For this Week 13 Fall 2020 Semester Nsg. 623 group assignment, the group analysis will focus on the period covered in the financial statements that groups have been provided, comprising the most recent year available and the prior year financial results—the latter is typically provided in audited financial statement for comparison purposes.
Steps in conducting the analysis of Financial Statements are addressed in a detailed, step-by step process described in the document below.
The Assignment Rubric begins on page 9 of this document.
When completing the title page for the APA-adherent paper that comprises the written portion of the Assignment, please use the correct spelling of my last name.

Assignment Purpose and Goals:
 To gain familiarity with the structure and content of health organizations’ annual financial statements/footnotes.
 To apply ratio analysis to assess the organization’s performance and compare the resulting ratios to national benchmarks relative to organizations’ size and service area.
 To summarize information developed through the group financial statement analysis and to provide an assessment of the financial status of the organization based on their financial statements provided for the assignment.
Financial statement analysis serves to:1,4
 Summarize and evaluate the financial condition and operating results of the enterprise (business, organization)
 Inform analysis re: where the organization is situated in terms of performance, liquidity, solvency, and leverage
 Provide a reliable basis for making economic forecasts and decisions
 Enable an assessment of whether the organization is stable or growing, or unstable

Three main objects of financial statement analysis are:
 Statement Financial Position (AKA Balance Sheet in for-profit organizations)
 Statement of Operating Results (Income Statement)
 Cash Flow Statement

Basic Concepts of Financial Analysis Based on Financial Statement Include:
 Specific data for each part of the report reflect only the starting point for analysis, or the surface of the analysis.
 Ratios of indicators comprise a skeleton of the analysis
 Trend analysis (comparing data from most recent year to at least prior year and additional later prior years, if available) reflects an elemental part of the analysis. This means: for the fiscal years in which you are reviewing data, how have major categories of assets and liabilities changed?

 Reference Note: financial statement analysis often is supplemented by operating indicator analysis (statistics or statistics budget), which is based on data not typically found in in audited financial statements of an organization.7 These factors can include productivity measures, as well as occupancy, case mix, payer mix, and length of stay, or outpatient settings’ units of service/procedure volume. These indicators provide context for understanding of factors that influenced the financial performance documented in financial statements. Specific ratios used in financial analysis of financial statements depend on the type of provider organization—meaning that select ratios may be more relevant for hospitals/systems, or MCOs, or medical care practices, or ambulatory care organizations.

Method of Financial Statement Analysis for this Assignment:
The primary assignment tasks are:
1.Reading the statements to experience/understand what audited financial statements look like; how financial information is reported in the standard reporting format; how they can be used to assess the financial status of the organization; how they can be analyzed; and what key information is reported in footnotes; or supplemental notes/Appendices.
2.Identifying major differences in documented values in and significance of the organization’s:
–Income Statement, between the two years (of figures)
–Balance Sheet between the two years (of figures)
–Cash Flow Statements between two years (of figures)
3. Calculating a nominal set of key financial ratios based on type of healthcare organization and its financial information contained in the statements, and then deciding on the meaning of calculated ratios.
4. Identifying/summarizing any significant issues identified in the auditors’ statements/footnotes—these can relate to market conditions, unexpected events impacting annual revenue and/or expense, and debt or purchase/sale of assets.
Here are the general steps for working through the financial statements to gain information on the organization’s reported financial statements to which you have been assigned to analyze:
A. First, review/compare the figures in each category horizontally across the two years of statement values to assess/ how figures compare from the same category from present year to previous year (or more years if available).
Evaluate: what changed between the current and prior years and by what % did the change amount to?

B. Second, review and evaluate figures for each year vertically, within each of the two years to assess how financial statement line items impacted other parts of the organization’s line items for each year.

Evaluate: Does any line item (vertically in each year) suggest concern regarding profitability or solvency?

C. Third, complete the calculation/ analysis/documentation of the listed performance ratios in the Balance Sheet, Income Statement, Cash Flow Statement sections (below) for the two years of financial information that you have been provided in your group’s assigned organization’s financial statements. Be sure to calculate/compare all listed ratios in each of the two fiscal years. Comparing these ratios between the two fiscal years of the Financial Statement is a part of determining “trend” in financial condition of the organization.
Note: Not all ratios used to interpret financial statement data are reflected in this assignment exercise. The ratios that you are expected to calculate and apply in your analysis are clearly identified in this guidance. For your future reference, the Almanac of Hospital and Operating Financial Indicators (Optum360, published annually)8 includes over 30 financial indicators.7

D. Fourth, read the auditors’ opinion letter and the organization’s executive’s letter which usually precedes the auditors’ opinion letter.

Evaluate and document: Did the financial statement auditors (CPA firm) provide a an acceptable (clean) audit opinion?

Evaluate and document: What was the principal message that the organization’s executive’s* letter provided (if one was provided with the audited statements—*these are not always made available on-line)?

E. Fifth, summarize your analysis findings in a maximum 4-5 page, APA-adherent (in scholarly format) paper. Include in an Appendix to your group paper a list of the calculated ratios that your group completed for the analysis of the financial statements.

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Three financial statement analysis categories are described below, with guidance on their significance, typical elements, and specific questions to be answered, analyses to be done and ratios to be calculated, analyzed, trended and summarized at the end of your analysis.
The Balance Sheet
1. The Balance Sheet (in Not-for Profits: referred to as the Statement of Financial Position, though Balance Sheet is term used in this overview) = a record of the organization’s financial position at one time point. The Balance Sheet lists the current period’s (per fiscal/calendar year for the purpose of this assignment) assets, liabilities, and net assets*(*referred to as owners’ or shareholders’ equity in a for-profit entity). For review:
Assets: what an organization uses to operate its business. Liabilities +Equity are two sources that support the business’ assets.
a. Evaluate: the status of the organization’s assets by identifying Total Assets, Total Liabilities and Net Assets (Total Assets-Total Liabilities =Net Assets).
b. Evaluate an document: The status of Current Assets: cash and cash equivalents, accounts receivable, and the value of inventory—these are assets that have a lifespan of one year or less, which means that they can be converted into cash.
 As noted above, included in Current Assets are Accounts Receivables (A/R), which represent short term obligations owed to company by clients (in healthcare, insurers, and other guarantors like patients).
Evaluate and document: How do the $ amounts compare from prior to current year in the Current Asset line item as a whole?
 Evaluate and document: Are Accounts Receivable being managed to maximize liquidity? (i.e., are Days in Accounts Receivable at or below average days for health systems per HFMA standards?) Several HFMA ratio averages are listed on pages 6 or refer to https://hfma.org for recent average figure.
 As noted above, included in other Current Assets are Cash Equivalents that can readily be converted into cash, or cash deposits.
 Evaluate and document: How does each category of Cash Equivalents $ amounts compare from prior to current year? In what category have cash equivalents changed from prior to current year?
c. Evaluate and document: Long-term Assets, that are also referred to as fixed assets or capital assets that a business will use, replace or convert to cash beyond one fiscal year (i.e., have a life over one year and/or cannot be turned into cash easily) This asset category is comprised of property, plant and equipment: can include buildings, vehicles, fixtures, land, capital equipment., technology or intangible assets (like goodwill, patents, and copyrights).
Liabilities: Liabilities are financial obligations that an organization owes to outside parties.
Current Liabilities: Liabilities that that are due or need to paid within one year. Liabilities in this category include short-term borrowings, such as accounts payables. The category also includes the current year portion of longer-term borrowing (i.e., an interest payment within the year on a 10-year loan.
Long Term Liabilities: Debt and non-debt financial obligations due after a period of at least one year from the date of Balance Sheet.
d. Evaluate and document Current Liabilities: How have Current Liabilities changed in $ value from prior to current year?
e. Evaluate and document Long-term Liabilities: How have Long-term Liabilities changed in $ value from prior to current year?
Information contained in a Balance Sheet is typically analyzed utilizing financial ratio analysis. Primary categories of financial ratios for analyzing a balance sheet include some ratios within the categories of Liquidity Ratios and Profitability Ratios; the latter category reflects ratios that fall into two categories: margin ratios and return ratios. Margin ratios are also utilized in financial analyis of income statements.
Financial Strength Ratios indicate how well an organization can meet its financial obligations and how these obligations are leveraged. Calculate and document:
 The Debt-to-equity ratio provides a measure of the financial condition of the organization and operating efficiency, debt utilized for financing an organization’s assets: Formula: Total Liabilities/Total Assets
 The Debt Service coverage ratio measures the business’s ability to meet its debt repayments. Formula: net revenue available* for debt service divided by principal payment +interest each (per fiscal year).
(See ReadyRatios.com or hfma.org for industry average 2019)
 The Current Ratio (also called the working capital ratio) measures the extent of the $ value of current assets to current liabilities. In general, the ratio of “1” or above is a reasonable ratio—it indicates that the business has enough current assets to repay its current liabilities.
Formula: Current ratio=Current Assets/Current Liabilities
 Average Age of Plant (in years) is an indicator of the financial age of plant fixed assets of the business. The older the average age of plant, the greater are the short- term needs for capital resources. Formula: Accumulated depreciation/depreciation expense (in each reporting year in which you are calculating the ratio). (See: https://hfma.org for recent average figure)
Activity Ratios focus on Current Assets management, and measure how the organization manages operations in the areas of Accounts Receivables, inventory, and Accounts Payable. Key ratios to Calculate and document are: (See https://hfma.org for recent average figures) are:
 Receivables Turnover (days) or also referred to as Accounts Receivable days, a measure of efficiency of the collections function. Formula: (Net patient accounts receivable x365)/net patient revenue

 Average Payment Period (days), a measure of how efficiently an organization pays its bills.
Formula: (Total current liabilitiesx365) Divided by (total operating expense minus depreciation and amortization expenses)

Income Statement:
2. The Income statement (Statement of Activities) documents the profit (or loss) of the business over the period of time covered by the financial statements.
. Evaluate and document: Describe the status of earnings—first identify gross and net revenue figures for the reporting year-compare current year to previous years’ figures, via the application of margin ratios (mentioned below).
. Evaluate and document: Is revenue increasing as fast as expenses? Did the bottom-line meet budgeted/expected amounts? The latter question might be addressed in the auditors’ notes or CEO/CFO cover letter if part of financial statements available publicly, otherwise you may not be able to answer this question.
. Evaluate and document: Is the organization overly-dependent on a revenue source outside of patient revenue, i.e., premiums from a contracting HMO? —this may be difficult to tell from financial statements but do check if that category is listed under revenues in the financial statement.
. Evaluate and document: Whether any increase in assets comes from debt or equity (for a not-for profit, equity includes accumulated funds). In a for-profit business, accumulated funds are called owners’/shareholders’ equity.
See https://hfma.org for recent average figures:
• Calculate and document: the Operating Expenses as a Percentage of Net Operating revenue—provides insight into how operating expenses relate to revenue for the year and how this may change over time. Formula: Operating expenses/net Operating revenue

• Calculate and document: the Operating Margin: Formula: operating margin = (total operating revenue-total operating expense)/net operating revenue

• Calculate and document the Total Margin (also called Profit Margin): measures the ability of the organization to generate revenues from all sources and to control expenses—the higher the total margin, the lower the expenses relative to revenues.7 Formula: net income/(net operating revenues+ non-operating income)

• Calculate and document the Return on Assets (ROA): measures how well the organization is using its assets to generate income while controlling expenses. The higher the ROA, the greater the net income is for each dollar invested in assets. Formula: net income/total assets

Statement of Cash Flow
It is important to examine the cash flow statement to see how much cash the business has received, used, and retained in each fiscal year (this accounting can be done in months and quarters as well, but not in this assignment).
Over the two-year period covered by the financial statements, Evaluate and then document the following:
• Determine/document whether the organization is using more cash that it is generating in each fiscal year
• Document how the current year cash flow compares to prior year
• Document whether there is a positive cash flow from operations in each fiscal year
• Document whether the organization has at sufficient (at least 60 days) operating cash on hand (see below for Ratio description/formula under Calculate: Days Cash on Hand).
• Document where funds came from (i.e., operations; an affiliated Charitable Foundation; borrowing proceeds, external grant funding; other sources (i.e., facility gift shop or an affiliated volunteer group).
• Document where the funds went, as well as how the overall liquidity of the organization was affected.
• Document how much cash remains at the end of the reporting period (each fiscal year in case if financial statements used in this Assignment).
• Document if the inflow of cash minus outflow of cash should equal the remaining cash on the Statement of Cash Flow in each of the two fiscal years.
Evaluate the liquidity assets of the organization via:
• Calculate and document: Days Cash on Hand (a Liquidity measure) Formula: unrestricted cash and cash equivalents +short term investments divided by/(expenses-depreciation)/365
See https://hfma.org for recent average figure
_____________________________
Here some examples of healthcare industry ratio/indicator averages available for 2017 from Becker’s Hospital CFO Report (3). You can find other benchmarks via a literature search or Web search or in your text.
 Operating Margin 1.6 percent
 Return on Assets: 3.7 percent
 Cash on Hand: 209 days
 Annual operating revenue growth rate: 4.6%
 Current ratio: 1.9x
 Total debt-to-capitalization: 33.7 percent
 Days in Accounts Receivable: 48.4 days
 Average age of plant: 11 years (2016)
 Debt to Equity Ratio (Equity=Fund Balance for Not-for-Profits) 1.0 or less
Additional Ratio Benchmarks:
Investopedia, Becker’s’ Financial Reports, the HFMA, or the American Hospital Association, your course text or any additional evidence-based source may be used a refence for any ratio not listed above.

References
1. Chou, Lewis. Guide to Financial Analysis for Beginners (06.26.2020). https//towardsdatascience.com
2. U.S. Securities and Exchange Commission, Beginners’ guide to financial statements (02.05.2007). https://www.sec.gov/reportspubs/investor-publications/investorpubsbegfinstmtguidehtm.html
3. Ellison, A. Becker’s Hospital CFO Report. 45 Financial benchmarks for hospital executives (06.26.2019). https://www.beckershospitalreview.com/e-weeklies/beckers-hospital-cfo-report-e-weekly.html
4. Healthcare Financial Management Association, Key Hospital Statistics and Ratio Medians: Glossary of Formulas (10.12.2012). Accessed 10/18/2020, from https://www.hfma.org/topics/research_reports/1113.html
5. Beasley, T. Becker’s Hospital Reports. How to gauge your hospital’s financial health. (10.05.2020). Accessed 10/20/2020 from: https://www.beckershospitalreview.com/how-to-gauge-your-hospital-s-financial-health.html
6. Investopedia_faq.com
7. Gapenski, L.C. & Reiter, K.L. 2016. Healthcare Finance, Sixth ed. Chicago: Health Administration Press.
8. www.optumcoding.com/Product/

Financial Statement Analysis Rubric
N623 Fall 2020
Writing/Composition/Organization Points: 24-22 Points: 21-19 Points 18-16
Structure-logical organization and clear sequence of writing • Shows coherence, logically developed paragraphs
• Consistently uses effective transitions between ideas and sections
• Constructs a fact-based and informative Exec summary, main introduction, and conclusion sections
• Shows some coherence and some logically developed paragraphs
• Uses some effective transitions between ideas and sections
• Shows some construction of appropriate Exec summary, main introduction, and conclusion sections • Shows minimal coherence and logically developed paragraphs
• Uses minimal transitions between ideas and sections
• Shows minimal construction of appropriate Exec summary, main introduction, and conclusion sections

Points: 24-22 Points: 21-19 Points 18-16
Writing Elements—effective application of vocabulary and basic sentence structure in sentences within Business Plan sections. • Writing is concise, effective, and focused on task (assignment) elements
• Effectively uses correct, varied, and concise sentence structure
• Writes appropriately for purpose and audience (i.e., for presenting a Business Plan or SWOT analysis summary in your organization)
• Writing reflects application of logic, reason, and graduate course learning activities and objectives
• Applies APA-writing, formatting, and referencing standards in written assignment, including pagination
• Provides cover sheet with date/course
and topic, as well as author’s name. • Writing is somewhat concise, effective, and focused on task (assignment) elements
• Generally, uses correct, varied, and concise sentence structure
• Generally, writes appropriately for purpose and audience (i.e., for presenting a Business Plan or SWOT analysis summary in your organization)
• Generally, writing reflects application of logic, reason, and graduate course learning activities and objectives
• Usually applies APA writing, formatting, and referencing standards in written assignment, including pagination
• Provides cover sheet with date/course
and topic, as well as author’s name. • Writing shows minimal conciseness, effectiveness and focus on task (assignment) elements
• Uses incorrect, simplistic, or haphazard sentence structure
• Submitted work lacks appropriate writing for purpose and audience (i.e., for presenting a Business Plan or SWOT analysis summary in your organization)
• Generally, writing reflects minimal logic, reason, and graduate course learning activities and objectives
• Uses inappropriate jargon or cliches in content
• No consistent evidence of application of APA writing, formatting, and referencing standards.
• No cover sheet completed and/or pagination absent

Writing Conventions-adherence to grammar rules: usage, spelling, and mechanics of Standard Edited English • Makes accurate word choices
• Makes virtually no errors in Standard Edited English (SEE) • Almost always makes accurate word choices
• Makes some errors in SEE • Makes many inaccurate word choices
• Makes many errors in SEE

Information Literacy and Source Integrity—locating, evaluating, and using effectively needed information relevant to assignment • Uses academic and reliable information sources
• Chooses timely resources for the topics/assignment
• Integrates references and quotations to fully support ideas
• Correctly sites sources for all quotations and paraphrases • Uses mostly academic and reliable information sources
• Mostly chooses timely resources for the topics/assignment
• Integrates references and quotations to provide support for most ideas
• Correctly sites sources for most quotations and paraphrases • Submission lacks academic and reliable information sources
• Chooses a few resources with inappropriate dates
• Integrates references or quotations that are loosely linked to content in the assignment
• Provides minimal quotations for quotations and paraphrases

Assignment Content—quality of information, ideas and supporting detail
Submitted group analysis (1 paper submission per group):

Paper contains answers to each of the Evaluate, Document and Calculate tasks/questions listed in Assignment description and completion guidance provided by faculty.

Provides depth of content in each: item
• Applies/conveys insight and original thinking in responding to Financial Statement analysis guidelines provided by faculty and course text
• Follows APA guidelines for presenting, formatting, and writing analysis of Financial Statements Submitted group analysis (1 paper submission per group):

Paper contains most answers to the Evaluation, Document and Calculate tasks/questions listed in Assignment description and completion guidance provided by faculty.

Provides depth of content in majority of each item:
• Applies/conveys insight and original thinking in responding to Financial Statement analysis guidelines provided by faculty
• Mostly follows guidelines for presenting, formatting, and writing of analysis of
Financial Statements

Submitted group analysis (1 paper submission per group):

Contains some but not all of the Evaluate, Document and Calculate tasks/questions listed in the Assignment description and completion guidance provided by faculty.

Provides minimal depth of content or mostly incorrect content in each item:
• Applies/conveys minimal insight and original thinking in submitted Financial Statement analysis guidelines provided by course text
• Does not follow guidelines for presenting, formatting, and writing of analysis of Financial Statements
Assignment Content, continued Calculates all assigned financial ratios correctly
and interprets their application to assigned financial statements
accurately, including comparing to current, average/median ratio values for healthcare organizations.

Provides a concise /clear summary of the Auditors’ opinion on the status of the financial statements/organizations’ finances.

Provides a structured, comprehensive summary of findings of the group’s analysis of assigned financial statements. The analysis follows assignment guidance provided by faculty.
Calculates all assigned financial ratios correctly and mostly accurately interprets their application to assigned financial statements, including comparing to current, average values for healthcare organizations.

Provides a mostly concise/clear summary of the Auditors’ opinion on the status of the financial statements/organizations’ finances.

Provides a structured, mostly comprehensive summary of findings of the group’s analysis of assigned financial statements. The analysis follows assignment guidance provided by faculty. Rarely correctly calculates or accurately interprets financial ratios and their application to current, average financial statements.

Provides inadequate or unclear summary of the Auditors’ opinion on the status of the financial statements/organizations’ finances.

Provides an unstructured, limited summary of
findings of the group’s analysis of assigned financial statements. The analysis does not reflect assignment guidance provided by faculty.

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