As of the July, 2022, release via CMS

JOHN MUIR MEDICAL CENTER - WC

CMS id: 050180
1601 YGNACIO VALLEY ROAD, WALNUT CREEK CA 94598. County: CONTRA COSTA
System: JOHN MUIR HEALTH
CBSA: San Francisco-Oakland-Berkeley, CA

The 554-bed, acute-care hospital had $127,879,561 in net service to patients*, with a total profit margin of 13.45829% in fiscal year 2021, the latest year available.
It spent 0.60% of its operating expenses on uncompensated care and reported $40,460,686 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	1 118	391 118	391 119.5	391 118	391 119
Total beds Median	164 162	554 162	554 162	554 162	554 163.5
FTEs Median	2,198.69 788.06	2,173.45 793.42	2,199.89 806.03	2,128.62 787.61	2,230.50 804.34

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	898,779,827 150,932,746	968,024,170 158,950,878	984,519,924 168,696,998	963,611,817 163,454,693	1,082,908,598 186,589,412
Operating expenses Median	824,100,304 149,311,209	894,496,823 156,110,414	897,023,360 164,890,568	937,337,721 166,516,854	955,029,037 180,120,888
Net income from service 2 patients (NS2P) ? Median	74,679,523 -964,173	73,527,347 -643,601.5	87,496,564 -116,254	26,274,096 -5,025,862	127,879,561 -1,284,564
NS2P margin ? Median	8.31% -0.62	7.60% -0.29	8.89% 0.18	2.73% -5.07	11.81% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for JOHN MUIR MEDICAL CENTER - WC 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	19,283,140 5,089,215	17,523,217 4,572,541	20,281,613 5,268,134	77,012,547 13,092,619	20,639,145 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	-3,727,874 299,524	-24,855 188,688.5	2,681,414 370,813	1,505,334 309,361.5	6,337,396 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	15,261	0	0	0
⊳ Line 11: Rebates and refunds of expenses	40,773	14,383	0	23,020	6,367
⊳ 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	2,491,972	2,093,918	2,394,636	1,730,542	1,600,401
⊳ 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	106	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	0	0	0	0	0
⊳ Line 21: Rental of vending machines	14,702	7,846	0	0	0
⊳ Line 22: Rental of hospital space	0	3,457,258	181,566	3,231,762	417,178
⊳ 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	20,463,567	11,959,300	15,023,997	70,521,889	12,277,803
Total income ? Median	93,962,663 6,586,430	91,050,564 6,767,106	107,778,177 8,419,950	103,286,643 8,094,175	148,518,706 15,162,888
Non-operating expenses Median	4 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	93,962,659 6,043,842	91,050,564 5,845,112	107,778,177 7,606,259	103,286,643 7,283,041	148,518,706 14,957,241
Net margin Median	10.23488% 4.62%	9.23858% 4.42%	10.72631% 5.16%	9.92545% 5.2%	13.45829% 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 JOHN MUIR MEDICAL CENTER - WC 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	127,175,746 23,241,334	125,450,312 23,709,545	131,652,121 24,248,380	134,722,713 22,858,541	140,292,468 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	118,961,967 21,577,146	116,209,189 22,041,594	123,514,202 22,722,063	125,760,795 21,570,441	130,922,516 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	8,213,779 3,535,627	9,241,123 3,746,588	8,137,919 3,782,288	8,961,918 3,865,578	9,369,952 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	47,391,454 11,160,864	47,020,361 11,987,345	48,450,284 12,926,866	46,768,014 11,884,480	53,052,974 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	34,833,594 10,918,923	34,258,977 11,706,976	34,594,895 12,615,917	31,462,348 11,458,116	37,134,115 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	12,557,860 1,282,808	12,761,384 1,407,728	13,855,389 1,341,512	15,305,666 1,407,046	15,918,859 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	245,871 3,250,551	282,839 3,386,837	307,250 3,360,806	334,880 3,508,953
Disproportionate-share hospital (DSH) Median	3,068,295 594,888	2,663,853 595,761	2,088,621 577,894	2,362,028 542,168	2,598,062 549,667
Outlier Median	14,706,677 582,572	13,496,515 538,116	2,787,793 212,434	3,893,796 126,559	4,313,005 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	15,482,498 3,662,910	89,106,244 3,730,911	19,640,198 4,081,319	56,123,470 4,643,908	40,460,686 4,389,147
Charity care Median	4,239,351 2,654,636	6,455,737 2,940,659	3,927,825 3,380,215	4,454,235 3,488,738	3,590,248 3,233,405
Uncompensated care (UCC) Median	8,139,224 5,147,790	10,193,250 5,337,617	7,236,521 5,711,082	7,483,537 5,923,418	5,760,864 5,508,107
UCC as a % of operating expenses Median	0.99% 3.24	1.14% 3.12	0.81% 3.21	0.80% 3.3	0.60% 2.86
Total shortfall/UCC Median	23,621,722 9,489,989	99,299,494 9,424,297	26,876,719 10,120,158	63,607,007 11,171,337	46,221,550 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	279,917,738 52,142,039	289,664,724 54,485,252	304,202,754 57,395,589	309,718,309 58,830,919	337,217,119 61,722,907
Salaries as a % of operating expenses Median	33.97 36.68	32.38 36.56	33.91 36.37	33.04 35.93	35.31 35.24
Intern, resident salaries* Median	0 2,598,592	273,299 2,686,824	249,622 2,753,773	400,299 2,937,156	306,319 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	12,949,714 1,449,244	13,429,109 1,475,986	10,989,771 1,563,078	14,306,184 1,721,954	26,146,787 2,991,828
Contract hours, direct-care Median	163,838.08 22,725	147,297.55 23,018.5	143,266.00 24,503.48	112,655.63 25,026.5	182,711.38 33,786
Contract wages, direct-care Median	79.04 64.67	91.17 64.53	76.71 65.06	126.99 68.97	143.10 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.