As of the July, 2022, release via CMS

COMMUNITY REGIONAL MEDICAL CENTER

CMS id: 050060
2823 FRESNO STREET, FRESNO CA 93721. County: FRESNO
System: COMMUNITY HOSPITALS OF CENTRAL CA
CBSA: Fresno, CA

The 899-bed, acute-care hospital had $-124,054,567 in net service to patients*, with a total profit margin of 5.49685% in fiscal year 2021, the latest year available.
It spent 0.20% of its operating expenses on uncompensated care and reported $65,886,248 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	599 118	577 118	605 119.5	589 118	589 119
Total beds Median	909 162	887 162	915 162	899 162	899 163.5
FTEs Median	4,522.48 788.06	6,809.26 793.42	4,821.90 806.03	4,961.03 787.61	4,643.34 804.34

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	1,187,899,848 150,932,746	1,322,393,442 158,950,878	1,229,876,155 168,696,998	1,588,246,683 163,454,693	1,248,275,472 186,589,412
Operating expenses Median	1,126,074,084 149,311,209	1,195,908,762 156,110,414	1,220,608,359 164,890,568	1,706,149,685 166,516,854	1,372,330,039 180,120,888
Net income from service 2 patients (NS2P) ? Median	61,825,764 -964,173	126,484,680 -643,601.5	9,267,796 -116,254	-117,903,002 -5,025,862	-124,054,567 -1,284,564
NS2P margin ? Median	5.20% -0.62	9.56% -0.29	0.75% 0.18	-7.42% -5.07	-9.94% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for COMMUNITY REGIONAL 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	30,497,654 5,089,215	22,625,368 4,572,541	137,520,668 5,268,134	200,216,939 13,092,619	203,877,168 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	22,832,641 299,524	14,168,892 188,688.5	28,614,125 370,813	45,640,596 309,361.5	83,832,495 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	149,543	160,909	1,847,599	199,002	270,021
⊳ Line 11: Rebates and refunds of expenses	2,219,894	1,013,451	313,877	1,612,584	3,316,646
⊳ 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	3,735,276	5,303,573	4,067,400	3,224,332	2,477,831
⊳ 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	966	286	0	18,266,246	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	1,497,962	1,532,321	1,565,115	1,191,961	0
⊳ Line 21: Rental of vending machines	34,593	0	0	22,571	16,124
⊳ Line 22: Rental of hospital space	26,779	445,936	180,000	180,000	3,140,869
⊳ 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	--	--	100,932,552	129,879,647	110,823,182
Total income ? Median	92,323,418 6,586,430	149,110,048 6,767,106	146,788,464 8,419,950	82,313,937 8,094,175	79,822,601 15,162,888
Non-operating expenses Median	65,718,823 146,289.5	83,238,107 164,857	835,799 89,880.5	296,008,651 106,761	0 31,473.5
Net income Median	26,604,595 6,043,842	65,871,941 5,845,112	145,952,665 7,606,259	-213,694,714 7,283,041	79,822,601 14,957,241
Net margin Median	2.18357% 4.62%	4.89747% 4.42%	10.67376% 5.16%	-11.94851% 5.2%	5.49685% 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 COMMUNITY REGIONAL 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	164,193,543 23,241,334	164,589,354 23,709,545	159,800,105 24,248,380	150,681,667 22,858,541	162,860,551 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	159,001,838 21,577,146	159,146,274 22,041,594	153,598,513 22,722,063	145,279,065 21,570,441	155,816,041 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	4,722,691 3,535,627	4,927,993 3,746,588	5,775,083 3,782,288	5,402,602 3,865,578	6,587,227 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	469,014 1,203,033	515,087 1,215,295	426,509 1,313,657	0 1,365,298	457,283 1,179,746
All outpatient revenue Median Click here to show/hide details	59,207,677 11,160,864	65,156,886 11,987,345	63,907,108 12,926,866	54,387,413 11,884,480	58,700,072 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	57,324,664 10,918,923	63,033,859 11,706,976	61,820,245 12,615,917	52,167,795 11,458,116	56,108,738 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,883,013 1,282,808	2,123,027 1,407,728	2,086,863 1,341,512	2,219,618 1,407,046	2,591,334 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	13,570,794 3,284,314	14,121,499 3,250,551	13,841,330 3,386,837	13,857,426 3,360,806	14,949,802 3,508,953
Disproportionate-share hospital (DSH) Median	13,690,841 594,888	13,409,938 595,761	13,440,611 577,894	12,782,996 542,168	13,283,485 549,667
Outlier Median	9,097,688 582,572	8,028,312 538,116	8,716,925 212,434	754,831 126,559	578,189 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	56,171,461 3,662,910	31,316,131 3,730,911	528,148 4,081,319	8,441,245 4,643,908	65,886,248 4,389,147
Charity care Median	3,790,978 2,654,636	4,922,544 2,940,659	7,948,226 3,380,215	8,794,531 3,488,738	582,302 3,233,405
Uncompensated care (UCC) Median	14,848,614 5,147,790	15,945,975 5,337,617	15,983,822 5,711,082	14,836,247 5,923,418	2,706,971 5,508,107
UCC as a % of operating expenses Median	1.32% 3.24	1.33% 3.12	1.31% 3.21	0.87% 3.3	0.20% 2.86
Total shortfall/UCC Median	71,020,075 9,489,989	47,262,106 9,424,297	16,511,970 10,120,158	23,277,492 11,171,337	68,593,219 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	383,095,189 52,142,039	390,094,339 54,485,252	383,328,416 57,395,589	395,970,711 58,830,919	407,519,312 61,722,907
Salaries as a % of operating expenses Median	34.02 36.68	32.64 36.56	31.40 36.37	31.16 35.93	29.70 35.24
Intern, resident salaries* Median	676,863 2,598,592	914,572 2,686,824	426,275 2,753,773	304,891 2,937,156	249,554 2,909,848
Contract intern, resident salaries* Median	42,880,780 1,251,927	51,623,614 1,186,494	50,498,085 1,204,885	35,175,129 1,279,653	71,537,196 1,469,317
Contract adjusted salaries, direct-care Median	21,626,361 1,449,244	10,337,337 1,475,986	10,227,493 1,563,078	8,826,935 1,721,954	36,470,254 2,991,828
Contract hours, direct-care Median	226,564.00 22,725	121,784.00 23,018.5	116,508.00 24,503.48	78,581.00 25,026.5	244,375.21 33,786
Contract wages, direct-care Median	95.45 64.67	84.88 64.53	87.78 65.06	112.33 68.97	149.24 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.