As of the July, 2022, release via CMS

KNAPP MEDICAL CENTER

CMS id: 450128
1401 EAST EIGHT STREET, WESLACO TX 78596. County: HIDALGO
System: PRIME HEALTHCARE MGMT SRVS
CBSA: McAllen-Edinburg-Mission, TX

The 186-bed, acute-care hospital had $-6,124,632 in net service to patients*, with a total profit margin of 1.81852% in fiscal year 2021, the latest year available.
It spent 11.11% of its operating expenses on uncompensated care and reported $2,049,322 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	170 118	170 118	170 119.5	170 118	170 119
Total beds Median	210 162	186 162	186 162	186 162	186 163.5
FTEs Median	698.39 788.06	649.48 793.42	626.05 806.03	531.15 787.61	491.88 804.34

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	90,971,432 150,932,746	95,095,953 158,950,878	101,164,862 168,696,998	94,678,001 163,454,693	95,739,510 186,589,412
Operating expenses Median	104,126,995 149,311,209	98,794,106 156,110,414	102,085,620 164,890,568	99,298,444 166,516,854	101,864,142 180,120,888
Net income from service 2 patients (NS2P) ? Median	-13,155,563 -964,173	-3,698,153 -643,601.5	-920,758 -116,254	-4,620,443 -5,025,862	-6,124,632 -1,284,564
NS2P margin ? Median	-14.46% -0.62	-3.89% -0.29	-0.91% 0.18	-4.88% -5.07	-6.40% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for KNAPP 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	6,834,649 5,089,215	6,710,266 4,572,541	8,936,043 5,268,134	20,251,040 13,092,619	8,152,570 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	4,766,604 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	845,366 370,813	845,033 309,361.5	1,708 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	4,243	4,870	11	0	0
⊳ Line 11: Rebates and refunds of expenses	373,621	218,940	399,596	5,923	8,628
⊳ 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	496,784	443,737	416,916	345,149	298,523
⊳ 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	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	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	1,193,397	6,042,719	7,274,154	19,054,935	7,843,711
Total income ? Median	-6,320,914 6,586,430	3,012,113 6,767,106	8,015,285 8,419,950	15,630,597 8,094,175	2,027,938 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	4,121,451 89,880.5	303,161 106,761	138,643 31,473.5
Net income Median	-6,320,914 6,043,842	3,012,113 5,845,112	3,893,834 7,606,259	15,327,436 7,283,041	1,889,295 14,957,241
Net margin Median	-6.46270% 4.62%	2.95867% 4.42%	3.53660% 5.16%	13.33643% 5.2%	1.81852% 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 KNAPP 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	25,758,170 23,241,334	27,659,860 23,709,545	28,353,146 24,248,380	25,539,029 22,858,541	19,329,747 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	25,758,170 21,577,146	27,659,860 22,041,594	28,353,146 22,722,063	25,539,029 21,570,441	19,329,747 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	5,197,536 11,160,864	4,748,915 11,987,345	3,938,336 12,926,866	2,888,581 11,884,480	3,224,284 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	5,197,536 10,918,923	4,748,915 11,706,976	3,938,336 12,615,917	2,888,581 11,458,116	3,224,284 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	649,248 3,250,551	842,232 3,386,837	1,399,338 3,360,806	2,122,601 3,508,953
Disproportionate-share hospital (DSH) Median	1,871,412 594,888	1,894,814 595,761	1,854,619 577,894	1,329,867 542,168	884,151 549,667
Outlier Median	124,380 582,572	37,862 538,116	77,828 212,434	89,232 126,559	41,438 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,215,002 3,662,910	3,599,997 3,730,911	8,524,788 4,081,319	5,300,579 4,643,908	2,049,322 4,389,147
Charity care Median	6,720,450 2,654,636	11,219,289 2,940,659	2,096,648 3,380,215	5,457,430 3,488,738	7,192,372 3,233,405
Uncompensated care (UCC) Median	20,691,194 5,147,790	13,329,178 5,337,617	10,587,882 5,711,082	9,654,504 5,923,418	11,313,335 5,508,107
UCC as a % of operating expenses Median	19.87% 3.24	13.49% 3.12	10.37% 3.21	9.72% 3.3	11.11% 2.86
Total shortfall/UCC Median	27,906,196 9,489,989	16,929,175 9,424,297	19,112,670 10,120,158	14,955,083 11,171,337	13,362,657 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	38,809,307 52,142,039	37,151,581 54,485,252	37,477,013 57,395,589	34,381,709 58,830,919	35,363,394 61,722,907
Salaries as a % of operating expenses Median	35.79 36.68	36.67 36.56	35.95 36.37	34.19 35.93	34.37 35.24
Intern, resident salaries* Median	0 2,598,592	914,000 2,686,824	800,000 2,753,773	2,116,618 2,937,156	3,907,439 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	49,113 1,449,244	0 1,475,986	0 1,563,078	1,258,524 1,721,954	0 2,991,828
Contract hours, direct-care Median	703.00 22,725	0.00 23,018.5	0.00 24,503.48	3,990.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	69.86 64.67	0.00 64.53	0.00 65.06	315.42 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.