Standard & Poors Update August 2005

2 Agenda UCSF Overview Strategic Plan and FY 2006 Operations Workplan Financial Performance Long Range Development Plan Summary and Conclusions Appendix: University of California Support

3 UCSF Overview

4 UCSF Medical Center has a proven track record of healthcare excellence San Francisco's only university medical center. Two hospital locations with 574 available beds (650 licensed) including 513 at Moffitt/Long and 61 at Mt. Zion as of June 30, % percent of patients live in San Francisco; 63% percent come from neighboring counties, throughout California, and around the world 1 Principal teaching site for UCSF Schools of Medicine, Dentistry, Pharmacy, and Nursing as well as the UCSF Graduate Division FY 2005 included 167,822 patient days – an ADC of 460 Footnote: 1.

5 UCSF Medical Center and UCSF Childrens Hospital are recognized throughout the world as leaders in Healthcare UCSF continues to maintain an outstanding national and international reputation 1 : –nationally designated Comprehensive Cancer Center –nationally designated Centers of Excellence in womens health –among the top five hospitals in the nation in the area of neurology and neurosurgery –one of the nations largest centers for kidney and liver transplants – performing the third largest number of transplants in the US in –internationally recognized for treating the spine UCSF Childrens Hospital is a hospital within a hospital with more than 150 pediatric specialists practicing in more than 50 areas of medicine 2 In 2004, UCSF MC received the equivalent of a perfect score from the Joint Commission on Accreditation of Healthcare Organization (JACHO). Only 17 percent of hospitals received accreditations with full standards compliance in UCSF Faculty leaders in Patient Safety (100,000 Lives Campaign) Footnote:

6 UCSF Medical Center and UCSF Childrens Hospital have been named to U.S. News & World Reports honor roll Hormonal disorders Neurology and Neurosurgery Pediatrics Respiratory disorders Digestive Disorders Ophthalmology Footnote: 1. All rankings from US News and World Report July 18, 2005 issue; Rheumatology Kidney Disease Ear, Nose and Throat Urology Psychiatry Gynecology UCSF Hospital is ranked in the top 10 hospitals in the country UCSF Childrens Hospital is ranked in the top 20 hospitals in the country Several of UCSFs programs were also rated among the top 15 in the nation.

7 UCSF is a leader a national leader in NIH funding and is making significant investments in research facilities UCSF was the fourth largest recipient of National Institutes of Health (NIH) research funds in 2004, receiving 977 research awards valued at $439 million 1 Development of the new research campus at Mission Bay is underway 2 : –Genentech Hall, The California Institute for Quantitative Biomedical Research (QB3) and The Arthur and Toni Rembe Rock Hall, a research facility for Genetics, Development and Behavioral Sciences are completed and occupied –The Campus Community Center, Housing Complex and two parking structures will be completed in FY 2006 –Construction on The Helen Diller Family Cancer Research Building is slated to begin in FY06. –The Cardiovascular and Neurosciences research buildings are in the design phase. Footnote:

8 UCSF is well positioned for the the future Strong execution of the current strategic plan Strong volume growth Strong financial performance Strong commitment to the future plan Footnote:

9 Strategic Plan and FY 2006 Operations Workplan

10 Our strategic plan for has six main goals… Create Capacity for targeted, profitable growth Grow targeted services Plan for the development of a Mothers and Childrens Hospital Raise customer service/satisfaction to match recognized excellence of clinical care and research Target initiatives to improve operating performance, monitoring and management Launch enterprise-wide workforce development initiative

11 …the operations workplan for FY 2006 is tied to the Medical Centers strategy

12 Financial Performance

13 Financial results significantly improved from 2003 to 2004 …and are even stronger in 2005 FY 2005 income before other changes in net assets of $69.3 million, $13.8 million ahead of FY 2004 Cash increased from $115.5 million at June 2004 to $144.2 million at June Days Cash on Hand increased from 44.2 to 51.3 Net Days in AR increased slightly from 64.8 days at June 2004 to 66.6 days at June 2005

14 The results over the past five years indicate sustained financial improvement… UCSF Medical Center Net Income - Combined FY 2000 through FY thousands Footnote: 1. FY 2005 financial performance is based on the unaudited financial statements while all previous periods are based on audited financial statements.

15 …as Net Income has improved so too has cash UCSF Medical Center Cash Balance 1 July 2002 – June 2005 Footnote: 1. Includes restricted and unrestricted cash. Thousands

16 This improved performance has resulted in stronger financial ratios Footnote: 1. Standard & Poors U.S. Not-For-Profit Health Care 2004 Median Ratios; publication date 10-Jun MADSC is Maximum Annual Debt Service Coverage. 3. FY 2005 financial performance is based on the unaudited financial statements.

17 Trended Service Data Fiscal Years 2002 to 2005 Volume in the Medical Centers key Service Lines continue to grow… Footnote: 1. Excludes Well baby days

18 …resulting in a 15% increase in the Medical Centers average daily census UCSF Medical Center Average Daily Census FY 2001 through FY 2005 Average Daily Census

19 UCSF Medical Center Statements of Revenue, Expenses and Net Income For the Years ended June 30, 2003, 2004 and (Dollars in thousands) Net income continues to grow Footnote: 1. FY 2005 financial performance is based on the unaudited financial statements while all previous periods are based on audited financial statements.

20 The balance sheet has improved… UCSF Medical Center Statements of Net Assets For the Years ended June 30, 2003, 2004 and (Dollars in thousands) Footnote: 1. FY 2005 financial performance is based on the unaudited financial statements while all previous periods are based on audited financial statements.

21 UCSF Medical Center Statements of Cash Flows For the Years ended June 30, 2003, 2004 and (Dollars in thousands) …as too has the cash balance Footnote: 1. FY 2005 financial performance is based on the unaudited financial statements while all previous periods are based on audited financial statements.

22 Continued operational and financial success secures capital funding of the current campuses UCSF Medical Center Estimated Capital Expenditure For the Years ended June 30, 2006, 2007 and 2008 (Dollars in thousands)

Available BedsAverage Daily Census Bed capacity will expand over the next three years Bed Capacity & Census Projection FY2001 – FY2009 Long 1 10 Observation beds MZ -- West Wing 15 Med/Surg beds Long 9 6 Med/Surg beds Long Med/Surg beds Moffitt 14 N&E 1 16 ICU beds Moffitt 13 N&E 16 ICU beds MZ East Wing 13 Med/Surg beds Close Moffitt 14 N&E 1 20 beds Footnote: 1. Moffitt 14 N & E currently has 20 med/surg beds. In FY2008, these beds will be taken offline and replaced and re-opened with 16 ICU beds. 2. All year ending periods are June 30 th. Projection years start with FY Increases in bed capacity between 2001 and 2005 have been accomplished through the opening of beds at Mt. Zion Completed ProjectsPlanned Projects

24 Long Range Development Plan

25 Seismic requirements and capacity needs must be addressed… The Need: –Seismic requirements (SB 1953) Repair Moffitt/Long by 2008 Repair or replace Mount Zion by 2013 (OSHPD extension received). –Increase capacity and improve functionality of hospitals The Process: –Joint School of Medicine and Medical Center effort –Objective: Highly functional hospital for patients and physicians –Objective: Link hospital services to academic programs.

26 …however current configuration and construction costs are constraints to UCSFs growth Constraints: –All land is encumbered: Parnassus: space ceiling, access; parking Mount Zion: small campus; limited research space Mission Bay: new land is expensive and carries obligations to Redevelopment Agency. –Community opinion: keep Emergency Department (and related hospital) on Parnassus Heights. –Finances: all options are expensive. –Timing/Phasing: all options must assure uninterrupted patient care – requires decant of existing volume to new facilities.

27 UCSFs long term development plan is a bold redesign of the Medical Centers facilities and delivery system Programmatic Options Separate Cancer Hospital Separate Womens and Childrens Hospital Separate specialty surgery hospital Facility Options (over the next decade): Ambulatory Care Center at Mission Bay; new small hospital at Mission Bay; new tower on Parnassus; maintain ambulatory care at Mount Zion. Ambulatory Care Center at Mission Bay; new small hospital at Mount Zion; new tower on Parnassus.

28 Summary and Conclusions

29 UCSF has the key Building Blocks for long term success Commitment to Mission, Vision, Values Tradition of Medical Excellence – focus on safety and quality World class faculty physicians Excellent Senior Management team Clear Strategic Plan and ability to execute Operations Workplan Shared goals for all staff Market and contracting strength Strong Relationship with top Medical School Strong UC and political support

30 Appendix – University of California Support

31 Regents Hospital Working Capital Program In 1989, The Regents implemented internal hospital working capital facility using Short Term Investment Pool (STIP): Maximum total outstanding for hospitals - 15% of unrestricted STIP. Maximum individual hospital outstanding - 60% of hospital gross accounts receivable. Can be drawn for any working capital purpose, including debt service.

32 UCSF Medical Center Available Cash from Hospital Working Capital Program Availability of UC Working Capital based on A/R as of June 2005: 60% X $ 258 Million Gross A/R: = $154.7 Million = 55 Days of Cash Historical Debt Service Coverage, June 2005 = 7.1 X Adjusted for Hospital Working Capital, June 2005 adjusted debt service coverage = 15.7 X