As of the July, 2022, release via CMS

NACOGDOCHES MEDICAL CENTER

CMS id: 450656
4920 NORTHEAST STALLINGS DRIVE, NACOGDOCHES TX 75965. County: NACOGDOCHES
System: TENET HEALTHCARE CORPORATION
CBSA: Nacogdoches, TX

The 155-bed, acute-care hospital had $14,048,793 in net service to patients*, with a total profit margin of 15.06638% in fiscal year 2021, the latest year available.
It spent 5.04% of its operating expenses on uncompensated care and reported $20,234 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	136 118	136 118	136 119.5	136 118	136 119
Total beds Median	155 162	155 162	155 162	155 162	155 163.5
FTEs Median	313.10 788.06	317.20 793.42	334.00 806.03	319.00 787.61	317.50 804.34

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	78,043,923 150,932,746	88,512,822 158,950,878	100,123,452 168,696,998	98,876,475 163,454,693	111,677,220 186,589,412
Operating expenses Median	75,511,727 149,311,209	82,096,965 156,110,414	92,750,199 164,890,568	89,179,490 166,516,854	97,628,427 180,120,888
Net income from service 2 patients (NS2P) ? Median	2,532,196 -964,173	6,415,857 -643,601.5	7,373,253 -116,254	9,696,985 -5,025,862	14,048,793 -1,284,564
NS2P margin ? Median	3.24% -0.62	7.25% -0.29	7.36% 0.18	9.81% -5.07	12.58% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for NACOGDOCHES 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	765,403 5,089,215	823,809 4,572,541	781,322 5,268,134	3,583,288 13,092,619	3,269,518 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	284 299,524	-217 188,688.5	24,779 370,813	3,760 309,361.5	-14 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	2,380	1,047	310	685	1,645
⊳ Line 11: Rebates and refunds of expenses	27,558	29,318	56,025	48,557	31,588
⊳ 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	7,034	6,826	8,412	9,007	14,024
⊳ 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	333	9,810
⊳ 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	700,144	742,662	689,395	473,811	470,526
⊳ 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	28,003	44,173	2,401	3,047,135	2,741,939
Total income ? Median	3,297,599 6,586,430	7,239,666 6,767,106	8,154,575 8,419,950	13,280,273 8,094,175	17,318,311 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	3,297,599 6,043,842	7,239,666 5,845,112	8,154,575 7,606,259	13,280,273 7,283,041	17,318,311 14,957,241
Net margin Median	4.18428% 4.62%	8.10380% 4.42%	8.08146% 5.16%	12.96145% 5.2%	15.06638% 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 NACOGDOCHES 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	14,991,352 23,241,334	15,160,869 23,709,545	16,919,648 24,248,380	17,683,426 22,858,541	17,191,388 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	14,991,352 21,577,146	15,160,869 22,041,594	16,919,648 22,722,063	17,683,426 21,570,441	17,191,388 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	8,228,320 11,160,864	8,441,502 11,987,345	9,485,499 12,926,866	6,992,174 11,884,480	7,726,709 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	8,228,320 10,918,923	8,441,502 11,706,976	9,485,499 12,615,917	6,992,174 11,458,116	7,726,709 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	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	184,449 594,888	219,643 595,761	273,169 577,894	290,904 542,168	353,636 549,667
Outlier Median	674,429 582,572	469,197 538,116	46,758 212,434	65,559 126,559	81,591 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	93,163 3,662,910	145,511 3,730,911	101,482 4,081,319	32,606 4,643,908	20,234 4,389,147
Charity care Median	3,203,767 2,654,636	3,585,007 2,940,659	4,755,649 3,380,215	3,832,585 3,488,738	3,881,052 3,233,405
Uncompensated care (UCC) Median	5,264,665 5,147,790	5,570,427 5,337,617	6,128,477 5,711,082	4,960,237 5,923,418	4,917,439 5,508,107
UCC as a % of operating expenses Median	6.97% 3.24	6.79% 3.12	6.61% 3.21	5.56% 3.3	5.04% 2.86
Total shortfall/UCC Median	5,357,828 9,489,989	5,715,938 9,424,297	6,229,959 10,120,158	4,992,843 11,171,337	4,937,673 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	24,081,824 52,142,039	24,707,804 54,485,252	25,994,106 57,395,589	25,899,555 58,830,919	27,869,247 61,722,907
Salaries as a % of operating expenses Median	31.91 36.68	30.12 36.56	28.02 36.37	29.06 35.93	28.59 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	362,068 1,449,244	328,694 1,475,986	300,075 1,563,078	1,005,494 1,721,954	3,880,121 2,991,828
Contract hours, direct-care Median	5,518.00 22,725	4,409.25 23,018.5	4,610.00 24,503.48	14,937.00 25,026.5	30,341.00 33,786
Contract wages, direct-care Median	65.62 64.67	74.55 64.53	65.09 65.06	67.32 68.97	127.88 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.