As of the July, 2022, release via CMS

KUAKINI MEDICAL CENTER

CMS id: 120007
347 N. KUAKINI STREET, HONOLULU HI 96717. County: HONOLULU
System: --
CBSA: Urban Honolulu, HI

The 357-bed, acute-care hospital had $-33,098,901 in net service to patients*, with a total profit margin of -3.28449% in fiscal year 2021, the latest year available.
It spent 0.89% of its operating expenses on uncompensated care and reported $5,191,368 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	146 118	146 118	146 119.5	146 118	146 119
Total beds Median	357 162	357 162	357 162	357 162	357 163.5
FTEs Median	935.51 788.06	918.70 793.42	834.67 806.03	828.57 787.61	808.26 804.34

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	144,007,405 150,932,746	144,221,772 158,950,878	145,628,966 168,696,998	130,345,319 163,454,693	135,545,853 186,589,412
Operating expenses Median	169,112,272 149,311,209	168,235,520 156,110,414	161,838,397 164,890,568	160,708,015 166,516,854	168,644,754 180,120,888
Net income from service 2 patients (NS2P) ? Median	-25,104,867 -964,173	-24,013,748 -643,601.5	-16,209,431 -116,254	-30,362,696 -5,025,862	-33,098,901 -1,284,564
NS2P margin ? Median	-17.43% -0.62	-16.65% -0.29	-11.13% 0.18	-23.29% -5.07	-24.42% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for KUAKINI 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	23,597,993 5,089,215	15,515,200 4,572,541	19,170,702 5,268,134	25,439,003 13,092,619	27,735,929 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,490,822 224,999	2,961,774 199,009	6,971,031 206,870.5	4,195,422 194,343	1,672,715 249,496
⊳ Line 7: Investments ? ⊳ Median	11,451,792 299,524	1,206,680 188,688.5	1,633,754 370,813	1,933,249 309,361.5	4,977,060 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	125,377	48,163	3,234	50,801	14,152
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	2,595,127	2,715,958	2,563,088	2,246,965	1,896,619
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	937,528	880,187	805,916	705,013	472,198
⊳ 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	1,046	883	1,666	879	4,921
⊳ 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	1,642,810	1,960,672	1,857,646	1,588,382	2,168,505
⊳ 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	5,353,491	5,740,883	5,334,367	14,718,292	16,529,759
Total income ? Median	-1,506,874 6,586,430	-8,498,548 6,767,106	2,961,271 8,419,950	-4,923,693 8,094,175	-5,362,972 15,162,888
Non-operating expenses Median	567,026 146,289.5	636,132 164,857	387,076 89,880.5	0 106,761	0 31,473.5
Net income Median	-2,073,900 6,043,842	-9,134,680 5,845,112	2,574,195 7,606,259	-4,923,693 7,283,041	-5,362,972 14,957,241
Net margin Median	-1.23737% 4.62%	-5.71858% 4.42%	1.56201% 5.16%	-3.16058% 5.2%	-3.28449% 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 KUAKINI 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	27,500,406 23,241,334	24,931,601 23,709,545	25,294,783 24,248,380	21,348,082 22,858,541	19,385,388 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	25,413,890 21,577,146	22,751,758 22,041,594	23,320,970 22,722,063	19,485,853 21,570,441	17,377,814 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	2,086,516 1,203,033	2,179,843 1,215,295	1,973,813 1,313,657	1,862,229 1,365,298	2,007,574 1,179,746
All outpatient revenue Median Click here to show/hide details	9,258,257 11,160,864	9,243,505 11,987,345	8,378,245 12,926,866	9,466,694 11,884,480	9,578,737 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	9,258,257 10,918,923	9,243,505 11,706,976	8,378,245 12,615,917	9,466,694 11,458,116	9,578,737 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	2,380,053 3,284,314	2,054,758 3,250,551	1,821,027 3,386,837	1,651,335 3,360,806	1,536,237 3,508,953
Disproportionate-share hospital (DSH) Median	139,055 594,888	173,286 595,761	192,168 577,894	103,055 542,168	149,528 549,667
Outlier Median	2,105,346 582,572	1,883,766 538,116	2,744,351 212,434	298,686 126,559	324,730 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,966,932 3,662,910	3,038,884 3,730,911	3,513,995 4,081,319	3,763,513 4,643,908	5,191,368 4,389,147
Charity care Median	11,608 2,654,636	36,156 2,940,659	21,310 3,380,215	86,754 3,488,738	82,482 3,233,405
Uncompensated care (UCC) Median	689,290 5,147,790	1,545,347 5,337,617	1,260,336 5,711,082	337,465 5,923,418	1,492,745 5,508,107
UCC as a % of operating expenses Median	0.41% 3.24	0.92% 3.12	0.78% 3.21	0.21% 3.3	0.89% 2.86
Total shortfall/UCC Median	2,656,222 9,489,989	4,584,231 9,424,297	4,774,331 10,120,158	4,100,978 11,171,337	6,684,113 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	65,285,994 52,142,039	64,465,364 54,485,252	60,040,201 57,395,589	60,530,502 58,830,919	62,463,306 61,722,907
Salaries as a % of operating expenses Median	38.61 36.68	38.32 36.56	37.10 36.37	37.66 35.93	37.04 35.24
Intern, resident salaries* Median	41,072 2,598,592	37,846 2,686,824	27,192 2,753,773	29,433 2,937,156	33,802 2,909,848
Contract intern, resident salaries* Median	1,361,904 1,251,927	1,412,829 1,186,494	1,329,934 1,204,885	1,335,265 1,279,653	1,278,059 1,469,317
Contract adjusted salaries, direct-care Median	3,220,094 1,449,244	3,271,430 1,475,986	1,990,302 1,563,078	2,287,636 1,721,954	3,060,742 2,991,828
Contract hours, direct-care Median	49,869.86 22,725	49,951.10 23,018.5	36,147.19 24,503.48	40,660.02 25,026.5	32,473.29 33,786
Contract wages, direct-care Median	64.57 64.67	65.49 64.53	55.06 65.06	56.26 68.97	94.25 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.