As of the July, 2022, release via CMS

SKYLINE MEDICAL CENTER

CMS id: 440006
3441 DICKERSON PIKE, NASHVILLE TN 37207. County: DAVIDSON
System: HCA
CBSA: Nashville-Davidson--Murfreesboro--Franklin, TN

The 407-bed, acute-care hospital had $97,757,976 in net service to patients*, with a total profit margin of 23.27544% in fiscal year 2021, the latest year available.
It spent 10.29% of its operating expenses on uncompensated care and reported $8,176,196 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	253 118	253 118	237 119.5	275 118	275 119
Total beds Median	353 162	353 162	351 162	407 162	407 163.5
FTEs Median	1,261.87 788.06	1,278.79 793.42	1,231.73 806.03	1,202.77 787.61	1,239.64 804.34

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	280,794,388 150,932,746	280,275,842 158,950,878	283,780,183 168,696,998	303,297,815 163,454,693	397,578,244 186,589,412
Operating expenses Median	226,411,809 149,311,209	237,212,775 156,110,414	236,222,046 164,890,568	253,000,156 166,516,854	299,820,268 180,120,888
Net income from service 2 patients (NS2P) ? Median	54,382,579 -964,173	43,063,067 -643,601.5	47,558,137 -116,254	50,297,659 -5,025,862	97,757,976 -1,284,564
NS2P margin ? Median	19.37% -0.62	15.36% -0.29	16.76% 0.18	16.58% -5.07	24.59% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SKYLINE 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	2,673,530 5,089,215	2,946,635 4,572,541	1,859,635 5,268,134	10,020,862 13,092,619	-6,803,357 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	696,993	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	2,673,530	2,249,642	1,859,635	10,020,862	-6,803,357
Total income ? Median	57,056,109 6,586,430	46,009,702 6,767,106	49,417,772 8,419,950	60,318,521 8,094,175	90,954,619 15,162,888
Non-operating expenses Median	2,846 146,289.5	15,437 164,857	2,840 89,880.5	27,313 106,761	30 31,473.5
Net income Median	57,053,263 6,043,842	45,994,265 5,845,112	49,414,932 7,606,259	60,291,208 7,283,041	90,954,589 14,957,241
Net margin Median	20.12689% 4.62%	16.23962% 4.42%	17.29974% 5.16%	19.24277% 5.2%	23.27544% 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 SKYLINE 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	54,967,314 23,241,334	53,861,116 23,709,545	54,597,253 24,248,380	58,456,418 22,858,541	58,820,130 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	46,835,051 21,577,146	44,792,698 22,041,594	45,874,424 22,722,063	48,949,475 21,570,441	49,829,326 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	1,391,173 1,845,420	1,722,873 1,757,392	1,648,700 1,738,842	1,640,081 1,510,463	1,092,885 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	6,741,090 3,535,627	7,345,545 3,746,588	7,074,129 3,782,288	7,866,862 3,865,578	7,897,919 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	8,400,570 11,160,864	8,245,448 11,987,345	8,307,502 12,926,866	7,151,959 11,884,480	6,777,125 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	8,400,570 10,918,923	8,245,448 11,706,976	8,307,502 12,615,917	7,151,959 11,458,116	6,777,125 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	2,310,042 594,888	2,299,754 595,761	1,794,268 577,894	1,815,633 542,168	1,885,790 549,667
Outlier Median	857,405 582,572	649,301 538,116	61,395 212,434	65,214 126,559	116,633 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,141,794 3,662,910	3,355,454 3,730,911	3,165,380 4,081,319	3,900,927 4,643,908	8,176,196 4,389,147
Charity care Median	17,638,030 2,654,636	21,334,982 2,940,659	23,077,627 3,380,215	25,763,072 3,488,738	28,132,527 3,233,405
Uncompensated care (UCC) Median	21,095,348 5,147,790	24,839,731 5,337,617	26,720,630 5,711,082	28,873,335 5,923,418	30,861,966 5,508,107
UCC as a % of operating expenses Median	9.32% 3.24	10.47% 3.12	11.31% 3.21	11.41% 3.3	10.29% 2.86
Total shortfall/UCC Median	25,237,142 9,489,989	28,195,185 9,424,297	29,886,010 10,120,158	32,774,262 11,171,337	39,038,162 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	80,574,054 52,142,039	82,028,220 54,485,252	80,862,464 57,395,589	81,584,425 58,830,919	88,862,103 61,722,907
Salaries as a % of operating expenses Median	35.59 36.68	34.58 36.56	34.23 36.37	32.25 35.93	29.64 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	3,131,489 1,449,244	1,456,686 1,475,986	2,339,651 1,563,078	4,997,469 1,721,954	15,879,545 2,991,828
Contract hours, direct-care Median	62,743.81 22,725	29,879.00 23,018.5	59,222.00 24,503.48	98,598.00 25,026.5	176,131.00 33,786
Contract wages, direct-care Median	49.91 64.67	48.75 64.53	39.51 65.06	50.69 68.97	90.16 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.