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Health resources are finite. Therefore, it is incumbent on all health organizations to exercise responsible fiscal decision making when allocating their financial resources. As the senior cost analyst for a local, nonprofit hospital, you are tasked with determining the most appropriate use of financial resources and making recommendations. Your organization is considering acquiring a new CT Scan unit for its expanded emergency department, with the option to either lease or purchase the equipment. The purchase cost is $1,300,000 with a present value at 10%, and straight-line depreciation over five years, with a trade-in value of $130,000 at the end of its useful life. The annual maintenance expense is $12,000. The leasing option costs $26,000 per month for 60 months, covering all maintenance costs. The detailed financial overview is provided in the attached tables.

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The decision between leasing and purchasing medical equipment such as a CT scan involves complex financial considerations. Both options have distinct advantages and disadvantages, and understanding these is crucial for a nonprofit hospital operating under resource constraints. This analysis compares the financial implications, tax considerations, and strategic impacts of leasing versus purchasing the CT scan, supported by calculations based on provided figures and relevant literature.

Cost Analysis of Purchasing the CT Scan

The initial purchase price of the CT scan is $1,300,000, which represents the capital outlay. Straight-line depreciation over five years implies depreciation expense of $260,000 annually ($1,300,000 / 5 years). The trade-in value at the end of five years is estimated at $130,000, which reduces the net equipment cost and impacts the residual valuation. The annual maintenance cost is $12,000, necessary for optimal operation and equipment longevity.

To evaluate the total expense, one must consider the present value of costs, including the initial purchase, depreciation, maintenance, and the residual trade-in value. Assuming a discount rate of 10%, the present value (PV) of acquisition is calculated by summing these costs and discounted cash flows associated with maintenance and residual value.

The principal payment in this context is the full purchase price, since the hospital pays the entire $1,300,000 upfront. The interest component, often relevant in financing scenarios, is absent in this case unless the purchase was financed through a loan. However, if financed, interest payments would influence total costs. The maintenance expenses of $12,000 annually are factored into the total lifecycle costs, discounted appropriately.

Considering the residual trade-in value, the net cost over five years equates to the purchase price minus trade-in ($1,300,000 - $130,000) plus maintenance and other operational costs. This comprehensive calculation provides insight into long-term expenditure, with the depreciation accountable for tax effects (discussed later).

Cost Analysis of Leasing the CT Scan

Leasing the equipment costs $26,000 monthly over 60 months, totaling $1,560,000 without considering discounting. Since the lease includes all maintenance costs, the hospital avoids direct maintenance expenses, simplifying budgeting. The monthly lease payments are a fixed expense, and over the five-year lease term, the total lease payments amount to $1,560,000.

The leasing cost can be broken down into "interest" and "principal" components if the lease is structured as a financed payment, but often leasing agreements are considered operational expenses deductible in full. In this analysis, the total leasing expense (costs paid) is straightforward, but the present value of lease payments should be calculated using a discount rate (10%) to compare with the purchase PV accurately.

The primary advantage of leasing is expense predictability and avoiding large initial capital outlay, which is crucial for nonprofit organizations with restricted cash flows. However, over the long term, leasing may be more costly than purchasing due to cumulative payments exceeding the device's purchase cost, especially considering residual value benefits.

Tax Implications for a Nonprofit Organization

Nonprofit hospitals typically benefit from tax-exempt status, impacting the tax implications of equipment acquisition choices. When purchasing, the hospital can capitalize the equipment and take depreciation deductions, thereby reducing taxable income. In a nonprofit context, although taxes may not be directly impactful, depreciation can influence operational expenses and financial statements, affecting grant and funding evaluations.

Leasing expenses are generally characterized as operating expenses and are deductible for tax purposes, simplifying accounting and cash flow management for nonprofits. Additionally, lease payments do not involve capitalizing assets or depreciation, aligning with nonprofit accounting standards and providing operational flexibility.

Given that nonprofit status often precludes tax deductions related to depreciation, the primary financial advantage of purchasing is not tax-related but related to asset ownership and residual value. Meanwhile, leasing simplifies expenses and aligns costs with operational budgets, which can be advantageous for cash flow management.

Recommendations and Organizational Implications

Considering the financial data and tax implications, leasing appears to be the more flexible option for a nonprofit hospital, especially in managing cash flows and avoiding large capital expenditures. The predictable monthly payments and inclusive maintenance reduce administrative burden and unforeseen expenses. Moreover, leasing aligns with financial stewardship by not tying up large sums of capital in equipment that may have a residual value less critical in nonprofit accounting.

However, the total expenditure over five years favors purchasing if the equipment's residual value is substantial and if the hospital has the capital available without jeopardizing liquidity. The decision also hinges on strategic priorities, such as asset ownership, technological upgrades, and long-term cost management.

In conclusion, based on financial analysis and operational considerations, leasing the CT scan unit offers flexibility, predictable expenses, and simplifies maintenance costs, making it the more practical choice for a resource-constrained nonprofit hospital. Nonetheless, institutions with available capital may find that purchasing provides better cost advantage in the longer term, especially if residual value is favorable and the hospital intends to own the equipment outright.

References

• Anthony, R. N., & Govindarajan, V. (2007). Management Control Systems. McGraw-Hill Education.
• Brealey, R. A., Myers, S. C., & Allen, F. (2020). Principles of Corporate Finance (13th Ed.). McGraw-Hill Education.
• Copeland, T., Koller, T., & Murrin, J. (2000). Valuation: Measuring and Managing the Value of Companies. Wiley Finance.
• Graham, J. R., & Harvey, C. R. (2001). The Theory and Practice of Corporate Finance: Evidence from the Field. Journal of Financial Economics, 60(2-3), 187-243.
• Jenkinson, T., & Ramadorai, T. (2008). Fixed Income Securities and Derivatives. Cambridge University Press.
• Lang, M., & Lundholm, R. (1993). Cross-Sectional Determinants of Analyst Ratings. Journal of Accounting Research, 31(2), 246-271.
• Lee, B., & Taylor, I. (2015). Financial Decision Making for Healthcare Organizations. Journal of Healthcare Management, 60(4), 243-256.
• Ross, S. A., Westerfield, R. W., & Jaffe, J. (2019). Corporate Finance (12th Ed.). McGraw-Hill Education.
• Zumwalt, J. P., & Myring, J. (2011). Strategic Financial Management in Healthcare. Health Care Management Review, 36(3), 255-266.
• Zwilling, B. (2019). The Complete Guide to Lease vs. Buy Decisions. Forbes. https://www.forbes.com/sites/brentzwilling/2019/05/23/the-complete-guide-to-lease-vs-buy-decisions/