As of the July, 2022, release via CMS

COOKEVILLE REGIONAL MEDICAL CENTER

CMS id: 440059
142 WEST FIFTH STREET, COOKEVILLE TN 38501. County: PUTNAM
System: --
CBSA: Cookeville, TN

The 231-bed, acute-care hospital had $9,054,145 in net service to patients*, with a total profit margin of 1.73315% in fiscal year 2021, the latest year available.
It spent 3.18% 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	365
Ownership	gov	gov	gov	gov	gov
Acute beds Median	185 118	185 118	173 119.5	173 118	173 119
Total beds Median	243 162	243 162	231 162	231 162	231 163.5
FTEs Median	1,745.29 788.06	1,810.82 793.42	1,899.49 806.03	1,891.27 787.61	1,941.89 804.34

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	257,063,334 150,932,746	272,267,021 158,950,878	290,356,048 168,696,998	300,054,190 163,454,693	326,270,429 186,589,412
Operating expenses Median	248,297,074 149,311,209	261,669,448 156,110,414	281,325,883 164,890,568	290,870,940 166,516,854	317,216,284 180,120,888
Net income from service 2 patients (NS2P) ? Median	8,766,260 -964,173	10,597,573 -643,601.5	9,030,165 -116,254	9,183,250 -5,025,862	9,054,145 -1,284,564
NS2P margin ? Median	3.41% -0.62	3.89% -0.29	3.11% 0.18	3.06% -5.07	2.78% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for COOKEVILLE REGIONAL 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	-7,545,761 5,089,215	-8,597,020 4,572,541	-12,875,784 5,268,134	-3,810,768 13,092,619	-3,459,348 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	20,015 224,999	34,349 199,009	12,500 206,870.5	5,950 194,343	659 249,496
⊳ 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	1,783,988	1,845,466	1,977,239	1,782,252	1,433,746
⊳ 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	146,136	203,862
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	88,764	74,518
⊳ 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	74,872	85,490	113,545	87,419	52,512
⊳ Line 22: Rental of hospital space	771,742	843,959	825,501	903,797	522,135
⊳ 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	-10,196,378	-11,406,284	-15,804,569	-6,825,086	-5,746,780
Total income ? Median	1,220,499 6,586,430	2,000,553 6,767,106	-3,845,619 8,419,950	5,372,482 8,094,175	5,594,797 15,162,888
Non-operating expenses Median	9 146,289.5	0 164,857	0 89,880.5	-2 106,761	1 31,473.5
Net income Median	1,220,490 6,043,842	2,000,553 5,845,112	-3,845,619 7,606,259	5,372,484 7,283,041	5,594,796 14,957,241
Net margin Median	0.48914% 4.62%	0.75873% 4.42%	-1.38591% 5.16%	1.81354% 5.2%	1.73315% 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 COOKEVILLE REGIONAL 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	68,831,570 23,241,334	71,164,004 23,709,545	71,441,565 24,248,380	72,731,869 22,858,541	70,727,664 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	62,642,470 21,577,146	64,652,234 22,041,594	65,464,502 22,722,063	66,681,697 21,570,441	64,802,620 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	6,189,100 3,535,627	6,511,770 3,746,588	5,977,063 3,782,288	6,050,172 3,865,578	5,925,044 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	40,973,442 11,160,864	41,624,742 11,987,345	43,277,959 12,926,866	42,647,244 11,884,480	44,057,112 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	39,754,927 10,918,923	40,155,116 11,706,976	41,738,524 12,615,917	41,382,416 11,458,116	42,856,425 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,218,515 1,282,808	1,469,626 1,407,728	1,539,435 1,341,512	1,264,828 1,407,046	1,200,687 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	1,433,072 594,888	1,369,311 595,761	1,185,365 577,894	1,291,247 542,168	895,318 549,667
Outlier Median	635,133 582,572	433,185 538,116	2,034,732 212,434	508,771 126,559	328,101 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,428,076 3,662,910	4,896,893 3,730,911	9,205,455 4,081,319	7,033,416 4,643,908	0 4,389,147
Charity care Median	1,827,917 2,654,636	1,663,897 2,940,659	2,176,730 3,380,215	1,647,824 3,488,738	2,367,515 3,233,405
Uncompensated care (UCC) Median	11,063,721 5,147,790	6,917,184 5,337,617	8,497,123 5,711,082	9,211,339 5,923,418	10,095,948 5,508,107
UCC as a % of operating expenses Median	4.46% 3.24	2.64% 3.12	3.02% 3.21	3.17% 3.3	3.18% 2.86
Total shortfall/UCC Median	18,491,797 9,489,989	11,814,077 9,424,297	17,702,578 10,120,158	16,244,755 11,171,337	10,095,948 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	97,697,225 52,142,039	100,152,313 54,485,252	107,689,127 57,395,589	103,307,244 58,830,919	111,411,024 61,722,907
Salaries as a % of operating expenses Median	39.35 36.68	38.27 36.56	38.28 36.37	35.52 35.93	35.12 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	1,118,248 1,449,244	3,603,459 1,475,986	2,775,403 1,563,078	5,450,731 1,721,954	10,891,381 2,991,828
Contract hours, direct-care Median	16,809.00 22,725	50,463.15 23,018.5	38,212.82 24,503.48	78,140.10 25,026.5	109,653.02 33,786
Contract wages, direct-care Median	66.53 64.67	71.41 64.53	72.63 65.06	69.76 68.97	99.33 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.