As of the July, 2022, release via CMS

LAKE REGIONAL HEALTH SYSTEM

CMS id: 260186
54 HOSPITAL DRIVE, OSAGE BEACH MO 65065. County: CAMDEN
System: --
CBSA: Rural Missouri

The 116-bed, acute-care hospital had $2,677,902 in net service to patients*, with a total profit margin of 11.45565% in fiscal year 2021, the latest year available.
It spent 4.75% 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	82 118	82 118	82 119.5	82 118	82 119
Total beds Median	116 162	116 162	116 162	116 162	116 163.5
FTEs Median	921.21 788.06	961.73 793.42	961.41 806.03	976.80 787.61	1,039.55 804.34

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	161,889,241 150,932,746	158,981,582 158,950,878	177,853,269 168,696,998	166,942,146 163,454,693	206,959,597 186,589,412
Operating expenses Median	156,241,702 149,311,209	162,688,707 156,110,414	172,672,083 164,890,568	188,932,203 166,516,854	204,281,695 180,120,888
Net income from service 2 patients (NS2P) ? Median	5,647,539 -964,173	-3,707,125 -643,601.5	5,181,186 -116,254	-21,990,057 -5,025,862	2,677,902 -1,284,564
NS2P margin ? Median	3.49% -0.62	-2.33% -0.29	2.91% 0.18	-13.17% -5.07	1.29% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for LAKE REGIONAL 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	11,886,828 5,089,215	14,915,915 4,572,541	15,928,883 5,268,134	15,009,430 13,092,619	36,210,151 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	213,570 224,999	213,101 199,009	314,508 206,870.5	457,385 194,343	590,531 249,496
⊳ Line 7: Investments ? ⊳ Median	3,956,028 299,524	5,991,899 188,688.5	6,401,364 370,813	-392,342 309,361.5	15,069,876 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	8,952	8,038	8,122	5,844	15,503
⊳ 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	942,691	1,135,631	1,072,578	1,015,360	816,010
⊳ 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	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	1,204,011	1,351,478	1,384,084	1,426,209	1,510,839
⊳ 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	5,561,576	6,215,768	6,748,227	12,496,974	18,207,392
Total income ? Median	17,534,367 6,586,430	11,208,790 6,767,106	21,110,069 8,419,950	-6,980,627 8,094,175	38,888,053 15,162,888
Non-operating expenses Median	6,077,917 146,289.5	9,382,081 164,857	9,220,695 89,880.5	11,899,861 106,761	11,031,381 31,473.5
Net income Median	11,456,450 6,043,842	1,826,709 5,845,112	11,889,374 7,606,259	-18,880,488 7,283,041	27,856,672 14,957,241
Net margin Median	6.59265% 4.62%	1.05045% 4.42%	6.13543% 5.16%	-10.37666% 5.2%	11.45565% 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 LAKE REGIONAL 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	27,363,741 23,241,334	27,331,207 23,709,545	26,369,516 24,248,380	23,616,114 22,858,541	27,269,190 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	26,646,522 21,577,146	26,598,713 22,041,594	25,766,734 22,722,063	22,890,172 21,570,441	26,421,468 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	717,219 1,203,033	732,494 1,215,295	602,782 1,313,657	725,942 1,365,298	847,722 1,179,746
All outpatient revenue Median Click here to show/hide details	24,744,039 11,160,864	25,170,710 11,987,345	28,935,648 12,926,866	26,976,078 11,884,480	32,137,188 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	21,432,063 10,918,923	22,001,382 11,706,976	25,285,118 12,615,917	23,827,763 11,458,116	28,461,831 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	471,784 1,282,808	431,833 1,407,728	658,929 1,341,512	411,391 1,407,046	1,081,155 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	2,840,192 618,038	2,737,495 697,279	2,991,601 690,232	2,736,924 684,010	2,594,202 670,558
⊳ 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	380,014 594,888	359,591 595,761	380,739 577,894	347,591 542,168	343,482 549,667
Outlier Median	831,075 582,572	288,512 538,116	280,925 212,434	78,980 126,559	133,384 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	1,550,546 4,081,319	5,813,398 4,643,908	0 4,389,147
Charity care Median	5,580,577 2,654,636	4,771,241 2,940,659	4,947,773 3,380,215	2,270,813 3,488,738	3,401,987 3,233,405
Uncompensated care (UCC) Median	10,418,927 5,147,790	10,932,706 5,337,617	11,385,001 5,711,082	7,929,911 5,923,418	9,708,434 5,508,107
UCC as a % of operating expenses Median	6.67% 3.24	6.72% 3.12	6.59% 3.21	4.20% 3.3	4.75% 2.86
Total shortfall/UCC Median	10,418,927 9,489,989	10,932,706 9,424,297	12,935,547 10,120,158	13,743,309 11,171,337	9,708,434 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	58,845,895 52,142,039	62,374,917 54,485,252	64,726,662 57,395,589	70,045,837 58,830,919	74,361,497 61,722,907
Salaries as a % of operating expenses Median	37.66 36.68	38.34 36.56	37.49 36.37	37.07 35.93	36.40 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	4,909,010 1,449,244	5,247,453 1,475,986	5,469,791 1,563,078	4,936,189 1,721,954	6,631,524 2,991,828
Contract hours, direct-care Median	99,330.74 22,725	101,013.46 23,018.5	96,477.00 24,503.48	89,183.66 25,026.5	101,116.27 33,786
Contract wages, direct-care Median	49.42 64.67	51.95 64.53	56.70 65.06	55.35 68.97	65.58 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.