As of the July, 2022, release via CMS

METROPOLITAN HOSPITAL

CMS id: 230236
5900 BYRON CENTER AVE SW, WYOMING MI 49519. County: KENT
System: --
CBSA: Grand Rapids-Kentwood, MI

The 208-bed, acute-care hospital had $838,021,468 in net service to patients*, with a total profit margin of 63.47272% in fiscal year 2021, the latest year available.
It spent 1.12% of its operating expenses on uncompensated care and reported $0 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	162 118	170 118	171 119.5	174 118	174 119
Total beds Median	208 162	208 162	208 162	208 162	208 163.5
FTEs Median	2,111.73 788.06	2,289.26 793.42	2,477.05 806.03	2,458.46 787.61	2,372.15 804.34

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	347,958,406 150,932,746	401,089,883 158,950,878	440,598,337 168,696,998	439,191,771 163,454,693	1,329,492,486 186,589,412
Operating expenses Median	399,964,908 149,311,209	456,393,948 156,110,414	472,403,835 164,890,568	478,560,660 166,516,854	491,471,018 180,120,888
Net income from service 2 patients (NS2P) ? Median	-52,006,502 -964,173	-55,304,065 -643,601.5	-31,805,498 -116,254	-39,368,889 -5,025,862	838,021,468 -1,284,564
NS2P margin ? Median	-14.95% -0.62	-13.79% -0.29	-7.22% 0.18	-8.96% -5.07	63.03% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for METROPOLITAN 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	24,963,278 5,089,215	30,860,292 4,572,541	31,883,877 5,268,134	51,013,081 13,092,619	15,998,002 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	1,000,000 249,496
⊳ Line 7: Investments ? ⊳ Median	2,049,947 299,524	1,333,063 188,688.5	386,086 370,813	212,993 309,361.5	1,348,114 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	9,954	2,700	0	0
⊳ Line 11: Rebates and refunds of expenses	6,447	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	1,999,096	1,963,337	1,934,067	1,589,162	1,361,001
⊳ 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	839,280	722,057	602,964	747,318	1,203,527
⊳ Line 18: Revenue from sale of medical records and abstracts	11,495	33,504	23,281	13,425	41,666
⊳ 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	3,723	1,064	1,458	0	0
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ 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	20,053,290	26,797,313	28,933,321	48,450,183	11,043,694
Total income ? Median	-27,043,224 6,586,430	-24,443,773 6,767,106	78,379 8,419,950	11,644,192 8,094,175	854,019,470 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	-27,043,224 6,043,842	-24,443,773 5,845,112	78,379 7,606,259	11,644,192 7,283,041	854,019,470 14,957,241
Net margin Median	-7.25172% 4.62%	-5.65893% 4.42%	0.01659% 5.16%	2.37537% 5.2%	63.47272% 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 METROPOLITAN 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	35,413,038 23,241,334	35,755,111 23,709,545	34,829,605 24,248,380	33,428,373 22,858,541	33,520,216 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	35,413,038 21,577,146	35,755,111 22,041,594	34,829,605 22,722,063	33,428,373 21,570,441	33,520,216 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	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	24,278,591 11,160,864	24,139,021 11,987,345	24,847,273 12,926,866	23,594,661 11,884,480	24,241,992 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	24,278,591 10,918,923	24,139,021 11,706,976	24,847,273 12,615,917	23,594,661 11,458,116	24,241,992 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	5,260,595 3,284,314	5,232,017 3,250,551	5,397,329 3,386,837	5,514,790 3,360,806	5,534,368 3,508,953
Disproportionate-share hospital (DSH) Median	635,655 594,888	775,556 595,761	715,348 577,894	680,183 542,168	602,624 549,667
Outlier Median	2,012,373 582,572	2,299,120 538,116	1,351,440 212,434	288,480 126,559	321,865 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,791,291 3,662,910	591,140 3,730,911	0 4,081,319	1,418,963 4,643,908	0 4,389,147
Charity care Median	438,495 2,654,636	740,005 2,940,659	269,306 3,380,215	525,110 3,488,738	2,618,456 3,233,405
Uncompensated care (UCC) Median	2,695,094 5,147,790	4,220,959 5,337,617	5,435,397 5,711,082	4,676,505 5,923,418	5,480,451 5,508,107
UCC as a % of operating expenses Median	0.67% 3.24	0.92% 3.12	1.15% 3.21	0.98% 3.3	1.12% 2.86
Total shortfall/UCC Median	4,486,385 9,489,989	4,812,099 9,424,297	5,435,397 10,120,158	6,095,468 11,171,337	5,480,451 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	151,818,465 52,142,039	178,665,682 54,485,252	195,687,357 57,395,589	202,091,078 58,830,919	202,111,115 61,722,907
Salaries as a % of operating expenses Median	37.96 36.68	39.15 36.56	41.42 36.37	42.23 35.93	41.12 35.24
Intern, resident salaries* Median	4,110,390 2,598,592	4,155,477 2,686,824	4,338,649 2,753,773	4,587,129 2,937,156	4,448,462 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	7,465,074 1,449,244	7,447,663 1,475,986	6,238,288 1,563,078	425,241 1,721,954	3,636,874 2,991,828
Contract hours, direct-care Median	181,425.00 22,725	174,998.00 23,018.5	156,595.00 24,503.48	5,793.00 25,026.5	105,206.00 33,786
Contract wages, direct-care Median	41.15 64.67	42.56 64.53	39.84 65.06	73.41 68.97	34.57 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.