As of the July, 2022, release via CMS

SPECTRUM HEALTH HOSPITALS

CMS id: 230038
100 MICHIGAN NE, GRAND RAPIDS MI 49503. County: KENT
System: SPECTRUM HEALTH SYSTEM
CBSA: Grand Rapids-Kentwood, MI

The 1,431-bed, acute-care hospital had $133,248,879 in net service to patients*, with a total profit margin of 8.70386% in fiscal year 2021, the latest year available.
It spent 1.01% of its operating expenses on uncompensated care and reported $17,268,064 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	862 118	876 118	894 119.5	858 118	921 119
Total beds Median	1,102 162	1,366 162	1,384 162	1,398 162	1,431 163.5
FTEs Median	8,411.61 788.06	8,468.92 793.42	8,688.94 806.03	8,558.81 787.61	9,552.99 804.34

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	1,904,243,556 150,932,746	2,009,495,322 158,950,878	2,195,104,792 168,696,998	2,329,025,938 163,454,693	2,532,885,733 186,589,412
Operating expenses Median	1,847,222,985 149,311,209	1,962,843,156 156,110,414	2,135,691,611 164,890,568	2,336,439,568 166,516,854	2,399,636,854 180,120,888
Net income from service 2 patients (NS2P) ? Median	57,020,571 -964,173	46,652,166 -643,601.5	59,413,181 -116,254	-7,413,630 -5,025,862	133,248,879 -1,284,564
NS2P margin ? Median	2.99% -0.62	2.32% -0.29	2.71% 0.18	-0.32% -5.07	5.26% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SPECTRUM HEALTH HOSPITALS 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	49,977,196 5,089,215	52,603,250 4,572,541	61,356,535 5,268,134	140,028,543 13,092,619	95,524,145 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	23,339,006 194,343	25,726,979 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	1,752,612 309,361.5	370,622 375,329
⊳ 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	353,435	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	1,950,356
⊳ Line 12: Parking lot receipts	0	0	0	1,112,036	1,060,296
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	10,874,608	11,227,853
⊳ 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	0	0	0	15,966	13,630
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	91,681	249,038
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	205,892	246,244
⊳ Line 21: Rental of vending machines	0	0	0	163	0
⊳ Line 22: Rental of hospital space	0	0	0	2,395,933	3,017,301
⊳ 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	49,977,196	52,603,250	61,356,535	99,887,211	51,661,826
Total income ? Median	106,997,767 6,586,430	99,255,416 6,767,106	120,769,716 8,419,950	132,614,913 8,094,175	228,773,024 15,162,888
Non-operating expenses Median	885,332 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	106,112,435 6,043,842	99,255,416 5,845,112	120,769,716 7,606,259	132,614,913 7,283,041	228,773,024 14,957,241
Net margin Median	5.42991% 4.62%	4.81332% 4.42%	5.35217% 5.16%	5.37108% 5.2%	8.70386% 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 SPECTRUM HEALTH HOSPITALS 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	216,672,689 23,241,334	217,298,197 23,709,545	228,538,970 24,248,380	204,754,992 22,858,541	215,033,872 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	211,674,560 21,577,146	210,629,219 22,041,594	220,498,455 22,722,063	196,631,809 21,570,441	207,876,068 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	4,998,129 3,535,627	4,784,800 3,746,588	6,510,019 3,782,288	6,338,284 3,865,578	5,629,526 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	1,884,178 1,215,295	1,530,496 1,313,657	1,784,899 1,365,298	1,528,278 1,179,746
All outpatient revenue Median Click here to show/hide details	62,669,947 11,160,864	64,409,705 11,987,345	66,093,297 12,926,866	61,118,406 11,884,480	65,105,221 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	62,669,947 10,918,923	64,409,705 11,706,976	66,093,297 12,615,917	61,118,406 11,458,116	65,105,221 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	21,672,174 3,284,314	22,746,164 3,250,551	24,505,538 3,386,837	24,150,093 3,360,806	26,723,846 3,508,953
Disproportionate-share hospital (DSH) Median	6,961,770 594,888	6,413,285 595,761	6,233,988 577,894	6,156,499 542,168	6,121,324 549,667
Outlier Median	12,418,307 582,572	12,097,993 538,116	15,864,382 212,434	1,977,639 126,559	1,170,244 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	9,914,498 3,662,910	47,877,493 3,730,911	41,735,877 4,081,319	32,930,514 4,643,908	17,268,064 4,389,147
Charity care Median	8,210,994 2,654,636	6,654,477 2,940,659	14,275,925 3,380,215	10,272,700 3,488,738	9,842,734 3,233,405
Uncompensated care (UCC) Median	26,193,823 5,147,790	37,988,478 5,337,617	39,402,949 5,711,082	29,405,964 5,923,418	24,158,895 5,508,107
UCC as a % of operating expenses Median	1.42% 3.24	1.94% 3.12	1.84% 3.21	1.26% 3.3	1.01% 2.86
Total shortfall/UCC Median	36,108,321 9,489,989	85,865,971 9,424,297	81,138,826 10,120,158	62,336,478 11,171,337	41,426,959 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	481,853,777 52,142,039	533,973,110 54,485,252	556,808,522 57,395,589	602,659,753 58,830,919	684,530,263 61,722,907
Salaries as a % of operating expenses Median	26.09 36.68	27.20 36.56	26.07 36.37	25.79 35.93	28.53 35.24
Intern, resident salaries* Median	0 2,598,592	8,295,745 2,686,824	18,696,858 2,753,773	23,109,001 2,937,156	25,669,424 2,909,848
Contract intern, resident salaries* Median	15,873,530 1,251,927	8,884,749 1,186,494	0 1,204,885	0 1,279,653	0 1,469,317
Contract adjusted salaries, direct-care Median	18,555,322 1,449,244	11,282,334 1,475,986	2,058,970 1,563,078	3,428,074 1,721,954	14,881,960 2,991,828
Contract hours, direct-care Median	482,031.00 22,725	271,982.00 23,018.5	19,271.00 24,503.48	57,482.00 25,026.5	139,467.00 33,786
Contract wages, direct-care Median	38.49 64.67	41.48 64.53	106.84 65.06	59.64 68.97	106.71 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.