As of the July, 2022, release via CMS

ADAIR COUNTY HEALTH CENTER

CMS id: 370178
100 HIGHWAY WEST, STILWELL OK 74960. County: ADAIR
System: --
CBSA: Rural Oklahoma

The 40-bed, acute-care hospital had $-5,014,933 in net service to patients*, with a total profit margin of -14.50417% in fiscal year 2021, the latest year available.
It spent 5.26% of its operating expenses on uncompensated care and reported $3,312,205 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	30 118	30 118	30 119.5	30 118	30 119
Total beds Median	40 162	40 162	40 162	40 162	40 163.5
FTEs Median	206.54 788.06	195.88 793.42	207.95 806.03	174.24 787.61	173.65 804.34

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	18,081,805 150,932,746	17,814,376 158,950,878	16,946,759 168,696,998	15,534,631 163,454,693	13,662,539 186,589,412
Operating expenses Median	20,225,181 149,311,209	19,283,211 156,110,414	19,484,707 164,890,568	18,955,787 166,516,854	18,677,472 180,120,888
Net income from service 2 patients (NS2P) ? Median	-2,143,376 -964,173	-1,468,835 -643,601.5	-2,537,948 -116,254	-3,421,156 -5,025,862	-5,014,933 -1,284,564
NS2P margin ? Median	-11.85% -0.62	-8.25% -0.29	-14.98% 0.18	-22.02% -5.07	-36.71% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ADAIR COUNTY HEALTH 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	2,914,394 5,089,215	1,823,767 4,572,541	2,604,645 5,268,134	748,143 13,092,619	2,649,070 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	250,000 199,009	-6,214 206,870.5	959 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	191 299,524	217 188,688.5	831 370,813	340 309,361.5	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	800	0	8,000	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	885	0	963	349	401
⊳ Line 17: Revenue from sale of drugs to other than patients	4,914	3,999	2,009	1,674	1,524
⊳ Line 18: Revenue from sale of medical records and abstracts	3,325	5,118	3,440	4,668	3,006
⊳ 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	76,921	65,167	56,922	50,069	31,512
⊳ Line 22: Rental of hospital space	18,640	0	5,200	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	1,341,294 1,017,693	1,029,706 983,261.5	0 1,173,286	0 1,987,202	2,413,840 1,597,664
⊳ Sum Line 24	1,468,224	468,760	2,541,494	682,084	198,787
Total income ? Median	771,018 6,586,430	354,932 6,767,106	66,697 8,419,950	-2,673,013 8,094,175	-2,365,863 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	771,018 6,043,842	354,932 5,845,112	66,697 7,606,259	-2,673,013 7,283,041	-2,365,863 14,957,241
Net margin Median	3.67218% 4.62%	1.80736% 4.42%	0.34114% 5.16%	-16.41620% 5.2%	-14.50417% 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 ADAIR COUNTY HEALTH 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	6,087,328 23,241,334	5,505,956 23,709,545	5,148,587 24,248,380	4,691,213 22,858,541	4,397,901 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	4,896,883 21,577,146	4,525,812 22,041,594	4,191,073 22,722,063	3,785,185 21,570,441	3,408,856 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	1,190,445 1,845,420	980,144 1,757,392	957,514 1,738,842	906,028 1,510,463	989,045 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	1,366,151 11,160,864	1,458,748 11,987,345	1,641,025 12,926,866	1,397,423 11,884,480	1,386,404 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	716,016 10,918,923	869,225 11,706,976	940,116 12,615,917	678,130 11,458,116	667,184 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	650,135 1,282,808	589,523 1,407,728	700,909 1,341,512	719,293 1,407,046	719,220 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	107,554 594,888	99,113 595,761	86,789 577,894	132,016 542,168	96,074 549,667
Outlier Median	57,548 582,572	12,034 538,116	15,579 212,434	5,243 126,559	11,539 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,176,491 3,662,910	3,978,198 3,730,911	3,878,744 4,081,319	1,971,157 4,643,908	3,312,205 4,389,147
Charity care Median	27,210 2,654,636	143,587 2,940,659	169,126 3,380,215	2,743 3,488,738	101,711 3,233,405
Uncompensated care (UCC) Median	305,277 5,147,790	578,321 5,337,617	503,852 5,711,082	124,591 5,923,418	981,588 5,508,107
UCC as a % of operating expenses Median	1.51% 3.24	3.00% 3.12	2.59% 3.21	0.66% 3.3	5.26% 2.86
Total shortfall/UCC Median	4,481,768 9,489,989	4,556,519 9,424,297	4,382,596 10,120,158	2,095,748 11,171,337	4,293,793 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	12,338,033 52,142,039	11,144,782 54,485,252	11,488,243 57,395,589	10,443,383 58,830,919	9,880,593 61,722,907
Salaries as a % of operating expenses Median	61.00 36.68	57.80 36.56	58.96 36.37	55.09 35.93	52.90 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	379,600 1,449,244	0 1,475,986	485,118 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	2,940.52 22,725	0.00 23,018.5	4,701.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	129.09 64.67	0.00 64.53	103.19 65.06	0.00 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.