As of the July, 2022, release via CMS

ST. LUKES HOSPITAL OF DULUTH

CMS id: 240047
915 EAST FIRST STREET, DULUTH MN 55805. County: ST. LOUIS
System: ST LUKES HOSPITAL HEALTH SYSTEM
CBSA: Duluth, MN-WI

The 267-bed, acute-care hospital had $-32,911,809 in net service to patients*, with a total profit margin of 2.79166% in fiscal year 2021, the latest year available.
It spent 0.80% of its operating expenses on uncompensated care and reported $9,853,446 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	177 118	176 118	176 119.5	176 118	176 119
Total beds Median	267 162	267 162	267 162	267 162	267 163.5
FTEs Median	2,251.78 788.06	2,347.60 793.42	2,472.33 806.03	2,230.96 787.61	2,190.48 804.34

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	442,815,809 150,932,746	495,664,642 158,950,878	492,061,262 168,696,998	452,636,415 163,454,693	488,590,754 186,589,412
Operating expenses Median	447,684,868 149,311,209	491,104,745 156,110,414	516,922,324 164,890,568	495,225,937 166,516,854	521,502,563 180,120,888
Net income from service 2 patients (NS2P) ? Median	-4,869,059 -964,173	4,559,897 -643,601.5	-24,861,062 -116,254	-42,589,522 -5,025,862	-32,911,809 -1,284,564
NS2P margin ? Median	-1.10% -0.62	0.92% -0.29	-5.05% 0.18	-9.41% -5.07	-6.74% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ST. LUKES HOSPITAL OF DULUTH 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	23,697,670 5,089,215	29,000,663 4,572,541	30,550,165 5,268,134	53,439,831 13,092,619	47,888,468 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	902,901 224,999	879,736 199,009	1,188,516 206,870.5	18,504,913 194,343	9,260,746 249,496
⊳ Line 7: Investments ? ⊳ Median	1,903,582 299,524	1,915,695 188,688.5	2,134,652 370,813	1,432,656 309,361.5	2,073,090 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	896,908	773,610	531,102	852,167	1,045,303
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	726,796	723,260	637,823	581,456	591,524
⊳ Line 13: Revenue from laundry and linen service	108,399	115,862	120,196	116,903	140,854
⊳ Line 14: Revenue from meals sold to emplyees and guests	1,473,489	1,705,936	1,936,478	1,423,973	1,458,019
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	205,117	200,889	158,763	68,633	430,269
⊳ Line 17: Revenue from sale of drugs to other than patients	-159,143	668,779	952,788	2,081,349	3,979,537
⊳ Line 18: Revenue from sale of medical records and abstracts	206,290	235,473	235,708	220,742	202,923
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	131,065	146,068	126,407	46,841	71,367
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	113,000	109,797	112,742	19,623	114
⊳ Line 21: Rental of vending machines	8,138	9,043	16,295	15,121	14,126
⊳ Line 22: Rental of hospital space	1,054,396	1,065,621	1,085,224	524,848	276,974
⊳ 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	16,077,751	20,406,633	21,269,211	27,506,345	28,304,115
Total income ? Median	18,828,611 6,586,430	33,560,560 6,767,106	5,689,103 8,419,950	10,850,309 8,094,175	14,976,659 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	18,828,611 6,043,842	33,560,560 5,845,112	5,689,103 7,606,259	10,850,309 7,283,041	14,976,659 14,957,241
Net margin Median	4.03603% 4.62%	6.39657% 4.42%	1.08859% 5.16%	2.14401% 5.2%	2.79166% 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 ST. LUKES HOSPITAL OF DULUTH 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	63,745,143 23,241,334	73,762,340 23,709,545	69,145,762 24,248,380	63,539,590 22,858,541	59,942,338 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	58,704,837 21,577,146	68,851,333 22,041,594	64,801,030 22,722,063	59,982,815 21,570,441	56,567,466 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	5,040,306 3,535,627	4,911,007 3,746,588	4,344,732 3,782,288	3,556,775 3,865,578	3,374,872 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	53,816,931 11,160,864	62,444,986 11,987,345	63,617,328 12,926,866	57,110,568 11,884,480	62,527,051 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	51,998,787 10,918,923	60,589,832 11,706,976	61,696,380 12,615,917	54,723,629 11,458,116	60,172,456 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,818,144 1,282,808	1,855,154 1,407,728	1,920,948 1,341,512	2,386,939 1,407,046	2,354,595 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	1,278,136 3,284,314	1,495,820 3,250,551	1,419,435 3,386,837	1,359,854 3,360,806	1,426,969 3,508,953
Disproportionate-share hospital (DSH) Median	1,650,476 594,888	1,756,366 595,761	1,948,425 577,894	1,973,632 542,168	1,595,178 549,667
Outlier Median	2,954,675 582,572	3,433,272 538,116	798,574 212,434	650,764 126,559	571,080 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,241,684 3,662,910	7,642,833 3,730,911	5,436,643 4,081,319	8,020,920 4,643,908	9,853,446 4,389,147
Charity care Median	2,498,423 2,654,636	2,451,907 2,940,659	2,336,939 3,380,215	2,485,986 3,488,738	2,244,074 3,233,405
Uncompensated care (UCC) Median	4,433,679 5,147,790	4,436,497 5,337,617	4,397,228 5,711,082	5,058,957 5,923,418	4,148,250 5,508,107
UCC as a % of operating expenses Median	0.99% 3.24	0.90% 3.12	0.85% 3.21	1.02% 3.3	0.80% 2.86
Total shortfall/UCC Median	11,675,363 9,489,989	12,079,330 9,424,297	9,833,871 10,120,158	13,079,877 11,171,337	14,001,696 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	215,008,889 52,142,039	232,436,894 54,485,252	243,148,648 57,395,589	231,068,756 58,830,919	241,545,376 61,722,907
Salaries as a % of operating expenses Median	48.03 36.68	47.33 36.56	47.04 36.37	46.66 35.93	46.32 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	1,233,232 1,449,244	1,711,133 1,475,986	944,282 1,563,078	348,620 1,721,954	2,791,679 2,991,828
Contract hours, direct-care Median	17,667.00 22,725	24,841.00 23,018.5	13,866.00 24,503.48	5,155.00 25,026.5	57,550.00 33,786
Contract wages, direct-care Median	69.80 64.67	68.88 64.53	68.10 65.06	67.63 68.97	48.51 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.