As of the July, 2022, release via CMS

SANFORD USD MEDICAL CENTER

CMS id: 430027
1305 W 18TH ST, SIOUX FALLS SD 57117. County: MINNEHAHA
System: SANFORD
CBSA: Sioux Falls, SD

The 473-bed, acute-care hospital had $12,097,545 in net service to patients*, with a total profit margin of 13.75634% in fiscal year 2021, the latest year available.
It spent 3.08% of its operating expenses on uncompensated care and reported $10,538,501 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	355 118	355 118	355 119.5	355 118	355 119
Total beds Median	473 162	473 162	473 162	473 162	473 163.5
FTEs Median	4,750.95 788.06	4,763.44 793.42	4,872.81 806.03	5,110.86 787.61	5,293.21 804.34

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	924,536,694 150,932,746	955,310,267 158,950,878	1,010,986,443 168,696,998	1,038,084,118 163,454,693	1,212,084,411 186,589,412
Operating expenses Median	830,429,116 149,311,209	885,215,719 156,110,414	984,253,955 164,890,568	1,067,723,176 166,516,854	1,199,986,866 180,120,888
Net income from service 2 patients (NS2P) ? Median	94,107,578 -964,173	70,094,548 -643,601.5	26,732,488 -116,254	-29,639,058 -5,025,862	12,097,545 -1,284,564
NS2P margin ? Median	10.18% -0.62	7.34% -0.29	2.64% 0.18	-2.86% -5.07	1.00% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SANFORD USD MEDICAL CENTER 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	76,842,931 5,089,215	91,016,203 4,572,541	153,195,926 5,268,134	252,223,486 13,092,619	216,037,428 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	0 299,524	0 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ 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	0	0	0	0	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	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	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	76,842,931	91,016,203	153,195,926	252,223,486	216,037,428
Total income ? Median	170,950,509 6,586,430	161,110,751 6,767,106	179,928,414 8,419,950	222,584,428 8,094,175	228,134,973 15,162,888
Non-operating expenses Median	21,725,362 146,289.5	20,556,133 164,857	34,755,189 89,880.5	28,832,045 106,761	31,677,610 31,473.5
Net income Median	149,225,147 6,043,842	140,554,618 5,845,112	145,173,225 7,606,259	193,752,383 7,283,041	196,457,363 14,957,241
Net margin Median	14.90196% 4.62%	13.43315% 4.42%	12.46997% 5.16%	15.01598% 5.2%	13.75634% 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 SANFORD USD MEDICAL CENTER 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	121,920,944 23,241,334	129,583,388 23,709,545	128,973,440 24,248,380	124,655,480 22,858,541	125,647,357 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	118,527,091 21,577,146	126,741,853 22,041,594	125,943,628 22,722,063	120,977,676 21,570,441	121,066,064 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	3,393,853 3,535,627	2,841,535 3,746,588	3,029,812 3,782,288	3,677,804 3,865,578	4,581,293 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	100,307,839 11,160,864	109,048,805 11,987,345	114,882,478 12,926,866	109,441,110 11,884,480	133,834,417 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	100,307,839 10,918,923	109,048,805 11,706,976	114,882,478 12,615,917	109,441,110 11,458,116	133,834,417 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	6,397,380 3,284,314	6,880,644 3,250,551	6,553,998 3,386,837	6,684,515 3,360,806	7,058,422 3,508,953
Disproportionate-share hospital (DSH) Median	3,531,929 594,888	3,355,361 595,761	3,320,480 577,894	2,718,352 542,168	3,009,051 549,667
Outlier Median	4,433,243 582,572	2,453,281 538,116	738,842 212,434	819,708 126,559	903,223 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	6,022,836 3,662,910	9,078,810 3,730,911	7,741,958 4,081,319	8,048,004 4,643,908	10,538,501 4,389,147
Charity care Median	21,686,584 2,654,636	21,942,436 2,940,659	23,403,679 3,380,215	21,374,440 3,488,738	24,086,872 3,233,405
Uncompensated care (UCC) Median	30,328,898 5,147,790	28,537,072 5,337,617	33,171,381 5,711,082	29,509,360 5,923,418	36,951,058 5,508,107
UCC as a % of operating expenses Median	3.65% 3.24	3.22% 3.12	3.37% 3.21	2.76% 3.3	3.08% 2.86
Total shortfall/UCC Median	36,351,734 9,489,989	37,615,882 9,424,297	40,913,339 10,120,158	37,557,364 11,171,337	47,489,559 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	368,301,215 52,142,039	381,978,577 54,485,252	418,101,440 57,395,589	457,069,579 58,830,919	505,756,893 61,722,907
Salaries as a % of operating expenses Median	44.35 36.68	43.15 36.56	42.48 36.37	42.81 35.93	42.15 35.24
Intern, resident salaries* Median	952,183 2,598,592	485,750 2,686,824	684,908 2,753,773	636,266 2,937,156	634,223 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	1,634,068 1,449,244	1,475,032 1,475,986	1,811,541 1,563,078	3,320,990 1,721,954	11,861,986 2,991,828
Contract hours, direct-care Median	23,343.00 22,725	23,804.50 23,018.5	19,725.50 24,503.48	47,443.00 25,026.5	131,799.00 33,786
Contract wages, direct-care Median	70.00 64.67	61.96 64.53	91.84 65.06	70.00 68.97	90.00 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.