As of the July, 2022, release via CMS

HEMPHILL COUNTY HOSPITAL

CMS id: 450578
1020 S 4TH ST, CANADIAN TX 79014. County: HEMPHILL
System: --
CBSA: Rural Texas

The 17-bed, acute-care hospital had $-7,464,322 in net service to patients*, with a total profit margin of 10.37925% in fiscal year 2021, the latest year available.
It spent 3.30% of its operating expenses on uncompensated care and reported $29,379 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	15 118	15 118	15 119.5	15 118	15 119
Total beds Median	17 162	17 162	15 162	17 162	17 163.5
FTEs Median	100.10 788.06	122.15 793.42	80.10 806.03	106.42 787.61	111.64 804.34

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	6,037,453 150,932,746	5,805,603 158,950,878	5,891,281 168,696,998	8,991,162 163,454,693	11,368,947 186,589,412
Operating expenses Median	11,325,155 149,311,209	11,802,842 156,110,414	13,369,125 164,890,568	14,979,626 166,516,854	18,833,269 180,120,888
Net income from service 2 patients (NS2P) ? Median	-5,287,702 -964,173	-5,997,239 -643,601.5	-7,477,844 -116,254	-5,988,464 -5,025,862	-7,464,322 -1,284,564
NS2P margin ? Median	-87.58% -0.62	-103.30% -0.29	-126.93% 0.18	-66.60% -5.07	-65.66% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HEMPHILL COUNTY HOSPITAL 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	11,273,059 5,089,215	6,602,954 4,572,541	13,544,001 5,268,134	19,138,545 13,092,619	16,157,932 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	27,016 224,999	10,567 199,009	176,600 206,870.5	193,121 194,343	4,917 249,496
⊳ Line 7: Investments ? ⊳ Median	22,974 299,524	43,835 188,688.5	57,127 370,813	87,587 309,361.5	24,489 375,329
⊳ 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	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	17,231	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	49,967	80,257	29,418	27,551	15,878
⊳ 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	534	651	279	330	173
⊳ 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	60	0
⊳ Line 21: Rental of vending machines	0	0	0	6,037,815	0
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	4,467,227 983,261.5	5,052,064 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	11,172,568	2,000,417	8,228,513	12,774,850	16,112,475
Total income ? Median	5,985,357 6,586,430	605,715 6,767,106	6,066,157 8,419,950	13,150,081 8,094,175	8,693,610 15,162,888
Non-operating expenses Median	5,802,778 146,289.5	1,027,725 164,857	6,690,806 89,880.5	10,866,247 106,761	5,836,526 31,473.5
Net income Median	182,579 6,043,842	-422,010 5,845,112	-624,649 7,606,259	2,283,834 7,283,041	2,857,084 14,957,241
Net margin Median	1.05473% 4.62%	-3.40096% 4.42%	-3.21400% 5.16%	8.11894% 5.2%	10.37925% 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 HEMPHILL COUNTY HOSPITAL 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	1,259,386 23,241,334	798,089 23,709,545	1,030,734 24,248,380	1,703,438 22,858,541	2,101,656 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	1,259,386 21,577,146	798,089 22,041,594	1,030,734 22,722,063	1,703,438 21,570,441	2,101,656 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	600,789 11,160,864	934,335 11,987,345	953,884 12,926,866	1,035,007 11,884,480	1,342,190 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	383,648 10,918,923	396,446 11,706,976	305,412 12,615,917	368,595 11,458,116	366,397 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	176,033 1,282,808	170,402 1,407,728	129,568 1,341,512	191,188 1,407,046	299,177 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	41,108 618,038	367,487 697,279	518,904 690,232	475,224 684,010	676,616 670,558
⊳ 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	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	5,518 582,572	5,413 538,116	5,183 212,434	4,201 126,559	0 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	293,265 3,662,910	5,860 3,730,911	0 4,081,319	0 4,643,908	29,379 4,389,147
Charity care Median	115,910 2,654,636	292,681 2,940,659	206,215 3,380,215	272,100 3,488,738	0 3,233,405
Uncompensated care (UCC) Median	603,018 5,147,790	508,101 5,337,617	663,619 5,711,082	1,332,150 5,923,418	621,374 5,508,107
UCC as a % of operating expenses Median	5.32% 3.24	4.30% 3.12	4.96% 3.21	8.89% 3.3	3.30% 2.86
Total shortfall/UCC Median	896,283 9,489,989	513,961 9,424,297	663,619 10,120,158	1,332,150 11,171,337	650,753 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	4,996,766 52,142,039	5,267,909 54,485,252	5,827,654 57,395,589	6,748,029 58,830,919	7,578,057 61,722,907
Salaries as a % of operating expenses Median	44.12 36.68	44.63 36.56	43.59 36.37	45.05 35.93	40.24 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	195,698 1,449,244	110,940 1,475,986	0 1,563,078	0 1,721,954	46,166 2,991,828
Contract hours, direct-care Median	1,261.00 22,725	589.66 23,018.5	0.00 24,503.48	0.00 25,026.5	724.75 33,786
Contract wages, direct-care Median	155.19 64.67	188.14 64.53	0.00 65.06	0.00 68.97	63.70 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.