As of the July, 2022, release via CMS

HANNIBAL REGIONAL HOSPITAL

CMS id: 260025
HIGHWAY 36 6000 HOSPITAL DRIVE, HANNIBAL MO 63401. County: MARION
System: --
CBSA: Hannibal, MO

The 99-bed, acute-care hospital had $-4,985,648 in net service to patients*, with a total profit margin of 6.05974% in fiscal year 2021, the latest year available.
It spent 4.18% of its operating expenses on uncompensated care and reported $3,933,314 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	78 118	78 118	78 119.5	78 118	78 119
Total beds Median	99 162	99 162	99 162	99 162	99 163.5
FTEs Median	891.02 788.06	989.50 793.42	1,036.97 806.03	1,076.87 787.61	1,128.02 804.34

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	136,854,067 150,932,746	166,218,466 158,950,878	167,859,391 168,696,998	170,757,801 163,454,693	199,720,878 186,589,412
Operating expenses Median	141,557,406 149,311,209	163,465,565 156,110,414	170,542,491 164,890,568	183,179,823 166,516,854	204,706,526 180,120,888
Net income from service 2 patients (NS2P) ? Median	-4,703,339 -964,173	2,752,901 -643,601.5	-2,683,100 -116,254	-12,422,022 -5,025,862	-4,985,648 -1,284,564
NS2P margin ? Median	-3.44% -0.62	1.66% -0.29	-1.60% 0.18	-7.27% -5.07	-2.50% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HANNIBAL REGIONAL HOSPITAL 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	11,253,551 5,089,215	8,855,684 4,572,541	6,433,962 5,268,134	9,737,136 13,092,619	18,190,519 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	599,661 224,999	735,026 199,009	383,195 206,870.5	984,431 194,343	768,944 249,496
⊳ Line 7: Investments ? ⊳ Median	3,097,750 299,524	5,305,242 188,688.5	2,650,405 370,813	2,015,222 309,361.5	2,669,499 375,329
⊳ 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	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	631,185	647,899	711,922	704,955	823,622
⊳ 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	1,107	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	25,593	26,361	17,747	25,139	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	339,611	387,385	465,327	474,167	477,240
⊳ 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	6,558,644	1,753,771	2,205,366	5,533,222	13,451,214
Total income ? Median	6,550,212 6,586,430	11,608,585 6,767,106	3,750,862 8,419,950	-2,684,886 8,094,175	13,204,871 15,162,888
Non-operating expenses Median	0 146,289.5	1,674,022 164,857	3,565,530 89,880.5	857,242 106,761	0 31,473.5
Net income Median	6,550,212 6,043,842	9,934,563 5,845,112	185,332 7,606,259	-3,542,128 7,283,041	13,204,871 14,957,241
Net margin Median	4.42260% 4.62%	5.67449% 4.42%	0.10633% 5.16%	-1.96245% 5.2%	6.05974% 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 HANNIBAL REGIONAL HOSPITAL 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	25,432,923 23,241,334	25,408,436 23,709,545	25,311,503 24,248,380	24,139,962 22,858,541	28,421,200 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	22,741,421 21,577,146	22,199,195 22,041,594	21,913,300 22,722,063	20,086,169 21,570,441	24,413,279 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	2,691,502 3,535,627	3,209,241 3,746,588	3,398,203 3,782,288	4,053,793 3,865,578	4,007,921 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	12,503,968 11,160,864	16,295,258 11,987,345	18,128,832 12,926,866	17,451,924 11,884,480	19,355,008 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	10,791,430 10,918,923	13,952,183 11,706,976	15,484,589 12,615,917	14,960,762 11,458,116	16,716,906 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	818,974 1,282,808	937,070 1,407,728	1,054,954 1,341,512	1,064,842 1,407,046	1,161,924 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	893,564 618,038	1,406,005 697,279	1,589,289 690,232	1,426,320 684,010	1,476,178 670,558
⊳ 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	232,868 594,888	191,980 595,761	203,882 577,894	217,797 542,168	236,338 549,667
Outlier Median	1,361,998 582,572	1,137,930 538,116	871,463 212,434	862,591 126,559	484,537 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,702,771 3,662,910	0 3,730,911	5,521,447 4,081,319	7,107,524 4,643,908	3,933,314 4,389,147
Charity care Median	4,020,304 2,654,636	2,406,543 2,940,659	2,525,957 3,380,215	3,829,773 3,488,738	3,872,280 3,233,405
Uncompensated care (UCC) Median	6,895,705 5,147,790	6,112,057 5,337,617	5,560,880 5,711,082	8,307,444 5,923,418	8,554,327 5,508,107
UCC as a % of operating expenses Median	4.87% 3.24	3.74% 3.12	3.26% 3.21	4.54% 3.3	4.18% 2.86
Total shortfall/UCC Median	11,598,476 9,489,989	6,112,057 9,424,297	11,082,327 10,120,158	15,414,968 11,171,337	12,487,641 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	64,732,626 52,142,039	73,881,670 54,485,252	77,558,322 57,395,589	82,296,605 58,830,919	92,202,003 61,722,907
Salaries as a % of operating expenses Median	45.73 36.68	45.20 36.56	45.48 36.37	44.93 35.93	45.04 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	2,610,462 1,449,244	2,733,070 1,475,986	721,652 1,563,078	2,300,934 1,721,954	3,889,754 2,991,828
Contract hours, direct-care Median	32,270.96 22,725	34,854.47 23,018.5	8,925.27 24,503.48	26,042.88 25,026.5	36,960.08 33,786
Contract wages, direct-care Median	80.89 64.67	78.41 64.53	80.85 65.06	88.35 68.97	105.24 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.