As of the July, 2022, release via CMS

SOUTHERN NH MEDICAL CENTER

CMS id: 300020
8 PROSPECT STREET, NASHUA NH 3060. County: HILLSBOROUGH
System: SOLUTIONHEALTH
CBSA: Manchester-Nashua, NH

The 158-bed, acute-care hospital had $-5,342,442 in net service to patients*, with a total profit margin of 23.28059% in fiscal year 2021, the latest year available.
It spent 3.54% of its operating expenses on uncompensated care and reported $6,957,459 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	273	366	365
Ownership	nfp	nfp	nfp	nfp	nfp
Acute beds Median	139 118	139 118	131 119.5	129 118	129 119
Total beds Median	168 162	168 162	160 162	158 162	158 163.5
FTEs Median	1,252.88 788.06	1,270.15 793.42	1,292.50 806.03	1,280.09 787.61	1,158.28 804.34

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	223,620,559 150,932,746	235,412,028 158,950,878	184,180,616 168,696,998	223,650,232 163,454,693	241,131,256 186,589,412
Operating expenses Median	196,359,855 149,311,209	209,581,061 156,110,414	165,030,102 164,890,568	222,857,130 166,516,854	246,473,698 180,120,888
Net income from service 2 patients (NS2P) ? Median	27,260,704 -964,173	25,830,967 -643,601.5	19,150,514 -116,254	793,102 -5,025,862	-5,342,442 -1,284,564
NS2P margin ? Median	12.19% -0.62	10.97% -0.29	10.40% 0.18	0.35% -5.07	-2.22% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SOUTHERN NH MEDICAL CENTER 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	29,019,298 5,089,215	31,429,591 4,572,541	21,189,299 5,268,134	27,538,058 13,092,619	78,831,706 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	-372,343 224,999	-376,849 199,009	-552,840 206,870.5	-235,982 194,343	-532,831 249,496
⊳ Line 7: Investments ? ⊳ Median	13,639,281 299,524	13,263,935 188,688.5	6,869,737 370,813	2,859,852 309,361.5	52,771,406 375,329
⊳ 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	943,095	357,564	292,613	352,919	343,577
⊳ 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	5,616	445	285	863	863
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	596,270	623,168	505,713	544,108	415,137
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	4,269,783	4,417,327	3,379,214	4,575,255	3,815,582
⊳ Line 23: Gov appropriations ? ⊳ Median	397,583 1,017,693	1,815,351 983,261.5	2,011,534 1,173,286	7,005,264 1,987,202	10,499,332 1,597,664
⊳ Sum Line 24	9,540,013	11,328,650	8,683,043	12,435,779	11,518,640
Total income ? Median	56,280,002 6,586,430	57,260,558 6,767,106	40,339,813 8,419,950	28,331,160 8,094,175	73,489,264 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	-1,038,792 106,761	-1,000,000 31,473.5
Net income Median	56,280,002 6,043,842	57,260,558 5,845,112	40,339,813 7,606,259	29,369,952 7,283,041	74,489,264 14,957,241
Net margin Median	22.27677% 4.62%	21.45863% 4.42%	19.64251% 5.16%	11.69240% 5.2%	23.28059% 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 SOUTHERN NH MEDICAL CENTER 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	32,424,243 23,241,334	35,415,472 23,709,545	26,783,157 24,248,380	31,090,480 22,858,541	31,638,740 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	31,020,840 21,577,146	34,133,120 22,041,594	25,890,095 22,722,063	30,051,988 21,570,441	30,903,704 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	1,403,403 1,845,420	1,282,352 1,757,392	893,062 1,738,842	1,038,492 1,510,463	735,036 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	15,557,850 11,160,864	16,173,283 11,987,345	12,858,253 12,926,866	14,966,831 11,884,480	14,946,448 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	15,557,850 10,918,923	16,173,283 11,706,976	12,858,253 12,615,917	14,966,831 11,458,116	14,946,448 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	572,223 3,284,314	514,031 3,250,551	289,691 3,386,837	270,702 3,360,806	312,258 3,508,953
Disproportionate-share hospital (DSH) Median	539,936 594,888	591,310 595,761	351,405 577,894	460,019 542,168	581,802 549,667
Outlier Median	786,186 582,572	1,138,964 538,116	185,942 212,434	78,205 126,559	98,689 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	656,463 3,662,910	241,894 3,730,911	1,259,777 4,081,319	3,837,996 4,643,908	6,957,459 4,389,147
Charity care Median	5,005,295 2,654,636	4,921,087 2,940,659	4,790,958 3,380,215	4,689,467 3,488,738	5,581,562 3,233,405
Uncompensated care (UCC) Median	9,976,786 5,147,790	7,872,351 5,337,617	8,238,663 5,711,082	9,221,185 5,923,418	8,718,814 5,508,107
UCC as a % of operating expenses Median	5.08% 3.24	3.76% 3.12	4.99% 3.21	4.14% 3.3	3.54% 2.86
Total shortfall/UCC Median	10,633,249 9,489,989	8,114,245 9,424,297	9,498,440 10,120,158	13,059,181 11,171,337	15,676,273 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	91,741,368 52,142,039	96,972,971 54,485,252	75,758,453 57,395,589	99,252,903 58,830,919	94,144,429 61,722,907
Salaries as a % of operating expenses Median	46.57 36.68	46.07 36.56	45.69 36.37	44.34 35.93	38.01 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	342,881 1,251,927	170,345 1,186,494	166,090 1,204,885	163,636 1,279,653	434,473 1,469,317
Contract adjusted salaries, direct-care Median	1,103,119 1,449,244	1,743,689 1,475,986	1,309,350 1,563,078	1,813,376 1,721,954	4,022,405 2,991,828
Contract hours, direct-care Median	18,209.00 22,725	24,429.67 23,018.5	18,733.00 24,503.48	25,509.00 25,026.5	8,611.00 33,786
Contract wages, direct-care Median	60.58 64.67	71.38 64.53	69.90 65.06	71.09 68.97	467.12 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.