As of the July, 2022, release via CMS

SHANNON MEDICAL CENTER

CMS id: 450571
120 EAST HARRIS AVENUE, SAN ANGELO TX 76903. County: TOM GREEN
System: --
CBSA: San Angelo, TX

The 445-bed, acute-care hospital had $51,303,360 in net service to patients*, with a total profit margin of 13.53454% in fiscal year 2021, the latest year available.
It spent 5.55% of its operating expenses on uncompensated care and reported $207,763 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	237 118	292 118	325 119.5	325 118	355 119
Total beds Median	310 162	369 162	409 162	408 162	445 163.5
FTEs Median	1,564.39 788.06	1,464.52 793.42	1,608.24 806.03	1,578.24 787.61	2,080.01 804.34

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	289,961,561 150,932,746	306,700,382 158,950,878	325,848,998 168,696,998	419,001,150 163,454,693	558,646,137 186,589,412
Operating expenses Median	261,986,211 149,311,209	276,392,496 156,110,414	291,610,025 164,890,568	373,676,028 166,516,854	507,342,777 180,120,888
Net income from service 2 patients (NS2P) ? Median	27,975,350 -964,173	30,307,886 -643,601.5	34,238,973 -116,254	45,325,122 -5,025,862	51,303,360 -1,284,564
NS2P margin ? Median	9.65% -0.62	9.88% -0.29	10.51% 0.18	10.82% -5.07	9.18% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SHANNON 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	14,250,258 5,089,215	5,320,559 4,572,541	5,268,215 5,268,134	14,216,385 13,092,619	28,111,581 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	370,544 224,999	-34,638 199,009	-24,236 206,870.5	169,107 194,343	-39,440 249,496
⊳ Line 7: Investments ? ⊳ Median	9,582,494 299,524	2,189,343 188,688.5	1,501,138 370,813	1,922,409 309,361.5	1,955,378 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	50,456	64,083	21,678	24,968	26,183
⊳ 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	1,920,920	1,952,985	1,974,714	1,670,603	1,771,241
⊳ 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	2,325,844	1,148,786	1,794,921	10,429,298	24,398,219
Total income ? Median	42,225,608 6,586,430	35,628,445 6,767,106	39,507,188 8,419,950	59,541,507 8,094,175	79,414,941 15,162,888
Non-operating expenses Median	1,381,200 146,289.5	0 164,857	0 89,880.5	8,919,354 106,761	0 31,473.5
Net income Median	40,844,408 6,043,842	35,628,445 5,845,112	39,507,188 7,606,259	50,622,153 7,283,041	79,414,941 14,957,241
Net margin Median	13.42631% 4.62%	11.41861% 4.42%	11.93148% 5.16%	11.68516% 5.2%	13.53454% 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 SHANNON 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	55,705,592 23,241,334	54,720,760 23,709,545	58,703,555 24,248,380	57,650,568 22,858,541	62,619,345 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	51,203,403 21,577,146	50,039,112 22,041,594	54,766,532 22,722,063	54,771,746 21,570,441	60,596,510 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	2,585,787 3,535,627	3,085,703 3,746,588	2,512,176 3,782,288	1,156,418 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	1,916,402 1,203,033	1,595,945 1,215,295	1,424,847 1,313,657	1,722,404 1,365,298	2,022,835 1,179,746
All outpatient revenue Median Click here to show/hide details	33,607,498 11,160,864	36,746,640 11,987,345	38,615,027 12,926,866	39,500,249 11,884,480	50,444,727 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	32,407,973 10,918,923	35,540,434 11,706,976	37,552,767 12,615,917	38,322,599 11,458,116	49,300,518 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,199,525 1,282,808	1,206,206 1,407,728	1,062,260 1,341,512	1,177,650 1,407,046	1,144,209 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	956,271 594,888	1,025,960 595,761	1,097,528 577,894	1,801,044 542,168	1,913,269 549,667
Outlier Median	1,463,686 582,572	1,578,635 538,116	791,652 212,434	369,964 126,559	333,771 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	531,056 3,662,910	718,474 3,730,911	790,593 4,081,319	6,618,086 4,643,908	207,763 4,389,147
Charity care Median	13,130,950 2,654,636	19,918,918 2,940,659	18,704,592 3,380,215	14,835,836 3,488,738	15,837,993 3,233,405
Uncompensated care (UCC) Median	18,106,565 5,147,790	26,657,558 5,337,617	22,554,483 5,711,082	16,970,560 5,923,418	28,136,619 5,508,107
UCC as a % of operating expenses Median	6.91% 3.24	9.64% 3.12	7.73% 3.21	4.54% 3.3	5.55% 2.86
Total shortfall/UCC Median	18,637,621 9,489,989	27,376,032 9,424,297	23,345,076 10,120,158	23,588,646 11,171,337	28,344,382 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	83,033,293 52,142,039	85,420,282 54,485,252	91,570,003 57,395,589	94,217,252 58,830,919	123,833,029 61,722,907
Salaries as a % of operating expenses Median	31.69 36.68	30.91 36.56	31.40 36.37	25.21 35.93	24.41 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	12,360,699 1,449,244	10,691,367 1,475,986	8,301,642 1,563,078	5,799,268 1,721,954	14,134,782 2,991,828
Contract hours, direct-care Median	203,460.75 22,725	173,755.00 23,018.5	130,904.23 24,503.48	91,926.00 25,026.5	155,254.22 33,786
Contract wages, direct-care Median	60.75 64.67	61.53 64.53	63.42 65.06	63.09 68.97	91.04 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.