As of the July, 2022, release via CMS

RUSSELL MEDICAL CENTER

CMS id: 010065
3316 HIGHWAY 280, ALEXANDER CITY AL 35010. County: TALLAPOOSA
System: --
CBSA: Alexander City, AL

The 45-bed, acute-care hospital had $-12,238,243 in net service to patients*, with a total profit margin of 5.72325% in fiscal year 2021, the latest year available.
It spent 2.10% 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	forprofit	forprofit	nfp	nfp	nfp
Acute beds Median	38 118	28 118	37 119.5	37 118	39 119
Total beds Median	44 162	34 162	43 162	43 162	45 163.5
FTEs Median	433.27 788.06	451.48 793.42	69.09 806.03	73.45 787.61	78.74 804.34

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	73,784,995 150,932,746	65,123,347 158,950,878	64,963,897 168,696,998	68,187,536 163,454,693	72,500,605 186,589,412
Operating expenses Median	84,324,094 149,311,209	80,088,618 156,110,414	71,312,966 164,890,568	78,289,087 166,516,854	84,738,848 180,120,888
Net income from service 2 patients (NS2P) ? Median	-10,539,099 -964,173	-14,965,271 -643,601.5	-6,349,069 -116,254	-10,101,551 -5,025,862	-12,238,243 -1,284,564
NS2P margin ? Median	-14.28% -0.62	-22.98% -0.29	-9.77% 0.18	-14.81% -5.07	-16.88% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for RUSSELL 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	3,612,664 5,089,215	9,688,202 4,572,541	1,992,293 5,268,134	14,139,279 13,092,619	17,382,477 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	15,568 206,870.5	9,007 194,343	140,474 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	445,136 370,813	365,546 309,361.5	471,825 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	0	131,978	139,575	152,329
⊳ 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	0	0	548,187	349,229	321,379
⊳ 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	34,200	40,610	69,234
⊳ 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	69,342	177,938
⊳ Line 21: Rental of vending machines	0	0	3,268	1,787	2,330
⊳ Line 22: Rental of hospital space	0	0	1,116,784	1,040,632	1,146,656
⊳ 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	3,612,664	9,688,202	-302,828	12,123,551	14,900,312
Total income ? Median	-6,926,435 6,586,430	-5,277,069 6,767,106	-4,356,776 8,419,950	4,037,728 8,094,175	5,144,234 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	-6,926,435 6,043,842	-5,277,069 5,845,112	-4,356,776 7,606,259	4,037,728 7,283,041	5,144,234 14,957,241
Net margin Median	-8.94915% 4.62%	-7.05382% 4.42%	-6.50691% 5.16%	4.90451% 5.2%	5.72325% 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 RUSSELL 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	9,711,649 23,241,334	7,206,450 23,709,545	6,425,377 24,248,380	6,810,959 22,858,541	5,513,553 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	9,711,649 21,577,146	7,206,450 22,041,594	6,425,377 22,722,063	6,810,959 21,570,441	5,513,553 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	16,587,607 11,160,864	12,356,153 11,987,345	12,959,203 12,926,866	11,917,017 11,884,480	11,945,880 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	16,487,828 10,918,923	12,296,787 11,706,976	12,913,462 12,615,917	11,889,159 11,458,116	11,927,566 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	99,779 618,038	59,366 697,279	45,741 690,232	27,858 684,010	18,314 670,558
⊳ 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	269,151 594,888	204,561 595,761	211,548 577,894	159,548 542,168	131,851 549,667
Outlier Median	404,614 582,572	106,993 538,116	41,479 212,434	39,375 126,559	13,441 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	663,623 3,662,910	3,025,356 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	241,243 2,654,636	191,723 2,940,659	161,799 3,380,215	65,790 3,488,738	86,622 3,233,405
Uncompensated care (UCC) Median	2,068,222 5,147,790	1,833,412 5,337,617	1,595,907 5,711,082	1,978,101 5,923,418	1,776,612 5,508,107
UCC as a % of operating expenses Median	2.45% 3.24	2.29% 3.12	2.24% 3.21	2.53% 3.3	2.10% 2.86
Total shortfall/UCC Median	2,731,845 9,489,989	4,858,768 9,424,297	1,595,907 10,120,158	1,978,101 11,171,337	1,776,612 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	26,973,437 52,142,039	26,280,049 54,485,252	27,272,033 57,395,589	30,119,205 58,830,919	32,040,193 61,722,907
Salaries as a % of operating expenses Median	35.23 36.68	35.11 36.56	38.24 36.37	38.47 35.93	37.81 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	1,628,715 1,449,244	1,598,146 1,475,986	1,270,353 1,563,078	1,684,600 1,721,954	2,907,696 2,991,828
Contract hours, direct-care Median	22,441.00 22,725	20,952.00 23,018.5	19,333.69 24,503.48	23,605.00 25,026.5	28,338.00 33,786
Contract wages, direct-care Median	72.58 64.67	76.28 64.53	65.71 65.06	71.37 68.97	102.61 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.