As of the July, 2022, release via CMS

AVERA ST. LUKES

CMS id: 430014
305 SOUTH STATE STREET, ABERDEEN SD 57402. County: BROWN
System: AVERA HEALTH
CBSA: Aberdeen, SD

The 197-bed, acute-care hospital had $-3,063,562 in net service to patients*, with a total profit margin of 6.25109% in fiscal year 2021, the latest year available.
It spent 1.50% of its operating expenses on uncompensated care and reported $1,166,426 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	40 118	40 118	43 119.5	40 118	40 119
Total beds Median	197 162	197 162	196 162	197 162	197 163.5
FTEs Median	1,103.32 788.06	1,011.75 793.42	997.54 806.03	945.05 787.61	885.59 804.34

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	179,623,136 150,932,746	184,956,765 158,950,878	188,662,199 168,696,998	189,356,198 163,454,693	209,059,486 186,589,412
Operating expenses Median	193,483,038 149,311,209	191,025,534 156,110,414	198,318,138 164,890,568	205,333,821 166,516,854	212,123,048 180,120,888
Net income from service 2 patients (NS2P) ? Median	-13,859,902 -964,173	-6,068,769 -643,601.5	-9,655,939 -116,254	-15,977,623 -5,025,862	-3,063,562 -1,284,564
NS2P margin ? Median	-7.72% -0.62	-3.28% -0.29	-5.12% 0.18	-8.44% -5.07	-1.47% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for AVERA ST. LUKES 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	7,264,417 5,089,215	6,083,854 4,572,541	5,395,110 5,268,134	14,898,141 13,092,619	18,200,869 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	41,237 224,999	17,220 199,009	61,343 206,870.5	36,160 194,343	68,538 249,496
⊳ Line 7: Investments ? ⊳ Median	207,622 299,524	186,511 188,688.5	250,526 370,813	198,529 309,361.5	144,728 375,329
⊳ 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	405,776	382,975	384,590	309,651	274,930
⊳ 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	0	0	0	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	294,821 1,017,693	355,519 983,261.5	339,283 1,173,286	137,377 1,987,202	69,823 1,597,664
⊳ Sum Line 24	6,314,961	5,141,629	4,359,368	14,216,424	17,642,850
Total income ? Median	-6,595,485 6,586,430	15,085 6,767,106	-4,260,829 8,419,950	-1,079,482 8,094,175	15,137,307 15,162,888
Non-operating expenses Median	424,790 146,289.5	493,717 164,857	765,111 89,880.5	1,006,938 106,761	931,056 31,473.5
Net income Median	-7,020,275 6,043,842	-478,632 5,845,112	-5,025,940 7,606,259	-2,086,420 7,283,041	14,206,251 14,957,241
Net margin Median	-3.75642% 4.62%	-0.25054% 4.42%	-2.58993% 5.16%	-1.02148% 5.2%	6.25109% 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 ST. LUKES 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	21,350,934 23,241,334	21,242,815 23,709,545	21,784,453 24,248,380	21,633,046 22,858,541	24,453,170 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	19,944,569 21,577,146	19,499,099 22,041,594	20,232,383 22,722,063	19,931,620 21,570,441	23,090,115 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	626,251 1,845,420	779,128 1,757,392	713,952 1,738,842	592,200 1,510,463	449,180 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	780,114 1,203,033	964,588 1,215,295	838,118 1,313,657	1,109,226 1,365,298	913,875 1,179,746
All outpatient revenue Median Click here to show/hide details	25,562,433 11,160,864	27,187,629 11,987,345	28,511,668 12,926,866	27,569,058 11,884,480	30,376,691 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	25,562,433 10,918,923	27,187,629 11,706,976	28,511,668 12,615,917	27,569,058 11,458,116	30,376,691 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	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	1,429,683 582,572	1,238,571 538,116	453,847 212,434	181,962 126,559	72,179 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,558,318 3,662,910	193,647 3,730,911	1,897,661 4,081,319	1,473,916 4,643,908	1,166,426 4,389,147
Charity care Median	1,408,262 2,654,636	5,561,031 2,940,659	2,473,354 3,380,215	1,342,778 3,488,738	764,431 3,233,405
Uncompensated care (UCC) Median	1,840,836 5,147,790	7,462,658 5,337,617	4,406,857 5,711,082	3,852,549 5,923,418	3,182,129 5,508,107
UCC as a % of operating expenses Median	0.95% 3.24	3.91% 3.12	2.22% 3.21	1.88% 3.3	1.50% 2.86
Total shortfall/UCC Median	4,399,154 9,489,989	7,656,305 9,424,297	6,304,518 10,120,158	5,326,465 11,171,337	4,348,555 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	89,406,901 52,142,039	87,662,901 54,485,252	88,788,711 57,395,589	87,882,070 58,830,919	87,202,983 61,722,907
Salaries as a % of operating expenses Median	46.21 36.68	45.89 36.56	44.77 36.37	44.97 35.93	43.42 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	496,791 1,449,244	199,745 1,475,986	128,781 1,563,078	156,363 1,721,954	204,990 2,991,828
Contract hours, direct-care Median	8,705.45 22,725	3,312.24 23,018.5	1,463.92 24,503.48	1,924.75 25,026.5	1,896.82 33,786
Contract wages, direct-care Median	57.07 64.67	60.31 64.53	87.97 65.06	81.24 68.97	108.07 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.