As of the July, 2022, release via CMS

SIOUXLAND SURGERY CENTER

CMS id: 430089
600 SIOUX POINT ROAD, DAKOTA DUNES SD 57049. County: UNION
System: --
CBSA: Sioux City, IA-NE-SD

The 38-bed, acute-care hospital had $37,778,715 in net service to patients*, with a total profit margin of 41.40983% in fiscal year 2020, the latest year available.
It spent 0.44% of its operating expenses on uncompensated care and reported $0 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	--
Ownership	forprofit	forprofit	forprofit	forprofit	--
Acute beds Median	40 118	38 118	38 119.5	38 118	-- 119
Total beds Median	40 162	38 162	38 162	38 162	-- 163.5
FTEs Median	215.00 788.06	229.00 793.42	236.00 806.03	214.00 787.61	-- 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	83,509,701 150,932,746	93,002,231 158,950,878	99,132,130 168,696,998	94,693,851 163,454,693	-- 186,589,412
Operating expenses Median	51,540,096 149,311,209	54,819,915 156,110,414	58,202,108 164,890,568	56,915,136 166,516,854	-- 180,120,888
Net income from service 2 patients (NS2P) ? Median	31,969,605 -964,173	38,182,316 -643,601.5	40,930,022 -116,254	37,778,715 -5,025,862	-- -1,284,564
NS2P margin ? Median	38.28% -0.62	41.06% -0.29	41.29% 0.18	39.90% -5.07	--% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SIOUXLAND SURGERY 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	89,622 5,089,215	63,843 4,572,541	149,003 5,268,134	2,570,679 13,092,619	-- 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	-- 249,496
⊳ Line 7: Investments ? ⊳ Median	12,486 299,524	50,262 188,688.5	94,342 370,813	122,328 309,361.5	-- 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	--
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	--
⊳ Line 12: Parking lot receipts	0	0	0	0	--
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	--
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	0	--
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	--
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	--
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	--
⊳ Line 18: Revenue from sale of medical records and abstracts	0	4,561	39,151	10,015	--
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	--
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	--
⊳ Line 21: Rental of vending machines	0	0	0	0	--
⊳ Line 22: Rental of hospital space	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	-- 1,597,664
⊳ Sum Line 24	77,136	9,020	15,510	2,438,336	--
Total income ? Median	32,059,227 6,586,430	38,246,159 6,767,106	41,079,025 8,419,950	40,349,394 8,094,175	-- 15,162,888
Non-operating expenses Median	34,552 146,289.5	18,787 164,857	0 89,880.5	72,314 106,761	-- 31,473.5
Net income Median	32,024,675 6,043,842	38,227,372 5,845,112	41,079,025 7,606,259	40,277,080 7,283,041	-- 14,957,241
Net margin Median	38.30734% 4.62%	41.07552% 4.42%	41.37647% 5.16%	41.40983% 5.2%	--% 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 SIOUXLAND SURGERY 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	10,184,443 23,241,334	10,236,120 23,709,545	11,385,118 24,248,380	6,682,981 22,858,541	-- 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	10,184,443 21,577,146	10,236,120 22,041,594	11,385,118 22,722,063	6,682,981 21,570,441	-- 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	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	-- 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	-- 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Critical-access hospitals ⊳ Median	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	-- 1,179,746
All outpatient revenue Median Click here to show/hide details	7,340,476 11,160,864	11,332,418 11,987,345	10,827,896 12,926,866	14,391,446 11,884,480	-- 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	7,340,476 10,918,923	11,332,418 11,706,976	10,827,896 12,615,917	14,391,446 11,458,116	-- 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	-- 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	-- 670,558
⊳ Other federally qualified health clinics ⊳ Median	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	-- 3,508,953
Disproportionate-share hospital (DSH) Median	0 594,888	0 595,761	0 577,894	0 542,168	-- 549,667
Outlier Median	40,646 582,572	70,447 538,116	7,679 212,434	14,955 126,559	-- 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	93,440 4,081,319	0 4,643,908	-- 4,389,147
Charity care Median	0 2,654,636	134,635 2,940,659	154,257 3,380,215	30,355 3,488,738	-- 3,233,405
Uncompensated care (UCC) Median	210,793 5,147,790	350,226 5,337,617	382,223 5,711,082	248,156 5,923,418	-- 5,508,107
UCC as a % of operating expenses Median	0.41% 3.24	0.64% 3.12	0.66% 3.21	0.44% 3.3	--% 2.86
Total shortfall/UCC Median	210,793 9,489,989	350,226 9,424,297	475,663 10,120,158	248,156 11,171,337	-- 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	11,003,811 52,142,039	11,890,803 54,485,252	12,815,118 57,395,589	11,777,162 58,830,919	-- 61,722,907
Salaries as a % of operating expenses Median	21.85 36.68	22.19 36.56	22.55 36.37	21.15 35.93	-- 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	-- 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	-- 1,469,317
Contract adjusted salaries, direct-care Median	350,325 1,449,244	497,673 1,475,986	439,938 1,563,078	440,651 1,721,954	-- 2,991,828
Contract hours, direct-care Median	3,892.50 22,725	5,299.00 23,018.5	4,782.00 24,503.48	4,790.00 25,026.5	-- 33,786
Contract wages, direct-care Median	90.00 64.67	93.92 64.53	92.00 65.06	91.99 68.97	-- 88.94

* in an approved program

Return to top

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.