As of the July, 2022, release via CMS

FIVE RIVERS MEDICAL CENTER

CMS id: 040047
2801 MEDICAL CENTER DRIVE, POCAHONTAS AR 72455. County: RANDOLPH
System: ST. BERNARDS HEALTHCARE
CBSA: Rural Arkansas

The 50-bed, acute-care hospital had $-3,590,641 in net service to patients*, with a total profit margin of 19.71962% in fiscal year 2021, the latest year available.
It spent 5.62% 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	273	366	365
Ownership	gov	gov	gov	gov	gov
Acute beds Median	30 118	30 118	30 119.5	30 118	36 119
Total beds Median	44 162	44 162	44 162	44 162	50 163.5
FTEs Median	182.28 788.06	217.40 793.42	123.34 806.03	157.77 787.61	167.16 804.34

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	16,905,512 150,932,746	15,663,464 158,950,878	13,157,294 168,696,998	16,414,987 163,454,693	18,337,793 186,589,412
Operating expenses Median	18,989,906 149,311,209	18,680,985 156,110,414	14,526,923 164,890,568	19,866,580 166,516,854	21,928,434 180,120,888
Net income from service 2 patients (NS2P) ? Median	-2,084,394 -964,173	-3,017,521 -643,601.5	-1,369,629 -116,254	-3,451,593 -5,025,862	-3,590,641 -1,284,564
NS2P margin ? Median	-12.33% -0.62	-19.26% -0.29	-10.41% 0.18	-21.03% -5.07	-19.58% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for FIVE RIVERS 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	1,742,998 5,089,215	1,201,165 4,572,541	1,060,463 5,268,134	2,035,196 13,092,619	8,977,019 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	95,562 206,870.5	71,890 194,343	101,203 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	608 370,813	3,149 309,361.5	6,369 375,329
⊳ 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	35	4,957	6,505
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	22,996	28,453	36,651
⊳ 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	50	75	104
⊳ 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	794,463 1,017,693	750,000 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	948,535	451,165	941,212	1,926,672	8,826,187
Total income ? Median	-341,396 6,586,430	-1,816,356 6,767,106	-309,166 8,419,950	-1,416,397 8,094,175	5,386,378 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	-341,396 6,043,842	-1,816,356 5,845,112	-309,166 7,606,259	-1,416,397 7,283,041	5,386,378 14,957,241
Net margin Median	-1.83069% 4.62%	-10.77021% 4.42%	-2.17451% 5.16%	-7.67687% 5.2%	19.71962% 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 FIVE RIVERS 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	4,577,576 23,241,334	4,370,265 23,709,545	3,469,592 24,248,380	4,187,929 22,858,541	4,585,514 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	2,263,322 21,577,146	2,185,132 22,041,594	1,948,399 22,722,063	2,668,462 21,570,441	3,412,000 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	2,314,254 1,845,420	2,185,133 1,757,392	1,521,193 1,738,842	1,519,467 1,510,463	1,173,514 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	4,265,152 11,160,864	4,089,305 11,987,345	3,021,385 12,926,866	3,995,347 11,884,480	3,620,269 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	2,093,121 10,918,923	2,043,976 11,706,976	1,488,975 12,615,917	1,737,119 11,458,116	1,584,669 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,172,031 1,282,808	1,976,314 1,407,728	1,488,061 1,341,512	2,192,542 1,407,046	1,983,752 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	0 618,038	69,015 697,279	44,349 690,232	65,686 684,010	51,848 670,558
⊳ 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	20,961 594,888	46,098 595,761	17,506 577,894	55,568 542,168	64,822 549,667
Outlier Median	60,052 582,572	17,267 538,116	15,129 212,434	27,135 126,559	16,045 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	449,463 3,662,910	469,762 3,730,911	172,385 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	235,571 2,654,636	115,975 2,940,659	75,112 3,380,215	230,439 3,488,738	326,977 3,233,405
Uncompensated care (UCC) Median	777,062 5,147,790	558,522 5,337,617	534,932 5,711,082	982,507 5,923,418	1,233,092 5,508,107
UCC as a % of operating expenses Median	4.09% 3.24	2.99% 3.12	3.68% 3.21	4.95% 3.3	5.62% 2.86
Total shortfall/UCC Median	1,226,525 9,489,989	1,028,284 9,424,297	707,317 10,120,158	982,507 11,171,337	1,233,092 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	9,886,952 52,142,039	9,411,816 54,485,252	7,271,424 57,395,589	9,848,856 58,830,919	11,102,584 61,722,907
Salaries as a % of operating expenses Median	52.06 36.68	50.38 36.56	50.05 36.37	49.99 35.93	50.63 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	0 1,449,244	9,146 1,475,986	0 1,563,078	110,847 1,721,954	189,193 2,991,828
Contract hours, direct-care Median	0.00 22,725	131.00 23,018.5	0.00 24,503.48	1,772.00 25,026.5	2,693.75 33,786
Contract wages, direct-care Median	0.00 64.67	69.82 64.53	0.00 65.06	62.55 68.97	70.23 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.