As of the July, 2022, release via CMS

CITIZENS MEDICAL CENTER

CMS id: 190184
7939 HWY 165, COLUMBIA LA 71418. County: CALDWELL PARISH
System: --
CBSA: Rural Louisiana

The 40-bed, acute-care hospital had $-5,618,182 in net service to patients*, with a total profit margin of 14.68773% in fiscal year 2021, the latest year available.
It spent 4.58% of its operating expenses on uncompensated care and reported $444,227 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	gov
Acute beds Median	40 118	40 118	40 119.5	40 118	40 119
Total beds Median	40 162	40 162	40 162	40 162	40 163.5
FTEs Median	116.24 788.06	116.14 793.42	122.34 806.03	122.54 787.61	111.58 804.34

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	8,249,754 150,932,746	9,399,480 158,950,878	10,259,982 168,696,998	9,714,903 163,454,693	9,541,264 186,589,412
Operating expenses Median	13,613,215 149,311,209	13,314,958 156,110,414	14,097,277 164,890,568	15,642,134 166,516,854	15,159,446 180,120,888
Net income from service 2 patients (NS2P) ? Median	-5,363,461 -964,173	-3,915,478 -643,601.5	-3,837,295 -116,254	-5,927,231 -5,025,862	-5,618,182 -1,284,564
NS2P margin ? Median	-65.01% -0.62	-41.66% -0.29	-37.40% 0.18	-61.01% -5.07	-58.88% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CITIZENS 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	4,301,038 5,089,215	4,538,748 4,572,541	4,370,005 5,268,134	4,630,004 13,092,619	8,228,097 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	74,094 299,524	71,111 188,688.5	137,366 370,813	191,814 309,361.5	130,829 375,329
⊳ 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	14,000	11,277	11,578	42,808	37,052
⊳ 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	6,046	7,603	9,257	6,100	3,674
⊳ 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	0	0	0	0
⊳ Line 22: Rental of hospital space	21,000	21,000	1,570	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	4,185,898	4,427,757	4,210,234	4,389,282	8,056,542
Total income ? Median	-1,062,423 6,586,430	623,270 6,767,106	532,710 8,419,950	-1,297,227 8,094,175	2,609,915 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	-1,062,423 6,043,842	623,270 5,845,112	532,710 7,606,259	-1,297,227 7,283,041	2,609,915 14,957,241
Net margin Median	-8.46499% 4.62%	4.47166% 4.42%	3.64122% 5.16%	-9.04312% 5.2%	14.68773% 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 CITIZENS 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	1,857,774 23,241,334	2,477,202 23,709,545	2,290,028 24,248,380	1,773,147 22,858,541	2,193,013 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	1,857,774 21,577,146	2,477,202 22,041,594	2,290,028 22,722,063	1,773,147 21,570,441	2,193,013 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	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	1,198,517 11,160,864	1,140,608 11,987,345	1,261,012 12,926,866	1,407,280 11,884,480	1,266,984 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	841,718 10,918,923	774,339 11,706,976	898,787 12,615,917	942,945 11,458,116	649,492 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	356,799 618,038	366,269 697,279	362,225 690,232	464,335 684,010	617,492 670,558
⊳ 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	37,976 594,888	66,807 595,761	52,660 577,894	28,100 542,168	41,670 549,667
Outlier Median	59,367 582,572	781 538,116	0 212,434	0 126,559	234 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	444,227 4,389,147
Charity care Median	42,529 2,654,636	23,097 2,940,659	6,627 3,380,215	7,899 3,488,738	9,773 3,233,405
Uncompensated care (UCC) Median	799,731 5,147,790	595,892 5,337,617	530,735 5,711,082	233,707 5,923,418	694,175 5,508,107
UCC as a % of operating expenses Median	5.87% 3.24	4.48% 3.12	3.76% 3.21	1.49% 3.3	4.58% 2.86
Total shortfall/UCC Median	799,731 9,489,989	595,892 9,424,297	530,735 10,120,158	233,707 11,171,337	1,138,402 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	6,377,280 52,142,039	6,444,224 54,485,252	7,039,099 57,395,589	7,397,341 58,830,919	7,147,123 61,722,907
Salaries as a % of operating expenses Median	46.85 36.68	48.40 36.56	49.93 36.37	47.29 35.93	47.15 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

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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.