As of the July, 2022, release via CMS

MARY HITCHCOCK MEMORIAL HOSP

CMS id: 300003
1 MEDICAL CENTER DRIVE, LEBANON NH 3756. County: GRAFTON
System: DARTMOUITH HITCHCOCK HEALTH
CBSA: Lebanon, NH-VT

The 422-bed, acute-care hospital had $-293,695,547 in net service to patients*, with a total profit margin of 13.91902% in fiscal year 2021, the latest year available.
It spent 1.17% of its operating expenses on uncompensated care and reported $91,475,237 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	294 118	311 119.5	311 118	311 119
Total beds Median	408 162	395 162	422 162	422 162	422 163.5
FTEs Median	3,704.00 788.06	4,057.00 793.42	4,185.00 806.03	4,276.00 787.61	3,947.00 804.34

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	1,049,239,676 150,932,746	1,079,812,805 158,950,878	1,189,522,229 168,696,998	1,141,938,206 163,454,693	1,275,865,373 186,589,412
Operating expenses Median	1,144,604,554 149,311,209	1,175,193,841 156,110,414	1,323,959,886 164,890,568	1,483,540,741 166,516,854	1,569,560,920 180,120,888
Net income from service 2 patients (NS2P) ? Median	-95,364,878 -964,173	-95,381,036 -643,601.5	-134,437,657 -116,254	-341,602,535 -5,025,862	-293,695,547 -1,284,564
NS2P margin ? Median	-9.09% -0.62	-8.83% -0.29	-11.30% 0.18	-29.91% -5.07	-23.02% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MARY HITCHCOCK MEMORIAL HOSP 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	156,648,670 5,089,215	156,971,299 4,572,541	219,354,118 5,268,134	325,558,059 13,092,619	547,488,592 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	100,937 206,870.5	23,793 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	18,424,636 299,524	9,505 188,688.5	19,152,204 370,813	19,186,604 309,361.5	171,910,646 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	177,490	166,016	156,666	143,307	138,442
⊳ Line 11: Rebates and refunds of expenses	2,559,437	2,549,332	2,774,557	3,776,945	5,277,740
⊳ 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	3,365,229	3,410,567	3,570,801	3,179,933	2,349,967
⊳ Line 15: Revenue from rental of living quarters	108,349	120,381	123,863	125,070	134,186
⊳ 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	609,195	747,164	5,605,169	4,833,896	4,833,896
⊳ 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	853,307	768,239	689,540	713,282	562,535
⊳ Line 21: Rental of vending machines	12,264	12,695	13,090	18,622	10,694
⊳ Line 22: Rental of hospital space	967,628	534,020	653,919	617,352	540,623
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	29,833,395 1,597,664
⊳ Sum Line 24	129,571,135	117,134,540	186,513,372	292,939,255	331,896,468
Total income ? Median	61,283,792 6,586,430	61,590,263 6,767,106	84,916,461 8,419,950	-16,044,476 8,094,175	253,793,045 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	61,283,792 6,043,842	61,590,263 5,845,112	84,916,461 7,606,259	-16,044,476 7,283,041	253,793,045 14,957,241
Net margin Median	5.08205% 4.62%	4.97987% 4.42%	6.02725% 5.16%	-1.09332% 5.2%	13.91902% 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 MARY HITCHCOCK MEMORIAL HOSP 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	190,113,729 23,241,334	203,000,448 23,709,545	208,202,273 24,248,380	198,258,621 22,858,541	205,419,715 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	188,009,429 21,577,146	200,728,037 22,041,594	206,077,937 22,722,063	196,040,755 21,570,441	202,653,402 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	2,104,300 1,845,420	2,272,411 1,757,392	2,124,336 1,738,842	2,217,866 1,510,463	2,766,313 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	131,365,112 11,160,864	142,348,058 11,987,345	153,921,610 12,926,866	147,283,797 11,884,480	162,667,137 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	131,365,112 10,918,923	142,348,058 11,706,976	153,921,610 12,615,917	147,283,797 11,458,116	162,667,137 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	54,790,619 3,284,314	59,069,283 3,250,551	58,820,555 3,386,837	56,821,715 3,360,806	56,691,953 3,508,953
Disproportionate-share hospital (DSH) Median	3,203,575 594,888	3,706,172 595,761	3,832,356 577,894	3,351,843 542,168	3,375,234 549,667
Outlier Median	12,232,958 582,572	11,895,204 538,116	11,798,472 212,434	1,608,765 126,559	2,058,335 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	59,229,553 3,662,910	53,671,081 3,730,911	64,990,715 4,081,319	79,889,478 4,643,908	91,475,237 4,389,147
Charity care Median	10,707,304 2,654,636	12,009,674 2,940,659	15,671,686 3,380,215	16,082,900 3,488,738	12,313,735 3,233,405
Uncompensated care (UCC) Median	19,585,719 5,147,790	15,368,674 5,337,617	26,379,194 5,711,082	27,603,952 5,923,418	18,379,254 5,508,107
UCC as a % of operating expenses Median	1.71% 3.24	1.31% 3.12	1.99% 3.21	1.86% 3.3	1.17% 2.86
Total shortfall/UCC Median	78,815,272 9,489,989	69,039,755 9,424,297	91,369,909 10,120,158	107,493,430 11,171,337	109,854,491 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	303,641,759 52,142,039	304,071,670 54,485,252	323,932,878 57,395,589	341,356,112 58,830,919	353,712,767 61,722,907
Salaries as a % of operating expenses Median	33.48 36.68	33.21 36.56	31.31 36.37	31.30 35.93	30.42 35.24
Intern, resident salaries* Median	20,689,093 2,598,592	21,437,936 2,686,824	22,644,359 2,753,773	23,919,388 2,937,156	24,539,484 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	15,823,735 1,449,244	17,968,652 1,475,986	19,671,804 1,563,078	19,525,144 1,721,954	21,784,144 2,991,828
Contract hours, direct-care Median	190,377.00 22,725	230,863.00 23,018.5	259,075.00 24,503.48	247,899.00 25,026.5	229,780.00 33,786
Contract wages, direct-care Median	83.12 64.67	77.83 64.53	75.93 65.06	78.76 68.97	94.80 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.