As of the July, 2022, release via CMS

BLACK HILLS SURGICAL HOSPITAL LLP

CMS id: 430091
216 ANAMARIA DRIVE, RAPID CITY SD 57701. County: PENNINGTON
System: --
CBSA: Rapid City, SD

The 26-bed, acute-care hospital had $19,240,232 in net service to patients*, with a total profit margin of 25.76135% in fiscal year 2021, the latest year available.
It spent 0.42% of its operating expenses on uncompensated care and reported $1,557 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	26 118	26 118	26 119.5	26 118	26 119
Total beds Median	26 162	26 162	26 162	26 162	26 163.5
FTEs Median	309.33 788.06	330.68 793.42	330.45 806.03	324.56 787.61	333.36 804.34

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	80,330,213 150,932,746	83,294,285 158,950,878	86,214,182 168,696,998	78,450,755 163,454,693	85,830,163 186,589,412
Operating expenses Median	55,128,168 149,311,209	58,922,439 156,110,414	63,746,892 164,890,568	61,377,172 166,516,854	66,589,931 180,120,888
Net income from service 2 patients (NS2P) ? Median	25,202,045 -964,173	24,371,846 -643,601.5	22,467,290 -116,254	17,073,583 -5,025,862	19,240,232 -1,284,564
NS2P margin ? Median	31.37% -0.62	29.26% -0.29	26.06% 0.18	21.76% -5.07	22.42% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for BLACK HILLS SURGICAL HOSPITAL LLP 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	90,518 5,089,215	134,030 4,572,541	524,080 5,268,134	4,039,042 13,092,619	3,866,954 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	11,936 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	3,258 299,524	0 188,688.5	6,732 370,813	1,774 309,361.5	1,823 375,329
⊳ 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	132	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	12,696	8,701	9,448	6,559	8,180
⊳ 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	70,363	81,110	401,277	418,423	415,148
⊳ 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	4,069	32,283	106,623	3,612,286	3,441,803
Total income ? Median	25,292,563 6,586,430	24,505,876 6,767,106	22,991,370 8,419,950	21,112,625 8,094,175	23,107,186 15,162,888
Non-operating expenses Median	2,159 146,289.5	-23,309 164,857	1,751 89,880.5	0 106,761	0 31,473.5
Net income Median	25,290,404 6,043,842	24,529,185 5,845,112	22,989,619 7,606,259	21,112,625 7,283,041	23,107,186 14,957,241
Net margin Median	31.44762% 4.62%	29.40151% 4.42%	26.50459% 5.16%	25.59423% 5.2%	25.76135% 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 BLACK HILLS SURGICAL HOSPITAL LLP 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	11,040,937 23,241,334	10,860,406 23,709,545	12,431,691 24,248,380	11,263,627 22,858,541	13,372,355 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	11,040,937 21,577,146	10,860,406 22,041,594	12,431,691 22,722,063	11,263,627 21,570,441	13,372,355 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	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	7,866,760 11,160,864	8,440,535 11,987,345	8,597,556 12,926,866	8,170,625 11,884,480	10,304,360 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	7,866,760 10,918,923	8,440,535 11,706,976	8,597,556 12,615,917	8,170,625 11,458,116	10,304,360 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	582 582,572	1,541 538,116	180 212,434	0 126,559	2,816 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	256 3,662,910	1,965 3,730,911	1,348 4,081,319	34,432 4,643,908	1,557 4,389,147
Charity care Median	105,398 2,654,636	142,796 2,940,659	95,164 3,380,215	0 3,488,738	0 3,233,405
Uncompensated care (UCC) Median	327,826 5,147,790	431,644 5,337,617	352,661 5,711,082	293,570 5,923,418	278,421 5,508,107
UCC as a % of operating expenses Median	0.59% 3.24	0.73% 3.12	0.55% 3.21	0.48% 3.3	0.42% 2.86
Total shortfall/UCC Median	328,082 9,489,989	433,609 9,424,297	354,009 10,120,158	328,002 11,171,337	279,978 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	22,763,883 52,142,039	24,488,997 54,485,252	25,286,836 57,395,589	25,669,982 58,830,919	28,342,503 61,722,907
Salaries as a % of operating expenses Median	41.29 36.68	41.56 36.56	40.42 36.37	42.57 35.93	43.29 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	284,926 1,449,244	688,226 1,475,986	542,108 1,563,078	162,283 1,721,954	215,080 2,991,828
Contract hours, direct-care Median	4,556.00 22,725	11,011.00 23,018.5	8,024.59 24,503.48	3,207.74 25,026.5	3,785.25 33,786
Contract wages, direct-care Median	62.54 64.67	62.50 64.53	67.56 65.06	50.59 68.97	56.82 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.