As of the July, 2022, release via CMS

AVERA SACRED HEART HOSPITAL

CMS id: 430012
501 SUMMIT ST, YANKTON SD 57078. County: YANKTON
System: AVERA SACRED HEART
CBSA: Yankton, SD

The 262-bed, acute-care hospital had $-2,730,721 in net service to patients*, with a total profit margin of 31.51595% in fiscal year 2021, the latest year available.
It spent 1.37% of its operating expenses on uncompensated care and reported $2,133,494 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	65 118	65 118	65 119.5	65 118	65 119
Total beds Median	262 162	262 162	262 162	262 162	262 163.5
FTEs Median	828.23 788.06	823.49 793.42	795.60 806.03	781.23 787.61	616.07 804.34

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	117,994,721 150,932,746	121,027,998 158,950,878	130,345,654 168,696,998	130,110,970 163,454,693	118,665,147 186,589,412
Operating expenses Median	119,061,232 149,311,209	124,489,940 156,110,414	129,296,905 164,890,568	137,205,098 166,516,854	121,395,868 180,120,888
Net income from service 2 patients (NS2P) ? Median	-1,066,511 -964,173	-3,461,942 -643,601.5	1,048,749 -116,254	-7,094,128 -5,025,862	-2,730,721 -1,284,564
NS2P margin ? Median	-0.90% -0.62	-2.86% -0.29	0.80% 0.18	-5.45% -5.07	-2.30% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for AVERA SACRED HEART 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	21,420,040 5,089,215	19,233,870 4,572,541	14,566,845 5,268,134	13,049,996 13,092,619	60,752,292 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	746,338 224,999	455,742 199,009	838,873 206,870.5	527,941 194,343	527,101 249,496
⊳ Line 7: Investments ? ⊳ Median	15,781,428 299,524	9,962,651 188,688.5	7,129,556 370,813	4,898,407 309,361.5	12,482,101 375,329
⊳ 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	569,643	596,707	592,311	526,285	461,250
⊳ 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	14,776	11,906	9,426	4,940	8,709
⊳ 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	568	1,889
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	267,596	398,040	407,049	429,189	468,018
⊳ 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	4,040,259	7,808,824	5,589,630	6,662,666	46,803,224
Total income ? Median	20,353,529 6,586,430	15,771,928 6,767,106	15,615,594 8,419,950	5,955,868 8,094,175	58,021,571 15,162,888
Non-operating expenses Median	1,086,241 146,289.5	976,469 164,857	1,226,400 89,880.5	1,273,158 106,761	1,476,467 31,473.5
Net income Median	19,267,288 6,043,842	14,795,459 5,845,112	14,389,194 7,606,259	4,682,710 7,283,041	56,545,104 14,957,241
Net margin Median	13.82012% 4.62%	10.54845% 4.42%	9.92957% 5.16%	3.27094% 5.2%	31.51595% 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 AVERA SACRED HEART 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	18,748,712 23,241,334	19,740,923 23,709,545	20,034,951 24,248,380	18,210,045 22,858,541	20,112,974 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	16,378,935 21,577,146	16,352,166 22,041,594	16,606,371 22,722,063	14,601,019 21,570,441	16,717,387 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	2,369,777 1,203,033	3,388,757 1,215,295	3,428,580 1,313,657	3,609,026 1,365,298	3,395,587 1,179,746
All outpatient revenue Median Click here to show/hide details	8,037,491 11,160,864	9,380,608 11,987,345	11,605,492 12,926,866	12,379,863 11,884,480	13,562,087 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	8,000,018 10,918,923	9,380,608 11,706,976	11,605,492 12,615,917	12,379,863 11,458,116	13,562,087 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	37,473 618,038	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	294,937 594,888	245,501 595,761	225,895 577,894	226,253 542,168	251,978 549,667
Outlier Median	149,147 582,572	120,648 538,116	214,364 212,434	42,397 126,559	10,727 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,735,401 3,662,910	2,174,092 3,730,911	1,336,032 4,081,319	2,390,494 4,643,908	2,133,494 4,389,147
Charity care Median	442,001 2,654,636	2,522,080 2,940,659	1,147,450 3,380,215	846,354 3,488,738	564,205 3,233,405
Uncompensated care (UCC) Median	1,816,104 5,147,790	3,785,119 5,337,617	2,302,746 5,711,082	2,092,013 5,923,418	1,668,229 5,508,107
UCC as a % of operating expenses Median	1.53% 3.24	3.04% 3.12	1.78% 3.21	1.52% 3.3	1.37% 2.86
Total shortfall/UCC Median	3,551,505 9,489,989	5,959,211 9,424,297	3,638,778 10,120,158	4,482,507 11,171,337	3,801,723 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	46,790,666 52,142,039	50,050,552 54,485,252	51,431,508 57,395,589	53,860,058 58,830,919	47,197,844 61,722,907
Salaries as a % of operating expenses Median	39.30 36.68	40.20 36.56	39.78 36.37	40.63 35.93	38.88 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	1,488,480 1,449,244	516,101 1,475,986	488,023 1,563,078	193,606 1,721,954	124,038 2,991,828
Contract hours, direct-care Median	19,683.31 22,725	9,934.00 23,018.5	6,246.40 24,503.48	2,183.54 25,026.5	2,574.50 33,786
Contract wages, direct-care Median	75.62 64.67	51.95 64.53	78.13 65.06	88.67 68.97	48.18 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.