As of the July, 2022, release via CMS

FREEMAN OAK HILL HEALTH SYSTEM

CMS id: 260137
1102 WEST 32ND STREET, JOPLIN MO 64804. County: JASPER
System: FREEMAN HEALTH SYSTEM
CBSA: Joplin, MO

The 390-bed, acute-care hospital had $18,936,196 in net service to patients*, with a total profit margin of 17.06225% in fiscal year 2021, the latest year available.
It spent 6.05% 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	nfp	nfp	nfp	nfp	nfp
Acute beds Median	297 118	298 118	298 119.5	305 118	297 119
Total beds Median	391 162	392 162	391 162	403 162	390 163.5
FTEs Median	2,784.86 788.06	2,762.30 793.42	2,815.29 806.03	2,867.30 787.61	2,799.54 804.34

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	469,928,340 150,932,746	480,837,479 158,950,878	500,859,772 168,696,998	525,149,503 163,454,693	527,713,125 186,589,412
Operating expenses Median	477,278,247 149,311,209	485,876,773 156,110,414	511,510,335 164,890,568	536,172,207 166,516,854	508,776,929 180,120,888
Net income from service 2 patients (NS2P) ? Median	-7,349,907 -964,173	-5,039,294 -643,601.5	-10,650,563 -116,254	-11,022,704 -5,025,862	18,936,196 -1,284,564
NS2P margin ? Median	-1.56% -0.62	-1.05% -0.29	-2.13% 0.18	-2.10% -5.07	3.59% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for FREEMAN OAK HILL HEALTH SYSTEM 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	41,416,752 5,089,215	46,330,441 4,572,541	53,338,310 5,268,134	46,376,522 13,092,619	146,002,284 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	3,276,393 224,999	1,310,499 199,009	1,286,329 206,870.5	938,647 194,343	890,004 249,496
⊳ Line 7: Investments ? ⊳ Median	6,022,126 299,524	9,326,714 188,688.5	11,430,623 370,813	10,108,114 309,361.5	11,813,691 375,329
⊳ 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	2,097,083	2,036,597	2,125,683	2,086,474	1,547,456
⊳ 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	39,511	4,394	3,309	3,147	3,247
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	1,418,986	1,408,181	1,460,341	1,424,690	969,866
⊳ Line 21: Rental of vending machines	29,869	37,543	39,198	34,739	26,852
⊳ Line 22: Rental of hospital space	2,557,096	2,749,812	2,736,218	2,821,622	2,849,345
⊳ 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	25,975,688	29,456,701	34,256,609	28,959,089	127,901,823
Total income ? Median	34,066,845 6,586,430	41,291,147 6,767,106	42,687,747 8,419,950	35,353,818 8,094,175	164,938,480 15,162,888
Non-operating expenses Median	325,190 146,289.5	0 164,857	659,778 89,880.5	18,424,270 106,761	49,987,501 31,473.5
Net income Median	33,741,655 6,043,842	41,291,147 5,845,112	42,027,969 7,606,259	16,929,548 7,283,041	114,950,979 14,957,241
Net margin Median	6.59861% 4.62%	7.83264% 4.42%	7.58356% 5.16%	2.96217% 5.2%	17.06225% 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 FREEMAN OAK HILL HEALTH SYSTEM 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	72,465,749 23,241,334	70,046,315 23,709,545	71,162,385 24,248,380	69,983,834 22,858,541	65,390,960 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	67,125,434 21,577,146	64,766,258 22,041,594	66,215,459 22,722,063	64,806,565 21,570,441	60,920,216 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	1,376,223 1,845,420	1,281,503 1,757,392	1,164,673 1,738,842	967,416 1,510,463	724,163 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	3,964,092 3,535,627	3,998,554 3,746,588	3,782,253 3,782,288	4,209,853 3,865,578	3,746,581 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	54,153,201 11,160,864	56,396,448 11,987,345	55,378,886 12,926,866	60,080,995 11,884,480	53,889,540 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	53,134,030 10,918,923	55,428,168 11,706,976	54,294,984 12,615,917	58,890,982 11,458,116	52,524,820 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,019,171 1,282,808	968,280 1,407,728	1,083,902 1,341,512	1,190,013 1,407,046	1,364,720 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	1,542,923 3,284,314	1,520,019 3,250,551	1,589,780 3,386,837	1,574,172 3,360,806	1,510,319 3,508,953
Disproportionate-share hospital (DSH) Median	1,709,699 594,888	1,905,493 595,761	1,645,998 577,894	1,738,093 542,168	1,643,651 549,667
Outlier Median	1,363,044 582,572	1,311,204 538,116	1,468,188 212,434	490,174 126,559	254,542 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,474,614 3,662,910	7,880,095 3,730,911	2,009,254 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	10,682,949 2,654,636	19,127,212 2,940,659	11,167,269 3,380,215	17,707,692 3,488,738	25,359,621 3,233,405
Uncompensated care (UCC) Median	19,615,460 5,147,790	26,794,710 5,337,617	17,966,705 5,711,082	25,247,173 5,923,418	30,767,942 5,508,107
UCC as a % of operating expenses Median	4.11% 3.24	5.51% 3.12	3.51% 3.21	4.71% 3.3	6.05% 2.86
Total shortfall/UCC Median	27,090,074 9,489,989	34,674,805 9,424,297	19,975,959 10,120,158	25,247,173 11,171,337	30,767,942 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	201,403,816 52,142,039	201,891,321 54,485,252	213,327,202 57,395,589	218,937,750 58,830,919	225,713,255 61,722,907
Salaries as a % of operating expenses Median	46.06 36.68	45.32 36.56	45.65 36.37	44.61 35.93	44.36 35.24
Intern, resident salaries* Median	1,286,884 2,598,592	1,505,622 2,686,824	1,987,518 2,753,773	2,938,798 2,937,156	3,578,278 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	787,066 1,449,244	963,490 1,475,986	1,722,910 1,563,078	937,302 1,721,954	866,309 2,991,828
Contract hours, direct-care Median	17,352.00 22,725	18,202.00 23,018.5	29,772.00 24,503.48	19,237.00 25,026.5	25,850.00 33,786
Contract wages, direct-care Median	45.36 64.67	52.93 64.53	57.87 65.06	48.72 68.97	33.51 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.