As of the July, 2022, release via CMS

BUCHANAN GENERAL HOSPITAL

CMS id: 490127
1535 SLATE CREEK ROAD, GRUNDY VA 24614. County: BUCHANAN
System: --
CBSA: Rural Virginia

The 49-bed, acute-care hospital had $-5,182,100 in net service to patients*, with a total profit margin of 10.28118% in fiscal year 2021, the latest year available.
It spent 2.34% of its operating expenses on uncompensated care and reported $876,942 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	37 118	37 118	37 119.5	37 118	37 119
Total beds Median	49 162	49 162	49 162	49 162	49 163.5
FTEs Median	220.16 788.06	215.36 793.42	209.27 806.03	203.18 787.61	202.35 804.34

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	23,938,551 150,932,746	22,789,812 158,950,878	23,203,956 168,696,998	20,801,831 163,454,693	21,062,251 186,589,412
Operating expenses Median	24,968,659 149,311,209	24,521,825 156,110,414	25,173,058 164,890,568	26,670,763 166,516,854	26,244,351 180,120,888
Net income from service 2 patients (NS2P) ? Median	-1,030,108 -964,173	-1,732,013 -643,601.5	-1,969,102 -116,254	-5,868,932 -5,025,862	-5,182,100 -1,284,564
NS2P margin ? Median	-4.30% -0.62	-7.60% -0.29	-8.49% 0.18	-28.21% -5.07	-24.60% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for BUCHANAN GENERAL 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	1,052,461 5,089,215	1,311,741 4,572,541	690,800 5,268,134	2,546,225 13,092,619	8,189,529 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	179,407 299,524	827,661 188,688.5	230,147 370,813	234,656 309,361.5	3,393,665 375,329
⊳ 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	1,908	1,047	98	95	31
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	20	306	20	36	29
⊳ Line 14: Revenue from meals sold to emplyees and guests	277,621	250,370	221,940	264,335	199,918
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	3,660	1,993	2,907	2,490	2,753
⊳ 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	15,072	17,019	15,885	15,687	16,549
⊳ 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	3,038	2,569	2,088	1,517	718
⊳ 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	571,735	210,776	217,715	2,027,409	4,575,866
Total income ? Median	22,353 6,586,430	-420,272 6,767,106	-1,278,302 8,419,950	-3,322,707 8,094,175	3,007,429 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	22,353 6,043,842	-420,272 5,845,112	-1,278,302 7,606,259	-3,322,707 7,283,041	3,007,429 14,957,241
Net margin Median	0.08944% 4.62%	-1.74375% 4.42%	-5.34972% 5.16%	-14.23119% 5.2%	10.28118% 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 BUCHANAN GENERAL 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	4,294,280 23,241,334	4,394,808 23,709,545	3,731,080 24,248,380	3,483,163 22,858,541	2,595,776 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	4,294,280 21,577,146	4,394,808 22,041,594	3,731,080 22,722,063	3,483,163 21,570,441	2,595,776 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	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	3,179,998 11,160,864	2,872,725 11,987,345	2,689,907 12,926,866	2,308,665 11,884,480	2,396,538 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	2,829,429 10,918,923	2,588,759 11,706,976	2,381,029 12,615,917	1,964,903 11,458,116	1,974,915 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	350,569 1,282,808	283,966 1,407,728	308,878 1,341,512	343,762 1,407,046	421,623 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	32,364 594,888	50,642 595,761	30,339 577,894	38,236 542,168	29,228 549,667
Outlier Median	44,560 582,572	62,047 538,116	86,922 212,434	8,395 126,559	7,476 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,250,370 3,662,910	1,259,823 3,730,911	1,236,201 4,081,319	2,537,662 4,643,908	876,942 4,389,147
Charity care Median	657,450 2,654,636	740,467 2,940,659	449,945 3,380,215	112,119 3,488,738	166,133 3,233,405
Uncompensated care (UCC) Median	1,839,246 5,147,790	1,707,057 5,337,617	1,404,504 5,711,082	852,887 5,923,418	614,899 5,508,107
UCC as a % of operating expenses Median	7.37% 3.24	6.96% 3.12	5.58% 3.21	3.20% 3.3	2.34% 2.86
Total shortfall/UCC Median	3,089,616 9,489,989	2,966,880 9,424,297	2,640,705 10,120,158	3,390,549 11,171,337	1,491,841 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	9,853,441 52,142,039	10,015,175 54,485,252	10,065,438 57,395,589	10,046,890 58,830,919	10,188,408 61,722,907
Salaries as a % of operating expenses Median	39.46 36.68	40.84 36.56	39.98 36.37	37.66 35.93	38.82 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	46,685 1,449,244	0 1,475,986	153,397 1,563,078	139,207 1,721,954	77,298 2,991,828
Contract hours, direct-care Median	820.00 22,725	0.00 23,018.5	2,302.00 24,503.48	2,078.00 25,026.5	1,257.00 33,786
Contract wages, direct-care Median	56.93 64.67	0.00 64.53	66.64 65.06	66.99 68.97	61.49 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.