As of the July, 2022, release via CMS

SANFORD MEDICAL CENTER - FARGO

CMS id: 350011
801 BROADWAY NORTH, FARGO ND 58102. County: CASS
System: SANFORD
CBSA: Fargo, ND-MN

The 554-bed, acute-care hospital had $-90,846,841 in net service to patients*, with a total profit margin of 9.11095% in fiscal year 2021, the latest year available.
It spent 1.72% of its operating expenses on uncompensated care and reported $18,102,948 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	320 118	361 118	349 119.5	374 118	382 119
Total beds Median	440 162	512 162	512 162	546 162	554 163.5
FTEs Median	4,851.63 788.06	5,480.13 793.42	5,906.40 806.03	5,929.62 787.61	5,835.38 804.34

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	1,069,396,966 150,932,746	1,154,200,732 158,950,878	1,230,778,892 168,696,998	1,305,556,246 163,454,693	1,463,430,066 186,589,412
Operating expenses Median	1,031,474,842 149,311,209	1,195,249,843 156,110,414	1,293,832,660 164,890,568	1,396,008,404 166,516,854	1,554,276,907 180,120,888
Net income from service 2 patients (NS2P) ? Median	37,922,124 -964,173	-41,049,111 -643,601.5	-63,053,768 -116,254	-90,452,158 -5,025,862	-90,846,841 -1,284,564
NS2P margin ? Median	3.55% -0.62	-3.56% -0.29	-5.12% 0.18	-6.93% -5.07	-6.21% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SANFORD MEDICAL CENTER - FARGO 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	57,715,026 5,089,215	102,459,117 4,572,541	172,977,098 5,268,134	266,475,191 13,092,619	255,165,664 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,470,305 224,999	1,863,088 199,009	2,837,518 206,870.5	2,596,319 194,343	2,977,541 249,496
⊳ Line 7: Investments ? ⊳ Median	498,406 299,524	395,369 188,688.5	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	3,583,716	3,670,026	4,030,509	3,141,271	3,209,938
⊳ 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	751,142	709,380	599,757	1,255,465	1,274,313
⊳ Line 23: Gov appropriations ? ⊳ Median	270,560 1,017,693	197,566 983,261.5	596,054 1,173,286	313,310 1,987,202	854,333 1,597,664
⊳ Sum Line 24	51,140,897	95,623,688	164,913,260	259,168,826	246,849,539
Total income ? Median	95,637,150 6,586,430	61,410,006 6,767,106	109,923,330 8,419,950	176,023,033 8,094,175	164,318,823 15,162,888
Non-operating expenses Median	3,238,133 146,289.5	4,680,753 164,857	5,735,220 89,880.5	10,860,104 106,761	7,738,454 31,473.5
Net income Median	92,399,017 6,043,842	56,729,253 5,845,112	104,188,110 7,606,259	165,162,929 7,283,041	156,580,369 14,957,241
Net margin Median	8.19786% 4.62%	4.51429% 4.42%	7.42210% 5.16%	10.50634% 5.2%	9.11095% 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 SANFORD MEDICAL CENTER - FARGO 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	136,053,079 23,241,334	146,367,406 23,709,545	154,015,047 24,248,380	149,040,655 22,858,541	151,994,134 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	131,193,311 21,577,146	141,160,008 22,041,594	149,262,507 22,722,063	144,484,512 21,570,441	147,615,503 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	2,736,911 1,845,420	2,492,183 1,757,392	2,235,447 1,738,842	1,588,782 1,510,463	1,433,964 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,122,857 3,535,627	2,715,215 3,746,588	2,517,093 3,782,288	2,967,361 3,865,578	2,944,667 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	123,290,542 11,160,864	136,848,390 11,987,345	133,279,481 12,926,866	126,319,359 11,884,480	138,942,183 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	120,697,335 10,918,923	134,112,279 11,706,976	130,266,267 12,615,917	122,947,665 11,458,116	135,078,314 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,593,207 1,282,808	2,736,111 1,407,728	3,013,214 1,341,512	3,371,694 1,407,046	3,863,869 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	6,575,276 3,284,314	7,072,957 3,250,551	8,189,060 3,386,837	8,396,991 3,360,806	9,236,345 3,508,953
Disproportionate-share hospital (DSH) Median	3,549,499 594,888	3,976,762 595,761	3,740,197 577,894	4,088,814 542,168	3,964,700 549,667
Outlier Median	6,150,165 582,572	7,611,774 538,116	1,842,518 212,434	1,491,283 126,559	1,453,768 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	12,309,111 3,662,910	18,157,076 3,730,911	20,729,538 4,081,319	15,822,271 4,643,908	18,102,948 4,389,147
Charity care Median	13,218,466 2,654,636	15,422,484 2,940,659	17,208,155 3,380,215	20,267,461 3,488,738	18,823,821 3,233,405
Uncompensated care (UCC) Median	21,423,560 5,147,790	22,683,069 5,337,617	25,539,941 5,711,082	29,476,937 5,923,418	26,750,956 5,508,107
UCC as a % of operating expenses Median	2.08% 3.24	1.90% 3.12	1.97% 3.21	2.11% 3.3	1.72% 2.86
Total shortfall/UCC Median	33,732,671 9,489,989	40,840,145 9,424,297	46,269,479 10,120,158	45,299,208 11,171,337	44,853,904 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	429,775,756 52,142,039	488,188,868 54,485,252	542,672,647 57,395,589	560,382,695 58,830,919	599,814,163 61,722,907
Salaries as a % of operating expenses Median	40.28 36.68	39.32 36.56	39.09 36.37	38.57 35.93	38.60 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	14,337,340 1,449,244	16,650,206 1,475,986	7,760,331 1,563,078	18,904,576 1,721,954	71,557,424 2,991,828
Contract hours, direct-care Median	187,306.00 22,725	232,764.13 23,018.5	114,350.00 24,503.48	185,002.00 25,026.5	435,344.00 33,786
Contract wages, direct-care Median	76.55 64.67	71.53 64.53	67.86 65.06	102.19 68.97	164.37 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.