As of the July, 2022, release via CMS

KAWEAH DELTA MEDICAL CENTER

CMS id: 050057
400 W. MINERAL KING AVE., VISALIA CA 93291. County: TULARE
System: --
CBSA: Visalia, CA

The 608-bed, acute-care hospital had $-145,302,793 in net service to patients*, with a total profit margin of 2.38279% in fiscal year 2021, the latest year available.
It spent 0.76% of its operating expenses on uncompensated care and reported $52,936 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	gov	gov	gov	gov	gov
Acute beds Median	347 118	347 118	347 119.5	347 118	366 119
Total beds Median	581 162	581 162	581 162	581 162	608 163.5
FTEs Median	3,665.12 788.06	3,898.05 793.42	4,045.17 806.03	4,108.69 787.61	4,228.34 804.34

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	517,723,868 150,932,746	570,304,639 158,950,878	632,330,534 168,696,998	622,919,979 163,454,693	642,289,908 186,589,412
Operating expenses Median	588,521,935 149,311,209	643,951,559 156,110,414	724,591,540 164,890,568	758,272,248 166,516,854	787,592,701 180,120,888
Net income from service 2 patients (NS2P) ? Median	-70,798,067 -964,173	-73,646,920 -643,601.5	-92,261,006 -116,254	-135,352,269 -5,025,862	-145,302,793 -1,284,564
NS2P margin ? Median	-13.67% -0.62	-12.91% -0.29	-14.59% 0.18	-21.73% -5.07	-22.62% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for KAWEAH DELTA 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	94,567,359 5,089,215	111,176,939 4,572,541	127,869,333 5,268,134	138,166,593 13,092,619	164,527,587 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	4,449,704 299,524	5,798,739 188,688.5	5,049,753 370,813	5,900,589 309,361.5	4,007,963 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	28,155	97,976	95,431	114,192	92,961
⊳ 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	22,346	20,697	13,416	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	2,595,561	2,916,230	3,219,538	2,911,768	2,263,312
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	93,756	97,629	108,307	79,014	44,763
⊳ 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	167,614	160,158	186,790	199,854	178,610
⊳ 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	114,339	37,523	12,400	-5	-2
⊳ Line 23: Gov appropriations ? ⊳ Median	4,378,744 1,017,693	4,441,336 983,261.5	4,604,620 1,173,286	4,742,325 1,987,202	4,981,787 1,597,664
⊳ Sum Line 24	82,739,486	97,605,002	114,571,797	124,205,440	152,958,193
Total income ? Median	23,769,292 6,586,430	37,530,019 6,767,106	35,608,327 8,419,950	2,814,324 8,094,175	19,224,794 15,162,888
Non-operating expenses Median	5,002,269 146,289.5	10,177,108 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	18,767,023 6,043,842	27,352,911 5,845,112	35,608,327 7,606,259	2,814,324 7,283,041	19,224,794 14,957,241
Net margin Median	3.06505% 4.62%	4.01374% 4.42%	4.68407% 5.16%	0.36978% 5.2%	2.38279% 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 KAWEAH DELTA 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	122,302,108 23,241,334	134,670,861 23,709,545	132,969,304 24,248,380	121,161,846 22,858,541	125,824,133 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	112,605,999 21,577,146	123,946,666 22,041,594	123,241,619 22,722,063	112,485,674 21,570,441	117,457,029 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	2,527,413 1,845,420	3,047,879 1,757,392	2,408,794 1,738,842	1,791,151 1,510,463	2,050,216 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	5,469,590 3,535,627	5,696,872 3,746,588	5,100,863 3,782,288	4,164,843 3,865,578	3,680,998 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	1,699,106 1,203,033	1,979,444 1,215,295	2,218,028 1,313,657	2,720,178 1,365,298	2,635,890 1,179,746
All outpatient revenue Median Click here to show/hide details	45,362,636 11,160,864	46,050,373 11,987,345	43,056,893 12,926,866	47,880,245 11,884,480	46,768,893 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	40,038,601 10,918,923	41,224,641 11,706,976	38,734,121 12,615,917	43,069,544 11,458,116	42,399,324 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	3,524,391 1,282,808	3,011,325 1,407,728	2,814,507 1,341,512	3,094,302 1,407,046	2,957,972 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	1,799,644 618,038	1,814,407 697,279	1,508,265 690,232	1,716,399 684,010	1,411,597 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	9,571,696 3,284,314	13,360,451 3,250,551	13,390,509 3,386,837	14,186,824 3,360,806	16,032,062 3,508,953
Disproportionate-share hospital (DSH) Median	6,444,453 594,888	7,235,220 595,761	6,302,705 577,894	5,690,026 542,168	5,407,830 549,667
Outlier Median	2,324,990 582,572	2,430,031 538,116	3,780,078 212,434	179,858 126,559	309,546 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	16,563,340 3,662,910	0 3,730,911	0 4,081,319	18,104,254 4,643,908	52,936 4,389,147
Charity care Median	2,830,147 2,654,636	2,428,261 2,940,659	1,220,713 3,380,215	2,858,134 3,488,738	2,846,733 3,233,405
Uncompensated care (UCC) Median	8,131,840 5,147,790	10,862,743 5,337,617	3,596,834 5,711,082	8,692,504 5,923,418	6,016,507 5,508,107
UCC as a % of operating expenses Median	1.38% 3.24	1.69% 3.12	0.50% 3.21	1.15% 3.3	0.76% 2.86
Total shortfall/UCC Median	24,695,180 9,489,989	10,862,743 9,424,297	3,596,834 10,120,158	26,796,758 11,171,337	6,069,443 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	246,387,895 52,142,039	267,431,394 54,485,252	279,964,965 57,395,589	302,180,958 58,830,919	315,395,972 61,722,907
Salaries as a % of operating expenses Median	41.87 36.68	41.53 36.56	38.64 36.37	39.85 35.93	40.05 35.24
Intern, resident salaries* Median	4,128,202 2,598,592	5,493,815 2,686,824	6,741,593 2,753,773	7,515,325 2,937,156	8,508,639 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	5,857,868 1,449,244	7,300,887 1,475,986	11,072,153 1,563,078	8,510,023 1,721,954	8,465,456 2,991,828
Contract hours, direct-care Median	59,963.00 22,725	76,733.00 23,018.5	103,781.84 24,503.48	92,425.13 25,026.5	78,850.13 33,786
Contract wages, direct-care Median	97.69 64.67	95.15 64.53	106.69 65.06	92.07 68.97	107.36 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.