As of the July, 2022, release via CMS

TEXOMA MEDICAL CENTER

CMS id: 450324
5016 US HWY 75, DENISON TX 75020. County: GRAYSON
System: UNIVERSAL HEALTH SERVICES INC
CBSA: Sherman-Denison, TX

The 376-bed, acute-care hospital had $15,328,818 in net service to patients*, with a total profit margin of 9.60416% in fiscal year 2020, the latest year available.
It spent 8.56% of its operating expenses on uncompensated care and reported $660,174 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	--
Ownership	forprofit	forprofit	forprofit	forprofit	--
Acute beds Median	245 118	265 118	275 119.5	275 118	-- 119
Total beds Median	326 162	378 162	376 162	376 162	-- 163.5
FTEs Median	1,637.79 788.06	1,760.39 793.42	1,821.95 806.03	1,802.28 787.61	-- 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	334,235,976 150,932,746	383,479,698 158,950,878	352,886,742 168,696,998	345,145,856 163,454,693	-- 186,589,412
Operating expenses Median	297,121,255 149,311,209	347,909,323 156,110,414	311,671,785 164,890,568	329,817,038 166,516,854	-- 180,120,888
Net income from service 2 patients (NS2P) ? Median	37,114,721 -964,173	35,570,375 -643,601.5	41,214,957 -116,254	15,328,818 -5,025,862	-- -1,284,564
NS2P margin ? Median	11.10% -0.62	9.28% -0.29	11.68% 0.18	4.44% -5.07	--% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for TEXOMA 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	4,046,297 5,089,215	2,703,341 4,572,541	2,948,284 5,268,134	19,712,806 13,092,619	-- 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	-- 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	0 309,361.5	-- 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	--
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	--
⊳ Line 12: Parking lot receipts	0	0	0	0	--
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	--
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	0	--
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	--
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	--
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	--
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	--
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	--
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	--
⊳ Line 21: Rental of vending machines	0	0	0	0	--
⊳ Line 22: Rental of hospital space	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	-- 1,597,664
⊳ Sum Line 24	4,046,297	2,703,341	2,948,284	19,712,806	--
Total income ? Median	41,161,018 6,586,430	38,273,716 6,767,106	44,163,241 8,419,950	35,041,624 8,094,175	-- 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	-- 31,473.5
Net income Median	41,161,018 6,043,842	38,273,716 5,845,112	44,163,241 7,606,259	35,041,624 7,283,041	-- 14,957,241
Net margin Median	12.16765% 4.62%	9.91077% 4.42%	12.41116% 5.16%	9.60416% 5.2%	--% 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 TEXOMA 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	85,211,980 23,241,334	90,977,308 23,709,545	97,043,404 24,248,380	95,197,020 22,858,541	-- 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	75,969,459 21,577,146	80,921,894 22,041,594	87,344,871 22,722,063	85,959,246 21,570,441	-- 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Inpatient psychiatric facility (IPF) ⊳ Median	1,728,620 1,845,420	1,609,254 1,757,392	1,847,357 1,738,842	2,002,861 1,510,463	-- 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	7,513,901 3,535,627	8,446,160 3,746,588	7,851,176 3,782,288	7,234,913 3,865,578	-- 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Critical-access hospitals ⊳ Median	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	-- 1,179,746
All outpatient revenue Median Click here to show/hide details	23,858,896 11,160,864	24,580,951 11,987,345	25,143,177 12,926,866	22,620,190 11,884,480	-- 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	22,221,141 10,918,923	22,639,042 11,706,976	22,791,249 12,615,917	19,092,077 11,458,116	-- 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,637,755 1,282,808	1,941,909 1,407,728	2,351,928 1,341,512	3,528,113 1,407,046	-- 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	-- 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	-- --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	2,349,220 3,284,314	3,307,420 3,250,551	3,516,251 3,386,837	3,571,018 3,360,806	-- 3,508,953
Disproportionate-share hospital (DSH) Median	971,781 594,888	1,760,186 595,761	1,933,759 577,894	1,725,770 542,168	-- 549,667
Outlier Median	1,374,182 582,572	1,046,749 538,116	303,733 212,434	548,113 126,559	-- 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,286,205 3,662,910	688,993 3,730,911	767,325 4,081,319	660,174 4,643,908	-- 4,389,147
Charity care Median	12,331,610 2,654,636	13,728,930 2,940,659	15,343,832 3,380,215	16,494,298 3,488,738	-- 3,233,405
Uncompensated care (UCC) Median	20,517,374 5,147,790	23,408,121 5,337,617	25,864,595 5,711,082	28,233,992 5,923,418	-- 5,508,107
UCC as a % of operating expenses Median	6.91% 3.24	6.73% 3.12	8.30% 3.21	8.56% 3.3	--% 2.86
Total shortfall/UCC Median	22,803,579 9,489,989	24,097,114 9,424,297	26,631,920 10,120,158	28,894,166 11,171,337	-- 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	97,761,324 52,142,039	109,667,392 54,485,252	119,276,753 57,395,589	123,282,661 58,830,919	-- 61,722,907
Salaries as a % of operating expenses Median	32.90 36.68	31.52 36.56	30.13 36.37	29.20 35.93	-- 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	-- 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	-- 1,469,317
Contract adjusted salaries, direct-care Median	332,540 1,449,244	215,957 1,475,986	626,296 1,563,078	2,831,207 1,721,954	-- 2,991,828
Contract hours, direct-care Median	5,600.00 22,725	3,896.12 23,018.5	8,860.00 24,503.48	35,839.00 25,026.5	-- 33,786
Contract wages, direct-care Median	59.38 64.67	55.43 64.53	70.69 65.06	79.00 68.97	-- 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.