As of the July, 2022, release via CMS

GRAHAM REGIONAL MEDICAL CENTER

CMS id: 450085
1301 MONTGOMERY ROAD, GRAHAM TX 76450. County: YOUNG
System: --
CBSA: Rural Texas

The 25-bed, acute-care hospital had $-5,304,448 in net service to patients*, with a total profit margin of 12.20816% in fiscal year 2021, the latest year available.
It spent 9.30% 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	25 118	25 118	25 119.5	25 118	25 119
Total beds Median	25 162	25 162	25 162	26 162	25 163.5
FTEs Median	172.91 788.06	0.00 793.42	141.75 806.03	144.58 787.61	163.87 804.34

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	14,089,071 150,932,746	13,100,540 158,950,878	14,906,801 168,696,998	15,148,276 163,454,693	18,829,244 186,589,412
Operating expenses Median	21,747,743 149,311,209	19,797,597 156,110,414	20,758,649 164,890,568	22,400,162 166,516,854	24,133,692 180,120,888
Net income from service 2 patients (NS2P) ? Median	-7,658,672 -964,173	-6,697,057 -643,601.5	-5,851,848 -116,254	-7,251,886 -5,025,862	-5,304,448 -1,284,564
NS2P margin ? Median	-54.36% -0.62	-51.12% -0.29	-39.26% 0.18	-47.87% -5.07	-28.17% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for GRAHAM REGIONAL 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	8,902,071 5,089,215	8,422,277 4,572,541	9,074,541 5,268,134	9,448,060 13,092,619	7,991,805 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	144,276 224,999	23,164 199,009	46,287 206,870.5	2,526 194,343	2,125,158 249,496
⊳ Line 7: Investments ? ⊳ Median	5,190 299,524	4,498 188,688.5	4,158 370,813	10,279 309,361.5	8,995 375,329
⊳ 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	37,062	32,051	35,028	4,061	17,379
⊳ 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	41,690	37,085	38,834	42,993	45,244
⊳ Line 15: Revenue from rental of living quarters	17,278	14,625	8,149	4,950	5,793
⊳ 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	6,809	3,416	2,462	2,689	3,142
⊳ 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	52,404	49,134	35,397	14,391	12,850
⊳ Line 23: Gov appropriations ? ⊳ Median	957,301 1,017,693	574,251 983,261.5	541,522 1,173,286	861,731 1,987,202	900,478 1,597,664
⊳ Sum Line 24	7,640,061	7,684,053	8,362,704	8,504,440	4,872,766
Total income ? Median	1,243,399 6,586,430	1,725,220 6,767,106	3,222,693 8,419,950	2,196,174 8,094,175	2,687,357 15,162,888
Non-operating expenses Median	2,183,197 146,289.5	2,174,307 164,857	2,509,650 89,880.5	1,889,654 106,761	-587,000 31,473.5
Net income Median	-939,798 6,043,842	-449,087 5,845,112	713,043 7,606,259	306,520 7,283,041	3,274,357 14,957,241
Net margin Median	-4.08765% 4.62%	-2.08656% 4.42%	2.97332% 5.16%	1.24620% 5.2%	12.20816% 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 GRAHAM REGIONAL 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	2,752,640 23,241,334	2,794,672 23,709,545	2,759,868 24,248,380	2,511,632 22,858,541	3,163,949 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	2,752,640 21,577,146	2,794,672 22,041,594	2,759,868 22,722,063	2,511,632 21,570,441	3,163,949 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	2,487,883 11,160,864	2,660,325 11,987,345	2,940,869 12,926,866	3,145,291 11,884,480	3,045,262 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	2,075,674 10,918,923	2,385,920 11,706,976	2,684,792 12,615,917	2,921,922 11,458,116	2,848,628 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	285,756 1,282,808	184,943 1,407,728	135,073 1,341,512	40,372 1,407,046	0 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	126,453 618,038	89,462 697,279	121,004 690,232	182,997 684,010	196,634 670,558
⊳ 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	22,846 582,572	16,527 538,116	125,625 212,434	150,529 126,559	129,295 139,139

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	0 2,654,636	886,394 2,940,659	1,442,426 3,380,215	722,560 3,488,738	923,232 3,233,405
Uncompensated care (UCC) Median	889,868 5,147,790	2,480,485 5,337,617	1,702,940 5,711,082	2,015,189 5,923,418	2,243,375 5,508,107
UCC as a % of operating expenses Median	4.09% 3.24	12.53% 3.12	8.20% 3.21	9.00% 3.3	9.30% 2.86
Total shortfall/UCC Median	889,868 9,489,989	2,480,485 9,424,297	1,702,940 10,120,158	2,015,189 11,171,337	2,243,375 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	8,145,614 52,142,039	7,608,623 54,485,252	7,813,126 57,395,589	8,287,506 58,830,919	8,914,083 61,722,907
Salaries as a % of operating expenses Median	37.45 36.68	38.43 36.56	37.64 36.37	37.00 35.93	36.94 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	103,191 1,449,244	963 1,475,986	201,566 1,563,078	9,926 1,721,954	0 2,991,828
Contract hours, direct-care Median	1,680.00 22,725	17.00 23,018.5	2,589.00 24,503.48	141.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	61.42 64.67	56.65 64.53	77.85 65.06	70.40 68.97	0.00 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.