As of the July, 2022, release via CMS

FIRELANDS REGIONAL MEDICAL CENTER

CMS id: 360025
1111 HAYES AVENUE, SANDUSKY OH 44870. County: ERIE
System: --
CBSA: Sandusky, OH

The 205-bed, acute-care hospital had $-14,637,013 in net service to patients*, with a total profit margin of 17.66868% in fiscal year 2021, the latest year available.
It spent 2.11% of its operating expenses on uncompensated care and reported $5,166,140 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	165 118	165 118	160 119.5	160 118	153 119
Total beds Median	217 162	217 162	212 162	212 162	205 163.5
FTEs Median	1,837.10 788.06	1,870.15 793.42	1,821.01 806.03	1,707.22 787.61	1,652.09 804.34

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	239,229,939 150,932,746	231,631,232 158,950,878	243,820,446 168,696,998	225,013,929 163,454,693	251,561,698 186,589,412
Operating expenses Median	243,820,690 149,311,209	246,860,280 156,110,414	252,606,290 164,890,568	252,633,763 166,516,854	266,198,711 180,120,888
Net income from service 2 patients (NS2P) ? Median	-4,590,751 -964,173	-15,229,048 -643,601.5	-8,785,844 -116,254	-27,619,834 -5,025,862	-14,637,013 -1,284,564
NS2P margin ? Median	-1.92% -0.62	-6.57% -0.29	-3.60% 0.18	-12.27% -5.07	-5.82% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for FIRELANDS REGIONAL MEDICAL CENTER 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	34,074,020 5,089,215	12,706,426 4,572,541	48,890,322 5,268,134	59,255,299 13,092,619	71,066,581 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	958,908 224,999	2,051,766 199,009	1,717,614 206,870.5	2,440,353 194,343	1,760,770 249,496
⊳ Line 7: Investments ? ⊳ Median	28,780,430 299,524	297,597 188,688.5	28,598,511 370,813	15,041,032 309,361.5	40,251,924 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	17,936	19,174	18,887	18,875	20,809
⊳ 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	19,979	19,309	16,212	12,145	12,293
⊳ Line 14: Revenue from meals sold to emplyees and guests	1,520,729	1,493,917	1,453,155	861,963	896,470
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	4,999	-2,461	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	6,566,997	7,760,772	8,941,254	9,875,079	10,607,231
⊳ Line 18: Revenue from sale of medical records and abstracts	64,226	46,786	23,847	511	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	501,165	412,206	593,145	685,782	521,640
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	28,001	37,071	38,463	25,162	30,639
⊳ 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	-4,389,350	570,289	7,489,234	30,294,397	16,964,805
Total income ? Median	29,483,269 6,586,430	-2,522,622 6,767,106	40,104,478 8,419,950	31,635,465 8,094,175	56,429,568 15,162,888
Non-operating expenses Median	23,495 146,289.5	-26,406 164,857	-221,890 89,880.5	-122,782 106,761	-574,575 31,473.5
Net income Median	29,459,774 6,043,842	-2,496,216 5,845,112	40,326,368 7,606,259	31,758,247 7,283,041	57,004,143 14,957,241
Net margin Median	10.77912% 4.62%	-1.02163% 4.42%	13.77687% 5.16%	11.17189% 5.2%	17.66868% 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 FIRELANDS REGIONAL MEDICAL CENTER 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	46,594,109 23,241,334	39,975,288 23,709,545	42,374,780 24,248,380	37,956,517 22,858,541	33,001,806 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	39,475,979 21,577,146	33,418,056 22,041,594	35,271,244 22,722,063	30,346,675 21,570,441	26,829,966 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	7,118,130 3,535,627	6,557,232 3,746,588	7,103,536 3,782,288	7,609,842 3,865,578	6,171,840 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	37,460,414 11,160,864	33,160,570 11,987,345	31,763,645 12,926,866	28,375,781 11,884,480	31,101,943 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	29,170,367 10,918,923	25,922,476 11,706,976	24,926,179 12,615,917	21,913,474 11,458,116	24,988,372 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	8,290,047 1,282,808	7,238,094 1,407,728	6,837,466 1,341,512	6,462,307 1,407,046	6,113,571 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	1,908,637 3,284,314	1,661,385 3,250,551	1,801,174 3,386,837	1,661,494 3,360,806	1,606,935 3,508,953
Disproportionate-share hospital (DSH) Median	1,133,731 594,888	927,886 595,761	960,285 577,894	774,995 542,168	658,286 549,667
Outlier Median	474,922 582,572	469,727 538,116	175,093 212,434	169,196 126,559	247,100 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	8,517,081 3,662,910	7,298,713 3,730,911	6,415,170 4,081,319	5,163,804 4,643,908	5,166,140 4,389,147
Charity care Median	5,339,803 2,654,636	5,928,607 2,940,659	4,379,445 3,380,215	4,308,586 3,488,738	3,520,123 3,233,405
Uncompensated care (UCC) Median	6,726,766 5,147,790	8,380,236 5,337,617	7,074,267 5,711,082	6,484,933 5,923,418	5,611,563 5,508,107
UCC as a % of operating expenses Median	2.76% 3.24	3.39% 3.12	2.80% 3.21	2.57% 3.3	2.11% 2.86
Total shortfall/UCC Median	15,243,847 9,489,989	15,678,949 9,424,297	13,489,437 10,120,158	11,648,737 11,171,337	10,777,703 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	101,733,609 52,142,039	100,623,542 54,485,252	103,093,654 57,395,589	101,594,133 58,830,919	107,507,396 61,722,907
Salaries as a % of operating expenses Median	41.98 36.68	41.01 36.56	41.05 36.37	40.44 35.93	40.61 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	468,210 1,449,244	494,953 1,475,986	343,202 1,563,078	224,543 1,721,954	415,718 2,991,828
Contract hours, direct-care Median	12,326.40 22,725	13,097.79 23,018.5	6,172.00 24,503.48	3,333.00 25,026.5	5,830.00 33,786
Contract wages, direct-care Median	37.98 64.67	37.79 64.53	55.61 65.06	67.37 68.97	71.31 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.