As of the July, 2022, release via CMS

CARY MEDICAL CENTER

CMS id: 200031
163 VAN BUREN ROAD STE 2, CARIBOU ME 4736. County: AROOSTOOK
System: --
CBSA: Rural Maine

The 58-bed, acute-care hospital had $-11,122,419 in net service to patients*, with a total profit margin of 1.50463% in fiscal year 2020, the latest year available.
It spent 2.55% of its operating expenses on uncompensated care and reported $2,389,745 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	--
Ownership	gov	gov	gov	gov	--
Acute beds Median	43 118	43 118	43 119.5	43 118	-- 119
Total beds Median	49 162	49 162	58 162	58 162	-- 163.5
FTEs Median	371.00 788.06	363.46 793.42	369.20 806.03	364.42 787.61	-- 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	47,306,641 150,932,746	52,391,172 158,950,878	55,819,002 168,696,998	48,143,891 163,454,693	-- 186,589,412
Operating expenses Median	52,386,442 149,311,209	55,943,616 156,110,414	59,273,456 164,890,568	59,266,310 166,516,854	-- 180,120,888
Net income from service 2 patients (NS2P) ? Median	-5,079,801 -964,173	-3,552,444 -643,601.5	-3,454,454 -116,254	-11,122,419 -5,025,862	-- -1,284,564
NS2P margin ? Median	-10.74% -0.62	-6.78% -0.29	-6.19% 0.18	-23.10% -5.07	--% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CARY 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	4,501,191 5,089,215	4,409,040 4,572,541	4,372,319 5,268,134	12,027,779 13,092,619	-- 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	31,999 224,999	45,144 199,009	24,879 206,870.5	39,322 194,343	-- 249,496
⊳ Line 7: Investments ? ⊳ Median	258 299,524	3,003 188,688.5	153,677 370,813	58,969 309,361.5	-- 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	147,381	157,378	154,097	234,392	--
⊳ Line 11: Rebates and refunds of expenses	21,343	14,574	16,001	14,925	--
⊳ Line 12: Parking lot receipts	0	0	0	0	--
⊳ Line 13: Revenue from laundry and linen service	19,434	22,795	26,962	14,694	--
⊳ Line 14: Revenue from meals sold to emplyees and guests	164,763	159,921	198,322	165,087	--
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	--
⊳ Line 16: Revenue from sale of medical and surgical supplies	8,930	-1,027	8,869	2,490	--
⊳ Line 17: Revenue from sale of drugs to other than patients	69,697	64,195	87,369	56,910	--
⊳ Line 18: Revenue from sale of medical records and abstracts	21,173	14,961	29,408	40,146	--
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	5,075	8,977	8,983	3,709	--
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	--
⊳ Line 21: Rental of vending machines	0	0	0	0	--
⊳ Line 22: Rental of hospital space	297,034	299,554	330,420	331,637	--
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	-- 1,597,664
⊳ Sum Line 24	3,714,104	3,619,565	3,333,332	11,065,498	--
Total income ? Median	-578,610 6,586,430	856,596 6,767,106	917,865 8,419,950	905,360 8,094,175	-- 15,162,888
Non-operating expenses Median	77,387 146,289.5	0 164,857	0 89,880.5	0 106,761	-- 31,473.5
Net income Median	-655,997 6,043,842	856,596 5,845,112	917,865 7,606,259	905,360 7,283,041	-- 14,957,241
Net margin Median	-1.26621% 4.62%	1.50809% 4.42%	1.52491% 5.16%	1.50463% 5.2%	--% 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 CARY 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	7,418,360 23,241,334	7,968,003 23,709,545	7,859,208 24,248,380	5,464,739 22,858,541	-- 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	7,418,360 21,577,146	7,968,003 22,041,594	7,859,208 22,722,063	5,464,739 21,570,441	-- 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	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	-- 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	-- 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Critical-access hospitals ⊳ Median	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	-- 1,179,746
All outpatient revenue Median Click here to show/hide details	5,615,798 11,160,864	7,232,903 11,987,345	7,009,419 12,926,866	6,840,949 11,884,480	-- 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	5,615,798 10,918,923	7,232,903 11,706,976	7,009,419 12,615,917	6,840,949 11,458,116	-- 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	-- 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	-- 670,558
⊳ Other federally qualified health clinics ⊳ Median	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	-- 3,508,953
Disproportionate-share hospital (DSH) Median	115,709 594,888	106,126 595,761	143,355 577,894	59,828 542,168	-- 549,667
Outlier Median	40,758 582,572	147,277 538,116	51,104 212,434	42,479 126,559	-- 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,095,466 3,662,910	737,227 3,730,911	6,379,502 4,081,319	2,389,745 4,643,908	-- 4,389,147
Charity care Median	2,028,081 2,654,636	1,324,143 2,940,659	666,990 3,380,215	344,742 3,488,738	-- 3,233,405
Uncompensated care (UCC) Median	3,408,763 5,147,790	2,478,344 5,337,617	1,854,592 5,711,082	1,512,679 5,923,418	-- 5,508,107
UCC as a % of operating expenses Median	6.51% 3.24	4.43% 3.12	3.13% 3.21	2.55% 3.3	--% 2.86
Total shortfall/UCC Median	5,504,229 9,489,989	3,215,571 9,424,297	8,234,094 10,120,158	3,902,424 11,171,337	-- 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	21,260,859 52,142,039	21,799,188 54,485,252	23,068,277 57,395,589	23,444,758 58,830,919	-- 61,722,907
Salaries as a % of operating expenses Median	40.52 36.68	38.97 36.56	38.90 36.37	39.56 35.93	-- 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	-- 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	-- 1,469,317
Contract adjusted salaries, direct-care Median	1,105,374 1,449,244	1,369,631 1,475,986	1,585,208 1,563,078	2,101,524 1,721,954	-- 2,991,828
Contract hours, direct-care Median	14,009.00 22,725	16,043.81 23,018.5	21,821.32 24,503.48	27,810.00 25,026.5	-- 33,786
Contract wages, direct-care Median	78.90 64.67	85.37 64.53	72.64 65.06	75.57 68.97	-- 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.