As of the July, 2022, release via CMS

THE CENTER FOR SPINAL SURGERY

CMS id: 440218
2011 MURPHY AVENUE THIRD FLOOR, NASHVILLE TN 37203. County: DAVIDSON
System: --
CBSA: Nashville-Davidson--Murfreesboro--Franklin, TN

The 23-bed, acute-care hospital had $31,026,547 in net service to patients*, with a total profit margin of 42.05179% in fiscal year 2021, the latest year available.
It spent 0.33% of its operating expenses on uncompensated care and reported $0 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	23 118	23 118	21 119.5	21 118	21 119
Total beds Median	23 162	23 162	23 162	23 162	23 163.5
FTEs Median	144.70 788.06	111.83 793.42	116.00 806.03	123.00 787.61	127.00 804.34

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	68,663,695 150,932,746	69,535,576 158,950,878	71,593,741 168,696,998	68,209,648 163,454,693	74,663,702 186,589,412
Operating expenses Median	37,325,293 149,311,209	37,597,773 156,110,414	41,069,412 164,890,568	38,847,154 166,516,854	43,637,155 180,120,888
Net income from service 2 patients (NS2P) ? Median	31,338,402 -964,173	31,937,803 -643,601.5	30,524,329 -116,254	29,362,494 -5,025,862	31,026,547 -1,284,564
NS2P margin ? Median	45.64% -0.62	45.93% -0.29	42.64% 0.18	43.05% -5.07	41.56% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for THE CENTER FOR SPINAL SURGERY 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	33,224 5,089,215	50,841 4,572,541	29,010 5,268,134	1,413,154 13,092,619	640,019 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	10,242 299,524	14,684 188,688.5	8,085 370,813	7,689 309,361.5	6,650 375,329
⊳ 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	20,239	18,069	15,069	283	1,448
⊳ 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	2,743	18,088	5,856	1,405,182	631,921
Total income ? Median	31,371,626 6,586,430	31,988,644 6,767,106	30,553,339 8,419,950	30,775,648 8,094,175	31,666,566 15,162,888
Non-operating expenses Median	328,877 146,289.5	0 164,857	0 89,880.5	1 106,761	0 31,473.5
Net income Median	31,042,749 6,043,842	31,988,644 5,845,112	30,553,339 7,606,259	30,775,647 7,283,041	31,666,566 14,957,241
Net margin Median	45.18798% 4.62%	45.96967% 4.42%	42.65871% 5.16%	44.20340% 5.2%	42.05179% 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 THE CENTER FOR SPINAL SURGERY 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	11,749,046 23,241,334	12,768,518 23,709,545	12,019,983 24,248,380	6,771,265 22,858,541	11,211,967 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	11,749,046 21,577,146	12,768,518 22,041,594	12,019,983 22,722,063	6,771,265 21,570,441	11,211,967 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	1,921,735 11,160,864	2,758,034 11,987,345	3,318,897 12,926,866	5,182,433 11,884,480	5,556,997 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	1,921,735 10,918,923	2,758,034 11,706,976	3,318,897 12,615,917	5,182,433 11,458,116	5,556,997 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	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	0 582,572	0 538,116	0 212,434	1,060 126,559	0 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	51,696 2,654,636	43,873 2,940,659	134,570 3,380,215	344,812 3,488,738	84,754 3,233,405
Uncompensated care (UCC) Median	276,564 5,147,790	190,902 5,337,617	303,525 5,711,082	434,118 5,923,418	145,851 5,508,107
UCC as a % of operating expenses Median	0.74% 3.24	0.51% 3.12	0.74% 3.21	1.12% 3.3	0.33% 2.86
Total shortfall/UCC Median	276,564 9,489,989	190,902 9,424,297	303,525 10,120,158	434,118 11,171,337	145,851 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	7,512,041 52,142,039	7,797,129 54,485,252	8,294,680 57,395,589	9,136,293 58,830,919	9,760,344 61,722,907
Salaries as a % of operating expenses Median	20.74 36.68	21.16 36.56	20.63 36.37	23.83 35.93	22.55 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	0 1,449,244	1,117,726 1,475,986	913,833 1,563,078	1,298,790 1,721,954	1,101,709 2,991,828
Contract hours, direct-care Median	0.00 22,725	26,196.00 23,018.5	15,065.00 24,503.48	24,442.00 25,026.5	19,213.00 33,786
Contract wages, direct-care Median	0.00 64.67	42.67 64.53	60.66 65.06	53.14 68.97	57.34 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.