As of the July, 2022, release via CMS

SIERRA NEVADA MEMORIAL HOSPITAL

CMS id: 050150
155 GLASSON WAY, GRASS VALLEY CA 95945. County: NEVADA
System: DIGNITY HEALTH
CBSA: Truckee-Grass Valley, CA

The 104-bed, acute-care hospital had $-789,457 in net service to patients*, with a total profit margin of 15.24463% in fiscal year 2021, the latest year available.
It spent 2.28% of its operating expenses on uncompensated care and reported $77,269 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	100 118	100 118	100 119.5	100 118	100 119
Total beds Median	104 162	104 162	104 162	104 162	104 163.5
FTEs Median	632.61 788.06	612.30 793.42	620.98 806.03	657.63 787.61	594.02 804.34

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	161,908,928 150,932,746	180,397,240 158,950,878	172,394,410 168,696,998	170,030,317 163,454,693	184,058,775 186,589,412
Operating expenses Median	166,227,764 149,311,209	170,443,210 156,110,414	173,615,253 164,890,568	178,616,396 166,516,854	184,848,232 180,120,888
Net income from service 2 patients (NS2P) ? Median	-4,318,836 -964,173	9,954,030 -643,601.5	-1,220,843 -116,254	-8,586,079 -5,025,862	-789,457 -1,284,564
NS2P margin ? Median	-2.67% -0.62	5.52% -0.29	-0.71% 0.18	-5.05% -5.07	-0.43% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SIERRA NEVADA MEMORIAL 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	21,576,378 5,089,215	16,410,732 4,572,541	9,109,047 5,268,134	60,784,639 13,092,619	34,037,405 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	437,503 224,999	106,123 199,009	207,687 206,870.5	175,763 194,343	114,673 249,496
⊳ Line 7: Investments ? ⊳ Median	17,462,952 299,524	13,992,871 188,688.5	6,994,746 370,813	23,712,942 309,361.5	27,098,197 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	16,479	10,792	10,945	5,020	5,093
⊳ Line 11: Rebates and refunds of expenses	0	28	0	542	219,895
⊳ Line 12: Parking lot receipts	0	0	0	0	1,302
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	192,381	151,727	179,796	226,817	143,341
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	452	496	487	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	62,326	74,530	56,764	46,973	2,436
⊳ 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	3,918	2,758	5,109	3,080	6,010
⊳ Line 22: Rental of hospital space	71,942	143,833	139,673	111,829	121,936
⊳ Line 23: Gov appropriations ? ⊳ Median	124,092 1,017,693	0 983,261.5	-227,076 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	3,204,333	1,927,574	1,740,916	36,501,673	6,324,522
Total income ? Median	17,257,542 6,586,430	26,364,762 6,767,106	7,888,204 8,419,950	52,198,560 8,094,175	33,247,948 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	17,257,542 6,043,842	26,364,762 5,845,112	7,888,204 7,606,259	52,198,560 7,283,041	33,247,948 14,957,241
Net margin Median	9.40541% 4.62%	13.39619% 4.42%	4.34604% 5.16%	22.61490% 5.2%	15.24463% 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 SIERRA NEVADA MEMORIAL 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	29,807,509 23,241,334	31,178,038 23,709,545	29,702,948 24,248,380	26,744,056 22,858,541	30,212,136 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	29,807,509 21,577,146	31,178,038 22,041,594	29,702,948 22,722,063	26,744,056 21,570,441	30,212,136 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	26,930,590 11,160,864	27,875,703 11,987,345	29,474,651 12,926,866	28,546,122 11,884,480	29,542,277 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	23,441,421 10,918,923	24,610,254 11,706,976	26,524,808 12,615,917	25,445,790 11,458,116	26,839,390 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	3,489,169 1,282,808	3,265,449 1,407,728	2,949,843 1,341,512	3,100,332 1,407,046	2,702,887 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	867,674 594,888	865,396 595,761	829,018 577,894	676,706 542,168	739,393 549,667
Outlier Median	1,485,172 582,572	2,173,565 538,116	1,318,018 212,434	409,387 126,559	651,279 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,403,347 3,662,910	9,391 3,730,911	34,115 4,081,319	66,932 4,643,908	77,269 4,389,147
Charity care Median	1,059,909 2,654,636	2,145,794 2,940,659	2,654,641 3,380,215	3,378,475 3,488,738	3,554,673 3,233,405
Uncompensated care (UCC) Median	3,222,173 5,147,790	3,868,166 5,337,617	4,451,235 5,711,082	4,693,636 5,923,418	4,208,499 5,508,107
UCC as a % of operating expenses Median	1.94% 3.24	2.27% 3.12	2.56% 3.21	2.63% 3.3	2.28% 2.86
Total shortfall/UCC Median	4,625,520 9,489,989	3,877,557 9,424,297	4,485,350 10,120,158	4,760,568 11,171,337	4,285,768 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	66,545,217 52,142,039	67,829,504 54,485,252	70,049,587 57,395,589	71,060,910 58,830,919	75,036,571 61,722,907
Salaries as a % of operating expenses Median	40.03 36.68	39.80 36.56	40.35 36.37	39.81 35.93	40.59 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	2,180,325 1,449,244	2,266,854 1,475,986	2,605,725 1,563,078	2,743,727 1,721,954	3,828,797 2,991,828
Contract hours, direct-care Median	23,350.00 22,725	26,842.00 23,018.5	31,159.00 24,503.48	28,027.00 25,026.5	35,759.00 33,786
Contract wages, direct-care Median	93.38 64.67	84.45 64.53	83.63 65.06	97.90 68.97	107.07 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.