As of the July, 2022, release via CMS

ST. JOHN MEDICAL CENTER

CMS id: 500041
1615 DELAWARE STREET, LONGVIEW WA 98632. County: COWLITZ
System: PEACEHEALTH
CBSA: Longview, WA

The 158-bed, acute-care hospital had $-9,022,998 in net service to patients*, with a total profit margin of 2.05894% in fiscal year 2021, the latest year available.
It spent 3.40% of its operating expenses on uncompensated care and reported $17,595,864 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	148 118	148 118	148 119.5	148 118	140 119
Total beds Median	166 162	166 162	166 162	166 162	158 163.5
FTEs Median	1,110.96 788.06	1,273.89 793.42	1,283.34 806.03	1,251.42 787.61	1,235.00 804.34

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	251,347,231 150,932,746	254,003,302 158,950,878	276,991,891 168,696,998	268,079,466 163,454,693	292,788,454 186,589,412
Operating expenses Median	257,036,537 149,311,209	266,438,064 156,110,414	281,182,202 164,890,568	287,501,249 166,516,854	301,811,452 180,120,888
Net income from service 2 patients (NS2P) ? Median	-5,689,306 -964,173	-12,434,762 -643,601.5	-4,190,311 -116,254	-19,421,783 -5,025,862	-9,022,998 -1,284,564
NS2P margin ? Median	-2.26% -0.62	-4.90% -0.29	-1.51% 0.18	-7.24% -5.07	-3.08% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ST. JOHN 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	18,265,643 5,089,215	-108,537,170 4,572,541	15,389,619 5,268,134	27,724,903 13,092,619	15,367,764 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	546,121 224,999	327,710 199,009	-233,603 206,870.5	180,524 194,343	434,735 249,496
⊳ Line 7: Investments ? ⊳ Median	12,940,002 299,524	47,829 188,688.5	38,951 370,813	33,735 309,361.5	39,217 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	-1,970	5,550	-6,679	-42	0
⊳ Line 11: Rebates and refunds of expenses	257,422	251,293	245,612	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	840,986	906,124	1,018,270	931,686	845,794
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	9,490	4,896	2,508	97,491	0
⊳ Line 17: Revenue from sale of drugs to other than patients	2,683,422	4,010,627	3,496,691	4,365,036	9,808,437
⊳ Line 18: Revenue from sale of medical records and abstracts	-1,802	0	935	0	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	159,939	110,326	771	816	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	11,045	9,741	8,613	12,643	4,134
⊳ Line 22: Rental of hospital space	171,283	216,641	183,331	470,906	501,193
⊳ Line 23: Gov appropriations ? ⊳ Median	23,172 1,017,693	22,574 983,261.5	156,239 1,173,286	6,242,688 1,987,202	0 1,597,664
⊳ Sum Line 24	626,533	-114,450,481	10,477,980	15,389,420	3,734,254
Total income ? Median	12,576,337 6,586,430	-120,971,932 6,767,106	11,199,308 8,419,950	8,303,120 8,094,175	6,344,766 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	2 106,761	0 31,473.5
Net income Median	12,576,337 6,043,842	-120,971,932 5,845,112	11,199,308 7,606,259	8,303,118 7,283,041	6,344,766 14,957,241
Net margin Median	4.66459% 4.62%	-83.16158% 4.42%	3.83037% 5.16%	2.80696% 5.2%	2.05894% 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 ST. JOHN 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	30,492,381 23,241,334	30,202,564 23,709,545	29,042,559 24,248,380	25,493,106 22,858,541	22,663,776 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	30,492,381 21,577,146	30,202,564 22,041,594	29,042,559 22,722,063	25,493,106 21,570,441	22,663,776 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	25,191,096 11,160,864	27,877,861 11,987,345	30,570,752 12,926,866	29,891,352 11,884,480	30,250,838 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	25,191,096 10,918,923	27,877,861 11,706,976	30,570,752 12,615,917	29,891,352 11,458,116	30,250,838 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	0 3,508,953
Disproportionate-share hospital (DSH) Median	1,254,249 594,888	1,374,093 595,761	1,375,510 577,894	1,020,208 542,168	1,090,257 549,667
Outlier Median	2,152,733 582,572	1,515,405 538,116	2,212,714 212,434	1,538,412 126,559	726,850 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	20,705,105 3,662,910	23,993,293 3,730,911	19,514,727 4,081,319	19,635,891 4,643,908	17,595,864 4,389,147
Charity care Median	3,866,043 2,654,636	4,349,903 2,940,659	7,848,854 3,380,215	8,394,420 3,488,738	8,230,998 3,233,405
Uncompensated care (UCC) Median	6,332,977 5,147,790	7,387,793 5,337,617	10,289,568 5,711,082	10,423,553 5,923,418	10,270,658 5,508,107
UCC as a % of operating expenses Median	2.46% 3.24	2.77% 3.12	3.66% 3.21	3.63% 3.3	3.40% 2.86
Total shortfall/UCC Median	27,038,082 9,489,989	31,381,086 9,424,297	29,804,295 10,120,158	30,059,444 11,171,337	27,866,522 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	107,853,598 52,142,039	117,665,825 54,485,252	120,536,617 57,395,589	123,056,733 58,830,919	122,822,508 61,722,907
Salaries as a % of operating expenses Median	41.96 36.68	44.16 36.56	42.87 36.37	42.80 35.93	40.70 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	3,239,930 1,449,244	642,984 1,475,986	628,393 1,563,078	1,217,441 1,721,954	1,217,441 2,991,828
Contract hours, direct-care Median	43,917.00 22,725	7,631.69 23,018.5	7,041.45 24,503.48	13,012.24 25,026.5	13,012.24 33,786
Contract wages, direct-care Median	73.77 64.67	84.25 64.53	89.24 65.06	93.56 68.97	93.56 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.