As of the July, 2022, release via CMS

MONUMENT HEALTH RAPID CITY HOSPITAL

CMS id: 430077
353 FAIRMONT BLVD, RAPID CITY SD 57701. County: PENNINGTON
System: MONUMENT HEALTH
CBSA: Rapid City, SD

The 401-bed, acute-care hospital had $-57,569,166 in net service to patients*, with a total profit margin of 15.59708% in fiscal year 2021, the latest year available.
It spent 3.63% of its operating expenses on uncompensated care and reported $13,386,965 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	287 118	305 118	304 119.5	315 118	313 119
Total beds Median	423 162	387 162	386 162	397 162	401 163.5
FTEs Median	2,938.41 788.06	2,756.72 793.42	2,502.86 806.03	2,577.43 787.61	2,855.67 804.34

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	479,705,090 150,932,746	514,096,760 158,950,878	573,483,457 168,696,998	626,615,778 163,454,693	727,896,642 186,589,412
Operating expenses Median	527,321,698 149,311,209	548,592,250 156,110,414	532,643,565 164,890,568	602,098,718 166,516,854	785,465,808 180,120,888
Net income from service 2 patients (NS2P) ? Median	-47,616,608 -964,173	-34,495,490 -643,601.5	40,839,892 -116,254	24,517,060 -5,025,862	-57,569,166 -1,284,564
NS2P margin ? Median	-9.93% -0.62	-6.71% -0.29	7.12% 0.18	3.91% -5.07	-7.91% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MONUMENT HEALTH RAPID CITY 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	105,666,698 5,089,215	76,178,014 4,572,541	75,362,264 5,268,134	74,240,360 13,092,619	202,717,808 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,000,000 224,999	1,500,000 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	47,870,704 299,524	22,364,348 188,688.5	6,642,013 370,813	9,833,985 309,361.5	115,898,769 375,329
⊳ 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	1,762,911	1,778,003	1,572,834	1,690,193	1,792,786
⊳ 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	21,072,178	15,528,247	624,371	525,495	675,692
⊳ Line 18: Revenue from sale of medical records and abstracts	549,228	1,786,371	1,859,956	1,941,537	2,244,674
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	17,400	15,000	10,510	-5,000	-2,677
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	19	25	0
⊳ Line 22: Rental of hospital space	0	169,310	0	960,599	1,547,350
⊳ Line 23: Gov appropriations ? ⊳ Median	264,835 1,017,693	158,351 983,261.5	305,027 1,173,286	149,315 1,987,202	710,241 1,597,664
⊳ Sum Line 24	33,129,442	32,878,384	64,347,534	59,144,211	79,850,973
Total income ? Median	58,050,090 6,586,430	41,682,524 6,767,106	116,202,156 8,419,950	98,757,420 8,094,175	145,148,642 15,162,888
Non-operating expenses Median	0 146,289.5	-1 164,857	72,708,701 89,880.5	77,051,275 106,761	0 31,473.5
Net income Median	58,050,090 6,043,842	41,682,525 5,845,112	43,493,455 7,606,259	21,706,145 7,283,041	145,148,642 14,957,241
Net margin Median	9.91679% 4.62%	7.06155% 4.42%	6.70320% 5.16%	3.09709% 5.2%	15.59708% 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 MONUMENT HEALTH RAPID CITY 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	101,903,553 23,241,334	95,366,962 23,709,545	106,097,040 24,248,380	100,461,542 22,858,541	110,159,915 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	95,857,486 21,577,146	92,180,624 22,041,594	102,184,771 22,722,063	97,429,338 21,570,441	107,053,354 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	854,637 1,845,420	1,847 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	5,191,430 3,535,627	3,184,491 3,746,588	3,912,269 3,782,288	3,032,204 3,865,578	3,106,561 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	63,941,493 11,160,864	67,887,942 11,987,345	73,180,182 12,926,866	77,446,485 11,884,480	89,063,928 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	63,484,732 10,918,923	67,887,942 11,706,976	73,180,182 12,615,917	77,446,485 11,458,116	89,063,928 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	456,761 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	1,978,555 3,284,314	1,851,559 3,250,551	2,111,071 3,386,837	2,028,235 3,360,806	2,115,245 3,508,953
Disproportionate-share hospital (DSH) Median	2,333,473 594,888	2,379,338 595,761	2,728,124 577,894	2,447,117 542,168	2,590,327 549,667
Outlier Median	4,339,549 582,572	3,679,574 538,116	5,948,568 212,434	1,091,722 126,559	909,911 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	15,227,581 3,662,910	12,403,601 3,730,911	10,181,111 4,081,319	13,056,456 4,643,908	13,386,965 4,389,147
Charity care Median	10,534,183 2,654,636	9,870,843 2,940,659	7,203,805 3,380,215	7,832,760 3,488,738	7,132,419 3,233,405
Uncompensated care (UCC) Median	22,782,243 5,147,790	25,350,557 5,337,617	26,029,501 5,711,082	29,946,886 5,923,418	28,496,538 5,508,107
UCC as a % of operating expenses Median	4.32% 3.24	4.62% 3.12	4.89% 3.21	4.97% 3.3	3.63% 2.86
Total shortfall/UCC Median	38,009,824 9,489,989	37,754,158 9,424,297	36,210,612 10,120,158	43,003,342 11,171,337	41,883,503 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	205,300,382 52,142,039	208,547,587 54,485,252	212,141,521 57,395,589	237,816,489 58,830,919	275,490,132 61,722,907
Salaries as a % of operating expenses Median	38.93 36.68	40.14 36.56	38.99 36.37	38.26 35.93	37.92 35.24
Intern, resident salaries* Median	3,759,495 2,598,592	4,050,607 2,686,824	4,073,905 2,753,773	4,051,033 2,937,156	4,232,093 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	19,493,908 1,449,244	13,947,887 1,475,986	19,171,102 1,563,078	26,844,993 1,721,954	35,701,642 2,991,828
Contract hours, direct-care Median	257,119.00 22,725	208,909.49 23,018.5	303,071.12 24,503.48	416,195.75 25,026.5	424,899.49 33,786
Contract wages, direct-care Median	75.82 64.67	66.77 64.53	63.26 65.06	64.50 68.97	84.02 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.