As of the July, 2022, release via CMS

MEMORIAL HEALTH CARE SYSTEM INC.

CMS id: 440091
2525 DE SALES AVENUE, CHATTANOOGA TN 37404. County: HAMILTON
System: CATHOLIC HEALTH INITIATIVES
CBSA: Chattanooga, TN-GA

The 423-bed, acute-care hospital had $-126,039,415 in net service to patients*, with a total profit margin of -0.96767% in fiscal year 2021, the latest year available.
It spent 2.72% of its operating expenses on uncompensated care and reported $13,501,036 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	382 118	372 118	363 119.5	363 118	363 119
Total beds Median	444 162	444 162	423 162	423 162	423 163.5
FTEs Median	2,436.00 788.06	2,441.00 793.42	2,587.00 806.03	2,506.00 787.61	2,496.00 804.34

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	560,076,042 150,932,746	572,518,108 158,950,878	576,894,791 168,696,998	515,817,589 163,454,693	487,902,970 186,589,412
Operating expenses Median	517,621,042 149,311,209	529,988,108 156,110,414	552,855,791 164,890,568	577,446,918 166,516,854	613,942,385 180,120,888
Net income from service 2 patients (NS2P) ? Median	42,455,000 -964,173	42,530,000 -643,601.5	24,039,000 -116,254	-61,629,329 -5,025,862	-126,039,415 -1,284,564
NS2P margin ? Median	7.58% -0.62	7.43% -0.29	4.17% 0.18	-11.95% -5.07	-25.83% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MEMORIAL HEALTH CARE SYSTEM INC. 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	36,513,000 5,089,215	31,578,000 4,572,541	29,370,000 5,268,134	45,201,154 13,092,619	120,155,415 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	796,000 224,999	980,000 199,009	572,000 206,870.5	672,000 194,343	561,000 249,496
⊳ Line 7: Investments ? ⊳ Median	21,118,000 299,524	16,375,000 188,688.5	12,538,000 370,813	6,088,000 309,361.5	54,196,000 375,329
⊳ 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	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	14,599,000	14,223,000	16,260,000	38,441,154	65,398,415
Total income ? Median	78,968,000 6,586,430	74,108,000 6,767,106	53,409,000 8,419,950	-16,428,175 8,094,175	-5,884,000 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	78,968,000 6,043,842	74,108,000 5,845,112	53,409,000 7,606,259	-16,428,175 7,283,041	-5,884,000 14,957,241
Net margin Median	13.23658% 4.62%	12.26758% 4.42%	8.80952% 5.16%	-2.92828% 5.2%	-0.96767% 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 MEMORIAL HEALTH CARE SYSTEM INC. 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	113,460,319 23,241,334	113,824,490 23,709,545	106,920,502 24,248,380	95,339,848 22,858,541	94,805,206 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	113,460,319 21,577,146	113,824,490 22,041,594	106,920,502 22,722,063	95,339,848 21,570,441	94,805,206 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	65,661,081 11,160,864	71,312,983 11,987,345	67,559,536 12,926,866	60,108,448 11,884,480	63,065,914 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	65,661,081 10,918,923	71,312,983 11,706,976	67,559,536 12,615,917	60,108,448 11,458,116	63,065,914 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	25,375 3,250,551	125,706 3,386,837	147,215 3,360,806	228,244 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	2,696,090 582,572	3,114,358 538,116	4,440,135 212,434	173,703 126,559	284,805 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	8,063,555 3,662,910	8,190,888 3,730,911	9,717,868 4,081,319	14,608,355 4,643,908	13,501,036 4,389,147
Charity care Median	8,866,457 2,654,636	9,653,054 2,940,659	10,418,720 3,380,215	8,950,719 3,488,738	10,800,058 3,233,405
Uncompensated care (UCC) Median	12,714,914 5,147,790	14,465,800 5,337,617	16,963,527 5,711,082	16,136,620 5,923,418	16,696,808 5,508,107
UCC as a % of operating expenses Median	2.46% 3.24	2.73% 3.12	3.07% 3.21	2.79% 3.3	2.72% 2.86
Total shortfall/UCC Median	20,778,469 9,489,989	22,656,688 9,424,297	26,681,395 10,120,158	30,744,975 11,171,337	30,197,844 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	140,683,572 52,142,039	145,705,931 54,485,252	155,994,531 57,395,589	154,325,615 58,830,919	163,832,354 61,722,907
Salaries as a % of operating expenses Median	28.10 36.68	28.70 36.56	30.00 36.37	28.30 35.93	27.90 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	111 2,753,773	0 2,937,156	17 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	3,917,557 1,449,244	3,444,056 1,475,986	1,450,968 1,563,078	936,890 1,721,954	2,312,285 2,991,828
Contract hours, direct-care Median	64,907.00 22,725	45,287.00 23,018.5	22,147.72 24,503.48	14,601.05 25,026.5	21,611.00 33,786
Contract wages, direct-care Median	60.36 64.67	76.05 64.53	65.51 65.06	64.17 68.97	107.00 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.