As of the July, 2022, release via CMS

LIVINGSTON REGIONAL HOSPITAL

CMS id: 440187
315 OAK STREET, LIVINGSTON TN 38570. County: OVERTON
System: LIFEPOINT HEALTH
CBSA: Cookeville, TN

The 114-bed, acute-care hospital had $643,117 in net service to patients*, with a total profit margin of 8.31907% in fiscal year 2021, the latest year available.
It spent 3.79% of its operating expenses on uncompensated care and reported $650,745 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	84 118	84 118	84 119.5	84 118	84 119
Total beds Median	114 162	114 162	114 162	114 162	114 163.5
FTEs Median	253.89 788.06	253.01 793.42	240.75 806.03	251.83 787.61	252.84 804.34

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	33,069,389 150,932,746	34,708,602 158,950,878	33,926,565 168,696,998	36,233,548 163,454,693	37,771,641 186,589,412
Operating expenses Median	33,356,760 149,311,209	34,332,255 156,110,414	34,249,815 164,890,568	35,890,245 166,516,854	37,128,524 180,120,888
Net income from service 2 patients (NS2P) ? Median	-287,371 -964,173	376,347 -643,601.5	-323,250 -116,254	343,303 -5,025,862	643,117 -1,284,564
NS2P margin ? Median	-0.87% -0.62	1.08% -0.29	-0.95% 0.18	0.95% -5.07	1.70% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for LIVINGSTON REGIONAL 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	570,816 5,089,215	130,131 4,572,541	127,957 5,268,134	117,958 13,092,619	2,725,900 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	4,079 299,524	0 188,688.5	24,400 370,813	10,773 309,361.5	156 375,329
⊳ 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	48,092	45,840	36,722	35,953	19,687
⊳ 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	1,611	0	3,781	2,322	830
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	184	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	53,332	60,208	57,798	51,428	35,837
⊳ 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	463,471	23,628	5,256	17,482	2,669,390
Total income ? Median	283,445 6,586,430	506,478 6,767,106	-195,293 8,419,950	461,261 8,094,175	3,369,017 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	283,445 6,043,842	506,478 5,845,112	-195,293 7,606,259	461,261 7,283,041	3,369,017 14,957,241
Net margin Median	0.84258% 4.62%	1.45378% 4.42%	-0.57347% 5.16%	1.26889% 5.2%	8.31907% 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 LIVINGSTON REGIONAL 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	10,553,040 23,241,334	12,057,274 23,709,545	10,965,236 24,248,380	10,999,909 22,858,541	9,134,961 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	6,496,810 21,577,146	7,763,780 22,041,594	6,675,953 22,722,063	6,667,709 21,570,441	5,618,648 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	2,049,346 1,845,420	2,061,762 1,757,392	2,048,251 1,738,842	2,189,170 1,510,463	1,657,529 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,006,884 3,535,627	2,231,732 3,746,588	2,241,032 3,782,288	2,143,030 3,865,578	1,858,784 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	2,550,321 11,160,864	2,385,931 11,987,345	2,243,699 12,926,866	2,244,658 11,884,480	2,001,225 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	2,550,321 10,918,923	2,385,931 11,706,976	2,243,699 12,615,917	2,244,658 11,458,116	2,001,225 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	0 3,250,551	0 3,386,837	0 3,360,806	0 3,508,953
Disproportionate-share hospital (DSH) Median	286,526 594,888	276,325 595,761	261,082 577,894	233,674 542,168	180,393 549,667
Outlier Median	59,915 582,572	141,364 538,116	73,353 212,434	17,745 126,559	21,029 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,103,179 3,662,910	1,170,882 3,730,911	947,973 4,081,319	1,039,518 4,643,908	650,745 4,389,147
Charity care Median	764,502 2,654,636	742,348 2,940,659	727,109 3,380,215	748,061 3,488,738	826,667 3,233,405
Uncompensated care (UCC) Median	1,521,299 5,147,790	1,541,686 5,337,617	1,306,593 5,711,082	1,196,277 5,923,418	1,407,898 5,508,107
UCC as a % of operating expenses Median	4.56% 3.24	4.49% 3.12	3.81% 3.21	3.33% 3.3	3.79% 2.86
Total shortfall/UCC Median	2,624,478 9,489,989	2,712,568 9,424,297	2,254,566 10,120,158	2,235,795 11,171,337	2,058,643 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	14,611,963 52,142,039	15,258,116 54,485,252	15,256,536 57,395,589	16,316,059 58,830,919	16,706,445 61,722,907
Salaries as a % of operating expenses Median	44.03 36.68	44.74 36.56	44.43 36.37	45.73 35.93	46.11 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	81,416 1,449,244	223,061 1,475,986	85,621 1,563,078	139,302 1,721,954	14,953 2,991,828
Contract hours, direct-care Median	1,667.00 22,725	4,359.00 23,018.5	1,339.00 24,503.48	2,246.50 25,026.5	221.00 33,786
Contract wages, direct-care Median	48.84 64.67	51.17 64.53	63.94 65.06	62.01 68.97	67.66 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.