As of the July, 2022, release via CMS

ERLANGER MEDICAL CENTER

CMS id: 440104
975 EAST THIRD STREET, CHATTANOOGA TN 37403. County: HAMILTON
System: ERLANGER HEALTH SYSTEM
CBSA: Chattanooga, TN-GA

The 688-bed, acute-care hospital had $-23,479,215 in net service to patients*, with a total profit margin of 2.74550% in fiscal year 2021, the latest year available.
It spent 7.95% of its operating expenses on uncompensated care and reported $129,964 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	444 118	462 118	462 119.5	468 118	474 119
Total beds Median	657 162	686 162	674 162	680 162	688 163.5
FTEs Median	4,215.00 788.06	4,762.06 793.42	4,976.93 806.03	4,670.69 787.61	4,242.88 804.34

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	818,319,345 150,932,746	911,085,220 158,950,878	970,437,997 168,696,998	921,838,674 163,454,693	938,440,762 186,589,412
Operating expenses Median	825,056,699 149,311,209	926,925,655 156,110,414	1,000,825,813 164,890,568	965,259,635 166,516,854	961,919,977 180,120,888
Net income from service 2 patients (NS2P) ? Median	-6,737,354 -964,173	-15,840,435 -643,601.5	-30,387,816 -116,254	-43,420,961 -5,025,862	-23,479,215 -1,284,564
NS2P margin ? Median	-0.82% -0.62	-1.74% -0.29	-3.13% 0.18	-4.71% -5.07	-2.50% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ERLANGER 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	12,578,381 5,089,215	15,883,156 4,572,541	22,779,870 5,268,134	69,144,585 13,092,619	50,635,115 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	-1,362,157 299,524	-1,057,849 188,688.5	5,380,378 370,813	3,700,178 309,361.5	-1,402,234 375,329
⊳ 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	13,940,538	16,941,005	17,399,489	65,444,407	52,037,349
Total income ? Median	5,841,027 6,586,430	42,721 6,767,106	-7,607,946 8,419,950	25,723,624 8,094,175	27,155,900 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	854 31,473.5
Net income Median	5,841,027 6,043,842	42,721 5,845,112	-7,607,946 7,606,259	25,723,624 7,283,041	27,155,046 14,957,241
Net margin Median	0.70298% 4.62%	0.00461% 4.42%	-0.76599% 5.16%	2.59577% 5.2%	2.74550% 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 ERLANGER 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	131,792,319 23,241,334	133,783,183 23,709,545	138,531,922 24,248,380	128,526,763 22,858,541	121,466,645 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	128,869,730 21,577,146	131,271,901 22,041,594	138,065,463 22,722,063	128,526,763 21,570,441	121,466,645 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	2,922,589 1,845,420	2,511,282 1,757,392	466,459 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	46,416,249 11,160,864	51,609,798 11,987,345	56,966,304 12,926,866	55,326,041 11,884,480	48,411,496 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	46,416,249 10,918,923	51,609,798 11,706,976	56,966,304 12,615,917	55,326,041 11,458,116	48,411,496 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	14,956,922 3,284,314	14,885,535 3,250,551	14,991,786 3,386,837	13,360,194 3,360,806	12,635,347 3,508,953
Disproportionate-share hospital (DSH) Median	4,668,719 594,888	4,558,906 595,761	4,344,560 577,894	3,740,913 542,168	3,360,786 549,667
Outlier Median	2,564,373 582,572	4,288,643 538,116	3,635,052 212,434	47,994 126,559	129,979 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	109,437 3,730,911	0 4,081,319	825,694 4,643,908	129,964 4,389,147
Charity care Median	36,086,220 2,654,636	43,449,769 2,940,659	44,863,508 3,380,215	69,760,378 3,488,738	69,627,110 3,233,405
Uncompensated care (UCC) Median	58,515,729 5,147,790	67,230,128 5,337,617	71,550,989 5,711,082	85,109,385 5,923,418	76,437,985 5,508,107
UCC as a % of operating expenses Median	7.09% 3.24	7.25% 3.12	7.15% 3.21	8.82% 3.3	7.95% 2.86
Total shortfall/UCC Median	58,515,729 9,489,989	67,339,565 9,424,297	71,550,989 10,120,158	85,935,079 11,171,337	76,567,949 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	292,493,560 52,142,039	338,198,346 54,485,252	359,131,795 57,395,589	357,500,211 58,830,919	351,685,478 61,722,907
Salaries as a % of operating expenses Median	48.40 36.68	49.55 36.56	48.43 36.37	48.46 35.93	48.10 35.24
Intern, resident salaries* Median	236,906 2,598,592	238,393 2,686,824	0 2,753,773	0 2,937,156	0 2,909,848
Contract intern, resident salaries* Median	11,796,955 1,251,927	12,525,653 1,186,494	13,375,145 1,204,885	13,850,507 1,279,653	14,382,025 1,469,317
Contract adjusted salaries, direct-care Median	17,918,796 1,449,244	18,450,559 1,475,986	18,818,734 1,563,078	19,401,004 1,721,954	19,636,107 2,991,828
Contract hours, direct-care Median	513,814.36 22,725	522,492.00 23,018.5	529,875.00 24,503.48	519,667.00 25,026.5	501,909.68 33,786
Contract wages, direct-care Median	34.87 64.67	35.31 64.53	35.52 65.06	37.33 68.97	39.12 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.