As of the July, 2022, release via CMS

EVERGREEN HEALTH MONROE

CMS id: 500084
14701 179TH SE, MONROE WA 98272. County: SNOHOMISH
System: --
CBSA: Seattle-Tacoma-Bellevue, WA

The 27-bed, acute-care hospital had $-8,181,103 in net service to patients*, with a total profit margin of 10.22630% in fiscal year 2021, the latest year available.
It spent 3.61% of its operating expenses on uncompensated care and reported $2,621,001 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	23 118	23 118	23 119.5	23 118	23 119
Total beds Median	27 162	27 162	27 162	27 162	27 163.5
FTEs Median	275.02 788.06	275.90 793.42	277.48 806.03	270.03 787.61	243.94 804.34

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	41,772,880 150,932,746	46,052,893 158,950,878	46,431,231 168,696,998	38,856,931 163,454,693	43,537,557 186,589,412
Operating expenses Median	48,353,139 149,311,209	49,156,744 156,110,414	52,438,830 164,890,568	51,042,520 166,516,854	51,718,660 180,120,888
Net income from service 2 patients (NS2P) ? Median	-6,580,259 -964,173	-3,103,851 -643,601.5	-6,007,599 -116,254	-12,185,589 -5,025,862	-8,181,103 -1,284,564
NS2P margin ? Median	-15.75% -0.62	-6.74% -0.29	-12.94% 0.18	-31.36% -5.07	-18.79% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for EVERGREEN HEALTH MONROE 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	5,191,143 5,089,215	6,016,472 4,572,541	2,855,236 5,268,134	2,637,109 13,092,619	2,097,403 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	339,183 224,999	383,053 199,009	21,475 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	514,541 188,688.5	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	17,203	90	89
⊳ 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	264,471	265,294	260,289	208,227	173,689
⊳ 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	5,069	3,651	4,347	12,056	4,625
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	425	1,221	1,431
⊳ 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	273,893	182,115	35,281	45,983	-15,452
⊳ Line 23: Gov appropriations ? ⊳ Median	3,206,129 1,017,693	3,271,374 983,261.5	1,467,650 1,173,286	1,254,902 1,987,202	663,547 1,597,664
⊳ Sum Line 24	1,102,398	1,396,444	1,048,566	1,114,630	1,269,474
Total income ? Median	-1,389,116 6,586,430	2,912,621 6,767,106	-3,152,363 8,419,950	-9,548,480 8,094,175	-6,083,700 15,162,888
Non-operating expenses Median	-1,486,486 146,289.5	0 164,857	-3,459,607 89,880.5	-10,288,174 106,761	-10,750,468 31,473.5
Net income Median	97,370 6,043,842	2,912,621 5,845,112	307,244 7,606,259	739,694 7,283,041	4,666,768 14,957,241
Net margin Median	0.20733% 4.62%	5.59373% 4.42%	0.62338% 5.16%	1.78265% 5.2%	10.22630% 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 EVERGREEN HEALTH MONROE 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	4,117,608 23,241,334	4,037,346 23,709,545	3,974,208 24,248,380	3,365,367 22,858,541	3,163,108 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	4,117,608 21,577,146	4,037,346 22,041,594	3,974,208 22,722,063	3,365,367 21,570,441	3,163,108 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	2,643,739 11,160,864	2,494,939 11,987,345	2,841,217 12,926,866	2,022,262 11,884,480	2,304,578 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	2,643,739 10,918,923	2,494,939 11,706,976	2,841,217 12,615,917	2,022,262 11,458,116	2,304,578 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	83,810 594,888	78,185 595,761	58,089 577,894	32,395 542,168	23,208 549,667
Outlier Median	185,467 582,572	53,144 538,116	18,865 212,434	5,557 126,559	22,486 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	4,705,067 3,662,910	4,630,068 3,730,911	4,852,684 4,081,319	2,438,520 4,643,908	2,621,001 4,389,147
Charity care Median	199,481 2,654,636	292,100 2,940,659	412,956 3,380,215	453,931 3,488,738	562,549 3,233,405
Uncompensated care (UCC) Median	1,833,041 5,147,790	1,656,421 5,337,617	1,876,419 5,711,082	1,832,746 5,923,418	1,866,524 5,508,107
UCC as a % of operating expenses Median	3.79% 3.24	3.37% 3.12	3.58% 3.21	3.59% 3.3	3.61% 2.86
Total shortfall/UCC Median	6,538,108 9,489,989	6,286,489 9,424,297	6,729,103 10,120,158	4,271,266 11,171,337	4,487,525 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	21,847,524 52,142,039	21,769,022 54,485,252	21,384,206 57,395,589	20,963,788 58,830,919	21,188,936 61,722,907
Salaries as a % of operating expenses Median	45.18 36.68	44.28 36.56	40.78 36.37	41.07 35.93	40.97 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	1,130,037 1,449,244	1,689,467 1,475,986	1,503,662 1,563,078	615,077 1,721,954	138,471 2,991,828
Contract hours, direct-care Median	16,709.00 22,725	23,183.00 23,018.5	21,461.00 24,503.48	8,264.00 25,026.5	1,575.00 33,786
Contract wages, direct-care Median	67.63 64.67	72.88 64.53	70.06 65.06	74.43 68.97	87.92 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.