As of the July, 2022, release via CMS

CASCADE VALLEY HOSPITAL

CMS id: 500060
330 S. STILLAGUAMISH AVE., ARLINGTON WA 98223. County: SNOHOMISH
System: SKAGIT REGIONAL HEALTH
CBSA: Seattle-Tacoma-Bellevue, WA

The 48-bed, acute-care hospital had $14,460,803 in net service to patients*, with a total profit margin of 23.35052% in fiscal year 2021, the latest year available.
It spent 4.63% of its operating expenses on uncompensated care and reported $3,358,353 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	gov	gov	gov	gov	gov
Acute beds Median	42 118	42 118	42 119.5	42 118	42 119
Total beds Median	48 162	48 162	48 162	48 162	48 163.5
FTEs Median	266.46 788.06	257.58 793.42	277.28 806.03	259.85 787.61	243.72 804.34

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	43,967,741 150,932,746	51,731,588 158,950,878	61,441,273 168,696,998	58,602,246 163,454,693	68,024,088 186,589,412
Operating expenses Median	44,573,179 149,311,209	44,663,343 156,110,414	48,359,613 164,890,568	47,685,200 166,516,854	53,563,285 180,120,888
Net income from service 2 patients (NS2P) ? Median	-605,438 -964,173	7,068,245 -643,601.5	13,081,660 -116,254	10,917,046 -5,025,862	14,460,803 -1,284,564
NS2P margin ? Median	-1.38% -0.62	13.66% -0.29	21.29% 0.18	18.63% -5.07	21.26% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CASCADE VALLEY 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	8,770,570 5,089,215	2,841,255 4,572,541	3,164,186 5,268,134	5,084,054 13,092,619	1,856,735 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	12,626 224,999	15,338 199,009	18,659 206,870.5	20,820 194,343	22,799 249,496
⊳ Line 7: Investments ? ⊳ Median	305,776 299,524	2,536,351 188,688.5	2,923,148 370,813	1,616,477 309,361.5	1,149,908 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	8,171	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	260,128	265,011	211,790	12,980	19,280
⊳ 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	786	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	8,183,083	24,555	10,589	3,433,777	664,748
Total income ? Median	8,165,132 6,586,430	9,909,500 6,767,106	16,245,846 8,419,950	16,001,100 8,094,175	16,317,538 15,162,888
Non-operating expenses Median	16 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	8,165,116 6,043,842	9,909,500 5,845,112	16,245,846 7,606,259	16,001,100 7,283,041	16,317,538 14,957,241
Net margin Median	15.48232% 4.62%	18.15830% 4.42%	25.14624% 5.16%	25.12487% 5.2%	23.35052% 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 CASCADE VALLEY 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	4,171,199 23,241,334	4,325,045 23,709,545	4,775,546 24,248,380	4,482,283 22,858,541	4,065,832 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	4,171,199 21,577,146	4,325,045 22,041,594	4,775,546 22,722,063	4,482,283 21,570,441	4,065,832 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	2,959,214 11,160,864	3,191,130 11,987,345	3,490,119 12,926,866	2,897,823 11,884,480	3,512,191 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	2,755,894 10,918,923	3,024,949 11,706,976	3,303,726 12,615,917	2,721,183 11,458,116	3,307,808 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	203,320 618,038	166,181 697,279	186,393 690,232	176,640 684,010	204,383 670,558
⊳ 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	80,042 594,888	86,382 595,761	92,774 577,894	86,474 542,168	73,755 549,667
Outlier Median	502,258 582,572	338,863 538,116	27,352 212,434	3,980 126,559	129,698 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	3,145,569 3,662,910	1,851,122 3,730,911	2,764,693 4,081,319	2,831,483 4,643,908	3,358,353 4,389,147
Charity care Median	246,654 2,654,636	427,925 2,940,659	628,809 3,380,215	611,372 3,488,738	1,054,593 3,233,405
Uncompensated care (UCC) Median	2,349,001 5,147,790	1,856,046 5,337,617	2,090,628 5,711,082	1,772,253 5,923,418	2,481,767 5,508,107
UCC as a % of operating expenses Median	5.27% 3.24	4.16% 3.12	4.32% 3.21	3.72% 3.3	4.63% 2.86
Total shortfall/UCC Median	5,494,570 9,489,989	3,707,168 9,424,297	4,855,321 10,120,158	4,603,736 11,171,337	5,840,120 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	21,073,410 52,142,039	21,290,815 54,485,252	24,263,941 57,395,589	23,640,988 58,830,919	24,922,974 61,722,907
Salaries as a % of operating expenses Median	47.28 36.68	47.67 36.56	50.17 36.37	49.58 35.93	46.53 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	1,156,622 1,449,244	1,182,111 1,475,986	304,829 1,563,078	956,131 1,721,954	2,297,143 2,991,828
Contract hours, direct-care Median	16,665.00 22,725	18,957.00 23,018.5	4,251.00 24,503.48	11,540.00 25,026.5	22,925.00 33,786
Contract wages, direct-care Median	69.40 64.67	62.36 64.53	71.71 65.06	82.85 68.97	100.20 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.