As of the July, 2022, release via CMS

ADVENTHEALTH WATERMAN

CMS id: 100057
1000 WATERMAN WAY, TAVARES FL 32778. County: LAKE
System: ADVENTIST HEALTH SYSTEM
CBSA: Orlando-Kissimmee-Sanford, FL

The 280-bed, acute-care hospital had $7,889,080 in net service to patients*, with a total profit margin of 8.61809% in fiscal year 2020, the latest year available.
It spent 5.16% of its operating expenses on uncompensated care and reported $15,616,625 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	--
Ownership	nfp	nfp	nfp	nfp	--
Acute beds Median	229 118	229 118	229 119.5	228 118	-- 119
Total beds Median	269 162	269 162	269 162	280 162	-- 163.5
FTEs Median	1,417.06 788.06	1,412.09 793.42	1,416.15 806.03	1,498.00 787.61	-- 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	244,755,451 150,932,746	260,182,553 158,950,878	270,417,173 168,696,998	279,755,261 163,454,693	-- 186,589,412
Operating expenses Median	221,337,777 149,311,209	231,983,679 156,110,414	243,994,927 164,890,568	271,866,181 166,516,854	-- 180,120,888
Net income from service 2 patients (NS2P) ? Median	23,417,674 -964,173	28,198,874 -643,601.5	26,422,246 -116,254	7,889,080 -5,025,862	-- -1,284,564
NS2P margin ? Median	9.57% -0.62	10.84% -0.29	9.77% 0.18	2.82% -5.07	--% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ADVENTHEALTH WATERMAN 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	25,532,810 5,089,215	-4,694,130 4,572,541	39,287,601 5,268,134	17,750,199 13,092,619	-- 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	-- 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	7,545,649 309,361.5	-- 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	--
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	--
⊳ Line 12: Parking lot receipts	0	0	0	0	--
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	--
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	873,141	--
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	--
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	--
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	--
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	--
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	--
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	--
⊳ Line 21: Rental of vending machines	0	0	0	0	--
⊳ Line 22: Rental of hospital space	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	-- 1,597,664
⊳ Sum Line 24	25,532,810	-4,694,130	39,287,601	9,331,409	--
Total income ? Median	48,950,484 6,586,430	23,504,744 6,767,106	65,709,847 8,419,950	25,639,279 8,094,175	-- 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	-- 31,473.5
Net income Median	48,950,484 6,043,842	23,504,744 5,845,112	65,709,847 7,606,259	25,639,279 7,283,041	-- 14,957,241
Net margin Median	18.11047% 4.62%	9.19993% 4.42%	21.21693% 5.16%	8.61809% 5.2%	--% 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 ADVENTHEALTH WATERMAN 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	63,455,371 23,241,334	64,598,049 23,709,545	57,772,417 24,248,380	58,681,418 22,858,541	-- 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	63,455,371 21,577,146	64,598,049 22,041,594	57,772,417 22,722,063	56,464,797 21,570,441	-- 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	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	-- 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	2,216,621 3,865,578	-- 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Critical-access hospitals ⊳ Median	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	-- 1,179,746
All outpatient revenue Median Click here to show/hide details	25,990,690 11,160,864	26,245,282 11,987,345	28,500,601 12,926,866	23,393,844 11,884,480	-- 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	23,308,963 10,918,923	23,146,064 11,706,976	25,426,253 12,615,917	20,680,166 11,458,116	-- 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,681,727 1,282,808	3,099,218 1,407,728	3,074,348 1,341,512	2,713,678 1,407,046	-- 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	-- 670,558
⊳ Other federally qualified health clinics ⊳ Median	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	-- 3,508,953
Disproportionate-share hospital (DSH) Median	519,924 594,888	552,901 595,761	616,294 577,894	602,558 542,168	-- 549,667
Outlier Median	338,042 582,572	330,927 538,116	86,394 212,434	178,786 126,559	-- 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	13,435,965 3,662,910	13,925,519 3,730,911	14,090,894 4,081,319	15,616,625 4,643,908	-- 4,389,147
Charity care Median	11,864,648 2,654,636	14,618,910 2,940,659	12,041,134 3,380,215	11,545,958 3,488,738	-- 3,233,405
Uncompensated care (UCC) Median	13,972,258 5,147,790	16,730,272 5,337,617	14,148,384 5,711,082	14,021,032 5,923,418	-- 5,508,107
UCC as a % of operating expenses Median	6.31% 3.24	7.21% 3.12	5.80% 3.21	5.16% 3.3	--% 2.86
Total shortfall/UCC Median	27,408,223 9,489,989	30,655,791 9,424,297	28,239,278 10,120,158	29,637,657 11,171,337	-- 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	87,710,428 52,142,039	91,714,355 54,485,252	96,690,630 57,395,589	100,586,253 58,830,919	-- 61,722,907
Salaries as a % of operating expenses Median	37.17 36.68	37.26 36.56	38.37 36.37	37.00 35.93	-- 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	-- 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	-- 1,469,317
Contract adjusted salaries, direct-care Median	946,706 1,449,244	3,504,498 1,475,986	1,615,198 1,563,078	3,454,759 1,721,954	-- 2,991,828
Contract hours, direct-care Median	16,557.00 22,725	68,540.00 23,018.5	27,940.00 24,503.48	64,334.00 25,026.5	-- 33,786
Contract wages, direct-care Median	57.18 64.67	51.13 64.53	57.81 65.06	53.70 68.97	-- 88.94

* in an approved program

Return to top

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.