As of the July, 2022, release via CMS

CAYUGA MEDICAL CENTER AT ITHACA

CMS id: 330307
101 DATES DRIVE, ITHACA NY 14850. County: TOMPKINS
System: CAYUGA HEALTH SYSTEM
CBSA: Ithaca, NY

The 124-bed, acute-care hospital had $-55,233,357 in net service to patients*, with a total profit margin of 8.32541% in fiscal year 2021, the latest year available.
It spent 0.66% of its operating expenses on uncompensated care and reported $9,476,603 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	128 118	147 118	147 119.5	154 118	97 119
Total beds Median	185 162	178 162	186 162	193 162	124 163.5
FTEs Median	1,198.20 788.06	1,228.40 793.42	1,277.30 806.03	1,332.20 787.61	1,459.70 804.34

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	201,375,099 150,932,746	227,554,668 158,950,878	248,035,107 168,696,998	230,855,929 163,454,693	273,962,361 186,589,412
Operating expenses Median	200,781,665 149,311,209	222,777,251 156,110,414	242,896,301 164,890,568	278,273,266 166,516,854	329,195,718 180,120,888
Net income from service 2 patients (NS2P) ? Median	593,434 -964,173	4,777,417 -643,601.5	5,138,806 -116,254	-47,417,337 -5,025,862	-55,233,357 -1,284,564
NS2P margin ? Median	0.29% -0.62	2.10% -0.29	2.07% 0.18	-20.54% -5.07	-20.16% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CAYUGA MEDICAL CENTER AT ITHACA 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	10,186,580 5,089,215	13,160,927 4,572,541	14,466,620 5,268,134	41,149,785 13,092,619	49,693,385 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	0 299,524	0 188,688.5	0 370,813	0 309,361.5	6,088,735 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	79,955	88,835	71,186	72,930	144,342
⊳ Line 11: Rebates and refunds of expenses	677,959	780,682	1,017,616	1,049,010	874,191
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	1,675	38,054	47,234	41,161	37,571
⊳ Line 14: Revenue from meals sold to emplyees and guests	1,453,163	1,562,211	1,786,871	1,215,243	1,221,127
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	25,327	4,768	4,640	1,015	23,779
⊳ Line 17: Revenue from sale of drugs to other than patients	3,020,430	2,787,586	4,748,051	5,693,619	6,064,714
⊳ Line 18: Revenue from sale of medical records and abstracts	15,757	1,366	2,232	34,159	46,871
⊳ 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	12,987	12,636	0	0	0
⊳ Line 22: Rental of hospital space	37,082	36,991	34,039	34,413	35,311
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	4,862,245	7,847,798	6,754,751	33,008,235	35,156,744
Total income ? Median	10,780,014 6,586,430	17,938,344 6,767,106	19,605,426 8,419,950	-6,267,552 8,094,175	-5,539,972 15,162,888
Non-operating expenses Median	10,142,702 146,289.5	23,514,453 164,857	19,072,032 89,880.5	3,742,943 106,761	-32,485,647 31,473.5
Net income Median	637,312 6,043,842	-5,576,109 5,845,112	533,394 7,606,259	-10,010,495 7,283,041	26,945,675 14,957,241
Net margin Median	0.30124% 4.62%	-2.31647% 4.42%	0.20320% 5.16%	-3.68025% 5.2%	8.32541% 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 CAYUGA MEDICAL CENTER AT ITHACA 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	25,337,903 23,241,334	25,901,291 23,709,545	27,118,063 24,248,380	23,321,862 22,858,541	23,689,343 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	22,634,663 21,577,146	23,903,226 22,041,594	24,999,359 22,722,063	20,816,159 21,570,441	21,177,857 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	1,117,757 1,845,420	232,237 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	1,585,483 3,535,627	1,765,828 3,746,588	2,118,704 3,782,288	2,505,703 3,865,578	2,511,486 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	21,156,444 11,160,864	23,669,660 11,987,345	25,978,795 12,926,866	26,839,070 11,884,480	28,317,182 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	21,156,444 10,918,923	23,669,660 11,706,976	25,978,795 12,615,917	26,839,070 11,458,116	28,317,182 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	0 3,284,314	0 3,250,551	0 3,386,837	393,393 3,360,806	906,593 3,508,953
Disproportionate-share hospital (DSH) Median	376,970 594,888	525,179 595,761	548,374 577,894	462,564 542,168	468,195 549,667
Outlier Median	381,816 582,572	547,238 538,116	331,330 212,434	148,157 126,559	1,252,732 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,677,146 3,662,910	6,126,682 3,730,911	7,399,557 4,081,319	4,910,793 4,643,908	9,476,603 4,389,147
Charity care Median	281,235 2,654,636	604,052 2,940,659	1,140,775 3,380,215	216,212 3,488,738	97,445 3,233,405
Uncompensated care (UCC) Median	2,985,140 5,147,790	3,981,872 5,337,617	4,699,701 5,711,082	3,429,239 5,923,418	2,183,133 5,508,107
UCC as a % of operating expenses Median	1.49% 3.24	1.79% 3.12	1.93% 3.21	1.23% 3.3	0.66% 2.86
Total shortfall/UCC Median	5,662,286 9,489,989	10,108,554 9,424,297	12,099,258 10,120,158	8,340,032 11,171,337	11,659,736 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	73,765,137 52,142,039	78,478,170 54,485,252	86,749,363 57,395,589	89,116,786 58,830,919	103,612,081 61,722,907
Salaries as a % of operating expenses Median	36.74 36.68	35.23 36.56	35.71 36.37	35.85 35.93	31.47 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	145,390 2,753,773	568,256 2,937,156	1,302,599 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	3,179,255 1,449,244	3,119,365 1,475,986	4,309,137 1,563,078	1,555,657 1,721,954	4,146,722 2,991,828
Contract hours, direct-care Median	38,264.00 22,725	35,653.00 23,018.5	53,381.00 24,503.48	21,461.00 25,026.5	39,137.00 33,786
Contract wages, direct-care Median	83.09 64.67	87.49 64.53	80.72 65.06	72.49 68.97	105.95 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.