As of the July, 2022, release via CMS

GRINNELL REGIONAL MEDICAL CENTER

CMS id: 160147
210 FOURTH AVE, GRINNELL IA 50112. County: POWESHIEK
System: CENTRAL IOWA HOSPITAL CORPORATION
CBSA: Rural Iowa

The 33-bed, acute-care hospital had $153,042 in net service to patients*, with a total profit margin of 3.18551% in fiscal year 2021, the latest year available.
It spent 1.45% of its operating expenses on uncompensated care and reported $1,803,272 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	44 118	44 118	44 119.5	25 118	25 119
Total beds Median	49 162	49 162	49 162	33 162	33 163.5
FTEs Median	321.20 788.06	322.87 793.42	309.71 806.03	267.53 787.61	271.13 804.34

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	49,651,806 150,932,746	47,691,743 158,950,878	48,825,353 168,696,998	48,789,624 163,454,693	60,846,303 186,589,412
Operating expenses Median	52,903,002 149,311,209	53,052,542 156,110,414	50,098,836 164,890,568	55,233,973 166,516,854	60,693,261 180,120,888
Net income from service 2 patients (NS2P) ? Median	-3,251,196 -964,173	-5,360,799 -643,601.5	-1,273,483 -116,254	-6,444,349 -5,025,862	153,042 -1,284,564
NS2P margin ? Median	-6.55% -0.62	-11.24% -0.29	-2.61% 0.18	-13.21% -5.07	0.25% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for GRINNELL REGIONAL 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	3,001,332 5,089,215	827,212 4,572,541	2,506,500 5,268,134	2,996,858 13,092,619	1,843,964 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,437,329 224,999	67,616 199,009	142,795 206,870.5	177,800 194,343	53,864 249,496
⊳ Line 7: Investments ? ⊳ Median	15,643 299,524	201,824 188,688.5	255,353 370,813	36,635 309,361.5	39,236 375,329
⊳ 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	163,295	158,026	140,287	117,657	108,495
⊳ 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	378	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	165,368	66,494	181,499	188,516	187,581
⊳ 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	1,219,697	333,252	1,786,188	2,476,250	1,454,788
Total income ? Median	-249,864 6,586,430	-4,533,587 6,767,106	1,233,017 8,419,950	-3,447,491 8,094,175	1,997,006 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	-249,864 6,043,842	-4,533,587 5,845,112	1,233,017 7,606,259	-3,447,491 7,283,041	1,997,006 14,957,241
Net margin Median	-0.47455% 4.62%	-9.34395% 4.42%	2.40205% 5.16%	-6.65713% 5.2%	3.18551% 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 GRINNELL REGIONAL 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	5,438,749 23,241,334	5,342,270 23,709,545	4,861,433 24,248,380	4,637,166 22,858,541	5,582,678 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	5,438,749 21,577,146	5,342,270 22,041,594	4,861,433 22,722,063	4,637,166 21,570,441	5,582,678 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	4,537,500 11,160,864	5,041,616 11,987,345	4,856,901 12,926,866	4,826,873 11,884,480	5,772,746 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	4,282,124 10,918,923	4,742,677 11,706,976	4,602,518 12,615,917	4,674,048 11,458,116	4,802,015 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	186,500 1,282,808	200,982 1,407,728	174,946 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	68,876 618,038	97,957 697,279	79,437 690,232	152,825 684,010	970,731 670,558
⊳ 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	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	114,559 582,572	196,120 538,116	25,598 212,434	53,301 126,559	43,668 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	131,361 3,662,910	1,387,993 3,730,911	1,869,716 4,081,319	2,000,140 4,643,908	1,803,272 4,389,147
Charity care Median	132,152 2,654,636	207,890 2,940,659	162,300 3,380,215	222,363 3,488,738	225,313 3,233,405
Uncompensated care (UCC) Median	827,729 5,147,790	918,709 5,337,617	873,829 5,711,082	778,184 5,923,418	879,820 5,508,107
UCC as a % of operating expenses Median	1.56% 3.24	1.73% 3.12	1.74% 3.21	1.41% 3.3	1.45% 2.86
Total shortfall/UCC Median	959,090 9,489,989	2,306,702 9,424,297	2,743,545 10,120,158	2,778,324 11,171,337	2,683,092 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	21,664,733 52,142,039	21,360,239 54,485,252	21,091,781 57,395,589	20,249,845 58,830,919	21,805,986 61,722,907
Salaries as a % of operating expenses Median	42.47 36.68	41.76 36.56	43.81 36.37	38.07 35.93	37.58 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	1,596,070 1,449,244	1,047,861 1,475,986	607,189 1,563,078	688,096 1,721,954	1,692,840 2,991,828
Contract hours, direct-care Median	20,871.00 22,725	14,640.00 23,018.5	7,326.00 24,503.48	9,798.00 25,026.5	13,063.00 33,786
Contract wages, direct-care Median	76.47 64.67	71.58 64.53	82.88 65.06	70.23 68.97	129.59 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.