Mississippi Baptist Health Systems continued to post operating losses in 2016. The hospital system has suffered such losses four out of the last five years and Fitch revised its ratings outlook to negative last March. Baptist revenue has increased but the system still suffered a $3.9 million loss that was nearly double projections. However, that was an improvement over the previous two years that saw operating losses of $17 million and $29 million. Baptist is also hurt by some gambling on variable rate swaps on bonds as well.
Baptist provides quarterly and annual financial statements as part of its regulatory compliance for issuing bonds. The 2016 annual report is posted at the bottom of this post. The annual report states:
For FY 2015, the Health System had a $32.1 million increase in total revenue, increased non-capital expenses of $17.1 million and increased capital expenses of $2.7 million. During FY 2015, MBHS acquired two critical access hospitals, Baptist Medical Center-Yazoo (BMC-Yazoo) and Baptist Medical Center-Attala (BMC-Attala) and opened the Baptist Heart Clinic. The addition of the two critical access hospitals resulted in $11.4 million in additional total revenue and $14.2 million in operating expense for FY 2015. The remaining increase in operating revenues can be attributed to inpatient and outpatient volume growth and revenue cycle stabilization during FY 2015. Excluding the critical access hospitals, total noncapital and capital expenses increased by only $5.5 million due to labor control and contract management....
This table shows year-to-date operating loss of $3.9 million and operating EBIDA of $38.2 million. Net operating revenue grew by 10.4% over prior year, and over the budgeted growth by $2.7 million. Actual inpatient volume as compared to budgeted volume for the Medical Center was under budget by 167 admissions but ahead of prior year. Outpatient volume has been above budget expectations and above prior year. Actual non-capital operating expenses are above budgeted expectations and above prior year. Actual capital related expenses are below budgeted amounts. This resulted in an operating loss of $3.9 million for the August 2016 year-to-date financial performance as compared to a budgeted loss of $2.1 million. The non-operating gain is $5.2 million versus the budgeted gain of $7.7 million and the $4.5 million gain in the prior year. Included in this line item are year-to-date realized investment gains totaling $19.3 million, unrealized investment losses of $14 million, and a $9.8 million negative change in valuation of the fixed payer swap transaction entered into in March 2007...
Some highlights of the 2016 annual report are:
*Admissions increased from 20,264 patients in 2011 to 21,868 patients in 2016. Nice increase but it was 167 patients below projections (See Table 5 on page 7). ER visits at MBMC showed positive growth while the average daily census dropped seven patient per day in five years. However, the 2016 budget expected the daily census to be 302 patients instead of the actual 290 that was posted.
*Revenue increased from $368 million in 2011 to $526 million in 2016 and exceeded projections. However, expenses are hurting Baptist. Salaries and benefits increased over $100 million in five years- $216 million to $331 million. Baptist acquired two hospitals and opened a clinic so such increases are probably to be expected after such expansion.
*Baptist has posted an operating loss four out of the last five years:
2011: -$6.6 million
2012: $4.5 million
2013: -$22.7 million
2014: -$29.3 million
2015: -$17 million
2016: -$3.9 million
The budget expected losses to be $2 million in 2016. However, the actual losses were almost double projections. The budgeted amount is in parenthesis.
*Mix of payors:
Medicare: 54% (56%)
Medicaid: 8% (8%)
Blue Cross: 15% (14%)
HMO/PPO: 14% (13%)
Private insurance: 1.5% (2%)
No Insurance: 7.7% (7%)
*However, there is one blight on the balance sheets of Baptist: Swaps. Yup, Baptist gambled with bonds that carried variable rates in 2007. Note IX states:
On March 1, 2007 Mississippi Baptist Health Systems entered into a 67% of one-month LIBOR fixed payor swap with USBAG. The swap had a notational amount of $80 million (Series 2007B bonds) and is fixed at 3.759% for a term of thirty years.
As a result of the 2010 Fitch downgrade to “BBB+” by Fitch Ratings, earlier in 2013, UBS requested that Baptist post collateral on the value of the swap agreement, in accordance with our swap agreement executed with the Series 2007 debt issuance. On April 29, 2013, Baptist entered into a swap novation agreement with Deutsche Bank. The agreement calls for Deutsche Bank to post $5M of collateral at the “BBB” rating level, by Fitch ratings with a net interest cost of 6.25 bps on the $80M swap. As of August 31, 2016, the Health System has posted collateral of $27,033,239, an increase of $22.6 million from August 31, 2015.
As of August 31, 2016, the valuation of the swap was a $31.1 million liability, an increase of $9.8 million from August 31, 2015. This is reported on the balance sheet in other long-term liabilities.
The hospital system also issued another $80 million in variable rate bonds in 2009 as well. Variable rates bonds do not have a fixed interest rate that is amortized for the term of the bonds. Baptist essentially bet against the market with a variable rate. When the bond gods are kind to Baptist, the system makes more money from the bonds. However, the system loses money when interest rates go the wrong way.
*Baptist owes $12 million on bonds issued to finance the construction of the Madison site. The interest rate was fixed at 2%. However, the bonds were issued in 2006 and supposed to mature in 2012 but were refinanced. The original bonds had a variable interest rate.
However, Fitch had a few things to say about Baptist's finances when it revised the outlook for Baptist to negative (Keep in mind that this statement is based on 2015 results):
The revision of the Outlook to Negative is driven by MBHS's failure to stem the sizeable operating losses of the last three years. Recent losses are related to the difficulties with MBHS' current Paragon Electronic Health Record (EHR) installed in 2014, which has been a barrier to implementing certain efficiency initiatives. The acquisition of two critical access hospitals (CAHs) and other unbudgeted expenses also contributed to MBHS' suboptimal performance in 2015. While improved over prior year, MBHS' operating results failed to meet budget in fiscal 2015 (year-end Aug. 31) with a $23.4 million operating loss (negative 5.1% operating margin), and continue to trail budget at a negative 3.4% operating margin through the three-month 2016 interim period ended Nov.30 2015....
Fitch issued its press release on March 1, 2016. It rated the MBHS's bonds at BBB.
Kingfish note: Notice the date of the annual report: twelve months ending August 31, 2016. Baptist announced the next day it would collaborate with Baptist Health Systems in Memphis.
32 comments:
Suggestion, QUIT PLAYING THE VARIABLE RATE markets.
Watch the movie The Big Short on Netflix.
If only Baptist had a Children's Hospital that received lots of donations it could annually suck dry to cover its losses.
Can someone show Chris Anderson where they keep the pension money? He'll get this fixed in no time.
The bonds aren't as risky as the swap. Interest rate swaps are simply a money maker for bankers, advisors and lawyers. Hospitals need to stay out of the arbitrage game.
Ask almost anyone who works there. It does not come as a surprise that they lost money. Their retirement system does the same thing.
employee costs have increased how much?
looks like its time for the entire place to take a 30% cut in pay.
Do they add in contract work in with employee costs? Too many employees cannot do their job and contractors have to be hired to do their job. This does give some people at Baptist the chance to make some extra spending money off the contractors. Just ask the one man who received a new truck the day after giving a certain company a contract.
As a vendor to this hospital, I'm not surprised. They are difficult to work with and dismiss cost savings iniatives routinely, usually because it takes a little work to employ. Not to mention, Group Purchasing Organizations (GPO) work to protect high volume vendors, and their profit margins. Free market, capitalistic purchasing policies do not exist in healthcare. This needs to change. http://www.forbes.com/2009/11/12/gpo-medicare-hospitals-medical-health-opinions-contributors-daniel-delay.html
As far as the Madison campus goes, it was the subject of a tax problem with Madison County. They contended for years that it was a hospital, which was not true. I understand they had to fork over $500,000 in back taxes.
cut employee salaries and refuse medical care to those without insurance.
Don't know a lot about how hospitals operate but upon returning home to SC after 15 years in MS I was shocked. Hospitals in the Greenville and Columbia markets have consolidate big time. In Columbia Richland Memorial (county hospital) Baptist and University have merged into Palmetto Health a six hospital system. In Greenville the Greenville Hospital System now has 11 hosptials and is searching for more.
The buzz word is hospital consolidation to save cost. patient care seems to be lost in all of this. The Greenville project is working to take out all legislative input into all the process in order to speed up the process and have less interference.
God help us.
Let's look at the facts---Baptist has several million dollars worth of property on Lakeland ($7,000,000+)---Hwy 49 Richland ($5,000,000)---Madison ($8,000,000) and they won't sell any of it. There is a certain person that handles the real estate for Baptist and it's obvious that he does not have a clue. The Board is full of talented Real Estate developers and I don't understand why they can't get a handle on this situation.
Baptist and St. D suck at patient care.
Karma
10:35, I have seen the Baptist hospital refuse to treat people before. One man was on his way to the hospital in an ambulance. When the ambulance got to the Baptist the driver was met at the emergency room door and told to take the man to another hospital. They refused to allow the man inside of the hospital. The man died on the way to another hospital.
I wouldn't worry about Baptist's profitability, the President Elect has promised that this health-care thing will be fixed very easy and quick.
Medicare cuts are killing healthcare. The volume of patients is going through the roof and Medicare is wacking reimbursement left and right. While adding on tons of regulation and auditing to claw back whatever they paid in the first place.
With the end of Obamacare and Medicaid and soon to come voucher program for Medicare they should not have any difficulty reaching a $30 million per year loss in 2018.
4:10 - Nobody cares to read verbose comments about problems with zero mention about solutions. Did you know that before you read my post?
6:28,
You're adorable. The only option is to opt out of medicare or bust your ass to increase your rating for a more favorable reimbursement rate.
Which one do you see happening?
While St. D is laying people off
I have worked there in the past...and all I can say is that "THE LORD WORKS IN MYSTERIOUS WAYS", especially at MBMC!!! I don't trust Baptist management any further than I can throw them.
Chris Anderson left a huge mess on the coast. He should be in jail
and for at least the past 4 years, they have had a construction / renovation project of some type going on at their campus. While they may be reporting a loss, they sure aren't sweating it. Admin heavy and and growing.
The continual construction, the facade of the cancer center and the new entrance to the left, rear are all simply tricky gimmicks to make us think the place is profitable and a preferred destination venue for sick people.
Take Me To Ruleville.
Baptist will be fine. All hospitals are losing money. Baptist is pursuing a merger to consolidate, St D's is a prime buyout target, only 1 of the 5 Merit hospitals makes any money and all 5 are for sale. UMC is in a different category as they are state supported (which makes them bloated and inefficient). Across America probably 1/4 of the hospitals open today will either merge or close in the next decade. Baptist's strength is its clinic network (to feed the hospital). St D's realized late that this is what they needed so they bought MEA. Now St D racing to build a primary care referral base to keep the mothership open. Somebody mentioned quality of care... Baptist and St D deliver the highest quality in the metro area. River Oaks is really just a procedure center for the docs that operate there to get richer. Or maybe you were saying Merit Central was better?
The entire medical industry must be reorged for the US financial system to survive. Read Karl,https://market-ticker.org/, on this and ignore on your children/grandchildren's own peril.
If it weren't for the swap loss (which leadership owned up to and took the heat for), MBHS would have posted a profit. Either way, they made a HUGE swing to the good this past year. They continue to be awarded for safety, quality, patient care. Why all the vitriol? I've had family there as patients. I've had major surgery there. The positives about Baptist far outnumber any negatives. How many people who are familiar with the treatment at all the metro hospitals would choose to go anywhere else but Baptist if they had a choice?
2:27; Do you see me waving my hand over here? I've undergone major procedures at UMC, Baptist, St. Dominic and what used to be River Oaks but is now Merit. I've never been to the one on I-20 and would never set foot in the one in Canton.
But, given a choice, I would not allow anybody to take me anywhere other than St. Dominic.
Some three years ago, or thereabout, Baptist in Madison moved it's medical clinic from the big intersection on the interstate to downtown Madison just east of McAlisters, at the corner of Old Canton Road. Really big, nice clinic with receptionists behind sliding glass and magazines and stuff and a handicap-button to make the front door open. They must be doing something right.
As KF noted. MBHS is 'collaborating' with Baptist Memorial in Memphis. In due time, we all will understand this to actually be a merger with Memphis making the decisions.
When vendors try to work with them on reducing cost, they won't even consider it. Why?
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