As of the July, 2022, release via CMS

HAZARD ARH

CMS id: 180029
100 MEDICAL CENTER DR, HAZARD KY 41701. County: PERRY
System: APPALACHAIN REGIONAL HEALTHCARE
CBSA: Rural Kentucky

The 300-bed, acute-care hospital had $12,867,049 in net service to patients*, with a total profit margin of 25.90586% in fiscal year 2021, the latest year available.
It spent 1.61% 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	nfp	nfp	nfp	nfp	nfp
Acute beds Median	180 118	197 118	197 119.5	197 118	198 119
Total beds Median	322 162	349 162	349 162	349 162	300 163.5
FTEs Median	1,008.62 788.06	1,017.89 793.42	1,108.09 806.03	1,120.04 787.61	1,035.25 804.34

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	168,417,180 150,932,746	188,694,077 158,950,878	228,975,267 168,696,998	217,778,609 163,454,693	241,254,152 186,589,412
Operating expenses Median	198,563,844 149,311,209	209,370,969 156,110,414	228,553,248 164,890,568	223,852,791 166,516,854	228,387,103 180,120,888
Net income from service 2 patients (NS2P) ? Median	-30,146,664 -964,173	-20,676,892 -643,601.5	422,019 -116,254	-6,074,182 -5,025,862	12,867,049 -1,284,564
NS2P margin ? Median	-17.90% -0.62	-10.96% -0.29	0.18% 0.18	-2.79% -5.07	5.33% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HAZARD ARH 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	49,509,037 5,089,215	44,650,674 4,572,541	17,080,133 5,268,134	34,552,563 13,092,619	66,984,919 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	509,724 188,688.5	438,226 370,813	463,649 309,361.5	717,506 375,329
⊳ 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	139,549	206,665	190,581	50,245
⊳ 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	289,034	281,409	253,756	181,087
⊳ Line 15: Revenue from rental of living quarters	0	177,770	181,826	180,049	180,049
⊳ 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	39,132	45,064	52,361	27,611
⊳ 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	49,509,037	43,495,465	15,926,943	33,412,167	65,828,421
Total income ? Median	19,362,373 6,586,430	23,973,782 6,767,106	17,502,152 8,419,950	28,478,381 8,094,175	79,851,968 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	19,362,373 6,043,842	23,973,782 5,845,112	17,502,152 7,606,259	28,478,381 7,283,041	79,851,968 14,957,241
Net margin Median	8.88483% 4.62%	10.27398% 4.42%	7.11309% 5.16%	11.28611% 5.2%	25.90586% 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 HAZARD ARH 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	47,625,363 23,241,334	50,773,436 23,709,545	48,658,336 24,248,380	42,289,142 22,858,541	39,006,426 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	39,488,915 21,577,146	42,978,754 22,041,594	41,033,394 22,722,063	36,387,818 21,570,441	33,219,898 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	3,678,295 1,845,420	3,078,488 1,757,392	3,610,935 1,738,842	2,446,544 1,510,463	2,241,105 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	4,458,153 3,535,627	4,716,194 3,746,588	4,014,007 3,782,288	3,454,780 3,865,578	3,545,423 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	19,084,597 11,160,864	19,063,509 11,987,345	17,922,164 12,926,866	16,733,862 11,884,480	14,989,432 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	19,084,597 10,918,923	19,063,509 11,706,976	17,922,164 12,615,917	16,733,862 11,458,116	14,989,432 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	728,549 3,284,314	721,493 3,250,551	671,035 3,386,837	625,866 3,360,806	605,951 3,508,953
Disproportionate-share hospital (DSH) Median	2,142,038 594,888	2,372,355 595,761	2,276,826 577,894	1,998,222 542,168	1,711,770 549,667
Outlier Median	613,184 582,572	874,101 538,116	948,028 212,434	41,018 126,559	159,140 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	10,211,653 3,662,910	5,575,443 3,730,911	8,832,379 4,081,319	4,722,118 4,643,908	0 4,389,147
Charity care Median	1,886,772 2,654,636	980,243 2,940,659	1,203,958 3,380,215	716,618 3,488,738	633,314 3,233,405
Uncompensated care (UCC) Median	5,412,527 5,147,790	4,285,301 5,337,617	3,588,045 5,711,082	3,208,325 5,923,418	3,666,885 5,508,107
UCC as a % of operating expenses Median	2.73% 3.24	2.05% 3.12	1.57% 3.21	1.43% 3.3	1.61% 2.86
Total shortfall/UCC Median	15,624,180 9,489,989	9,860,744 9,424,297	12,420,424 10,120,158	7,930,443 11,171,337	3,666,885 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	55,243,506 52,142,039	57,123,992 54,485,252	62,501,687 57,395,589	65,190,203 58,830,919	68,730,650 61,722,907
Salaries as a % of operating expenses Median	27.82 36.68	27.28 36.56	27.35 36.37	29.12 35.93	30.09 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	662,756 1,251,927	737,161 1,186,494	662,756 1,204,885	701,037 1,279,653	943,288 1,469,317
Contract adjusted salaries, direct-care Median	15,553,708 1,449,244	16,459,422 1,475,986	24,211,521 1,563,078	20,613,144 1,721,954	17,861,741 2,991,828
Contract hours, direct-care Median	228,726.54 22,725	236,718.00 23,018.5	394,396.43 24,503.48	314,456.22 25,026.5	249,633.93 33,786
Contract wages, direct-care Median	68.00 64.67	69.53 64.53	61.39 65.06	65.55 68.97	71.55 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.