As of the July, 2022, release via CMS

ASCENSION BORGESS HOSPITAL

CMS id: 230117
1521 GULL ROAD, KALAMAZOO MI 49048. County: KALAMAZOO
System: ASCENSION MICHIGAN
CBSA: Kalamazoo-Portage, MI

The 356-bed, acute-care hospital had $-26,583,537 in net service to patients*, with a total profit margin of 14.17315% in fiscal year 2021, the latest year available.
It spent 2.15% of its operating expenses on uncompensated care and reported $11,357,686 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	252 118	252 118	276 119.5	261 118	261 119
Total beds Median	353 162	353 162	371 162	356 162	356 163.5
FTEs Median	2,324.00 788.06	2,499.72 793.42	2,046.63 806.03	2,235.37 787.61	2,138.98 804.34

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	407,465,945 150,932,746	425,239,085 158,950,878	467,464,535 168,696,998	426,594,701 163,454,693	443,419,450 186,589,412
Operating expenses Median	381,456,739 149,311,209	434,436,421 156,110,414	436,671,847 164,890,568	445,759,684 166,516,854	470,002,987 180,120,888
Net income from service 2 patients (NS2P) ? Median	26,009,206 -964,173	-9,197,336 -643,601.5	30,792,688 -116,254	-19,164,983 -5,025,862	-26,583,537 -1,284,564
NS2P margin ? Median	6.38% -0.62	-2.16% -0.29	6.59% 0.18	-4.49% -5.07	-6.00% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASCENSION BORGESS 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	45,307,432 5,089,215	53,948,133 4,572,541	21,907,161 5,268,134	33,861,147 13,092,619	104,198,193 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	183,288 224,999	0 199,009	538,134 206,870.5	288,715 194,343	334,426 249,496
⊳ Line 7: Investments ? ⊳ Median	1,392 299,524	761 188,688.5	191,030 370,813	0 309,361.5	-365,044 375,329
⊳ 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	-45,410	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	1,490,401	1,300,611	1,347,388	941,403
⊳ 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	10,557,344	9,322,095	7,744,786	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	4,952	0	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	2,790,218	356,628	318,013	0	0
⊳ Line 21: Rental of vending machines	0	0	46,151	0	0
⊳ Line 22: Rental of hospital space	414,745	623,710	728,606	987,455	1,108,035
⊳ 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	31,360,445	42,154,538	11,080,288	31,237,589	102,179,373
Total income ? Median	71,316,638 6,586,430	44,750,797 6,767,106	52,699,849 8,419,950	14,696,164 8,094,175	77,614,656 15,162,888
Non-operating expenses Median	0 146,289.5	4,132,501 164,857	0 89,880.5	986,939 106,761	0 31,473.5
Net income Median	71,316,638 6,043,842	40,618,296 5,845,112	52,699,849 7,606,259	13,709,225 7,283,041	77,614,656 14,957,241
Net margin Median	15.75107% 4.62%	8.47650% 4.42%	10.76888% 5.16%	2.97732% 5.2%	14.17315% 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 ASCENSION BORGESS 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	95,313,749 23,241,334	97,777,480 23,709,545	95,548,165 24,248,380	82,242,860 22,858,541	80,583,899 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	89,368,560 21,577,146	90,896,000 22,041,594	88,603,303 22,722,063	77,025,107 21,570,441	75,410,369 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	3,489,524 1,845,420	3,836,200 1,757,392	3,657,371 1,738,842	2,532,039 1,510,463	2,145,483 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,455,665 3,535,627	3,045,280 3,746,588	3,287,491 3,782,288	2,685,714 3,865,578	3,028,047 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	41,252,026 11,160,864	43,032,453 11,987,345	43,477,653 12,926,866	37,436,283 11,884,480	33,730,773 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	41,252,026 10,918,923	43,032,453 11,706,976	43,477,653 12,615,917	37,436,283 11,458,116	33,730,773 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	14,013,888 3,284,314	15,038,938 3,250,551	13,872,871 3,386,837	13,156,909 3,360,806	12,818,329 3,508,953
Disproportionate-share hospital (DSH) Median	1,130,458 594,888	1,042,746 595,761	1,092,854 577,894	1,052,536 542,168	1,148,992 549,667
Outlier Median	2,164,564 582,572	4,529,462 538,116	3,115,360 212,434	357,764 126,559	648,644 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	31,973,693 3,662,910	5,797,584 3,730,911	6,796,480 4,081,319	14,756,974 4,643,908	11,357,686 4,389,147
Charity care Median	3,286,210 2,654,636	8,254,045 2,940,659	7,888,111 3,380,215	5,528,267 3,488,738	6,502,268 3,233,405
Uncompensated care (UCC) Median	6,717,878 5,147,790	10,906,979 5,337,617	11,108,190 5,711,082	9,059,966 5,923,418	10,106,992 5,508,107
UCC as a % of operating expenses Median	1.76% 3.24	2.51% 3.12	2.54% 3.21	2.03% 3.3	2.15% 2.86
Total shortfall/UCC Median	38,691,571 9,489,989	16,704,563 9,424,297	17,904,670 10,120,158	23,816,940 11,171,337	21,464,678 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	137,100,754 52,142,039	129,668,350 54,485,252	120,738,066 57,395,589	130,058,720 58,830,919	132,090,873 61,722,907
Salaries as a % of operating expenses Median	35.94 36.68	29.85 36.56	28.50 36.37	29.18 35.93	28.10 35.24
Intern, resident salaries* Median	289,287 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	232,483 1,186,494	7,602,632 1,204,885	7,491,997 1,279,653	7,744,771 1,469,317
Contract adjusted salaries, direct-care Median	4,492,238 1,449,244	4,582,706 1,475,986	972,804 1,563,078	9,504,512 1,721,954	13,206,185 2,991,828
Contract hours, direct-care Median	54,524.00 22,725	49,501.00 23,018.5	14,961.73 24,503.48	232,063.29 25,026.5	251,825.30 33,786
Contract wages, direct-care Median	82.39 64.67	92.58 64.53	65.02 65.06	40.96 68.97	52.44 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.