As of the July, 2022, release via CMS

MISSION HOSPITAL REG MEDICAL CENTER

CMS id: 050567
27700 MEDICAL CENTER ROAD, MISSION VIEJO CA 92691. County: ORANGE
System: ST JOSEPH HEALTH SYSTEM
CBSA: Los Angeles-Long Beach-Anaheim, CA

The 504-bed, acute-care hospital had $-19,847,597 in net service to patients*, with a total profit margin of 2.64405% in fiscal year 2021, the latest year available.
It spent 1.89% of its operating expenses on uncompensated care and reported $29,928,536 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	392 118	392 118	392 119.5	392 118	373 119
Total beds Median	523 162	523 162	523 162	523 162	504 163.5
FTEs Median	2,083.83 788.06	2,149.77 793.42	2,088.97 806.03	2,141.89 787.61	2,130.62 804.34

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	557,469,232 150,932,746	590,628,013 158,950,878	662,115,677 168,696,998	647,783,339 163,454,693	719,404,626 186,589,412
Operating expenses Median	573,353,878 149,311,209	587,468,210 156,110,414	631,192,706 164,890,568	684,353,347 166,516,854	739,252,223 180,120,888
Net income from service 2 patients (NS2P) ? Median	-15,884,646 -964,173	3,159,803 -643,601.5	30,922,971 -116,254	-36,570,008 -5,025,862	-19,847,597 -1,284,564
NS2P margin ? Median	-2.85% -0.62	0.53% -0.29	4.67% 0.18	-5.65% -5.07	-2.76% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MISSION HOSPITAL REG 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	48,538,805 5,089,215	34,422,008 4,572,541	29,262,076 5,268,134	43,466,556 13,092,619	39,924,658 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	955,352 199,009	-1,097,374 206,870.5	-129,733 194,343	812,374 249,496
⊳ Line 7: Investments ? ⊳ Median	1,518,362 299,524	6,104,978 188,688.5	4,887,805 370,813	5,212,880 309,361.5	15,002,217 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	47,263	0	0	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	210,026	137,000	146,800	3,800	62,000
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	3,237,965	3,743,318	2,886,734	2,068,469	1,675,971
⊳ 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	99,407	496,857	3,237	0
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	135	-135
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	102,726	106,893	452,522	18,377
⊳ 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	12,908,576	14,509,266	10,460,707	5,505,562	5,353,832
⊳ Line 23: Gov appropriations ? ⊳ Median	83,286 1,017,693	92,903 983,261.5	88,584 1,173,286	150,000 1,987,202	0 1,597,664
⊳ Sum Line 24	30,580,590	8,629,795	11,285,070	30,199,684	17,000,022
Total income ? Median	32,654,159 6,586,430	37,581,811 6,767,106	60,185,047 8,419,950	6,896,548 8,094,175	20,077,061 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	17,814 89,880.5	0 106,761	0 31,473.5
Net income Median	32,654,159 6,043,842	37,581,811 5,845,112	60,167,233 7,606,259	6,896,548 7,283,041	20,077,061 14,957,241
Net margin Median	5.38840% 4.62%	6.01261% 4.42%	8.70251% 5.16%	0.99769% 5.2%	2.64405% 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 MISSION HOSPITAL REG 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	83,437,804 23,241,334	87,119,911 23,709,545	84,511,044 24,248,380	82,867,953 22,858,541	81,885,428 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	78,323,844 21,577,146	80,531,014 22,041,594	77,983,321 22,722,063	76,033,635 21,570,441	75,777,383 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	1,491,263 1,845,420	1,842,924 1,757,392	1,275,838 1,738,842	1,072,347 1,510,463	722,459 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	3,622,697 3,535,627	4,745,973 3,746,588	5,251,885 3,782,288	5,761,971 3,865,578	5,385,586 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	28,046,569 11,160,864	32,425,513 11,987,345	36,429,768 12,926,866	35,163,961 11,884,480	44,060,838 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	28,046,569 10,918,923	32,425,513 11,706,976	36,429,768 12,615,917	35,163,961 11,458,116	44,060,838 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	2,035,417 594,888	1,822,037 595,761	1,447,822 577,894	1,640,522 542,168	1,323,877 549,667
Outlier Median	8,351,060 582,572	5,936,067 538,116	5,407,436 212,434	725,134 126,559	850,375 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	25,743,391 3,662,910	0 3,730,911	27,521,328 4,081,319	7,253,887 4,643,908	29,928,536 4,389,147
Charity care Median	7,689,296 2,654,636	13,954,661 2,940,659	15,904,400 3,380,215	11,195,624 3,488,738	10,002,299 3,233,405
Uncompensated care (UCC) Median	13,379,918 5,147,790	17,455,574 5,337,617	17,007,636 5,711,082	15,863,884 5,923,418	13,961,495 5,508,107
UCC as a % of operating expenses Median	2.33% 3.24	2.97% 3.12	2.69% 3.21	2.32% 3.3	1.89% 2.86
Total shortfall/UCC Median	39,123,309 9,489,989	17,455,574 9,424,297	44,528,964 10,120,158	23,117,771 11,171,337	43,890,031 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	183,611,310 52,142,039	196,867,753 54,485,252	198,864,620 57,395,589	201,117,195 58,830,919	211,914,552 61,722,907
Salaries as a % of operating expenses Median	32.02 36.68	33.51 36.56	35.50 36.37	36.91 35.93	36.17 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	17,818,873 1,449,244	786,672 1,475,986	13,127,164 1,563,078	12,065,417 1,721,954	15,234,524 2,991,828
Contract hours, direct-care Median	275,528.00 22,725	6,328.00 23,018.5	170,365.00 24,503.48	153,038.00 25,026.5	173,807.95 33,786
Contract wages, direct-care Median	64.67 64.67	124.32 64.53	77.05 65.06	78.84 68.97	87.65 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.