As of the July, 2022, release via CMS

AUGUSTA MEDICAL CENTER

CMS id: 490018
78 MEDICAL CENTER DRIVE, FISHERSVILLE VA 22939. County: AUGUSTA
System: --
CBSA: Staunton, VA

The 256-bed, acute-care hospital had $39,751,076 in net service to patients*, with a total profit margin of 26.23013% in fiscal year 2021, the latest year available.
It spent 3.32% of its operating expenses on uncompensated care and reported $10,791,023 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	197 118	197 118	197 119.5	178 118	206 119
Total beds Median	242 162	242 162	242 162	229 162	256 163.5
FTEs Median	1,532.64 788.06	1,507.65 793.42	1,584.23 806.03	1,628.25 787.61	1,639.82 804.34

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	286,804,439 150,932,746	287,202,920 158,950,878	333,640,579 168,696,998	327,266,460 163,454,693	373,838,827 186,589,412
Operating expenses Median	254,287,000 149,311,209	257,170,913 156,110,414	291,249,890 164,890,568	300,757,934 166,516,854	334,087,751 180,120,888
Net income from service 2 patients (NS2P) ? Median	32,517,439 -964,173	30,032,007 -643,601.5	42,390,689 -116,254	26,508,526 -5,025,862	39,751,076 -1,284,564
NS2P margin ? Median	11.34% -0.62	10.46% -0.29	12.71% 0.18	8.10% -5.07	10.63% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for AUGUSTA 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	19,656,406 5,089,215	25,494,022 4,572,541	25,844,834 5,268,134	73,882,349 13,092,619	79,039,505 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	-455,333 199,009	-615,890 206,870.5	0 194,343	-407,667 249,496
⊳ Line 7: Investments ? ⊳ Median	19,589,413 299,524	22,447,552 188,688.5	23,918,950 370,813	0 309,361.5	18,800,736 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	7,648	2,339	3,901	0	8,776
⊳ 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	1,460,323	1,481,168	1,572,771	0	1,053,046
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	52,250	73,325	110,235	0	37,615
⊳ Line 17: Revenue from sale of drugs to other than patients	21,549	15,186	30,701	0	194,129
⊳ Line 18: Revenue from sale of medical records and abstracts	5,920	80	0	0	-5
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	39,370	46,060	45,388	0	61,448
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	26,533	24,913	24,356	0	19,779
⊳ Line 22: Rental of hospital space	0	0	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	-1,546,600	1,858,732	754,422	73,882,349	59,271,648
Total income ? Median	52,173,845 6,586,430	55,526,029 6,767,106	68,235,523 8,419,950	100,390,875 8,094,175	118,790,581 15,162,888
Non-operating expenses Median	1,632,593 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	50,541,252 6,043,842	55,526,029 5,845,112	68,235,523 7,606,259	100,390,875 7,283,041	118,790,581 14,957,241
Net margin Median	16.49191% 4.62%	17.75714% 4.42%	18.98144% 5.16%	25.02584% 5.2%	26.23013% 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 AUGUSTA 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	55,466,365 23,241,334	56,367,787 23,709,545	55,799,543 24,248,380	49,024,393 22,858,541	46,687,891 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	51,602,024 21,577,146	53,152,801 22,041,594	51,859,888 22,722,063	45,502,387 21,570,441	43,161,761 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	1,075,783 1,845,420	597,850 1,757,392	898,573 1,738,842	557,111 1,510,463	845,208 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	1,588,617 3,535,627	1,409,544 3,746,588	1,329,571 3,782,288	1,136,359 3,865,578	781,857 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	1,199,941 1,203,033	1,207,592 1,215,295	1,711,511 1,313,657	1,828,536 1,365,298	1,899,065 1,179,746
All outpatient revenue Median Click here to show/hide details	49,686,628 11,160,864	59,829,476 11,987,345	57,373,281 12,926,866	51,607,268 11,884,480	53,709,734 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	47,204,531 10,918,923	56,928,652 11,706,976	54,546,663 12,615,917	48,896,359 11,458,116	51,257,617 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,482,097 1,282,808	2,900,824 1,407,728	2,826,618 1,341,512	2,710,909 1,407,046	2,452,117 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	487,827 594,888	499,918 595,761	921,350 577,894	992,709 542,168	1,030,052 549,667
Outlier Median	2,255,821 582,572	1,706,049 538,116	628,703 212,434	371,882 126,559	351,791 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	308,689 3,662,910	757,714 3,730,911	224,933 4,081,319	7,358,563 4,643,908	10,791,023 4,389,147
Charity care Median	16,143,163 2,654,636	9,662,057 2,940,659	8,341,462 3,380,215	8,145,222 3,488,738	7,603,245 3,233,405
Uncompensated care (UCC) Median	18,726,566 5,147,790	13,920,255 5,337,617	12,551,505 5,711,082	11,958,322 5,923,418	11,102,322 5,508,107
UCC as a % of operating expenses Median	7.36% 3.24	5.41% 3.12	4.31% 3.21	3.98% 3.3	3.32% 2.86
Total shortfall/UCC Median	19,035,255 9,489,989	14,677,969 9,424,297	12,776,438 10,120,158	19,316,885 11,171,337	21,893,345 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	94,904,220 52,142,039	96,587,595 54,485,252	106,462,128 57,395,589	113,070,904 58,830,919	122,743,941 61,722,907
Salaries as a % of operating expenses Median	37.32 36.68	37.56 36.56	36.55 36.37	37.60 35.93	36.74 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	2,858,955 1,449,244	1,970,983 1,475,986	5,574,943 1,563,078	5,172,626 1,721,954	9,129,562 2,991,828
Contract hours, direct-care Median	39,814.00 22,725	28,748.72 23,018.5	81,953.75 24,503.48	73,218.31 25,026.5	95,331.13 33,786
Contract wages, direct-care Median	71.81 64.67	68.56 64.53	68.03 65.06	70.65 68.97	95.77 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.