As of the July, 2022, release via CMS

THE MEDICAL CENTER

CMS id: 180013
250 PARK STREET, BOWLING GREEN KY 42102. County: WARREN
System: MED CENTER HEALTH
CBSA: Bowling Green, KY

The 316-bed, acute-care hospital had $13,946,986 in net service to patients*, with a total profit margin of 14.42389% in fiscal year 2021, the latest year available.
It spent 1.45% of its operating expenses on uncompensated care and reported $0 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	nfp
Acute beds Median	258 118	260 118	260 119.5	260 118	260 119
Total beds Median	314 162	316 162	316 162	316 162	316 163.5
FTEs Median	1,798.82 788.06	1,925.33 793.42	1,823.72 806.03	1,838.24 787.61	1,748.99 804.34

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	299,444,410 150,932,746	305,100,397 158,950,878	345,723,941 168,696,998	374,621,338 163,454,693	400,769,565 186,589,412
Operating expenses Median	311,487,301 149,311,209	318,810,938 156,110,414	315,565,129 164,890,568	353,956,754 166,516,854	386,822,579 180,120,888
Net income from service 2 patients (NS2P) ? Median	-12,042,891 -964,173	-13,710,541 -643,601.5	30,158,812 -116,254	20,664,584 -5,025,862	13,946,986 -1,284,564
NS2P margin ? Median	-4.02% -0.62	-4.49% -0.29	8.72% 0.18	5.52% -5.07	3.48% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for THE 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	38,484,594 5,089,215	44,822,783 4,572,541	30,657,492 5,268,134	21,635,057 13,092,619	51,252,131 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	-641,536 199,009	-478,920 206,870.5	-625,049 194,343	-74,641 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	12,449,080 188,688.5	11,136,672 370,813	0 309,361.5	0 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	91,701	104,518	113,392	97,608
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	0	12,377	8,989	5,281	1,045
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	1,193,167	1,234,157	1,268,409	936,538
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	1,357,294	1,378,319	214,142	14,428
⊳ Line 17: Revenue from sale of drugs to other than patients	0	13,345,603	6,035,007	7,248,989	6,953,902
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	4,897
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	5,600	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	5,999	0	23,678	9,838
⊳ Line 22: Rental of hospital space	0	3,518,595	4,074,150	3,851,075	4,380,981
⊳ 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	38,484,594	13,490,503	7,164,600	9,529,540	38,927,535
Total income ? Median	26,441,703 6,586,430	31,112,242 6,767,106	60,816,304 8,419,950	42,299,641 8,094,175	65,199,117 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	20,903,626 89,880.5	0 106,761	0 31,473.5
Net income Median	26,441,703 6,043,842	31,112,242 5,845,112	39,912,678 7,606,259	42,299,641 7,283,041	65,199,117 14,957,241
Net margin Median	7.82463% 4.62%	8.89116% 4.42%	10.60432% 5.16%	10.67482% 5.2%	14.42389% 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 THE 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	67,606,340 23,241,334	68,843,323 23,709,545	69,877,889 24,248,380	65,237,625 22,858,541	62,035,043 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	66,345,291 21,577,146	67,600,132 22,041,594	68,476,418 22,722,063	64,128,491 21,570,441	61,372,201 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	1,261,049 1,845,420	1,243,191 1,757,392	1,401,471 1,738,842	1,109,134 1,510,463	662,842 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	26,076,711 11,160,864	26,623,086 11,987,345	27,703,910 12,926,866	28,111,321 11,884,480	25,899,596 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	24,200,261 10,918,923	24,844,864 11,706,976	25,827,025 12,615,917	26,435,986 11,458,116	24,718,218 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,876,450 1,282,808	1,778,222 1,407,728	1,876,885 1,341,512	1,675,335 1,407,046	1,181,378 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	1,634,088 3,284,314	3,023,567 3,250,551	4,409,220 3,386,837	6,606,321 3,360,806	7,427,448 3,508,953
Disproportionate-share hospital (DSH) Median	2,851,694 594,888	2,703,761 595,761	2,619,694 577,894	2,393,270 542,168	2,241,681 549,667
Outlier Median	1,134,903 582,572	679,646 538,116	1,043,128 212,434	100,698 126,559	192,432 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	15,969,579 3,662,910	12,490,376 3,730,911	10,517,679 4,081,319	862,327 4,643,908	0 4,389,147
Charity care Median	1,624,540 2,654,636	2,585,013 2,940,659	2,508,556 3,380,215	3,009,909 3,488,738	1,421,465 3,233,405
Uncompensated care (UCC) Median	6,193,934 5,147,790	8,725,121 5,337,617	8,960,276 5,711,082	7,708,850 5,923,418	5,621,615 5,508,107
UCC as a % of operating expenses Median	1.99% 3.24	2.74% 3.12	2.84% 3.21	2.18% 3.3	1.45% 2.86
Total shortfall/UCC Median	22,163,513 9,489,989	21,215,497 9,424,297	19,477,955 10,120,158	8,571,177 11,171,337	5,621,615 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	92,428,031 52,142,039	96,626,789 54,485,252	98,862,454 57,395,589	103,072,606 58,830,919	101,053,798 61,722,907
Salaries as a % of operating expenses Median	29.67 36.68	30.31 36.56	29.38 36.37	29.12 35.93	26.12 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	1,602,069 1,204,885	3,663,571 1,279,653	4,751,935 1,469,317
Contract adjusted salaries, direct-care Median	1,725,612 1,449,244	1,353,204 1,475,986	3,397,557 1,563,078	5,587,172 1,721,954	16,017,532 2,991,828
Contract hours, direct-care Median	20,386.94 22,725	15,252.20 23,018.5	68,600.45 24,503.48	129,229.12 25,026.5	224,660.40 33,786
Contract wages, direct-care Median	84.64 64.67	88.72 64.53	49.53 65.06	43.23 68.97	71.30 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.