Comanche County Hospital A Component Unit of Comanche County, Kansas

Comanche County Hospital

A Component Unit of Comanche County, Kansas

Accountants' Report and Financial Statements

December 31, 2010 and 2009

Comanche County Hospital

A Component Unit of Comanche County, Kansas

December 31, 2010 and 2009

Contents

Independent Accountants' Report........................................................................................ 1

Financial Statements Balance Sheets.................................................................................................................................... 2 Statements of Revenues, Expenses and Changes in Net Assets ......................................................... 3 Statements of Cash Flows................................................................................................................... 4 Notes to Financial Statements ............................................................................................................ 6

Independent Accountants' Report

Board of Trustees Comanche County Hospital Coldwater, Kansas

We have audited the accompanying balance sheet of Comanche County Hospital (Hospital), a component unit of Comanche County, Kansas (County), as of December 31, 2010, and the related statements of revenues, expenses and changes in net assets and cash flows for the year then ended. These financial statements are the responsibility of the Hospital's management. Our responsibility is to express an opinion on these financial statements based on our audit. The financial statements of Comanche County Hospital as of and for the year ended December 31, 2009, were audited by other accountants whose report dated May 5, 2010, expressed an unqualified opinion on those statements.

We conducted our audit in accordance with auditing standards generally accepted in the United States of America and the provisions in the Kansas Municipal Audit Guide. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion.

In our opinion, the 2010 financial statements referred to above present fairly, in all material respects, the financial position of Comanche County Hospital as of December 31, 2010, and the changes in financial position and cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America.

The Hospital has not presented a management's discussion and analysis that the Governmental Accounting Standards Board has determined is necessary to supplement, although not required to be a part of, the basic financial statements.

May 12, 2011

Comanche County Hospital

A Component Unit of Comanche County, Kansas

Balance Sheets December 31, 2010 and 2009

Assets

Current Assets Cash Short-term investments Patient accounts receivable, net Estimated amounts due from third-party payers Supplies Prepaid expenses and other

Total current assets

Noncurrent Cash and Investments Restricted by donors for capital acquisitions

Capital Assets, Net

Total assets

Liabilities and Net Assets

Current Liabilities Current maturities of long-term debt Accounts payable Accrued salaries and payroll taxes Accrued vacation benefits Estimated amounts due to third party payers

Total current liabilities

Long-term Debt

Total liabilities

Net Assets Invested in capital assets, net of related debt Restricted-expendable for capital acquisitions Unrestricted

Total net assets

Total liabilities and net assets

2010

2009

$ 411,850 600,000 682,754 109,222 81,779

1,885,605

$

86,436

650,000

281,092

750,000

88,326

42,239

1,898,093

8,389 3,905,750 $ 5,799,744

57,661 4,013,260 $ 5,969,014

$

35,263

36,373

93,037

75,835

125,000

365,508

194,435

559,943

$

11,305

23,245

118,927

82,752

-

236,229

2,112

238,341

3,676,052 8,389

1,555,360

5,239,801

$ 5,799,744

3,999,843 57,661

1,673,169

5,730,673

$ 5,969,014

See Notes to Financial Statements

2

Comanche County Hospital

A Component Unit of Comanche County, Kansas

Statements of Revenues, Expenses and Changes in Net Assets Years Ended December 31, 2010 and 2009

Operating Revenues Net patient service revenue Other

Total operating revenues

Operating Expenses Salaries and wages Supplies and other Depreciation

Total operating expenses

Operating Loss

Nonoperating Revenues (Expenses) Property taxes Investment income Interest expense Noncapital grants and gifts Other

Total nonoperating revenues

Deficiency of Revenues Over Expenses Before Capital Grants and Gifts and Transfers

Capital Grants and Gifts

Transfers to County

Decrease in Net Assets

Net Assets, Beginning of Year

Net Assets, End of Year

2010

$ 2,976,311 26,530

3,002,841

2009

$ 2,975,172 32,226

3,007,398

2,018,850 1,476,151

387,139

3,882,140

(879,299)

1,863,677 1,337,015

376,690

3,577,382

(569,984)

563,412 12,317 (392) 16,786 4,739

596,862

528,405 14,934 (883) 17,667 4,141

564,264

(282,437) 1,565

(210,000) (490,872) 5,730,673 $ 5,239,801

(5,720) 13,579 (205,000) (197,141) 5,927,814 $ 5,730,673

See Notes to Financial Statements

3

Comanche County Hospital

A Component Unit of Comanche County, Kansas

Statements of Cash Flows Years Ended December 31, 2010 and 2009

Operating Activities Receipts from and on behalf of patients Payments to suppliers and contractors Payments to employees Other receipts, net

Net cash used in operating activities

Noncapital Financing Activities Property taxes Noncapital grants and gifts Other

Net cash provided by noncapital financing activities

Capital and Related Financing Activities Purchases of capital assets Capital grants and gifts Principal paid on long-term debt Interest paid on long-term debt Transfers to County

Net cash used in capital and related financing activities

Investing Activities Proceeds from disposition Interest on investments

Net cash provided by investing activities

Increase (Decrease) in Cash

Cash, Beginning of Year

Cash, End of Year

Reconciliation of Cash to the Balance Sheets Cash in current assets Cash in noncurrent cash and investments

2010

$ 3,449,649 (1,539,792) (2,051,657) 26,530

(115,270)

2009

$ 2,701,830 (1,347,670) (1,847,913) 32,226

(461,527)

563,412 16,786 4,739

584,937

528,405 17,667 4,141

550,213

(33,598) 1,565

(13,417) (392)

(210,000)

(43,632) 13,579 (10,801)

(883) (205,000)

(255,842)

(246,737)

50,000 12,317 62,317 276,142 144,097 $ 420,239

50,000 14,934 64,934 (93,117) 237,214 $ 144,097

$ 411,850 8,389

$ 420,239

$

86,436

57,661

$ 144,097

See Notes to Financial Statements

4

Comanche County Hospital

A Component Unit of Comanche County, Kansas

Statements of Cash Flows (Continued) Years Ended December 31, 2010 and 2009

Reconciliation of Net Operating Revenues (Expenses) to Net Cash Used in Operating Activities Operating loss Depreciation and amortization Provision for uncollectible accounts Changes in operating assets and liabilities Patient accounts receivable Estimated amounts due from/to third-party payers Supplies Prepaid expenses and other Accounts payable and accrued expenses

Net cash used in operating activities

Supplemental Cash Flows Information

Capital lease obligations incurred for capital assets

Capital assets acquisitions included in accounts payable

2010

2009

$ (879,299) 387,139 48,847

(450,509) 875,000 (20,896) (39,540) (36,012)

$ (115,270)

$ (569,984) 376,690 75,763

65,895 (415,000)

(6,259) 3,764 7,604

$ (461,527)

$ 229,698

$

-

$

16,333

$

-

See Notes to Financial Statements

5

Comanche County Hospital

A Component Unit of Comanche County, Kansas

Notes to Financial Statements December 31, 2010 and 2009

Note 1: Nature of Operations and Summary of Significant Accounting Policies

Nature of Operations and Reporting Entity

Comanche County Hospital (Hospital) is a rural acute care hospital located in Coldwater, Kansas. The Hospital is a component unit of Comanche County (County) and the Board of County Commissioners appoints members to the Board of Trustees of the Hospital. The Hospital primarily earns revenues by providing inpatient, outpatient and emergency care services to patients in the Comanche county area.

Basis of Accounting and Presentation

The financial statements of the Hospital have been prepared on the accrual basis of accounting using the economic resources measurement focus. Revenues, expenses, gains, losses, assets and liabilities from exchange and exchange-like transactions are recognized when the exchange transaction takes place, while those from government-mandated nonexchange transactions (principally federal and state grants and county appropriations) are recognized when all applicable eligibility requirements are met. Operating revenues and expenses include exchange transactions and program-specific, government-mandated nonexchange transactions. Government-mandated nonexchange transactions that are not program specific, such as county appropriations, property taxes, investment income and interest on capital assets-related debt are included in nonoperating revenues and expenses. The Hospital first applies restricted net assets when an expense or outlay is incurred for purposes for which both restricted and unrestricted net assets are available.

The Hospital prepares its financial statements as a business-type activity in conformity with applicable pronouncements of the Governmental Accounting Standards Board (GASB). Pursuant to GASB Statement No. 20, the Hospital has elected to apply the provisions of all relevant pronouncements of the Financial Accounting Standards Board (FASB), included those that were issued on or after November 30, 1989, and do not conflict with or contradict GASB pronouncements.

Use of Estimates

The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Cash Equivalents

The Hospital considers all liquid investments with original maturities of three months or less to be cash equivalents. There were no cash equivalents at December 31, 2010 and 2009.

6

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