As of the July, 2022, release via CMS

ST. AGNES MEDICAL CENTER

CMS id: 050093
1303 E. HERNDON AVENUE, FRESNO CA 93720. County: FRESNO
System: TRINITY HEALTH
CBSA: Fresno, CA

The 385-bed, acute-care hospital had $23,011,136 in net service to patients*, with a total profit margin of 16.88542% in fiscal year 2021, the latest year available.
It spent 1.42% of its operating expenses on uncompensated care and reported $0 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	391 118	335 118	345 119.5	345 118	345 119
Total beds Median	436 162	375 162	385 162	385 162	385 163.5
FTEs Median	2,206.07 788.06	2,134.97 793.42	2,358.61 806.03	2,180.84 787.61	2,074.24 804.34

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	468,774,824 150,932,746	490,698,966 158,950,878	511,962,164 168,696,998	491,731,724 163,454,693	557,105,232 186,589,412
Operating expenses Median	473,820,959 149,311,209	473,877,336 156,110,414	505,206,287 164,890,568	524,160,171 166,516,854	534,094,096 180,120,888
Net income from service 2 patients (NS2P) ? Median	-5,046,135 -964,173	16,821,630 -643,601.5	6,755,877 -116,254	-32,428,447 -5,025,862	23,011,136 -1,284,564
NS2P margin ? Median	-1.08% -0.62	3.43% -0.29	1.32% 0.18	-6.59% -5.07	4.13% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ST. AGNES 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	47,513,902 5,089,215	32,011,797 4,572,541	28,783,999 5,268,134	33,145,978 13,092,619	85,494,530 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	317,678 224,999	433,964 199,009	352,156 206,870.5	16,354 194,343	15,677 249,496
⊳ Line 7: Investments ? ⊳ Median	38,222,499 299,524	23,014,197 188,688.5	18,615,313 370,813	12,976,255 309,361.5	75,650,994 375,329
⊳ 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	0	0	0	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	2,423,002	2,538,672	2,639,184	2,269,175	1,471,928
⊳ Line 15: Revenue from rental of living quarters	0	0	0	2,371,643	2,430,883
⊳ 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	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	704,818	417,084	2,280,971	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	775,670 1,987,202	1,701,371 1,597,664
⊳ Sum Line 24	5,845,905	5,607,880	4,896,375	14,736,881	4,223,677
Total income ? Median	42,467,767 6,586,430	48,833,427 6,767,106	35,539,876 8,419,950	717,531 8,094,175	108,505,666 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	42,467,767 6,043,842	48,833,427 5,845,112	35,539,876 7,606,259	717,531 7,283,041	108,505,666 14,957,241
Net margin Median	8.22558% 4.62%	9.34234% 4.42%	6.57238% 5.16%	0.13670% 5.2%	16.88542% 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 ST. AGNES 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	120,899,259 23,241,334	127,285,948 23,709,545	131,702,974 24,248,380	117,269,840 22,858,541	124,331,830 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	120,899,259 21,577,146	127,285,948 22,041,594	131,702,974 22,722,063	117,269,840 21,570,441	124,331,830 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	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	38,652,320 11,160,864	39,996,772 11,987,345	40,107,807 12,926,866	42,053,942 11,884,480	45,363,203 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	38,652,320 10,918,923	39,996,772 11,706,976	40,107,807 12,615,917	42,053,942 11,458,116	45,363,203 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	3,316,844 3,386,837	6,300,790 3,360,806	10,082,605 3,508,953
Disproportionate-share hospital (DSH) Median	7,192,587 594,888	7,974,452 595,761	8,215,304 577,894	7,370,634 542,168	7,261,945 549,667
Outlier Median	4,152,795 582,572	3,980,335 538,116	3,384,934 212,434	213,869 126,559	131,310 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	315,467 3,662,910	79,551 3,730,911	0 4,081,319	15,422,146 4,643,908	0 4,389,147
Charity care Median	4,159,555 2,654,636	3,897,505 2,940,659	5,427,768 3,380,215	4,610,377 3,488,738	4,062,768 3,233,405
Uncompensated care (UCC) Median	6,661,797 5,147,790	6,024,708 5,337,617	7,898,426 5,711,082	8,289,038 5,923,418	7,563,317 5,508,107
UCC as a % of operating expenses Median	1.41% 3.24	1.27% 3.12	1.56% 3.21	1.58% 3.3	1.42% 2.86
Total shortfall/UCC Median	6,977,264 9,489,989	6,104,259 9,424,297	7,898,426 10,120,158	23,711,184 11,171,337	7,563,317 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	180,395,582 52,142,039	185,204,844 54,485,252	197,711,184 57,395,589	194,816,005 58,830,919	196,869,863 61,722,907
Salaries as a % of operating expenses Median	38.07 36.68	39.08 36.56	39.13 36.37	37.17 35.93	36.86 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	12,124,890 1,449,244	11,122,618 1,475,986	10,122,072 1,563,078	7,940,573 1,721,954	19,609,684 2,991,828
Contract hours, direct-care Median	106,956.00 22,725	102,445.00 23,018.5	98,192.33 24,503.48	71,659.00 25,026.5	114,195.00 33,786
Contract wages, direct-care Median	113.36 64.67	108.57 64.53	103.08 65.06	110.81 68.97	171.72 88.94

* in an approved program

Return to top

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.