As of the July, 2022, release via CMS

VCU HEALTH SYSTEM MCV HOSPITAL

CMS id: 490032
1250 EAST MARSHALL STREET, RICHMOND VA 23298. County: RICHMOND
System: VIRGINIA COMMONWEALTH UNIVERSITY HOS
CBSA: Richmond, VA

The 756-bed, acute-care hospital had $-47,988,317 in net service to patients*, with a total profit margin of 23.40065% in fiscal year 2021, the latest year available.
It spent 2.26% of its operating expenses on uncompensated care and reported $22,271,416 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	gov	gov	gov	gov	gov
Acute beds Median	531 118	500 118	502 119.5	482 118	499 119
Total beds Median	800 162	771 162	781 162	764 162	756 163.5
FTEs Median	7,702.12 788.06	7,288.72 793.42	8,179.68 806.03	8,833.45 787.61	7,448.99 804.34

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	1,550,104,452 150,932,746	1,663,673,329 158,950,878	1,708,618,040 168,696,998	1,576,398,502 163,454,693	1,778,042,572 186,589,412
Operating expenses Median	1,411,634,799 149,311,209	1,513,158,608 156,110,414	1,635,895,039 164,890,568	1,898,243,753 166,516,854	1,826,030,889 180,120,888
Net income from service 2 patients (NS2P) ? Median	138,469,653 -964,173	150,514,721 -643,601.5	72,723,001 -116,254	-321,845,251 -5,025,862	-47,988,317 -1,284,564
NS2P margin ? Median	8.93% -0.62	9.05% -0.29	4.26% 0.18	-20.42% -5.07	-2.70% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for VCU HEALTH SYSTEM MCV 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	134,987,357 5,089,215	92,241,198 4,572,541	127,688,358 5,268,134	164,992,597 13,092,619	605,829,849 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	91,793,970 299,524	53,731,556 188,688.5	66,384,313 370,813	36,263,058 309,361.5	409,303,877 375,329
⊳ 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	10,353	0	0	0
⊳ Line 12: Parking lot receipts	1,817,635	1,859,581	1,527,879	1,004,094	750,085
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	3,144,920	4,541,914	6,027,419	2,771,742	3,601,440
⊳ 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	25,973	11,416	56,762	40,232	53,026
⊳ Line 18: Revenue from sale of medical records and abstracts	91	297	2,655	550	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	170,201	135,883	174,974	60,131	10,930
⊳ 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	1,943,116	1,890,939	1,834,349	1,587,077	82,961
⊳ Line 23: Gov appropriations ? ⊳ Median	376,271 1,017,693	387,700 983,261.5	290,775 1,173,286	393,279 1,987,202	484,625 1,597,664
⊳ Sum Line 24	35,715,180	29,671,559	51,389,232	122,872,434	191,542,905
Total income ? Median	273,457,010 6,586,430	242,755,919 6,767,106	200,411,359 8,419,950	-156,852,654 8,094,175	557,841,532 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	273,457,010 6,043,842	242,755,919 5,845,112	200,411,359 7,606,259	-156,852,654 7,283,041	557,841,532 14,957,241
Net margin Median	16.22802% 4.62%	13.82504% 4.42%	10.91383% 5.16%	-9.00732% 5.2%	23.40065% 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 VCU HEALTH SYSTEM MCV 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	214,781,944 23,241,334	222,660,965 23,709,545	229,821,570 24,248,380	241,955,327 22,858,541	257,161,540 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	202,784,391 21,577,146	211,133,231 22,041,594	219,450,119 22,722,063	232,281,793 21,570,441	253,959,307 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	4,865,070 1,845,420	4,631,149 1,757,392	3,683,030 1,738,842	3,858,003 1,510,463	3,202,233 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	7,132,483 3,535,627	6,896,585 3,746,588	6,688,421 3,782,288	5,815,531 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	78,295,107 11,160,864	84,796,681 11,987,345	96,431,822 12,926,866	90,803,433 11,884,480	92,235,721 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	78,295,107 10,918,923	84,796,681 11,706,976	96,431,822 12,615,917	90,803,433 11,458,116	92,235,721 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	40,058,199 3,284,314	41,344,109 3,250,551	41,792,773 3,386,837	40,104,429 3,360,806	41,813,402 3,508,953
Disproportionate-share hospital (DSH) Median	5,254,441 594,888	5,415,285 595,761	5,712,681 577,894	6,523,198 542,168	5,958,864 549,667
Outlier Median	37,220,835 582,572	34,472,508 538,116	33,298,016 212,434	7,369,487 126,559	5,751,570 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	877,745 3,662,910	4,048,571 3,730,911	4,148,410 4,081,319	37,856,277 4,643,908	22,271,416 4,389,147
Charity care Median	106,597,886 2,654,636	103,695,976 2,940,659	93,698,081 3,380,215	23,562,003 3,488,738	25,019,416 3,233,405
Uncompensated care (UCC) Median	145,853,696 5,147,790	148,381,642 5,337,617	136,505,777 5,711,082	40,384,230 5,923,418	41,211,883 5,508,107
UCC as a % of operating expenses Median	10.33% 3.24	9.81% 3.12	8.34% 3.21	2.13% 3.3	2.26% 2.86
Total shortfall/UCC Median	146,731,441 9,489,989	152,430,213 9,424,297	140,654,187 10,120,158	78,240,507 11,171,337	63,483,299 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	477,037,599 52,142,039	495,751,313 54,485,252	536,113,175 57,395,589	606,411,992 58,830,919	517,525,353 61,722,907
Salaries as a % of operating expenses Median	33.79 36.68	32.76 36.56	32.77 36.37	31.95 35.93	28.34 35.24
Intern, resident salaries* Median	30,908,496 2,598,592	32,266,116 2,686,824	34,415,150 2,753,773	36,337,954 2,937,156	38,066,914 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	3,928,645 1,449,244	4,909,922 1,475,986	17,599,555 1,563,078	16,884,929 1,721,954	8,809,858 2,991,828
Contract hours, direct-care Median	61,761.90 22,725	78,505.22 23,018.5	283,578.60 24,503.48	271,135.55 25,026.5	144,940.00 33,786
Contract wages, direct-care Median	63.61 64.67	62.54 64.53	62.06 65.06	62.27 68.97	60.78 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.