUHC is in the process of a Campus Transformation, a multiyear, multi-phase plan to construct and renovate 2.3 million square feet of facilities for state-ofthe-art patient care, research and education. 7

11 Recognized Leader in Quality of Care NYUHC is a Top 50 Cardiovascular Hospitals 2012 Award winner. Only hospital in New York State with distinction Ranked #11 in the nation on the Best Hospitals Honor Roll with 13 nationally ranked specialties Ranked #2 in New York State and the New York Metro area Achieved a 5 star rating; the only hospital in New York State to achieve this top ten ranking Received the Gold Seal of Approval in 2010 for excellence in quality and patient safety Awarded an A Hospital Safety ScoreSM in June 2012 for excellence in patient safety; one of only two hospitals in NYC Recipient of 10 HealthGrades Quality awards from 2009 to 2012 Magnet Status designation for excellence in nursing in 2005 and

12 NYUHC s Strategic Investments Ambulatory Care - NYUHC is competing in the metro NY healthcare market by continuing to invest in the development of its ambulatory care network, including: Completed Projects Center for Musculoskeletal Care 333 East 38 th Street Opened in March 2012 Specializing in orthopaedics, rheumatology, rehabilitation and musculoskeletal radiology Ambulatory Care Center East 38 th Street Opened in April 2012 Specializing in outpatient adult and pediatric rehab 34 th Street Cancer Center Opened in 2006 with recent expansion of services Specializing in radiation oncology, diagnostic radiology, breast cancer, breast surgery Under construction - expansion of existing Emergency Department Working to support NYUSM s expansion of the Faculty Group Practice Model currently a network of more than 1,050 physicians 85 medical practices a geographical presence in Manhattan and the outer boroughs of New York City (ie. Brooklyn, Queens and Long Island) 9

13 NYUHC s Strategic Investments (continued) Technology NYUHC s investment in EPIC enables a patient centered vision by 2014 Patient access to health records electronically Mobile apps for health updates and Emergency Department waiting times Further improves highly ranked patient workflow, satisfaction and safety scores Continue to improve our revenue cycle performance Standardized best practice protocols Posting of metrics and benchmarks Successful Physician Recruitment Across Key Specialties - Physician recruitment is targeted on specific clinical programs with increasing demand for patient care services in the future and key primary care referral groups 371 net increase in physicians to the active/courtesy staff from New recruitments focused on the following specialties: Cardiothoracic surgeons Pediatric cardiothoracic surgeons Neurosurgeons Gastroenterologist oncologists Neuro-oncologists Hematology oncologists 10

14 Philanthropic Success to Support Continued NYULMC Growth (1) Total Support FY YTD Cumulative Philanthropy Raised: $1.21 billion $600 $500 $508 New Commitments and Outright Gifts Cash $400 $300 $200 $100 $180 $199 $169 $124 $194 $205 $155 $137 $203 $ $38 $78 (1) Includes combined gifts to NYUHC and NYUSM. 11

15 Section 2: Financial Performance Presentation Title Goes Here 12

16 Financial Performance Highlights (Pre-Superstorm Sandy) Profitability has improved liquidity levels and balance sheet $785.9mm in cash as of December 31, 2012 $400mm in working capital lines Improved Operations: achieved by higher case mix acuity/higher margin services and increased ambulatory volume; CCC550 equity return totaling $31.2 million in FY 2012 Increased Volume: Driven by increased outpatient and ambulatory services and aggressive physician recruitment Revenue Cycle Initiatives: Improvements in clinical documentation, coding, charge capture as well as successful managed care strategies Expense Management: Target expense savings in areas such as medical/surgical, labs, distribution, corporate services; NYUHC has realized expense savings totaling $14.3 million Increased Patient Flow and Efficiencies: Lean/Six SIGMA and improved productivity Working Capital Discipline: Investment policy is to provide liquidity for operating and capital expenditures. The balance of working capital is maintained in a capital program reserve fund which is targeted to be at least 2x the amount of any working capital draws Operating Revenue ($MM) FY 2011 (1) FY 2012 (1,2) $1,712 $1,965 Operating Income ($MM) $177.6 $242.1 Operating Margin 10.4% 12.3% EBIDA Margin 15.2% 17.3% DCOH (days) Cash to Debt 62% 61% Debt to Capitalization 55% 59% MADS Coverage (1) NYUHC s fiscal year end audited reporting period is August 31. (2) Includes Series 2012A Taxable Bonds $250MM. 13

17 Inpatient and Outpatient Trends Total Inpatient Discharges Outpatient Visits 37,813 2,556 4,750 36,478 36,973 37,503 37,585 2,724 2,787 2,806 2,939 4,492 4,381 4,612 5, ,877 23,306 27, ,789 25,643 29, ,770 28,009 31, ,835 29,659 33, ,558 32,286 37,940 30,507 29,262 29,805 30,085 29, , , , , ,332 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 Med/Surg Maternity Rehab Cancer Center ER Amb Surg 14

18 Operating Performance (4) Total Revenue (1) Operating Margin (1,3) $000 % $000 1,964, EBIDA (1,2,3) 339, % 1,561,265 1,711, , % 260, % 1,175,994 1,369, , % 81, % 1.2 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 (1) Equals total operating revenue in audited financial statements less investment income and realized gains (losses) on investments and unrestricted contributions. (2) Equals operating margin indicator plus depreciation and interest less investment income and unrestricted contributions. (3) Operating margin and EBIDA excludes mission payments to NYUSM. (4) NYUHC s fiscal year end audited reporting period is August

19 Liquidity Ratios (3) Cash on Hand (1) Cash to Debt (2) Days % Liquidity Level: Total liquidity/capacity is approximately $1.0 billion (inclusive of cash, marketable securities and undrawn lines of credit) Current liquidity as of 12/31/12: $785.9MM vs. $564.9MM at FY 2012 NYUHC maintains $400MM in commercial lines of credit Undrawn capacity of $260MM FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 (1) Based on MTI methodology. (2) Cash to Debt for FY 2012 includes Series 2012A $250MM taxable bonds. (3) NYUHC s fiscal year end audited reporting period is August

20 Leverage Indicators (2) Debt to Capitalization (1) % MADS Coverage (1) x Outstanding Debt: Total $903.2MM $753MM rated debt Fixed ~ 94% Variable ~ 6% $150MM capital leases/lines of credit No derivatives 2.46 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 (1) FY 2012 includes Series 2012A $250MM taxable bonds. (2) NYUHC s fiscal year end audited reporting period is August

21 Section 3: Superstorm Sandy Presentation Title Goes Here 18 Note: Above from NYULMC advertisement in January 6, 2013 NY Times

22 Superstorm Sandy October 29, Superstorm Sandy struck New York City causing widespread damage to properties throughout the region, including lower Manhattan. All NYUHC facilities with the exception of Hospital for Joint Diseases ( HJD ) were closed. As of November 16, 2012 NYUHC re-opened several facilities including the Clinical Cancer Center on East 34 th Street, the Ambulatory Care Center and Ambulatory Surgery Centers on East 38 th Street and the Center for Musculoskeletal Care. December 17, 2012 various outpatient procedural and surgical services (ie. cardiac catherization) re-opened in the Schwartz Health Care Center ( HCC ) adjacent to Tisch Hospital. December 27, 2012 a phased re-opening of Tisch Hospital began Services including ambulatory and inpatient surgery, electrophysiology, radiology, neurosurgery, post-anesthesia care units, medical and surgical ICU s and select ancillary services became operational. The services, re-opening through December 27, 2012, accounted for approximately two-thirds of NYUHC s patient care capacity in FY Press conference on December 27, 2012, to announce re-opening of Tisch Hospital with Mr. Ken Langone, Senator Charles Schumer and NYULMC Dean and CEO Robert Grossman 19

23 Superstorm Sandy (continued) Emergency Department NYUHC was in the initial stage of a major construction and expansion project related to emergency department services. As a result of Sandy, it is not possible to open or immediately relocate the emergency department. An urgent care center, staffed by emergency department clinicians, is being established to handle walk-in and other urgent care cases. January 2013 phased re-opening of Tisch Hospital is scheduled to continue throughout month of January. Services such as an urgent care center, epilepsy, internal medicine, labor and delivery, neurology, pediatrics and pediatrics ICU are expected to become operational. The services described above are planned to ramp up to a fully operational state between January 2013 and March 2013 and together with already opened facilities are expected to comprise 98% of NYUHC s patient care capacity (based on FY 2012 results). 20

24 Superstorm Sandy (continued) Business Interruption & Insurance Coverage NYUHC has business interruption, water, property casualty and other insurance coverage with respect to the incurred losses in effect at the time of the storm. Discussions with insurance carriers are ongoing as is our investigation into the causes and measurement of our losses. Management expects to receive substantial recoveries; however, the amount of recovery cannot be determined at this time and remains subject to investigation, measurement, negotiation, and settlement. A $20 million advance was received in November 2012 followed by an additional $20 million payment in December Management has submitted three applications for assistance to the Federal Emergency Management Association ( FEMA ) for an initial total amount of approximately $200 million, of which $149.7 million has been funded by FEMA. Management will apply for additional FEMA funding for reconstruction and mitigation as rebuilding plans and costs become known. Management expects FEMA to provide funding of at least 75% of allowable claims not covered by insurance. Funding percentage may increase pending certain variables at the federal level. Rating Agency Communications Management has communicated frequently with Moody s, Standard & Poor s and Fitch since Superstorm Sandy and during the re-opening of NYUHC s inpatient and outpatient facilities. Moody s had placed the NYUHC A3 rating under review for possible downgrade on November 20, At this time, Standard & Poor s (A-) and Fitch (A-) maintain stable outlooks for NYUHC s ratings. Management will continue proactive communication with the rating agencies with the planned re-opening of NYUHC facilities. 21

25 NYU Hospitals Center Timeline of Events Post Superstorm Sandy Oct. 29: Hurricane Sandy Strikes NY Metro Area Tisch evacuated Nov. 26: Schwartz Care Center (HCC) re-opens for physician office operations* Dec. 17: HCC re-opens for procedural and surgical services Jan March 2013: NYUHC inpatient and outpatient facilities planned to be fully operational HJD remains open Oct. 31: Center for Musculoskeletal Care re-opens Nov. 30: NYUHC publishes FY2012 annual disclosure on DAC/EMMA October November December January Nov. 5: 34 th Street Cancer Center re-opens Nov. 16: NYUHC publishes voluntary disclosure filing on DAC/EMMA related to Sandy Nov. 16: Skirball Building (NYUSM) re-opens* Nov. 5-9: Ambulatory Care Center and Ambulatory Surgery Centers re-open Dec. 14: NYUHC publishes FY2012 audit report on DAC/EMMA Dec. 2: EPIC inpatient clinical systems go-live at HJD campus (as previously scheduled); EPIC to be deployed as sites re-open (1) Dec. 27: Tisch Hospital begins phased re-opening * Not on NYUHC credit (1) EPIC inpatient clinical systems go-live simultaneously with re-opening of HCC & Tisch Hospital beginning on December 17 th and through January

26 Section 4: Future Strategic Focus Presentation Title Goes Here 23

27 NYUHC- An Academic Medical Center of the Future The new NYUHC campus will promote and enhance the integration of patient care, education and research, and meet community needs. Construction of a new 800,000 square foot, 20-story clinical pavilion on the First Avenue Campus (expected construction ) Financed through debt, philanthropy and equity NYUHC plans to participate with the University on construction of two facilities: Energy Building Construction began in Summer 2012 Science Building dedicated to research Construction is expected to begin in 2013 As a result of Superstorm Sandy, a reassessment of the design for these projects is underway to ensure the appropriate risk mitigation considerations are in place. 24

28 Building Design and Layout (*) * Includes NYUSM facilities Emergency Department Kimmel Pavilion The Envisioned Campus Energy Building 25 Science Building 25

29 Conclusion NYULMC is a world-class, patient-centered, highly integrated medical center, with close ties to NYU Proven management team with a multi-year track record of increased volume and profitability levels Significant track record of revenue growth Continued strong operating performance characterized by double-digit margins over the last 3 years Substantial improvement in balance sheet measures over the last 5 years Focused on long-term strategy and best positioning the Medical Center for the future of healthcare Strong physician recruitment efforts Solid execution of ambulatory care strategy NYUHC s immediate focus is restoring our inpatient facilities post Superstorm Sandy; we believe sufficient resources are in place to achieve this goal NYUHC is committed to keeping the investor community updated on its progress NYUHC and Board of Trustees focused on short-term recovery and long-term strategic goals 26