As of the July, 2022, release via CMS

RYDER

CMS id: 400007
ROAD 30, HUMACAO PR 792. County: HUMACAO
System: --
CBSA: San Juan-Bayamon-Caguas, PR

The 227-bed, acute-care hospital had $-8,436,820 in net service to patients*, with a total profit margin of -2.22831% in fiscal year 2021, the latest year available.
It spent 0.10% of its operating expenses on uncompensated care and reported $9,655,362 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	136 118	136 118	136 119.5	136 118	136 119
Total beds Median	227 162	227 162	227 162	227 162	227 163.5
FTEs Median	709.64 788.06	508.76 793.42	547.16 806.03	470.11 787.61	458.18 804.34

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	35,534,750 150,932,746	23,383,093 158,950,878	32,466,635 168,696,998	30,712,278 163,454,693	33,485,026 186,589,412
Operating expenses Median	50,610,934 149,311,209	41,946,676 156,110,414	47,112,043 164,890,568	45,542,092 166,516,854	41,921,846 180,120,888
Net income from service 2 patients (NS2P) ? Median	-15,076,184 -964,173	-18,563,583 -643,601.5	-14,645,408 -116,254	-14,829,814 -5,025,862	-8,436,820 -1,284,564
NS2P margin ? Median	-42.43% -0.62	-79.39% -0.29	-45.11% 0.18	-48.29% -5.07	-25.20% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for RYDER 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	9,989,050 5,089,215	10,759,477 4,572,541	13,062,335 5,268,134	13,602,446 13,092,619	7,523,033 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	18,722 224,999	0 199,009	2,079 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	56,266 299,524	108,922 188,688.5	487,431 370,813	54,967 309,361.5	191,097 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	3--,000	3,958	2,--79	12,413	--
⊳ Line 10: Purchase discounts	0	33,443	4,087	13,386	705
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	341,182	0	292,862	183,181	231,751
⊳ Line 13: Revenue from laundry and linen service	7,469	500	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	593,053	469,188	0	247,218	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	8,623	4,754	5,559	5,337	17,309
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	76,619	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	154,199	34,801	197,856	164,553	0
⊳ Line 21: Rental of vending machines	23,684	19,291	19,314	13,102	2,541
⊳ Line 22: Rental of hospital space	124,487	619,801	57,720	128,895	106,275
⊳ Line 23: Gov appropriations ? ⊳ Median	817,931 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	7,736,815	9,464,819	11,979,489	12,779,394	6,973,355
Total income ? Median	-5,087,134 6,586,430	-7,804,106 6,767,106	-1,583,073 8,419,950	-1,227,368 8,094,175	-913,787 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	-5,087,134 6,043,842	-7,804,106 5,845,112	-1,583,073 7,606,259	-1,227,368 7,283,041	-913,787 14,957,241
Net margin Median	-11.17467% 4.62%	-22.85741% 4.42%	-3.47707% 5.16%	-2.76966% 5.2%	-2.22831% 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 RYDER 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	4,243,749 23,241,334	3,464,451 23,709,545	4,947,009 24,248,380	5,127,816 22,858,541	4,520,571 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	4,084,236 21,577,146	3,299,979 22,041,594	4,731,946 22,722,063	4,886,142 21,570,441	4,424,374 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	159,513 1,203,033	164,472 1,215,295	215,063 1,313,657	241,674 1,365,298	96,197 1,179,746
All outpatient revenue Median Click here to show/hide details	575,347 11,160,864	458,528 11,987,345	557,227 12,926,866	180,597 11,884,480	323,280 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	179,567 10,918,923	127,605 11,706,976	144,656 12,615,917	87,801 11,458,116	67,483 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	395,780 1,282,808	330,923 1,407,728	412,571 1,341,512	92,796 1,407,046	255,797 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	35,441 594,888	5,137 595,761	20,414 577,894	33,136 542,168	41,988 549,667
Outlier Median	19,302 582,572	0 538,116	3,826 212,434	2,735 126,559	3,965 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	1,953,007 4,081,319	11,655,450 4,643,908	9,655,362 4,389,147
Charity care Median	0 2,654,636	0 2,940,659	0 3,380,215	0 3,488,738	0 3,233,405
Uncompensated care (UCC) Median	1,761,484 5,147,790	34,591 5,337,617	49,330 5,711,082	1,184,154 5,923,418	42,565 5,508,107
UCC as a % of operating expenses Median	3.48% 3.24	0.08% 3.12	0.10% 3.21	2.60% 3.3	0.10% 2.86
Total shortfall/UCC Median	1,761,484 9,489,989	34,591 9,424,297	2,002,337 10,120,158	12,839,604 11,171,337	9,697,927 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	19,560,005 52,142,039	14,871,023 54,485,252	16,090,882 57,395,589	15,018,160 58,830,919	14,202,552 61,722,907
Salaries as a % of operating expenses Median	38.65 36.68	36.01 36.56	34.15 36.37	32.98 35.93	33.88 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	0 1,449,244	0 1,475,986	0 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	0.00 22,725	0.00 23,018.5	0.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	0.00 64.67	0.00 64.53	0.00 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.