As of the July, 2022, release via CMS

TAHLEQUAH CITY HOSPITAL

CMS id: 370089
E DOWNING, TAHLEQUAH OK 74464. County: CHEROKEE
System: --
CBSA: Tahlequah, OK

The 90-bed, acute-care hospital had $-13,880,170 in net service to patients*, with a total profit margin of -2.71004% in fiscal year 2021, the latest year available.
It spent 5.19% 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	gov	gov	gov	gov	gov
Acute beds Median	40 118	40 118	40 119.5	40 118	40 119
Total beds Median	90 162	90 162	90 162	90 162	90 163.5
FTEs Median	794.94 788.06	778.65 793.42	807.39 806.03	821.80 787.61	819.67 804.34

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	94,317,619 150,932,746	96,938,296 158,950,878	104,948,274 168,696,998	95,351,277 163,454,693	111,168,530 186,589,412
Operating expenses Median	97,891,265 149,311,209	105,831,659 156,110,414	111,679,912 164,890,568	117,760,265 166,516,854	125,048,700 180,120,888
Net income from service 2 patients (NS2P) ? Median	-3,573,646 -964,173	-8,893,363 -643,601.5	-6,731,638 -116,254	-22,408,988 -5,025,862	-13,880,170 -1,284,564
NS2P margin ? Median	-3.79% -0.62	-9.17% -0.29	-6.41% 0.18	-23.50% -5.07	-12.49% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for TAHLEQUAH CITY 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	8,134,113 5,089,215	7,097,665 4,572,541	11,985,508 5,268,134	23,584,526 13,092,619	10,580,715 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	60,000 249,496
⊳ Line 7: Investments ? ⊳ Median	195,911 299,524	85,574 188,688.5	720,470 370,813	1,492,248 309,361.5	693,850 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	68,723	59,152	102,713	587,134	246,191
⊳ 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	803,196	804,395	880,802	716,817	722,257
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	29,400	33,823	35,753	15,913	24,080
⊳ 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	14,302	1,609	7,278	5,395	11,539
⊳ 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	7,595	3,923	3,873	3,194	1,471
⊳ Line 22: Rental of hospital space	781,860	724,851	691,099	951,792	621,370
⊳ 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	6,233,126	5,384,338	9,543,520	19,812,033	8,199,957
Total income ? Median	4,560,467 6,586,430	-1,795,698 6,767,106	5,253,870 8,419,950	1,175,538 8,094,175	-3,299,455 15,162,888
Non-operating expenses Median	495,129 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	4,065,338 6,043,842	-1,795,698 5,845,112	5,253,870 7,606,259	1,175,538 7,283,041	-3,299,455 14,957,241
Net margin Median	3.96805% 4.62%	-1.72604% 4.42%	4.49303% 5.16%	0.98838% 5.2%	-2.71004% 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 TAHLEQUAH CITY 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	25,485,047 23,241,334	26,267,063 23,709,545	26,141,974 24,248,380	23,917,512 22,858,541	23,636,689 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	21,590,347 21,577,146	22,299,971 22,041,594	22,321,104 22,722,063	20,481,766 21,570,441	22,300,196 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	1,646,295 1,845,420	1,647,638 1,757,392	1,603,363 1,738,842	1,632,104 1,510,463	1,336,493 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,248,405 3,535,627	2,319,454 3,746,588	2,217,507 3,782,288	1,803,642 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	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	14,789,518 11,160,864	17,959,142 11,987,345	21,042,789 12,926,866	20,731,843 11,884,480	18,363,345 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	14,789,518 10,918,923	17,123,662 11,706,976	20,002,094 12,615,917	19,891,570 11,458,116	17,643,750 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	835,480 697,279	1,040,695 690,232	840,273 684,010	719,595 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	1,592,178 3,284,314	1,588,460 3,250,551	1,595,327 3,386,837	1,637,695 3,360,806	1,250,799 3,508,953
Disproportionate-share hospital (DSH) Median	358,185 594,888	346,501 595,761	390,181 577,894	363,917 542,168	345,745 549,667
Outlier Median	1,008,448 582,572	1,211,103 538,116	516,516 212,434	160,739 126,559	81,640 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,318,405 3,662,910	2,293,571 3,730,911	1,290,000 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	1,673,158 2,654,636	903,964 2,940,659	0 3,380,215	1,378,908 3,488,738	1,291,755 3,233,405
Uncompensated care (UCC) Median	5,079,688 5,147,790	6,198,146 5,337,617	4,176,644 5,711,082	2,273,519 5,923,418	6,488,297 5,508,107
UCC as a % of operating expenses Median	5.19% 3.24	5.86% 3.12	3.74% 3.21	1.93% 3.3	5.19% 2.86
Total shortfall/UCC Median	6,398,093 9,489,989	8,491,717 9,424,297	5,466,644 10,120,158	2,273,519 11,171,337	6,488,297 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	39,079,148 52,142,039	40,260,439 54,485,252	41,391,432 57,395,589	42,197,285 58,830,919	44,800,967 61,722,907
Salaries as a % of operating expenses Median	39.92 36.68	38.04 36.56	37.06 36.37	35.83 35.93	35.83 35.24
Intern, resident salaries* Median	1,416,001 2,598,592	1,361,455 2,686,824	1,388,452 2,753,773	1,403,987 2,937,156	803,069 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	6,128,812 1,449,244	6,835,455 1,475,986	6,653,755 1,563,078	0 1,721,954	6,590,093 2,991,828
Contract hours, direct-care Median	159,166.51 22,725	168,529.31 23,018.5	164,262.00 24,503.48	0.00 25,026.5	140,864.58 33,786
Contract wages, direct-care Median	38.51 64.67	40.56 64.53	40.51 65.06	0.00 68.97	46.78 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.