As of the July, 2022, release via CMS

RANCHO LOS AMIGOS NATL.REHAB.CTR.

CMS id: 050717
7601 E. IMPERIAL HIGHWAY, DOWNEY CA 90242. County: LOS ANGELES
System: L.A. COUNTY DEPT. OF HEALTH SVCS.ADM
CBSA: Los Angeles-Long Beach-Anaheim, CA

The 158-bed, acute-care hospital had $-83,083,598 in net service to patients*, with a total profit margin of -58.39022% in fiscal year 2021, the latest year available.
It spent 13.38% of its operating expenses on uncompensated care and reported $90,817,884 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	gov	gov	gov	gov	gov
Acute beds Median	111 118	102 118	102 119.5	75 118	75 119
Total beds Median	235 162	214 162	189 162	158 162	158 163.5
FTEs Median	1,354.69 788.06	1,335.81 793.42	1,174.46 806.03	1,380.23 787.61	1,348.00 804.34

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	175,996,021 150,932,746	280,515,000 158,950,878	275,116,000 168,696,998	432,830,000 163,454,693	265,368,434 186,589,412
Operating expenses Median	221,751,773 149,311,209	294,682,474 156,110,414	301,013,463 164,890,568	288,583,364 166,516,854	348,452,032 180,120,888
Net income from service 2 patients (NS2P) ? Median	-45,755,752 -964,173	-14,167,474 -643,601.5	-25,897,463 -116,254	144,246,636 -5,025,862	-83,083,598 -1,284,564
NS2P margin ? Median	-26.00% -0.62	-5.05% -0.29	-9.41% 0.18	33.33% -5.07	-31.31% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for RANCHO LOS AMIGOS NATL.REHAB.CTR. 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	1,594,138 5,089,215	80,766,000 4,572,541	35,217,000 5,268,134	16,251,000 13,092,619	21,817,076 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	9,300 299,524	-158,000 188,688.5	287,000 370,813	563,000 309,361.5	0 375,329
⊳ 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	139,955	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	392,552	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	35,774	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	1,744	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	1,014,813	80,924,000	34,930,000	15,688,000	21,817,076
Total income ? Median	-44,161,614 6,586,430	66,598,526 6,767,106	9,319,537 8,419,950	160,497,636 8,094,175	-61,266,522 15,162,888
Non-operating expenses Median	0 146,289.5	95,334,000 164,857	151,186,000 89,880.5	200,827,000 106,761	106,421,715 31,473.5
Net income Median	-44,161,614 6,043,842	-28,735,474 5,845,112	-141,866,463 7,606,259	-40,329,364 7,283,041	-167,688,237 14,957,241
Net margin Median	-24.86715% 4.62%	-7.95377% 4.42%	-45.71427% 5.16%	-8.98042% 5.2%	-58.39022% 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 RANCHO LOS AMIGOS NATL.REHAB.CTR. 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	12,222,690 23,241,334	12,008,442 23,709,545	12,958,909 24,248,380	13,541,347 22,858,541	17,892,747 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	8,363,132 21,577,146	7,815,560 22,041,594	8,089,840 22,722,063	10,154,659 21,570,441	11,277,295 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	3,859,558 3,535,627	4,192,882 3,746,588	4,869,069 3,782,288	3,386,688 3,865,578	6,615,452 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	2,163,565 11,160,864	2,305,645 11,987,345	2,473,796 12,926,866	2,211,504 11,884,480	2,443,678 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	2,163,565 10,918,923	2,305,645 11,706,976	2,473,796 12,615,917	2,211,504 11,458,116	2,443,678 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	331,780 3,284,314	317,111 3,250,551	316,506 3,386,837	318,932 3,360,806	514,575 3,508,953
Disproportionate-share hospital (DSH) Median	419,467 594,888	443,358 595,761	369,207 577,894	388,015 542,168	455,746 549,667
Outlier Median	1,723,473 582,572	1,562,726 538,116	1,470,385 212,434	1,048,201 126,559	2,095,106 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	618,612 3,662,910	10,449,739 3,730,911	88,869,497 4,081,319	61,729,702 4,643,908	90,817,884 4,389,147
Charity care Median	20,283,352 2,654,636	23,186,092 2,940,659	24,990,709 3,380,215	41,701,356 3,488,738	45,417,952 3,233,405
Uncompensated care (UCC) Median	20,625,553 5,147,790	23,484,653 5,337,617	25,641,618 5,711,082	42,798,780 5,923,418	46,614,879 5,508,107
UCC as a % of operating expenses Median	9.30% 3.24	7.97% 3.12	8.52% 3.21	14.83% 3.3	13.38% 2.86
Total shortfall/UCC Median	21,244,165 9,489,989	33,934,392 9,424,297	114,511,115 10,120,158	104,528,482 11,171,337	137,432,763 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	109,875,083 52,142,039	112,669,292 54,485,252	118,665,901 57,395,589	127,348,831 58,830,919	129,897,295 61,722,907
Salaries as a % of operating expenses Median	31.54 36.68	29.92 36.56	34.56 36.37	26.24 35.93	31.36 35.24
Intern, resident salaries* Median	123,182 2,598,592	123,224 2,686,824	154,203 2,753,773	170,552 2,937,156	170,528 2,909,848
Contract intern, resident salaries* Median	575,574 1,251,927	524,640 1,186,494	471,366 1,204,885	985,852 1,279,653	1,206,230 1,469,317
Contract adjusted salaries, direct-care Median	2,601,361 1,449,244	1,399,071 1,475,986	1,455,740 1,563,078	2,650,714 1,721,954	7,476,396 2,991,828
Contract hours, direct-care Median	32,685.00 22,725	32,947.00 23,018.5	32,715.00 24,503.48	56,555.00 25,026.5	126,515.00 33,786
Contract wages, direct-care Median	79.59 64.67	42.46 64.53	44.50 65.06	46.87 68.97	59.09 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.