As of the July, 2022, release via CMS

CITIZENS MEDICAL CENTER

CMS id: 450023
2701 HOSPITAL DRIVE, VICTORIA TX 77901. County: VICTORIA
System: --
CBSA: Victoria, TX

The 306-bed, acute-care hospital had $-8,630,238 in net service to patients*, with a total profit margin of 8.49995% in fiscal year 2021, the latest year available.
It spent 6.23% of its operating expenses on uncompensated care and reported $17,210 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	291 118	291 118	285 119.5	264 118	264 119
Total beds Median	333 162	333 162	327 162	306 162	306 163.5
FTEs Median	1,090.37 788.06	1,064.61 793.42	926.35 806.03	956.97 787.61	979.49 804.34

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	125,771,675 150,932,746	120,451,342 158,950,878	130,471,787 168,696,998	138,523,125 163,454,693	153,574,339 186,589,412
Operating expenses Median	169,132,516 149,311,209	168,880,131 156,110,414	161,398,341 164,890,568	158,282,371 166,516,854	162,204,577 180,120,888
Net income from service 2 patients (NS2P) ? Median	-43,360,841 -964,173	-48,428,789 -643,601.5	-30,926,554 -116,254	-19,759,246 -5,025,862	-8,630,238 -1,284,564
NS2P margin ? Median	-34.48% -0.62	-40.21% -0.29	-23.70% 0.18	-14.26% -5.07	-5.62% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CITIZENS 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	24,211,268 5,089,215	33,119,079 4,572,541	33,682,997 5,268,134	22,083,419 13,092,619	23,698,325 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	2,633,197 224,999	4,558,362 199,009	2,773,999 206,870.5	750,573 194,343	546,666 249,496
⊳ Line 7: Investments ? ⊳ Median	4,424,146 299,524	7,040,750 188,688.5	8,024,573 370,813	11,727,167 309,361.5	16,027,886 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	1,439	218	28	7	140
⊳ Line 11: Rebates and refunds of expenses	32,224	92,412	469,173	275,606	255,971
⊳ 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	721,777	684,789	19,328	107,806	72,475
⊳ 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	370,455	360,023	341,657	341,279	495,655
⊳ Line 18: Revenue from sale of medical records and abstracts	222,020	345,577	6,608	1,333	2,729
⊳ 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	1,547,980	1,341,604	1,497,326	1,823,095	1,927,179
⊳ 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	14,258,030	18,695,344	20,550,305	7,056,553	4,369,624
Total income ? Median	-19,149,573 6,586,430	-15,309,710 6,767,106	2,756,443 8,419,950	2,324,173 8,094,175	15,068,087 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	-19,149,573 6,043,842	-15,309,710 5,845,112	2,756,443 7,606,259	2,324,173 7,283,041	15,068,087 14,957,241
Net margin Median	-12.76783% 4.62%	-9.96918% 4.42%	1.67917% 5.16%	1.44712% 5.2%	8.49995% 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 CITIZENS 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	27,944,323 23,241,334	24,149,184 23,709,545	24,216,312 24,248,380	24,712,536 22,858,541	26,490,146 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	26,213,154 21,577,146	22,575,668 22,041,594	22,490,598 22,722,063	22,448,486 21,570,441	24,599,094 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	1,731,169 1,203,033	1,573,516 1,215,295	1,725,714 1,313,657	2,264,050 1,365,298	1,891,052 1,179,746
All outpatient revenue Median Click here to show/hide details	14,970,353 11,160,864	14,841,572 11,987,345	17,563,405 12,926,866	18,172,235 11,884,480	17,777,453 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	14,970,353 10,918,923	14,841,572 11,706,976	17,563,405 12,615,917	18,172,235 11,458,116	17,777,453 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	293,324 594,888	277,460 595,761	226,320 577,894	233,799 542,168	230,875 549,667
Outlier Median	1,446,269 582,572	435,751 538,116	688,795 212,434	15,311 126,559	11,097 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,522,895 3,662,910	4,216,793 3,730,911	43,664 4,081,319	108,800 4,643,908	17,210 4,389,147
Charity care Median	10,518,855 2,654,636	10,860,233 2,940,659	9,365,819 3,380,215	8,985,938 3,488,738	7,389,972 3,233,405
Uncompensated care (UCC) Median	16,055,228 5,147,790	14,529,068 5,337,617	14,181,271 5,711,082	12,304,800 5,923,418	10,109,870 5,508,107
UCC as a % of operating expenses Median	9.49% 3.24	8.60% 3.12	8.79% 3.21	7.77% 3.3	6.23% 2.86
Total shortfall/UCC Median	20,578,123 9,489,989	18,745,861 9,424,297	14,224,935 10,120,158	12,413,600 11,171,337	10,127,080 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	72,763,380 52,142,039	70,679,315 54,485,252	65,804,316 57,395,589	69,089,011 58,830,919	72,638,036 61,722,907
Salaries as a % of operating expenses Median	43.02 36.68	41.85 36.56	40.77 36.37	43.65 35.93	44.78 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	533,287 1,449,244	533,385 1,475,986	399,189 1,563,078	1,713,268 1,721,954	1,875,137 2,991,828
Contract hours, direct-care Median	5,700.82 22,725	5,941.92 23,018.5	6,599.87 24,503.48	35,982.62 25,026.5	46,192.49 33,786
Contract wages, direct-care Median	93.55 64.67	89.77 64.53	60.48 65.06	47.61 68.97	40.59 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.