As of the July, 2022, release via CMS

VAL VERDE REGIONAL MEDICAL CENTER

CMS id: 450154
801 BEDELL ST, DEL RIO TX 78840. County: VAL VERDE
System: --
CBSA: Del Rio, TX

The 48-bed, acute-care hospital had $-9,364,687 in net service to patients*, with a total profit margin of -1.60853% in fiscal year 2021, the latest year available.
It spent 21.24% of its operating expenses on uncompensated care and reported $829,913 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	40 118	40 118	40 119.5	40 118	40 119
Total beds Median	48 162	48 162	48 162	48 162	48 163.5
FTEs Median	486.20 788.06	551.62 793.42	793.49 806.03	715.41 787.61	625.35 804.34

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	65,870,780 150,932,746	65,871,683 158,950,878	61,956,328 168,696,998	56,958,146 163,454,693	59,135,577 186,589,412
Operating expenses Median	65,105,375 149,311,209	67,431,986 156,110,414	70,102,160 164,890,568	67,299,060 166,516,854	68,500,264 180,120,888
Net income from service 2 patients (NS2P) ? Median	765,405 -964,173	-1,560,303 -643,601.5	-8,145,832 -116,254	-10,340,914 -5,025,862	-9,364,687 -1,284,564
NS2P margin ? Median	1.16% -0.62	-2.37% -0.29	-13.15% 0.18	-18.16% -5.07	-15.84% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for VAL VERDE 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	1,141,159 5,089,215	5,239,834 4,572,541	13,098,887 5,268,134	31,501,166 13,092,619	8,357,910 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	112,711 206,870.5	7,370,903 194,343	2,196,987 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	6,117 309,361.5	10,686 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	0	133,099	103,593	72,434
⊳ 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	0	0	373,097	292,753	283,661
⊳ Line 15: Revenue from rental of living quarters	0	0	22,887	10,669	10,528
⊳ 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	18,249	20,168	10,634
⊳ 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	1,141,159	5,239,834	12,438,844	23,696,963	5,772,980
Total income ? Median	1,906,564 6,586,430	3,679,531 6,767,106	4,953,055 8,419,950	21,160,252 8,094,175	-1,006,777 15,162,888
Non-operating expenses Median	6 146,289.5	2 164,857	144,864 89,880.5	152,799 106,761	78,877 31,473.5
Net income Median	1,906,558 6,043,842	3,679,529 5,845,112	4,808,191 7,606,259	21,007,453 7,283,041	-1,085,654 14,957,241
Net margin Median	2.84510% 4.62%	5.17431% 4.42%	6.40621% 5.16%	23.74815% 5.2%	-1.60853% 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 VAL VERDE 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	7,191,642 23,241,334	6,457,447 23,709,545	6,840,703 24,248,380	6,170,364 22,858,541	6,721,835 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	7,191,642 21,577,146	6,457,447 22,041,594	6,840,703 22,722,063	6,170,364 21,570,441	6,721,835 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	5,386,935 11,160,864	6,271,799 11,987,345	6,118,098 12,926,866	4,755,155 11,884,480	4,318,200 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	4,751,562 10,918,923	5,375,541 11,706,976	5,319,472 12,615,917	4,033,376 11,458,116	3,580,043 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	635,373 618,038	896,258 697,279	798,626 690,232	721,779 684,010	738,157 670,558
⊳ 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	131,147 594,888	130,919 595,761	150,818 577,894	113,643 542,168	113,225 549,667
Outlier Median	80,832 582,572	29,024 538,116	46,008 212,434	19,056 126,559	30,154 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	5,493,979 3,662,910	0 3,730,911	0 4,081,319	295,141 4,643,908	829,913 4,389,147
Charity care Median	1,123,245 2,654,636	5,108,781 2,940,659	13,218,803 3,380,215	7,481,027 3,488,738	13,997,511 3,233,405
Uncompensated care (UCC) Median	3,679,423 5,147,790	6,656,804 5,337,617	14,664,793 5,711,082	8,723,958 5,923,418	14,548,531 5,508,107
UCC as a % of operating expenses Median	5.65% 3.24	9.87% 3.12	20.92% 3.21	12.96% 3.3	21.24% 2.86
Total shortfall/UCC Median	9,173,402 9,489,989	6,656,804 9,424,297	14,664,793 10,120,158	9,019,099 11,171,337	15,378,444 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	23,967,453 52,142,039	26,988,161 54,485,252	24,406,862 57,395,589	26,870,248 58,830,919	24,539,557 61,722,907
Salaries as a % of operating expenses Median	36.81 36.68	40.02 36.56	34.82 36.37	39.93 35.93	35.82 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	3,131,063 1,449,244	2,310,514 1,475,986	2,370,424 1,563,078	1,855,478 1,721,954	1,380,725 2,991,828
Contract hours, direct-care Median	49,082.00 22,725	34,999.00 23,018.5	38,243.00 24,503.48	30,361.00 25,026.5	27,727.84 33,786
Contract wages, direct-care Median	63.79 64.67	66.02 64.53	61.98 65.06	61.11 68.97	49.80 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.