As of the July, 2022, release via CMS

ASCENSION PROVIDENCE

CMS id: 450042
6901 MEDICAL PARKWAY, WACO TX 76712. County: MCLENNAN
System: ASCENSION TEXAS
CBSA: Waco, TX

The 271-bed, acute-care hospital had $12,070,300 in net service to patients*, with a total profit margin of 15.33882% in fiscal year 2021, the latest year available.
It spent 10.84% 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	nfp	nfp	nfp	nfp	nfp
Acute beds Median	199 118	199 118	195 119.5	195 118	195 119
Total beds Median	277 162	277 162	271 162	271 162	271 163.5
FTEs Median	1,729.40 788.06	1,675.42 793.42	1,519.72 806.03	1,571.73 787.61	1,107.93 804.34

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	276,422,021 150,932,746	272,409,791 158,950,878	307,260,854 168,696,998	246,937,646 163,454,693	282,922,818 186,589,412
Operating expenses Median	301,757,482 149,311,209	304,854,687 156,110,414	299,212,080 164,890,568	247,623,117 166,516,854	270,852,518 180,120,888
Net income from service 2 patients (NS2P) ? Median	-25,335,461 -964,173	-32,444,896 -643,601.5	8,048,774 -116,254	-685,471 -5,025,862	12,070,300 -1,284,564
NS2P margin ? Median	-9.17% -0.62	-11.91% -0.29	2.62% 0.18	-0.28% -5.07	4.27% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASCENSION PROVIDENCE 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	12,982,450 5,089,215	23,164,520 4,572,541	15,652,726 5,268,134	16,148,609 13,092,619	37,143,817 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,571,347 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ 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	2,029,504	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	407,833	0	0	0	0
⊳ Line 21: Rental of vending machines	76,927	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	8,896,839	23,164,520	15,652,726	16,148,609	37,143,817
Total income ? Median	-12,353,011 6,586,430	-9,280,376 6,767,106	23,701,500 8,419,950	15,463,138 8,094,175	49,214,117 15,162,888
Non-operating expenses Median	584,782 146,289.5	383,706 164,857	618,469 89,880.5	672,665 106,761	119,656 31,473.5
Net income Median	-12,937,793 6,043,842	-9,664,082 5,845,112	23,083,031 7,606,259	14,790,473 7,283,041	49,094,461 14,957,241
Net margin Median	-4.47049% 4.62%	-3.26959% 4.42%	7.14836% 5.16%	5.62191% 5.2%	15.33882% 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 ASCENSION PROVIDENCE 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	62,967,912 23,241,334	61,768,360 23,709,545	61,533,195 24,248,380	59,592,836 22,858,541	62,988,250 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	61,066,875 21,577,146	60,412,280 22,041,594	60,316,543 22,722,063	58,811,507 21,570,441	62,190,703 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	1,901,037 1,845,420	1,356,080 1,757,392	1,216,652 1,738,842	781,329 1,510,463	797,547 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	22,425,885 11,160,864	23,542,109 11,987,345	23,326,563 12,926,866	19,945,400 11,884,480	17,599,838 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	22,425,885 10,918,923	23,542,109 11,706,976	23,326,563 12,615,917	19,945,400 11,458,116	17,599,838 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	950,803 3,284,314	970,082 3,250,551	904,120 3,386,837	849,109 3,360,806	909,114 3,508,953
Disproportionate-share hospital (DSH) Median	654,132 594,888	706,167 595,761	1,381,340 577,894	1,670,880 542,168	977,634 549,667
Outlier Median	393,989 582,572	240,382 538,116	149,888 212,434	23,928 126,559	41,475 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	868,986 3,662,910	828,372 3,730,911	210,924 4,081,319	491,033 4,643,908	0 4,389,147
Charity care Median	21,735,753 2,654,636	25,734,150 2,940,659	23,576,810 3,380,215	26,113,792 3,488,738	23,647,028 3,233,405
Uncompensated care (UCC) Median	26,849,180 5,147,790	30,995,623 5,337,617	28,843,224 5,711,082	33,603,476 5,923,418	29,364,501 5,508,107
UCC as a % of operating expenses Median	8.90% 3.24	10.17% 3.12	9.64% 3.21	13.57% 3.3	10.84% 2.86
Total shortfall/UCC Median	27,718,166 9,489,989	31,823,995 9,424,297	29,054,148 10,120,158	34,094,509 11,171,337	29,364,501 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	115,713,574 52,142,039	117,118,657 54,485,252	111,671,734 57,395,589	72,036,994 58,830,919	75,310,833 61,722,907
Salaries as a % of operating expenses Median	40.93 36.68	38.42 36.56	37.32 36.37	29.09 35.93	27.81 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	1,155,403 1,251,927	1,144,795 1,186,494	1,163,311 1,204,885	874,690 1,279,653	888,434 1,469,317
Contract adjusted salaries, direct-care Median	2,989,648 1,449,244	1,909,033 1,475,986	1,547,742 1,563,078	1,451,557 1,721,954	11,361,028 2,991,828
Contract hours, direct-care Median	39,938.00 22,725	22,373.00 23,018.5	15,750.83 24,503.48	18,437.27 25,026.5	79,867.26 33,786
Contract wages, direct-care Median	74.86 64.67	85.33 64.53	98.26 65.06	78.73 68.97	142.25 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.