As of the July, 2022, release via CMS

ASHTABULA COUNTY MEDICAL CENTER

CMS id: 360125
2420 LAKE, ASHTABULA OH 44004. County: ASHTABULA
System: --
CBSA: Ashtabula, OH

The 105-bed, acute-care hospital had $-11,875,286 in net service to patients*, with a total profit margin of 7.61812% in fiscal year 2021, the latest year available.
It spent 1.67% 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	365	366	365
Ownership	nfp	nfp	nfp	nfp	nfp
Acute beds Median	96 118	95 118	95 119.5	104 118	96 119
Total beds Median	137 162	137 162	137 162	113 162	105 163.5
FTEs Median	891.00 788.06	920.00 793.42	899.00 806.03	779.00 787.61	764.00 804.34

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	123,483,884 150,932,746	126,742,058 158,950,878	134,838,341 168,696,998	115,458,493 163,454,693	143,841,079 186,589,412
Operating expenses Median	127,734,197 149,311,209	136,518,593 156,110,414	145,205,714 164,890,568	147,667,840 166,516,854	155,716,365 180,120,888
Net income from service 2 patients (NS2P) ? Median	-4,250,313 -964,173	-9,776,535 -643,601.5	-10,367,373 -116,254	-32,209,347 -5,025,862	-11,875,286 -1,284,564
NS2P margin ? Median	-3.44% -0.62	-7.71% -0.29	-7.69% 0.18	-27.90% -5.07	-8.26% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASHTABULA COUNTY 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	16,245,090 5,089,215	6,454,668 4,572,541	21,065,005 5,268,134	37,278,100 13,092,619	24,716,189 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	610,702 224,999	427,688 199,009	168,215 206,870.5	328,532 194,343	68,051 249,496
⊳ Line 7: Investments ? ⊳ Median	1,694,831 299,524	1,972,583 188,688.5	2,252,982 370,813	1,763,026 309,361.5	2,788,980 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	6,861	15,338	8,587	13,731	6,559
⊳ Line 11: Rebates and refunds of expenses	283,146	300,361	396,840	565,772	698,463
⊳ 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	10,726	8,307	6,910	4,169	4,321
⊳ 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	136,485	121,995	251,045	322,018	446,656
⊳ 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	13,502,339	3,608,396	17,980,426	34,280,852	20,703,159
Total income ? Median	11,994,777 6,586,430	-3,321,867 6,767,106	10,697,632 8,419,950	5,068,753 8,094,175	12,840,903 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	11,994,777 6,043,842	-3,321,867 5,845,112	10,697,632 7,606,259	5,068,753 7,283,041	12,840,903 14,957,241
Net margin Median	8.58432% 4.62%	-2.49396% 4.42%	6.86171% 5.16%	3.31862% 5.2%	7.61812% 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 ASHTABULA COUNTY 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	20,476,602 23,241,334	19,091,425 23,709,545	19,652,462 24,248,380	14,862,899 22,858,541	16,772,596 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	18,551,962 21,577,146	17,220,023 22,041,594	17,753,555 22,722,063	14,526,880 21,570,441	16,772,596 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	730,576 1,845,420	671,719 1,757,392	563,687 1,738,842	4,636 1,510,463	0 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	1,194,064 1,203,033	1,199,683 1,215,295	1,335,220 1,313,657	331,383 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	17,957,906 11,160,864	18,633,824 11,987,345	22,856,767 12,926,866	19,049,980 11,884,480	21,553,766 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	17,957,906 10,918,923	18,633,824 11,706,976	22,856,767 12,615,917	19,049,980 11,458,116	21,553,766 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	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	400,253 594,888	428,096 595,761	353,068 577,894	310,680 542,168	311,210 549,667
Outlier Median	265,438 582,572	206,710 538,116	29,766 212,434	28,863 126,559	47,106 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	3,054,817 3,662,910	1,914,555 3,730,911	8,085,001 4,081,319	5,590,424 4,643,908	0 4,389,147
Charity care Median	781,130 2,654,636	875,845 2,940,659	643,233 3,380,215	777,779 3,488,738	890,270 3,233,405
Uncompensated care (UCC) Median	3,405,849 5,147,790	2,758,413 5,337,617	2,959,180 5,711,082	3,440,256 5,923,418	2,606,270 5,508,107
UCC as a % of operating expenses Median	2.67% 3.24	2.02% 3.12	2.04% 3.21	2.33% 3.3	1.67% 2.86
Total shortfall/UCC Median	6,460,666 9,489,989	4,672,968 9,424,297	11,044,181 10,120,158	9,030,680 11,171,337	2,606,270 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	60,134,475 52,142,039	64,025,697 54,485,252	65,533,887 57,395,589	62,024,379 58,830,919	62,658,068 61,722,907
Salaries as a % of operating expenses Median	47.08 36.68	46.90 36.56	45.13 36.37	42.00 35.93	40.24 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	52,710 1,449,244	446,293 1,475,986	90,255 1,563,078	129,420 1,721,954	366,726 2,991,828
Contract hours, direct-care Median	1,066.00 22,725	8,025.00 23,018.5	1,953.00 24,503.48	1,434.00 25,026.5	5,639.00 33,786
Contract wages, direct-care Median	49.45 64.67	55.61 64.53	46.21 65.06	90.25 68.97	65.03 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.