As of the July, 2022, release via CMS

ROCKCASTLE HOSPT. & RESPIR CARE CTR

CMS id: 180115
145 NEWCOMB AVENUE, MT VERNON KY 40456. County: ROCKCASTLE
System: --
CBSA: Rural Kentucky

The 173-bed, acute-care hospital had $449,123 in net service to patients*, with a total profit margin of 3.96192% in fiscal year 2021, the latest year available.
It spent 0.91% of its operating expenses on uncompensated care and reported $1,516,851 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	20 118	20 118	20 119.5	30 118	26 119
Total beds Median	147 162	147 162	163 162	173 162	173 163.5
FTEs Median	677.75 788.06	698.64 793.42	719.50 806.03	691.82 787.61	683.96 804.34

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	57,147,742 150,932,746	64,812,386 158,950,878	69,691,495 168,696,998	68,263,702 163,454,693	74,378,769 186,589,412
Operating expenses Median	56,958,393 149,311,209	63,980,362 156,110,414	69,182,797 164,890,568	68,860,880 166,516,854	73,929,646 180,120,888
Net income from service 2 patients (NS2P) ? Median	189,349 -964,173	832,024 -643,601.5	508,698 -116,254	-597,178 -5,025,862	449,123 -1,284,564
NS2P margin ? Median	0.33% -0.62	1.28% -0.29	0.73% 0.18	-0.87% -5.07	0.60% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ROCKCASTLE HOSPT. & RESPIR CARE 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	2,515,212 5,089,215	2,500,706 4,572,541	3,955,746 5,268,134	9,198,441 13,092,619	2,600,747 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	184,267 224,999	124,971 199,009	178,736 206,870.5	51,170 194,343	42,026 249,496
⊳ Line 7: Investments ? ⊳ Median	159,334 299,524	213,471 188,688.5	247,350 370,813	167,165 309,361.5	87,779 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	117,561	143,696	176,420	180,860	181,223
⊳ 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	216,519	254,644	256,253	212,106	169,178
⊳ 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	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	13,630	14,702	10,534	10,388	6,503
⊳ 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	104,956	91,154	84,234	66,390	57,214
⊳ Line 22: Rental of hospital space	42,722	45,852	103,827	124,152	119,325
⊳ 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	1,676,223	1,612,216	2,898,392	8,386,210	1,937,499
Total income ? Median	2,704,561 6,586,430	3,332,730 6,767,106	4,464,444 8,419,950	8,601,263 8,094,175	3,049,870 15,162,888
Non-operating expenses Median	2,054 146,289.5	92 164,857	0 89,880.5	3 106,761	3 31,473.5
Net income Median	2,702,507 6,043,842	3,332,638 5,845,112	4,464,444 7,606,259	8,601,260 7,283,041	3,049,867 14,957,241
Net margin Median	4.52962% 4.62%	4.95095% 4.42%	6.06193% 5.16%	11.10382% 5.2%	3.96192% 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 ROCKCASTLE HOSPT. & RESPIR CARE 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	5,230,576 23,241,334	6,205,873 23,709,545	4,270,371 24,248,380	7,082,487 22,858,541	6,076,590 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	3,333,949 21,577,146	3,807,476 22,041,594	2,898,045 22,722,063	3,556,310 21,570,441	3,961,087 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	1,896,627 1,203,033	2,398,397 1,215,295	1,372,326 1,313,657	3,526,177 1,365,298	2,115,503 1,179,746
All outpatient revenue Median Click here to show/hide details	5,404,545 11,160,864	5,893,812 11,987,345	6,427,377 12,926,866	5,805,795 11,884,480	5,452,277 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	2,961,857 10,918,923	2,912,637 11,706,976	3,447,661 12,615,917	3,386,997 11,458,116	3,251,701 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	2,442,688 618,038	2,981,175 697,279	2,979,716 690,232	2,418,798 684,010	2,200,576 670,558
⊳ 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	83,132 594,888	100,666 595,761	56,663 577,894	129,429 542,168	123,680 549,667
Outlier Median	25,778 582,572	53,217 538,116	0 212,434	2,717 126,559	3,434 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	773,255 3,662,910	866,442 3,730,911	2,215,372 4,081,319	2,077,215 4,643,908	1,516,851 4,389,147
Charity care Median	0 2,654,636	0 2,940,659	12,279 3,380,215	0 3,488,738	0 3,233,405
Uncompensated care (UCC) Median	643,444 5,147,790	537,981 5,337,617	778,890 5,711,082	729,854 5,923,418	670,814 5,508,107
UCC as a % of operating expenses Median	1.13% 3.24	0.84% 3.12	1.13% 3.21	1.06% 3.3	0.91% 2.86
Total shortfall/UCC Median	1,416,699 9,489,989	1,404,423 9,424,297	2,994,262 10,120,158	2,807,069 11,171,337	2,187,665 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	27,448,561 52,142,039	31,860,436 54,485,252	34,757,744 57,395,589	34,053,993 58,830,919	34,754,893 61,722,907
Salaries as a % of operating expenses Median	48.19 36.68	49.80 36.56	50.24 36.37	49.45 35.93	47.01 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	0 1,449,244	0 1,475,986	0 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	0.00 22,725	0.00 23,018.5	0.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	0.00 64.67	0.00 64.53	0.00 65.06	0.00 68.97	0.00 88.94

* in an approved program

Return to top

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.