As of the July, 2022, release via CMS

ADVENTIST HEALTH AND RIDEOUT

CMS id: 050133
726 FOURTH STREET, MARYSVILLE CA 95901. County: YUBA
System: ADVENTIST HEALTH
CBSA: Yuba City, CA

The 209-bed, acute-care hospital had $-81,351,432 in net service to patients*, with a total profit margin of -15.35128% in fiscal year 2021, the latest year available.
It spent 1.94% 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	191 118	179 118	179 119.5	179 118	179 119
Total beds Median	221 162	209 162	209 162	209 162	209 163.5
FTEs Median	1,443.44 788.06	1,354.71 793.42	1,509.35 806.03	1,281.89 787.61	1,329.49 804.34

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	319,608,792 150,932,746	391,760,811 158,950,878	420,879,042 168,696,998	404,442,629 163,454,693	442,040,968 186,589,412
Operating expenses Median	350,685,935 149,311,209	401,246,334 156,110,414	436,445,324 164,890,568	482,161,246 166,516,854	523,392,400 180,120,888
Net income from service 2 patients (NS2P) ? Median	-31,077,143 -964,173	-9,485,523 -643,601.5	-15,566,282 -116,254	-77,718,617 -5,025,862	-81,351,432 -1,284,564
NS2P margin ? Median	-9.72% -0.62	-2.42% -0.29	-3.70% 0.18	-19.22% -5.07	-18.40% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ADVENTIST HEALTH AND RIDEOUT 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	17,432,635 5,089,215	329,309,727 4,572,541	-7,497,899 5,268,134	40,266,988 13,092,619	11,696,884 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	6,381,455 224,999	93,713 199,009	3,743 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	4,912,024 299,524	782,046 188,688.5	1,307,050 370,813	1,354,289 309,361.5	885,362 375,329
⊳ 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	635,916	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	976,018	1,198,794	1,294,831	251,406	897,518
⊳ 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	20	0	3,289,612	2,081,186
⊳ Line 18: Revenue from sale of medical records and abstracts	16,891	21,166	20,670	15,170	7,796
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	905	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	18,399	14,968	6,492	5,732	2,486
⊳ Line 22: Rental of hospital space	-103,062	155,879	159,680	540,272	595,284
⊳ 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	4,594,089	327,043,141	-10,251,018	34,810,507	7,227,252
Total income ? Median	-13,644,508 6,586,430	319,824,204 6,767,106	-23,064,181 8,419,950	-37,451,629 8,094,175	-69,654,548 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	-13,644,508 6,043,842	319,824,204 5,845,112	-23,064,181 7,606,259	-37,451,629 7,283,041	-69,654,548 14,957,241
Net margin Median	-4.04832% 4.62%	44.35408% 4.42%	-5.57940% 5.16%	-8.42159% 5.2%	-15.35128% 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 ADVENTIST HEALTH AND RIDEOUT 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	76,741,683 23,241,334	78,753,894 23,709,545	81,978,543 24,248,380	79,042,330 22,858,541	92,024,888 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	76,741,683 21,577,146	78,753,894 22,041,594	81,978,543 22,722,063	79,042,330 21,570,441	92,024,888 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	31,892,366 11,160,864	35,038,245 11,987,345	39,126,306 12,926,866	37,765,502 11,884,480	39,474,784 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	31,892,366 10,918,923	35,038,245 11,706,976	38,822,869 12,615,917	36,865,227 11,458,116	39,474,784 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	303,437 690,232	900,275 684,010	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	1,659,775 594,888	1,670,796 595,761	1,745,998 577,894	1,709,366 542,168	1,755,441 549,667
Outlier Median	7,059,064 582,572	9,915,399 538,116	8,520,470 212,434	2,970,485 126,559	4,001,321 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,050,298 3,662,910	0 3,730,911	7,539,138 4,081,319	37,520,840 4,643,908	0 4,389,147
Charity care Median	4,470,295 2,654,636	2,592,084 2,940,659	0 3,380,215	2,084,851 3,488,738	6,564,567 3,233,405
Uncompensated care (UCC) Median	7,139,667 5,147,790	7,501,952 5,337,617	484,150 5,711,082	6,101,510 5,923,418	10,153,778 5,508,107
UCC as a % of operating expenses Median	2.04% 3.24	1.87% 3.12	0.11% 3.21	1.27% 3.3	1.94% 2.86
Total shortfall/UCC Median	8,189,965 9,489,989	7,501,952 9,424,297	8,023,288 10,120,158	43,622,350 11,171,337	10,153,778 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	124,360,534 52,142,039	121,824,669 54,485,252	136,676,747 57,395,589	149,390,195 58,830,919	146,468,265 61,722,907
Salaries as a % of operating expenses Median	35.63 36.68	32.74 36.56	31.32 36.37	30.98 35.93	27.98 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	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	7,770,611 1,449,244	837,275 1,475,986	5,431,193 1,563,078	5,305,596 1,721,954	32,781,390 2,991,828
Contract hours, direct-care Median	74,294.56 22,725	10,526.00 23,018.5	59,045.00 24,503.48	48,539.31 25,026.5	247,102.22 33,786
Contract wages, direct-care Median	104.59 64.67	79.54 64.53	91.98 65.06	109.31 68.97	132.66 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.