As of the July, 2022, release via CMS

SCRIPPS MERCY HOSPITAL

CMS id: 050077
4077 FIFTH AVENUE, SAN DIEGO CA 92103. County: SAN DIEGO
System: SCRIPPS HEALTH
CBSA: San Diego-Chula Vista-Carlsbad, CA

The 523-bed, acute-care hospital had $-220,529,815 in net service to patients*, with a total profit margin of 0.07052% in fiscal year 2021, the latest year available.
It spent 2.03% of its operating expenses on uncompensated care and reported $115,626,982 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	431 118	431 118	431 119.5	431 118	431 119
Total beds Median	523 162	523 162	523 162	523 162	523 163.5
FTEs Median	3,192.46 788.06	3,221.54 793.42	3,348.40 806.03	3,520.87 787.61	3,955.52 804.34

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	698,674,860 150,932,746	872,494,525 158,950,878	789,491,669 168,696,998	835,691,042 163,454,693	708,455,778 186,589,412
Operating expenses Median	708,889,975 149,311,209	824,122,651 156,110,414	807,858,668 164,890,568	868,888,021 166,516,854	928,985,593 180,120,888
Net income from service 2 patients (NS2P) ? Median	-10,215,115 -964,173	48,371,874 -643,601.5	-18,366,999 -116,254	-33,196,979 -5,025,862	-220,529,815 -1,284,564
NS2P margin ? Median	-1.46% -0.62	5.54% -0.29	-2.33% 0.18	-3.97% -5.07	-31.13% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SCRIPPS MERCY HOSPITAL 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	27,043,790 5,089,215	32,768,235 4,572,541	38,988,593 5,268,134	83,065,695 13,092,619	221,185,428 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	4,001,976 224,999	3,645,317 199,009	1,314,203 206,870.5	6,041,631 194,343	7,228,802 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ 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	40,388	105,562	194,840	115,079	0
⊳ Line 12: Parking lot receipts	509,336	508,464	538,007	316,099	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	2,312,369	2,403,775	2,605,665	2,136,078	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	1,818,435	6,762,138	17,299,951	21,991,167	0
⊳ Line 18: Revenue from sale of medical records and abstracts	75	96	61	455	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	377,586	328,868	319,534	160,739	0
⊳ Line 21: Rental of vending machines	41,039	48,530	64,384	43,645	0
⊳ Line 22: Rental of hospital space	185,592	186,654	184,259	192,129	0
⊳ Line 23: Gov appropriations ? ⊳ Median	1,421,089 1,017,693	1,388,076 983,261.5	1,641,226 1,173,286	37,845,847 1,987,202	0 1,597,664
⊳ Sum Line 24	16,335,905	17,390,755	14,826,463	14,222,826	213,956,626
Total income ? Median	16,828,675 6,586,430	81,140,109 6,767,106	20,621,594 8,419,950	49,868,716 8,094,175	655,613 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	16,828,675 6,043,842	81,140,109 5,845,112	20,621,594 7,606,259	49,868,716 7,283,041	655,613 14,957,241
Net margin Median	2.31890% 4.62%	8.96316% 4.42%	2.48909% 5.16%	5.42785% 5.2%	0.07052% 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 SCRIPPS MERCY HOSPITAL 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	103,903,989 23,241,334	105,191,653 23,709,545	107,925,869 24,248,380	97,717,073 22,858,541	94,891,046 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	101,554,240 21,577,146	102,913,825 22,041,594	105,835,326 22,722,063	95,862,231 21,570,441	93,666,526 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	2,349,749 1,845,420	2,277,828 1,757,392	2,090,543 1,738,842	1,854,842 1,510,463	1,224,520 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	28,510,427 11,160,864	29,258,554 11,987,345	32,016,755 12,926,866	28,464,969 11,884,480	32,451,022 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	28,510,427 10,918,923	29,258,554 11,706,976	32,016,755 12,615,917	28,464,969 11,458,116	32,451,022 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	9,894,868 3,284,314	10,366,328 3,250,551	11,640,491 3,386,837	11,153,086 3,360,806	10,754,466 3,508,953
Disproportionate-share hospital (DSH) Median	5,840,488 594,888	5,762,079 595,761	5,960,248 577,894	5,345,774 542,168	5,088,087 549,667
Outlier Median	6,904,035 582,572	5,109,655 538,116	1,275,200 212,434	1,578,829 126,559	1,535,870 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	28,638,161 3,662,910	46,650,398 3,730,911	42,405,397 4,081,319	40,774,100 4,643,908	115,626,982 4,389,147
Charity care Median	12,882,724 2,654,636	13,468,518 2,940,659	10,197,565 3,380,215	15,321,203 3,488,738	14,189,595 3,233,405
Uncompensated care (UCC) Median	15,888,132 5,147,790	17,252,102 5,337,617	13,278,954 5,711,082	17,301,863 5,923,418	18,843,904 5,508,107
UCC as a % of operating expenses Median	2.24% 3.24	2.09% 3.12	1.64% 3.21	1.99% 3.3	2.03% 2.86
Total shortfall/UCC Median	44,526,293 9,489,989	63,902,500 9,424,297	55,684,351 10,120,158	58,075,963 11,171,337	134,470,886 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	270,716,269 52,142,039	281,791,130 54,485,252	302,625,998 57,395,589	325,304,515 58,830,919	354,013,863 61,722,907
Salaries as a % of operating expenses Median	38.19 36.68	34.19 36.56	37.46 36.37	37.44 35.93	38.11 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	2,697,498 1,449,244	5,224,626 1,475,986	4,205,673 1,563,078	2,779,422 1,721,954	9,699,709 2,991,828
Contract hours, direct-care Median	34,245.00 22,725	70,343.00 23,018.5	53,417.00 24,503.48	26,516.00 25,026.5	73,041.00 33,786
Contract wages, direct-care Median	78.77 64.67	74.27 64.53	78.73 65.06	104.82 68.97	132.80 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.