As of the July, 2022, release via CMS

ADVENTHEALTH FISH MEMORIAL

CMS id: 100072
1055 SAXON BLVD, ORANGE CITY FL 32673. County: VOLUSIA
System: ADVENTHEALTH
CBSA: Deltona-Daytona Beach-Ormond Beach, FL

The 257-bed, acute-care hospital had $8,793,066 in net service to patients*, with a total profit margin of 7.15767% in fiscal year 2021, the latest year available.
It spent 5.32% of its operating expenses on uncompensated care and reported $15,609,768 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	158 118	158 118	156 119.5	170 118	221 119
Total beds Median	179 162	179 162	179 162	197 162	257 163.5
FTEs Median	794.98 788.06	784.61 793.42	767.76 806.03	811.52 787.61	851.25 804.34

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	158,050,545 150,932,746	165,308,224 158,950,878	185,648,869 168,696,998	192,075,808 163,454,693	234,651,576 186,589,412
Operating expenses Median	143,578,038 149,311,209	151,674,134 156,110,414	162,717,963 164,890,568	175,414,313 166,516,854	225,858,510 180,120,888
Net income from service 2 patients (NS2P) ? Median	14,472,507 -964,173	13,634,090 -643,601.5	22,930,906 -116,254	16,661,495 -5,025,862	8,793,066 -1,284,564
NS2P margin ? Median	9.16% -0.62	8.25% -0.29	12.35% 0.18	8.67% -5.07	3.75% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ADVENTHEALTH FISH MEMORIAL 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	9,333,245 5,089,215	-1,697,225 4,572,541	16,081,305 5,268,134	6,253,921 13,092,619	8,619,460 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	0 299,524	0 188,688.5	0 370,813	1,641,105 309,361.5	7,232,243 375,329
⊳ 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	495	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	104,500
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	0	516,972
⊳ 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	126,238	90,375
⊳ 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	9,333,245	-1,697,225	16,081,305	4,486,083	675,370
Total income ? Median	23,805,752 6,586,430	11,936,865 6,767,106	39,012,211 8,419,950	22,915,416 8,094,175	17,412,526 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	23,805,752 6,043,842	11,936,865 5,845,112	39,012,211 7,606,259	22,915,416 7,283,041	17,412,526 14,957,241
Net margin Median	14.22226% 4.62%	7.29588% 4.42%	19.33881% 5.16%	11.55420% 5.2%	7.15767% 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 FISH MEMORIAL 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	28,458,984 23,241,334	29,539,159 23,709,545	31,027,747 24,248,380	29,204,518 22,858,541	27,686,874 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	28,458,984 21,577,146	29,539,159 22,041,594	31,027,747 22,722,063	29,204,518 21,570,441	27,686,874 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	8,206,355 11,160,864	8,150,618 11,987,345	8,999,646 12,926,866	8,031,351 11,884,480	8,245,225 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	8,206,355 10,918,923	8,150,618 11,706,976	8,999,646 12,615,917	8,031,351 11,458,116	8,245,225 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	183,527 594,888	949,050 595,761	256,222 577,894	218,597 542,168	316,607 549,667
Outlier Median	444,853 582,572	168,829 538,116	9,232 212,434	25,376 126,559	41,052 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	6,609,229 3,662,910	9,023,853 3,730,911	8,196,347 4,081,319	10,905,208 4,643,908	15,609,768 4,389,147
Charity care Median	8,511,966 2,654,636	8,082,110 2,940,659	9,280,843 3,380,215	7,554,301 3,488,738	9,729,385 3,233,405
Uncompensated care (UCC) Median	10,886,119 5,147,790	10,214,891 5,337,617	11,752,926 5,711,082	9,917,322 5,923,418	12,012,961 5,508,107
UCC as a % of operating expenses Median	7.58% 3.24	6.73% 3.12	7.22% 3.21	5.65% 3.3	5.32% 2.86
Total shortfall/UCC Median	17,495,348 9,489,989	19,238,744 9,424,297	19,949,273 10,120,158	20,822,530 11,171,337	27,622,729 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	57,756,933 52,142,039	60,298,824 54,485,252	64,796,221 57,395,589	70,039,717 58,830,919	70,194,525 61,722,907
Salaries as a % of operating expenses Median	37.13 36.68	39.76 36.56	39.82 36.37	39.93 35.93	31.08 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	1,371,543 1,449,244	1,114,500 1,475,986	1,012,638 1,563,078	1,039,224 1,721,954	10,316,502 2,991,828
Contract hours, direct-care Median	24,285.00 22,725	17,082.00 23,018.5	16,025.00 24,503.48	13,738.00 25,026.5	78,534.00 33,786
Contract wages, direct-care Median	56.48 64.67	65.24 64.53	63.19 65.06	75.65 68.97	131.36 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.