REVISED DISCLOSURE REPORT DATED MAY 27, 2016 THE NEW YORK AND PRESBYTERIAN HOSPITAL FOR THE QUARTER ENDED MARCH 31, 2016
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1 REVISED DISCLOSURE REPORT DATED MAY 27, 2016 THE NEW YORK AND PRESBYTERIAN HOSPITAL FOR THE QUARTER ENDED MARCH 31, 2016 This Disclosure Report is a revised version of the initial Disclosure Report for the quarter ended March 31, 2016 that was filed on May 27, In the initial Disclosure Report on the Summary Statements of Operations (Hospital Only), the following amounts were reported for the quarter ended March 31, 2016: Net patient service revenue - $1,246,009; Net patient service revenue, less provision for bad debts - $1,230,709; and Other revenue - $63,510. The correct amounts, as reported in this revised Disclosure Report, are: Net patient service revenue - $1,238,771; Net patient service revenue, less provision for bad debts - $1,223,471; and Other revenue - $70,748. With the correction of these amounts, revisions have been made to the second and third paragraphs of Management s Discussion and Analysis of Recent Financial Performance Quarter ended March 31, 2016 compared to quarter ended March 31, In the initial Disclosure Report, the first sentence of the second pargraph of the Management s Discussion reads as follows: For the quarter ended March 31, 2016, net patient service revenue, less provision for bad debt, increased $162.3 million or 15.2% over the same period the previous year. In this revised Disclosure Report, this sentence has been corrected to read: For the quarter ended March 31, 2016, net patient service revenue, less provision for bad debt, increased $155.1 million or 14.5% over the same period the previous year. In the initial Disclosure Report, the third pargraph of the Management s Discussion reads as follows: For the quarter ended March 31, 2016, other revenue was consistent with the same period in In this revised Disclosure Report, this paragraph has been corrected to read: For the quarter ended March 31, 2016, other revenue increased $7.4 million or 11.6% over the same period in 2015, due primarily to increased distributions from provider owned health insurance plans.
2 TABLE OF CONTENT INTRODUCTION General... 1 Hospital Campuses... 1 FINANCIAL AND OPERATING INFORMATION Utilization... 3 Sources of Patient Service Revenue... 4 Summary Statements of Operations... 5 Summary Statements of Financial Position... 6 Liquidity... 8 Cash to Debt... 9 Long-Term Debt Service Coverage Capitalization Management s Discussion and Analysis of Utilization Management s Discussion and Analysis of Recent Financial Performance Outstanding Long-Term Indebtedness Investments Philanthropy Capital Expenditures Royal Charter Properties New York-Presbyterian Fund, Inc Interim Unaudited Consolidated Financial Statements and other information for the quarter ended March 31, 2016 i
3 FORWARD-LOOKING STATEMENTS Certain statements in this Disclosure Report are forward-looking statements that are based on the beliefs of, and assumptions made by, the management of The New York and Presbyterian Hospital (the Hospital ). Such forward-looking statements involve known and unknown risks, uncertainties and other factors which may cause the actual results or performance of the Hospital to be materially different from any expected future results or performance. * * * * * PREVIOUSLY REPORTED INFORMATION WITH RESPECT TO PRIOR PERIODS Certain financial information and utilization data with respect to prior periods for which the Hospital has previously reported such information and data may differ from what was previously reported. This is generally due to changes in accounting rules and guidance that require a reclassification or restatement of certain items and to adjustments in utilization data that occur in the normal course of patient care or as services are billed and coded. * * * * * The Hospital has prepared and released this Disclosure Report in order to provide certain information regarding its financial and operating performance for the quarter ended March 31, 2016 and to meet its continuing disclosure obligations under certain of its financing documents. Except as required by law or by its contractual obligations, the Hospital undertakes no obligation to update this Disclosure Report after its date. * * * * * ii
4 Obligated Group 2 Non-Obligated Group 4 Queens 1 The New York and Presbyterian Hospital NYP Community Services, Inc. New York- Presbyterian / Lawrence Hospital New York- Presbyterian Fund, Inc. NYP Community Programs, Inc. New York- Presbyterian / Hudson Valley Hospital Supporting Corporations, Non-Obligated Group 3 Hospital Subsidiary, Other Related Corporations Non-Obligated Group 5 Corporate Members, Non-Obligated Group 6 Royal Charter Properties, Inc. New York-Presbyterian / New York-Presbyterian Organizational Structure New York-Presbyterian Foundation, Inc. Royal Charter Properties- East, Inc. The Hospital For Special Surgery Footnotes on next page Royal Charter Properties- Westchester, Inc. The New York Methodist Hospital The Rogosin Institute Gracie Square Hospital The Silvercrest Center for Nursing and Rehabilitation NYHB, Inc. New York- Presbyterian Healthcare System, Inc. The New York Community Hospital of Brooklyn iii
5 1. The New York Hospital Queens became an indirect subsidiary of the Hospital as of July 1, In connection with the issuance by the Hospital of its Series 2015 Bonds, the Hospital formed an Obligated Group under and as defined in its Master Trust Indenture. Currently, the Hospital is the sole member of the Obligated Group. For a discussion of the Master Trust Indenture, the Obligated Group and the debt covered thereby, see Debt Structure The MTI Indebtedness in the Disclosure Report for the Fiscal Year Ended December 31, 2014, which was released on May 29, For a discussion of the Supporting Corporations, see the third paragraph under the heading General on page 1 of this Disclosure Report. 4. The Hospital subsidiaries are those entities under the control of the Hospital. These entities are part of the Hospital s consolidated group that are reported in the consolidated financial statements prepared in accordance with U.S. GAAP. 5. These corporations serve as parent corporations that coordinate membership in the Health Care System (as hereinafter defined). For additional details, see the third paragraph under the heading General on page 1 of this Disclosure Report. 6. For a discussion of the Corporate Members, see the third paragraph under the heading General on page 1 of this Disclosure Report. Note: The Hospital is the only entity that is legally obligated with respect to repayment of its indebtedness. None of the assets or revenue of any of the other entities described above is legally committed to the repayment of the Hospital s indebtedness. iv
6 General The New York and Presbyterian Hospital (the Hospital ), a New York not-for-profit corporation created as a result of the January 1998 merger of The Society of The New York Hospital ( New York Hospital ) and The Presbyterian Hospital in the City of New York ( Presbyterian Hospital ), operates at six campuses in Manhattan and Westchester County, New York. The Hospital serves as the academic and quaternary care hub of a network of health care providers (the Health Care System ), which, as of December 31, 2015, included 9 acute care hospitals, 3 long-term care facilities, 3 ambulatory sites, and 1 rehabilitation hospital, located in New York and Connecticut. Over the years the Hospital has developed relationships with the other members of the Health Care System as part of its strategic goal of providing high quality, integrated care throughout the tri-state New York metropolitan area (the Metropolitan Area ). One of the country s largest academic medical centers, the Hospital ranked #7 in the U.S. News & World Report annual ranking of the best hospitals in the United States, and was the top-ranked hospital in the New York Metropolitan Area. The Hospital is the primary clinical teaching facility for two of the country s leading medical colleges: The Joan and Sanford I. Weill Medical College of Cornell University ( Weill Cornell Medical School ) and the Columbia University College of Physicians & Surgeons ( Columbia University Medical School ), collectively referred to as the Medical Schools. All members of the Attending Medical Staff of the Hospital hold faculty appointments at one of the Medical Schools. The Hospital has several affiliated entities that support the Hospital through fundraising and real estate holdings. These affiliated entities ( Supporting Corporations ) include: (i) New York-Presbyterian Fund, Inc. ( Fund, Inc. ), which solicits, receives, holds, invests and administers philanthropic funds for the Hospital and other healthcare-related charitable organizations approved by the board of directors of Fund, Inc. and (ii) three real estate holding companies: Royal Charter Properties, Inc., Royal Charter Properties East, Inc., and Royal Charter Properties Westchester, Inc. (collectively, the RCP Corporations ). Another affiliated entity, the New York-Presbyterian Healthcare System, Inc. ( NYPHSI ), coordinates membership in the Health Care System and provides educational and information programs designed to promote healthcare quality improvement and enhance medical education and research among the members. The corporate organizational structure (see page iii) shows the relationship among the Hospital, its Corporate Members (as defined below) and New York Presbyterian Foundation, Inc. ( NYPFI ), and the health care organizations that are direct or indirect subsidiaries of NYPFI (the Corporate Members ). NYP Community Services, Inc. is a subsidiary of the Hospital that serves as the parent corporation of Lawrence Hospital Center (d/b/a NewYork-Presbyterian/Lawrence Hospital). NYP Community Programs, Inc. is a subsidiary of the Hospital that serves as the parent corporation to Hudson Valley Hospital Center (d/b/a NewYork-Presbyterian/Hudson Valley Hospital) and NewYork-Presbyterian/Queens. Hospital Campuses The Hospital owns and operates one of the oldest hospitals in the nation. It has a history of over 200 years providing medical care in the New York Metropolitan Area, with five of the Hospital s six campuses having roots going back more than 120 years. Weill Cornell Campus The Weill Cornell Campus occupies the city blocks bounded by East 68 th Street to East 71 st Street and from York Avenue to the East River, together with various buildings in the area. Portions of the buildings that comprise the Weill Cornell Campus are owned and occupied by Weill Cornell Medical School. The Hospital has 862 certified inpatient beds at its facilities on the Weill Cornell Campus. The attending physicians at this campus hold faculty appointments at the Weill Cornell Medical School. 1
7 Westchester Division The Westchester Division located in White Plains, New York, has 270 certified beds, and provides inpatient and outpatient psychiatric and behavioral health services. The attending physicians at this campus hold faculty appointments at the Weill Cornell Medical School. Lower Manhattan Hospital The Hospital s newest campus, New York-Presbyterian Lower Manhattan Hospital ( Lower Manhattan Hospital ), is located at 170 William Street, Manhattan, and is the only acute care facility in Manhattan below 14 th Street. It has 180 certified beds. Lower Manhattan Hospital became part of the Hospital in July 2013 when New York Downtown Hospital, then a separate member of the Health Care System, was merged into the Hospital. The attending physicians at this campus hold faculty appointments at the Weill Cornell Medical School. Columbia Campus The Columbia Campus located in the Washington Heights section of Manhattan occupies the city blocks bounded by West 165 th Street to West 168 th Street and from Broadway to Riverside Drive, together with various other buildings in the area. Portions of the buildings that comprise the Columbia Campus are owned and occupied by Columbia University Medical School. The Hospital has 738 certified beds at its facilities on this campus. The attending physicians at this campus hold faculty appointments at the Columbia University Medical School. Morgan Stanley Children s Hospital The Morgan Stanley Children s Hospital of New York-Presbyterian ( MS-CHONY ) is a pediatric acute care and ancillary services facility with 269 certified beds, and is located on a site contiguous with the Columbia Campus. The attending physicians at this campus hold faculty appointments at the Columbia University Medical School. Allen Hospital The Allen Hospital, has 196 certified beds and is located at Broadway and the Harlem River in the Inwood section of Manhattan, and offers acute care to residents of its service area in a community-based setting. The attending physicians at this campus hold faculty appointments at the Columbia University Medical School. 2
8 FINANCIAL AND OPERATING INFORMATION (HOSPITAL ONLY) The financial and operating data set forth in this Disclosure Report reflects the financial and operating results of the Hospital only. It does not reflect the financial or operating results of any of the Hospital s affiliates, including without limitation any of the Hospital s subsidiaries. Utilization A summary of utilization data for the quarters March 31, 2016 and 2015 for the Hospital is presented in the following table: HISTORICAL UTILIZATION OF THE HOSPITAL Quarter Ended 3/31/2016 3/31/2015 Certified Beds (at end of period) 2,515 2,508 Staffed Beds (at end of period) 2,381 2,328 Discharges 1 27,574 26,203 Patient Days 1 186, ,490 Staffed Bed Days Available 216, ,520 Average Length of Stay (days) Case Mix Index Medicare Case Mix Index - Hospital wide Average Occupancy (%) % 84.7% Emergency Room Visits 5 73,028 66,187 Outpatient Clinic Visits 163, ,507 Ambulatory Surgery Procedures 25,084 22,962 Mental Health Clinic Visits 29,615 29, Excludes newborns. 2. Excludes psychiatry, rehabilitation, normal newborn, uncoded and LOS greater than 300 days. 3. Hospital wide CMI is calculated using the payor specific cost weight (APR, AP, or MSDRG). 4. Based on staffed bed days available. 5. Includes only patients seen in the emergency room and not admitted. Source: Hospital records 3
9 Sources of Patient Service Revenue The majority of patient service revenue received by the Hospital is derived from programs that are either insured or administered by third-party organizations. The following table reports the percentage of net patient service revenue by payor source for the quarters ended March 31, Percent of Net Patient Service Revenue by Payor Source Payor Source: Hospital records 1. Medicare includes Medicare Advantage and Medicaid includes Medicaid Managed Care. 2. Totals may not foot due to rounding. All revenue, statistics and reimbursement information in this Disclosure Report represents historical data and may not be indicative of future activity. The Hospital cannot assess or predict the ultimate effect on its operations which may result from existing or future reimbursement legislation or regulations. Summary Statements of Operations and of Financial Position Quarter Ended 3/31/2016 3/31/2015 Medicare % 26.7% Medicaid % 18.8% Commercial 55.9% 53.9% Self Pay & Other 0.5% 0.6% Total 2 100% 100% Summary statements of operations and financial position for the Hospital are set forth below. These summary statements reflect financial results of the Hospital only and are derived from the Hospital s interim unaudited consolidated financial statements and other information for the quarter ended March 31, 2016, which, accompany this Disclosure Report. The interim unaudited consolidated financial statements for the quarter ended March 31, 2016 include the results of Hospital affiliates that are part of the Hospital s consolidated financial reporting. The interim unaudited consolidated financial statements also contain supplemental information setting forth consolidating statements of financial position and operations that present separately the financial results of the Hospital and the other members of the consolidated group. The Hospital is the only entity that is legally obligated with respect to repayment of its indebtedness. None of the assets or revenue of any of the other entities described above is legally committed to the repayment of the Hospital s indebtedness. 4
10 SUMMARY STATEMENTS OF OPERATIONS (HOSPITAL ONLY) (in thousands) Unaudited Quarter Ended 3/31/16 3/31/15 Operating Revenues Net patient service revenue $1,238,771 $1,082,973 Provision for bad debts (15,300) (14,577) Net patient service revenue, less provision for bad debts 1,223,471 1,068,396 Other revenue 70,748 63,369 Total operating revenues 1,294,219 1,131,765 Operating Expenses Salaries and wages 570, ,609 Employee benefits 159, ,895 Supplies and other expenses 391, ,343 Interest and amortization of deferred financing fees 16,213 15,088 Depreciation and amortization 67,858 64,276 Total operating expenses 1,204,437 1,099,211 Operating income 89,782 32,554 Investment return 20,492 38,012 Excess of revenue over expenses 110,274 70,566 Other changes in unrestricted net assets: Distributions from New York-Presbyterian Fund, Inc. for the purchase of fixed assets 31,214 43,998 Net asset transfer to related parties (2,078) - Change in pension and postretirement benefit liabilities to be recognized in future periods (94,184) (31,271) Change in unrestricted net assets $ 45,226 $ 83,293 Source: Interim Unaudited Consolidated Financial Statements of the Hospital for the quarters ended March 31, 2016 and
11 SUMMARY STATEMENTS OF FINANCIAL POSITION (HOSPITAL ONLY) (in thousands) Unaudited Audited March 31, December 31, Assets Current assets: Cash and cash equivalents $ 244,962 $ 227,515 Short-term investments 1,098,113 1,087,581 Patient accounts receivable, net 556, ,992 Other current assets 131, ,249 Assets limited as to use - current portion 27,158 29,640 Professional liabilities insurance recoveries receivable - current portion 69,322 69,322 Beneficial interest in net assets held by related organizations - current portion 63,900 73,635 Due from related organizations - net 11,450 7,427 Total current assets 2,201,957 2,126,361 Assets limited as to use - noncurrent 2,076,210 2,120,717 Property, buildings and equipment - net 2,666,763 2,546,518 Other noncurrent assets - net 3,029 3,029 Professional liabilities insurance recoveries receivable - noncurrent 171, ,702 Beneficial interest in net assets held by related organizations - noncurrent 1,612,020 1,659,973 Total assets $ 8,731,681 $ 8,628,300 Source: Interim Unaudited Consolidated Financial Statements of the Hospital for the quarter ended March 31, 2016 and Audited Consolidated Financial Statements of the Hospital for the year ended December 31,
12 SUMMARY STATEMENTS OF FINANCIAL POSITION (HOSPITAL ONLY) (CONTINUED) (in thousands) March 31, December 31, Liabilities and net assets Current liabilities: Long-term debt - current portion $ 53,520 $ 55,375 Accounts payable and accrued expenses 421, ,604 Accrued salaries and related liabilities 206, ,114 Pension and postretirement benefit liabilities - current portion 16,014 16,014 Professional liabilities and other - current portion 69,322 69,322 Other current liabilities 185, ,351 Total current liabilities 952, ,780 Long-term debt 1,641,378 1,651,884 Professional liabilities and other 310, ,468 Pension liability 271, ,432 Postretirement benefit liability 23,833 23,846 Deferred revenue 2,077 2,266 Other noncurrent liabilities 303, ,682 Total liabilities 3,505,201 3,389,358 Net assets: Unrestricted 3,550,560 3,505,334 Temporarily restricted - held by related organizations 1,434,141 1,486,642 Permanently restricted - held by related organizations 241, ,966 Total net assets 5,226,480 5,238,942 Total liabilities and net assets $ 8,731,681 $ 8,628,300 Source: Interim Unaudited Consolidated Financial Statements of the Hospital for the quarter ended March 31, 2016 and Audited Consolidated Financial Statements of the Hospital for the year ended December 31,
13 The following ratios are presented for informational purposes to demonstrate the Hospital s liquidity, cash to debt, long-term debt service coverage and capitalization. The Hospital is subject to certain financial covenants under the documents governing its long-term indebtedness, the terms of which are set forth in the respective loan documents. Liquidity (Hospital Only) The following table sets forth: (i) the Hospital s unrestricted cash and investments and average daily operating expenses as of March 31, 2016 and December 31, 2015 derived from the interim unaudited consolidated financial statements for the quarter ended and audited consolidated financial statements for the year ended and (ii) days cash on hand derived therefrom. Liquidity Quarter Ended Year Ended March 31, December 31, ($ in thousands) Unrestricted cash and investments 1 $ 2,979,254 $ 2,942,748 Average daily operating expenses 2 12,629 11,733 Days cash on hand Includes all cash and cash equivalents, short-term investments, funded depreciation investments, board designated funds required by the Department of Housing and Urban Development to be set aside for completion of the Hospital s 2013 FHA-insured mortgage loan and investments made with 2015 bond proceeds, but excluding any donor restricted funds and other third party restricted funds. 2. Total operating expenses for the period less depreciation and amortization, divided by 90 and 365 respectively. 3. Unrestricted cash and investments divided by average daily operating expenses. 8
14 Cash to Debt (Hospital Only) The following table sets forth the Hospital s unrestricted cash and investments to long-term debt as of March 31, 2016 and December 31, 2015 derived from the interim unaudited consolidated financial statements for the quarter ended and audited consolidated financial statements for the year then ended. Cash to Debt Quarter Ended Year Ended March 31 December 31, ($ in thousands) Unrestricted cash and investments 1 $ 2,979,254 $2,942,748 Long-term debt: Bonds 1,693,427 1,706,659 Other long-term debt 2 53,415 53,608 Total long-term debt 1,746,842 1,760,267 Less: Current portion of long-term debt (58,007) (59,923) Net long-term debt 1,688,835 1,700,344 Unrestricted cash and investments to Long-term debt 176.4% 173.1% 1. Includes all cash and cash equivalents, short-term investments, funded depreciation investments, board designated funds required by the Department of Housing and Urban Development to be set aside for completion of the Hospital's 2013 FHA-insured mortgage loan and investments made with 2015 bond proceeds, but excluding any donor restricted funds and other third party restricted funds. 2. Includes capitalized leases. 9
15 Long-Term Debt Service Coverage (Hospital Only) The following table sets forth the debt service coverage based on maximum annual debt service for the Hospital for the quarter ended March 31, 2016 and year ended December 31, Long-Term Debt Service Coverage March 31, December 31, ($ in thousands) Income available for debt service 1 Change in unrestricted net assets $ 45,226 $ 265,670 Depreciation and amortization 67, ,098 Interest expense (including receipts and payments related to derivative instruments) 16,213 65,799 Net assets received from Fund, Inc. for the purchase of fixed assets (31,214) (105,460) Gain or (loss) from sale or disposition of assets not in the ordinary course of business _ 10,748 Gain or (loss) from pension termination settlements or curtailments _ 283 Change in unrealized gains and losses on investments (27,099) 73,778 Equity in income on alternative investments 8,634 18,856 Change in pension liability to be recognized in future periods 94,184 8,752 Total $ 173,802 $ 600,524 Annualized Total 1 695,208 _ Pro-Forma Maximum annual debt service 2 142, ,197 Pro-Forma Coverage 4.9x 4.2x 1. Income available for debt service is determined in accordance with the Master Trust Indenture. Line items not relevant to these periods are omitted. 2. Pro-Forma maximum annual debt service for the quarter ended March 31, 2016 and the fiscal year ended December 31, 2015 is determined giving effect to the issuance of the Series 2015 Bonds, and assumes level debt service on the Series 2015 Bonds over 30 years with the first principal payment payable in the fiscal year ending December 31, The Series 2015 Bonds in fact require no payment of principal until their maturity in
16 Capitalization (Hospital Only) The following table sets forth the capitalization of the Hospital as of March 31, 2016 and December 31, Capitalization As of March 31, As of December 31, ($ in thousands) Long-term debt: Bonds $ 1,693,427 $ 1,706,659 Other long-term debt 1 53,415 53,608 Total long-term debt 1,746,842 1,760,267 Less: Current portion of long-term debt (58,007) (59,923) Net long-term debt 1,688,835 1,700,344 Unrestricted net assets 3,550,560 3,505,334 Total capitalization 5,239,395 5,205,678 Long-term debt to total capitalization 32.2% 32.7% 1. Includes capitalized leases. 11
17 Management s Discussion and Analysis of Utilization Quarter ended March 31, 2016 compared to quarter ended March 31, 2015 For the quarter ended March 31, 2016, the Hospital s inpatient discharges increased 1,371 cases or 5.2% compared to the same period in This is partially attributable to the new physician recruits across various programs and the addition of new programs at various campuses. Emergency Room visits increased 6,841 visits or 10.3% compared to the same period in 2015 primarily due to the completion of the first phase of a multi-phase renovation and expansion of the Milstein Emergency Department at the Columbia Campus, increase in flu related volume and increase in psychiatric volume. Outpatient Clinic visits increased 6,002 or 3.8% compared to the same period in 2015 primarily due to extended hours at the Weill Cornell Campus rehabilitation clinic and increased volume at the offsite primary care clinics associated with the Columbia Campus. Ambulatory Surgery procedures increased 2,122 cases or 9.2% compared to the same period in 2015 primarily due to an increase in outpatient cardiac catheterization volume, resulting from the opening of a new catheterization lab in Westchester County. In addition, there were increased ambulatory surgery volumes at the Columbia Campus and Lower Manhattan Campus as a result of new physician recruits across various programs. Mental Health Clinic visits increased 576 visits or 2.0% compared to the same period in 2015 was driven primarily by the increase in the psychiatric clinic visits at the Westchester Division and the pediatric psychiatric visits at the Columbia Campus. 12
18 Management s Discussion and Analysis of Recent Financial Performance Quarter ended March 31, 2016 compared to quarter ended March 31, 2015 For the quarter ended March 31, 2016, the Hospital had operating income of $89.8 million, a $57.2 million or % increase over the same period in Excess of revenues over expenses was $110.3 million, which represented a $39.7 million or 56.2% increase over the same period in For the quarter ended March 31, 2016, net patient service revenue, less provision for bad debt, increased $155.1 million or 14.5% over the same period the previous year. This increase was driven primarily due to higher utilization across most of the inpatient services, realizing higher rates, a higher case mix and increased outpatient activity across most outpatient services. For the quarter ended March 31, 2016, other revenue increased $7.4 million or 11.6% over the same period in 2015, due primarily to increased distributions from provider owned health insurance plans. For the quarter ended March 31, 2016, total operating expenses increased $105.2 million or 9.6% compared with the same period in the previous year. Salaries and benefits increased $57.8 million or 8.6% over the same period in the previous year. This increase is primarily a function of having 1,065 more full time equivalents to accommodate increased patient days, investments in care coordination, population health improvements, information technology and innovation, expanded emergency services and new clinical initiatives, most notably the spine programs at the Allen Hospital and Lower Manhattan Hospital, coupled with the corresponding increase in benefits and wage increases. For the quarter ended March 31, 2016, supplies and other expenses increased $42.7 million or 12.3% over the previous year. This increase was primarily due to an increase in expenses related to pharmaceuticals resulting from more ambulatory oncology visits. Interest and amortization of deferred fees has increased by $1.1 million or 7.5%, primarily due to the Hospital issuing $750.0 million of taxable debt in February Depreciation expense increased $3.6 million or 5.6% reflecting the completion of a number of Hospital capital projects. 13
19 Outstanding Long-term Indebtedness A summary of long-term indebtedness of the Hospital as of March 31, 2016 and December 31, 2015 is set forth in the table below. For a detailed discussion of the Hospital s debt structure, including the categories of debt shown below, see Debt Structure in the Disclosure Report for the Fiscal Year Ended December 31, 2014, which was released on May 29, Outstanding Long-term Indebtedness Outstanding at March 31, December 31, Indebtedness Maturity Date ($ in thousands) FHA-Insured Mortgage loan (fixed rate, taxable) 2025 $213,755 $218,404 Mortgage loan (fixed rate, taxable) , ,341 Mortgage loan (fixed rate, taxable) , ,359 MTI - Series 2015 Bonds , ,000 (fixed rate, taxable) Lower Manhattan Hospital Dormitory Authority of the State of New York Secured Hospital Revenue Refunding Bonds, Series 2011 (fixed rate, tax-exempt) ,295 26,555 Other Capitalized leases 53,415 53,608 Total $1,746,842 $1,760,267 Add: Unamortized fair value adjustment related to NYP/Lower Manhattan acquisition 1,199 1,289 Less: Deferred financing cost, net of accumulated 53,143 54,297 amortization Total $1,694,898 $1,707,259 The Hospital has a $100.0 million committed unsecured line of credit agreement with a bank that expires on June 30, No amounts have been drawn on this facility. This is a 364-day line of credit that is generally renewed annually. The Hospital is in the process of renewing it through June 30,
20 Investments The following is a summary table of the Hospital s cash and investment assets, including the Hospital s beneficial interest in net assets held by related organizations as of March 31, 2016: Total Beneficial Hospital Investment Assets Interest Assets Total (in billions) $4.7 $1.3 $3.4 Cash 8% 1% 10% Treasuries Public Equity Private Equity Real Estate Natural Resources Hedge Funds Credit % 100% 100% Source: Hospital records. For long-term funds, the Hospital has adopted a return-oriented, well-diversified asset allocation strategy. Long-term (trailing 3 and 5 year) results for the investment funds have outperformed benchmarks. The above table detailing the Hospital s investment assets, including the Hospital s beneficial interest in net assets held by related organizations comprises the majority of the investment assets under the purview of the Investment Committee and Office of Investments. The Hospital component includes investments limited as to use, including funded depreciation, funds held under loan agreements, and funded self-insurance. The Hospital component also includes short-term and cash equivalent investments maintained for purposes of operations and other needs of the Hospital, escrow funds, and other assets. The beneficial interest component is almost entirely comprised of the Hospital s beneficial interest in Fund, Inc. The table does not include investments for the Hospital s pension plan, which is invested similar to other long-term assets. The table below shows, as of March 31, 2016, the liquidity of the Hospital s investment portfolio, with 78% or $3.7 billion of assets accessible within one month. Pension assets are not included. Hospital Hospital Long-Term Fund Current Investments Total 1-5 Days 40% 100% 72% 6-31 Days 13 N/A Months 10 N/A Months 5 N/A Years 3 N/A 2 3+ Years 29 N/A 13 Total 100% 100% 100% Source: Hospital records. 15
21 The table below shows (i) the amount of investment assets of the Hospital under management as of March 31, 2016 and December 31, 2015, and (ii) the investment performance of the long-term portfolio through March 31, 2016 and December 31, March 31, December 31, Investment Assets Under Management (in billions) $4.7 $4.8 March 31, December 31, Long-term Portfolio Investment Performance (2.7%) (1.3%) Source: Hospital records Philanthropy In 2012, the Hospital, through Fund, Inc., publicly launched a $2.0 billion capital campaign. As of March 31, 2016, over $862.0 million in pledges and gifts have been made towards this campaign since its launch date. In 2007, after completing a historic $1.0 billion campaign three years ahead of schedule, the Hospital began the Quiet Phase of the current $2.0 billion campaign. When considering pledges and gifts received during the Quiet Phase of the campaign, as of December 31, 2015 the Hospital has received pledges and gifts of $1.6 billion against the $2.0 billion campaign. Capital Expenditures For the quarter ended March 31, 2016 and the year ended December 31, 2015, the Hospital incurred capital expenditures of $184.1 million and $492.7 million, respectively, for acquisition of plant, buildings and equipment (net of disposals). In 2014, the Hospital commenced construction of a 452,964 square foot ambulatory care center which is expected to be completed in These expenditures were funded from internally generated cash flow, donations and proceeds of an FHA-insured mortgage loan. Royal Charter Properties For the quarters ended March 31, 2016 and 2015, the Hospital received distributions from the RCP Corporations of $10.9 million and $12.1 million respectively. The amounts are included in other revenues on page 5 of this report Summary Statements of Operations. The board of directors of each of the RCP Corporations has complete discretion within its stated corporate purposes with respect to the distribution of its excess revenue; there is no legal or contractual requirement that these amounts be distributed to the Hospital. New York-Presbyterian Fund, Inc. See page 5 of this Report, Summary Statements of Operations for amounts distributed by Fund, Inc. to the Hospital for the purchase of fixed assets for the quarters ended March 31, 2016 and Fund, Inc. holds certain assets on behalf the Hospital that are restricted and may only be used for the benefit of the Hospital. In addition, Fund, Inc. holds unrestricted assets which it may use in its discretion. There is no legal or contractual requirement that Fund Inc. make distributions of unrestricted assets to the Hospital. 16
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