As of the July, 2022, release via CMS

MERCY SAN JUAN MEDICAL CENTER

CMS id: 050516
6501 COYLE AVENUE, CARMICHAEL CA 95608. County: SACRAMENTO
System: DIGNITY HEALTH
CBSA: Sacramento-Roseville-Folsom, CA

The 370-bed, acute-care hospital had $-8,481,178 in net service to patients*, with a total profit margin of 5.58413% in fiscal year 2021, the latest year available.
It spent 2.42% of its operating expenses on uncompensated care and reported $4,915,105 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	288 118	288 118	288 119.5	288 118	288 119
Total beds Median	370 162	370 162	370 162	370 162	370 163.5
FTEs Median	1,986.43 788.06	1,951.93 793.42	2,022.22 806.03	1,954.22 787.61	1,983.00 804.34

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	536,238,479 150,932,746	642,632,132 158,950,878	613,369,111 168,696,998	712,823,192 163,454,693	732,352,575 186,589,412
Operating expenses Median	622,381,141 149,311,209	671,536,464 156,110,414	680,685,165 164,890,568	701,378,585 166,516,854	740,833,753 180,120,888
Net income from service 2 patients (NS2P) ? Median	-86,142,662 -964,173	-28,904,332 -643,601.5	-67,316,054 -116,254	11,444,607 -5,025,862	-8,481,178 -1,284,564
NS2P margin ? Median	-16.06% -0.62	-4.50% -0.29	-10.97% 0.18	1.61% -5.07	-1.16% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MERCY SAN JUAN 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	78,327,685 5,089,215	80,346,939 4,572,541	86,758,654 5,268,134	136,806,831 13,092,619	52,297,001 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	406,428 224,999	499,458 199,009	562,964 206,870.5	701,566 194,343	666,743 249,496
⊳ Line 7: Investments ? ⊳ Median	8,153,170 299,524	5,665,646 188,688.5	1,697,283 370,813	1,389,647 309,361.5	21,714,801 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	80,150	72,279	69,581	56,683	32,939
⊳ Line 11: Rebates and refunds of expenses	498	0	0	2,518	908,182
⊳ 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	1,239,779	1,224,899	1,305,573	1,261,453	1,086,566
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	2,663	2,054	2,012	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	36,527	30,079	27,601	29,395	6,931
⊳ 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	7,740	16,283	16,490	18,243	9,467
⊳ Line 22: Rental of hospital space	401,955	421,878	701,527	677,792	539,934
⊳ Line 23: Gov appropriations ? ⊳ Median	-1,246,400 1,017,693	0 983,261.5	320,977 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	69,245,175	72,414,363	82,054,646	132,669,534	27,331,438
Total income ? Median	-7,814,977 6,586,430	51,442,607 6,767,106	19,442,600 8,419,950	148,251,438 8,094,175	43,815,823 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	-7,814,977 6,043,842	51,442,607 5,845,112	19,442,600 7,606,259	148,251,438 7,283,041	43,815,823 14,957,241
Net margin Median	-1.27163% 4.62%	7.11537% 4.42%	2.77701% 5.16%	17.44894% 5.2%	5.58413% 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 MERCY SAN JUAN 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	100,430,453 23,241,334	103,514,734 23,709,545	98,470,243 24,248,380	95,330,175 22,858,541	94,585,584 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	100,430,453 21,577,146	103,514,734 22,041,594	98,470,243 22,722,063	95,330,175 21,570,441	94,585,584 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	31,544,965 11,160,864	36,206,730 11,987,345	40,331,444 12,926,866	37,765,485 11,884,480	35,369,949 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	25,216,684 10,918,923	31,361,356 11,706,976	35,888,370 12,615,917	34,059,449 11,458,116	32,945,884 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	6,328,281 1,282,808	4,845,374 1,407,728	4,443,074 1,341,512	3,706,036 1,407,046	2,424,065 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	160,533 3,284,314	160,597 3,250,551	155,171 3,386,837	166,773 3,360,806	180,711 3,508,953
Disproportionate-share hospital (DSH) Median	6,858,145 594,888	6,642,369 595,761	5,697,276 577,894	5,877,476 542,168	5,856,751 549,667
Outlier Median	5,366,061 582,572	6,410,802 538,116	4,974,812 212,434	425,403 126,559	354,410 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	24,041,344 3,662,910	0 3,730,911	20,219,447 4,081,319	29,714,449 4,643,908	4,915,105 4,389,147
Charity care Median	4,013,324 2,654,636	6,321,172 2,940,659	9,278,538 3,380,215	12,687,653 3,488,738	13,604,161 3,233,405
Uncompensated care (UCC) Median	7,399,171 5,147,790	11,133,202 5,337,617	15,182,760 5,711,082	19,304,263 5,923,418	17,962,345 5,508,107
UCC as a % of operating expenses Median	1.19% 3.24	1.66% 3.12	2.23% 3.21	2.75% 3.3	2.42% 2.86
Total shortfall/UCC Median	31,440,515 9,489,989	11,133,202 9,424,297	35,402,207 10,120,158	49,018,712 11,171,337	22,877,450 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	237,447,127 52,142,039	245,996,752 54,485,252	257,052,001 57,395,589	260,858,664 58,830,919	275,215,696 61,722,907
Salaries as a % of operating expenses Median	38.15 36.68	36.63 36.56	37.76 36.37	37.19 35.93	37.15 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	8,877,663 1,449,244	8,698,524 1,475,986	5,722,768 1,563,078	4,519,501 1,721,954	10,522,803 2,991,828
Contract hours, direct-care Median	88,442.00 22,725	90,212.00 23,018.5	70,931.00 24,503.48	56,414.00 25,026.5	93,354.00 33,786
Contract wages, direct-care Median	100.38 64.67	96.42 64.53	80.68 65.06	80.11 68.97	112.72 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.