As of the July, 2022, release via CMS

COX MEDICAL CENTER BRANSON

CMS id: 260094
251 SKAGGS ROAD, BRANSON MO 65615. County: TANEY
System: COXHEALTH HOME OFFICE
CBSA: Branson, MO

The 157-bed, acute-care hospital had $15,504,961 in net service to patients*, with a total profit margin of 16.24674% in fiscal year 2021, the latest year available.
It spent 7.14% of its operating expenses on uncompensated care and reported $2,286,896 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	87 118	87 118	93 119.5	93 118	124 119
Total beds Median	118 162	118 162	124 162	124 162	157 163.5
FTEs Median	1,017.67 788.06	1,048.12 793.42	1,067.50 806.03	1,037.58 787.61	1,028.70 804.34

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	177,891,056 150,932,746	187,285,709 158,950,878	191,471,797 168,696,998	185,369,878 163,454,693	222,424,801 186,589,412
Operating expenses Median	173,005,459 149,311,209	181,464,045 156,110,414	184,869,520 164,890,568	189,450,434 166,516,854	206,919,840 180,120,888
Net income from service 2 patients (NS2P) ? Median	4,885,597 -964,173	5,821,664 -643,601.5	6,602,277 -116,254	-4,080,556 -5,025,862	15,504,961 -1,284,564
NS2P margin ? Median	2.75% -0.62	3.11% -0.29	3.45% 0.18	-2.20% -5.07	6.97% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for COX MEDICAL CENTER BRANSON 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	7,651,121 5,089,215	7,806,025 4,572,541	7,435,476 5,268,134	9,965,592 13,092,619	24,634,035 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	284,965 224,999	-238,972 199,009	-44,295 206,870.5	23,632 194,343	1,801,791 249,496
⊳ Line 7: Investments ? ⊳ Median	1,303,887 299,524	1,809,962 188,688.5	1,821,430 370,813	3,649,878 309,361.5	8,525,950 375,329
⊳ 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	88,802	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	1,239,934	1,208,575	1,409,261	1,200,919	1,124,453
⊳ 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	933,299	1,474,598	1,816,495	855,307	0
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	-600	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	207,892	222,281	128,836	122,296
⊳ Line 21: Rental of vending machines	2,233	25,404	25,306	22,117	0
⊳ Line 22: Rental of hospital space	0	143,313	142,577	122,482	150,632
⊳ 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	3,798,001	3,175,253	2,043,021	3,962,421	12,908,913
Total income ? Median	12,536,718 6,586,430	13,627,689 6,767,106	14,037,753 8,419,950	5,885,036 8,094,175	40,138,996 15,162,888
Non-operating expenses Median	0 146,289.5	1,144,099 164,857	1,364,747 89,880.5	875,806 106,761	0 31,473.5
Net income Median	12,536,718 6,043,842	12,483,590 5,845,112	12,673,006 7,606,259	5,009,230 7,283,041	40,138,996 14,957,241
Net margin Median	6.75680% 4.62%	6.39883% 4.42%	6.37131% 5.16%	2.56442% 5.2%	16.24674% 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 COX MEDICAL CENTER BRANSON 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	26,353,576 23,241,334	24,253,692 23,709,545	24,006,407 24,248,380	22,998,503 22,858,541	22,133,437 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	22,547,048 21,577,146	20,873,768 22,041,594	20,853,361 22,722,063	19,763,205 21,570,441	19,216,942 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	3,806,528 3,535,627	3,379,924 3,746,588	3,153,046 3,782,288	3,235,298 3,865,578	2,916,495 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	20,423,355 11,160,864	22,559,591 11,987,345	22,937,124 12,926,866	21,963,653 11,884,480	20,418,203 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	19,354,633 10,918,923	21,601,005 11,706,976	21,956,424 12,615,917	21,110,771 11,458,116	19,626,755 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	1,068,722 618,038	958,586 697,279	980,700 690,232	852,882 684,010	791,448 670,558
⊳ 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	380,347 594,888	353,081 595,761	271,384 577,894	275,351 542,168	287,985 549,667
Outlier Median	311,508 582,572	406,824 538,116	33,837 212,434	62,282 126,559	44,806 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,471,447 3,662,910	1,786,226 3,730,911	2,270,067 4,081,319	2,148,320 4,643,908	2,286,896 4,389,147
Charity care Median	7,299,297 2,654,636	8,313,244 2,940,659	7,379,846 3,380,215	9,184,525 3,488,738	9,786,774 3,233,405
Uncompensated care (UCC) Median	10,866,856 5,147,790	12,280,333 5,337,617	11,255,984 5,711,082	14,363,761 5,923,418	14,764,433 5,508,107
UCC as a % of operating expenses Median	6.28% 3.24	6.77% 3.12	6.09% 3.21	7.58% 3.3	7.14% 2.86
Total shortfall/UCC Median	12,338,303 9,489,989	14,066,559 9,424,297	13,526,051 10,120,158	16,512,081 11,171,337	17,051,329 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	63,285,963 52,142,039	66,213,711 54,485,252	70,269,578 57,395,589	70,025,546 58,830,919	76,438,258 61,722,907
Salaries as a % of operating expenses Median	36.58 36.68	36.49 36.56	38.01 36.37	36.96 35.93	36.94 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	2,346,855 1,449,244	1,860,671 1,475,986	1,712,730 1,563,078	468,911 1,721,954	4,056,809 2,991,828
Contract hours, direct-care Median	30,382.00 22,725	25,880.00 23,018.5	20,472.00 24,503.48	6,032.92 25,026.5	31,009.00 33,786
Contract wages, direct-care Median	77.24 64.67	71.90 64.53	83.66 65.06	77.73 68.97	130.83 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.