As of the July, 2022, release via CMS

CULLMAN REGIONAL

CMS id: 010035
1912 ALABAMA HIGHWAY 157, CULLMAN AL 35056. County: CULLMAN
System: --
CBSA: Cullman, AL

The 133-bed, acute-care hospital had $-2,470,514 in net service to patients*, with a total profit margin of 7.43431% in fiscal year 2021, the latest year available.
It spent 5.63% of its operating expenses on uncompensated care and reported $0 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	gov	gov	gov	gov	gov
Acute beds Median	103 118	133 118	133 119.5	121 118	121 119
Total beds Median	115 162	145 162	145 162	133 162	133 163.5
FTEs Median	841.80 788.06	882.62 793.42	943.62 806.03	948.70 787.61	0.00 804.34

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	112,844,451 150,932,746	115,312,256 158,950,878	123,298,628 168,696,998	125,500,706 163,454,693	152,985,770 186,589,412
Operating expenses Median	104,452,043 149,311,209	109,306,588 156,110,414	118,881,755 164,890,568	129,335,673 166,516,854	155,456,284 180,120,888
Net income from service 2 patients (NS2P) ? Median	8,392,408 -964,173	6,005,668 -643,601.5	4,416,873 -116,254	-3,834,967 -5,025,862	-2,470,514 -1,284,564
NS2P margin ? Median	7.44% -0.62	5.21% -0.29	3.58% 0.18	-3.06% -5.07	-1.61% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CULLMAN REGIONAL 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	6,576,768 5,089,215	5,533,033 4,572,541	7,569,459 5,268,134	11,271,716 13,092,619	14,955,815 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	2,173,289 224,999	671,560 199,009	641,394 206,870.5	761,961 194,343	563,313 249,496
⊳ Line 7: Investments ? ⊳ Median	2,755,974 299,524	1,928,361 188,688.5	2,353,560 370,813	1,671,871 309,361.5	1,914,264 375,329
⊳ 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	555,400	558,296	0	671,957	725,574
⊳ Line 15: Revenue from rental of living quarters	176,746	206,596	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	1,028,629	1,271,701	2,239,315	1,763,670	1,641,303
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	171,192	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	101,385	72,425
⊳ 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	-113,270	896,519	2,163,998	6,300,872	10,038,936
Total income ? Median	14,969,176 6,586,430	11,538,701 6,767,106	11,986,332 8,419,950	7,436,749 8,094,175	12,485,301 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	14,969,176 6,043,842	11,538,701 5,845,112	11,986,332 7,606,259	7,436,749 7,283,041	12,485,301 14,957,241
Net margin Median	12.53477% 4.62%	9.54833% 4.42%	9.15909% 5.16%	5.43732% 5.2%	7.43431% 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 CULLMAN REGIONAL 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	32,560,759 23,241,334	29,262,536 23,709,545	26,692,108 24,248,380	23,798,153 22,858,541	27,259,392 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	32,560,759 21,577,146	29,262,536 22,041,594	26,692,108 22,722,063	23,798,153 21,570,441	27,259,392 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	13,332,322 11,160,864	12,742,109 11,987,345	13,235,387 12,926,866	12,536,528 11,884,480	14,063,320 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	12,649,084 10,918,923	12,059,743 11,706,976	12,511,806 12,615,917	11,450,833 11,458,116	12,729,657 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	683,238 1,282,808	682,366 1,407,728	723,581 1,341,512	1,085,695 1,407,046	1,333,663 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	0 3,508,953
Disproportionate-share hospital (DSH) Median	383,810 594,888	334,789 595,761	373,010 577,894	347,052 542,168	244,175 549,667
Outlier Median	206,372 582,572	282,092 538,116	78,893 212,434	46,994 126,559	121,543 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	1,410,516 2,654,636	1,532,943 2,940,659	2,210,514 3,380,215	1,731,382 3,488,738	1,634,251 3,233,405
Uncompensated care (UCC) Median	8,212,381 5,147,790	8,759,311 5,337,617	9,903,710 5,711,082	9,726,416 5,923,418	8,746,562 5,508,107
UCC as a % of operating expenses Median	7.86% 3.24	8.01% 3.12	8.33% 3.21	7.52% 3.3	5.63% 2.86
Total shortfall/UCC Median	8,212,381 9,489,989	8,759,311 9,424,297	9,903,710 10,120,158	9,726,416 11,171,337	8,746,562 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	41,036,133 52,142,039	43,351,788 54,485,252	48,654,600 57,395,589	57,883,034 58,830,919	71,836,975 61,722,907
Salaries as a % of operating expenses Median	39.29 36.68	39.66 36.56	40.93 36.37	44.75 35.93	46.21 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	466,117 1,449,244	32,135 1,475,986	43,081 1,563,078	22,753 1,721,954	1,937,211 2,991,828
Contract hours, direct-care Median	4,529.00 22,725	873.00 23,018.5	1,087.00 24,503.48	643.00 25,026.5	19,720.00 33,786
Contract wages, direct-care Median	102.92 64.67	36.81 64.53	39.63 65.06	35.39 68.97	98.24 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.