As of the July, 2022, release via CMS

THE TOLEDO HOSPITAL

CMS id: 360068
2142 NORTH COVE BLVD., TOLEDO OH 43606. County: LUCAS
System: PROMEDICA HEALTH SYSTEM
CBSA: Toledo, OH

The 846-bed, acute-care hospital had $72,495,497 in net service to patients*, with a total profit margin of -11.50657% in fiscal year 2021, the latest year available.
It spent 1.24% of its operating expenses on uncompensated care and reported $23,444,015 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	482 118	585 118	579 119.5	545 118	530 119
Total beds Median	704 162	859 162	881 162	844 162	846 163.5
FTEs Median	4,109.61 788.06	4,078.94 793.42	4,854.86 806.03	4,899.82 787.61	5,344.49 804.34

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	779,843,521 150,932,746	854,038,302 158,950,878	1,084,891,791 168,696,998	1,094,214,112 163,454,693	1,281,970,718 186,589,412
Operating expenses Median	793,526,307 149,311,209	838,479,288 156,110,414	1,074,761,326 164,890,568	1,134,364,608 166,516,854	1,209,475,221 180,120,888
Net income from service 2 patients (NS2P) ? Median	-13,682,786 -964,173	15,559,014 -643,601.5	10,130,465 -116,254	-40,150,496 -5,025,862	72,495,497 -1,284,564
NS2P margin ? Median	-1.75% -0.62	1.82% -0.29	0.93% 0.18	-3.67% -5.07	5.66% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for THE TOLEDO HOSPITAL 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	-115,412,108 5,089,215	-1,056,204,313 4,572,541	56,550,284 5,268,134	95,646,141 13,092,619	63,137,629 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	26,152,175 299,524	23,545,593 188,688.5	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	-141,564,283	-1,079,749,906	56,550,284	95,646,141	63,137,629
Total income ? Median	-129,094,894 6,586,430	-1,040,645,299 6,767,106	66,680,749 8,419,950	55,495,645 8,094,175	135,633,126 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	135,381,206 89,880.5	-495,583,686 106,761	290,409,017 31,473.5
Net income Median	-129,094,894 6,043,842	-1,040,645,299 5,845,112	-68,700,457 7,606,259	551,079,331 7,283,041	-154,775,891 14,957,241
Net margin Median	-19.42938% 4.62%	514.74790% 4.42%	-6.01874% 5.16%	46.31463% 5.2%	-11.50657% 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 THE TOLEDO HOSPITAL 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	115,444,942 23,241,334	122,984,096 23,709,545	154,169,799 24,248,380	145,772,867 22,858,541	142,329,938 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	112,910,723 21,577,146	121,553,745 22,041,594	144,006,890 22,722,063	136,752,536 21,570,441	134,507,413 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	475,690 1,845,420	305,658 1,757,392	3,206,125 1,738,842	2,312,989 1,510,463	1,816,181 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	308,263 3,746,588	6,956,784 3,782,288	6,707,342 3,865,578	6,006,344 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	2,058,529 1,203,033	816,430 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	31,085,506 11,160,864	44,325,869 11,987,345	61,495,442 12,926,866	61,345,858 11,884,480	72,708,854 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	31,085,506 10,918,923	44,325,869 11,706,976	61,495,442 12,615,917	61,345,858 11,458,116	72,708,854 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	10,041,532 3,284,314	14,764,503 3,250,551	20,548,488 3,386,837	23,007,430 3,360,806	24,237,767 3,508,953
Disproportionate-share hospital (DSH) Median	3,964,696 594,888	3,996,722 595,761	4,203,567 577,894	4,073,725 542,168	3,680,501 549,667
Outlier Median	5,806,427 582,572	5,303,246 538,116	3,795,264 212,434	2,240,590 126,559	1,491,483 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	19,580,326 3,662,910	27,109,226 3,730,911	38,836,724 4,081,319	49,513,519 4,643,908	23,444,015 4,389,147
Charity care Median	3,804,529 2,654,636	3,444,499 2,940,659	5,283,657 3,380,215	9,246,705 3,488,738	7,005,728 3,233,405
Uncompensated care (UCC) Median	9,678,473 5,147,790	12,639,262 5,337,617	17,442,131 5,711,082	19,760,254 5,923,418	14,954,184 5,508,107
UCC as a % of operating expenses Median	1.22% 3.24	1.51% 3.12	1.62% 3.21	1.74% 3.3	1.24% 2.86
Total shortfall/UCC Median	29,258,799 9,489,989	39,748,488 9,424,297	56,278,855 10,120,158	69,273,773 11,171,337	38,398,199 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	238,178,884 52,142,039	242,996,878 54,485,252	293,720,831 57,395,589	311,425,172 58,830,919	361,553,772 61,722,907
Salaries as a % of operating expenses Median	30.02 36.68	28.98 36.56	27.33 36.37	27.45 35.93	29.89 35.24
Intern, resident salaries* Median	941,644 2,598,592	329,527 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	8,294,557 1,449,244	7,752,740 1,475,986	6,471,618 1,563,078	12,400,080 1,721,954	0 2,991,828
Contract hours, direct-care Median	129,636.60 22,725	118,268.00 23,018.5	96,266.44 24,503.48	162,323.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	63.98 64.67	65.55 64.53	67.23 65.06	76.39 68.97	0.00 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.