As of the July, 2022, release via CMS

KINGS DAUGHTERS MEDICAL CENTER

CMS id: 180009
2201 LEXINGTON AVENUE, ASHLAND KY 41101. County: BOYD
System: --
CBSA: Huntington-Ashland, WV-KY-OH

The 387-bed, acute-care hospital had $-33,401,576 in net service to patients*, with a total profit margin of 20.12921% in fiscal year 2021, the latest year available.
It spent 1.57% of its operating expenses on uncompensated care and reported $20,241,925 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	388 118	388 118	389 119.5	292 118	292 119
Total beds Median	486 162	486 162	465 162	387 162	387 163.5
FTEs Median	2,723.32 788.06	2,659.19 793.42	2,719.00 806.03	2,725.33 787.61	3,321.59 804.34

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	371,783,536 150,932,746	378,377,704 158,950,878	390,642,893 168,696,998	422,928,086 163,454,693	538,885,731 186,589,412
Operating expenses Median	399,707,391 149,311,209	394,604,205 156,110,414	404,414,356 164,890,568	433,718,624 166,516,854	572,287,307 180,120,888
Net income from service 2 patients (NS2P) ? Median	-27,923,855 -964,173	-16,226,501 -643,601.5	-13,771,463 -116,254	-10,790,538 -5,025,862	-33,401,576 -1,284,564
NS2P margin ? Median	-7.51% -0.62	-4.29% -0.29	-3.53% 0.18	-2.55% -5.07	-6.20% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for KINGS DAUGHTERS 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	39,291,692 5,089,215	27,272,067 4,572,541	29,734,190 5,268,134	43,798,083 13,092,619	178,069,476 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	25 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	19,355,291 299,524	6,110,318 188,688.5	681,331 370,813	6,168,033 309,361.5	33,409,684 375,329
⊳ 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	2,238,204	2,262,841	2,327,183	1,865,632	0
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	1,789,295
⊳ 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	54,095	44,440	34,175	60,465	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	72,597
⊳ 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	1,261,566	1,253,915	984,099	1,212,195	0
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	1,227,300 1,597,664
⊳ Sum Line 24	16,382,511	17,600,553	25,707,402	34,491,758	141,570,600
Total income ? Median	11,367,837 6,586,430	11,045,566 6,767,106	15,962,727 8,419,950	33,007,545 8,094,175	144,667,900 15,162,888
Non-operating expenses Median	418,280 146,289.5	3,129 164,857	-68,598 89,880.5	517,557 106,761	350,492 31,473.5
Net income Median	10,949,557 6,043,842	11,042,437 5,845,112	16,031,325 7,606,259	32,489,988 7,283,041	144,317,408 14,957,241
Net margin Median	2.66364% 4.62%	2.72216% 4.42%	3.81356% 5.16%	6.96125% 5.2%	20.12921% 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 KINGS DAUGHTERS 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	66,353,552 23,241,334	64,863,353 23,709,545	62,673,708 24,248,380	59,014,943 22,858,541	66,405,444 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	64,548,749 21,577,146	63,124,222 22,041,594	61,028,897 22,722,063	58,341,439 21,570,441	66,403,738 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	1,804,803 1,203,033	1,739,131 1,215,295	1,644,811 1,313,657	673,504 1,365,298	1,706 1,179,746
All outpatient revenue Median Click here to show/hide details	54,382,548 11,160,864	58,337,342 11,987,345	57,671,232 12,926,866	49,576,006 11,884,480	55,011,707 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	52,902,233 10,918,923	56,552,312 11,706,976	56,034,868 12,615,917	47,685,062 11,458,116	51,770,354 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,480,315 1,282,808	1,785,030 1,407,728	1,636,364 1,341,512	1,890,944 1,407,046	3,241,353 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	2,868,321 594,888	2,990,954 595,761	2,835,732 577,894	2,940,297 542,168	3,031,465 549,667
Outlier Median	2,232,922 582,572	1,574,048 538,116	396,803 212,434	260,559 126,559	294,181 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	15,866,441 3,662,910	16,822,991 3,730,911	10,112,311 4,081,319	17,612,927 4,643,908	20,241,925 4,389,147
Charity care Median	3,561,256 2,654,636	3,403,720 2,940,659	3,124,434 3,380,215	3,498,318 3,488,738	3,876,751 3,233,405
Uncompensated care (UCC) Median	9,453,429 5,147,790	8,662,748 5,337,617	8,708,469 5,711,082	9,856,293 5,923,418	8,971,863 5,508,107
UCC as a % of operating expenses Median	2.37% 3.24	2.20% 3.12	2.15% 3.21	2.27% 3.3	1.57% 2.86
Total shortfall/UCC Median	25,319,870 9,489,989	25,485,739 9,424,297	18,820,780 10,120,158	27,469,220 11,171,337	29,213,788 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	149,592,954 52,142,039	141,165,595 54,485,252	147,667,752 57,395,589	161,078,230 58,830,919	208,850,513 61,722,907
Salaries as a % of operating expenses Median	37.66 36.68	35.99 36.56	36.71 36.37	37.31 35.93	36.54 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	333,500 1,449,244	1,032,397 1,475,986	2,528 1,563,078	0 1,721,954	13,865,591 2,991,828
Contract hours, direct-care Median	4,824.00 22,725	14,951.30 23,018.5	27.30 24,503.48	0.00 25,026.5	110,788.41 33,786
Contract wages, direct-care Median	69.13 64.67	69.05 64.53	92.60 65.06	0.00 68.97	125.15 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.