As of the July, 2022, release via CMS

ZUCKERBERG SAN FRANCISCO GENERAL

CMS id: 050228
1001 POTRERO AVENUE, SAN FRANCISCO CA 94110. County: SAN FRANCISCO
System: --
CBSA: San Francisco-Oakland-Berkeley, CA

The 385-bed, acute-care hospital had $-445,336,886 in net service to patients*, with a total profit margin of -12.92553% in fiscal year 2021, the latest year available.
It spent 7.43% of its operating expenses on uncompensated care and reported $81,850,594 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	213 118	213 118	213 119.5	213 118	213 119
Total beds Median	397 162	397 162	397 162	386 162	385 163.5
FTEs Median	3,044.25 788.06	3,153.46 793.42	3,135.82 806.03	3,136.90 787.61	3,036.59 804.34

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	614,008,935 150,932,746	814,243,926 158,950,878	871,062,385 168,696,998	872,977,719 163,454,693	802,732,875 186,589,412
Operating expenses Median	1,053,182,573 149,311,209	1,061,323,129 156,110,414	1,057,016,954 164,890,568	1,164,214,344 166,516,854	1,248,069,761 180,120,888
Net income from service 2 patients (NS2P) ? Median	-439,173,638 -964,173	-247,079,203 -643,601.5	-185,954,569 -116,254	-291,236,625 -5,025,862	-445,336,886 -1,284,564
NS2P margin ? Median	-71.53% -0.62	-30.34% -0.29	-21.35% 0.18	-33.36% -5.07	-55.48% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ZUCKERBERG SAN FRANCISCO GENERAL 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	159,493,044 5,089,215	130,142,175 4,572,541	118,919,234 5,268,134	216,982,408 13,092,619	293,626,646 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	2,986,473 299,524	4,710 188,688.5	10,474 370,813	25,722 309,361.5	49 375,329
⊳ 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	0	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	1,063,838	1,124,105	1,129,480	987,376	782,395
⊳ 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	4,466,277	7,793,255	8,469,185	10,865,555	455,560
⊳ Line 18: Revenue from sale of medical records and abstracts	87,342	76,482	71,442	68,863	63,133
⊳ 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	1,514,119	1,466,395	1,568,159	1,654,089	1,674,357
⊳ Line 23: Gov appropriations ? ⊳ Median	206,613,777 1,017,693	3,639,439 983,261.5	-6,864 1,173,286	420,824 1,987,202	0 1,597,664
⊳ Sum Line 24	-57,238,782	116,037,789	107,677,358	202,959,979	290,651,152
Total income ? Median	-279,680,594 6,586,430	-116,937,028 6,767,106	-67,035,335 8,419,950	-74,254,217 8,094,175	-151,710,240 15,162,888
Non-operating expenses Median	144,773 146,289.5	6,615,187 164,857	0 89,880.5	0 106,761	-10,000,008 31,473.5
Net income Median	-279,825,367 6,043,842	-123,552,215 5,845,112	-67,035,335 7,606,259	-74,254,217 7,283,041	-141,710,232 14,957,241
Net margin Median	-36.17643% 4.62%	-13.08281% 4.42%	-6.77137% 5.16%	-6.81256% 5.2%	-12.92553% 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 ZUCKERBERG SAN FRANCISCO GENERAL 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	74,179,631 23,241,334	82,166,850 23,709,545	100,550,971 24,248,380	105,112,248 22,858,541	115,118,024 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	73,011,212 21,577,146	81,078,368 22,041,594	99,201,377 22,722,063	103,115,446 21,570,441	113,308,178 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	791,504 1,845,420	496,486 1,757,392	739,685 1,738,842	1,150,404 1,510,463	1,099,687 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	376,915 1,203,033	591,996 1,215,295	609,909 1,313,657	846,398 1,365,298	710,159 1,179,746
All outpatient revenue Median Click here to show/hide details	25,195,258 11,160,864	28,868,491 11,987,345	30,658,327 12,926,866	27,476,649 11,884,480	31,519,506 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	25,195,258 10,918,923	28,868,491 11,706,976	30,658,327 12,615,917	27,476,649 11,458,116	31,519,506 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	15,776,233 3,284,314	17,179,178 3,250,551	20,120,879 3,386,837	21,095,559 3,360,806	23,137,583 3,508,953
Disproportionate-share hospital (DSH) Median	5,293,778 594,888	5,544,861 595,761	6,056,715 577,894	6,460,301 542,168	7,201,360 549,667
Outlier Median	9,850,831 582,572	10,509,652 538,116	16,208,341 212,434	3,238,466 126,559	3,314,708 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	94,595,193 3,662,910	122,513,329 3,730,911	266,397,893 4,081,319	101,702,716 4,643,908	81,850,594 4,389,147
Charity care Median	65,346,912 2,654,636	45,569,278 2,940,659	51,823,885 3,380,215	57,339,093 3,488,738	88,560,023 3,233,405
Uncompensated care (UCC) Median	83,240,733 5,147,790	62,008,501 5,337,617	67,308,304 5,711,082	69,361,692 5,923,418	92,674,752 5,508,107
UCC as a % of operating expenses Median	7.90% 3.24	5.84% 3.12	6.37% 3.21	5.96% 3.3	7.43% 2.86
Total shortfall/UCC Median	177,835,926 9,489,989	184,521,830 9,424,297	333,706,197 10,120,158	171,064,408 11,171,337	174,525,346 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	363,401,397 52,142,039	389,973,114 54,485,252	394,768,785 57,395,589	423,135,005 58,830,919	440,321,481 61,722,907
Salaries as a % of operating expenses Median	34.51 36.68	36.74 36.56	37.35 36.37	36.35 35.93	35.28 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	16,228,956 1,251,927	16,752,300 1,186,494	18,465,145 1,204,885	23,886,941 1,279,653	24,731,505 1,469,317
Contract adjusted salaries, direct-care Median	30,162,978 1,449,244	26,830,954 1,475,986	28,451,360 1,563,078	39,453,771 1,721,954	33,476,905 2,991,828
Contract hours, direct-care Median	720,166.67 22,725	680,281.00 23,018.5	645,620.00 24,503.48	744,829.00 25,026.5	646,081.00 33,786
Contract wages, direct-care Median	41.88 64.67	39.44 64.53	44.07 65.06	52.97 68.97	51.82 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.