As of the July, 2022, release via CMS

VAN BUREN COUNTY HOSPITAL

CMS id: 161337
304 FRANKLIN STREET, KEOSAUQUA IA 52565. County: VAN BUREN
System: MERCY HEALTH NETWORK INC.
CBSA: Rural Iowa

The 25-bed, CAH hospital had $-2,272,201 in net service to patients*, with a total profit margin of 26.03665% in fiscal year 2021, the latest year available.
It spent 1.38% of its operating expenses on uncompensated care and reported $427,318 in Medicaid shortfall.

* For more about Net Service to Patients and operating revenue, please the finance section below.

Note: Medians are from CAH hospitals with "complete" fiscal years. For more about how we calculated medians and cost reports in general, please click here.

Details

	2017	2018	2019	2020	2021
# of days in fyear	365	365	365	366	365
Ownership	gov	gov	gov	gov	gov
Acute beds Median	25 23	25 23	25 23	25 23	25 23
Total beds Median	25 25	25 25	25 25	25 25	25 25
FTEs Median	150.50 149.18	144.50 151.6	140.18 151.58	132.75 152.78	137.86 151.99

Finances As they appear in worksheet G3 of the cost reports.

Note: Net Patient Revenue is considered operating revenue, which means Net Service to Patients is considered operating profit. Click here for more about cost report financials

Hospital cost reports are an enormously complicated dataset. There are whole organizations and an offical CMS vendor dedicated to helping researchers work with the data.
It's important to understand that hospital financials in cost reports are not organized in the same as other sources such as annual financial reports to bond holders.

The biggest difference is the concept of operating revenue and profit. Net Service to patients (NS2P), which is the sum of net patient revenue minus operating expenses, is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

That would make Net Patient Revenue = operating revenue.

All this makes things challenging when comparing what's reported in cost reports to other sources. It becomes clearer when you consider that, beyond the purpose of reimbursement, cost reports are a tool for policymakers trying to understand the financial situation of a hospital doing the tasks specific to hospitals.

In other words, while a facility with a division that formulates drugs might include earnings from that as operating revenue in their corporate annual result, this is not central to the operations of a hospital caring for patients and so it is counted as "other income." (See below the financials section for more on "other income")

The healthcare consulting firm HMP, in a former partnership with Modern Healthcare, did develop a formula for estimating operating revenue closer to what one might find in other sources. We no longer use this for the following reasons:

The measure was not widely used beyond HMP and Modern Healthcare. Many hospitals had their own internal estimates of operating revenue and profit.
Because of this, there was confusion when reporting operating results for individual hospitals. There was often pushback when a facility's internal numbers did not match what Modern Healthcare was reporting.
The formula includes revenue from portions of the "other income" section, which may also include non-operating revenue. HMP themselves point out in a caveat on their site that they cannot exclude all non-operating revenue from their measure.

HMP's operating measure has proven problematic in the past for our reporting and the partnership with them ended years ago. It's best to not use a measure that we alone cannot defend.

	2017	2018	2019	2020	2021
Net patient revenue ? Median	12,666,162 19,395,819	12,974,726 19,790,685	12,786,595 20,891,573	12,947,301 20,752,910	16,430,849 22,925,976
Operating expenses Median	15,878,127 21,082,256	16,821,040 21,740,728	16,448,132 22,449,917	17,253,177 23,028,561	18,703,050 24,906,213
Net income from service 2 patients (NS2P) ? Median	-3,211,965 -1,166,928	-3,846,314 -1,178,891	-3,661,537 -1,189,234	-4,305,876 -1,989,193	-2,272,201 -1,175,562
NS2P margin ? Median	-25.36% -6.37	-29.64% -6.47	-28.64% -6.58	-33.26% -10.52	-13.83% -5.81

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for VAN BUREN COUNTY HOSPITAL compared to all** CAH hospitals, from CMS cost reports.
Note: NS2P is considered operating margin by MACPAC. The chart below is interactive: click or touch to see more.

* Data range does not show outliers, which fall beyond the minimum and maximum of the range.
** From cost reports with complete fiscal years. Number of CAH hospitals available to calculate medians:

2017	2018	2019	2020	2021
1,314	1,322	1,316	1,319	1,132

	2017	2018	2019	2020	2021
Other income* Median Click here to show/hide details	2,661,764 1,517,926	2,431,639 1,554,100	2,894,761 1,708,825	3,455,523 3,606,354	8,948,748 4,946,640
⊳ Line 6: Contributions ? ⊳ Median	38,700 68,435	0 61,711.5	33,558 71,344	5,000 80,654	7,151 103,902
⊳ Line 7: Investments ? ⊳ Median	52,940 25,389	34,727 35,427	39,743 59,240	67,988 47,652	175,357 52,317
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	0	0	0	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	26,631	22,310	22,987	20,066	11,625
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	2,303	4,691	4,569	4,517	4,358
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	18,881	17,700	5,552	3,600	4,037
⊳ Line 23: Gov appropriations ? ⊳ Median	946,041 525,619.5	973,540 568,101.5	1,080,966 581,486	1,197,195 657,916	1,168,544 640,942
⊳ Sum Line 24	1,576,268	1,378,671	1,707,386	2,157,157	7,577,676
Total income ? Median	-550,201 445,049	-1,414,675 379,292	-766,776 655,032	-850,353 1,453,054	6,676,547 3,734,026
Non-operating expenses Median	0 56,329	0 45,230	0 61,507	0 80,747	68,550 39,130
Net income Median	-550,201 309,249	-1,414,675 305,537	-766,776 515,321.5	-850,353 1,282,423	6,607,997 3,678,491
Net margin Median	-3.58953% 1.7%	-9.18241% 1.61%	-4.88973% 2.36%	-5.18419% 5.41%	26.03665% 13.38%

* About "Other income": Other income, or line 25 in worksheet G3, is the sum of lines 6 through 24. It includes three lines that are considered non-operating revenue - contributions, investments and government appropriations. Medians are included for these three lines. It also contains items that are not central to providing healthcare, such as revenue from parking or gift shops.
"Sum Line 24" is a special case. Called "Other (specify)" in the cost reports, CMS allows for this line to be "subscripted," or divided into sublines like 002400, 002401, 002402. And hospitals do that, up to 100 lines, to detail income (and sometimes negative returns) that are otherwise not covered in the previous "other" lines. Therefore, "Sum Line 24" is the sum of all the lines 24.

Range* of total profit (loss) margins

= Total margin for VAN BUREN COUNTY HOSPITAL compared to all** CAH hospitals, from CMS cost reports.
The chart below is interactive: click or touch to see more.

* Data range does not show outliers, which fall beyond the minimum and maximum of the range.
** From cost reports with complete fiscal years. Number of CAH hospitals available to calculate medians:

2017	2018	2019	2020	2021
1,314	1,322	1,316	1,319	1,132

Medicare revenue

Inpatient and outpatient revenue

	2017	2018	2019	2020	2021
All inpatient revenue Median Click here to show/hide details	1,072,557 1,512,374	1,044,739 1,478,094	1,077,721 1,365,460	775,848 1,289,169	860,980 1,354,214
"All inpatient revenue" is made up of any Medicare payments for routine inpatient, swingbed SNFs, TEFRA, IPF, IRF, inpatient long-term care, CAH and inpatient SNF facilities. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine inpatient revenue ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Inpatient psychiatric facility (IPF) ⊳ Median	0 1,435,730	0 1,483,001	0 1,283,328	0 992,950.5	0 --
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Critical-access hospitals ⊳ Median	1,072,557 1,441,589	1,044,739 1,403,245	1,077,721 1,290,206	775,848 1,229,191	860,980 1,287,699
⊳ Skilled-nursing facilities (SNF) ⊳ Median	0 206,041.5	0 214,490	0 174,030.5	0 236,717.5	0 192,758.5
All outpatient revenue Median Click here to show/hide details	3,557,420 4,108,627	3,960,722 4,367,646	4,149,745 4,566,928	4,376,565 4,517,324	4,630,524 4,554,272
"All outpatient revenue" is made up of any payments for routine outpatient, HHA, CMHC, rural health and other federally-qualified health clinics. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine outpatient revenue ⊳ Median	2,621,303 3,508,078	2,948,611 3,742,383	3,202,585 3,932,686	3,254,328 3,847,302	3,499,963 3,879,271
⊳ Home Health agencies (HHA) ⊳ Median	0 299,331.5	0 299,936	0 316,639	0 288,635	0 297,926
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	936,117 702,405	1,012,111 746,179	947,160 800,433	1,122,237 774,040	1,130,561 742,054
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	0 --	0 --	0 --	0 --	0 --
Disproportionate-share hospital (DSH) Median	0 --	0 --	0 --	0 --	0 --
Outlier Median	0 4,679	0 5,256	0 5,165.5	0 6,341	0 5,998

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	590,083 553,475.5	1,730,596 567,149	1,132,100 599,174.5	1,109,414 641,417	427,318 631,057
Charity care Median	76,787 190,496	109,989 225,101	101,529 238,624	152,885 260,478.5	64,826 225,887
Uncompensated care (UCC) Median	309,789 860,218.5	412,889 933,428	329,565 986,290	404,239 998,939	258,986 871,713
UCC as a % of operating expenses Median	1.95% 3.77	2.45% 3.82	2.00% 3.7	2.34% 3.74	1.38% 3.04
Total shortfall/UCC Median	899,872 1,405,482	2,143,485 1,525,979	1,461,665 1,576,055	1,513,653 1,691,815	686,304 1,476,802

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	7,714,096 8,521,101	8,255,385 8,786,419	8,239,484 9,086,354	8,599,059 9,512,636	9,289,544 9,933,360
Salaries as a % of operating expenses Median	48.58 42.53	49.08 42.58	50.09 42.62	49.84 42.72	49.67 42.27
Intern, resident salaries* Median	0 --	0 --	0 --	0 --	0 --
Contract intern, resident salaries* Median	0 --	0 --	0 --	0 --	0 --
Contract adjusted salaries, direct-care Median	0 --	0 --	0 --	0 --	0 --
Contract hours, direct-care Median	0.00 --	0.00 --	0.00 --	0.00 --	0.00 --
Contract wages, direct-care Median	0.00 --	0.00 --	0.00 --	0.00 --	0.00 --

* in an approved program

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Cost reports are self-reported by the facility, are subject to revision and should be considered preliminary.

* Net Service to patients (NS2P) equals net patient revenue minus operating expenses. NS2P is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

About medians

Medians are calculated from reports with "complete" fiscal years, or reports with fiscal years of at least 300 days and no more than 420 days.

In cases where there are fewer than 50 values reported, medians are not calculated. For childrens' hospitals, it's when fewer than 20 are reported.

Web app by Tim Broderick | email.