As of the July, 2022, release via CMS

FLAGSTAFF MEDICAL CENTER

CMS id: 030023
1200 NORTH BEAVER, FLAGSTAFF AZ 86001. County: COCONINO
System: NO AZ HEALTHCARE
CBSA: Flagstaff, AZ

The 268-bed, acute-care hospital had $30,780,114 in net service to patients*, with a total profit margin of 26.70147% in fiscal year 2021, the latest year available.
It spent 3.78% of its operating expenses on uncompensated care and reported $18,329,648 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	nfp	nfp	nfp	nfp	nfp
Acute beds Median	182 118	182 118	183 119.5	183 118	183 119
Total beds Median	267 162	267 162	264 162	264 162	268 163.5
FTEs Median	1,843.10 788.06	1,835.36 793.42	1,847.81 806.03	1,839.25 787.61	1,686.97 804.34

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	418,498,780 150,932,746	442,150,940 158,950,878	445,048,371 168,696,998	420,062,499 163,454,693	450,206,231 186,589,412
Operating expenses Median	378,807,425 149,311,209	394,721,892 156,110,414	404,230,109 164,890,568	399,031,062 166,516,854	419,426,117 180,120,888
Net income from service 2 patients (NS2P) ? Median	39,691,355 -964,173	47,429,048 -643,601.5	40,818,262 -116,254	21,031,437 -5,025,862	30,780,114 -1,284,564
NS2P margin ? Median	9.48% -0.62	10.73% -0.29	9.17% 0.18	5.01% -5.07	6.84% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for FLAGSTAFF 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	24,309,485 5,089,215	31,925,412 4,572,541	36,467,850 5,268,134	35,659,478 13,092,619	122,010,048 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	-33,487,801 224,999	-8,624,531 199,009	-1,505,000 206,870.5	-1,015,000 194,343	-258,534 249,496
⊳ Line 7: Investments ? ⊳ Median	44,343,135 299,524	28,386,776 188,688.5	27,920,000 370,813	18,409,612 309,361.5	100,166,014 375,329
⊳ 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	0	0	0	0	0
⊳ 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	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	13,454,151	12,163,167	10,052,850	18,264,866	22,102,568
Total income ? Median	64,000,840 6,586,430	79,354,460 6,767,106	77,286,112 8,419,950	56,690,915 8,094,175	152,790,162 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	64,000,840 6,043,842	79,354,460 5,845,112	77,286,112 7,606,259	56,690,915 7,283,041	152,790,162 14,957,241
Net margin Median	14.45340% 4.62%	16.73875% 4.42%	16.05057% 5.16%	12.43980% 5.2%	26.70147% 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 FLAGSTAFF 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	92,758,692 23,241,334	100,011,260 23,709,545	102,738,848 24,248,380	92,194,437 22,858,541	82,771,864 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	91,976,634 21,577,146	99,433,570 22,041,594	102,293,443 22,722,063	92,010,033 21,570,441	82,387,660 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	782,058 1,845,420	577,690 1,757,392	445,405 1,738,842	184,404 1,510,463	384,204 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	15,429,229 11,160,864	17,960,574 11,987,345	20,415,732 12,926,866	18,894,303 11,884,480	19,615,417 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	15,429,229 10,918,923	17,960,574 11,706,976	20,415,732 12,615,917	18,894,303 11,458,116	19,615,417 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	0 3,508,953
Disproportionate-share hospital (DSH) Median	3,644,547 594,888	4,113,353 595,761	4,040,643 577,894	3,345,285 542,168	2,913,132 549,667
Outlier Median	3,525,136 582,572	3,924,995 538,116	3,452,346 212,434	276,414 126,559	409,649 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	42,445,032 3,662,910	43,650,485 3,730,911	49,797,888 4,081,319	46,389,783 4,643,908	18,329,648 4,389,147
Charity care Median	8,008,719 2,654,636	9,493,389 2,940,659	7,322,005 3,380,215	1,226,546 3,488,738	11,436,059 3,233,405
Uncompensated care (UCC) Median	15,922,482 5,147,790	14,452,554 5,337,617	10,693,411 5,711,082	7,279,366 5,923,418	15,872,801 5,508,107
UCC as a % of operating expenses Median	4.20% 3.24	3.66% 3.12	2.65% 3.21	1.82% 3.3	3.78% 2.86
Total shortfall/UCC Median	58,367,514 9,489,989	58,103,039 9,424,297	60,491,299 10,120,158	53,669,149 11,171,337	34,202,449 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	127,609,495 52,142,039	131,685,919 54,485,252	136,521,302 57,395,589	136,492,648 58,830,919	132,280,800 61,722,907
Salaries as a % of operating expenses Median	33.69 36.68	33.36 36.56	33.77 36.37	34.21 35.93	31.54 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	16,995,772 1,449,244	6,234,159 1,475,986	4,330,421 1,563,078	3,742,349 1,721,954	10,545,963 2,991,828
Contract hours, direct-care Median	132,076.00 22,725	89,662.00 23,018.5	60,870.00 24,503.48	65,597.10 25,026.5	121,399.58 33,786
Contract wages, direct-care Median	128.68 64.67	69.53 64.53	71.14 65.06	57.05 68.97	86.87 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.