As of the July, 2022, release via CMS

ASCENSION SETON MEDICAL CENTER

CMS id: 450056
1201 WEST 38TH STREET, AUSTIN TX 78705. County: TRAVIS
System: ASCENSION TEXAS
CBSA: Austin-Round Rock-Georgetown, TX

The 391-bed, acute-care hospital had $96,904,102 in net service to patients*, with a total profit margin of 21.59802% in fiscal year 2021, the latest year available.
It spent 8.60% of its operating expenses on uncompensated care and reported $8,338,593 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	317 118	319 118	304 119.5	274 118	264 119
Total beds Median	447 162	448 162	430 162	401 162	391 163.5
FTEs Median	1,517.31 788.06	1,422.23 793.42	1,451.63 806.03	1,478.99 787.61	1,560.64 804.34

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	454,537,856 150,932,746	457,594,041 158,950,878	489,632,645 168,696,998	486,069,231 163,454,693	571,468,944 186,589,412
Operating expenses Median	394,222,654 149,311,209	400,658,310 156,110,414	405,280,241 164,890,568	432,350,414 166,516,854	474,564,842 180,120,888
Net income from service 2 patients (NS2P) ? Median	60,315,202 -964,173	56,935,731 -643,601.5	84,352,404 -116,254	53,718,817 -5,025,862	96,904,102 -1,284,564
NS2P margin ? Median	13.27% -0.62	12.44% -0.29	17.23% 0.18	11.05% -5.07	16.96% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASCENSION SETON 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	4,940,088 5,089,215	3,425,542 4,572,541	3,240,740 5,268,134	13,307,265 13,092,619	33,904,290 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	81,192 224,999	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	949,887	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	1,552,632	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	225	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	315,484	0	0	0	0
⊳ Line 21: Rental of vending machines	96,314	0	0	0	0
⊳ Line 22: Rental of hospital space	113,848	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	1,830,506	3,425,542	3,240,740	13,307,265	33,904,290
Total income ? Median	65,255,290 6,586,430	60,361,273 6,767,106	87,593,144 8,419,950	67,026,082 8,094,175	130,808,392 15,162,888
Non-operating expenses Median	189,250 146,289.5	0 164,857	0 89,880.5	350,515 106,761	59,732 31,473.5
Net income Median	65,066,040 6,043,842	60,361,273 5,845,112	87,593,144 7,606,259	66,675,567 7,283,041	130,748,660 14,957,241
Net margin Median	14.16086% 4.62%	13.09300% 4.42%	17.77194% 5.16%	13.35176% 5.2%	21.59802% 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 SETON 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	66,797,947 23,241,334	64,779,731 23,709,545	65,468,868 24,248,380	59,592,162 22,858,541	62,616,857 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	66,797,947 21,577,146	64,779,731 22,041,594	65,468,868 22,722,063	59,592,162 21,570,441	62,616,857 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	18,287,948 11,160,864	18,139,711 11,987,345	19,132,519 12,926,866	17,351,196 11,884,480	18,136,561 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	18,287,948 10,918,923	18,139,711 11,706,976	19,132,519 12,615,917	17,351,196 11,458,116	18,136,561 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	2,089,672 3,386,837	2,051,470 3,360,806	2,844,077 3,508,953
Disproportionate-share hospital (DSH) Median	1,722,325 594,888	1,659,499 595,761	1,985,728 577,894	1,896,975 542,168	2,135,018 549,667
Outlier Median	8,246,868 582,572	7,032,664 538,116	8,021,167 212,434	591,746 126,559	581,744 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	9,155,753 3,662,910	9,614,902 3,730,911	10,358,911 4,081,319	7,395,531 4,643,908	8,338,593 4,389,147
Charity care Median	19,313,485 2,654,636	23,042,702 2,940,659	29,297,684 3,380,215	37,633,661 3,488,738	35,196,857 3,233,405
Uncompensated care (UCC) Median	25,283,678 5,147,790	29,615,190 5,337,617	36,725,669 5,711,082	42,900,164 5,923,418	40,827,251 5,508,107
UCC as a % of operating expenses Median	6.41% 3.24	7.39% 3.12	9.06% 3.21	9.92% 3.3	8.60% 2.86
Total shortfall/UCC Median	34,439,431 9,489,989	39,230,092 9,424,297	47,084,580 10,120,158	50,295,695 11,171,337	49,165,844 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	108,340,255 52,142,039	103,479,813 54,485,252	106,840,999 57,395,589	113,873,003 58,830,919	118,700,545 61,722,907
Salaries as a % of operating expenses Median	27.49 36.68	25.83 36.56	26.36 36.37	26.34 35.93	25.01 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	5,200,095 1,449,244	2,229,440 1,475,986	2,983,245 1,563,078	2,088,505 1,721,954	7,573,094 2,991,828
Contract hours, direct-care Median	75,581.00 22,725	28,402.94 23,018.5	26,181.64 24,503.48	21,918.33 25,026.5	64,675.91 33,786
Contract wages, direct-care Median	68.80 64.67	78.49 64.53	113.94 65.06	95.29 68.97	117.09 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.