As of the July, 2022, release via CMS

SAN RAMON REG. MEDICAL CENTER

CMS id: 050689
6001 NORRIS CANYON RD, SAN RAMON CA 94583. County: CONTRA COSTA
System: TENET HEALTHCARE CORPORATION
CBSA: San Francisco-Oakland-Berkeley, CA

The 123-bed, acute-care hospital had $6,989,319 in net service to patients*, with a total profit margin of 12.30197% in fiscal year 2021, the latest year available.
It spent 0.86% of its operating expenses on uncompensated care and reported $16,089,623 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	109 118	109 118	109 119.5	109 118	109 119
Total beds Median	123 162	123 162	123 162	123 162	123 163.5
FTEs Median	475.50 788.06	459.10 793.42	450.00 806.03	376.00 787.61	379.00 804.34

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	190,096,155 150,932,746	192,262,873 158,950,878	195,238,457 168,696,998	181,588,431 163,454,693	169,151,620 186,589,412
Operating expenses Median	174,807,700 149,311,209	172,202,834 156,110,414	174,950,736 164,890,568	170,140,652 166,516,854	162,162,301 180,120,888
Net income from service 2 patients (NS2P) ? Median	15,288,455 -964,173	20,060,039 -643,601.5	20,287,721 -116,254	11,447,779 -5,025,862	6,989,319 -1,284,564
NS2P margin ? Median	8.04% -0.62	10.43% -0.29	10.39% 0.18	6.30% -5.07	4.13% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SAN RAMON 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	1,217,374 5,089,215	1,198,880 4,572,541	1,289,548 5,268,134	1,322,869 13,092,619	15,758,245 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	26,170 299,524	1,633 188,688.5	1,598 370,813	1,091 309,361.5	18,263 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	3,406	-408	2,390	421	824
⊳ Line 11: Rebates and refunds of expenses	56,313	40,255	56,879	46,869	140,368
⊳ 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	284,970	279,498	243,393	203,445	107,732
⊳ 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	12,583	17,413	15,524	3,729	5,127
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	13,710	26,570	24,725	18,600	13,500
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	63,574	61,688	68,220	54,246	18,811
⊳ Line 21: Rental of vending machines	1,909	1,626	3,613	23,339	-16,225
⊳ Line 22: Rental of hospital space	712,448	726,569	814,666	907,398	975,944
⊳ 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	42,291	44,036	58,540	63,731	14,493,901
Total income ? Median	16,505,829 6,586,430	21,258,919 6,767,106	21,577,269 8,419,950	12,770,648 8,094,175	22,747,564 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	16,505,829 6,043,842	21,258,919 5,845,112	21,577,269 7,606,259	12,770,648 7,283,041	22,747,564 14,957,241
Net margin Median	8.62763% 4.62%	10.98869% 4.42%	10.97923% 5.16%	6.98188% 5.2%	12.30197% 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 SAN RAMON 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	24,075,425 23,241,334	22,409,020 23,709,545	23,338,386 24,248,380	26,148,736 22,858,541	23,130,604 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	24,075,425 21,577,146	22,409,020 22,041,594	23,338,386 22,722,063	26,148,736 21,570,441	23,130,604 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	11,038,237 11,160,864	12,252,768 11,987,345	13,030,511 12,926,866	11,681,244 11,884,480	11,163,884 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	11,038,237 10,918,923	12,252,768 11,706,976	13,030,511 12,615,917	11,681,244 11,458,116	11,163,884 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	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	1,491,353 582,572	2,273,900 538,116	2,249,210 212,434	229,743 126,559	197,320 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,346,005 3,662,910	3,745,826 3,730,911	8,700,809 4,081,319	9,921,915 4,643,908	16,089,623 4,389,147
Charity care Median	938,001 2,654,636	1,502,026 2,940,659	1,444,422 3,380,215	1,353,911 3,488,738	937,674 3,233,405
Uncompensated care (UCC) Median	1,753,082 5,147,790	2,316,926 5,337,617	2,138,951 5,711,082	2,016,922 5,923,418	1,396,215 5,508,107
UCC as a % of operating expenses Median	1.00% 3.24	1.35% 3.12	1.22% 3.21	1.19% 3.3	0.86% 2.86
Total shortfall/UCC Median	9,099,087 9,489,989	6,062,752 9,424,297	10,839,760 10,120,158	11,938,837 11,171,337	17,485,838 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	68,378,825 52,142,039	68,305,490 54,485,252	68,832,577 57,395,589	65,829,639 58,830,919	65,187,548 61,722,907
Salaries as a % of operating expenses Median	42.73 36.68	44.21 36.56	43.94 36.37	41.73 35.93	42.39 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	3,329,901 1,449,244	0 1,475,986	2,142,521 1,563,078	3,023,771 1,721,954	2,235,396 2,991,828
Contract hours, direct-care Median	40,123.00 22,725	0.00 23,018.5	25,341.00 24,503.48	31,282.00 25,026.5	14,877.00 33,786
Contract wages, direct-care Median	82.99 64.67	0.00 64.53	84.55 65.06	96.66 68.97	150.26 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.