As of the July, 2022, release via CMS

HEARTLAND REGIONAL MEDICAL CENTER

CMS id: 260006
5325 FARAON, ST. JOSEPH MO 64506. County: BUCHANAN
System: MOSAIC HEALTH SYSTEM
CBSA: St. Joseph, MO-KS

The 352-bed, acute-care hospital had $-19,314,574 in net service to patients*, with a total profit margin of 6.94334% in fiscal year 2021, the latest year available.
It spent 6.64% of its operating expenses on uncompensated care and reported $6,168,585 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	331 118	331 118	331 119.5	331 118	331 119
Total beds Median	352 162	352 162	352 162	352 162	352 163.5
FTEs Median	3,306.95 788.06	2,671.74 793.42	3,243.32 806.03	2,628.13 787.61	2,586.17 804.34

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	575,641,860 150,932,746	558,345,690 158,950,878	581,662,828 168,696,998	608,466,083 163,454,693	619,738,859 186,589,412
Operating expenses Median	616,166,710 149,311,209	583,537,582 156,110,414	480,602,002 164,890,568	614,655,907 166,516,854	639,053,433 180,120,888
Net income from service 2 patients (NS2P) ? Median	-40,524,850 -964,173	-25,191,892 -643,601.5	101,060,826 -116,254	-6,189,824 -5,025,862	-19,314,574 -1,284,564
NS2P margin ? Median	-7.04% -0.62	-4.51% -0.29	17.37% 0.18	-1.02% -5.07	-3.12% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HEARTLAND REGIONAL 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	52,066,341 5,089,215	67,761,865 4,572,541	101,683,067 5,268,134	110,668,260 13,092,619	73,221,149 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	43,914 224,999	0 199,009	112,750 206,870.5	7,432,996 194,343	138,362 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	81,752,397 309,361.5	39,486,983 375,329
⊳ 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	83,178	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	3,096,179	60,745
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	603,613	2,704,623
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	393,600
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	199,251	0
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	200,753
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	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	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	52,022,427	67,761,865	101,570,317	17,500,646	30,236,083
Total income ? Median	11,541,491 6,586,430	42,569,973 6,767,106	202,743,893 8,419,950	104,478,436 8,094,175	53,906,575 15,162,888
Non-operating expenses Median	-24,266,521 146,289.5	0 164,857	115,689,803 89,880.5	6,689,513 106,761	5,791,994 31,473.5
Net income Median	35,808,012 6,043,842	42,569,973 5,845,112	87,054,090 7,606,259	97,788,923 7,283,041	48,114,581 14,957,241
Net margin Median	5.70456% 4.62%	6.79915% 4.42%	12.73939% 5.16%	13.59814% 5.2%	6.94334% 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 HEARTLAND REGIONAL 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	96,166,582 23,241,334	103,105,194 23,709,545	96,670,513 24,248,380	94,098,818 22,858,541	96,625,787 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	96,166,582 21,577,146	103,105,194 22,041,594	96,670,513 22,722,063	94,098,818 21,570,441	96,625,787 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	63,292,074 11,160,864	72,066,058 11,987,345	80,053,176 12,926,866	85,200,038 11,884,480	85,446,951 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	58,721,769 10,918,923	68,028,321 11,706,976	76,175,805 12,615,917	80,478,776 11,458,116	80,858,530 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	4,570,305 1,282,808	4,037,737 1,407,728	3,877,371 1,341,512	4,721,262 1,407,046	4,588,421 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	1,605,471 594,888	1,814,695 595,761	1,916,581 577,894	1,773,272 542,168	1,546,510 549,667
Outlier Median	2,886,234 582,572	3,807,738 538,116	4,569,872 212,434	2,127,676 126,559	4,087,419 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	21,617,464 3,662,910	18,199,677 3,730,911	10,009,076 4,081,319	58,229,661 4,643,908	6,168,585 4,389,147
Charity care Median	17,082,787 2,654,636	26,493,486 2,940,659	37,736,481 3,380,215	41,215,419 3,488,738	37,110,679 3,233,405
Uncompensated care (UCC) Median	37,248,215 5,147,790	34,541,479 5,337,617	47,871,925 5,711,082	47,780,923 5,923,418	42,456,732 5,508,107
UCC as a % of operating expenses Median	6.05% 3.24	5.92% 3.12	9.96% 3.21	7.77% 3.3	6.64% 2.86
Total shortfall/UCC Median	58,865,679 9,489,989	52,741,156 9,424,297	57,881,001 10,120,158	106,010,584 11,171,337	48,625,317 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	266,606,458 52,142,039	227,918,746 54,485,252	223,794,156 57,395,589	231,295,659 58,830,919	241,931,636 61,722,907
Salaries as a % of operating expenses Median	46.57 36.68	38.37 36.56	48.40 36.37	38.21 35.93	39.49 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	2,018,052 1,449,244	4,843,397 1,475,986	6,007,912 1,563,078	11,918,673 1,721,954	9,434,968 2,991,828
Contract hours, direct-care Median	27,703.00 22,725	69,331.00 23,018.5	88,300.00 24,503.48	170,891.77 25,026.5	113,470.00 33,786
Contract wages, direct-care Median	72.85 64.67	69.86 64.53	68.04 65.06	69.74 68.97	83.15 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.