As of the July, 2022, release via CMS

CAPE COD HOSPITAL

CMS id: 220012
27 PARK STREET, HYANNIS MA 2601. County: BARNSTABLE
System: CAPE COD HEALTHCARE
CBSA: Barnstable Town, MA

The 259-bed, acute-care hospital had $9,262,292 in net service to patients*, with a total profit margin of 5.77649% in fiscal year 2021, the latest year available.
It spent 1.29% of its operating expenses on uncompensated care and reported $14,590,372 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	215 118	215 118	215 119.5	215 118	215 119
Total beds Median	259 162	259 162	259 162	259 162	259 163.5
FTEs Median	1,988.02 788.06	1,665.13 793.42	2,105.52 806.03	0.00 787.61	2,014.97 804.34

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	526,713,036 150,932,746	553,509,082 158,950,878	589,085,023 168,696,998	529,773,925 163,454,693	578,303,638 186,589,412
Operating expenses Median	493,352,766 149,311,209	524,353,876 156,110,414	554,373,386 164,890,568	548,287,812 166,516,854	569,041,346 180,120,888
Net income from service 2 patients (NS2P) ? Median	33,360,270 -964,173	29,155,206 -643,601.5	34,711,637 -116,254	-18,513,887 -5,025,862	9,262,292 -1,284,564
NS2P margin ? Median	6.33% -0.62	5.27% -0.29	5.89% 0.18	-3.49% -5.07	1.60% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CAPE COD HOSPITAL 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	14,012,332 5,089,215	18,935,612 4,572,541	21,153,327 5,268,134	46,075,325 13,092,619	27,379,047 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	4,579,419 249,496
⊳ Line 7: Investments ? ⊳ Median	1,079,649 299,524	940,362 188,688.5	967,525 370,813	997,653 309,361.5	22,836,681 375,329
⊳ 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	1,260,247	1,465,099	1,410,543	1,045,791	192,589
⊳ 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	59,518	60,094	63,116	67,142	42,517
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	134,105	138,739	83,050	39,075	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	1,460,832	1,515,895	1,428,049	1,343,213	1,269,438
⊳ 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	10,017,981	14,815,423	17,201,044	42,582,451	-1,541,597
Total income ? Median	47,372,602 6,586,430	48,090,818 6,767,106	55,864,964 8,419,950	27,561,438 8,094,175	36,641,339 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	1,654,109 31,473.5
Net income Median	47,372,602 6,043,842	48,090,818 5,845,112	55,864,964 7,606,259	27,561,438 7,283,041	34,987,230 14,957,241
Net margin Median	8.76094% 4.62%	8.40095% 4.42%	9.15461% 5.16%	4.78622% 5.2%	5.77649% 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 CAPE COD HOSPITAL 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	139,991,519 23,241,334	151,055,575 23,709,545	159,211,095 24,248,380	140,060,483 22,858,541	144,782,079 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	136,805,935 21,577,146	148,210,842 22,041,594	156,669,990 22,722,063	137,699,723 21,570,441	142,401,936 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	3,185,584 1,845,420	2,844,733 1,757,392	2,541,105 1,738,842	2,360,760 1,510,463	2,380,143 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	77,364,218 11,160,864	86,964,662 11,987,345	93,613,241 12,926,866	82,003,848 11,884,480	91,779,841 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	77,364,218 10,918,923	86,964,662 11,706,976	93,613,241 12,615,917	82,003,848 11,458,116	91,779,841 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	0 618,038	0 697,279	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	905,048 3,284,314	1,002,946 3,250,551	1,052,500 3,386,837	939,996 3,360,806	961,033 3,508,953
Disproportionate-share hospital (DSH) Median	971,044 594,888	1,195,754 595,761	1,130,519 577,894	1,397,510 542,168	1,106,753 549,667
Outlier Median	7,200,308 582,572	3,799,856 538,116	1,106,234 212,434	1,016,625 126,559	1,570,006 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,853,264 3,662,910	10,307,130 3,730,911	12,103,128 4,081,319	11,415,305 4,643,908	14,590,372 4,389,147
Charity care Median	3,446,968 2,654,636	5,439,590 2,940,659	4,985,920 3,380,215	6,813,814 3,488,738	4,453,718 3,233,405
Uncompensated care (UCC) Median	6,584,480 5,147,790	9,560,507 5,337,617	9,814,158 5,711,082	10,661,564 5,923,418	7,321,568 5,508,107
UCC as a % of operating expenses Median	1.33% 3.24	1.82% 3.12	1.77% 3.21	1.94% 3.3	1.29% 2.86
Total shortfall/UCC Median	11,437,744 9,489,989	19,867,637 9,424,297	21,917,286 10,120,158	22,076,869 11,171,337	21,911,940 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	182,765,016 52,142,039	196,469,528 54,485,252	212,793,766 57,395,589	207,314,424 58,830,919	211,300,949 61,722,907
Salaries as a % of operating expenses Median	37.05 36.68	37.47 36.56	38.38 36.37	38.63 35.93	37.13 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	387,001 1,251,927	328,361 1,186,494	475,175 1,204,885	478,052 1,279,653	420,183 1,469,317
Contract adjusted salaries, direct-care Median	5,843,276 1,449,244	0 1,475,986	0 1,563,078	10,872,795 1,721,954	13,253,943 2,991,828
Contract hours, direct-care Median	94,496.00 22,725	0.00 23,018.5	0.00 24,503.48	164,438.00 25,026.5	164,357.00 33,786
Contract wages, direct-care Median	61.84 64.67	0.00 64.53	0.00 65.06	66.12 68.97	80.64 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.