As of the July, 2022, release via CMS

TRI-CITY MEDICAL CENTER

CMS id: 050128
4002 VISTA WAY, OCEANSIDE CA 92056. County: SAN DIEGO
System: --
CBSA: San Diego-Chula Vista-Carlsbad, CA

The 331-bed, acute-care hospital had $-19,612,453 in net service to patients*, with a total profit margin of 1.47199% in fiscal year 2021, the latest year available.
It spent 2.13% of its operating expenses on uncompensated care and reported $2,471,579 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	250 118	250 118	242 119.5	262 118	268 119
Total beds Median	326 162	326 162	305 162	320 162	331 163.5
FTEs Median	1,818.72 788.06	1,834.23 793.42	1,803.60 806.03	1,350.71 787.61	1,514.20 804.34

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	323,240,316 150,932,746	347,354,398 158,950,878	337,629,162 168,696,998	300,881,979 163,454,693	319,640,080 186,589,412
Operating expenses Median	338,134,310 149,311,209	372,545,933 156,110,414	359,330,130 164,890,568	341,257,289 166,516,854	339,252,533 180,120,888
Net income from service 2 patients (NS2P) ? Median	-14,893,994 -964,173	-25,191,535 -643,601.5	-21,700,968 -116,254	-40,375,310 -5,025,862	-19,612,453 -1,284,564
NS2P margin ? Median	-4.61% -0.62	-7.25% -0.29	-6.43% 0.18	-13.42% -5.07	-6.14% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for TRI-CITY 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	19,254,304 5,089,215	19,794,608 4,572,541	21,469,880 5,268,134	28,754,795 13,092,619	25,696,180 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	847,485 224,999	423,472 199,009	656,213 206,870.5	1,772,546 194,343	1,936,134 249,496
⊳ Line 7: Investments ? ⊳ Median	310,900 299,524	573,631 188,688.5	755,943 370,813	831,694 309,361.5	545,287 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	1,566	1,319	3,229	9,832	18,811
⊳ Line 11: Rebates and refunds of expenses	465,967	483,171	1,044,289	371,511	301,079
⊳ 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	1,120,917	1,136,112	1,102,409	932,290	428,623
⊳ 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	80,047	23,732	15,896	18,347	3,051
⊳ Line 18: Revenue from sale of medical records and abstracts	99,555	106,972	102,221	99,498	114,541
⊳ 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	10,534	11,482	56,902	79,134	58,908
⊳ Line 22: Rental of hospital space	121,941	92,857	129,173	321,046	546,665
⊳ Line 23: Gov appropriations ? ⊳ Median	9,638,130 1,017,693	10,245,197 983,261.5	10,927,012 1,173,286	11,691,525 1,987,202	12,366,122 1,597,664
⊳ Sum Line 24	6,557,262	6,696,663	6,676,593	12,627,372	9,376,959
Total income ? Median	4,360,310 6,586,430	-5,396,927 6,767,106	-231,088 8,419,950	-11,620,515 8,094,175	6,083,727 15,162,888
Non-operating expenses Median	4,033,861 146,289.5	713,172 164,857	5,752,416 89,880.5	1,139,063 106,761	1,000,414 31,473.5
Net income Median	326,449 6,043,842	-6,110,099 5,845,112	-5,983,504 7,606,259	-12,759,578 7,283,041	5,083,313 14,957,241
Net margin Median	0.09532% 4.62%	-1.66420% 4.42%	-1.66625% 5.16%	-3.87080% 5.2%	1.47199% 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 TRI-CITY 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	50,102,571 23,241,334	50,080,049 23,709,545	47,080,734 24,248,380	41,643,993 22,858,541	39,657,581 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	46,918,301 21,577,146	46,916,846 22,041,594	44,687,939 22,722,063	39,474,891 21,570,441	35,653,266 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	1,075,257 1,845,420	699,563 1,757,392	263,696 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,109,013 3,535,627	2,463,640 3,746,588	2,129,099 3,782,288	2,169,102 3,865,578	4,004,315 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	27,293,824 11,160,864	26,306,096 11,987,345	27,029,171 12,926,866	25,628,937 11,884,480	23,192,059 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	24,339,705 10,918,923	23,424,270 11,706,976	24,234,356 12,615,917	22,955,587 11,458,116	20,801,602 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,954,119 1,282,808	2,881,826 1,407,728	2,794,815 1,341,512	2,673,350 1,407,046	2,390,457 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	202,194 3,284,314	211,621 3,250,551	212,320 3,386,837	193,109 3,360,806	163,896 3,508,953
Disproportionate-share hospital (DSH) Median	2,869,081 594,888	2,865,478 595,761	2,193,394 577,894	1,980,796 542,168	1,893,484 549,667
Outlier Median	2,528,304 582,572	2,452,447 538,116	2,162,221 212,434	369,604 126,559	442,222 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	8,193,462 4,643,908	2,471,579 4,389,147
Charity care Median	903,755 2,654,636	1,272,450 2,940,659	1,054,705 3,380,215	1,510,868 3,488,738	1,207,114 3,233,405
Uncompensated care (UCC) Median	7,695,049 5,147,790	8,270,367 5,337,617	6,435,890 5,711,082	8,086,828 5,923,418	7,209,564 5,508,107
UCC as a % of operating expenses Median	2.28% 3.24	2.22% 3.12	1.79% 3.21	2.37% 3.3	2.13% 2.86
Total shortfall/UCC Median	7,695,049 9,489,989	8,270,367 9,424,297	6,435,890 10,120,158	16,280,290 11,171,337	9,681,143 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	145,228,200 52,142,039	151,212,219 54,485,252	143,305,823 57,395,589	137,414,218 58,830,919	128,832,430 61,722,907
Salaries as a % of operating expenses Median	42.95 36.68	40.59 36.56	39.88 36.37	40.27 35.93	37.98 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	98,717 1,251,927	98,717 1,186,494	98,717 1,204,885	0 1,279,653	98,717 1,469,317
Contract adjusted salaries, direct-care Median	8,020,671 1,449,244	12,236,461 1,475,986	9,946,201 1,563,078	6,293,755 1,721,954	6,135,540 2,991,828
Contract hours, direct-care Median	115,851.14 22,725	142,033.95 23,018.5	148,529.00 24,503.48	84,833.21 25,026.5	69,389.87 33,786
Contract wages, direct-care Median	69.23 64.67	86.15 64.53	66.96 65.06	74.19 68.97	88.42 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.