EL PASO COUNTY HOSPITAL DISTRICT

UMC Surgical Hospital

R. Jacob Cintron
President & CEO

Michael Nunez
District Chief Financial Officer

TO HEAL, TO SERVE, AND TO EDUCATE

 El Paso County Hospital District
1416 George Dieter Drive
 On February 27, 2023, an agenda item of “the purchase of certain real property
by the El Paso County Hospital District located on George Dieter Drive in East El
Paso (i.e. “Lease Agreement”) was brought forward to Commissioners’ Court.
 The Commissioners’ Court unanimously approved the said agenda item.

 Plan was to come back to Commissioners’ Court once a financing package had
been negotiated with a financial institution to purchase the facility.

 UMC Board of Managers approved on May 10, 2023 to forward this specific
agenda to the El Paso County Commissioners’ Court.

2
 El Paso County Hospital District
1416 George Dieter Drive
 6 operating rooms
 1 cardiac catheterization lab
 2 procedure rooms (Endo)
 40 beds – Patient transfers to open up main
hospital
 2 bay Emergency Department
 Imaging includes:
 MRI room
 CT Scanner room
 Ultrasound room
 2 X-ray rooms

3
 El Paso County Hospital District
Opportunity

 Operating rooms replace bond request for ambulatory surgical

center (ASC)
 Cath lab augments capacity required by bond request
 Endo Rooms – Enable movement of Endo department from 3rd
floor of West Tower (future critical care beds)
 40 beds – Patient transfers to open up main hospital
 Eastside location – key growth area in the service area
 Emergency Department – in the long-term becomes another
access point for system

4
 El Paso County Hospital District
1st Floor Plan
Two Stories, plus basement
Approximately 72,000 sq ft total

5
 El Paso County Hospital District
Revenue Bonds, Series 2023
 No impact to the County Property Tax Owner.
 The Bonds shall be issued to:
 Finance the acquisition, repair, renovation, improvement, and
equipping of the UMC Surgical Hospital.
 Pay all costs of issuance of the Bonds.
 Principal amount: $55,000,000.
 Interest Rate: Adjusted Secured Overnight Financial Rate (SOFR)
Currently at 6.09% (as of June 1, 2023)
 Interest-only payments for CY2023 and CY2024.
 “Step Up” date: Jan. 2, 2025.
 Amortization end date: Dec. 15, 2026.
6
 El Paso County Hospital District
Revenue Bonds, Series 2023
 In the event the District does not pay the outstanding
principal amount of Bonds on or before January 2, 2025,
the District shall instead pay the outstanding principal
amount of the Bonds in equal payments:
 Commencing on the Amortization Start Date (June 15, 2025)
 December 15, 2025
 June 15, 2026 and
 December 15, 2026

 Hospital District’s plan is to refinance / refund this interim

financing debt into a 30-year Revenue Bond amortization in
Spring / Summer CY2024.

7
 El Paso County Hospital District
Revenue Bonds, Series 2023

 Special Covenants
 The District shall maintain a Debt Service Coverage Ratio of at least 1.50 to 1.0
as of the last day of each March and September on a trailing twelve month
basis.

 The District and its blended component units shall as of the last day of each
March and September maintain Unrestricted Cash and Investments of at least
$125,000,000.

8
 El Paso County Hospital District
Revenue Bonds, Series 2023

Supplemental Information

9
 El Paso County Hospital District
Revenue Bonds, Series 2023
1. Assumes a 9/1/2023 operational start date, with preopening costs beginning 2/1/23.
2. Outpatient Surgeries will be primarily Orthopedic, Neuorsurgery and Cardiology.
3. Does not include downstream benefits from freeing up Inpatient and Operating Room capacity at the main campus.

UMC Surgical Hospital 5 Year Proforma and Start Up Costs (Most Likely)
CY 2023 Partial CY 2024 CY 2025 CY 2026 CY 2027
Total Total Total Total Total

Revenue $ 9,416,253 $ 52,849,893 $ 59,225,577 $ 63,810,075 $ 68,106,300

Operating expenses 14,213,265 50,533,458 55,857,602 59,845,790 63,575,914
EBITDA / Operating Margin $ (4,797,013) $ 2,316,435 $ 3,367,975 $ 3,964,285 $ 4,530,386

Annual Debt Service $ (1,653,141) $ (3,298,807) $ (4,013,023) $ (4,013,023) $ (4,013,023)

Inpatient Admissions 611 3,512 3,822 4,084 4,235

Outpatient Surgeries 177 1,325 1,524 1,752 2,015
Average Daily Census 15 29 31 34 35

10
 El Paso County Hospital District
Revenue Bonds, Series 2023
1. Assumes a 9/1/2023 operational start date, with preopening costs beginning 2/1/23.
2. Outpatient Surgeries will be primarily Orthopedic, Neuorsurgery and Cardiology.
3. Does not include downstream benefits from freeing up Inpatient and Operating Room capacity at the main campus.

UMC Surgical Hospital 5 Year Proforma and Start Up Costs (Optimistic)

CY 2023 Partial CY 2024 CY 2025 CY 2026 CY 2027
Total Total Total Total Total
Revenue $ 9,248,297 $ 55,325,843 $ 62,762,381 $ 67,333,399 $ 72,377,589
Operating expenses 12,925,711 52,233,769 58,365,262 62,219,247 66,452,690
EBITDA / Operating Margin $ (3,677,414) $ 3,092,074 $ 4,397,119 $ 5,114,152 $ 5,924,899

Annual Debt Service $ (1,653,141) $ (3,298,807) $ (4,013,023) $ (4,013,023) $ (4,013,023)

Inpatient Admissions 707 3,800 4,164 4,249 4,326

Outpatient Surgeries 245 1,834 2,109 2,425 2,789
Average Daily Census 18 31 34 35 36

11
 El Paso County Hospital District
Revenue Bonds, Series 2023
1. Assumes a 9/1/2023 operational start date, with preopening costs beginning 2/1/23.
2. Outpatient Surgeries will be primarily Orthopedic, Neuorsurgery and Cardiology.
3. Does not include downstream benefits from freeing up Inpatient and Operating Room capacity at the main campus.

UMC Surgical Hospital 5 Year Proforma and Start Up Costs (Conservative)

CY 2023 Partial CY 2024 CY 2025 CY 2026 CY 2027
Total Total Total Total Total

Revenue $ 9,584,208 $ 50,373,943 $ 55,688,772 $ 60,286,751 $ 63,835,010

Operating expenses 15,500,819 48,833,148 53,349,942 57,472,333 60,699,138
EBITDA / Operating Margin $ (5,916,611) $ 1,540,795 $ 2,338,830 $ 2,814,418 $ 3,135,872

Annual Debt Service $ (1,653,141) $ (3,298,807) $ (4,013,023) $ (4,013,023) $ (4,013,023)

Inpatient Admissions 611 3,512 3,822 4,084 4,235

Outpatient Surgeries 208 1,559 1,793 2,062 2,371
Average Daily Census 15 29 31 34 35

12
 TO HEAL, TO SERVE, AND TO EDUCATE

THANK YOU

13