As of the July, 2022, release via CMS

MISSION HOSPITAL INC

CMS id: 340002
509 BILTMORE AVENUE, ASHEVILLE NC 28801. County: BUNCOMBE
System: HCA
CBSA: Asheville, NC

The 815-bed, acute-care hospital had $220,779,193 in net service to patients*, with a total profit margin of 20.49671% in fiscal year 2021, the latest year available.
It spent 5.18% of its operating expenses on uncompensated care and reported $0 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	242	366	365
Ownership	nfp	nfp	forprofit	forprofit	forprofit
Acute beds Median	448 118	448 118	462 119.5	480 118	480 119
Total beds Median	727 162	727 162	761 162	815 162	815 163.5
FTEs Median	6,116.02 788.06	6,252.50 793.42	5,037.47 806.03	4,368.68 787.61	3,910.58 804.34

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	1,162,494,481 150,932,746	1,209,452,518 158,950,878	860,968,083 168,696,998	1,027,208,460 163,454,693	1,267,230,070 186,589,412
Operating expenses Median	1,119,373,038 149,311,209	1,182,135,053 156,110,414	847,792,072 164,890,568	1,156,550,593 166,516,854	1,046,450,877 180,120,888
Net income from service 2 patients (NS2P) ? Median	43,121,443 -964,173	27,317,465 -643,601.5	13,176,011 -116,254	-129,342,133 -5,025,862	220,779,193 -1,284,564
NS2P margin ? Median	3.71% -0.62	2.26% -0.29	1.53% 0.18	-12.59% -5.07	17.42% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MISSION HOSPITAL 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	68,048,419 5,089,215	87,549,142 4,572,541	120,262,397 5,268,134	136,672,960 13,092,619	62,330,021 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	0 375,329
⊳ 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	0	0	0	0	0
⊳ 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	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	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ 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	68,048,419	87,549,142	120,262,397	136,672,960	62,330,021
Total income ? Median	111,169,862 6,586,430	114,866,607 6,767,106	133,438,408 8,419,950	7,330,827 8,094,175	283,109,214 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	7,437,189 106,761	10,593,157 31,473.5
Net income Median	111,169,862 6,043,842	114,866,607 5,845,112	133,438,408 7,606,259	-106,362 7,283,041	272,516,057 14,957,241
Net margin Median	9.03421% 4.62%	8.85632% 4.42%	13.59909% 5.16%	-0.00914% 5.2%	20.49671% 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 MISSION HOSPITAL 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	184,761,294 23,241,334	195,983,822 23,709,545	135,830,822 24,248,380	190,310,175 22,858,541	197,617,753 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	180,982,169 21,577,146	192,375,839 22,041,594	133,379,763 22,722,063	185,894,065 21,570,441	193,333,773 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	3,779,125 1,845,420	3,607,983 1,757,392	2,451,059 1,738,842	4,416,110 1,510,463	4,283,980 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	86,849,929 11,160,864	93,943,674 11,987,345	68,621,638 12,926,866	85,522,349 11,884,480	87,227,244 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	86,849,929 10,918,923	93,943,674 11,706,976	68,621,638 12,615,917	85,522,349 11,458,116	87,227,244 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	7,347,897 3,284,314	9,258,881 3,250,551	6,986,022 3,386,837	9,611,562 3,360,806	10,944,983 3,508,953
Disproportionate-share hospital (DSH) Median	4,776,494 594,888	5,399,545 595,761	3,270,257 577,894	4,690,456 542,168	4,513,791 549,667
Outlier Median	7,011,998 582,572	5,526,585 538,116	1,197,228 212,434	2,625,701 126,559	3,228,759 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	317,891 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	35,614,251 2,654,636	32,653,037 2,940,659	26,296,999 3,380,215	65,580,678 3,488,738	48,390,190 3,233,405
Uncompensated care (UCC) Median	62,648,294 5,147,790	67,452,720 5,337,617	29,612,744 5,711,082	74,570,722 5,923,418	54,185,869 5,508,107
UCC as a % of operating expenses Median	5.60% 3.24	5.71% 3.12	3.49% 3.21	6.45% 3.3	5.18% 2.86
Total shortfall/UCC Median	62,966,185 9,489,989	67,452,720 9,424,297	29,612,744 10,120,158	74,570,722 11,171,337	54,185,869 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	309,924,554 52,142,039	315,722,528 54,485,252	212,684,257 57,395,589	279,002,413 58,830,919	265,621,241 61,722,907
Salaries as a % of operating expenses Median	27.69 36.68	26.71 36.56	26.99 36.37	25.32 35.93	26.02 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	4,128,323 1,251,927	5,190,645 1,186,494	3,771,292 1,204,885	5,737,977 1,279,653	5,054,722 1,469,317
Contract adjusted salaries, direct-care Median	15,600,255 1,449,244	9,631,624 1,475,986	10,321,626 1,563,078	24,442,912 1,721,954	51,904,032 2,991,828
Contract hours, direct-care Median	288,452.00 22,725	235,303.00 23,018.5	240,165.40 24,503.48	446,102.24 25,026.5	661,593.40 33,786
Contract wages, direct-care Median	54.08 64.67	40.93 64.53	42.98 65.06	54.79 68.97	78.45 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.