Page 367 - CEO Orientation

Network Providence Health Care St. Joseph's Health Centre St. Michael's Hospital
Bud Act Var Var $'000 Bud Act Var Var $ Bud Act Var Var $ Bud Act Var Var $
LHIN QBPs - Elective
Primary Unilateral Hip Replacement 504 468 (36) ($321) 37 43 6 $38 112 97 (15) ($130) 355 328 (27) ($229)
Primary Unilateral Knee Replacement 478 572 94 $685 56 81 25 $143 206 214 8 $71 216 277 61 $471
Primary Bilateral Joint Repl (Hip/Knee) 11 4 (7) ($85) 1 2 1 $4 1 0 (1) ($8) 9 2 (7) ($81)
Knee Arthroscopy 283 281 (2) ($15) 207 224 17 $28 76 57 (19) ($43)
Vascular AA excl Adv Pathway 48 24 (24) ($765) 0 0 0 $0 48 24 (24) ($765)
Cataract Surgeries 1,007 1,504 497 $124 1,007 1,504 497 $124 0 0 0 $0
Non-Routine Cataract & Bilateral 8 66 58 $52 0 66 66 $59 8 0 (8) ($7)
Tonsillectomy (IP & Outpatient) 100 67 (33) ($39) 100 67 (33) ($39) 0 0 0 $0
Lower Extremity Occlusive Disease (LEOD) 24 24 0 $0 0 0 0 $0 24 24 0 $0
TOTAL Elective LHIN QBPs 2,463 3,010 547 ($364) 94 126 32 $185 1,633 2,172 539 $105 736 712 (24) ($655)
LHIN QBPs - Non-Elective
Stroke Hemorrhage 38 54 16 $287 13 25 12 $206 25 29 4 $81
Stroke Ischemic or Unspecified 218 223 5 $69 109 104 (5) ($54) 109 119 10 $124
Stroke EVT 32 29 (3) ($89) 0 0 0 $0 32 29 (3) ($89)
Stroke Transient Ischemic Attack (TIA) 48 48 0 ($8) 17 21 4 $7 31 27 (4) ($14)
Congestive Heart Failure 598 585 (13) ($67) 322 305 (17) ($105) 276 280 4 $38
Hip Fracture 222 211 (11) ($145) 134 126 (8) ($84) 88 85 (3) ($61)
Chronic Obstructive Pulmonary Disease 404 385 (19) ($191) 204 211 7 $42 200 174 (26) ($233)
Pneumonia 319 391 72 $474 202 239 37 $243 117 152 35 $231
TOTAL Non-Elective LHIN QBPs 1,879 1,926 47 $330 0 0 0 $0 1,001 1,031 30 $254 878 895 17 $76

TOTAL LHIN QBPs 4,342 4,936 594 ($34) 94 126 32 $185 2,634 3,203 569 $359 1,614 1,607 (7) ($579)

Quality Based Procedures (QBPs) are funded by Ministry based on volumes performed to a
maximum approved funding per envelope per site. The above table shows QBP volume results as
at the end of November 30, 2017 for the network. St. Michael’s continue to be behind on targets
(elective envelopes) resulting in a lost revenue of ($0.6M), whereas St. Joseph’s and Providence
are ahead of their respective targets in both envelopes. Once the Ministry of Health and Long-
Term Care and the Toronto Central LHIN’s funding processes recognize the Network sites as one
entity, the overages at St. Joseph’s and Providence would be funded by the shortfall of volumes at
St. Michael’s. We will advocate for this treatment in 2017/18 and 2018/19.

Site Specific Discussion:

SJHC’s $5.2M deficit position is driven by $10.6M in expenditures above plan partially offset by
$5.1M positive revenues compared to budget, primarily due to positive LHIN/MOHLTC/CCO grants
of $3.8M; patient revenues of $0.8M; and other income of $0.6M. The unfavourable expenses are
primarily due to benefit contributions of $5.7M comprised of employee future benefits including
the negative impact of $2.9M from estimated pension liabilities valued at July 31, 2017, and
integration severance costs of $0.7M; the unfavourable other supplies and expenses of $4.7M that
includes $2.9M of unidentified clinical savings to close the original budget gap and $1.1M one-time
integration costs.

SJHC is forecasting a deficit of $3.9M based on estimated actuarial pension liability at March 31,
2018 and $4.3M of unidentified/unrealized clinical savings. Run-rate issues continue to persist as
well as operation of beds beyond the approved bed map. While this is a system issue compounded
by ALC challenges, the expense over revenue presents future operating challenges.

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