As of the July, 2022, release via CMS

CHESTNUT HILL HOSPITAL

CMS id: 390026
8835 GERMANTOWN AVENUE, PHILADELPHIA PA 19118. County: PHILADELPHIA
System: TOWER HEALTH
CBSA: Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

The 148-bed, acute-care hospital had $-16,954,215 in net service to patients*, with a total profit margin of -12.35408% in fiscal year 2021, the latest year available.
It spent 2.11% of its operating expenses on uncompensated care and reported $6,829,140 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	273	365	366	365
Ownership	forprofit	nfp	nfp	nfp	nfp
Acute beds Median	114 118	114 118	114 119.5	114 118	114 119
Total beds Median	148 162	148 162	148 162	148 162	148 163.5
FTEs Median	609.96 788.06	615.69 793.42	682.90 806.03	713.32 787.61	621.37 804.34

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	124,108,352 150,932,746	109,532,754 158,950,878	108,185,757 168,696,998	111,821,659 163,454,693	126,721,281 186,589,412
Operating expenses Median	130,662,404 149,311,209	104,246,376 156,110,414	136,721,952 164,890,568	152,520,450 166,516,854	143,675,496 180,120,888
Net income from service 2 patients (NS2P) ? Median	-6,554,052 -964,173	5,286,378 -643,601.5	-28,536,195 -116,254	-40,698,791 -5,025,862	-16,954,215 -1,284,564
NS2P margin ? Median	-5.28% -0.62	4.83% -0.29	-26.38% 0.18	-36.40% -5.07	-13.38% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CHESTNUT HILL 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	1,071,888 5,089,215	408,651 4,572,541	980,423 5,268,134	1,540,552 13,092,619	1,156,139 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	98,022 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	42,097 370,813	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	59,378	134,523	235,135
⊳ Line 12: Parking lot receipts	0	143,852	172,639	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	240,382	598,321	633,189	466,966
⊳ 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	289	610	1,234	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	1,071,888	24,128	9,356	771,606	454,038
Total income ? Median	-5,482,164 6,586,430	5,695,029 6,767,106	-27,555,772 8,419,950	-39,158,239 8,094,175	-15,798,076 15,162,888
Non-operating expenses Median	0 146,289.5	563,151 164,857	59,766 89,880.5	0 106,761	0 31,473.5
Net income Median	-5,482,164 6,043,842	5,131,878 5,845,112	-27,615,538 7,606,259	-39,158,239 7,283,041	-15,798,076 14,957,241
Net margin Median	-4.37942% 4.62%	4.66783% 4.42%	-25.29679% 5.16%	-34.54259% 5.2%	-12.35408% 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 CHESTNUT HILL 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	36,493,565 23,241,334	26,979,956 23,709,545	34,013,242 24,248,380	39,886,476 22,858,541	38,464,824 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	32,768,284 21,577,146	24,303,536 22,041,594	30,361,779 22,722,063	36,676,847 21,570,441	35,251,735 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	3,725,281 1,845,420	2,676,420 1,757,392	3,651,463 1,738,842	3,209,629 1,510,463	3,213,089 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	8,761,506 11,160,864	6,073,202 11,987,345	8,349,571 12,926,866	6,899,272 11,884,480	7,294,467 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	8,761,506 10,918,923	6,073,202 11,706,976	8,349,571 12,615,917	6,899,272 11,458,116	7,294,467 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	6,167,501 3,284,314	4,566,769 3,250,551	5,338,832 3,386,837	9,029,490 3,360,806	9,545,368 3,508,953
Disproportionate-share hospital (DSH) Median	371,948 594,888	234,803 595,761	284,383 577,894	309,818 542,168	335,406 549,667
Outlier Median	332,890 582,572	142,818 538,116	51,314 212,434	2,210 126,559	83,740 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	9,377,116 4,081,319	11,380,401 4,643,908	6,829,140 4,389,147
Charity care Median	1,139,208 2,654,636	28,722 2,940,659	136,864 3,380,215	100,398 3,488,738	135,009 3,233,405
Uncompensated care (UCC) Median	2,255,832 5,147,790	197,148 5,337,617	2,497,171 5,711,082	3,498,124 5,923,418	3,036,986 5,508,107
UCC as a % of operating expenses Median	1.73% 3.24	0.19% 3.12	1.83% 3.21	2.29% 3.3	2.11% 2.86
Total shortfall/UCC Median	2,255,832 9,489,989	197,148 9,424,297	11,874,287 10,120,158	14,878,525 11,171,337	9,866,126 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	42,617,803 52,142,039	34,748,477 54,485,252	49,487,327 57,395,589	53,344,604 58,830,919	47,881,906 61,722,907
Salaries as a % of operating expenses Median	32.62 36.68	33.33 36.56	36.20 36.37	34.98 35.93	33.33 35.24
Intern, resident salaries* Median	1,598,314 2,598,592	1,324,578 2,686,824	1,813,746 2,753,773	3,072,599 2,937,156	3,224,341 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	2,059,272 1,449,244	840,901 1,475,986	1,448,101 1,563,078	1,103,207 1,721,954	784,394 2,991,828
Contract hours, direct-care Median	28,908.00 22,725	12,272.00 23,018.5	19,143.00 24,503.48	14,900.00 25,026.5	12,195.00 33,786
Contract wages, direct-care Median	71.24 64.67	68.52 64.53	75.65 65.06	74.04 68.97	64.32 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.