The report broke down standalone children's hospital financials even further, providing fiscal year 2011 medians in 25 different categories, and compared those medians to general acute-care hospitals. The children's hospitals excelled in several areas, including having more days of cash on hand, higher cushion ratios, higher operating margins and less bad debt.
Here are 50 statistics on FY 2011 medians between standalone children's hospitals and general acute-care hospitals in Fitch's portfolio.
Fiscal Year 2011 Median Category |
Standalone Children's Hospitals |
Acute-Care Hospitals |
Days cash on hand |
278.3 days |
180.5 days |
Days in accounts receivable |
47.3 days |
43.8 days |
Cushion ratio |
20.8 |
13.6 |
Days in current liabilities |
65.5 days |
63.4 days |
Cash to debt |
135.4 percent |
112.8 percent |
Operating margin |
6.9 percent |
2.6 percent |
Operating EBITDA margin |
12.4 percent |
9.4 percent |
Excess margin |
9.3 percent |
3.9 percent |
EBITDA margin |
15 percent |
10.8 percent |
Cash flow margin |
11 percent |
8.2 percent |
Investment income as % of excess income |
18.2 percent |
25.8 percent |
Personnel costs as % |
50.1 percent |
50.8 percent |
Bad debt expense as % |
1.4 percent |
5.4 percent |
EBITDA debt service coverage |
5.9 |
3.5 |
Operating EBITDA debt service coverage |
5.2 |
3.0 |
Cash flow from operations before interest debt service coverage |
4.8 |
3.1 |
Cash flow from operations before interest debt service coverage less capital expenditures |
1.0 |
1.0 |
Maximum annual debt service as % of revenues |
2.6 |
3.0 |
Debt to EBITDA |
2.2 |
3.4 |
Debt to free cash flow |
4.0 |
5.2 |
Debt to capitalization |
30.1 percent |
42.1 percent |
Average age of plant |
8.3 years |
10.2 years |
Capital expenditures as % of depreciation expense |
211.7 percent |
115.7 percent |
Capital expenditures as % of EBITDA |
56.7 percent |
52.8 percent |
Capital expenditures as % of total revenue |
8.4 percent |
5.8 percent |
Note: Fitch analysts looked at 21 standalone children's hospitals and 248 general acute-care hospitals.
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