As of the July, 2022, release via CMS

KALEIDA HEALTH

CMS id: 330005
100 HIGH STREET, BUFFALO NY 14203. County: ERIE
System: --
CBSA: Buffalo-Cheektowaga, NY

The 1,068-bed, acute-care hospital had $-78,604,062 in net service to patients*, with a total profit margin of -2.95994% in fiscal year 2021, the latest year available.
It spent 1.10% of its operating expenses on uncompensated care and reported $52,158,923 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	736 118	750 118	750 119.5	750 118	750 119
Total beds Median	1,066 162	1,068 162	1,068 162	1,068 162	1,068 163.5
FTEs Median	7,241.89 788.06	7,285.64 793.42	7,300.40 806.03	7,353.80 787.61	6,778.88 804.34

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	1,204,753,927 150,932,746	1,272,308,000 158,950,878	1,251,640,824 168,696,998	1,204,592,705 163,454,693	1,328,771,655 186,589,412
Operating expenses Median	1,258,336,235 149,311,209	1,333,978,219 156,110,414	1,357,601,219 164,890,568	1,386,229,980 166,516,854	1,407,375,717 180,120,888
Net income from service 2 patients (NS2P) ? Median	-53,582,308 -964,173	-61,670,219 -643,601.5	-105,960,395 -116,254	-181,637,275 -5,025,862	-78,604,062 -1,284,564
NS2P margin ? Median	-4.45% -0.62	-4.85% -0.29	-8.47% 0.18	-15.08% -5.07	-5.92% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for KALEIDA HEALTH 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	40,280,113 5,089,215	35,891,118 4,572,541	25,738,750 5,268,134	118,174,499 13,092,619	38,480,867 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	2,135,829 299,524	1,220,041 188,688.5	422,927 370,813	-2,745,055 309,361.5	45,727 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	1,139,475	1,100,135	813,486	573,754	634,933
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	46,960	2,349	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	0	0	0	0	0
⊳ Line 15: Revenue from rental of living quarters	0	2,446,987	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	293,440	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	364,212	399,015	297,744	0	393,419
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	290	460	200	220	80
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	551,724	409,481	587,165	410,749	501,059
⊳ Line 22: Rental of hospital space	3,764,025	0	3,317,751	2,850,571	2,786,783
⊳ Line 23: Gov appropriations ? ⊳ Median	16,102,968 1,017,693	13,242,797 983,261.5	6,015,669 1,173,286	2,403,168 1,987,202	3,133,799 1,597,664
⊳ Sum Line 24	16,174,630	17,069,853	14,283,808	114,387,652	30,985,067
Total income ? Median	-13,302,195 6,586,430	-25,779,101 6,767,106	-80,221,645 8,419,950	-63,462,776 8,094,175	-40,123,195 15,162,888
Non-operating expenses Median	3,699,376 146,289.5	19,453,942 164,857	-8,926,534 89,880.5	-3,496,776 106,761	346,710 31,473.5
Net income Median	-17,001,571 6,043,842	-45,233,043 5,845,112	-71,295,111 7,606,259	-59,966,000 7,283,041	-40,469,905 14,957,241
Net margin Median	-1.36555% 4.62%	-3.45766% 4.42%	-5.58136% 5.16%	-4.53338% 5.2%	-2.95994% 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 KALEIDA HEALTH 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	204,887,572 23,241,334	200,562,224 23,709,545	198,365,058 24,248,380	187,907,476 22,858,541	203,608,627 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	200,444,227 21,577,146	196,298,663 22,041,594	193,807,662 22,722,063	183,407,353 21,570,441	198,206,748 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	3,643,031 3,535,627	3,497,038 3,746,588	3,687,320 3,782,288	3,626,850 3,865,578	4,568,673 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	800,314 1,203,033	766,523 1,215,295	870,076 1,313,657	873,273 1,365,298	833,206 1,179,746
All outpatient revenue Median Click here to show/hide details	40,421,459 11,160,864	40,910,055 11,987,345	42,023,659 12,926,866	40,809,535 11,884,480	48,036,607 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	40,421,459 10,918,923	40,910,055 11,706,976	42,023,659 12,615,917	40,809,535 11,458,116	48,036,607 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	39,175,817 3,284,314	38,574,080 3,250,551	38,306,471 3,386,837	37,421,403 3,360,806	40,904,028 3,508,953
Disproportionate-share hospital (DSH) Median	5,022,501 594,888	4,972,778 595,761	4,886,076 577,894	4,658,856 542,168	4,884,319 549,667
Outlier Median	8,576,631 582,572	7,741,695 538,116	1,294,709 212,434	1,345,999 126,559	1,640,381 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	27,457,677 3,662,910	12,105,805 3,730,911	89,707,756 4,081,319	95,140,964 4,643,908	52,158,923 4,389,147
Charity care Median	6,786,662 2,654,636	14,026,755 2,940,659	12,660,828 3,380,215	13,290,544 3,488,738	9,727,440 3,233,405
Uncompensated care (UCC) Median	13,805,729 5,147,790	20,046,538 5,337,617	17,731,879 5,711,082	21,171,062 5,923,418	15,435,192 5,508,107
UCC as a % of operating expenses Median	1.10% 3.24	1.50% 3.12	1.31% 3.21	1.53% 3.3	1.10% 2.86
Total shortfall/UCC Median	41,263,406 9,489,989	32,152,343 9,424,297	107,439,635 10,120,158	116,312,026 11,171,337	67,594,115 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	515,879,511 52,142,039	536,769,326 54,485,252	564,512,629 57,395,589	541,540,905 58,830,919	535,641,453 61,722,907
Salaries as a % of operating expenses Median	41.00 36.68	40.24 36.56	41.58 36.37	39.07 35.93	38.06 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	26,598,750 1,251,927	27,506,768 1,186,494	27,202,706 1,204,885	0 1,279,653	29,491,151 1,469,317
Contract adjusted salaries, direct-care Median	30,553,282 1,449,244	32,331,446 1,475,986	28,355,376 1,563,078	0 1,721,954	35,237,345 2,991,828
Contract hours, direct-care Median	875,269.00 22,725	861,439.25 23,018.5	818,796.00 24,503.48	0.00 25,026.5	889,097.00 33,786
Contract wages, direct-care Median	34.91 64.67	37.53 64.53	34.63 65.06	0.00 68.97	39.63 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.