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MAIN APPLICATION
<br />Section M. Financial Data
<br />Operating Budget for Entire Agency
<br />AGENCY NAME: Piedmont Health Services. Inc.
<br />AGENCY REVENUE
<br />Private Donations
<br />Agency Generated Revenue (fees)
<br />Local Government Grants:
<br />Orange County
<br />Town of Chapel Hill
<br />Town of Carrboro
<br />Other Local: Orange Partnership /Smart Star
<br />Other Local: NC Community Grant - IFC CHI
<br />Other Local:
<br />If more than 3 sources, please
<br />provide a separate list.
<br />Non -Local Government Grants
<br />Triangle United Way
<br />State Government
<br />Federal Government
<br />Other Grants: Non -Gott grant:
<br />Other Grants:
<br />Miscellaneous/Other Revenue
<br />Please list 3 largest Miscellanous sources:
<br />atient Management Fees (CCNC $
<br />Board Fundraiser $
<br />Technical Assistance $
<br />Total Agency Revenue
<br />AGENCY EXPENSES
<br />Compensation
<br />Rent & Utilities
<br />Supplies & Equipment
<br />Travel & Training
<br />Other Expenses:
<br />Please list 3 largest "Other Expenses ":
<br />Contracted Patient Care $
<br />Repairs /Maintenance $
<br />Contracted Admin. Services $
<br />Total Agency Expenses
<br />Actual
<br />FY2014
<br />Estimated
<br />FY2015
<br />Projected
<br />FY2016
<br />Percent
<br />Change
<br />$ 48,798
<br />$ 59,330
<br />$ -
<br />- 100%
<br />$ 27,557,940
<br />$ 10,000
<br />$ 36,946,576
<br />$ 10,000
<br />$ 43,091,569
<br />$ 11,000
<br />17%
<br />10%
<br />$ 3,000
<br />$ 2,500
<br />$ 3,500
<br />40%
<br />$ 2,500
<br />$ 2,500
<br />$ 3,500
<br />40%
<br />$ 40,000
<br />$ 38,000
<br />$ 28,500
<br />-25%
<br />$ 150,000
<br />#VALUE!
<br />$
<br />$
<br />$
<br />0
<br />0
<br />$ 248,271
<br />$ 74,563
<br />$ 865,498
<br />1061%
<br />$ 7,993,848
<br />$ 8,781,411
<br />$ 7,997,978
<br />-9%
<br />$ 1,194,089
<br />$ 1,447,365
<br />$ 1,207,500
<br />-17%
<br />0
<br />$ J571,767
<br />$ 37 670 213
<br />$ 23, 352,142
<br />$ 625,445
<br />$ 47 987 690
<br />$ 28,148, 274
<br />$ 322,597
<br />$ 53 681 642
<br />$ 39, 798,139
<br />-48%
<br />12%
<br />41%
<br />$ 748,303
<br />$ 947,484
<br />$ 2,038,985
<br />115%
<br />$ 3,401,725
<br />$ 4,179,399
<br />$ 334,075
<br />-92%
<br />$ 394,496
<br />$ 499,275
<br />$ 330,108
<br />-34%
<br />$ 10,298,990
<br />$ 38,195,656
<br />$ 13,437,036
<br />$ 47,211,468
<br />$ 18,180,335
<br />$ 60,681,642
<br />35%
<br />29%
<br />SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (525,443)1 $ 776,222 1 $ (7,000,000) - 1002 ° /
<br />Revised November 20, 2014
<br />Page 22 of 22 Pages
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