As of the July, 2022, release via CMS

SANFORD MEDICAL CENTER CLEAR LAKE

CMS id: 431307
701 3RD AVE, CLEAR LAKE SD 57226. County: DEUEL
System: SANFORD
CBSA: Rural South Dakota

The 10-bed, CAH hospital had $787,787 in net service to patients*, with a total profit margin of 18.34794% in fiscal year 2021, the latest year available.
It spent 8.32% of its operating expenses on uncompensated care and reported $22,226 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	nfp	nfp	nfp	nfp	nfp
Acute beds Median	10 23	10 23	10 23	10 23	10 23
Total beds Median	10 25	10 25	10 25	10 25	10 25
FTEs Median	47.20 149.18	46.67 151.6	43.15 151.58	40.02 152.78	39.38 151.99

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	6,662,728 19,395,819	6,290,517 19,790,685	6,704,227 20,891,573	6,934,373 20,752,910	7,394,366 22,925,976
Operating expenses Median	6,370,098 21,082,256	6,274,794 21,740,728	6,391,211 22,449,917	6,361,801 23,028,561	6,606,579 24,906,213
Net income from service 2 patients (NS2P) ? Median	292,630 -1,166,928	15,723 -1,178,891	313,016 -1,189,234	572,572 -1,989,193	787,787 -1,175,562
NS2P margin ? Median	4.39% -6.37	0.25% -6.47	4.67% -6.58	8.26% -10.52	10.65% -5.81

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SANFORD MEDICAL CENTER CLEAR LAKE 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	241,515 1,517,926	228,011 1,554,100	490,355 1,708,825	494,503 3,606,354	696,854 4,946,640
⊳ Line 6: Contributions ? ⊳ Median	7,624 68,435	0 61,711.5	0 71,344	0 80,654	0 103,902
⊳ Line 7: Investments ? ⊳ Median	730 25,389	981 35,427	252 59,240	28 47,652	244 52,317
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	70	303	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	8,802	7,868	2,715	645	402
⊳ 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	0	0	0	0	0
⊳ 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	0	0	0	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	29,265 525,619.5	39,353 568,101.5	35,207 581,486	100,434 657,916	91,991 640,942
⊳ Sum Line 24	195,024	179,506	452,181	393,396	604,217
Total income ? Median	534,145 445,049	243,734 379,292	803,371 655,032	1,067,075 1,453,054	1,484,641 3,734,026
Non-operating expenses Median	409 56,329	2,444 45,230	162 61,507	20 80,747	69 39,130
Net income Median	533,736 309,249	241,290 305,537	803,209 515,321.5	1,067,055 1,282,423	1,484,572 3,678,491
Net margin Median	7.73055% 1.7%	3.70160% 1.61%	11.16408% 2.36%	14.36361% 5.41%	18.34794% 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 SANFORD MEDICAL CENTER CLEAR LAKE 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	500,477 1,512,374	894,810 1,478,094	477,673 1,365,460	449,836 1,289,169	401,655 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	500,477 1,441,589	894,810 1,403,245	477,673 1,290,206	449,836 1,229,191	401,655 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	1,966,878 4,108,627	2,202,172 4,367,646	2,100,899 4,566,928	1,841,410 4,517,324	1,891,511 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	1,482,374 3,508,078	1,744,329 3,742,383	1,708,782 3,932,686	1,561,918 3,847,302	1,608,427 3,879,271
⊳ Home Health agencies (HHA) ⊳ Median	88,959 299,331.5	44,214 299,936	0 316,639	0 288,635	0 297,926
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	395,545 702,405	413,629 746,179	392,117 800,433	279,492 774,040	283,084 742,054
⊳ 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	1 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	14,357 553,475.5	39,874 567,149	38,325 599,174.5	44,785 641,417	22,226 631,057
Charity care Median	163,682 190,496	317,631 225,101	392,607 238,624	528,494 260,478.5	459,190 225,887
Uncompensated care (UCC) Median	356,112 860,218.5	321,772 933,428	569,786 986,290	641,469 998,939	549,358 871,713
UCC as a % of operating expenses Median	5.59% 3.77	5.13% 3.82	8.92% 3.7	10.08% 3.74	8.32% 3.04
Total shortfall/UCC Median	370,469 1,405,482	361,646 1,525,979	608,111 1,576,055	686,254 1,691,815	571,584 1,476,802

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	3,158,158 8,521,101	3,192,283 8,786,419	3,219,610 9,086,354	3,154,281 9,512,636	3,144,437 9,933,360
Salaries as a % of operating expenses Median	50.17 42.53	51.49 42.58	50.97 42.62	50.17 42.72	48.14 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

Return to top

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.