As of the July, 2022, release via CMS

JOHNSON CITY MEDICAL CENTER

CMS id: 440063
400 N. STATE OF FRANKLIN RD, JOHNSON CITY TN 37604. County: WASHINGTON
System: BALLAD HEALTH
CBSA: Johnson City, TN

The 539-bed, acute-care hospital had $-46,523,631 in net service to patients*, with a total profit margin of -5.28402% in fiscal year 2021, the latest year available.
It spent 5.91% of its operating expenses on uncompensated care and reported $2,062,013 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	419 118	417 118	419 119.5	416 118	389 119
Total beds Median	527 162	526 162	528 162	525 162	539 163.5
FTEs Median	2,406.76 788.06	2,417.44 793.42	2,119.64 806.03	1,898.30 787.61	1,790.99 804.34

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	443,725,833 150,932,746	445,237,664 158,950,878	454,127,462 168,696,998	438,844,703 163,454,693	453,810,418 186,589,412
Operating expenses Median	404,667,884 149,311,209	422,060,563 156,110,414	430,747,612 164,890,568	450,201,832 166,516,854	500,334,049 180,120,888
Net income from service 2 patients (NS2P) ? Median	39,057,949 -964,173	23,177,101 -643,601.5	23,379,850 -116,254	-11,357,129 -5,025,862	-46,523,631 -1,284,564
NS2P margin ? Median	8.80% -0.62	5.21% -0.29	5.15% 0.18	-2.59% -5.07	-10.25% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for JOHNSON CITY 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	7,398,716 5,089,215	5,165,188 4,572,541	6,661,317 5,268,134	18,680,135 13,092,619	21,412,739 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	846,823 224,999	725,120 199,009	695,012 206,870.5	1,123,513 194,343	719,865 249,496
⊳ Line 7: Investments ? ⊳ Median	286,655 299,524	0 188,688.5	368,108 370,813	20,197 309,361.5	80,708 375,329
⊳ 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	83	0	0	1,680,981	1,251,819
⊳ 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	1,681	0	2,559	1,430	1,844
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	2,206	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	92,723	90,956	98,497	70,781	40,767
⊳ Line 22: Rental of hospital space	83,650	106,683	113,613	97,078	2,000
⊳ Line 23: Gov appropriations ? ⊳ Median	3,056,633 1,017,693	2,949,842 983,261.5	2,688,929 1,173,286	9,796,552 1,987,202	3,172,215 1,597,664
⊳ Sum Line 24	3,030,468	1,290,381	2,694,599	5,889,603	16,143,521
Total income ? Median	46,456,665 6,586,430	28,342,289 6,767,106	30,041,167 8,419,950	7,323,006 8,094,175	-25,110,892 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	46,456,665 6,043,842	28,342,289 5,845,112	30,041,167 7,606,259	7,323,006 7,283,041	-25,110,892 14,957,241
Net margin Median	10.29797% 4.62%	6.29265% 4.42%	6.51951% 5.16%	1.60057% 5.2%	-5.28402% 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 JOHNSON CITY 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	82,794,641 23,241,334	82,494,593 23,709,545	80,781,339 24,248,380	74,009,449 22,858,541	76,177,124 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	81,682,351 21,577,146	81,238,278 22,041,594	79,599,496 22,722,063	73,049,491 21,570,441	75,400,625 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	1,112,290 1,845,420	1,256,315 1,757,392	1,181,843 1,738,842	959,958 1,510,463	776,499 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	23,297,862 11,160,864	25,862,273 11,987,345	29,214,685 12,926,866	28,241,795 11,884,480	28,349,835 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	23,297,862 10,918,923	25,862,273 11,706,976	29,214,685 12,615,917	28,241,795 11,458,116	28,349,835 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	6,834,592 3,284,314	7,826,162 3,250,551	8,058,722 3,386,837	7,646,933 3,360,806	7,480,201 3,508,953
Disproportionate-share hospital (DSH) Median	2,714,030 594,888	2,602,214 595,761	2,359,639 577,894	2,320,892 542,168	2,403,173 549,667
Outlier Median	2,189,477 582,572	1,404,238 538,116	871,196 212,434	321,986 126,559	117,437 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,959,699 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	2,062,013 4,389,147
Charity care Median	6,765,851 2,654,636	19,261,525 2,940,659	22,587,664 3,380,215	21,429,659 3,488,738	24,546,009 3,233,405
Uncompensated care (UCC) Median	13,188,648 5,147,790	25,574,992 5,337,617	28,430,101 5,711,082	24,967,735 5,923,418	29,588,250 5,508,107
UCC as a % of operating expenses Median	3.26% 3.24	6.06% 3.12	6.60% 3.21	5.55% 3.3	5.91% 2.86
Total shortfall/UCC Median	15,148,347 9,489,989	25,574,992 9,424,297	28,430,101 10,120,158	24,967,735 11,171,337	31,650,263 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	129,117,096 52,142,039	132,537,860 54,485,252	130,061,584 57,395,589	130,226,814 58,830,919	135,410,133 61,722,907
Salaries as a % of operating expenses Median	31.91 36.68	31.40 36.56	30.19 36.37	28.93 35.93	27.06 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	6,818,711 1,251,927	6,655,426 1,186,494	6,820,409 1,204,885	7,138,142 1,279,653	8,436,597 1,469,317
Contract adjusted salaries, direct-care Median	3,476,732 1,449,244	6,588,979 1,475,986	4,444,619 1,563,078	9,172,390 1,721,954	14,040,726 2,991,828
Contract hours, direct-care Median	85,670.33 22,725	125,344.86 23,018.5	99,106.07 24,503.48	159,547.61 25,026.5	171,886.61 33,786
Contract wages, direct-care Median	40.58 64.67	52.57 64.53	44.85 65.06	57.49 68.97	81.69 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.