As of the July, 2022, release via CMS

LEWISGALEHOSPITAL - ALLEGHANY

CMS id: 490126
1 ARH LANE, LOW MOOR VA 24457. County: ALLEGHANY
System: HCA
CBSA: Rural Virginia

The 110-bed, acute-care hospital had $1,986,418 in net service to patients*, with a total profit margin of 5.72066% in fiscal year 2021, the latest year available.
It spent 3.82% of its operating expenses on uncompensated care and reported $3,032,630 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	85 118	85 118	85 119.5	85 118	85 119
Total beds Median	110 162	110 162	110 162	110 162	110 163.5
FTEs Median	202.97 788.06	196.68 793.42	1,497.00 806.03	177.98 787.61	158.23 804.34

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	40,972,670 150,932,746	38,843,897 158,950,878	39,181,332 168,696,998	39,483,640 163,454,693	33,341,499 186,589,412
Operating expenses Median	36,826,334 149,311,209	36,217,065 156,110,414	35,765,268 164,890,568	36,714,272 166,516,854	31,355,081 180,120,888
Net income from service 2 patients (NS2P) ? Median	4,146,336 -964,173	2,626,832 -643,601.5	3,416,064 -116,254	2,769,368 -5,025,862	1,986,418 -1,284,564
NS2P margin ? Median	10.12% -0.62	6.76% -0.29	8.72% 0.18	7.01% -5.07	5.96% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for LEWISGALEHOSPITAL - ALLEGHANY 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	521,674 5,089,215	560,094 4,572,541	457,401 5,268,134	163,466 13,092,619	139,032 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	521,674	560,094	457,401	163,466	139,032
Total income ? Median	4,668,010 6,586,430	3,186,926 6,767,106	3,873,465 8,419,950	2,932,834 8,094,175	2,125,450 15,162,888
Non-operating expenses Median	1,427,742 146,289.5	783,789 164,857	730,459 89,880.5	210,141 106,761	210,141 31,473.5
Net income Median	3,240,268 6,043,842	2,403,137 5,845,112	3,143,006 7,606,259	2,722,693 7,283,041	1,915,309 14,957,241
Net margin Median	7.80894% 4.62%	6.09871% 4.42%	7.92913% 5.16%	6.86732% 5.2%	5.72066% 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 LEWISGALEHOSPITAL - ALLEGHANY 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	10,760,999 23,241,334	11,202,414 23,709,545	11,083,190 24,248,380	10,309,396 22,858,541	9,586,434 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	8,941,681 21,577,146	8,842,753 22,041,594	8,338,693 22,722,063	7,545,899 21,570,441	7,100,394 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	1,819,318 1,845,420	2,359,661 1,757,392	2,744,497 1,738,842	2,763,497 1,510,463	2,486,040 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	4,815,420 11,160,864	4,767,350 11,987,345	4,886,346 12,926,866	5,248,251 11,884,480	3,883,524 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	4,815,420 10,918,923	4,767,350 11,706,976	4,886,346 12,615,917	5,248,251 11,458,116	3,883,524 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	0 3,284,314	0 3,250,551	0 3,386,837	0 3,360,806	669 3,508,953
Disproportionate-share hospital (DSH) Median	0 594,888	0 595,761	0 577,894	40,742 542,168	47,871 549,667
Outlier Median	298,312 582,572	260,756 538,116	77,798 212,434	53,962 126,559	13,062 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	995,153 3,662,910	1,055,775 3,730,911	1,015,800 4,081,319	1,633,429 4,643,908	3,032,630 4,389,147
Charity care Median	304,162 2,654,636	1,328,412 2,940,659	1,571,527 3,380,215	946,199 3,488,738	792,589 3,233,405
Uncompensated care (UCC) Median	905,524 5,147,790	1,882,588 5,337,617	2,117,433 5,711,082	1,489,573 5,923,418	1,198,594 5,508,107
UCC as a % of operating expenses Median	2.46% 3.24	5.20% 3.12	5.92% 3.21	4.06% 3.3	3.82% 2.86
Total shortfall/UCC Median	1,900,677 9,489,989	2,938,363 9,424,297	3,133,233 10,120,158	3,123,002 11,171,337	4,231,224 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	12,561,638 52,142,039	12,591,638 54,485,252	12,161,312 57,395,589	12,248,763 58,830,919	11,065,766 61,722,907
Salaries as a % of operating expenses Median	32.83 36.68	34.01 36.56	33.31 36.37	32.88 35.93	34.72 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	856,486 1,449,244	551,549 1,475,986	478,835 1,563,078	576,785 1,721,954	203,112 2,991,828
Contract hours, direct-care Median	18,499.00 22,725	10,952.00 23,018.5	8,977.00 24,503.48	9,064.75 25,026.5	3,273.41 33,786
Contract wages, direct-care Median	46.30 64.67	50.36 64.53	53.34 65.06	63.63 68.97	62.05 88.94

* in an approved program

Return to top

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.