As of the July, 2022, release via CMS

ELKVIEW GENERAL HOSPITAL

CMS id: 370153
429 ELM, HOBART OK 73654. County: KIOWA
System: --
CBSA: Rural Oklahoma

The 38-bed, acute-care hospital had $-876,682 in net service to patients*, with a total profit margin of 6.97179% in fiscal year 2021, the latest year available.
It spent 4.92% 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	38 118	38 118	38 119.5	38 118	38 119
Total beds Median	38 162	38 162	38 162	38 162	38 163.5
FTEs Median	118.88 788.06	115.31 793.42	100.84 806.03	97.49 787.61	96.00 804.34

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	10,455,347 150,932,746	11,180,474 158,950,878	11,223,483 168,696,998	10,891,971 163,454,693	11,060,650 186,589,412
Operating expenses Median	12,331,568 149,311,209	13,054,079 156,110,414	11,841,217 164,890,568	11,563,311 166,516,854	11,937,332 180,120,888
Net income from service 2 patients (NS2P) ? Median	-1,876,221 -964,173	-1,873,605 -643,601.5	-617,734 -116,254	-671,340 -5,025,862	-876,682 -1,284,564
NS2P margin ? Median	-17.95% -0.62	-16.76% -0.29	-5.50% 0.18	-6.16% -5.07	-7.93% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ELKVIEW GENERAL 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	142,077 5,089,215	134,706 4,572,541	90,028 5,268,134	396,722 13,092,619	1,771,298 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	354,680 194,343	1,206,738 249,496
⊳ Line 7: Investments ? ⊳ Median	15,473 299,524	14,423 188,688.5	17,657 370,813	16,019 309,361.5	31,116 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	460	358	1,465	258	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	20,705	20,444	8,738	7,737	3,000
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	16,608	17,626	15,520	10,642	7,581
⊳ 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	461	30	445	141	1,279
⊳ 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	12,816	15,150	13,262	15,006	14,550
⊳ 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	75,554	66,675	32,941	-7,761	507,034
Total income ? Median	-1,734,144 6,586,430	-1,738,899 6,767,106	-527,706 8,419,950	-274,618 8,094,175	894,616 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	-1,734,144 6,043,842	-1,738,899 5,845,112	-527,706 7,606,259	-274,618 7,283,041	894,616 14,957,241
Net margin Median	-16.36383% 4.62%	-15.36784% 4.42%	-4.66439% 5.16%	-2.43268% 5.2%	6.97179% 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 ELKVIEW GENERAL 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	2,741,212 23,241,334	2,786,639 23,709,545	2,774,115 24,248,380	2,901,720 22,858,541	2,886,135 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	2,741,212 21,577,146	2,786,639 22,041,594	2,774,115 22,722,063	2,901,720 21,570,441	2,886,135 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	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	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	1,347,901 11,160,864	1,666,510 11,987,345	1,632,884 12,926,866	1,426,751 11,884,480	1,508,306 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	1,321,946 10,918,923	1,666,510 11,706,976	1,632,884 12,615,917	1,426,751 11,458,116	1,235,952 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	25,955 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	272,354 670,558
⊳ 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	40,820 594,888	32,141 595,761	21,094 577,894	36,737 542,168	42,465 549,667
Outlier Median	98,619 582,572	28,204 538,116	7,722 212,434	804 126,559	0 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	191,128 3,662,910	0 3,730,911	42,397 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	57,761 2,654,636	91,405 2,940,659	29,551 3,380,215	29,249 3,488,738	62,434 3,233,405
Uncompensated care (UCC) Median	1,057,158 5,147,790	795,137 5,337,617	594,213 5,711,082	589,865 5,923,418	587,697 5,508,107
UCC as a % of operating expenses Median	8.57% 3.24	6.09% 3.12	5.02% 3.21	5.10% 3.3	4.92% 2.86
Total shortfall/UCC Median	1,248,286 9,489,989	795,137 9,424,297	636,610 10,120,158	589,865 11,171,337	587,697 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	6,005,730 52,142,039	6,070,725 54,485,252	5,568,343 57,395,589	5,442,706 58,830,919	5,549,295 61,722,907
Salaries as a % of operating expenses Median	48.70 36.68	46.50 36.56	47.03 36.37	47.07 35.93	46.49 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	115,434 1,449,244	362,180 1,475,986	169,508 1,563,078	112,432 1,721,954	190,855 2,991,828
Contract hours, direct-care Median	2,733.00 22,725	4,846.00 23,018.5	3,375.00 24,503.48	2,342.40 25,026.5	3,392.00 33,786
Contract wages, direct-care Median	42.24 64.67	74.74 64.53	50.22 65.06	48.00 68.97	56.27 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.