As of the July, 2022, release via CMS

SIERRA VIEW MEDICAL CENTER

CMS id: 050261
465 W. PUTMAN AVENUE, PORTERVILLE CA 93257. County: TULARE
System: --
CBSA: Visalia, CA

The 163-bed, acute-care hospital had $-17,675,537 in net service to patients*, with a total profit margin of -1.47807% in fiscal year 2021, the latest year available.
It spent 1.77% of its operating expenses on uncompensated care and reported $0 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	118 118	118 118	118 119.5	118 118	118 119
Total beds Median	163 162	163 162	163 162	163 162	163 163.5
FTEs Median	911.68 788.06	848.56 793.42	844.58 806.03	872.31 787.61	857.45 804.34

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	133,029,747 150,932,746	138,327,667 158,950,878	147,411,827 168,696,998	147,874,890 163,454,693	139,630,716 186,589,412
Operating expenses Median	140,248,230 149,311,209	147,898,414 156,110,414	151,257,722 164,890,568	158,999,175 166,516,854	157,306,253 180,120,888
Net income from service 2 patients (NS2P) ? Median	-7,218,483 -964,173	-9,570,747 -643,601.5	-3,845,895 -116,254	-11,124,285 -5,025,862	-17,675,537 -1,284,564
NS2P margin ? Median	-5.43% -0.62	-6.92% -0.29	-2.61% 0.18	-7.52% -5.07	-12.66% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SIERRA VIEW 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	11,111,087 5,089,215	14,373,719 4,572,541	15,537,126 5,268,134	17,515,435 13,092,619	15,384,308 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	114,582 224,999	156,000 199,009	100,000 206,870.5	8,880,353 194,343	6,408,714 249,496
⊳ Line 7: Investments ? ⊳ Median	2,586,051 299,524	541,673 188,688.5	3,215,733 370,813	3,548,327 309,361.5	2,241,776 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	26,869	26,711	27,580	28,212	20,081
⊳ Line 11: Rebates and refunds of expenses	40,371	223,026	103,587	76,404	83,123
⊳ 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	661,404	677,753	633,941	585,553	400,807
⊳ 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	19,009	28,426	36,039	22,552	16,458
⊳ 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	5,700	8,474	4,404
⊳ Line 22: Rental of hospital space	419,667	428,880	515,239	609,724	415,968
⊳ Line 23: Gov appropriations ? ⊳ Median	1,105,646 1,017,693	1,184,652 983,261.5	1,248,547 1,173,286	1,309,901 1,987,202	1,388,925 1,597,664
⊳ Sum Line 24	6,137,488	11,106,598	9,650,760	2,445,935	4,404,052
Total income ? Median	3,892,604 6,586,430	4,802,972 6,767,106	11,691,231 8,419,950	6,391,150 8,094,175	-2,291,229 15,162,888
Non-operating expenses Median	2,860,742 146,289.5	3,710,531 164,857	530,096 89,880.5	0 106,761	0 31,473.5
Net income Median	1,031,862 6,043,842	1,092,441 5,845,112	11,161,135 7,606,259	6,391,150 7,283,041	-2,291,229 14,957,241
Net margin Median	0.71587% 4.62%	0.71541% 4.42%	6.84947% 5.16%	3.86428% 5.2%	-1.47807% 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 SIERRA VIEW 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	23,192,216 23,241,334	23,364,092 23,709,545	24,277,982 24,248,380	22,628,815 22,858,541	21,269,910 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	23,110,066 21,577,146	23,243,452 22,041,594	24,160,752 22,722,063	22,512,862 21,570,441	21,049,677 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	82,150 1,203,033	120,640 1,215,295	117,230 1,313,657	115,953 1,365,298	220,233 1,179,746
All outpatient revenue Median Click here to show/hide details	15,052,629 11,160,864	15,905,130 11,987,345	14,072,151 12,926,866	13,345,873 11,884,480	13,018,170 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	15,052,629 10,918,923	15,905,130 11,706,976	14,072,151 12,615,917	13,345,873 11,458,116	13,018,170 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	1,857,017 594,888	1,805,345 595,761	1,944,182 577,894	1,940,618 542,168	1,809,562 549,667
Outlier Median	372,752 582,572	421,830 538,116	419,825 212,434	42,237 126,559	107,396 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	6,549,696 3,730,911	8,035,393 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	1,308,379 2,654,636	88,988 2,940,659	5,595,747 3,380,215	3,026,859 3,488,738	2,367,644 3,233,405
Uncompensated care (UCC) Median	2,173,708 5,147,790	811,547 5,337,617	6,701,382 5,711,082	4,456,534 5,923,418	2,786,519 5,508,107
UCC as a % of operating expenses Median	1.55% 3.24	0.55% 3.12	4.43% 3.21	2.80% 3.3	1.77% 2.86
Total shortfall/UCC Median	2,173,708 9,489,989	7,361,243 9,424,297	14,736,775 10,120,158	4,456,534 11,171,337	2,786,519 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	57,718,618 52,142,039	61,666,165 54,485,252	62,661,253 57,395,589	63,379,949 58,830,919	63,371,029 61,722,907
Salaries as a % of operating expenses Median	41.15 36.68	41.69 36.56	41.43 36.37	41.90 35.93	41.93 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	3,110,945 1,449,244	2,975,891 1,475,986	3,199,201 1,563,078	4,964,957 1,721,954	2,817,558 2,991,828
Contract hours, direct-care Median	32,336.00 22,725	30,368.00 23,018.5	32,903.00 24,503.48	51,971.00 25,026.5	24,886.00 33,786
Contract wages, direct-care Median	96.21 64.67	97.99 64.53	97.23 65.06	95.53 68.97	113.22 88.94

* in an approved program

Return to top

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.