As of the July, 2022, release via CMS

HOSPITAL SAN CRISTOBAL

CMS id: 400113
509 KM 1 COTTO LAUREL, PONCE PR 980. County: PONCE
System: --
CBSA: Ponce, PR

The 150-bed, acute-care hospital had $-3,335,930 in net service to patients*, with a total profit margin of 9.70709% in fiscal year 2021, the latest year available.
It spent 0.37% of its operating expenses on uncompensated care and reported $1,115,508 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	110 118	110 118	110 119.5	110 118	108 119
Total beds Median	145 162	157 162	157 162	157 162	150 163.5
FTEs Median	350.26 788.06	339.98 793.42	337.18 806.03	320.30 787.61	320.44 804.34

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	31,970,255 150,932,746	32,460,396 158,950,878	31,224,930 168,696,998	28,304,875 163,454,693	30,733,600 186,589,412
Operating expenses Median	34,542,118 149,311,209	34,423,833 156,110,414	34,358,542 164,890,568	33,143,930 166,516,854	34,069,530 180,120,888
Net income from service 2 patients (NS2P) ? Median	-2,571,863 -964,173	-1,963,437 -643,601.5	-3,133,612 -116,254	-4,839,055 -5,025,862	-3,335,930 -1,284,564
NS2P margin ? Median	-8.04% -0.62	-6.05% -0.29	-10.04% 0.18	-17.10% -5.07	-10.85% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HOSPITAL SAN CRISTOBAL 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	2,318,681 5,089,215	3,402,565 4,572,541	2,158,933 5,268,134	5,662,386 13,092,619	6,998,633 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	3,699 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	24,082 299,524	30,598 188,688.5	54,258 370,813	46,113 309,361.5	67,353 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	86,868	43,322	74,35--	51,126	4--,828
⊳ Line 10: Purchase discounts	32,130	61,386	-14,914	0	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	439,200	441,307	442,131	331,845	278,124
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	492,311	561,081	520,459	341,668	234,103
⊳ 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	195,654	211,079	201,150	159,600	143,550
⊳ Line 18: Revenue from sale of medical records and abstracts	5,873	1,246	1,981	344	16,890
⊳ 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	5,702	5,479	3,792	3,468	3,531
⊳ 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	1,033,694	2,042,096	874,350	4,726,702	6,213,398
Total income ? Median	-253,182 6,586,430	1,439,128 6,767,106	-974,679 8,419,950	823,331 8,094,175	3,662,703 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	-253,182 6,043,842	1,439,128 5,845,112	-974,679 7,606,259	823,331 7,283,041	3,662,703 14,957,241
Net margin Median	-0.73838% 4.62%	4.01285% 4.42%	-2.91961% 5.16%	2.42390% 5.2%	9.70709% 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 HOSPITAL SAN CRISTOBAL 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	4,544,597 23,241,334	4,296,851 23,709,545	4,468,471 24,248,380	4,891,920 22,858,541	4,613,784 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	4,544,597 21,577,146	4,296,851 22,041,594	4,468,471 22,722,063	4,891,920 21,570,441	4,613,784 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	238,264 11,160,864	248,854 11,987,345	250,173 12,926,866	216,374 11,884,480	245,693 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	238,264 10,918,923	248,854 11,706,976	250,173 12,615,917	216,374 11,458,116	245,693 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	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	61,715 594,888	54,821 595,761	54,935 577,894	49,869 542,168	61,795 549,667
Outlier Median	22,915 582,572	50,501 538,116	2,063 212,434	612 126,559	0 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	647,203 4,081,319	1,375,174 4,643,908	1,115,508 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	350,306 5,147,790	164,678 5,337,617	125,087 5,711,082	130,852 5,923,418	126,472 5,508,107
UCC as a % of operating expenses Median	1.01% 3.24	0.48% 3.12	0.36% 3.21	0.39% 3.3	0.37% 2.86
Total shortfall/UCC Median	350,306 9,489,989	164,678 9,424,297	772,290 10,120,158	1,506,026 11,171,337	1,241,980 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	10,160,828 52,142,039	10,084,124 54,485,252	9,471,449 57,395,589	8,736,082 58,830,919	8,519,227 61,722,907
Salaries as a % of operating expenses Median	29.42 36.68	29.29 36.56	27.57 36.37	26.36 35.93	25.01 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	210,310 1,449,244	212,870 1,475,986	87,255 1,563,078	122,250 1,721,954	1,552,545 2,991,828
Contract hours, direct-care Median	22,616.00 22,725	20,984.00 23,018.5	9,160.00 24,503.48	12,928.00 25,026.5	100,878.98 33,786
Contract wages, direct-care Median	9.30 64.67	10.14 64.53	9.53 65.06	9.46 68.97	15.39 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.