As of the July, 2022, release via CMS

WINCHESTER MEDICAL CENTER

CMS id: 490005
1840 AMHERST STREET, WINCHESTER VA 22604. County: WINCHESTER CITY
System: VALLEY HEALTH
CBSA: Winchester, VA-WV

The 512-bed, acute-care hospital had $-24,905,225 in net service to patients*, with a total profit margin of 17.07026% in fiscal year 2021, the latest year available.
It spent 3.17% of its operating expenses on uncompensated care and reported $22,113,358 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	341 118	341 118	341 119.5	390 118	407 119
Total beds Median	455 162	455 162	455 162	495 162	512 163.5
FTEs Median	2,603.42 788.06	2,633.07 793.42	2,574.90 806.03	2,648.98 787.61	2,675.12 804.34

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	591,103,930 150,932,746	578,130,512 158,950,878	623,421,531 168,696,998	584,321,958 163,454,693	646,961,402 186,589,412
Operating expenses Median	557,568,481 149,311,209	579,132,350 156,110,414	614,063,719 164,890,568	624,215,013 166,516,854	671,866,627 180,120,888
Net income from service 2 patients (NS2P) ? Median	33,535,449 -964,173	-1,001,838 -643,601.5	9,357,812 -116,254	-39,893,055 -5,025,862	-24,905,225 -1,284,564
NS2P margin ? Median	5.67% -0.62	-0.17% -0.29	1.50% 0.18	-6.83% -5.07	-3.85% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for WINCHESTER 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	35,678,899 5,089,215	81,809,032 4,572,541	31,686,936 5,268,134	53,064,819 13,092,619	163,202,285 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	11,367,590 224,999	1,399,013 199,009	1,952,729 206,870.5	31,722,591 194,343	117,858 249,496
⊳ Line 7: Investments ? ⊳ Median	3,756,078 299,524	69,685,522 188,688.5	20,360,000 370,813	12,846,271 309,361.5	126,959,972 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	741	703	23	20	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	2,330,684	2,381,034	2,852,200	2,371,460	2,327,404
⊳ 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	58
⊳ Line 18: Revenue from sale of medical records and abstracts	166,954	181,057	169,802	153,998	274,907
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	199,017	191,304	154,588	132,029	86,683
⊳ 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	3,417,691	2,235,942	2,390,599	3,071,556	3,748,723
⊳ 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	14,391,214	5,698,108	3,760,583	2,754,554	29,686,680
Total income ? Median	69,214,348 6,586,430	80,807,194 6,767,106	41,044,748 8,419,950	13,171,764 8,094,175	138,297,060 15,162,888
Non-operating expenses Median	42,970 146,289.5	47,549 164,857	42,736 89,880.5	3,272,284 106,761	0 31,473.5
Net income Median	69,171,378 6,043,842	80,759,645 5,845,112	41,002,012 7,606,259	9,899,480 7,283,041	138,297,060 14,957,241
Net margin Median	11.03594% 4.62%	12.23743% 4.42%	6.25881% 5.16%	1.55314% 5.2%	17.07026% 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 WINCHESTER 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	123,835,177 23,241,334	124,651,015 23,709,545	128,077,064 24,248,380	108,418,053 22,858,541	107,604,248 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	117,739,455 21,577,146	117,942,855 22,041,594	122,127,631 22,722,063	102,937,726 21,570,441	101,812,098 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	2,244,855 1,845,420	2,241,621 1,757,392	2,351,598 1,738,842	2,021,597 1,510,463	1,115,446 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	3,850,867 3,535,627	4,466,539 3,746,588	3,597,835 3,782,288	3,458,730 3,865,578	4,676,704 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	65,285,890 11,160,864	66,726,019 11,987,345	66,876,755 12,926,866	60,879,726 11,884,480	65,269,373 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	57,608,962 10,918,923	59,441,152 11,706,976	60,097,263 12,615,917	54,564,649 11,458,116	58,961,115 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	7,676,928 1,282,808	7,284,867 1,407,728	6,779,492 1,341,512	6,315,077 1,407,046	6,271,273 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	36,985 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	1,459,787 3,284,314	1,533,192 3,250,551	1,474,461 3,386,837	1,355,579 3,360,806	1,287,303 3,508,953
Disproportionate-share hospital (DSH) Median	1,307,975 594,888	1,413,575 595,761	1,539,800 577,894	2,095,852 542,168	2,171,044 549,667
Outlier Median	4,077,508 582,572	3,833,267 538,116	446,971 212,434	522,319 126,559	596,035 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	10,203,191 3,662,910	10,875,700 3,730,911	11,864,217 4,081,319	17,066,884 4,643,908	22,113,358 4,389,147
Charity care Median	11,278,545 2,654,636	11,490,526 2,940,659	8,770,311 3,380,215	8,090,265 3,488,738	8,211,646 3,233,405
Uncompensated care (UCC) Median	21,523,102 5,147,790	25,520,458 5,337,617	19,717,235 5,711,082	18,622,671 5,923,418	21,276,726 5,508,107
UCC as a % of operating expenses Median	3.86% 3.24	4.41% 3.12	3.21% 3.21	2.98% 3.3	3.17% 2.86
Total shortfall/UCC Median	31,726,293 9,489,989	36,396,158 9,424,297	31,581,452 10,120,158	35,689,555 11,171,337	43,390,084 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	169,011,473 52,142,039	175,973,732 54,485,252	180,602,673 57,395,589	180,365,493 58,830,919	192,000,714 61,722,907
Salaries as a % of operating expenses Median	30.31 36.68	30.39 36.56	29.41 36.37	28.89 35.93	28.58 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	667,094 1,251,927	765,580 1,186,494	551,274 1,204,885	547,578 1,279,653	806,089 1,469,317
Contract adjusted salaries, direct-care Median	6,958,840 1,449,244	6,314,922 1,475,986	4,750,818 1,563,078	6,288,410 1,721,954	19,069,293 2,991,828
Contract hours, direct-care Median	111,013.00 22,725	92,324.00 23,018.5	67,350.50 24,503.48	104,807.00 25,026.5	194,438.00 33,786
Contract wages, direct-care Median	62.68 64.67	68.40 64.53	70.54 65.06	60.00 68.97	98.07 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.