As of the July, 2022, release via CMS

CHRISTUS ST MICHAEL

CMS id: 450801
2600 ST MICHAEL DRIVE, TEXARKANA TX 75503. County: BOWIE
System: CHRISTUS HEALTH
CBSA: Texarkana, TX-AR

The 275-bed, acute-care hospital had $15,097,311 in net service to patients*, with a total profit margin of 7.74633% in fiscal year 2021, the latest year available.
It spent 7.72% of its operating expenses on uncompensated care and reported $3,658,381 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	290 118	290 118	235 119.5	235 118	235 119
Total beds Median	354 162	354 162	275 162	275 162	275 163.5
FTEs Median	1,394.00 788.06	1,354.22 793.42	1,345.57 806.03	1,406.25 787.61	1,289.85 804.34

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	368,919,878 150,932,746	278,183,380 158,950,878	304,673,118 168,696,998	307,780,237 163,454,693	335,195,292 186,589,412
Operating expenses Median	251,465,249 149,311,209	262,275,503 156,110,414	289,463,316 164,890,568	301,923,122 166,516,854	320,097,981 180,120,888
Net income from service 2 patients (NS2P) ? Median	117,454,629 -964,173	15,907,877 -643,601.5	15,209,802 -116,254	5,857,115 -5,025,862	15,097,311 -1,284,564
NS2P margin ? Median	31.84% -0.62	5.72% -0.29	4.99% 0.18	1.90% -5.07	4.50% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CHRISTUS ST MICHAEL 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	10,459,370 5,089,215	10,849,516 4,572,541	10,320,054 5,268,134	7,292,257 13,092,619	11,780,582 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	704,179 224,999	753,143 199,009	374,467 206,870.5	117,377 194,343	-18,694 249,496
⊳ Line 7: Investments ? ⊳ Median	-57,785 299,524	-173 188,688.5	2,610 370,813	133 309,361.5	59 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	76,386	53,657	59,495	33,729	1,189
⊳ 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	0	0	0	0
⊳ 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	4,380,765	3,708,113	3,721,275	2,927,491	2,533,701
⊳ Line 18: Revenue from sale of medical records and abstracts	41	648	1,195	-193,514	170,356
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	150,517	10,000	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	206,505	184,352	191,087	136,837	25,925
⊳ Line 21: Rental of vending machines	1,223	1,115	1,074	936	1,604
⊳ Line 22: Rental of hospital space	0	3,754,499	3,680,583	3,095,408	2,898,654
⊳ 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	5,148,056	2,243,645	2,278,268	1,173,860	6,167,788
Total income ? Median	127,913,999 6,586,430	26,757,393 6,767,106	25,529,856 8,419,950	13,149,372 8,094,175	26,877,893 15,162,888
Non-operating expenses Median	101,535,099 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	26,378,900 6,043,842	26,757,393 5,845,112	25,529,856 7,606,259	13,149,372 7,283,041	26,877,893 14,957,241
Net margin Median	6.95317% 4.62%	9.25756% 4.42%	8.10489% 5.16%	4.17344% 5.2%	7.74633% 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 CHRISTUS ST MICHAEL 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	53,447,150 23,241,334	59,589,613 23,709,545	65,390,026 24,248,380	64,191,587 22,858,541	70,885,048 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	53,447,150 21,577,146	59,589,613 22,041,594	65,390,026 22,722,063	64,191,587 21,570,441	70,885,048 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	25,633,890 11,160,864	28,946,169 11,987,345	32,293,429 12,926,866	33,845,115 11,884,480	35,657,844 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	24,522,107 10,918,923	28,274,071 11,706,976	32,293,429 12,615,917	33,845,115 11,458,116	35,657,844 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	1,111,783 1,282,808	672,098 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	671,011 3,284,314	748,049 3,250,551	825,260 3,386,837	969,516 3,360,806	1,019,539 3,508,953
Disproportionate-share hospital (DSH) Median	1,482,088 594,888	1,629,038 595,761	1,612,444 577,894	1,590,314 542,168	1,851,451 549,667
Outlier Median	1,208,179 582,572	1,483,736 538,116	1,095,520 212,434	52,708 126,559	76,497 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,634,880 3,662,910	103,170 3,730,911	143,347 4,081,319	171,056 4,643,908	3,658,381 4,389,147
Charity care Median	18,682,395 2,654,636	9,977,050 2,940,659	20,836,975 3,380,215	22,065,997 3,488,738	21,872,972 3,233,405
Uncompensated care (UCC) Median	26,902,248 5,147,790	12,923,661 5,337,617	24,935,553 5,711,082	26,085,100 5,923,418	24,720,596 5,508,107
UCC as a % of operating expenses Median	10.70% 3.24	4.93% 3.12	8.61% 3.21	8.64% 3.3	7.72% 2.86
Total shortfall/UCC Median	28,537,128 9,489,989	13,026,831 9,424,297	25,078,900 10,120,158	26,256,156 11,171,337	28,378,977 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	75,086,570 52,142,039	79,010,669 54,485,252	85,455,454 57,395,589	88,240,314 58,830,919	90,879,463 61,722,907
Salaries as a % of operating expenses Median	29.86 36.68	30.13 36.56	29.52 36.37	29.23 35.93	28.39 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	935,115 1,251,927	872,704 1,186,494	872,704 1,204,885	901,091 1,279,653	902,464 1,469,317
Contract adjusted salaries, direct-care Median	1,874,628 1,449,244	1,613,292 1,475,986	2,082,051 1,563,078	1,674,487 1,721,954	8,538,685 2,991,828
Contract hours, direct-care Median	43,075.00 22,725	38,425.00 23,018.5	42,562.00 24,503.48	32,011.26 25,026.5	100,419.00 33,786
Contract wages, direct-care Median	43.52 64.67	41.99 64.53	48.92 65.06	52.31 68.97	85.03 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.