As of the July, 2022, release via CMS

GUADALUPE REGIONAL MEDICAL CENTER

CMS id: 450104
1215 EAST COURT STREET, SEGUIN TX 78155. County: GUADALUPE
System: --
CBSA: San Antonio-New Braunfels, TX

The 139-bed, acute-care hospital had $210,870 in net service to patients*, with a total profit margin of 15.04102% in fiscal year 2021, the latest year available.
It spent 10.96% of its operating expenses on uncompensated care and reported $252,468 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	83 118	108 118	108 119.5	108 118	108 119
Total beds Median	114 162	139 162	139 162	139 162	139 163.5
FTEs Median	601.97 788.06	583.39 793.42	605.89 806.03	753.44 787.61	643.91 804.34

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	96,274,911 150,932,746	101,490,853 158,950,878	109,154,629 168,696,998	102,691,190 163,454,693	126,181,346 186,589,412
Operating expenses Median	102,730,260 149,311,209	105,920,050 156,110,414	111,251,939 164,890,568	114,419,147 166,516,854	125,970,476 180,120,888
Net income from service 2 patients (NS2P) ? Median	-6,455,349 -964,173	-4,429,197 -643,601.5	-2,097,310 -116,254	-11,727,957 -5,025,862	210,870 -1,284,564
NS2P margin ? Median	-6.71% -0.62	-4.36% -0.29	-1.92% 0.18	-11.42% -5.07	0.17% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for GUADALUPE 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	6,180,443 5,089,215	7,633,701 4,572,541	9,075,393 5,268,134	17,199,987 13,092,619	22,090,767 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	709,551 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	526,236 299,524	0 188,688.5	1,955,519 370,813	721,220 309,361.5	10,792,211 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	128,494	0	0	68,809	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	64,337	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	412,358	0	0	432,457	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	1,907	0	0	1,753	0
⊳ 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	2,297	0
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	2,278,541 983,261.5	127,198 1,173,286	0 1,987,202	3,415,316 1,597,664
⊳ Sum Line 24	4,401,897	5,355,160	6,992,676	15,909,114	7,883,240
Total income ? Median	-274,906 6,586,430	3,204,504 6,767,106	6,978,083 8,419,950	5,472,030 8,094,175	22,301,637 15,162,888
Non-operating expenses Median	-35,782 146,289.5	0 164,857	218,299 89,880.5	0 106,761	0 31,473.5
Net income Median	-239,124 6,043,842	3,204,504 5,845,112	6,759,784 7,606,259	5,472,030 7,283,041	22,301,637 14,957,241
Net margin Median	-0.23339% 4.62%	2.93656% 4.42%	5.71749% 5.16%	4.56416% 5.2%	15.04102% 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 GUADALUPE 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	16,372,142 23,241,334	16,712,623 23,709,545	15,686,543 24,248,380	17,467,831 22,858,541	20,997,870 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	13,007,694 21,577,146	13,893,951 22,041,594	13,033,603 22,722,063	14,536,915 21,570,441	17,438,131 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	3,364,448 3,535,627	2,818,672 3,746,588	2,652,940 3,782,288	2,930,916 3,865,578	3,559,739 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	11,323,540 11,160,864	11,592,868 11,987,345	12,085,976 12,926,866	10,345,402 11,884,480	11,781,601 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	11,323,540 10,918,923	11,592,868 11,706,976	12,085,976 12,615,917	10,345,402 11,458,116	11,781,601 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	324,754 594,888	325,005 595,761	314,994 577,894	603,527 542,168	408,376 549,667
Outlier Median	551,994 582,572	835,810 538,116	321,037 212,434	544,075 126,559	453,461 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,587,838 3,662,910	94,168 3,730,911	44,116 4,081,319	0 4,643,908	252,468 4,389,147
Charity care Median	14,890,689 2,654,636	6,743,154 2,940,659	7,452,122 3,380,215	8,213,910 3,488,738	9,716,634 3,233,405
Uncompensated care (UCC) Median	15,828,701 5,147,790	10,700,806 5,337,617	11,654,251 5,711,082	12,803,826 5,923,418	13,809,458 5,508,107
UCC as a % of operating expenses Median	15.41% 3.24	10.10% 3.12	10.48% 3.21	11.19% 3.3	10.96% 2.86
Total shortfall/UCC Median	17,416,539 9,489,989	10,794,974 9,424,297	11,698,367 10,120,158	12,803,826 11,171,337	14,061,926 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	38,837,894 52,142,039	40,911,939 54,485,252	43,522,708 57,395,589	46,967,629 58,830,919	50,255,289 61,722,907
Salaries as a % of operating expenses Median	37.81 36.68	38.63 36.56	39.12 36.37	41.05 35.93	39.89 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	1,274,263 1,449,244	1,674,746 1,475,986	2,017,671 1,563,078	1,621,822 1,721,954	2,563,049 2,991,828
Contract hours, direct-care Median	15,512.51 22,725	25,712.00 23,018.5	35,278.29 24,503.48	28,045.29 25,026.5	34,996.00 33,786
Contract wages, direct-care Median	82.14 64.67	65.13 64.53	57.19 65.06	57.83 68.97	73.24 88.94

* in an approved program

Return to top

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.