As of the July, 2022, release via CMS

UNION HOSPITAL ASSOCIATION

CMS id: 360010
659 BOULEVARD, DOVER OH 44622. County: TUSCARAWAS
System: CLEVELAND CLINIC
CBSA: New Philadelphia-Dover, OH

The 87-bed, acute-care hospital had $-14,679,066 in net service to patients*, with a total profit margin of 2.04728% in fiscal year 2021, the latest year available.
It spent 4.86% of its operating expenses on uncompensated care and reported $4,396,566 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	90 118	90 118	50 119.5	69 118	39 119
Total beds Median	138 162	138 162	98 162	132 162	87 163.5
FTEs Median	851.94 788.06	841.17 793.42	790.26 806.03	750.79 787.61	712.61 804.34

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	108,598,481 150,932,746	103,643,749 158,950,878	100,992,460 168,696,998	102,472,437 163,454,693	106,029,260 186,589,412
Operating expenses Median	117,555,784 149,311,209	115,598,137 156,110,414	112,621,427 164,890,568	113,610,293 166,516,854	120,708,326 180,120,888
Net income from service 2 patients (NS2P) ? Median	-8,957,303 -964,173	-11,954,388 -643,601.5	-11,628,967 -116,254	-11,137,856 -5,025,862	-14,679,066 -1,284,564
NS2P margin ? Median	-8.25% -0.62	-11.53% -0.29	-11.51% 0.18	-10.87% -5.07	-13.84% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for UNION HOSPITAL ASSOCIATION 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	11,009,269 5,089,215	4,037,982 4,572,541	9,600,713 5,268,134	19,388,473 13,092,619	17,201,957 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	5,432,059 299,524	344,849 188,688.5	5,488,362 370,813	4,802,576 309,361.5	7,418,378 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	2,818	2,796	1,234	1,436	1,188
⊳ Line 11: Rebates and refunds of expenses	378,580	1,387	29,448	0	0
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	37,718	32,588	33,987	39,853	27,371
⊳ Line 14: Revenue from meals sold to emplyees and guests	828,059	831,216	798,707	591,113	489,015
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	10,857	601	7,835	1,912	105
⊳ Line 17: Revenue from sale of drugs to other than patients	1,950,589	1,967,216	1,980,919	2,414,148	2,356,208
⊳ Line 18: Revenue from sale of medical records and abstracts	4,053	7,045	5,575	90	55
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	881	5,149	3,451	1,525	-37
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	8,889	8,490	8,048	1,599	4,782
⊳ 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	2,354,766	836,530	1,243,147	11,534,221	6,904,892
Total income ? Median	2,051,966 6,586,430	-7,916,406 6,767,106	-2,028,254 8,419,950	8,250,617 8,094,175	2,522,891 15,162,888
Non-operating expenses Median	36,160 146,289.5	959,040 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	2,015,806 6,043,842	-8,875,446 5,845,112	-2,028,254 7,606,259	8,250,617 7,283,041	2,522,891 14,957,241
Net margin Median	1.68535% 4.62%	-8.24230% 4.42%	-1.83398% 5.16%	6.77052% 5.2%	2.04728% 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 UNION HOSPITAL ASSOCIATION 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	16,926,469 23,241,334	13,537,226 23,709,545	13,525,764 24,248,380	15,075,288 22,858,541	12,942,675 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	15,338,656 21,577,146	12,151,498 22,041,594	11,741,414 22,722,063	13,160,552 21,570,441	11,454,356 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	1,587,813 3,535,627	1,385,728 3,746,588	1,784,350 3,782,288	1,914,736 3,865,578	1,488,319 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	9,010,586 11,160,864	8,982,050 11,987,345	9,188,502 12,926,866	7,513,465 11,884,480	7,657,140 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	8,350,694 10,918,923	8,450,068 11,706,976	8,644,780 12,615,917	6,922,843 11,458,116	7,239,998 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	659,892 1,282,808	531,982 1,407,728	543,722 1,341,512	590,622 1,407,046	417,142 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	262,964 594,888	191,012 595,761	171,872 577,894	170,054 542,168	171,582 549,667
Outlier Median	323,555 582,572	145,388 538,116	62,782 212,434	103,659 126,559	25,490 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	6,098,401 3,662,910	4,649,739 3,730,911	5,072,986 4,081,319	5,430,733 4,643,908	4,396,566 4,389,147
Charity care Median	2,021,485 2,654,636	2,165,328 2,940,659	2,672,801 3,380,215	2,315,941 3,488,738	1,792,258 3,233,405
Uncompensated care (UCC) Median	4,428,100 5,147,790	4,619,984 5,337,617	5,558,796 5,711,082	2,830,058 5,923,418	5,864,481 5,508,107
UCC as a % of operating expenses Median	3.77% 3.24	4.00% 3.12	4.94% 3.21	2.49% 3.3	4.86% 2.86
Total shortfall/UCC Median	10,526,501 9,489,989	9,269,723 9,424,297	10,631,782 10,120,158	8,260,791 11,171,337	10,261,047 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	49,194,677 52,142,039	49,177,119 54,485,252	46,864,824 57,395,589	44,908,129 58,830,919	46,825,977 61,722,907
Salaries as a % of operating expenses Median	41.85 36.68	42.54 36.56	41.61 36.37	39.53 35.93	38.79 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	464,048 1,449,244	70,525 1,475,986	71,253 1,563,078	148,503 1,721,954	856,298 2,991,828
Contract hours, direct-care Median	6,827.00 22,725	1,356.25 23,018.5	1,370.00 24,503.48	2,345.00 25,026.5	10,494.00 33,786
Contract wages, direct-care Median	67.97 64.67	52.00 64.53	52.01 65.06	63.33 68.97	81.60 88.94

* in an approved program

Return to top

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.