As of the July, 2022, release via CMS

HARLAN ARH

CMS id: 180050
81 BALL PARK ROAD, HARLAN KY 40831. County: HARLAN
System: APPALACHAIN REGIONAL HEALTHCARE
CBSA: Rural Kentucky

The 111-bed, acute-care hospital had $1,904,472 in net service to patients*, with a total profit margin of 28.90682% 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	63 118	66 118	74 119.5	74 118	74 119
Total beds Median	100 162	103 162	111 162	111 162	111 163.5
FTEs Median	383.64 788.06	456.78 793.42	457.20 806.03	429.57 787.61	412.26 804.34

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	67,489,150 150,932,746	77,957,973 158,950,878	82,174,472 168,696,998	78,544,680 163,454,693	78,323,043 186,589,412
Operating expenses Median	59,987,887 149,311,209	69,316,282 156,110,414	72,297,334 164,890,568	71,748,005 166,516,854	76,418,571 180,120,888
Net income from service 2 patients (NS2P) ? Median	7,501,263 -964,173	8,641,691 -643,601.5	9,877,138 -116,254	6,796,675 -5,025,862	1,904,472 -1,284,564
NS2P margin ? Median	11.11% -0.62	11.09% -0.29	12.02% 0.18	8.65% -5.07	2.43% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HARLAN 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	6,621,495 5,089,215	6,953,033 4,572,541	4,059,475 5,268,134	9,896,307 13,092,619	29,167,672 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	187,590 188,688.5	158,001 370,813	167,167 309,361.5	254,587 375,329
⊳ 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	49,658	41,221	54,602	42,951
⊳ 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	223,860	227,422	198,920	145,637
⊳ Line 15: Revenue from rental of living quarters	0	87,302	83,469	25,202	39,302
⊳ 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	13,639	9,082	10,281	6,859
⊳ 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	6,621,495	6,390,984	3,540,280	9,440,135	28,678,336
Total income ? Median	14,122,758 6,586,430	15,594,724 6,767,106	13,936,613 8,419,950	16,692,982 8,094,175	31,072,144 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	14,122,758 6,043,842	15,594,724 5,845,112	13,936,613 7,606,259	16,692,982 7,283,041	31,072,144 14,957,241
Net margin Median	19.05632% 4.62%	18.36596% 4.42%	16.16140% 5.16%	18.87471% 5.2%	28.90682% 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 HARLAN 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	12,503,264 23,241,334	11,478,461 23,709,545	12,011,513 24,248,380	10,832,719 22,858,541	11,463,169 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	10,819,735 21,577,146	10,198,442 22,041,594	10,631,496 22,722,063	9,344,364 21,570,441	10,461,831 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	1,683,529 1,845,420	1,280,019 1,757,392	1,380,017 1,738,842	1,488,355 1,510,463	1,001,338 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	6,529,577 11,160,864	7,859,889 11,987,345	7,509,565 12,926,866	7,021,016 11,884,480	6,195,834 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	6,527,756 10,918,923	6,951,690 11,706,976	6,108,588 12,615,917	5,750,724 11,458,116	5,094,141 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	1,821 618,038	908,199 697,279	1,400,977 690,232	1,270,292 684,010	1,101,693 670,558
⊳ 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	151,605 3,360,806	466,013 3,508,953
Disproportionate-share hospital (DSH) Median	655,371 594,888	562,530 595,761	585,407 577,894	532,589 542,168	517,908 549,667
Outlier Median	84,649 582,572	69,741 538,116	251,839 212,434	15,059 126,559	1,373 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	233,205 4,643,908	0 4,389,147
Charity care Median	661,122 2,654,636	373,281 2,940,659	660,805 3,380,215	416,637 3,488,738	319,648 3,233,405
Uncompensated care (UCC) Median	1,552,031 5,147,790	1,397,654 5,337,617	1,393,271 5,711,082	1,245,340 5,923,418	1,229,958 5,508,107
UCC as a % of operating expenses Median	2.59% 3.24	2.02% 3.12	1.93% 3.21	1.74% 3.3	1.61% 2.86
Total shortfall/UCC Median	1,552,031 9,489,989	1,397,654 9,424,297	1,393,271 10,120,158	1,478,545 11,171,337	1,229,958 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	18,778,563 52,142,039	27,082,224 54,485,252	27,662,149 57,395,589	26,711,807 58,830,919	27,349,859 61,722,907
Salaries as a % of operating expenses Median	31.30 36.68	39.07 36.56	38.26 36.37	37.23 35.93	35.79 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	185,025 1,279,653	749,134 1,469,317
Contract adjusted salaries, direct-care Median	1,083,843 1,449,244	710,945 1,475,986	459,471 1,563,078	2,986,359 1,721,954	2,475,821 2,991,828
Contract hours, direct-care Median	15,665.00 22,725	10,511.46 23,018.5	7,758.00 24,503.48	47,552.00 25,026.5	41,237.30 33,786
Contract wages, direct-care Median	69.19 64.67	67.64 64.53	59.23 65.06	62.80 68.97	60.04 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.