As of the July, 2022, release via CMS

EPHRAIM MCDOWELL REG MED CTR

CMS id: 180048
217 3RD STREET, DANVILLE KY 40422. County: BOYLE
System: EPHRIAM MCDOWELL HEALTH INC
CBSA: Danville, KY

The 164-bed, acute-care hospital had $-15,565,224 in net service to patients*, with a total profit margin of 11.49373% in fiscal year 2021, the latest year available.
It spent 1.51% 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	forprofit	nfp	nfp	nfp	nfp
Acute beds Median	148 118	148 118	148 119.5	120 118	130 119
Total beds Median	222 162	222 162	222 162	150 162	164 163.5
FTEs Median	912.54 788.06	1,020.94 793.42	944.29 806.03	910.61 787.61	1,019.11 804.34

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	157,102,993 150,932,746	159,965,997 158,950,878	173,035,750 168,696,998	177,649,034 163,454,693	194,098,891 186,589,412
Operating expenses Median	157,149,075 149,311,209	171,283,389 156,110,414	178,200,428 164,890,568	178,627,047 166,516,854	209,664,115 180,120,888
Net income from service 2 patients (NS2P) ? Median	-46,082 -964,173	-11,317,392 -643,601.5	-5,164,678 -116,254	-978,013 -5,025,862	-15,565,224 -1,284,564
NS2P margin ? Median	-0.03% -0.62	-7.07% -0.29	-2.98% 0.18	-0.55% -5.07	-8.02% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for EPHRAIM MCDOWELL REG MED CTR 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	17,536,714 5,089,215	11,707,609 4,572,541	14,699,970 5,268,134	17,312,519 13,092,619	42,792,925 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	33,645 299,524	71,367 188,688.5	56,015 370,813	57,025 309,361.5	37,765 375,329
⊳ 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	718,318	697,033	710,426	533,984	510,981
⊳ 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	3,801,985	0	186,064	938,472	2,215,146
⊳ Line 18: Revenue from sale of medical records and abstracts	578	496	317	-267	194
⊳ 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	19,024	18,781	20,341	16,669	11,310
⊳ Line 22: Rental of hospital space	30,951	13,406	6,790	248,778	613,528
⊳ 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	12,932,213	10,906,526	13,720,017	15,517,858	39,404,001
Total income ? Median	17,490,632 6,586,430	390,217 6,767,106	9,535,292 8,419,950	16,334,506 8,094,175	27,227,701 15,162,888
Non-operating expenses Median	0 146,289.5	-168 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	17,490,632 6,043,842	390,385 5,845,112	9,535,292 7,606,259	16,334,506 7,283,041	27,227,701 14,957,241
Net margin Median	10.01527% 4.62%	0.22740% 4.42%	5.07910% 5.16%	8.37832% 5.2%	11.49373% 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 EPHRAIM MCDOWELL REG MED CTR 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	29,489,365 23,241,334	28,407,684 23,709,545	30,207,718 24,248,380	26,653,509 22,858,541	26,062,880 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	28,286,115 21,577,146	27,340,235 22,041,594	29,247,519 22,722,063	25,737,069 21,570,441	25,093,112 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	1,155,538 1,845,420	1,067,449 1,757,392	960,199 1,738,842	916,440 1,510,463	969,768 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	47,712 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	23,055,906 11,160,864	23,612,929 11,987,345	25,565,369 12,926,866	24,525,737 11,884,480	24,487,007 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	22,872,260 10,918,923	23,622,034 11,706,976	25,565,369 12,615,917	24,525,737 11,458,116	24,487,007 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	183,646 618,038	-9,105 697,279	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	1,113,082 594,888	951,501 595,761	1,200,147 577,894	1,087,230 542,168	914,918 549,667
Outlier Median	456,476 582,572	512,793 538,116	89,064 212,434	115,397 126,559	101,591 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	10,596,782 3,662,910	3,310,285 3,730,911	5,599,606 4,081,319	5,445,777 4,643,908	0 4,389,147
Charity care Median	1,704,561 2,654,636	1,313,671 2,940,659	1,526,884 3,380,215	1,342,592 3,488,738	847,799 3,233,405
Uncompensated care (UCC) Median	3,912,971 5,147,790	3,973,969 5,337,617	4,247,757 5,711,082	3,947,781 5,923,418	3,159,270 5,508,107
UCC as a % of operating expenses Median	2.49% 3.24	2.32% 3.12	2.38% 3.21	2.21% 3.3	1.51% 2.86
Total shortfall/UCC Median	14,509,753 9,489,989	7,284,254 9,424,297	9,847,363 10,120,158	9,393,558 11,171,337	3,159,270 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	48,472,308 52,142,039	60,804,973 54,485,252	63,821,107 57,395,589	63,968,778 58,830,919	72,670,469 61,722,907
Salaries as a % of operating expenses Median	32.27 36.68	35.50 36.56	35.81 36.37	35.81 35.93	34.66 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	56,516 1,449,244	0 1,475,986	136,544 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	1,168.95 22,725	0.00 23,018.5	1,845.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	48.35 64.67	0.00 64.53	74.01 65.06	0.00 68.97	0.00 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.