As of the July, 2022, release via CMS

AUXILIO MUTUO HOSPITAL

CMS id: 400016
PONCE DE LEON, SAN JUAN PR 919. County: SAN JUAN
System: --
CBSA: San Juan-Bayamon-Caguas, PR

The 500-bed, acute-care hospital had $-26,022,203 in net service to patients*, with a total profit margin of 1.27937% in fiscal year 2021, the latest year available.
It spent 0.16% of its operating expenses on uncompensated care and reported $2,644,748 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	382 118	363 118	382 119.5	389 118	372 119
Total beds Median	492 162	460 162	497 162	516 162	500 163.5
FTEs Median	2,000.00 788.06	1,934.00 793.42	2,067.00 806.03	2,028.00 787.61	1,989.00 804.34

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	200,093,153 150,932,746	212,680,644 158,950,878	225,463,479 168,696,998	200,933,338 163,454,693	205,483,594 186,589,412
Operating expenses Median	219,625,835 149,311,209	227,397,395 156,110,414	232,511,092 164,890,568	224,726,135 166,516,854	231,505,797 180,120,888
Net income from service 2 patients (NS2P) ? Median	-19,532,682 -964,173	-14,716,751 -643,601.5	-7,047,613 -116,254	-23,792,797 -5,025,862	-26,022,203 -1,284,564
NS2P margin ? Median	-9.76% -0.62	-6.92% -0.29	-3.13% 0.18	-11.84% -5.07	-12.66% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for AUXILIO MUTUO 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	14,545,136 5,089,215	18,164,432 4,572,541	14,080,442 5,268,134	26,873,010 13,092,619	29,231,623 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	39,821 299,524	70,014 188,688.5	117,163 370,813	168,916 309,361.5	236,147 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	192,589	212,689	217,998	182,487	182,5--1
⊳ Line 10: Purchase discounts	748,669	715,090	789,379	665,923	915,530
⊳ Line 11: Rebates and refunds of expenses	447,980	585,920	621,191	256,440	657,467
⊳ Line 12: Parking lot receipts	4,145,531	4,414,100	4,778,565	3,477,736	3,357,679
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	140,297	174,424	147,673	122,435	87,952
⊳ Line 15: Revenue from rental of living quarters	29,925	24,300	18,575	13,900	12,050
⊳ 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	2,071,523	2,127,375	1,754,712	1,533,351	1,667,169
⊳ Line 18: Revenue from sale of medical records and abstracts	34,344	37,937	38,842	24,819	43,730
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	47,761	31,242	33,420
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	1,319,522	1,393,015	1,566,330	1,432,197	1,296,149
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	1,455,403	1,451,361	1,594,761	1,582,607	1,700,235
⊳ 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	3,919,047	6,957,842	2,387,274	17,380,642	19,041,473
Total income ? Median	-4,987,546 6,586,430	3,447,681 6,767,106	7,032,829 8,419,950	3,080,213 8,094,175	3,209,420 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	4,081,496 89,880.5	0 106,761	206,544 31,473.5
Net income Median	-4,987,546 6,043,842	3,447,681 5,845,112	2,951,333 7,606,259	3,080,213 7,283,041	3,002,876 14,957,241
Net margin Median	-2.32370% 4.62%	1.49350% 4.42%	1.23206% 5.16%	1.35212% 5.2%	1.27937% 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 AUXILIO MUTUO 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	23,974,897 23,241,334	27,550,951 23,709,545	28,887,561 24,248,380	27,524,176 22,858,541	22,830,087 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	23,849,196 21,577,146	26,080,375 22,041,594	27,469,909 22,722,063	26,423,879 21,570,441	21,732,406 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	125,701 3,535,627	1,470,576 3,746,588	1,417,652 3,782,288	1,100,297 3,865,578	1,097,681 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	6,806,332 11,160,864	6,791,493 11,987,345	7,990,747 12,926,866	7,261,087 11,884,480	7,557,389 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	6,806,332 10,918,923	6,791,493 11,706,976	7,990,747 12,615,917	7,261,087 11,458,116	7,557,389 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	49,446 3,284,314	28,727 3,250,551	74,999 3,386,837	74,338 3,360,806	70,136 3,508,953
Disproportionate-share hospital (DSH) Median	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	1,518,781 582,572	1,679,098 538,116	203,123 212,434	176,622 126,559	85,545 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,382,028 3,662,910	3,500,972 3,730,911	4,241,939 4,081,319	3,295,748 4,643,908	2,644,748 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	421,456 5,147,790	347,137 5,337,617	387,959 5,711,082	323,332 5,923,418	365,223 5,508,107
UCC as a % of operating expenses Median	0.19% 3.24	0.15% 3.12	0.17% 3.21	0.14% 3.3	0.16% 2.86
Total shortfall/UCC Median	2,803,484 9,489,989	3,848,109 9,424,297	4,629,898 10,120,158	3,619,080 11,171,337	3,009,971 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	75,430,096 52,142,039	76,942,641 54,485,252	77,159,627 57,395,589	76,592,143 58,830,919	79,723,535 61,722,907
Salaries as a % of operating expenses Median	34.34 36.68	33.85 36.56	33.19 36.37	34.08 35.93	34.44 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	3,197,352 1,449,244	2,540,501 1,475,986	2,778,593 1,563,078	2,676,769 1,721,954	2,473,290 2,991,828
Contract hours, direct-care Median	109,529.00 22,725	86,403.00 23,018.5	91,909.50 24,503.48	89,232.00 25,026.5	86,963.00 33,786
Contract wages, direct-care Median	29.19 64.67	29.40 64.53	30.23 65.06	30.00 68.97	28.44 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.