As of the July, 2022, release via CMS

PALOMAR MEDICAL CENTER ESCONDIDO

CMS id: 050115
555 EAST VALLEY PARKWAY, ESCONDIDO CA 92025. County: SAN DIEGO
System: PALOMAR HEALTH
CBSA: San Diego-Chula Vista-Carlsbad, CA

The 304-bed, acute-care hospital had $46,671,164 in net service to patients*, with a total profit margin of 9.54653% in fiscal year 2021, the latest year available.
It spent 3.36% 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	gov	gov	gov	gov	gov
Acute beds Median	328 118	320 118	238 119.5	238 118	238 119
Total beds Median	407 162	399 162	329 162	304 162	304 163.5
FTEs Median	2,421.56 788.06	2,511.69 793.42	2,449.63 806.03	2,242.08 787.61	2,714.39 804.34

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	549,587,145 150,932,746	562,029,330 158,950,878	577,044,003 168,696,998	561,403,670 163,454,693	591,301,000 186,589,412
Operating expenses Median	550,643,509 149,311,209	566,325,848 156,110,414	556,009,839 164,890,568	548,591,662 166,516,854	544,629,836 180,120,888
Net income from service 2 patients (NS2P) ? Median	-1,056,364 -964,173	-4,296,518 -643,601.5	21,034,164 -116,254	12,812,008 -5,025,862	46,671,164 -1,284,564
NS2P margin ? Median	-0.19% -0.62	-0.76% -0.29	3.65% 0.18	2.28% -5.07	7.89% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for PALOMAR MEDICAL CENTER ESCONDIDO 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	21,756,749 5,089,215	21,687,203 4,572,541	19,122,053 5,268,134	39,159,244 13,092,619	37,335,848 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	991,894 199,009	169,006 206,870.5	880,867 194,343	112,301 249,496
⊳ Line 7: Investments ? ⊳ Median	1,561,694 299,524	1,365,385 188,688.5	865,147 370,813	234,136 309,361.5	374,060 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	2,960	1,691	253	2,751	8,703
⊳ Line 11: Rebates and refunds of expenses	3,716	195,293	38,264	25,859	18,107
⊳ 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	1,333,665	1,317,938	1,263,612	1,121,678	819,373
⊳ 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	2,214,420	2,906,763	1,338,136	1,480,088	1,931,087
⊳ Line 21: Rental of vending machines	2,253	24,798	18,738	20,499	30,505
⊳ Line 22: Rental of hospital space	63,502	43,259	40,000	107,436	245,529
⊳ Line 23: Gov appropriations ? ⊳ Median	11,137,039 1,017,693	11,745,647 983,261.5	12,326,263 1,173,286	11,931,720 1,987,202	15,269,831 1,597,664
⊳ Sum Line 24	5,437,500	3,094,535	3,062,634	23,354,210	18,526,352
Total income ? Median	20,700,385 6,586,430	17,390,685 6,767,106	40,156,217 8,419,950	51,971,252 8,094,175	84,007,012 15,162,888
Non-operating expenses Median	0 146,289.5	1,197,291 164,857	3,764,662 89,880.5	1,810,995 106,761	23,993,995 31,473.5
Net income Median	20,700,385 6,043,842	16,193,394 5,845,112	36,391,555 7,606,259	50,160,257 7,283,041	60,013,017 14,957,241
Net margin Median	3.62310% 4.62%	2.77419% 4.42%	6.10426% 5.16%	8.35221% 5.2%	9.54653% 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 PALOMAR MEDICAL CENTER ESCONDIDO 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	71,370,760 23,241,334	68,624,754 23,709,545	73,641,231 24,248,380	72,435,096 22,858,541	68,579,371 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	64,976,698 21,577,146	61,703,040 22,041,594	65,983,177 22,722,063	64,524,928 21,570,441	63,025,488 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	978,789 1,845,420	880,744 1,757,392	876,468 1,738,842	362,261 1,510,463	534,208 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	5,415,273 3,535,627	6,040,970 3,746,588	6,781,586 3,782,288	7,547,907 3,865,578	5,019,675 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	23,549,563 11,160,864	25,763,393 11,987,345	25,065,797 12,926,866	23,498,574 11,884,480	23,186,196 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	19,844,176 10,918,923	21,356,357 11,706,976	20,172,080 12,615,917	17,776,099 11,458,116	17,064,411 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	3,705,387 1,282,808	4,407,036 1,407,728	4,893,717 1,341,512	5,722,475 1,407,046	6,121,785 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	65,071 3,284,314	61,663 3,250,551	66,166 3,386,837	77,243 3,360,806	109,742 3,508,953
Disproportionate-share hospital (DSH) Median	2,572,537 594,888	2,355,788 595,761	2,455,098 577,894	2,760,643 542,168	2,455,892 549,667
Outlier Median	6,026,245 582,572	5,470,661 538,116	5,690,903 212,434	1,271,519 126,559	1,753,411 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	120,271 3,662,910	75,658 3,730,911	44,402 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	4,004,407 2,654,636	2,879,985 2,940,659	2,599,785 3,380,215	7,050,817 3,488,738	7,370,786 3,233,405
Uncompensated care (UCC) Median	11,507,580 5,147,790	12,984,303 5,337,617	10,492,572 5,711,082	16,783,150 5,923,418	18,276,975 5,508,107
UCC as a % of operating expenses Median	2.09% 3.24	2.29% 3.12	1.89% 3.21	3.06% 3.3	3.36% 2.86
Total shortfall/UCC Median	11,627,851 9,489,989	13,059,961 9,424,297	10,536,974 10,120,158	16,783,150 11,171,337	18,276,975 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	202,747,281 52,142,039	211,414,305 54,485,252	212,765,111 57,395,589	198,411,099 58,830,919	197,753,179 61,722,907
Salaries as a % of operating expenses Median	36.82 36.68	37.33 36.56	38.27 36.37	36.17 35.93	36.31 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	10,312,368 1,449,244	11,389,433 1,475,986	4,904,661 1,563,078	5,087,575 1,721,954	9,683,218 2,991,828
Contract hours, direct-care Median	135,877.00 22,725	147,379.00 23,018.5	61,557.00 24,503.48	69,226.25 25,026.5	126,041.00 33,786
Contract wages, direct-care Median	75.89 64.67	77.28 64.53	79.68 65.06	73.49 68.97	76.83 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.