As of the July, 2022, release via CMS

BROOKS-TLC HOSPITAL SYSTEM INC.

CMS id: 330229
529 CENTRAL AVE, DUNKIRK NY 14048. County: CHAUTAUQUA
System: --
CBSA: Jamestown-Dunkirk-Fredonia, NY

The 65-bed, acute-care hospital had $-12,346,836 in net service to patients*, with a total profit margin of -0.12258% in fiscal year 2021, the latest year available.
It spent 1.52% of its operating expenses on uncompensated care and reported $3,527,587 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	56 118	42 118	42 119.5	60 118	56 119
Total beds Median	65 162	65 162	65 162	65 162	65 163.5
FTEs Median	309.90 788.06	536.80 793.42	459.20 806.03	331.60 787.61	311.60 804.34

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	37,729,147 150,932,746	50,443,633 158,950,878	46,478,739 168,696,998	31,421,400 163,454,693	37,930,350 186,589,412
Operating expenses Median	45,335,897 149,311,209	64,072,292 156,110,414	64,842,707 164,890,568	49,906,222 166,516,854	50,277,186 180,120,888
Net income from service 2 patients (NS2P) ? Median	-7,606,750 -964,173	-13,628,659 -643,601.5	-18,363,968 -116,254	-18,484,822 -5,025,862	-12,346,836 -1,284,564
NS2P margin ? Median	-20.16% -0.62	-27.02% -0.29	-39.51% 0.18	-58.83% -5.07	-32.55% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for BROOKS-TLC HOSPITAL SYSTEM INC. 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	7,113,700 5,089,215	12,383,178 4,572,541	16,013,308 5,268,134	22,040,846 13,092,619	12,424,616 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	40,217 224,999	79,976 199,009	84,831 206,870.5	57,142 194,343	32,060 249,496
⊳ Line 7: Investments ? ⊳ Median	27,264 299,524	-276,738 188,688.5	143,764 370,813	211,125 309,361.5	27,623 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	204	422	0	1,361	0
⊳ Line 11: Rebates and refunds of expenses	20,007	0	54	54,962	594
⊳ 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	148,089	199,698	172,517	117,478	111,544
⊳ 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	3,537	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	14,363	26,483	9,278	1,123	4,900
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	5,105	11,620	8,438	4,506
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	1,895	627	0
⊳ Line 22: Rental of hospital space	17,155	24,434	4,000	4,000	4,000
⊳ Line 23: Gov appropriations ? ⊳ Median	6,182,339 1,017,693	9,803,003 983,261.5	14,764,582 1,173,286	6,424,757 1,987,202	11,437,062 1,597,664
⊳ Sum Line 24	660,525	2,520,795	820,767	15,159,833	802,327
Total income ? Median	-493,050 6,586,430	-1,245,481 6,767,106	-2,350,660 8,419,950	3,556,024 8,094,175	77,780 15,162,888
Non-operating expenses Median	398,267 146,289.5	2,918,149 164,857	10,212,026 89,880.5	-297,923 106,761	139,503 31,473.5
Net income Median	-891,317 6,043,842	-4,163,630 5,845,112	-12,562,686 7,606,259	3,853,947 7,283,041	-61,723 14,957,241
Net margin Median	-1.98765% 4.62%	-6.62715% 4.42%	-20.10286% 5.16%	7.20873% 5.2%	-0.12258% 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 BROOKS-TLC HOSPITAL SYSTEM INC. 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	4,930,545 23,241,334	6,173,890 23,709,545	5,541,201 24,248,380	4,815,878 22,858,541	5,292,632 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	4,930,545 21,577,146	5,390,833 22,041,594	4,768,248 22,722,063	4,652,296 21,570,441	5,292,632 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	783,057 1,757,392	772,953 1,738,842	163,582 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	3,115,367 11,160,864	4,876,758 11,987,345	3,915,049 12,926,866	2,786,282 11,884,480	2,903,002 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	3,115,367 10,918,923	4,340,813 11,706,976	3,915,049 12,615,917	2,786,282 11,458,116	2,903,002 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	535,945 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	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	121,960 594,888	128,449 595,761	104,201 577,894	100,422 542,168	114,363 549,667
Outlier Median	70,152 582,572	77,300 538,116	5,007 212,434	3,120 126,559	29,520 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,668,086 3,662,910	0 3,730,911	3,482,109 4,081,319	4,224,038 4,643,908	3,527,587 4,389,147
Charity care Median	195,526 2,654,636	137,289 2,940,659	248,997 3,380,215	56,943 3,488,738	55,658 3,233,405
Uncompensated care (UCC) Median	865,714 5,147,790	1,756,333 5,337,617	1,176,732 5,711,082	971,137 5,923,418	763,181 5,508,107
UCC as a % of operating expenses Median	1.91% 3.24	2.74% 3.12	1.81% 3.21	1.95% 3.3	1.52% 2.86
Total shortfall/UCC Median	3,533,800 9,489,989	1,756,333 9,424,297	4,658,841 10,120,158	5,195,175 11,171,337	4,290,768 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	16,325,436 52,142,039	24,518,177 54,485,252	23,307,098 57,395,589	17,249,580 58,830,919	18,587,892 61,722,907
Salaries as a % of operating expenses Median	36.01 36.68	38.27 36.56	35.94 36.37	34.67 35.93	36.97 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	854,174 1,449,244	1,448,939 1,475,986	2,880,298 1,563,078	621,792 1,721,954	3,450,433 2,991,828
Contract hours, direct-care Median	10,888.00 22,725	18,335.00 23,018.5	36,700.00 24,503.48	7,664.00 25,026.5	41,810.00 33,786
Contract wages, direct-care Median	78.45 64.67	79.03 64.53	78.48 65.06	81.13 68.97	82.53 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.