As of the July, 2022, release via CMS

SAINT THOMAS WEST HOSPITAL

CMS id: 440082
4220 HARDING ROAD, NASHVILLE TN 37202. County: DAVIDSON
System: ST. THOMAS HEALTH SERVICE
CBSA: Nashville-Davidson--Murfreesboro--Franklin, TN

The 729-bed, acute-care hospital had $43,557,426 in net service to patients*, with a total profit margin of 8.83570% in fiscal year 2021, the latest year available.
It spent 5.08% of its operating expenses on uncompensated care and reported $39,684,411 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	300 118	253 118	252 119.5	255 118	516 119
Total beds Median	412 162	351 162	340 162	341 162	729 163.5
FTEs Median	1,440.46 788.06	1,514.01 793.42	1,462.76 806.03	1,457.39 787.61	3,058.70 804.34

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	419,134,402 150,932,746	440,876,737 158,950,878	448,070,877 168,696,998	448,300,615 163,454,693	1,012,196,646 186,589,412
Operating expenses Median	403,303,312 149,311,209	415,591,319 156,110,414	427,023,942 164,890,568	449,160,606 166,516,854	968,639,220 180,120,888
Net income from service 2 patients (NS2P) ? Median	15,831,090 -964,173	25,285,418 -643,601.5	21,046,935 -116,254	-859,991 -5,025,862	43,557,426 -1,284,564
NS2P margin ? Median	3.78% -0.62	5.74% -0.29	4.70% 0.18	-0.19% -5.07	4.30% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SAINT THOMAS WEST HOSPITAL 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	24,910,891 5,089,215	23,900,452 4,572,541	26,559,161 5,268,134	34,449,509 13,092,619	56,078,277 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	70,000 224,999	90,000 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	34,391 299,524	2,360 188,688.5	1,591 370,813	6,156 309,361.5	22,484 375,329
⊳ 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	5	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	2,449,372	2,527,196	2,575,995	2,091,787	2,837,975
⊳ 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	1,396,119	1,428,150	1,458,104	1,382,312	1,288,702
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	50
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	434	0	39,295
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	-8,572
⊳ Line 21: Rental of vending machines	124,179	107,123	112,479	112,254	189,723
⊳ Line 22: Rental of hospital space	1,344,656	1,498,264	1,385,476	1,262,859	8,172,786
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	950,591 1,597,664
⊳ Sum Line 24	19,492,169	18,247,359	21,025,082	29,594,141	42,585,243
Total income ? Median	40,741,981 6,586,430	49,185,870 6,767,106	47,606,096 8,419,950	33,589,518 8,094,175	99,635,703 15,162,888
Non-operating expenses Median	1,385,643 146,289.5	2,798,627 164,857	1,392,616 89,880.5	1,202,108 106,761	5,246,113 31,473.5
Net income Median	39,356,338 6,043,842	46,387,243 5,845,112	46,213,480 7,606,259	32,387,410 7,283,041	94,389,590 14,957,241
Net margin Median	8.86314% 4.62%	9.98053% 4.42%	9.73674% 5.16%	6.70894% 5.2%	8.83570% 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 SAINT THOMAS WEST HOSPITAL 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	108,926,961 23,241,334	113,611,018 23,709,545	112,767,558 24,248,380	111,044,644 22,858,541	189,090,701 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	107,277,011 21,577,146	112,127,287 22,041,594	112,767,558 22,722,063	111,044,644 21,570,441	184,657,911 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	1,649,950 1,845,420	1,483,731 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	4,432,790 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	33,628,551 11,160,864	35,543,271 11,987,345	36,643,442 12,926,866	32,836,960 11,884,480	61,344,904 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	33,628,551 10,918,923	35,543,271 11,706,976	36,643,442 12,615,917	32,836,960 11,458,116	61,344,904 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	3,096,546 3,284,314	3,778,871 3,250,551	4,100,944 3,386,837	4,272,704 3,360,806	7,384,363 3,508,953
Disproportionate-share hospital (DSH) Median	0 594,888	0 595,761	0 577,894	806,878 542,168	2,283,988 549,667
Outlier Median	6,072,370 582,572	4,414,160 538,116	5,350,195 212,434	239,607 126,559	659,532 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,253,962 3,662,910	6,932,499 3,730,911	10,164,197 4,081,319	9,817,620 4,643,908	39,684,411 4,389,147
Charity care Median	14,723,054 2,654,636	17,999,060 2,940,659	21,680,463 3,380,215	20,339,550 3,488,738	42,511,852 3,233,405
Uncompensated care (UCC) Median	18,069,452 5,147,790	21,628,590 5,337,617	26,393,093 5,711,082	24,403,395 5,923,418	49,213,031 5,508,107
UCC as a % of operating expenses Median	4.48% 3.24	5.20% 3.12	6.18% 3.21	5.43% 3.3	5.08% 2.86
Total shortfall/UCC Median	22,323,414 9,489,989	28,561,089 9,424,297	36,557,290 10,120,158	34,221,015 11,171,337	88,897,442 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	93,956,221 52,142,039	96,050,506 54,485,252	98,484,257 57,395,589	105,296,397 58,830,919	223,617,376 61,722,907
Salaries as a % of operating expenses Median	23.30 36.68	23.11 36.56	23.06 36.37	23.44 35.93	23.09 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	4,597,989 1,449,244	4,780,413 1,475,986	3,214,204 1,563,078	3,108,013 1,721,954	11,828,494 2,991,828
Contract hours, direct-care Median	49,463.00 22,725	42,456.00 23,018.5	28,429.00 24,503.48	26,133.46 25,026.5	134,558.00 33,786
Contract wages, direct-care Median	92.96 64.67	112.60 64.53	113.06 65.06	118.93 68.97	87.91 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.