As of the July, 2022, release via CMS

ASCENSION MACOMB-OAKLAND HOSPITAL

CMS id: 230195
11800 TWELVE MILE RD., WARREN MI 48093. County: MACOMB
System: ASCENSION MICHIGAN
CBSA: Detroit-Warren-Dearborn, MI

The 484-bed, acute-care hospital had $252,700 in net service to patients*, with a total profit margin of -4.58623% in fiscal year 2021, the latest year available.
It spent 2.34% of its operating expenses on uncompensated care and reported $1,344,629 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	414 118	386 118	388 119.5	380 118	353 119
Total beds Median	529 162	505 162	507 162	499 162	484 163.5
FTEs Median	2,269.77 788.06	2,250.22 793.42	2,125.08 806.03	2,182.72 787.61	2,251.50 804.34

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	412,041,424 150,932,746	416,231,868 158,950,878	422,066,127 168,696,998	416,139,825 163,454,693	458,673,783 186,589,412
Operating expenses Median	382,644,874 149,311,209	402,840,881 156,110,414	387,771,400 164,890,568	418,007,157 166,516,854	458,421,083 180,120,888
Net income from service 2 patients (NS2P) ? Median	29,396,550 -964,173	13,390,987 -643,601.5	34,294,727 -116,254	-1,867,332 -5,025,862	252,700 -1,284,564
NS2P margin ? Median	7.13% -0.62	3.22% -0.29	8.13% 0.18	-0.45% -5.07	0.06% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASCENSION MACOMB-OAKLAND 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	5,975,207 5,089,215	4,842,115 4,572,541	3,872,390 5,268,134	37,378,257 13,092,619	-18,492,262 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	85 224,999	61 199,009	38,666 206,870.5	35,950 194,343	634,928 249,496
⊳ Line 7: Investments ? ⊳ Median	48 299,524	31,949 188,688.5	318,858 370,813	22,428 309,361.5	25,325 375,329
⊳ 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	1,036,876	1,084,278	1,056,684	876,518	961,408
⊳ 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	719	3,811	0	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	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	396,916	455,531	456,895	459,686	443,432
⊳ 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	4,540,563	3,266,485	2,001,287	35,983,675	-20,557,355
Total income ? Median	35,371,757 6,586,430	18,233,102 6,767,106	38,167,117 8,419,950	35,510,925 8,094,175	-18,239,562 15,162,888
Non-operating expenses Median	3,951,023 146,289.5	3,788,990 164,857	4,339,940 89,880.5	4,703,159 106,761	1,948,179 31,473.5
Net income Median	31,420,734 6,043,842	14,444,112 5,845,112	33,827,177 7,606,259	30,807,766 7,283,041	-20,187,741 14,957,241
Net margin Median	7.51662% 4.62%	3.43030% 4.42%	7.94180% 5.16%	6.79306% 5.2%	-4.58623% 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 MACOMB-OAKLAND 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	131,556,383 23,241,334	126,866,505 23,709,545	125,970,339 24,248,380	126,765,399 22,858,541	118,606,991 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	120,784,597 21,577,146	116,379,918 22,041,594	116,153,774 22,722,063	116,895,308 21,570,441	110,667,884 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	5,277,056 1,845,420	4,694,122 1,757,392	5,024,074 1,738,842	4,527,535 1,510,463	3,271,192 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	5,494,730 3,535,627	5,792,465 3,746,588	4,792,491 3,782,288	5,342,556 3,865,578	4,667,915 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	32,828,218 11,160,864	31,703,711 11,987,345	30,384,713 12,926,866	25,395,102 11,884,480	24,335,658 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	32,828,218 10,918,923	31,703,711 11,706,976	30,384,713 12,615,917	25,395,102 11,458,116	24,335,658 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	24,216,001 3,284,314	23,498,974 3,250,551	24,446,971 3,386,837	25,003,033 3,360,806	22,599,357 3,508,953
Disproportionate-share hospital (DSH) Median	2,939,023 594,888	3,020,843 595,761	2,866,945 577,894	2,800,529 542,168	3,031,817 549,667
Outlier Median	776,835 582,572	1,020,159 538,116	868,986 212,434	192,027 126,559	237,237 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	5,224,125 3,662,910	950,476 3,730,911	55,025 4,081,319	1,768,306 4,643,908	1,344,629 4,389,147
Charity care Median	1,243,898 2,654,636	4,319,048 2,940,659	3,430,346 3,380,215	4,128,713 3,488,738	4,149,239 3,233,405
Uncompensated care (UCC) Median	7,569,331 5,147,790	12,149,565 5,337,617	10,694,558 5,711,082	12,000,094 5,923,418	10,714,251 5,508,107
UCC as a % of operating expenses Median	1.98% 3.24	3.02% 3.12	2.76% 3.21	2.87% 3.3	2.34% 2.86
Total shortfall/UCC Median	12,793,456 9,489,989	13,100,041 9,424,297	10,749,583 10,120,158	13,768,400 11,171,337	12,058,880 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	153,135,631 52,142,039	156,563,089 54,485,252	154,388,118 57,395,589	166,535,053 58,830,919	181,116,939 61,722,907
Salaries as a % of operating expenses Median	40.02 36.68	38.86 36.56	39.81 36.37	39.84 35.93	39.51 35.24
Intern, resident salaries* Median	12,878,081 2,598,592	14,222,615 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	2,772,222 1,449,244	1,874,903 1,475,986	13,208 1,563,078	409,065 1,721,954	4,793,949 2,991,828
Contract hours, direct-care Median	35,157.00 22,725	21,721.00 23,018.5	720.00 24,503.48	5,644.00 25,026.5	41,223.00 33,786
Contract wages, direct-care Median	78.85 64.67	86.32 64.53	18.34 65.06	72.48 68.97	116.29 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.