As of the July, 2022, release via CMS

MADERA COMMUNITY HOSPITAL

CMS id: 050568
1250 EAST ALMOND AVENUE, MADERA CA 93637. County: MADERA
System: --
CBSA: Madera, CA

The 106-bed, acute-care hospital had $-7,824,378 in net service to patients*, with a total profit margin of -2.34304% in fiscal year 2021, the latest year available.
It spent 2.30% of its operating expenses on uncompensated care and reported $12,830,483 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	96 118	96 118	96 119.5	96 118	96 119
Total beds Median	106 162	106 162	106 162	106 162	106 163.5
FTEs Median	593.86 788.06	621.13 793.42	628.02 806.03	615.38 787.61	638.64 804.34

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	75,323,092 150,932,746	90,918,707 158,950,878	92,771,519 168,696,998	84,956,263 163,454,693	96,473,638 186,589,412
Operating expenses Median	84,979,035 149,311,209	90,032,245 156,110,414	93,635,544 164,890,568	91,301,287 166,516,854	104,298,016 180,120,888
Net income from service 2 patients (NS2P) ? Median	-9,655,943 -964,173	886,462 -643,601.5	-864,025 -116,254	-6,345,024 -5,025,862	-7,824,378 -1,284,564
NS2P margin ? Median	-12.82% -0.62	0.98% -0.29	-0.93% 0.18	-7.47% -5.07	-8.11% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MADERA COMMUNITY HOSPITAL 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	2,892,325 5,089,215	2,383,335 4,572,541	2,680,536 5,268,134	5,277,615 13,092,619	5,436,581 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	600,000 224,999	293,700 199,009	147,097 206,870.5	61,567 194,343	1,062,885 249,496
⊳ Line 7: Investments ? ⊳ Median	283,985 299,524	349,290 188,688.5	626,912 370,813	878,464 309,361.5	483,221 375,329
⊳ 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	0	0	0	0	0
⊳ 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	0	0	0	0	0
⊳ 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	0	0	0
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ 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	2,008,340	1,740,345	1,906,527	4,337,584	3,890,475
Total income ? Median	-6,763,618 6,586,430	3,269,797 6,767,106	1,816,511 8,419,950	-1,067,409 8,094,175	-2,387,797 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	-6,763,618 6,043,842	3,269,797 5,845,112	1,816,511 7,606,259	-1,067,409 7,283,041	-2,387,797 14,957,241
Net margin Median	-8.64742% 4.62%	3.50453% 4.42%	1.90306% 5.16%	-1.18294% 5.2%	-2.34304% 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 MADERA COMMUNITY HOSPITAL 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	13,906,435 23,241,334	15,900,516 23,709,545	13,708,657 24,248,380	11,112,762 22,858,541	12,487,487 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	13,906,435 21,577,146	15,900,516 22,041,594	13,708,657 22,722,063	11,112,762 21,570,441	12,487,487 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	4,969,997 11,160,864	5,077,514 11,987,345	5,149,834 12,926,866	4,895,692 11,884,480	3,545,798 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	4,346,732 10,918,923	4,244,792 11,706,976	4,422,179 12,615,917	4,255,877 11,458,116	2,973,658 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	623,265 618,038	832,722 697,279	727,655 690,232	639,815 684,010	572,140 670,558
⊳ 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	994,569 594,888	1,042,913 595,761	981,267 577,894	920,508 542,168	963,371 549,667
Outlier Median	452,753 582,572	557,368 538,116	400,153 212,434	20,054 126,559	11,056 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	16,582,487 3,662,910	16,736,566 3,730,911	8,311,447 4,081,319	12,966,099 4,643,908	12,830,483 4,389,147
Charity care Median	846,826 2,654,636	737,536 2,940,659	870,997 3,380,215	816,775 3,488,738	721,653 3,233,405
Uncompensated care (UCC) Median	2,185,892 5,147,790	1,938,342 5,337,617	1,483,850 5,711,082	1,866,204 5,923,418	2,397,061 5,508,107
UCC as a % of operating expenses Median	2.57% 3.24	2.15% 3.12	1.58% 3.21	2.04% 3.3	2.30% 2.86
Total shortfall/UCC Median	18,768,379 9,489,989	18,674,908 9,424,297	9,795,297 10,120,158	14,832,303 11,171,337	15,227,544 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	34,969,799 52,142,039	37,388,957 54,485,252	39,096,791 57,395,589	39,882,876 58,830,919	42,562,550 61,722,907
Salaries as a % of operating expenses Median	41.15 36.68	41.53 36.56	41.75 36.37	43.68 35.93	40.81 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	0 1,449,244	0 1,475,986	0 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	0.00 22,725	0.00 23,018.5	0.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	0.00 64.67	0.00 64.53	0.00 65.06	0.00 68.97	0.00 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.