As of the July, 2022, release via CMS

CARILION MEDICAL CENTER

CMS id: 490024
BELLEVUE AVE. AT JEFFERSON ST., ROANOKE VA 24033. County: ROANOKE
System: --
CBSA: Roanoke, VA

The 722-bed, acute-care hospital had $-67,725,591 in net service to patients*, with a total profit margin of 18.13770% in fiscal year 2021, the latest year available.
It spent 1.70% of its operating expenses on uncompensated care and reported $41,199 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	486 118	486 118	485 119.5	486 118	486 119
Total beds Median	722 162	719 162	715 162	722 162	722 163.5
FTEs Median	6,324.91 788.06	6,540.28 793.42	6,694.33 806.03	6,634.32 787.61	6,860.92 804.34

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	1,160,710,222 150,932,746	1,206,366,921 158,950,878	1,314,032,787 168,696,998	1,248,207,234 163,454,693	1,418,340,254 186,589,412
Operating expenses Median	1,166,788,527 149,311,209	1,214,454,914 156,110,414	1,292,972,535 164,890,568	1,303,370,215 166,516,854	1,486,065,845 180,120,888
Net income from service 2 patients (NS2P) ? Median	-6,078,305 -964,173	-8,087,993 -643,601.5	21,060,252 -116,254	-55,162,981 -5,025,862	-67,725,591 -1,284,564
NS2P margin ? Median	-0.52% -0.62	-0.67% -0.29	1.60% 0.18	-4.42% -5.07	-4.77% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CARILION 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	145,694,270 5,089,215	119,407,050 4,572,541	62,113,047 5,268,134	127,824,672 13,092,619	396,983,654 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	8,406,394 224,999	10,205,328 199,009	11,028,909 206,870.5	8,573,550 194,343	8,259,842 249,496
⊳ Line 7: Investments ? ⊳ Median	71,439,826 299,524	43,680,264 188,688.5	-7,412,612 370,813	23,037,829 309,361.5	267,058,762 375,329
⊳ 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	25	25	1,040	370	115
⊳ 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	8,176,335	8,673,836	8,194,576	38,610,407	46,748,753
⊳ Line 18: Revenue from sale of medical records and abstracts	3,132	1,273	4,950	2,137	2,671
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	25,080,142	26,327,653	20,971,087	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	163,064	171,309	170,597	144,840	139,488
⊳ Line 22: Rental of hospital space	1,734,891	1,747,475	2,798,211	5,153,852	5,487,908
⊳ 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	28,469,361	26,584,413	24,653,403	50,764,623	67,609,385
Total income ? Median	139,615,965 6,586,430	111,319,057 6,767,106	83,173,299 8,419,950	72,661,691 8,094,175	329,258,063 15,162,888
Non-operating expenses Median	3 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	139,615,962 6,043,842	111,319,057 5,845,112	83,173,299 7,606,259	72,661,691 7,283,041	329,258,063 14,957,241
Net margin Median	10.68704% 4.62%	8.39653% 4.42%	6.04393% 5.16%	5.28052% 5.2%	18.13770% 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 CARILION 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	188,345,707 23,241,334	198,261,201 23,709,545	193,898,296 24,248,380	172,818,155 22,858,541	164,651,588 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	181,490,494 21,577,146	190,321,231 22,041,594	184,870,402 22,722,063	164,619,328 21,570,441	156,585,723 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	2,174,413 1,845,420	2,475,552 1,757,392	1,733,249 1,738,842	1,838,770 1,510,463	1,229,485 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	4,680,800 3,535,627	5,464,418 3,746,588	7,294,645 3,782,288	6,360,057 3,865,578	6,836,380 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	76,856,515 11,160,864	87,608,562 11,987,345	89,768,873 12,926,866	79,609,548 11,884,480	90,205,471 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	71,637,572 10,918,923	80,937,521 11,706,976	82,729,529 12,615,917	73,208,591 11,458,116	84,052,418 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	5,218,943 1,282,808	6,671,041 1,407,728	7,039,344 1,341,512	6,400,957 1,407,046	6,153,053 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	17,398,027 3,284,314	18,119,943 3,250,551	17,463,501 3,386,837	16,305,457 3,360,806	16,244,597 3,508,953
Disproportionate-share hospital (DSH) Median	5,040,025 594,888	5,447,353 595,761	5,368,036 577,894	5,232,004 542,168	4,603,977 549,667
Outlier Median	10,501,934 582,572	9,538,139 538,116	3,948,935 212,434	2,386,975 126,559	2,460,412 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	7,449,725 3,662,910	9,941,318 3,730,911	0 4,081,319	0 4,643,908	41,199 4,389,147
Charity care Median	26,654,880 2,654,636	37,670,181 2,940,659	21,388,659 3,380,215	12,997,787 3,488,738	10,896,753 3,233,405
Uncompensated care (UCC) Median	42,496,072 5,147,790	56,173,203 5,337,617	39,147,317 5,711,082	31,891,725 5,923,418	25,232,281 5,508,107
UCC as a % of operating expenses Median	3.64% 3.24	4.63% 3.12	3.03% 3.21	2.45% 3.3	1.70% 2.86
Total shortfall/UCC Median	49,945,797 9,489,989	66,114,521 9,424,297	39,147,317 10,120,158	31,891,725 11,171,337	25,273,480 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	483,330,190 52,142,039	516,312,256 54,485,252	536,870,929 57,395,589	520,535,092 58,830,919	583,747,804 61,722,907
Salaries as a % of operating expenses Median	41.42 36.68	42.51 36.56	41.52 36.37	39.94 35.93	39.28 35.24
Intern, resident salaries* Median	14,118,975 2,598,592	15,226,504 2,686,824	16,849,496 2,753,773	17,510,349 2,937,156	18,389,275 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	13,718,659 1,449,244	14,286,417 1,475,986	12,376,977 1,563,078	12,026,496 1,721,954	28,843,000 2,991,828
Contract hours, direct-care Median	203,790.00 22,725	203,067.00 23,018.5	188,551.00 24,503.48	178,628.00 25,026.5	330,356.00 33,786
Contract wages, direct-care Median	67.32 64.67	70.35 64.53	65.64 65.06	67.33 68.97	87.31 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.