As of the July, 2022, release via CMS

HCA HOUSTON HEALTHCARE TOMBALL

CMS id: 450670
605 HOLDERRIETH BLVD, TOMBALL TX 77375. County: HARRIS
System: HCA
CBSA: Houston-The Woodlands-Sugar Land, TX

The 241-bed, acute-care hospital had $2,811,111 in net service to patients*, with a total profit margin of 0.20038% in fiscal year 2021, the latest year available.
It spent 8.86% of its operating expenses on uncompensated care and reported $247,290 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	252 118	167 118	167 119.5	155 118	167 119
Total beds Median	326 162	241 162	241 162	241 162	241 163.5
FTEs Median	956.82 788.06	733.04 793.42	754.23 806.03	823.63 787.61	788.87 804.34

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	151,126,048 150,932,746	151,381,291 158,950,878	160,228,226 168,696,998	198,131,059 163,454,693	211,249,035 186,589,412
Operating expenses Median	197,045,055 149,311,209	172,132,395 156,110,414	193,034,472 164,890,568	207,574,497 166,516,854	208,437,924 180,120,888
Net income from service 2 patients (NS2P) ? Median	-45,919,007 -964,173	-20,751,104 -643,601.5	-32,806,246 -116,254	-9,443,438 -5,025,862	2,811,111 -1,284,564
NS2P margin ? Median	-30.38% -0.62	-13.71% -0.29	-20.47% 0.18	-4.77% -5.07	1.33% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for HCA HOUSTON HEALTHCARE TOMBALL 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	2,034,561 5,089,215	1,142,514 4,572,541	1,626,380 5,268,134	4,750,817 13,092,619	-2,392,604 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	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	0	10,768	0	0	0
⊳ 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	272,596	630,221	576,710	360,990
⊳ 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	548	953	2,152	1,324
⊳ 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	11,264	12,125	10,952	2,868
⊳ Line 22: Rental of hospital space	0	145,231	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	2,034,561	702,107	983,081	4,161,003	-2,757,786
Total income ? Median	-43,884,446 6,586,430	-19,608,590 6,767,106	-31,179,866 8,419,950	-4,692,621 8,094,175	418,507 15,162,888
Non-operating expenses Median	0 146,289.5	19 164,857	24 89,880.5	12 106,761	10 31,473.5
Net income Median	-43,884,446 6,043,842	-19,608,609 5,845,112	-31,179,890 7,606,259	-4,692,633 7,283,041	418,497 14,957,241
Net margin Median	-28.65257% 4.62%	-12.85610% 4.42%	-19.26414% 5.16%	-2.31299% 5.2%	0.20038% 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 HCA HOUSTON HEALTHCARE TOMBALL 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	34,181,898 23,241,334	37,315,744 23,709,545	38,922,984 24,248,380	43,421,830 22,858,541	41,435,128 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	25,833,228 21,577,146	29,045,227 22,041,594	29,731,681 22,722,063	34,868,857 21,570,441	31,732,149 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	1,556,543 1,845,420	1,839,502 1,757,392	1,426,044 1,738,842	1,515,540 1,510,463	1,599,603 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	6,792,127 3,535,627	6,431,015 3,746,588	7,765,259 3,782,288	7,037,433 3,865,578	8,103,376 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	11,068,464 11,160,864	10,017,783 11,987,345	9,387,456 12,926,866	10,227,153 11,884,480	10,807,489 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	11,068,464 10,918,923	10,017,783 11,706,976	9,387,456 12,615,917	10,227,153 11,458,116	10,807,489 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	334,891 594,888	270,062 595,761	661,820 577,894	346,016 542,168	324,066 549,667
Outlier Median	930,731 582,572	1,027,342 538,116	1,718,212 212,434	546,869 126,559	707,053 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	218,442 3,662,910	4,262,346 3,730,911	109,560 4,081,319	447,201 4,643,908	247,290 4,389,147
Charity care Median	4,975,896 2,654,636	9,691,299 2,940,659	12,233,284 3,380,215	18,828,503 3,488,738	16,180,264 3,233,405
Uncompensated care (UCC) Median	12,112,551 5,147,790	9,875,218 5,337,617	13,299,937 5,711,082	20,842,439 5,923,418	18,463,409 5,508,107
UCC as a % of operating expenses Median	6.15% 3.24	5.74% 3.12	6.89% 3.21	10.04% 3.3	8.86% 2.86
Total shortfall/UCC Median	12,330,993 9,489,989	14,137,564 9,424,297	13,409,497 10,120,158	21,289,640 11,171,337	18,710,699 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	67,961,416 52,142,039	55,885,251 54,485,252	56,172,994 57,395,589	62,385,037 58,830,919	62,986,608 61,722,907
Salaries as a % of operating expenses Median	34.49 36.68	32.47 36.56	29.10 36.37	30.05 35.93	30.22 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	972,559 1,449,244	1,989,988 1,475,986	1,928,747 1,563,078	3,371,217 1,721,954	6,338,454 2,991,828
Contract hours, direct-care Median	16,502.29 22,725	52,186.00 23,018.5	50,622.00 24,503.48	75,822.00 25,026.5	106,418.00 33,786
Contract wages, direct-care Median	58.93 64.67	38.13 64.53	38.10 65.06	44.46 68.97	59.56 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.