As of the July, 2022, release via CMS

ST. ROSE DOMINICAN - SIENA

CMS id: 290045
3001 ST ROSE PARKWAY, HENDERSON NV 89052. County: CLARK
System: DIGNITY HEALTH
CBSA: Las Vegas-Henderson-Paradise, NV

The 326-bed, acute-care hospital had $-11,321,357 in net service to patients*, with a total profit margin of 4.89334% in fiscal year 2021, the latest year available.
It spent 3.97% of its operating expenses on uncompensated care and reported $26,821,561 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	244 118	244 118	244 119.5	244 118	244 119
Total beds Median	326 162	326 162	326 162	326 162	326 163.5
FTEs Median	1,863.60 788.06	1,870.95 793.42	1,796.82 806.03	1,799.62 787.61	1,823.27 804.34

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	440,232,554 150,932,746	465,085,210 158,950,878	484,032,990 168,696,998	462,124,043 163,454,693	490,702,204 186,589,412
Operating expenses Median	432,204,852 149,311,209	443,727,861 156,110,414	469,097,166 164,890,568	479,386,328 166,516,854	502,023,561 180,120,888
Net income from service 2 patients (NS2P) ? Median	8,027,702 -964,173	21,357,349 -643,601.5	14,935,824 -116,254	-17,262,285 -5,025,862	-11,321,357 -1,284,564
NS2P margin ? Median	1.82% -0.62	4.59% -0.29	3.09% 0.18	-3.74% -5.07	-2.31% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ST. ROSE DOMINICAN - SIENA 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	24,686,761 5,089,215	21,552,711 4,572,541	19,668,979 5,268,134	64,077,424 13,092,619	37,151,030 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	36,239 224,999	50,000 199,009	30,000 206,870.5	1,000 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	17,651,954 299,524	14,744,987 188,688.5	2,263,050 370,813	1,671,271 309,361.5	14,782,725 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	92,341	73,188	82,141	89,364	56,553
⊳ Line 11: Rebates and refunds of expenses	0	8,680	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	1,827,927	1,849,918	1,928,149	1,679,312	936,021
⊳ 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	12	0	389
⊳ Line 18: Revenue from sale of medical records and abstracts	14,370	7,641	16,297	12,351	11,065
⊳ 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	1,590	4,326	4,428	3,946	5,459
⊳ Line 22: Rental of hospital space	199,556	259,650	463,981	391,365	379,687
⊳ Line 23: Gov appropriations ? ⊳ Median	427,476 1,017,693	84,584 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	4,435,308	4,469,737	14,880,921	60,228,815	20,979,131
Total income ? Median	32,714,463 6,586,430	42,910,060 6,767,106	34,604,803 8,419,950	46,815,139 8,094,175	25,829,673 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	32,714,463 6,043,842	42,910,060 5,845,112	34,604,803 7,606,259	46,815,139 7,283,041	25,829,673 14,957,241
Net margin Median	7.03659% 4.62%	8.81766% 4.42%	6.87009% 5.16%	8.89681% 5.2%	4.89334% 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 ST. ROSE DOMINICAN - SIENA 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	77,439,087 23,241,334	83,822,453 23,709,545	90,084,309 24,248,380	85,457,327 22,858,541	81,047,869 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	77,439,087 21,577,146	83,822,453 22,041,594	90,084,309 22,722,063	85,457,327 21,570,441	81,047,869 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	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	21,384,025 11,160,864	22,624,154 11,987,345	24,461,054 12,926,866	23,785,114 11,884,480	22,998,465 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	21,384,025 10,918,923	22,624,154 11,706,976	24,461,054 12,615,917	23,785,114 11,458,116	22,998,465 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	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	2,513,239 3,284,314	2,611,623 3,250,551	2,665,909 3,386,837	2,225,106 3,360,806	1,731,288 3,508,953
Disproportionate-share hospital (DSH) Median	1,857,009 594,888	1,745,994 595,761	1,586,463 577,894	1,655,594 542,168	1,207,253 549,667
Outlier Median	2,954,380 582,572	4,026,631 538,116	3,179,944 212,434	404,996 126,559	309,089 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	23,299,712 3,662,910	21,632,016 3,730,911	27,634,844 4,081,319	32,804,109 4,643,908	26,821,561 4,389,147
Charity care Median	5,911,837 2,654,636	7,497,886 2,940,659	9,959,336 3,380,215	13,016,276 3,488,738	14,840,500 3,233,405
Uncompensated care (UCC) Median	11,493,414 5,147,790	14,078,565 5,337,617	17,635,891 5,711,082	19,981,328 5,923,418	19,936,977 5,508,107
UCC as a % of operating expenses Median	2.66% 3.24	3.17% 3.12	3.76% 3.21	4.17% 3.3	3.97% 2.86
Total shortfall/UCC Median	34,793,126 9,489,989	35,710,581 9,424,297	45,270,735 10,120,158	52,785,437 11,171,337	46,758,538 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	166,450,996 52,142,039	170,816,986 54,485,252	176,544,478 57,395,589	183,834,998 58,830,919	196,183,622 61,722,907
Salaries as a % of operating expenses Median	38.51 36.68	38.50 36.56	37.63 36.37	38.35 35.93	39.08 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	2,351,573 1,449,244	3,890,879 1,475,986	3,954,970 1,563,078	2,645,628 1,721,954	7,699,842 2,991,828
Contract hours, direct-care Median	26,783.00 22,725	41,155.00 23,018.5	56,275.00 24,503.48	29,223.00 25,026.5	64,415.00 33,786
Contract wages, direct-care Median	87.80 64.67	94.54 64.53	70.28 65.06	90.53 68.97	119.53 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.