As of the July, 2022, release via CMS

NOVATO COMMUNITY HOSPITAL

CMS id: 050131
180 ROWLAND WAY, NOVATO CA 94945. County: MARIN
System: SUTTER HEALTH
CBSA: San Francisco-Oakland-Berkeley, CA

The 47-bed, acute-care hospital had $-2,966,958 in net service to patients*, with a total profit margin of -2.12455% in fiscal year 2021, the latest year available.
It spent 1.51% of its operating expenses on uncompensated care and reported $4,497,747 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	39 118	39 118	39 119.5	39 118	39 119
Total beds Median	47 162	47 162	47 162	47 162	47 163.5
FTEs Median	230.05 788.06	219.74 793.42	216.05 806.03	215.28 787.61	206.40 804.34

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	68,038,638 150,932,746	66,195,900 158,950,878	78,112,258 168,696,998	72,897,907 163,454,693	81,840,232 186,589,412
Operating expenses Median	81,704,060 149,311,209	79,678,642 156,110,414	83,720,945 164,890,568	85,162,709 166,516,854	84,807,190 180,120,888
Net income from service 2 patients (NS2P) ? Median	-13,665,422 -964,173	-13,482,742 -643,601.5	-5,608,687 -116,254	-12,264,802 -5,025,862	-2,966,958 -1,284,564
NS2P margin ? Median	-20.08% -0.62	-20.37% -0.29	-7.18% 0.18	-16.82% -5.07	-3.63% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for NOVATO COMMUNITY 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	7,209,113 5,089,215	3,815,945 4,572,541	1,733,061 5,268,134	3,877,380 13,092,619	1,202,673 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	961,676 224,999	58,843 199,009	0 206,870.5	7,381 194,343	109,645 249,496
⊳ Line 7: Investments ? ⊳ Median	15,969 299,524	11,977 188,688.5	28,213 370,813	11,796 309,361.5	-4,916 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	120	1	0	2	0
⊳ Line 11: Rebates and refunds of expenses	15,644	40,157	46,994	35,754	36,450
⊳ 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	125,778	124,623	121,464	62,455	42,095
⊳ 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	71,085	63,950	71,432	17,155	46,325
⊳ Line 21: Rental of vending machines	173	0	0	0	292
⊳ Line 22: Rental of hospital space	2,249,696	2,356,591	935,239	746,247	781,806
⊳ 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	3,768,972	1,159,803	529,719	2,996,590	190,976
Total income ? Median	-6,456,309 6,586,430	-9,666,797 6,767,106	-3,875,626 8,419,950	-8,387,422 8,094,175	-1,764,285 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	-6,456,309 6,043,842	-9,666,797 5,845,112	-3,875,626 7,606,259	-8,387,422 7,283,041	-1,764,285 14,957,241
Net margin Median	-8.58007% 4.62%	-13.80737% 4.42%	-4.85392% 5.16%	-10.92464% 5.2%	-2.12455% 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 NOVATO COMMUNITY 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	14,969,165 23,241,334	14,927,055 23,709,545	18,110,500 24,248,380	14,292,815 22,858,541	13,314,218 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	14,969,165 21,577,146	14,927,055 22,041,594	18,110,500 22,722,063	14,292,815 21,570,441	13,314,218 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	6,339,218 11,160,864	6,507,858 11,987,345	7,358,276 12,926,866	8,486,071 11,884,480	11,146,829 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	6,339,218 10,918,923	6,507,858 11,706,976	7,358,276 12,615,917	8,486,071 11,458,116	11,146,829 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	0 3,386,837	0 3,360,806	0 3,508,953
Disproportionate-share hospital (DSH) Median	273,638 594,888	251,776 595,761	271,595 577,894	263,666 542,168	330,943 549,667
Outlier Median	500,250 582,572	311,336 538,116	95,502 212,434	47,817 126,559	12,187 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	8,578,847 3,662,910	6,100,967 3,730,911	5,553,035 4,081,319	6,947,658 4,643,908	4,497,747 4,389,147
Charity care Median	949,968 2,654,636	987,820 2,940,659	1,304,259 3,380,215	1,333,266 3,488,738	982,465 3,233,405
Uncompensated care (UCC) Median	1,443,006 5,147,790	1,380,788 5,337,617	1,760,772 5,711,082	1,783,105 5,923,418	1,282,403 5,508,107
UCC as a % of operating expenses Median	1.77% 3.24	1.73% 3.12	2.10% 3.21	2.09% 3.3	1.51% 2.86
Total shortfall/UCC Median	10,021,853 9,489,989	7,481,755 9,424,297	7,313,807 10,120,158	8,730,763 11,171,337	5,780,150 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	28,849,734 52,142,039	28,239,989 54,485,252	29,764,930 57,395,589	31,193,394 58,830,919	31,465,323 61,722,907
Salaries as a % of operating expenses Median	35.31 36.68	35.44 36.56	35.55 36.37	36.63 35.93	37.10 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	3,962,888 1,449,244	0 1,475,986	0 1,563,078	2,320,496 1,721,954	0 2,991,828
Contract hours, direct-care Median	39,686.54 22,725	0.00 23,018.5	0.00 24,503.48	27,573.99 25,026.5	0.00 33,786
Contract wages, direct-care Median	99.85 64.67	0.00 64.53	0.00 65.06	84.16 68.97	0.00 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.