As of the July, 2022, release via CMS

SANTA ROSA MEMORIAL HOSPITAL

CMS id: 050174
1165 MONTGOMERY DRIVE, SANTA ROSA CA 95405. County: SONOMA
System: ST. JOSEPH HEALTH SYSTEM
CBSA: Santa Rosa-Petaluma, CA

The 290-bed, acute-care hospital had $-20,099,507 in net service to patients*, with a total profit margin of 2.37417% in fiscal year 2021, the latest year available.
It spent 2.92% of its operating expenses on uncompensated care and reported $465,789 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	274	365	366	365
Ownership	nfp	nfp	nfp	nfp	nfp
Acute beds Median	224 118	224 118	244 119.5	236 118	236 119
Total beds Median	278 162	278 162	298 162	290 162	290 163.5
FTEs Median	1,515.19 788.06	1,551.11 793.42	1,553.83 806.03	1,515.74 787.61	1,429.82 804.34

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	518,078,294 150,932,746	388,692,646 158,950,878	552,043,737 168,696,998	568,246,696 163,454,693	589,415,723 186,589,412
Operating expenses Median	472,308,816 149,311,209	367,570,855 156,110,414	523,822,666 164,890,568	588,691,559 166,516,854	609,515,230 180,120,888
Net income from service 2 patients (NS2P) ? Median	45,769,478 -964,173	21,121,791 -643,601.5	28,221,071 -116,254	-20,444,863 -5,025,862	-20,099,507 -1,284,564
NS2P margin ? Median	8.83% -0.62	5.43% -0.29	5.11% 0.18	-3.60% -5.07	-3.41% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SANTA ROSA 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	24,270,969 5,089,215	20,500,546 4,572,541	18,179,884 5,268,134	29,732,214 13,092,619	34,922,347 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	-48,591 194,343	75,267 249,496
⊳ Line 7: Investments ? ⊳ Median	13,071,277 299,524	11,342,638 188,688.5	4,521,629 370,813	1,677,029 309,361.5	17,419,478 375,329
⊳ 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	42,122	12,944	256,374	0	0
⊳ Line 12: Parking lot receipts	0	0	61,545	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	1,088,401	842,191	1,019,555	0	0
⊳ 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	260,455	127,980	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	6,927	5,893	8,723	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	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	2,875,772	2,481,721	0	3,795,561	6,085,518
⊳ 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	6,926,015	5,687,179	12,312,058	24,308,215	11,342,084
Total income ? Median	70,040,447 6,586,430	41,622,337 6,767,106	46,400,955 8,419,950	9,287,351 8,094,175	14,822,840 15,162,888
Non-operating expenses Median	14,647,908 146,289.5	3,999,626 164,857	2,508,698 89,880.5	0 106,761	0 31,473.5
Net income Median	55,392,539 6,043,842	37,622,711 5,845,112	43,892,257 7,606,259	9,287,351 7,283,041	14,822,840 14,957,241
Net margin Median	10.21344% 4.62%	9.19436% 4.42%	7.69738% 5.16%	1.55312% 5.2%	2.37417% 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 SANTA ROSA 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	99,099,676 23,241,334	76,932,949 23,709,545	107,385,514 24,248,380	104,858,457 22,858,541	100,245,128 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	94,736,147 21,577,146	73,087,282 22,041,594	102,236,316 22,722,063	99,956,786 21,570,441	95,523,546 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	4,363,529 3,535,627	3,845,667 3,746,588	5,149,198 3,782,288	4,901,671 3,865,578	4,721,582 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	60,659,190 11,160,864	46,128,720 11,987,345	67,075,161 12,926,866	66,767,064 11,884,480	70,618,621 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	60,659,190 10,918,923	46,128,720 11,706,976	67,075,161 12,615,917	66,767,064 11,458,116	70,618,621 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	4,837,756 594,888	3,336,045 595,761	4,536,359 577,894	4,385,965 542,168	4,282,131 549,667
Outlier Median	6,316,099 582,572	7,225,651 538,116	7,641,557 212,434	1,104,227 126,559	1,555,425 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	5,710,655 3,662,910	11,879,664 3,730,911	27,214,969 4,081,319	226,633 4,643,908	465,789 4,389,147
Charity care Median	55,765,817 2,654,636	7,303,872 2,940,659	18,432,683 3,380,215	12,590,201 3,488,738	12,514,808 3,233,405
Uncompensated care (UCC) Median	57,126,189 5,147,790	10,500,309 5,337,617	20,326,936 5,711,082	17,509,780 5,923,418	17,800,000 5,508,107
UCC as a % of operating expenses Median	12.10% 3.24	2.86% 3.12	3.88% 3.21	2.97% 3.3	2.92% 2.86
Total shortfall/UCC Median	62,836,844 9,489,989	22,379,973 9,424,297	47,541,905 10,120,158	17,736,413 11,171,337	18,265,789 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	170,837,786 52,142,039	134,967,071 54,485,252	192,068,334 57,395,589	191,551,022 58,830,919	194,667,005 61,722,907
Salaries as a % of operating expenses Median	36.17 36.68	36.72 36.56	40.67 36.37	39.33 35.93	39.27 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	21,534,346 1,449,244	19,776,203 1,475,986	7,971,200 1,563,078	9,124,967 1,721,954	10,982,890 2,991,828
Contract hours, direct-care Median	328,531.98 22,725	237,534.00 23,018.5	92,491.04 24,503.48	100,311.00 25,026.5	104,887.00 33,786
Contract wages, direct-care Median	65.55 64.67	83.26 64.53	86.18 65.06	90.97 68.97	104.71 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.