As of the July, 2022, release via CMS

NORTH ALABAMA MEDICAL CENTER

CMS id: 010006
1701 VETERANS DRIVE, FLORENCE AL 35630. County: LAUDERDALE
System: LIFEPOINT HEALTH
CBSA: Florence-Muscle Shoals, AL

The 223-bed, acute-care hospital had $16,900,384 in net service to patients*, with a total profit margin of 13.50675% in fiscal year 2021, the latest year available.
It spent 6.57% of its operating expenses on uncompensated care and reported $2,127,305 in Medicaid shortfall.

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

Note: Medians are from acute-care 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	310 118	310 118	181 119.5	167 118	167 119
Total beds Median	358 162	358 162	233 162	223 162	223 163.5
FTEs Median	971.12 788.06	960.63 793.42	970.89 806.03	967.29 787.61	995.28 804.34

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	158,328,355 150,932,746	161,874,263 158,950,878	170,503,663 168,696,998	177,193,949 163,454,693	194,620,314 186,589,412
Operating expenses Median	147,812,014 149,311,209	144,290,886 156,110,414	157,276,267 164,890,568	165,422,707 166,516,854	177,719,930 180,120,888
Net income from service 2 patients (NS2P) ? Median	10,516,341 -964,173	17,583,377 -643,601.5	13,227,396 -116,254	11,771,242 -5,025,862	16,900,384 -1,284,564
NS2P margin ? Median	6.64% -0.62	10.86% -0.29	7.76% 0.18	6.64% -5.07	8.68% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for NORTH ALABAMA MEDICAL CENTER compared to all** acute-care 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 acute-care hospitals available to calculate medians:

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

	2017	2018	2019	2020	2021
Other income* Median Click here to show/hide details	2,330,868 5,089,215	1,746,949 4,572,541	3,992,011 5,268,134	2,071,350 13,092,619	10,852,298 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	3,393 299,524	9,711 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	1,102	1,085	0	0	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	309,928	80,986	29,641	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	739,332	761,612	899,056	944,962	814,985
⊳ 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	7,458	7,663	4,288	13,095	9,174
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	316,326	299,378	325,129	269,643	235,583
⊳ Line 21: Rental of vending machines	59,194	59,048	36,157	23,260	15,900
⊳ Line 22: Rental of hospital space	27,383	40,431	29,702	14,348	0
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	866,752	487,035	2,668,038	806,042	9,776,656
Total income ? Median	12,847,209 6,586,430	19,330,326 6,767,106	17,219,407 8,419,950	13,842,592 8,094,175	27,752,682 15,162,888
Non-operating expenses Median	1,518 146,289.5	343,655 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	12,845,691 6,043,842	18,986,671 5,845,112	17,219,407 7,606,259	13,842,592 7,283,041	27,752,682 14,957,241
Net margin Median	7.99561% 4.62%	11.60404% 4.42%	9.86810% 5.16%	7.72185% 5.2%	13.50675% 9.25%

* 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 NORTH ALABAMA MEDICAL CENTER compared to all** acute-care hospitals, from CMS cost reports.
The chart below is interactive: click or touch to see more.

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

Medicare revenue

Inpatient and outpatient revenue

	2017	2018	2019	2020	2021
All inpatient revenue Median Click here to show/hide details	47,199,011 23,241,334	45,146,219 23,709,545	44,915,683 24,248,380	46,572,037 22,858,541	50,289,340 23,620,613
"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	47,199,011 21,577,146	45,146,219 22,041,594	44,915,683 22,722,063	46,572,037 21,570,441	50,289,340 22,140,684
⊳ 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 1,845,420	0 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	0 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Critical-access hospitals ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Skilled-nursing facilities (SNF) ⊳ Median	0 1,203,033	0 1,215,295	0 1,313,657	0 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	15,354,419 11,160,864	15,402,914 11,987,345	16,821,626 12,926,866	15,524,068 11,884,480	15,714,050 13,145,163
"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	15,354,419 10,918,923	15,402,914 11,706,976	16,821,626 12,615,917	15,524,068 11,458,116	15,714,050 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	0 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	0 670,558
⊳ 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 3,284,314	0 3,250,551	0 3,386,837	0 3,360,806	3,444,214 3,508,953
Disproportionate-share hospital (DSH) Median	1,009,140 594,888	933,348 595,761	994,840 577,894	896,487 542,168	752,572 549,667
Outlier Median	372,673 582,572	384,555 538,116	446,613 212,434	38,010 126,559	106,143 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	518,216 3,730,911	2,766,724 4,081,319	1,664,285 4,643,908	2,127,305 4,389,147
Charity care Median	4,285,147 2,654,636	1,420,571 2,940,659	1,489,103 3,380,215	4,540,114 3,488,738	7,776,757 3,233,405
Uncompensated care (UCC) Median	11,028,048 5,147,790	8,546,311 5,337,617	7,987,490 5,711,082	7,570,938 5,923,418	11,676,336 5,508,107
UCC as a % of operating expenses Median	7.46% 3.24	5.92% 3.12	5.08% 3.21	4.58% 3.3	6.57% 2.86
Total shortfall/UCC Median	11,028,048 9,489,989	9,064,527 9,424,297	10,754,214 10,120,158	9,235,223 11,171,337	13,803,641 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	47,453,180 52,142,039	49,562,198 54,485,252	51,626,960 57,395,589	53,661,994 58,830,919	59,033,935 61,722,907
Salaries as a % of operating expenses Median	32.10 36.68	34.35 36.56	32.83 36.37	33.73 35.93	34.66 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	0 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	0 1,469,317
Contract adjusted salaries, direct-care Median	800,829 1,449,244	760,684 1,475,986	857,285 1,563,078	324,613 1,721,954	1,840,421 2,991,828
Contract hours, direct-care Median	13,058.00 22,725	14,547.00 23,018.5	11,396.00 24,503.48	3,994.00 25,026.5	19,236.00 33,786
Contract wages, direct-care Median	61.33 64.67	52.29 64.53	75.23 65.06	81.28 68.97	95.68 88.94

* 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.