As of the July, 2022, release via CMS

ARROWHEAD REGIONAL MEDICAL CENTER

CMS id: 050245
400 NORTH PEPPER AVENUE, COLTON CA 92324. County: SAN BERNARDINO
System: --
CBSA: Riverside-San Bernardino-Ontario, CA

The 456-bed, acute-care hospital had $-495,617,160 in net service to patients*, with a total profit margin of 0.78987% in fiscal year 2021, the latest year available.
It spent 3.48% of its operating expenses on uncompensated care and reported $63,271,712 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	274 118	274 118	274 119.5	274 118	274 119
Total beds Median	456 162	456 162	456 162	456 162	456 163.5
FTEs Median	3,186.92 788.06	3,217.79 793.42	3,128.94 806.03	3,129.09 787.61	3,323.18 804.34

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	313,889,940 150,932,746	317,097,909 158,950,878	361,622,694 168,696,998	339,423,546 163,454,693	370,327,282 186,589,412
Operating expenses Median	653,122,590 149,311,209	715,607,847 156,110,414	677,786,169 164,890,568	771,574,868 166,516,854	865,944,442 180,120,888
Net income from service 2 patients (NS2P) ? Median	-339,232,650 -964,173	-398,509,938 -643,601.5	-316,163,475 -116,254	-432,151,322 -5,025,862	-495,617,160 -1,284,564
NS2P margin ? Median	-108.07% -0.62	-125.67% -0.29	-87.43% 0.18	-127.32% -5.07	-133.83% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ARROWHEAD REGIONAL MEDICAL CENTER 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	407,795,638 5,089,215	454,162,832 4,572,541	380,731,381 5,268,134	456,683,209 13,092,619	502,569,803 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	-50,741 299,524	437,142 188,688.5	1,739,827 370,813	465,620 309,361.5	28 375,329
⊳ 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	1,333,791	1,420,050	1,495,193	1,361,712	1,253,262
⊳ 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	3,220,112	3,079,269	2,997,715	2,895,519
⊳ Line 18: Revenue from sale of medical records and abstracts	49,774	24,935	15,857	660	829
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	2,010,620	1,651,133	2,595,550	2,997,245	2,884,993
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	13,375	13,831	11,094	8,766	0
⊳ Line 21: Rental of vending machines	61,871	24,271	29,209	29,732	15,194
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	378,464,228 1,017,693	422,351,229 983,261.5	357,794,041 1,173,286	418,880,868 1,987,202	423,222,585 1,597,664
⊳ Sum Line 24	25,912,720	25,020,129	13,971,341	29,940,891	72,297,393
Total income ? Median	68,562,988 6,586,430	55,652,894 6,767,106	64,567,906 8,419,950	24,531,887 8,094,175	6,952,643 15,162,888
Non-operating expenses Median	-184,318 146,289.5	15,318,026 164,857	-118,790 89,880.5	-50,349 106,761	57,889 31,473.5
Net income Median	68,747,306 6,043,842	40,334,868 5,845,112	64,686,696 7,606,259	24,582,236 7,283,041	6,894,754 14,957,241
Net margin Median	9.52594% 4.62%	5.22973% 4.42%	8.71373% 5.16%	3.08781% 5.2%	0.78987% 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 ARROWHEAD REGIONAL MEDICAL CENTER 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	44,262,660 23,241,334	43,271,471 23,709,545	48,480,404 24,248,380	43,922,790 22,858,541	44,531,980 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	42,026,507 21,577,146	40,872,517 22,041,594	46,236,939 22,722,063	41,657,881 21,570,441	43,090,968 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	2,236,153 1,845,420	2,398,954 1,757,392	2,243,465 1,738,842	2,264,909 1,510,463	1,441,012 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	11,411,245 11,160,864	11,920,830 11,987,345	11,850,264 12,926,866	10,311,473 11,884,480	9,291,579 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	11,411,245 10,918,923	11,920,830 11,706,976	11,850,264 12,615,917	10,311,473 11,458,116	9,291,579 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	5,598,803 3,284,314	5,447,278 3,250,551	6,145,652 3,386,837	5,563,644 3,360,806	6,298,016 3,508,953
Disproportionate-share hospital (DSH) Median	2,836,745 594,888	2,653,392 595,761	2,908,179 577,894	2,469,240 542,168	2,529,496 549,667
Outlier Median	1,800,703 582,572	1,593,607 538,116	3,318,839 212,434	916,401 126,559	861,977 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	84,891,961 3,662,910	197,276,888 3,730,911	2,062,501 4,081,319	74,210,000 4,643,908	63,271,712 4,389,147
Charity care Median	24,082,775 2,654,636	17,529,390 2,940,659	20,321,147 3,380,215	19,403,414 3,488,738	18,982,191 3,233,405
Uncompensated care (UCC) Median	45,334,448 5,147,790	19,142,181 5,337,617	28,914,517 5,711,082	37,793,101 5,923,418	30,150,889 5,508,107
UCC as a % of operating expenses Median	6.94% 3.24	2.67% 3.12	4.27% 3.21	4.90% 3.3	3.48% 2.86
Total shortfall/UCC Median	130,226,409 9,489,989	216,419,069 9,424,297	30,977,018 10,120,158	112,003,101 11,171,337	93,422,601 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	197,586,664 52,142,039	206,686,798 54,485,252	218,105,058 57,395,589	233,013,883 58,830,919	253,510,494 61,722,907
Salaries as a % of operating expenses Median	30.25 36.68	28.88 36.56	32.18 36.37	30.20 35.93	29.28 35.24
Intern, resident salaries* Median	9,759,159 2,598,592	10,929,638 2,686,824	11,050,838 2,753,773	11,799,256 2,937,156	12,572,949 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	15,536,201 1,449,244	18,605,195 1,475,986	21,522,961 1,563,078	25,575,372 1,721,954	19,839,843 2,991,828
Contract hours, direct-care Median	277,175.00 22,725	328,640.00 23,018.5	391,538.09 24,503.48	504,083.27 25,026.5	367,543.16 33,786
Contract wages, direct-care Median	56.05 64.67	56.61 64.53	54.97 65.06	50.74 68.97	53.98 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.