As of the July, 2022, release via CMS

ADVENTIST HEALTH SIMI VALLEY

CMS id: 050236
2675 NORTH SYCAMORE DRIVE, SIMI VALLEY CA 93065. County: VENTURA
System: ADVENTIST HEALTH SYSTEMS - WEST
CBSA: Oxnard-Thousand Oaks-Ventura, CA

The 144-bed, acute-care hospital had $-12,657,231 in net service to patients*, with a total profit margin of -3.13619% in fiscal year 2021, the latest year available.
It spent 1.50% of its operating expenses on uncompensated care and reported $1,553,975 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	112 118	112 118	112 119.5	112 118	112 119
Total beds Median	144 162	144 162	144 162	144 162	144 163.5
FTEs Median	595.00 788.06	577.09 793.42	570.47 806.03	582.49 787.61	597.90 804.34

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	145,163,034 150,932,746	146,418,938 158,950,878	165,403,319 168,696,998	158,633,099 163,454,693	192,613,402 186,589,412
Operating expenses Median	152,741,579 149,311,209	158,576,339 156,110,414	165,570,437 164,890,568	176,526,976 166,516,854	205,270,633 180,120,888
Net income from service 2 patients (NS2P) ? Median	-7,578,545 -964,173	-12,157,401 -643,601.5	-167,118 -116,254	-17,893,877 -5,025,862	-12,657,231 -1,284,564
NS2P margin ? Median	-5.22% -0.62	-8.30% -0.29	-0.10% 0.18	-11.28% -5.07	-6.57% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ADVENTIST HEALTH SIMI VALLEY 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	1,657,920 5,089,215	14,067,793 4,572,541	3,117,062 5,268,134	16,415,795 13,092,619	6,415,320 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	-37,342 224,999	59,929 199,009	1,915 206,870.5	3,252,890 194,343	469,432 249,496
⊳ Line 7: Investments ? ⊳ Median	385,135 299,524	372,491 188,688.5	492,042 370,813	515,787 309,361.5	137,903 375,329
⊳ 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	418,661	184,372	209,475	87,529	136,301
⊳ Line 15: Revenue from rental of living quarters	91,700	146,153	115,499	71,929	51,628
⊳ 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	2,320	1,113	2,360	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	41,910	36,760	70,376	46,800	59,641
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	13,077	15,830	10,602	4,689	1,614
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	142,694	54,181	63,171	9,508	15,868
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	402,563	606,399	1,074,478	1,348,803	1,392,025
⊳ 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	197,202	12,590,565	1,077,144	11,077,860	4,150,908
Total income ? Median	-5,920,625 6,586,430	1,910,392 6,767,106	2,949,944 8,419,950	-1,478,082 8,094,175	-6,241,911 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	-5,920,625 6,043,842	1,910,392 5,845,112	2,949,944 7,606,259	-1,478,082 7,283,041	-6,241,911 14,957,241
Net margin Median	-4.03255% 4.62%	1.19037% 4.42%	1.75050% 5.16%	-0.84438% 5.2%	-3.13619% 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 ADVENTIST HEALTH SIMI VALLEY 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	30,065,289 23,241,334	28,693,278 23,709,545	31,615,364 24,248,380	31,573,782 22,858,541	37,316,633 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	30,065,289 21,577,146	28,693,278 22,041,594	31,615,364 22,722,063	31,573,782 21,570,441	37,316,633 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	8,069,797 11,160,864	8,386,434 11,987,345	7,734,276 12,926,866	7,256,028 11,884,480	9,638,388 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	5,570,212 10,918,923	6,022,479 11,706,976	7,191,209 12,615,917	7,256,028 11,458,116	9,638,388 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,499,585 1,282,808	2,363,955 1,407,728	543,067 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	782,098 594,888	783,555 595,761	729,360 577,894	656,079 542,168	805,922 549,667
Outlier Median	792,876 582,572	966,763 538,116	113,073 212,434	170,755 126,559	168,174 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	11,875,108 3,662,910	12,396,468 3,730,911	12,766,893 4,081,319	12,196,648 4,643,908	1,553,975 4,389,147
Charity care Median	5,368,890 2,654,636	352,257 2,940,659	588,833 3,380,215	722,661 3,488,738	2,271,004 3,233,405
Uncompensated care (UCC) Median	6,601,384 5,147,790	1,341,939 5,337,617	1,689,671 5,711,082	1,726,523 5,923,418	3,074,775 5,508,107
UCC as a % of operating expenses Median	4.32% 3.24	0.85% 3.12	1.02% 3.21	0.98% 3.3	1.50% 2.86
Total shortfall/UCC Median	18,476,492 9,489,989	13,738,407 9,424,297	14,456,564 10,120,158	13,923,171 11,171,337	4,628,750 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	56,069,777 52,142,039	56,929,698 54,485,252	58,044,572 57,395,589	57,710,794 58,830,919	66,369,959 61,722,907
Salaries as a % of operating expenses Median	36.71 36.68	35.90 36.56	35.06 36.37	32.69 35.93	32.33 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	582,589 1,449,244	986,639 1,475,986	0 1,563,078	1,361,970 1,721,954	8,724,963 2,991,828
Contract hours, direct-care Median	6,529.00 22,725	12,068.51 23,018.5	0.00 24,503.48	10,223.13 25,026.5	50,560.17 33,786
Contract wages, direct-care Median	89.23 64.67	81.75 64.53	0.00 65.06	133.22 68.97	172.57 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.