As of the July, 2022, release via CMS

CARILION NEW RIVER VALLEY MED CENTER

CMS id: 490042
2900 LAMB CIRCLE, CHRISTIANSBURG VA 24073. County: MONTGOMERY
System: --
CBSA: Blacksburg-Christiansburg, VA

The 130-bed, acute-care hospital had $21,371,630 in net service to patients*, with a total profit margin of 30.14936% in fiscal year 2021, the latest year available.
It spent 2.12% of its operating expenses on uncompensated care and reported $0 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	98 118	98 118	98 119.5	82 118	82 119
Total beds Median	146 162	146 162	146 162	130 162	130 163.5
FTEs Median	913.75 788.06	932.31 793.42	947.38 806.03	1,001.23 787.61	1,050.09 804.34

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	192,988,079 150,932,746	208,810,375 158,950,878	232,410,756 168,696,998	211,792,012 163,454,693	247,034,962 186,589,412
Operating expenses Median	174,082,144 149,311,209	177,274,926 156,110,414	192,770,561 164,890,568	201,781,744 166,516,854	225,663,332 180,120,888
Net income from service 2 patients (NS2P) ? Median	18,905,935 -964,173	31,535,449 -643,601.5	39,640,195 -116,254	10,010,268 -5,025,862	21,371,630 -1,284,564
NS2P margin ? Median	9.80% -0.62	15.10% -0.29	17.06% 0.18	4.73% -5.07	8.65% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CARILION NEW RIVER VALLEY MED 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	27,862,263 5,089,215	18,895,451 4,572,541	6,293,475 5,268,134	13,932,739 13,092,619	78,907,005 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	24,424,130 299,524	16,295,971 188,688.5	3,143,559 370,813	3,737,734 309,361.5	59,272,520 375,329
⊳ 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	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	143,444	137,772	149,459	91,470	54,532
⊳ 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	0
⊳ Line 18: Revenue from sale of medical records and abstracts	335	70	323	16	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	34,203	29,999	31,552	24,459	18,585
⊳ Line 22: Rental of hospital space	1,109,389	1,157,789	1,294,275	1,262,890	1,265,699
⊳ 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	2,150,762	1,273,850	1,674,307	8,816,170	18,295,669
Total income ? Median	46,768,198 6,586,430	50,430,900 6,767,106	45,933,670 8,419,950	23,943,007 8,094,175	100,278,635 15,162,888
Non-operating expenses Median	1,831,839 146,289.5	1,449,767 164,857	523,530 89,880.5	1,567,444 106,761	2,009,229 31,473.5
Net income Median	44,936,359 6,043,842	48,981,133 5,845,112	45,410,140 7,606,259	22,375,563 7,283,041	98,269,406 14,957,241
Net margin Median	20.34697% 4.62%	21.51071% 4.42%	19.02360% 5.16%	9.91276% 5.2%	30.14936% 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 NEW RIVER VALLEY MED 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	24,202,597 23,241,334	26,738,875 23,709,545	25,192,668 24,248,380	23,203,196 22,858,541	23,591,829 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	22,528,172 21,577,146	24,480,439 22,041,594	23,460,721 22,722,063	22,008,706 21,570,441	22,764,594 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	1,674,425 1,845,420	2,258,436 1,757,392	1,731,947 1,738,842	1,194,490 1,510,463	827,235 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	17,665,841 11,160,864	21,116,408 11,987,345	23,578,847 12,926,866	21,728,252 11,884,480	23,540,036 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	14,743,449 10,918,923	17,811,767 11,706,976	20,280,528 12,615,917	18,738,150 11,458,116	20,396,557 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	2,922,392 1,282,808	3,304,641 1,407,728	3,298,319 1,341,512	2,990,102 1,407,046	3,143,479 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	339,036 594,888	370,794 595,761	321,335 577,894	319,169 542,168	282,603 549,667
Outlier Median	596,053 582,572	478,351 538,116	374,660 212,434	311,018 126,559	475,715 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,076,157 3,662,910	538,490 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	6,823,179 2,654,636	8,759,131 2,940,659	4,671,306 3,380,215	2,338,042 3,488,738	2,049,481 3,233,405
Uncompensated care (UCC) Median	10,589,768 5,147,790	13,359,269 5,337,617	9,090,831 5,711,082	6,546,715 5,923,418	4,773,314 5,508,107
UCC as a % of operating expenses Median	6.08% 3.24	7.54% 3.12	4.72% 3.21	3.24% 3.3	2.12% 2.86
Total shortfall/UCC Median	11,665,925 9,489,989	13,897,759 9,424,297	9,090,831 10,120,158	6,546,715 11,171,337	4,773,314 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	52,843,742 52,142,039	54,111,850 54,485,252	56,788,183 57,395,589	59,743,580 58,830,919	63,998,488 61,722,907
Salaries as a % of operating expenses Median	30.36 36.68	30.52 36.56	29.46 36.37	29.61 35.93	28.36 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	1,068,422 1,449,244	28,958 1,475,986	1,002,648 1,563,078	2,258,586 1,721,954	4,661,018 2,991,828
Contract hours, direct-care Median	17,316.75 22,725	456.00 23,018.5	16,934.00 24,503.48	35,665.00 25,026.5	58,603.00 33,786
Contract wages, direct-care Median	61.70 64.67	63.50 64.53	59.21 65.06	63.33 68.97	79.54 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.