As of the July, 2022, release via CMS

CALIFORNIA PACIFIC MEDICAL CENTER

CMS id: 050047
1101 VAN NESS AVE, SAN FRANCISCO CA 94109. County: SAN FRANCISCO
System: SUTTER HEALTH
CBSA: San Francisco-Oakland-Berkeley, CA

The 292-bed, acute-care hospital had $-211,218,496 in net service to patients*, with a total profit margin of -13.53576% in fiscal year 2021, the latest year available.
It spent 0.82% of its operating expenses on uncompensated care and reported $90,150,263 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	384 118	384 118	226 119.5	195 118	195 119
Total beds Median	480 162	480 162	323 162	292 162	292 163.5
FTEs Median	2,555.66 788.06	2,482.91 793.42	2,339.49 806.03	2,271.42 787.61	2,491.80 804.34

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	1,012,778,161 150,932,746	990,875,136 158,950,878	944,512,441 168,696,998	882,100,380 163,454,693	968,849,736 186,589,412
Operating expenses Median	666,004,472 149,311,209	708,024,149 156,110,414	789,675,390 164,890,568	791,084,819 166,516,854	1,180,068,232 180,120,888
Net income from service 2 patients (NS2P) ? Median	346,773,689 -964,173	282,850,987 -643,601.5	154,837,051 -116,254	91,015,561 -5,025,862	-211,218,496 -1,284,564
NS2P margin ? Median	34.24% -0.62	28.55% -0.29	16.39% 0.18	10.32% -5.07	-21.80% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CALIFORNIA PACIFIC 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	65,061,453 5,089,215	47,194,707 4,572,541	48,837,424 5,268,134	85,242,807 13,092,619	70,530,527 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	8,229,371 224,999	7,462,430 199,009	6,627,820 206,870.5	10,193,327 194,343	14,174,585 249,496
⊳ Line 7: Investments ? ⊳ Median	31,637,548 299,524	21,040,061 188,688.5	23,191,514 370,813	22,247,315 309,361.5	27,971,556 375,329
⊳ 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	373
⊳ Line 11: Rebates and refunds of expenses	6,060,977	6,800,097	6,943,605	5,690,739	6,559,526
⊳ 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	2,076,591	1,425,565	53,267	74,641	80,015
⊳ 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	784,218	736,243	693,433	437,649	361,365
⊳ Line 21: Rental of vending machines	42,187	46,667	45,640	19,027	14,454
⊳ Line 22: Rental of hospital space	5,253,934	772	0	0	8,714,806
⊳ 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	10,976,627	9,682,872	11,282,145	46,580,109	12,653,847
Total income ? Median	411,835,142 6,586,430	330,045,694 6,767,106	203,674,475 8,419,950	176,258,368 8,094,175	-140,687,969 15,162,888
Non-operating expenses Median	0 146,289.5	-25,748 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	411,835,142 6,043,842	330,071,442 5,845,112	203,674,475 7,606,259	176,258,368 7,283,041	-140,687,969 14,957,241
Net margin Median	38.20932% 4.62%	31.79665% 4.42%	20.50380% 5.16%	18.22087% 5.2%	-13.53576% 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 CALIFORNIA PACIFIC 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	140,946,568 23,241,334	153,616,730 23,709,545	135,492,016 24,248,380	142,424,820 22,858,541	156,693,138 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	138,785,935 21,577,146	151,724,686 22,041,594	133,240,618 22,722,063	140,922,893 21,570,441	155,017,003 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	2,160,633 1,845,420	1,892,044 1,757,392	2,251,398 1,738,842	1,501,927 1,510,463	1,676,135 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	46,537,008 11,160,864	48,214,190 11,987,345	47,018,394 12,926,866	42,589,716 11,884,480	49,566,129 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	46,537,008 10,918,923	48,214,190 11,706,976	47,018,394 12,615,917	42,589,716 11,458,116	49,566,129 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	12,941,169 3,284,314	13,703,401 3,250,551	12,290,585 3,386,837	15,517,505 3,360,806	16,857,918 3,508,953
Disproportionate-share hospital (DSH) Median	4,416,907 594,888	4,518,497 595,761	3,273,767 577,894	3,653,970 542,168	3,748,128 549,667
Outlier Median	9,335,842 582,572	13,028,640 538,116	1,086,668 212,434	970,490 126,559	3,457,873 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	45,961,281 3,662,910	43,613,488 3,730,911	70,316,988 4,081,319	111,150,749 4,643,908	90,150,263 4,389,147
Charity care Median	6,525,059 2,654,636	7,750,118 2,940,659	11,309,916 3,380,215	9,980,220 3,488,738	7,657,477 3,233,405
Uncompensated care (UCC) Median	8,245,362 5,147,790	10,438,647 5,337,617	14,139,802 5,711,082	12,236,214 5,923,418	9,648,868 5,508,107
UCC as a % of operating expenses Median	1.24% 3.24	1.47% 3.12	1.79% 3.21	1.55% 3.3	0.82% 2.86
Total shortfall/UCC Median	54,206,643 9,489,989	54,052,135 9,424,297	84,456,790 10,120,158	123,386,963 11,171,337	99,799,131 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	298,843,097 52,142,039	307,856,467 54,485,252	306,936,382 57,395,589	314,343,103 58,830,919	379,009,473 61,722,907
Salaries as a % of operating expenses Median	44.87 36.68	43.48 36.56	38.87 36.37	39.74 35.93	32.12 35.24
Intern, resident salaries* Median	7,251,709 2,598,592	7,762,398 2,686,824	7,690,928 2,753,773	7,716,826 2,937,156	7,776,049 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	14,316,715 1,449,244	0 1,475,986	0 1,563,078	13,055,121 1,721,954	0 2,991,828
Contract hours, direct-care Median	160,801.04 22,725	0.00 23,018.5	0.00 24,503.48	148,001.31 25,026.5	0.00 33,786
Contract wages, direct-care Median	89.03 64.67	0.00 64.53	0.00 65.06	88.21 68.97	0.00 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.