**Capital Structure Decisions **

Consider the following scenario:

You are the Comptroller for a healthcare organization and you are tasked with analyzing potential scenarios regarding their funding.

**Problem #1: Changing Debt & Interest Rates**

- They have an operating income of 1,500,000 SAR (SAUDI RIYAL)
- They have assets of 7,500,000 SAR
- The Tax rate is 22.5%
- They currently do not have any debt but are considering the following scenarios:

Scenario A

No debt

Scenario B

Interest rate 9.5%

B1 increase debt to 2,500,000 SAR

B2 increase debt to 5,000,000 SAR

Scenario C

Interest rate 12.5%

B1 increase debt to 2,500,000 SAR

B2 increase debt to 5,000,000 SAR

Based on the above information, address the following questions:

Compare Scenario A (no debt) to Scenario B (increasing debt 9.5% interest rate)

- What impact does increasing the debt have on the taxable income?

- What impact does increasing the debt have on the net income?
- What impact does increasing the debt have on the dollar return to investors?

Compare Scenario B (increasing debt 9.5% interest rate) to Scenario C (increasing debt 12.5% interest rate)

- What impact does the higher interest rate have on the taxable income?

- What impact does the higher interest rate have on the net income?
- What impact does the higher interest rate have on the dollar return to investors?

Key points

- How does debt financing influence ROE?

- Increasing debt can have what impact on the amount of tax paid?
- A higher interest rate can have what effect on the level of taxes paid?
- A higher interest rate can have what effect on the dollar return to investors?
- How does a higher interest rate affect ROE?

**Problem #2: Uncertainty**

Scenario D

Zero Debt

Calculate:

- The expected net income for each probability

- The expected dollar return to investors for each probability
- The expected ROE for each probability
- What the company can expect its net income to be given these probabilities
- What the company can expect dollar return to investors to be given these probabilities
- What the company can expect its ROE to be given these probabilities

Scenario E

However, assume the company now has 5,000,000 SAR Debt

Calculate:

- The expected net income for each probability

- The expected dollar return to investors for each probability
- The expected ROE for each probability
- What the company can expect its net income to be given these probabilities
- What the company can expect dollar return to investors to be given these probabilities
- What the company can expect its ROE to be given these probabilities

Based upon those calculations answer the following questions:

- Does the increased leverage offer the potential of an increased ROE?

- What impact does the increased leverage have on the risk to stock holders?
- Is it always a good idea to use debt financing?

Make recommendations to the organization as to the course of action that they should follow considering all risk factors. Please make certain that you show your calculations. Submit your findings in a proposal to the hospital.

T. M., Saw, Y. M., Khaing, M., Win, E. M., Cho, S. M., Kariya, T., … & Hamajima, N. (2017). Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting? BMC Health Services Research, 17(1), 669-669. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605979/Recommended: Chapter 10 PowerPoint slides SEU_HCM565_Module10_PPT_Ch10&11.pptx – Alternative Formats Chapter 11 PowerPoint slides SEU_HCM565_Module10_PPT_Ch10&11.pptx – Alternative FormatsWood, B., Williams, O., Baker, P., Nagarajan, V., & Sacks, G. (2021). The influence of corporate market power on health: exploring the structure-conduct-performance model from a public health perspective. Globalization and Health, 1, 1-17.Ermasova, N., & Mikesell, J. (2019). Public capital budgeting and management: The concept and its application in three important federations. Public Finance and Management, 19(3), 175-199.Ghilan, K., Mehmood, A., Ahmed, Z., Almalki, M. J., Jabour, A. M., & Khan, F. (2021, January). Development of unit cost for the health services offered at King FAHD Central hospital Jazan, Saudi Arabia. Saudi Journal of Biological Sciences, 28(1), pp. 643-650.