As of the July, 2022, release via CMS

WASHINGTON HOSPITAL DISTRICT

CMS id: 050195
2000 MOWRY AVENUE, FREMONT CA 94538. County: ALAMEDA
System: --
CBSA: San Francisco-Oakland-Berkeley, CA

The 385-bed, acute-care hospital had $-35,805,211 in net service to patients*, with a total profit margin of -1.10431% in fiscal year 2021, the latest year available.
It spent 1.40% of its operating expenses on uncompensated care and reported $46,206,510 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	gov	gov	gov	gov	gov
Acute beds Median	250 118	250 118	268 119.5	306 118	326 119
Total beds Median	289 162	289 162	320 162	365 162	385 163.5
FTEs Median	1,414.00 788.06	1,416.00 793.42	1,484.00 806.03	1,484.30 787.61	1,498.90 804.34

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	443,545,287 150,932,746	454,891,556 158,950,878	466,626,341 168,696,998	448,259,782 163,454,693	465,069,875 186,589,412
Operating expenses Median	429,246,755 149,311,209	435,835,307 156,110,414	482,906,208 164,890,568	488,001,431 166,516,854	500,875,086 180,120,888
Net income from service 2 patients (NS2P) ? Median	14,298,532 -964,173	19,056,249 -643,601.5	-16,279,867 -116,254	-39,741,649 -5,025,862	-35,805,211 -1,284,564
NS2P margin ? Median	3.22% -0.62	4.19% -0.29	-3.49% 0.18	-8.87% -5.07	-7.70% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for WASHINGTON HOSPITAL DISTRICT 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	28,204,980 5,089,215	31,726,487 4,572,541	28,699,807 5,268,134	61,673,459 13,092,619	30,334,389 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	0 299,524	0 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ 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	195,571	502,221	357,265	387,334	393,479
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	64,835	67,719	72,385	68,062	56,876
⊳ Line 14: Revenue from meals sold to emplyees and guests	855,909	363,741	673,232	572,520	432,966
⊳ 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	77,850	80,116	64,006	48,436	37,602
⊳ 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	2,430	2,753	3,570	3,410	2,744
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	16,148,094 1,017,693	16,260,000 983,261.5	17,185,000 1,173,286	17,026,000 1,987,202	17,317,000 1,597,664
⊳ Sum Line 24	10,860,291	14,449,937	10,344,349	43,567,697	12,093,722
Total income ? Median	42,503,512 6,586,430	50,782,736 6,767,106	12,419,940 8,419,950	21,931,810 8,094,175	-5,470,822 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	42,503,512 6,043,842	50,782,736 5,845,112	12,419,940 7,606,259	21,931,810 7,283,041	-5,470,822 14,957,241
Net margin Median	9.00975% 4.62%	10.43585% 4.42%	2.50743% 5.16%	4.30092% 5.2%	-1.10431% 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 WASHINGTON HOSPITAL DISTRICT 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	86,719,224 23,241,334	86,380,322 23,709,545	85,192,208 24,248,380	79,326,486 22,858,541	78,902,577 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	86,719,224 21,577,146	86,380,322 22,041,594	85,192,208 22,722,063	79,326,486 21,570,441	78,902,577 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	23,851,600 11,160,864	22,355,695 11,987,345	32,736,531 12,926,866	34,506,584 11,884,480	42,321,872 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	23,851,600 10,918,923	22,355,695 11,706,976	32,736,531 12,615,917	34,506,584 11,458,116	42,321,872 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	3,558,156 594,888	3,644,249 595,761	3,351,876 577,894	2,766,279 542,168	2,760,346 549,667
Outlier Median	7,392,851 582,572	7,596,269 538,116	7,799,803 212,434	1,300,214 126,559	2,659,240 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	37,322,094 3,662,910	29,370,287 3,730,911	38,906,358 4,081,319	41,548,369 4,643,908	46,206,510 4,389,147
Charity care Median	1,174,439 2,654,636	928,008 2,940,659	621,905 3,380,215	821,303 3,488,738	773,971 3,233,405
Uncompensated care (UCC) Median	8,204,408 5,147,790	8,929,965 5,337,617	10,007,157 5,711,082	9,065,321 5,923,418	6,997,076 5,508,107
UCC as a % of operating expenses Median	1.91% 3.24	2.05% 3.12	2.07% 3.21	1.86% 3.3	1.40% 2.86
Total shortfall/UCC Median	45,526,502 9,489,989	38,300,252 9,424,297	48,913,515 10,120,158	50,613,690 11,171,337	53,203,586 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	181,427,797 52,142,039	189,359,257 54,485,252	205,620,980 57,395,589	206,820,985 58,830,919	218,716,365 61,722,907
Salaries as a % of operating expenses Median	40.69 36.68	41.70 36.56	41.96 36.37	42.31 35.93	43.66 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	1,461,769 1,449,244	1,539,762 1,475,986	1,422,943 1,563,078	1,710,671 1,721,954	773,079 2,991,828
Contract hours, direct-care Median	14,600.00 22,725	15,177.00 23,018.5	13,522.25 24,503.48	15,475.00 25,026.5	6,974.00 33,786
Contract wages, direct-care Median	100.12 64.67	101.45 64.53	105.23 65.06	110.54 68.97	110.85 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.