As of the July, 2022, release via CMS

BOTHWELL REGIONAL HEALTH CENTER

CMS id: 260009
601 E. 14TH STREET, SEDALIA MO 65302. County: PETTIS
System: --
CBSA: Sedalia, MO

The 108-bed, acute-care hospital had $6,860,254 in net service to patients*, with a total profit margin of -0.57352% in fiscal year 2021, the latest year available.
It spent 4.13% 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	gov	gov	gov	gov	gov
Acute beds Median	98 118	89 118	99 119.5	99 118	99 119
Total beds Median	122 162	113 162	108 162	108 162	108 163.5
FTEs Median	697.98 788.06	723.67 793.42	736.86 806.03	807.67 787.61	770.43 804.34

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	115,852,920 150,932,746	122,278,121 158,950,878	128,601,639 168,696,998	131,323,231 163,454,693	140,027,942 186,589,412
Operating expenses Median	107,886,010 149,311,209	112,181,670 156,110,414	124,710,165 164,890,568	126,447,257 166,516,854	133,167,688 180,120,888
Net income from service 2 patients (NS2P) ? Median	7,966,910 -964,173	10,096,451 -643,601.5	3,891,474 -116,254	4,875,974 -5,025,862	6,860,254 -1,284,564
NS2P margin ? Median	6.88% -0.62	8.26% -0.29	3.03% 0.18	3.71% -5.07	4.90% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for BOTHWELL REGIONAL HEALTH 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	1,125,490 5,089,215	1,310,921 4,572,541	899,387 5,268,134	10,028,025 13,092,619	7,929,287 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	47,151 224,999	82,876 199,009	47,114 206,870.5	0 194,343	60,815 249,496
⊳ Line 7: Investments ? ⊳ Median	224,675 299,524	166,905 188,688.5	218,624 370,813	328,112 309,361.5	219,900 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	50,839	64,912	54,143	48,471	441,920
⊳ Line 11: Rebates and refunds of expenses	0	0	0	349,657	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	465,002	486,428	514,363	518,326	444,117
⊳ 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	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	68,026	9,225	53,188	66,321	53,292
⊳ 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	1,322	4,699	3,722	6,546	2,454
⊳ 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	8,301,613 1,987,202	0 1,597,664
⊳ Sum Line 24	268,475	495,876	8,233	408,979	6,706,789
Total income ? Median	9,092,400 6,586,430	11,407,372 6,767,106	4,790,861 8,419,950	14,903,999 8,094,175	14,789,541 15,162,888
Non-operating expenses Median	12,425,976 146,289.5	14,464,790 164,857	15,061,652 89,880.5	19,808,226 106,761	15,638,111 31,473.5
Net income Median	-3,333,576 6,043,842	-3,057,418 5,845,112	-10,270,791 7,606,259	-4,904,227 7,283,041	-848,570 14,957,241
Net margin Median	-2.84974% 4.62%	-2.47386% 4.42%	-7.93105% 5.16%	-3.46953% 5.2%	-0.57352% 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 BOTHWELL REGIONAL HEALTH 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	17,778,275 23,241,334	16,833,804 23,709,545	16,345,264 24,248,380	13,821,358 22,858,541	15,040,492 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	16,809,556 21,577,146	15,703,580 22,041,594	15,472,695 22,722,063	13,821,358 21,570,441	15,040,492 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	968,719 1,203,033	1,130,224 1,215,295	872,569 1,313,657	0 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	17,396,545 11,160,864	17,335,430 11,987,345	15,834,172 12,926,866	15,844,480 11,884,480	16,156,339 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	17,081,624 10,918,923	17,048,798 11,706,976	15,596,379 12,615,917	15,590,535 11,458,116	15,916,442 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	314,921 618,038	286,632 697,279	237,793 690,232	253,945 684,010	239,897 670,558
⊳ 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	196,641 594,888	206,173 595,761	229,374 577,894	214,999 542,168	148,931 549,667
Outlier Median	150,708 582,572	181,477 538,116	141,335 212,434	37,791 126,559	22,838 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	487,332 2,654,636	386,791 2,940,659	120,875 3,380,215	732,052 3,488,738	1,276,546 3,233,405
Uncompensated care (UCC) Median	4,017,353 5,147,790	4,468,983 5,337,617	4,191,535 5,711,082	6,114,792 5,923,418	5,497,991 5,508,107
UCC as a % of operating expenses Median	3.72% 3.24	3.98% 3.12	3.36% 3.21	4.84% 3.3	4.13% 2.86
Total shortfall/UCC Median	4,017,353 9,489,989	4,468,983 9,424,297	4,191,535 10,120,158	6,114,792 11,171,337	5,497,991 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	41,347,478 52,142,039	43,315,253 54,485,252	49,075,405 57,395,589	52,710,729 58,830,919	53,972,964 61,722,907
Salaries as a % of operating expenses Median	38.33 36.68	38.61 36.56	39.35 36.37	41.69 35.93	40.53 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	15,417 2,937,156	64,017 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	1,481,895 1,449,244	2,895,167 1,475,986	3,407,302 1,563,078	3,075,166 1,721,954	3,555,221 2,991,828
Contract hours, direct-care Median	20,372.00 22,725	50,266.00 23,018.5	74,093.00 24,503.48	74,740.00 25,026.5	34,575.00 33,786
Contract wages, direct-care Median	72.74 64.67	57.60 64.53	45.99 65.06	41.14 68.97	102.83 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.