As of the July, 2022, release via CMS

HILLSDALE HOSPITAL

CMS id: 230037
168 SOUTH HOWELL STREET, HILLSDALE MI 49242. County: HILLSDALE
System: --
CBSA: Hillsdale, MI

The 93-bed, acute-care hospital had $-146,644,512 in net service to patients*, with a total profit margin of 206.71186% in fiscal year 2021, the latest year available.
It spent 1.91% of its operating expenses on uncompensated care and reported $5,345,954 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	40 118	40 118	40 119.5	40 118	40 119
Total beds Median	93 162	93 162	93 162	93 162	93 163.5
FTEs Median	372.92 788.06	380.09 793.42	384.20 806.03	374.52 787.61	362.92 804.34

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	55,493,237 150,932,746	55,617,375 158,950,878	58,611,247 168,696,998	55,251,837 163,454,693	-79,233,297 186,589,412
Operating expenses Median	59,149,870 149,311,209	60,329,320 156,110,414	69,025,195 164,890,568	63,850,819 166,516,854	67,411,215 180,120,888
Net income from service 2 patients (NS2P) ? Median	-3,656,633 -964,173	-4,711,945 -643,601.5	-10,413,948 -116,254	-8,598,982 -5,025,862	-146,644,512 -1,284,564
NS2P margin ? Median	-6.59% -0.62	-8.47% -0.29	-17.77% 0.18	-15.56% -5.07	185.08% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HILLSDALE 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	3,152,245 5,089,215	4,104,308 4,572,541	12,458,760 5,268,134	8,021,124 13,092,619	16,062,050 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	31,300 224,999	142,445 199,009	142,140 206,870.5	226,771 194,343	355,609 249,496
⊳ Line 7: Investments ? ⊳ Median	776,741 299,524	1,455,493 188,688.5	1,401,344 370,813	1,042,807 309,361.5	5,569,241 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	9,665	9,477	8,641	4,237	3,869
⊳ 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	165,367	156,421	150,608	124,988	107,676
⊳ 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	1,098,290	107,796	87,474	82,361	69,608
⊳ Line 18: Revenue from sale of medical records and abstracts	22,022	19,748	21,615	22,590	19,629
⊳ 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	190,076	188,676	124,132	107,204	99,454
⊳ 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	858,784	2,024,252	10,522,806	6,410,166	9,836,964
Total income ? Median	-504,388 6,586,430	-607,637 6,767,106	2,044,812 8,419,950	-577,858 8,094,175	-130,582,462 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	-504,388 6,043,842	-607,637 5,845,112	2,044,812 7,606,259	-577,858 7,283,041	-130,582,462 14,957,241
Net margin Median	-0.86006% 4.62%	-1.01745% 4.42%	2.87718% 5.16%	-0.91328% 5.2%	206.71186% 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 HILLSDALE 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	10,462,810 23,241,334	9,198,829 23,709,545	7,781,472 24,248,380	6,707,671 22,858,541	6,540,545 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	7,292,950 21,577,146	6,588,863 22,041,594	6,025,299 22,722,063	5,116,262 21,570,441	5,293,665 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	375,019 1,845,420	348,014 1,757,392	361,750 1,738,842	405,490 1,510,463	172,739 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	2,794,841 1,203,033	2,261,952 1,215,295	1,394,423 1,313,657	1,185,919 1,365,298	1,074,141 1,179,746
All outpatient revenue Median Click here to show/hide details	8,037,792 11,160,864	7,728,339 11,987,345	7,661,352 12,926,866	6,011,814 11,884,480	5,252,934 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	6,928,405 10,918,923	6,591,512 11,706,976	6,740,775 12,615,917	5,117,717 11,458,116	4,316,631 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,074,661 1,282,808	1,032,322 1,407,728	866,743 1,341,512	801,021 1,407,046	631,244 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	34,726 618,038	104,505 697,279	53,834 690,232	93,076 684,010	305,059 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	416,158 3,284,314	312,079 3,250,551	0 3,386,837	0 3,360,806	0 3,508,953
Disproportionate-share hospital (DSH) Median	244,498 594,888	218,419 595,761	218,586 577,894	184,026 542,168	186,935 549,667
Outlier Median	21,817 582,572	45,452 538,116	14,801 212,434	7,773 126,559	8,320 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	922,261 3,662,910	637,485 3,730,911	0 4,081,319	4,397,054 4,643,908	5,345,954 4,389,147
Charity care Median	1,813,398 2,654,636	1,895,740 2,940,659	109,131 3,380,215	57,024 3,488,738	70,463 3,233,405
Uncompensated care (UCC) Median	3,286,817 5,147,790	3,341,058 5,337,617	2,121,446 5,711,082	1,431,693 5,923,418	1,287,399 5,508,107
UCC as a % of operating expenses Median	5.56% 3.24	5.54% 3.12	3.07% 3.21	2.24% 3.3	1.91% 2.86
Total shortfall/UCC Median	4,209,078 9,489,989	3,978,543 9,424,297	2,121,446 10,120,158	5,828,747 11,171,337	6,633,353 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	21,642,988 52,142,039	22,868,965 54,485,252	24,099,202 57,395,589	25,299,390 58,830,919	25,229,926 61,722,907
Salaries as a % of operating expenses Median	36.59 36.68	37.91 36.56	37.22 36.37	39.62 35.93	37.43 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	2,848,234 1,449,244	2,020,651 1,475,986	1,703,819 1,563,078	2,542,589 1,721,954	1,852,968 2,991,828
Contract hours, direct-care Median	61,356.00 22,725	34,226.00 23,018.5	26,272.00 24,503.48	57,537.11 25,026.5	18,731.00 33,786
Contract wages, direct-care Median	46.42 64.67	59.04 64.53	64.85 65.06	44.19 68.97	98.93 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.