As of the July, 2022, release via CMS

LAKE REGION HEALTHCARE

CMS id: 240052
712 SOUTH CASCADE STREET, FERGUS FALLS MN 56538. County: OTTER TAIL
System: LAKE REGION HEALTHCARE CORPORATION
CBSA: Fergus Falls, MN

The 94-bed, acute-care hospital had $-7,945,024 in net service to patients*, with a total profit margin of 7.85022% in fiscal year 2021, the latest year available.
It spent 1.43% of its operating expenses on uncompensated care and reported $6,984,400 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	75 118	75 118	75 119.5	75 118	75 119
Total beds Median	108 162	108 162	94 162	94 162	94 163.5
FTEs Median	695.54 788.06	704.92 793.42	679.71 806.03	641.45 787.61	625.86 804.34

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	116,976,751 150,932,746	121,272,495 158,950,878	123,179,187 168,696,998	120,104,514 163,454,693	135,694,661 186,589,412
Operating expenses Median	124,976,512 149,311,209	128,484,584 156,110,414	134,460,833 164,890,568	131,679,053 166,516,854	143,639,685 180,120,888
Net income from service 2 patients (NS2P) ? Median	-7,999,761 -964,173	-7,212,089 -643,601.5	-11,281,646 -116,254	-11,574,539 -5,025,862	-7,945,024 -1,284,564
NS2P margin ? Median	-6.84% -0.62	-5.95% -0.29	-9.16% 0.18	-9.64% -5.07	-5.86% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for LAKE REGION HEALTHCARE 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	8,898,522 5,089,215	10,207,283 4,572,541	12,871,880 5,268,134	26,922,642 13,092,619	20,894,271 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	670,495 224,999	402,331 199,009	233,861 206,870.5	233,261 194,343	244,644 249,496
⊳ Line 7: Investments ? ⊳ Median	1,138,049 299,524	2,314,393 188,688.5	4,617,641 370,813	3,963,574 309,361.5	10,987,759 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	5,694	3,093	61,475	49,828	74,884
⊳ 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	561,735	545,612	552,962	483,856	429,784
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	5,899	3,642	18,118	1,861	1,805
⊳ Line 17: Revenue from sale of drugs to other than patients	15,142	14,344	15,795	11,806	8,311
⊳ Line 18: Revenue from sale of medical records and abstracts	39,038	27,112	19,849	21,445	23,989
⊳ 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	220,251	263,269	272,890	1,041,971	2,504,376
⊳ 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	6,242,219	6,633,487	7,079,289	21,115,040	6,618,719
Total income ? Median	898,761 6,586,430	2,995,194 6,767,106	1,590,234 8,419,950	15,348,103 8,094,175	12,949,247 15,162,888
Non-operating expenses Median	828,296 146,289.5	699,835 164,857	930,248 89,880.5	984,337 106,761	656,672 31,473.5
Net income Median	70,465 6,043,842	2,295,359 5,845,112	659,986 7,606,259	14,363,766 7,283,041	12,292,575 14,957,241
Net margin Median	0.05598% 4.62%	1.74579% 4.42%	0.48510% 5.16%	9.76946% 5.2%	7.85022% 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 LAKE REGION HEALTHCARE 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	11,637,067 23,241,334	11,191,834 23,709,545	8,707,779 24,248,380	6,632,089 22,858,541	7,138,829 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	9,935,767 21,577,146	10,312,930 22,041,594	8,329,948 22,722,063	6,284,442 21,570,441	6,848,614 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	445,698 1,845,420	516,045 1,757,392	377,831 1,738,842	347,647 1,510,463	290,215 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	1,255,602 3,535,627	362,859 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	20,335,641 11,160,864	21,092,099 11,987,345	17,183,987 12,926,866	15,693,560 11,884,480	17,372,216 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	20,335,641 10,918,923	21,092,099 11,706,976	17,183,987 12,615,917	15,693,560 11,458,116	17,372,216 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	0 3,284,314	0 3,250,551	0 3,386,837	0 3,360,806	0 3,508,953
Disproportionate-share hospital (DSH) Median	115,469 594,888	100,212 595,761	75,209 577,894	31,758 542,168	67,622 549,667
Outlier Median	549,958 582,572	224,167 538,116	145,785 212,434	143,493 126,559	142,194 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,778,583 3,662,910	6,185,782 3,730,911	6,642,431 4,081,319	5,440,795 4,643,908	6,984,400 4,389,147
Charity care Median	355,557 2,654,636	550,017 2,940,659	622,450 3,380,215	698,540 3,488,738	847,761 3,233,405
Uncompensated care (UCC) Median	1,142,443 5,147,790	1,442,957 5,337,617	1,165,619 5,711,082	2,084,816 5,923,418	2,047,302 5,508,107
UCC as a % of operating expenses Median	0.91% 3.24	1.12% 3.12	0.87% 3.21	1.58% 3.3	1.43% 2.86
Total shortfall/UCC Median	8,921,026 9,489,989	7,628,739 9,424,297	7,808,050 10,120,158	7,525,611 11,171,337	9,031,702 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	41,548,630 52,142,039	43,150,605 54,485,252	42,494,683 57,395,589	42,458,069 58,830,919	42,444,267 61,722,907
Salaries as a % of operating expenses Median	33.25 36.68	33.58 36.56	31.60 36.37	32.24 35.93	30.55 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	901,932 1,449,244	0 1,475,986	0 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	11,482.25 22,725	0.00 23,018.5	0.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	78.55 64.67	0.00 64.53	0.00 65.06	0.00 68.97	0.00 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.