As of the July, 2022, release via CMS

KONA COMMUNITY HOSPITAL

CMS id: 120019
79-1019 HAUKAPILA STREET, KEALAKEKUA HI 96750. County: HAWAII
System: HAWAII HEALTH SYSTEMS CORP
CBSA: Hilo, HI

The 94-bed, acute-care hospital had $-33,936,239 in net service to patients*, with a total profit margin of 4.31598% in fiscal year 2021, the latest year available.
It spent 1.79% of its operating expenses on uncompensated care and reported $9,656,653 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	70 118	74 118	74 119.5	74 118	74 119
Total beds Median	90 162	94 162	94 162	94 162	94 163.5
FTEs Median	395.34 788.06	401.45 793.42	429.52 806.03	429.52 787.61	438.70 804.34

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	78,029,743 150,932,746	89,961,400 158,950,878	77,603,188 168,696,998	89,987,630 163,454,693	83,437,595 186,589,412
Operating expenses Median	91,126,277 149,311,209	98,587,981 156,110,414	106,510,865 164,890,568	114,935,495 166,516,854	117,373,834 180,120,888
Net income from service 2 patients (NS2P) ? Median	-13,096,534 -964,173	-8,626,581 -643,601.5	-28,907,677 -116,254	-24,947,865 -5,025,862	-33,936,239 -1,284,564
NS2P margin ? Median	-16.78% -0.62	-9.59% -0.29	-37.25% 0.18	-27.72% -5.07	-40.67% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for KONA COMMUNITY HOSPITAL 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	24,178,614 5,089,215	32,372,724 4,572,541	31,997,224 5,268,134	40,618,867 13,092,619	47,320,136 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	653,860 224,999	628,754 199,009	535,724 206,870.5	460,467 194,343	590,410 249,496
⊳ Line 7: Investments ? ⊳ Median	32,925 299,524	27,657 188,688.5	124,676 370,813	140,691 309,361.5	42,543 375,329
⊳ 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	20,451	96,256	90,120	82,069	77,607
⊳ 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	225,071	255,785	266,782	242,906	242,454
⊳ 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	16,788	10,440	5,548	9,120	5,689
⊳ 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	61,520	61,520	59,430	58,733	57,456
⊳ Line 23: Gov appropriations ? ⊳ Median	17,300,232 1,017,693	23,101,000 983,261.5	23,454,500 1,173,286	31,948,000 1,987,202	32,530,000 1,597,664
⊳ Sum Line 24	5,867,767	8,191,312	7,460,444	7,676,881	13,773,977
Total income ? Median	11,082,080 6,586,430	23,746,143 6,767,106	3,089,547 8,419,950	15,671,002 8,094,175	13,383,897 15,162,888
Non-operating expenses Median	3,836,585 146,289.5	3,836,585 164,857	7,705,371 89,880.5	8,589,274 106,761	7,740,421 31,473.5
Net income Median	7,245,495 6,043,842	19,909,558 5,845,112	-4,615,824 7,606,259	7,081,728 7,283,041	5,643,476 14,957,241
Net margin Median	7.08895% 4.62%	16.27474% 4.42%	-4.21150% 5.16%	5.42219% 5.2%	4.31598% 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 KONA COMMUNITY HOSPITAL 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	12,843,846 23,241,334	14,298,603 23,709,545	14,548,622 24,248,380	13,704,922 22,858,541	13,459,565 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	12,453,950 21,577,146	14,085,858 22,041,594	14,237,764 22,722,063	13,364,441 21,570,441	13,380,350 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	389,896 1,845,420	212,745 1,757,392	310,858 1,738,842	340,481 1,510,463	79,215 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	4,007,700 11,160,864	5,381,151 11,987,345	5,374,129 12,926,866	6,140,353 11,884,480	6,655,420 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	4,007,700 10,918,923	5,381,151 11,706,976	5,374,129 12,615,917	6,140,353 11,458,116	6,655,420 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	167,800 594,888	198,320 595,761	219,326 577,894	212,543 542,168	208,099 549,667
Outlier Median	352,777 582,572	285,236 538,116	739,235 212,434	104,271 126,559	152,514 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,334,504 3,662,910	6,337,879 3,730,911	9,277,573 4,081,319	9,237,988 4,643,908	9,656,653 4,389,147
Charity care Median	319,793 2,654,636	396,035 2,940,659	737,483 3,380,215	490,123 3,488,738	535,197 3,233,405
Uncompensated care (UCC) Median	1,701,414 5,147,790	1,914,620 5,337,617	3,044,378 5,711,082	3,181,097 5,923,418	2,103,684 5,508,107
UCC as a % of operating expenses Median	1.87% 3.24	1.94% 3.12	2.86% 3.21	2.77% 3.3	1.79% 2.86
Total shortfall/UCC Median	6,035,918 9,489,989	8,252,499 9,424,297	12,321,951 10,120,158	12,419,085 11,171,337	11,760,337 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	31,673,735 52,142,039	33,453,087 54,485,252	35,938,270 57,395,589	39,251,264 58,830,919	40,610,647 61,722,907
Salaries as a % of operating expenses Median	34.76 36.68	33.93 36.56	33.74 36.37	34.15 35.93	34.60 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	4,111,675 1,449,244	4,671,466 1,475,986	4,376,897 1,563,078	5,864,330 1,721,954	7,879,129 2,991,828
Contract hours, direct-care Median	58,692.00 22,725	66,724.00 23,018.5	61,322.00 24,503.48	82,359.00 25,026.5	113,770.00 33,786
Contract wages, direct-care Median	70.06 64.67	70.01 64.53	71.38 65.06	71.20 68.97	69.25 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.