As of the July, 2022, release via CMS

SANTA ROSA HEALTHCARE

CMS id: 450237
2827 BABCOCK ROAD, SAN ANTONIO TX 78229. County: BEXAR
System: CHRISTUS HEALTH
CBSA: San Antonio-New Braunfels, TX

The 367-bed, acute-care hospital had $-16,270,785 in net service to patients*, with a total profit margin of 3.27056% in fiscal year 2021, the latest year available.
It spent 9.71% of its operating expenses on uncompensated care and reported $149,660 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	283 118	323 118	323 119.5	323 118	312 119
Total beds Median	424 162	386 162	377 162	377 162	367 163.5
FTEs Median	1,794.62 788.06	1,780.46 793.42	1,838.04 806.03	1,696.98 787.61	1,656.59 804.34

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	352,912,453 150,932,746	368,737,502 158,950,878	406,532,245 168,696,998	402,602,290 163,454,693	461,836,497 186,589,412
Operating expenses Median	372,469,434 149,311,209	395,950,163 156,110,414	428,682,710 164,890,568	416,620,529 166,516,854	478,107,282 180,120,888
Net income from service 2 patients (NS2P) ? Median	-19,556,981 -964,173	-27,212,661 -643,601.5	-22,150,465 -116,254	-14,018,239 -5,025,862	-16,270,785 -1,284,564
NS2P margin ? Median	-5.54% -0.62	-7.38% -0.29	-5.45% 0.18	-3.48% -5.07	-3.52% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SANTA ROSA HEALTHCARE 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	23,329,856 5,089,215	10,989,087 4,572,541	18,176,270 5,268,134	2,256,953 13,092,619	32,436,282 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	901,683 224,999	1,708,087 199,009	1,316,061 206,870.5	837,676 194,343	30,366,302 249,496
⊳ 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	16,452	1,659	6,825	0	1,815
⊳ 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	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	8,780	9,650	8,120	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	363,848	190,619	224,128	166,877	3,954
⊳ 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	22,039,093	9,079,072	16,621,136	1,252,400	2,064,211
Total income ? Median	3,772,875 6,586,430	-16,223,574 6,767,106	-3,974,195 8,419,950	-11,761,286 8,094,175	16,165,497 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	3,772,875 6,043,842	-16,223,574 5,845,112	-3,974,195 7,606,259	-11,761,286 7,283,041	16,165,497 14,957,241
Net margin Median	1.00278% 4.62%	-4.27244% 4.42%	-0.93575% 5.16%	-2.90503% 5.2%	3.27056% 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 SANTA ROSA HEALTHCARE 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	81,400,991 23,241,334	79,984,527 23,709,545	83,859,326 24,248,380	84,311,855 22,858,541	87,106,805 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	78,135,452 21,577,146	78,953,380 22,041,594	83,859,326 22,722,063	84,311,855 21,570,441	87,106,805 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	3,265,539 1,845,420	1,031,147 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	23,744,455 11,160,864	22,761,371 11,987,345	26,564,726 12,926,866	26,913,089 11,884,480	27,832,611 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	23,744,455 10,918,923	22,761,371 11,706,976	26,564,726 12,615,917	26,913,089 11,458,116	27,832,611 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	3,526,049 3,284,314	3,520,199 3,250,551	4,320,026 3,386,837	4,386,576 3,360,806	4,528,191 3,508,953
Disproportionate-share hospital (DSH) Median	1,311,699 594,888	1,275,213 595,761	1,396,803 577,894	1,408,057 542,168	1,915,043 549,667
Outlier Median	2,759,009 582,572	2,588,443 538,116	983,120 212,434	252,113 126,559	440,901 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	256,897 3,662,910	282,184 3,730,911	425,382 4,081,319	262,462 4,643,908	149,660 4,389,147
Charity care Median	28,148,586 2,654,636	35,088,414 2,940,659	35,401,496 3,380,215	42,773,328 3,488,738	40,846,216 3,233,405
Uncompensated care (UCC) Median	48,952,180 5,147,790	45,518,143 5,337,617	45,558,752 5,711,082	53,144,709 5,923,418	46,436,753 5,508,107
UCC as a % of operating expenses Median	13.14% 3.24	11.50% 3.12	10.63% 3.21	12.76% 3.3	9.71% 2.86
Total shortfall/UCC Median	49,209,077 9,489,989	45,800,327 9,424,297	45,984,134 10,120,158	53,407,171 11,171,337	46,586,413 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	114,659,778 52,142,039	126,694,275 54,485,252	127,821,395 57,395,589	130,512,181 58,830,919	127,396,615 61,722,907
Salaries as a % of operating expenses Median	30.78 36.68	32.00 36.56	30.90 36.37	31.33 35.93	26.65 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	1,839,708 1,251,927	0 1,186,494	1,859,547 1,204,885	1,859,547 1,279,653	2,017,801 1,469,317
Contract adjusted salaries, direct-care Median	4,228,998 1,449,244	6,419,419 1,475,986	6,569,110 1,563,078	7,993,231 1,721,954	41,395,429 2,991,828
Contract hours, direct-care Median	102,707.00 22,725	140,973.00 23,018.5	135,996.00 24,503.48	166,218.00 25,026.5	541,715.34 33,786
Contract wages, direct-care Median	41.18 64.67	45.54 64.53	48.30 65.06	48.09 68.97	76.42 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.