As of the July, 2022, release via CMS

ST. JOSEPHS MEDICAL CENTER

CMS id: 240075
523 NORTH THIRD STREET, BRAINERD MN 56401. County: CROW WING
System: ESSENTIA HEALTH
CBSA: Brainerd, MN

The 127-bed, acute-care hospital had $13,775,963 in net service to patients*, with a total profit margin of 20.47360% in fiscal year 2021, the latest year available.
It spent 0.92% of its operating expenses on uncompensated care and reported $6,211,475 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	102 118	102 118	117 119.5	117 118	117 119
Total beds Median	127 162	127 162	127 162	127 162	127 163.5
FTEs Median	1,018.01 788.06	1,029.51 793.42	1,047.33 806.03	998.93 787.61	983.31 804.34

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	208,944,058 150,932,746	223,646,930 158,950,878	236,651,274 168,696,998	230,548,754 163,454,693	254,281,526 186,589,412
Operating expenses Median	197,387,291 149,311,209	213,541,982 156,110,414	226,268,182 164,890,568	232,647,188 166,516,854	240,505,563 180,120,888
Net income from service 2 patients (NS2P) ? Median	11,556,767 -964,173	10,104,948 -643,601.5	10,383,092 -116,254	-2,098,434 -5,025,862	13,775,963 -1,284,564
NS2P margin ? Median	5.53% -0.62	4.52% -0.29	4.39% 0.18	-0.91% -5.07	5.42% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ST. JOSEPHS MEDICAL CENTER 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	17,966,739 5,089,215	16,271,068 4,572,541	12,075,958 5,268,134	18,565,484 13,092,619	48,140,773 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	1,859,048 299,524	2,545,921 188,688.5	3,303,686 370,813	3,141,526 309,361.5	2,293,009 375,329
⊳ 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	-24	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	505,161	498,787	510,549	394,436	202,253
⊳ Line 15: Revenue from rental of living quarters	110,812	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	135,021	112,985	98,878	85,649
⊳ Line 18: Revenue from sale of medical records and abstracts	11,740	11,085	12,640	13,645	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	69,702	45,741	46,265	35,236	34,794
⊳ Line 22: Rental of hospital space	0	211,062	195,263	207,031	188,326
⊳ 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	15,410,300	12,823,451	7,894,570	14,674,732	45,336,742
Total income ? Median	29,523,506 6,586,430	26,376,016 6,767,106	22,459,050 8,419,950	16,467,050 8,094,175	61,916,736 15,162,888
Non-operating expenses Median	0 146,289.5	3,209,753 164,857	4,554,649 89,880.5	4,724,585 106,761	0 31,473.5
Net income Median	29,523,506 6,043,842	23,166,263 5,845,112	17,904,401 7,606,259	11,742,465 7,283,041	61,916,736 14,957,241
Net margin Median	13.01106% 4.62%	9.65591% 4.42%	7.19841% 5.16%	4.71369% 5.2%	20.47360% 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. JOSEPHS MEDICAL CENTER 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	26,510,841 23,241,334	27,741,410 23,709,545	22,162,621 24,248,380	17,434,874 22,858,541	15,762,503 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	25,443,665 21,577,146	27,289,828 22,041,594	22,162,621 22,722,063	17,434,874 21,570,441	15,762,503 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	1,067,176 1,845,420	451,582 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	31,561,500 11,160,864	34,421,571 11,987,345	33,598,987 12,926,866	27,161,405 11,884,480	25,789,881 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	31,561,500 10,918,923	34,421,571 11,706,976	33,598,987 12,615,917	27,161,405 11,458,116	25,789,881 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	479,167 594,888	461,974 595,761	596,861 577,894	457,623 542,168	352,835 549,667
Outlier Median	624,866 582,572	392,379 538,116	397,515 212,434	187,814 126,559	154,686 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	3,757,128 3,730,911	5,675,734 4,081,319	4,108,518 4,643,908	6,211,475 4,389,147
Charity care Median	1,882,281 2,654,636	2,424,760 2,940,659	1,774,767 3,380,215	2,688,279 3,488,738	959,452 3,233,405
Uncompensated care (UCC) Median	3,277,467 5,147,790	3,576,915 5,337,617	3,234,298 5,711,082	3,947,046 5,923,418	2,209,795 5,508,107
UCC as a % of operating expenses Median	1.66% 3.24	1.68% 3.12	1.43% 3.21	1.70% 3.3	0.92% 2.86
Total shortfall/UCC Median	3,277,467 9,489,989	7,334,043 9,424,297	8,910,032 10,120,158	8,055,564 11,171,337	8,421,270 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	90,833,086 52,142,039	95,540,228 54,485,252	103,495,083 57,395,589	104,036,680 58,830,919	106,150,706 61,722,907
Salaries as a % of operating expenses Median	46.02 36.68	44.74 36.56	45.74 36.37	44.72 35.93	44.14 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	548,829 1,449,244	933,787 1,475,986	804,302 1,563,078	983,603 1,721,954	2,281,936 2,991,828
Contract hours, direct-care Median	6,659.43 22,725	14,231.00 23,018.5	12,311.63 24,503.48	13,991.58 25,026.5	18,755.12 33,786
Contract wages, direct-care Median	82.41 64.67	65.62 64.53	65.33 65.06	70.30 68.97	121.67 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.