As of the July, 2022, release via CMS

THCC TWIN CITIES COMMUNITY HOSPITAL

CMS id: 050633
1100 LAS TABLAS RD, TEMPLETON CA 93465. County: SAN LUIS OBISPO
System: TENET HEALTHCARE CORPORATION
CBSA: San Luis Obispo-Paso Robles, CA

The 122-bed, acute-care hospital had $14,260,482 in net service to patients*, with a total profit margin of 15.25298% in fiscal year 2021, the latest year available.
It spent 2.19% of its operating expenses on uncompensated care and reported $10,860 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	104 118	104 118	104 119.5	104 118	104 119
Total beds Median	122 162	122 162	122 162	122 162	122 163.5
FTEs Median	334.50 788.06	342.80 793.42	348.00 806.03	322.00 787.61	321.00 804.34

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	103,770,924 150,932,746	110,792,627 158,950,878	114,398,088 168,696,998	107,071,355 163,454,693	120,224,048 186,589,412
Operating expenses Median	95,881,539 149,311,209	93,886,989 156,110,414	98,658,027 164,890,568	101,842,043 166,516,854	105,963,566 180,120,888
Net income from service 2 patients (NS2P) ? Median	7,889,385 -964,173	16,905,638 -643,601.5	15,740,061 -116,254	5,229,312 -5,025,862	14,260,482 -1,284,564
NS2P margin ? Median	7.60% -0.62	15.26% -0.29	13.76% 0.18	4.88% -5.07	11.86% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for THCC TWIN CITIES 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	446,944 5,089,215	569,208 4,572,541	349,524 5,268,134	464,685 13,092,619	4,811,104 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	410 299,524	276 188,688.5	412 370,813	19 309,361.5	283 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	319	269	533	1,231	1,154
⊳ Line 11: Rebates and refunds of expenses	30,760	24,644	43,468	46,120	70,967
⊳ 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	28,906	31,732	29,910	27,844	20,873
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	1,330	684	1,035	535	684
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	8,859	8,656	8,036	8,425	1,050
⊳ Line 22: Rental of hospital space	263,537	251,532	125,739	161,972	163,187
⊳ 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	112,823	251,415	140,391	218,539	4,552,906
Total income ? Median	8,336,329 6,586,430	17,474,846 6,767,106	16,089,585 8,419,950	5,693,997 8,094,175	19,071,586 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	8,336,329 6,043,842	17,474,846 5,845,112	16,089,585 7,606,259	5,693,997 7,283,041	19,071,586 14,957,241
Net margin Median	7.99894% 4.62%	15.69195% 4.42%	14.02172% 5.16%	5.29497% 5.2%	15.25298% 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 THCC TWIN CITIES 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	19,989,290 23,241,334	20,619,972 23,709,545	19,541,172 24,248,380	18,735,611 22,858,541	18,208,448 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	19,989,290 21,577,146	20,619,972 22,041,594	19,541,172 22,722,063	18,735,611 21,570,441	18,208,448 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	6,809,560 11,160,864	7,090,286 11,987,345	7,237,624 12,926,866	7,128,968 11,884,480	8,439,902 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	6,809,560 10,918,923	7,090,286 11,706,976	7,237,624 12,615,917	7,128,968 11,458,116	8,439,902 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	668,115 594,888	675,139 595,761	788,532 577,894	701,458 542,168	584,507 549,667
Outlier Median	348,525 582,572	504,775 538,116	565,470 212,434	43,848 126,559	51,992 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	180,294 3,662,910	0 3,730,911	41,125 4,081,319	65,599 4,643,908	10,860 4,389,147
Charity care Median	1,392,479 2,654,636	1,456,302 2,940,659	1,650,294 3,380,215	2,068,057 3,488,738	1,736,145 3,233,405
Uncompensated care (UCC) Median	2,117,927 5,147,790	2,255,840 5,337,617	2,525,997 5,711,082	2,899,983 5,923,418	2,323,997 5,508,107
UCC as a % of operating expenses Median	2.21% 3.24	2.40% 3.12	2.56% 3.21	2.85% 3.3	2.19% 2.86
Total shortfall/UCC Median	2,298,221 9,489,989	2,255,840 9,424,297	2,567,122 10,120,158	2,965,582 11,171,337	2,334,857 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	37,908,688 52,142,039	39,836,266 54,485,252	40,122,878 57,395,589	39,935,727 58,830,919	42,085,414 61,722,907
Salaries as a % of operating expenses Median	39.53 36.68	42.46 36.56	40.67 36.37	39.22 35.93	39.72 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	2,850,440 1,449,244	1,863,385 1,475,986	2,657,416 1,563,078	3,274,538 1,721,954	3,666,908 2,991,828
Contract hours, direct-care Median	26,804.00 22,725	19,792.50 23,018.5	30,272.00 24,503.48	33,274.00 25,026.5	29,966.00 33,786
Contract wages, direct-care Median	106.34 64.67	94.15 64.53	87.78 65.06	98.41 68.97	122.37 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.