As of the July, 2022, release via CMS

LEWIS GALE MEDICAL CENTER

CMS id: 490048
1900 ELECTRIC ROAD, SALEM VA 24153. County: SALEM CITY
System: HCA
CBSA: Roanoke, VA

The 373-bed, acute-care hospital had $53,776,924 in net service to patients*, with a total profit margin of 20.30159% in fiscal year 2021, the latest year available.
It spent 2.38% of its operating expenses on uncompensated care and reported $4,218 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	294 118	294 118	294 119.5	294 118	296 119
Total beds Median	365 162	365 162	365 162	365 162	373 163.5
FTEs Median	1,112.09 788.06	1,135.47 793.42	1,128.70 806.03	1,096.48 787.61	1,168.71 804.34

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	301,908,831 150,932,746	320,514,139 158,950,878	337,013,197 168,696,998	356,484,632 163,454,693	389,211,528 186,589,412
Operating expenses Median	290,197,985 149,311,209	289,530,596 156,110,414	296,737,473 164,890,568	311,012,879 166,516,854	335,434,604 180,120,888
Net income from service 2 patients (NS2P) ? Median	11,710,846 -964,173	30,983,543 -643,601.5	40,275,724 -116,254	45,471,753 -5,025,862	53,776,924 -1,284,564
NS2P margin ? Median	3.88% -0.62	9.67% -0.29	11.95% 0.18	12.76% -5.07	13.82% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for LEWIS GALE 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	23,632,232 5,089,215	18,475,969 4,572,541	23,434,194 5,268,134	26,368,721 13,092,619	31,668,385 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	0 299,524	0 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ 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	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	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	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	0	0	0	0	0
⊳ 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	23,632,232	18,475,969	23,434,194	26,368,721	31,668,385
Total income ? Median	35,343,078 6,586,430	49,459,512 6,767,106	63,709,918 8,419,950	71,840,474 8,094,175	85,445,309 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	35,343,078 6,043,842	49,459,512 5,845,112	63,709,918 7,606,259	71,840,474 7,283,041	85,445,309 14,957,241
Net margin Median	10.85672% 4.62%	14.59025% 4.42%	17.67523% 5.16%	18.76449% 5.2%	20.30159% 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 LEWIS GALE 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	78,568,068 23,241,334	79,566,457 23,709,545	84,562,771 24,248,380	84,739,535 22,858,541	83,589,434 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	67,436,038 21,577,146	70,058,075 22,041,594	75,493,306 22,722,063	77,148,726 21,570,441	74,876,785 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	0 1,845,420	0 1,757,392	0 1,738,842	0 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	11,132,030 3,535,627	9,508,382 3,746,588	9,069,465 3,782,288	7,590,809 3,865,578	8,712,649 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	28,516,885 11,160,864	32,027,462 11,987,345	31,279,834 12,926,866	34,292,195 11,884,480	34,512,420 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	28,516,885 10,918,923	32,027,462 11,706,976	31,279,834 12,615,917	34,292,195 11,458,116	34,512,420 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	677,470 3,284,314	3,666,821 3,250,551	6,847,912 3,386,837	9,725,058 3,360,806	12,564,219 3,508,953
Disproportionate-share hospital (DSH) Median	992,984 594,888	1,034,114 595,761	2,080,202 577,894	2,123,407 542,168	1,655,101 549,667
Outlier Median	2,902,803 582,572	3,243,410 538,116	687,564 212,434	583,655 126,559	490,434 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,787 3,662,910	1,935 3,730,911	0 4,081,319	523 4,643,908	4,218 4,389,147
Charity care Median	9,960,000 2,654,636	11,401,581 2,940,659	8,533,511 3,380,215	5,928,409 3,488,738	6,536,113 3,233,405
Uncompensated care (UCC) Median	12,085,341 5,147,790	13,621,042 5,337,617	10,649,431 5,711,082	7,753,325 5,923,418	7,985,499 5,508,107
UCC as a % of operating expenses Median	4.16% 3.24	4.70% 3.12	3.59% 3.21	2.49% 3.3	2.38% 2.86
Total shortfall/UCC Median	12,087,128 9,489,989	13,622,977 9,424,297	10,649,431 10,120,158	7,753,848 11,171,337	7,989,717 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	74,601,777 52,142,039	77,244,081 54,485,252	78,821,577 57,395,589	77,983,555 58,830,919	85,483,685 61,722,907
Salaries as a % of operating expenses Median	27.87 36.68	28.36 36.56	28.70 36.37	27.26 35.93	27.96 35.24
Intern, resident salaries* Median	418,083 2,598,592	1,645,865 2,686,824	3,222,180 2,753,773	4,581,027 2,937,156	6,308,856 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	8,728,344 1,449,244	8,431,620 1,475,986	8,524,702 1,563,078	11,568,671 1,721,954	0 2,991,828
Contract hours, direct-care Median	138,295.00 22,725	135,434.00 23,018.5	141,588.00 24,503.48	166,991.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	63.11 64.67	62.26 64.53	60.21 65.06	69.28 68.97	0.00 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.