Critical Access Hospital Coalition Workshop Financial Impact Study August 22, 2003 Richard Donkle, CPA Rural Wisconsin Health Cooperative

CAH’s in Wisconsin YEAR Number of Facilities

CAH’s in Wisconsin Inpatient Medicare Reimbursement Acute % Payment/Costs 92.18%88.88%85.37%89.48%95.14%100.00% Swing Bed % Payment/Costs 31.83%32.23%32.83%42.05%64.59%100.00% Swing Bed Per Diem $247.71$272.55$293.83$316.64$542.70$876.41

CAH’s in Wisconsin Outpatient Medicare Reimbursement Outpatient % Costs/Charges 58.14%55.25%53.06%52.52%53.57%57.19% Outpatient % Payment/Charges 51.62%47.91%46.88%47.49%51.22%57.19%

CAH’s in Wisconsin

Year Medicare Utilization (Days) 69.87%73.32%73.25%72.75%74.60%76.39%

CAH’s in Wisconsin Average Total Acute LOS Average Medicare Acute LOS Swing-bed days as % of Total Days 31.27%34.59%36.61%36.52%38.62%40.19%

CAH’s in Wisconsin ServicesPre-CAHPost-CAH Skilled Nursing Facilities 88 Swing Bed 1616 Home Health Agency 32 Hospice01 Rural Health Clinics 02 Ambulance66

Critical Access Hospital Coalition Workshop Financial Impact Study August 22, 2003 Richard Donkle, CPA Rural Wisconsin Health Cooperative