As of the July, 2022, release via CMS

QUEEN OF THE VALLEY MEDICAL CENTER

CMS id: 050009
1000 TRANCAS STREET, NAPA CA 94558. County: NAPA
System: ST JOSEPH HEALTH SYSTEM
CBSA: Napa, CA

The 148-bed, acute-care hospital had $-19,321,675 in net service to patients*, with a total profit margin of 6.95750% in fiscal year 2021, the latest year available.
It spent 2.64% of its operating expenses on uncompensated care and reported $27,214,272 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	274	365	366	365
Ownership	nfp	nfp	nfp	nfp	nfp
Acute beds Median	150 118	150 118	110 119.5	92 118	92 119
Total beds Median	186 162	186 162	166 162	148 162	148 163.5
FTEs Median	862.15 788.06	821.55 793.42	885.06 806.03	835.35 787.61	828.42 804.34

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	268,191,531 150,932,746	196,718,939 158,950,878	308,985,388 168,696,998	270,483,169 163,454,693	285,991,702 186,589,412
Operating expenses Median	272,503,070 149,311,209	204,819,886 156,110,414	287,677,842 164,890,568	281,074,217 166,516,854	305,313,377 180,120,888
Net income from service 2 patients (NS2P) ? Median	-4,311,539 -964,173	-8,100,947 -643,601.5	21,307,546 -116,254	-10,591,048 -5,025,862	-19,321,675 -1,284,564
NS2P margin ? Median	-1.61% -0.62	-4.12% -0.29	6.90% 0.18	-3.92% -5.07	-6.76% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for QUEEN OF THE VALLEY 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	20,796,458 5,089,215	17,387,484 4,572,541	14,158,996 5,268,134	16,631,361 13,092,619	43,104,519 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	-80,513 224,999	-268,350 199,009	-559,725 206,870.5	391,697 194,343	304,927 249,496
⊳ Line 7: Investments ? ⊳ Median	13,294,447 299,524	11,571,395 188,688.5	6,966,281 370,813	2,900,543 309,361.5	36,148,139 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	10,247	14,999	-76	0	0
⊳ Line 11: Rebates and refunds of expenses	18,381	115,487	169,838	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	572,249	196,771	718,670	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	5,938	1,517	3,281	0	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	180,371	69,513	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	39,380	7,704	9,803	0	0
⊳ Line 22: Rental of hospital space	0	0	547,649	1,465,035	816,425
⊳ 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	6,755,958	5,678,448	6,303,275	11,874,086	5,835,028
Total income ? Median	16,484,919 6,586,430	9,286,537 6,767,106	35,466,542 8,419,950	6,040,313 8,094,175	23,782,844 15,162,888
Non-operating expenses Median	2,973,500 146,289.5	-220,347 164,857	0 89,880.5	0 106,761	885,990 31,473.5
Net income Median	13,511,419 6,043,842	9,506,884 5,845,112	35,466,542 7,606,259	6,040,313 7,283,041	22,896,854 14,957,241
Net margin Median	4.67543% 4.62%	4.44026% 4.42%	10.97545% 5.16%	2.10380% 5.2%	6.95750% 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 QUEEN OF THE VALLEY 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	54,730,715 23,241,334	41,755,179 23,709,545	54,768,486 24,248,380	47,097,851 22,858,541	49,497,783 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	51,898,282 21,577,146	39,593,846 22,041,594	51,291,578 22,722,063	41,799,366 21,570,441	43,631,839 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	2,832,433 3,535,627	2,161,333 3,746,588	3,476,908 3,782,288	5,298,485 3,865,578	5,865,944 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	23,674,130 11,160,864	17,799,604 11,987,345	30,324,582 12,926,866	28,561,181 11,884,480	31,747,532 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	23,674,130 10,918,923	17,799,604 11,706,976	30,324,582 12,615,917	28,561,181 11,458,116	31,747,532 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	1,959,745 594,888	1,593,674 595,761	1,986,341 577,894	1,664,149 542,168	1,937,599 549,667
Outlier Median	4,510,786 582,572	3,704,432 538,116	3,586,727 212,434	1,003,935 126,559	1,103,550 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	11,005,052 3,662,910	0 3,730,911	24,632,235 4,081,319	25,684,432 4,643,908	27,214,272 4,389,147
Charity care Median	3,674,490 2,654,636	4,218,542 2,940,659	6,409,334 3,380,215	6,538,076 3,488,738	6,146,227 3,233,405
Uncompensated care (UCC) Median	5,376,241 5,147,790	6,559,155 5,337,617	7,637,813 5,711,082	8,498,691 5,923,418	8,068,889 5,508,107
UCC as a % of operating expenses Median	1.97% 3.24	3.20% 3.12	2.65% 3.21	3.02% 3.3	2.64% 2.86
Total shortfall/UCC Median	16,381,293 9,489,989	6,559,155 9,424,297	32,270,048 10,120,158	34,183,123 11,171,337	35,283,161 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	93,277,912 52,142,039	73,402,010 54,485,252	103,901,272 57,395,589	102,833,430 58,830,919	104,420,311 61,722,907
Salaries as a % of operating expenses Median	34.23 36.68	35.84 36.56	39.85 36.37	40.15 35.93	42.00 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	12,917,690 1,449,244	9,813,847 1,475,986	3,461,269 1,563,078	2,584,835 1,721,954	3,853,054 2,991,828
Contract hours, direct-care Median	118,697.82 22,725	86,295.00 23,018.5	34,531.00 24,503.48	26,766.04 25,026.5	32,060.00 33,786
Contract wages, direct-care Median	108.83 64.67	113.72 64.53	100.24 65.06	96.57 68.97	120.18 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.