November 1, 2010. 8:00am – 9:30am MICHAEL FLYNN Chief Executive Officer Smith Senior Living 43-B: Financial Ratios: Tools to Measure Organizational Success MICHAEL KELLY Managing Director Ziegler KEVIN MULHEARN CFO, Senior Ministries Alexian Brothers Health System
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43-B: Financial Ratios: Tools to Measure Organizational Success
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November 1, 2010. 8:00am – 9:30am
MICHAEL FLYNNChief Executive OfficerSmith Senior Living
43-B: Financial Ratios: Tools to Measure Organizational Success
MICHAEL KELLYManaging DirectorZiegler
KEVIN MULHEARNCFO, Senior MinistriesAlexian Brothers Health System
Average Age of Facility (Years) 13.04 11.18 8.24 12.37 11.50 9.64 11.20 10.50 10.60 12.00 11.00 12.00 10.30
PROFITABILITY
FITCH (1) STANDARD & POOR'S (3)Single-Site Multi-Site
LIQUIDITY
Multi-SiteCARF-CCAC (2)
CAPITAL STRUCTURE
Single-Site
KEY RATIOS
SOURCE: Research from the Senior Living Finance Team of Ziegler
(1) Fitch 2010 ratios are based primarily on 2009 audited financials; some 2009 data included.(2) CARF-CCAC 2010 publication is based on 2009 audited financials.(3) Standard & Poor’s (S&P) 2009 ratios are based on 2008 audited financials.(4) CARF-CCAC ratios computed using Annual Debt Service; Fitch & S&P ratios computed with Maximum Annual Debt Service (MADS).
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Trends In RatingsKey Financial Ratios - Comparison of Published Ratios
Liquidity Ratios Fitch CCAC S&PDays Cash on Hand (Unrestricted) (1) � � �Cushion Ratio � � �Cash to Debt � � �Net Days in Accounts Receivable � � NoDays in Current Liabilities � No No
Profitability RatiosOperating Margin � � (2) � (4)Operating and Investment Income Margin No No �Operating Ratio � � � (5)Excess Margin � � �Net Operating Margin No � NoNet Operating Margin (Includes Net Entry Fees) No � No
Capital Structure RatiosDebt Service Coverage Ratio (Includes Net Entry Fees) � � (3) �Debt Service Coverage Ratio-Revenue Only � � (3) �MADS as a % of Revenue � � (3) �Debt to Capitalization � � �Debt to Capitalization-Adj. (Includes Deferred Revenue) � � �Debt to Assets � � NoAverage Age of Facility � � NoCapital Expenditures as a % of Depreciation � � No
(1) None provide good guidance as to what constitutes “Unrestricted Cash”(2) CCAC computes ratio excluding contributions(3) CCAC computes ratio using annual debt service(4) S&P computes ratio excluding investment income and contributions(5) S&P computes ratio excluding interest expense
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Key Financial RatiosRatio Strengths
• Ratios are a useful tool in analyzing an organization’s financial strengths and weaknesses
• Ratios are most useful in identifying trends
• Arithmetic computations are easy to use for comparisons, both internally and externally
• Ratios are useful in identifying unusual operating results
• Ratios are a useful reporting tool
• Ratios are widely accepted by the external credit markets (rating agencies, banks, etc.)
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Key Financial RatiosRatio Limitations
• Flashlight problem– Ratios are very specific as to what they measure
• Trees through the forest problem– What does the big picture look like?
• Comparability problem– Accredited and rated facilities may operate at a higher
financial level than the average– Lifecycle issues– Contract issues– Organization structure/composition
Dozens of reasons given as to why a facility “can’t be compared”…
Why Don’t More Senior Living Communities Benchmark Their Operations?
• We have more Medicaid than a typical SNF or CCRC, and those regulations are more costly and burdensome
• We don’t have Medicaid; we only cater to the upper crust, and they expect more
• Our hallways are too long so we are inefficient
• Our hallways are too short so we need more staff
• Our buildings are older so everything is inefficient
• We are an urban high-rise; our competitors are all 3-story wood-frame buildings in the suburbs
• We have more SNF beds as a percentage of the total than an average CCRC
• We have the union – most of our competitors don’t
• We are connected to a hospital that uses us as a patient dumping ground
Net Operating Margin RatioNet Operating Margin Ratio – Focuses on the core operations: resident revenue – resident expense. Excludes non-resident revenues and excludes interest/dividend income, interest expense, depreciation, taxes, amortization, contributions and entry fee amortization.
Net Operating Margin RatioNet Operating Margin Ratio--AdjustedAdjusted – Same as above, but including net entry fees received.
Operating RatioOperating Ratio –– Differs from NOM only in that it includes interest income, interest expense and net assets released for operations. Like NOM --- cash-based.
Operating MarginOperating Margin –– Includes the impact of non-cash operating items such as earned entry fees and depreciation
Total Excess MarginTotal Excess Margin – Builds on the Operating Margin Ratio but adds impact of realized investment gains or losses, contributions and other non-operating revenues/gains.
•• Net Operating Margin RatioNet Operating Margin Ratio – focuses on the core operations. Resident revenue - operating expenses plus interest, depreciation, taxes and amortization expenses.
•• Net Operating Margin RatioNet Operating Margin Ratio--AdjustedAdjusted - same as above, but including net entry fees received.
* Highlighting CARF- CCAC Throughout
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Key Financial Definitions*Profitability Ratios
•• Operating MarginOperating Margin - reflects the percentage of operating revenue retained after payment of operating expenses. Primary measure of profitability.
•• Operating RatioOperating Ratio - measures the percentage of cash expenses as related to revenue and is a measurement of the efficiency of an operation.
•• Total Excess MarginTotal Excess Margin - same as operating margin except this ratio includes non-operating revenue.
•• Debt Service Coverage RatioDebt Service Coverage Ratio - measures the ability of the organization to pay its long-term debt through operations.
•• Debt Service Coverage RatioDebt Service Coverage Ratio--Revenue BasisRevenue Basis - more stringent measure of Debt Service Coverage by excluding net entrance fees received.
•• Debt Service as a Percentage of RevenueDebt Service as a Percentage of Revenue - measures percentage of total revenue applied to annual debt reductions.
•• Unrestricted Cash and Investments to LongUnrestricted Cash and Investments to Long--Term DebtTerm Debt -- gaugesthe relative strength of organization’s cash (and equivalents) position as related to long-term debt.
* Highlighting CARF-CCAC Throughout
•• LongLong--Term Debt as a Percentage of Total Capital RatioTerm Debt as a Percentage of Total Capital Ratio - measure of extent to which a business has relied on debt versus retainedearnings and invested or donated capital.
•• LongLong--Term Debt as a Percentage of Total Capital Ratio AdjustedTerm Debt as a Percentage of Total Capital Ratio Adjusted -similar to the Long-Term Debt as a Percentage of Total Capital Ratio, except that it adds deferred revenue from entry fees to the denominator.
•• LongLong--Term Debt to Total AssetsTerm Debt to Total Assets - measures percentage of the organization owned by creditors.
•• Average Age of FacilityAverage Age of Facility - shows evidence of a commitment to renewal through renovation and/or replacement of their buildingsand grounds.
•• Capital Expenditures as a Percentage of DepreciationCapital Expenditures as a Percentage of Depreciation – a tool for understanding the sufficiency of their annual reinvestment in their physical plant.
* Highlighting CARF- CCAC Throughout
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Nineteen-Year Trends Debt Service Coverage Ratio (DSCR)
• Debt Service Coverage (DSCR) ratio is generally considered to be the most important ratio for evaluating an organization’s short- and long-term financial viability
Reflects an organization’s ability to fund debt service with cash flow from net cash revenues and net entrance fees
• DSCR declined across all quartiles for both provider types
• This ratio (AGE) measures an organization’s commitment to maintaining its physical plant
• Many organizations are embarking upon repositionings and renovations, but AGE suggests the investment isn’t sufficient to counter the aging of their physical plants– Rating agencies are
increasingly pushing for equivalency between annual capital expenditures and annual deprecation expense
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Capital Expenditures as a Percentage of Depreciation
• First year of data collection so no trending possible
• Important for organizations to show commitment to reinvest in physical plant at least to level of annual depreciation
• Views emerging from actively serving over 200 senior living organizations from an investment bank (Ziegler, of course!)
The strong are getting stronger… when: management is proactive, understanding the key drivers of financial success… when: the board keeps a strategic focus… when: planning is a priority, built on the strengths and addressing the weaknesses of past, present and future operations
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Operational ExcellenceThe Weak
The weak are getting weaker… when: management is distracted or unwilling to tackle challenging issues (e.g., fee increases)… when: the board lacks focus or interest on key strategic initiatives needed to keep organization surviving and thriving… when: planning is reactive
Going Beyond Financial Ratios
Section 2
TOM GIBBONSManaging DirectorZiegler Capital Markets
KEVIN MULHEARNCFO, Senior MinistriesAlexian Brothers Health System
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Alexian Brothers Health System
• AZ 100 #: 11 (Hospital-Sponsored) Headquarters Location: Arlington Heights, IL
• Year Founded: 1259Senior Living Founded: 1980’s
• Total Units (as of 12/31/08): 1,507– 704 ILUs– 304 ALUs– 494 NCBs
• Total # of Communities: 9 # of CCRCs: 2
• Debt Rating: Yes Fitch: A- Moody’s : A-3
• Affordable Housing: St. Louis, Chicago
• Home & Community Based : PACE, Live at Home, Senior Centers, Home Care, Senior Centers, Senior Employment programs
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What’s Important Depends on Your Perspective
• Employees
• Managers
• Senior Leadership Team
• Board of Directors
• Residents
• Other Stakeholders
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What’s Important Depends on Your Perspective
• Employees– Individual Hours Worked– PTO Available– Census
• Managers– Census– Financial Performance Compared To Budget– Departmental Expenses Compared To Budget– Per Unit Costs– Staffing Variances
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What’s Important Depends on Your Perspective
• Senior Leadership Team– Census– Financial Performance Compared To Budget– Departmental Expenses Compared To Budget– Staffing Variances– Capital Expenditures
• Board of Directors– Census– Financial Performance Compared To Budget– Financial Performance Compared To Benchmarks– Capital Expenditures– Quality Indicators– Debt Compliance
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What’s Important Depends on Your Perspective
• Residents– Census– Financial Performance Compared To Budget– Benchmark Comparison to Industry/Others– CMS Five Star Ratings
• Other Stakeholders
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Picking Your Key Financial Ratios
Financial Ratio's Actual Budget Variance Actual Budget Variance Prior Year
• Staffing– F.T.E.’S– F.T.E.’s Per Occupied Unit– Overtime Hours as % of Total Hours– Non-Productive Hours as % of Total Hours– Nursing Hours Per Resident Day
• Gross• Net
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Communicating the Information Effectively
• KISS Principle - Keep It Simple– What are the Key Drivers
Marketing and Occupancy:
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Communicating the Information Effectively
• KISS Principle - Keep It Simple– What are the Key Drivers
Actual Budget Variance STAFFING INDICATORS Actual Budget Variance Prior Year
149.0 145.7 (3.4) TOTAL FTE'S 147.7 145.7 (2.0) 147.3
Innovative Ways to Communicate Information to Leadership and The Board
Section 3
TOM GIBBONSManaging DirectorZiegler Capital Markets
MICHAEL FLYNNChief Executive OfficerSmith Senior Living
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Smith Senior Living Organizational Structure
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Smith Senior Living Units
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Unit Type Smith Village Smith Crossing Total
Independent 152 97 249
Assisted 58 32 90
Assisted Memory 24 16 40
Skilled 61 30 91
Skilled Memory 39 0 39
Total 334 175 509
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Paperless Environment
• A Microsoft product called SharePoint is used to disseminate information through the organization’s intranet.– Financial statements and key indicator reports are
distributed through the intranet to avoid hard copy distribution
– Accounts payable invoices, receiving documents, etc. are scanned and routed to the appropriate manager for review and approval
– Planning is underway to distribute board materials electronically and use I-Pads in lieu of paper
E-mails are sent to department heads to approve items forpayment electronically
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Accounts Payable Approval Screen
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Detail that supports approval request
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Click on “Edit Item” to approve invoice
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Board Materials
• Organization of Board materials allows for use of electronic devices such as laptops or I-Pads.
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Board of Trustees Meeting Materials
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Drill down through laptop or I-Pad to specific page
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Library of Public Information
A secure board portal is in place for easy access to publicdocuments such as:• 990 Tax Returns• Audited Financial Statements• Interim Financial Results• Financial Ratios
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Board Portal Home Screen
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To Log InIn the upper right corner of the display box click “Log in”.
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Log-in Screen
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Your Username is your first initial followed by your last name. By example:dhart = Deborah Hartmflynn = Mike Flynn
The password is XXXXXXAfter you enter the above information, click on the Log In button.
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Select Charts
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There are two areas for you to see information.ChartsClick on the word Charts from the Home Page. The following screen will populate.
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Sample Dashboard Charts
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These charts are populated from financial information as it is captured from the census and financial records of the company. Financial, Ancillary and Census Dashboards are updated when a month is closed in the general ledger system. Therefore month end results will not be available until after the 15th day of the following month. Publishing dates may vary.Payroll Dashboards are updated after each payroll is processed.To Navigate through the charts, simply click on the entity under each title.
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Report Browser Screen
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The browser is a repository of published reports. All reports are listed to the left by file name. You can sort columns by clicking on the title to each column. Multiple columns can be sorted by holding down the shift key during the column selection process. When columns are sorted, a small triangle will appear to show you if the column is presented in ascending or descending order.
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Topics Selection “Cloud”
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Because the repository is quite large and will only grow, it is recommended to use the topics selection area (cloud) to narrow down the index to find a document of your choice. The topic selection area can be made larger by sliding the divide bar. Hover over the bar until the dual directional arrows appear, hold down the left mouse button and drag side to side to change its shape.
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Select Tax Return Category
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Click on topics in the upper right box that help narrow your selection. These selections will appear in the lower right box. Selections can be removed from the lower right box by clicking on the ‘x’.
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Pick the specific return you are looking for
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For instance, if you are looking for the 990 Tax Return for 2006 for Smith Village, then click on Smith Village. You can then click on the smallicon to the left of the 2006 990 return.
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990 Tax Return Detail
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Navigation of the screen:Using your mouse, you can use the mouse wheel to zoom in/out. You can double click on a certain page and it will zoom to that page. You can use the arrows on the right or left to move pages.You can hold down the left mouse button and drag to position the document.You can print a page or the entire document via Adobe Acrobat by clicking on the Adobe icon in the lower right hand corner.The return arrow in the lower right corner will return you to the report browser selection box.