As of the July, 2022, release via CMS

SOUTHWEST GENERAL HOSPITAL

CMS id: 450697
7400 BARLITE BLVD, SAN ANTONIO TX 78224. County: BEXAR
System: STEWARD HEALTHCARE INC.
CBSA: San Antonio-New Braunfels, TX

The 217-bed, acute-care hospital had $-19,769,897 in net service to patients*, with a total profit margin of 5.57380% in fiscal year 2021, the latest year available.
It spent 11.62% of its operating expenses on uncompensated care and reported $234,113 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	173 118	143 118	143 119.5	143 118	159 119
Total beds Median	259 162	225 162	225 162	225 162	217 163.5
FTEs Median	674.09 788.06	678.32 793.42	1,163.14 806.03	569.70 787.61	621.77 804.34

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	105,031,150 150,932,746	104,737,067 158,950,878	81,172,060 168,696,998	82,801,418 163,454,693	107,192,617 186,589,412
Operating expenses Median	119,896,344 149,311,209	117,880,948 156,110,414	105,301,438 164,890,568	106,036,951 166,516,854	126,962,514 180,120,888
Net income from service 2 patients (NS2P) ? Median	-14,865,194 -964,173	-13,143,881 -643,601.5	-24,129,378 -116,254	-23,235,533 -5,025,862	-19,769,897 -1,284,564
NS2P margin ? Median	-14.15% -0.62	-12.55% -0.29	-29.73% 0.18	-28.06% -5.07	-18.44% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for SOUTHWEST GENERAL 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	4,565,361 5,089,215	3,540,757 4,572,541	4,354,093 5,268,134	12,876,348 13,092,619	27,264,251 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	0	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	471,763	424,735	378,666	297,392	243,668
⊳ 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	1,733	2,518	4,254	11,471	84
⊳ 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	6,403	3,278	3,350	1,995	0
⊳ Line 22: Rental of hospital space	3,065,535	3,060,070	3,617,545	5,948,204	9,781,407
⊳ 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	1,019,927	50,156	350,278	6,617,286	17,239,092
Total income ? Median	-10,299,833 6,586,430	-9,603,124 6,767,106	-19,775,285 8,419,950	-10,359,185 8,094,175	7,494,354 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	4,305,570 89,880.5	0 106,761	0 31,473.5
Net income Median	-10,299,833 6,043,842	-9,603,124 5,845,112	-24,080,855 7,606,259	-10,359,185 7,283,041	7,494,354 14,957,241
Net margin Median	-9.39796% 4.62%	-8.86897% 4.42%	-28.15613% 5.16%	-10.82716% 5.2%	5.57380% 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 SOUTHWEST GENERAL 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	23,377,520 23,241,334	20,982,210 23,709,545	17,869,822 24,248,380	15,671,324 22,858,541	15,545,768 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	19,558,793 21,577,146	17,538,837 22,041,594	14,767,675 22,722,063	13,824,742 21,570,441	15,545,768 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	1,778,838 1,845,420	1,241,196 1,757,392	1,274,268 1,738,842	889,339 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	2,039,889 3,535,627	2,202,177 3,746,588	1,827,879 3,782,288	957,243 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	3,192,160 11,160,864	3,118,154 11,987,345	2,928,937 12,926,866	2,012,454 11,884,480	1,643,236 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	3,192,160 10,918,923	3,118,154 11,706,976	2,928,937 12,615,917	2,012,454 11,458,116	1,643,236 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	34,804 3,386,837	475,667 3,360,806	687,898 3,508,953
Disproportionate-share hospital (DSH) Median	1,366,159 594,888	1,352,749 595,761	1,005,784 577,894	794,955 542,168	794,708 549,667
Outlier Median	210,950 582,572	350,255 538,116	317,513 212,434	120,038 126,559	15,434 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,652,670 3,662,910	0 3,730,911	135,259 4,081,319	63,203 4,643,908	234,113 4,389,147
Charity care Median	5,421,213 2,654,636	4,048,335 2,940,659	13,415,671 3,380,215	14,508,751 3,488,738	12,344,496 3,233,405
Uncompensated care (UCC) Median	13,176,883 5,147,790	13,283,930 5,337,617	17,877,484 5,711,082	17,789,346 5,923,418	14,747,758 5,508,107
UCC as a % of operating expenses Median	10.99% 3.24	11.27% 3.12	16.98% 3.21	16.78% 3.3	11.62% 2.86
Total shortfall/UCC Median	17,829,553 9,489,989	13,283,930 9,424,297	18,012,743 10,120,158	17,852,549 11,171,337	14,981,871 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	41,829,628 52,142,039	43,135,959 54,485,252	39,727,404 57,395,589	37,061,905 58,830,919	40,248,895 61,722,907
Salaries as a % of operating expenses Median	34.89 36.68	36.59 36.56	37.73 36.37	34.95 35.93	31.70 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	150,000 1,204,885	0 1,279,653	17,670 1,469,317
Contract adjusted salaries, direct-care Median	4,424,005 1,449,244	999,492 1,475,986	1,124,566 1,563,078	3,738,648 1,721,954	7,228,903 2,991,828
Contract hours, direct-care Median	87,636.00 22,725	18,588.00 23,018.5	21,167.00 24,503.48	60,175.00 25,026.5	83,763.00 33,786
Contract wages, direct-care Median	50.48 64.67	53.77 64.53	53.13 65.06	62.13 68.97	86.30 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.