As of the July, 2022, release via CMS

MERCY MEDICAL CENTER-DES MOINES

CMS id: 160083
1111 6TH AVENUE, DES MOINES IA 50314. County: POLK
System: CATHOLIC HEALTH INITIATIVES
CBSA: Des Moines-West Des Moines, IA

The 603-bed, acute-care hospital had $-80,384,155 in net service to patients*, with a total profit margin of -0.47691% in fiscal year 2021, the latest year available.
It spent 1.77% of its operating expenses on uncompensated care and reported $14,894,458 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	440 118	449 118	447 119.5	441 118	441 119
Total beds Median	576 162	585 162	583 162	580 162	603 163.5
FTEs Median	5,271.80 788.06	5,404.10 793.42	5,228.48 806.03	5,065.43 787.61	4,922.98 804.34

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	620,572,330 150,932,746	620,160,119 158,950,878	617,882,586 168,696,998	563,711,031 163,454,693	654,600,960 186,589,412
Operating expenses Median	649,926,573 149,311,209	673,063,713 156,110,414	671,240,457 164,890,568	632,484,891 166,516,854	734,985,115 180,120,888
Net income from service 2 patients (NS2P) ? Median	-29,354,243 -964,173	-52,903,594 -643,601.5	-53,357,871 -116,254	-68,773,860 -5,025,862	-80,384,155 -1,284,564
NS2P margin ? Median	-4.73% -0.62	-8.53% -0.29	-8.64% 0.18	-12.20% -5.07	-12.28% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MERCY MEDICAL CENTER-DES MOINES 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	48,522,531 5,089,215	50,522,577 4,572,541	63,127,078 5,268,134	80,745,355 13,092,619	76,895,559 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	784,449 224,999	771,455 199,009	665,045 206,870.5	656,255 194,343	362,505 249,496
⊳ Line 7: Investments ? ⊳ Median	993,603 299,524	797,323 188,688.5	737,059 370,813	114,812 309,361.5	130,156 375,329
⊳ 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	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	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	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	0	0
⊳ 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	46,744,479	48,953,799	61,724,974	79,974,288	76,402,898
Total income ? Median	19,168,288 6,586,430	-2,381,017 6,767,106	9,769,207 8,419,950	11,971,495 8,094,175	-3,488,596 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	19,168,288 6,043,842	-2,381,017 5,845,112	9,769,207 7,606,259	11,971,495 7,283,041	-3,488,596 14,957,241
Net margin Median	2.86481% 4.62%	-0.35501% 4.42%	1.43452% 5.16%	1.85761% 5.2%	-0.47691% 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 MERCY MEDICAL CENTER-DES MOINES 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	145,741,059 23,241,334	143,772,621 23,709,545	135,315,817 24,248,380	131,416,699 22,858,541	133,223,906 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	141,959,212 21,577,146	141,057,225 22,041,594	134,694,983 22,722,063	130,797,116 21,570,441	132,693,109 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	1,132,959 1,845,420	824,572 1,757,392	620,834 1,738,842	619,583 1,510,463	530,797 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,648,888 3,535,627	1,890,824 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	50,575,851 11,160,864	53,089,274 11,987,345	56,278,375 12,926,866	50,893,877 11,884,480	59,543,154 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	50,575,851 10,918,923	53,089,274 11,706,976	56,278,375 12,615,917	50,893,877 11,458,116	59,543,154 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	6,447,453 3,284,314	5,694,665 3,250,551	5,728,355 3,386,837	5,711,026 3,360,806	6,076,500 3,508,953
Disproportionate-share hospital (DSH) Median	4,792,215 594,888	5,109,240 595,761	4,761,974 577,894	4,509,083 542,168	4,121,008 549,667
Outlier Median	4,237,845 582,572	3,407,075 538,116	4,067,534 212,434	244,732 126,559	266,053 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	11,624,285 3,662,910	12,333,683 3,730,911	15,732,275 4,081,319	4,653,883 4,643,908	14,894,458 4,389,147
Charity care Median	6,646,919 2,654,636	8,431,769 2,940,659	10,475,792 3,380,215	9,286,804 3,488,738	8,944,371 3,233,405
Uncompensated care (UCC) Median	10,413,447 5,147,790	12,311,191 5,337,617	14,860,554 5,711,082	14,256,721 5,923,418	13,036,273 5,508,107
UCC as a % of operating expenses Median	1.60% 3.24	1.83% 3.12	2.21% 3.21	2.25% 3.3	1.77% 2.86
Total shortfall/UCC Median	22,037,732 9,489,989	24,644,874 9,424,297	30,592,829 10,120,158	18,910,604 11,171,337	27,930,731 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	400,904,198 52,142,039	411,469,896 54,485,252	420,489,240 57,395,589	423,011,303 58,830,919	431,236,575 61,722,907
Salaries as a % of operating expenses Median	41.41 36.68	41.33 36.56	41.81 36.37	41.99 35.93	39.68 35.24
Intern, resident salaries* Median	4,735,538 2,598,592	3,794,982 2,686,824	4,114,121 2,753,773	4,812,847 2,937,156	5,637,954 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	5,984,493 1,449,244	4,884,292 1,475,986	2,361,210 1,563,078	3,092,447 1,721,954	11,627,968 2,991,828
Contract hours, direct-care Median	94,615.00 22,725	85,745.00 23,018.5	63,535.00 24,503.48	67,164.08 25,026.5	119,569.00 33,786
Contract wages, direct-care Median	63.25 64.67	56.96 64.53	37.16 65.06	46.04 68.97	97.25 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.