As of the July, 2022, release via CMS

VALLEY HOSPITAL & MEDICAL CENTER

CMS id: 500119
12606 EAST MISSION, SPOKANE WA 99210. County: SPOKANE
System: MULTICARE HEALTH SYSTEM
CBSA: Spokane-Spokane Valley, WA

The 123-bed, acute-care hospital had $10,476,055 in net service to patients*, with a total profit margin of 10.07044% in fiscal year 2020, the latest year available.
It spent 4.74% of its operating expenses on uncompensated care and reported $8,257,669 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	273	365	365	366	--
Ownership	forprofit	nfp	nfp	nfp	--
Acute beds Median	97 118	113 118	113 119.5	113 118	-- 119
Total beds Median	123 162	123 162	123 162	123 162	-- 163.5
FTEs Median	423.49 788.06	593.64 793.42	589.25 806.03	595.72 787.61	-- 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	91,825,736 150,932,746	128,595,997 158,950,878	143,277,386 168,696,998	145,221,379 163,454,693	-- 186,589,412
Operating expenses Median	69,734,495 149,311,209	122,038,919 156,110,414	129,377,999 164,890,568	134,745,324 166,516,854	-- 180,120,888
Net income from service 2 patients (NS2P) ? Median	22,091,241 -964,173	6,557,078 -643,601.5	13,899,387 -116,254	10,476,055 -5,025,862	-- -1,284,564
NS2P margin ? Median	24.06% -0.62	5.10% -0.29	9.70% 0.18	7.21% -5.07	--% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for VALLEY HOSPITAL & 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	1,089,522 5,089,215	968,464 4,572,541	995,311 5,268,134	4,612,918 13,092,619	-- 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	-- 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	0 309,361.5	-- 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	--
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	--
⊳ Line 12: Parking lot receipts	0	0	0	0	--
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	--
⊳ Line 14: Revenue from meals sold to emplyees and guests	304,031	0	0	0	--
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	--
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	--
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	--
⊳ Line 18: Revenue from sale of medical records and abstracts	3,000	0	0	0	--
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	--
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	--
⊳ Line 21: Rental of vending machines	484	0	0	0	--
⊳ Line 22: Rental of hospital space	367,213	506,699	432,931	133,268	--
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	-- 1,597,664
⊳ Sum Line 24	414,794	461,765	562,380	4,479,650	--
Total income ? Median	23,180,763 6,586,430	7,525,542 6,767,106	14,894,698 8,419,950	15,088,973 8,094,175	-- 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	-- 31,473.5
Net income Median	23,180,763 6,043,842	7,525,542 5,845,112	14,894,698 7,606,259	15,088,973 7,283,041	-- 14,957,241
Net margin Median	24.94828% 4.62%	5.80834% 4.42%	10.32399% 5.16%	10.07044% 5.2%	--% 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 VALLEY HOSPITAL & 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	14,995,950 23,241,334	20,966,259 23,709,545	19,647,388 24,248,380	16,030,666 22,858,541	-- 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	14,995,950 21,577,146	20,966,259 22,041,594	19,647,388 22,722,063	16,030,666 21,570,441	-- 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	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	-- 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	-- 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Critical-access hospitals ⊳ Median	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	-- 1,179,746
All outpatient revenue Median Click here to show/hide details	6,234,899 11,160,864	10,688,890 11,987,345	12,520,885 12,926,866	12,909,019 11,884,480	-- 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	6,234,899 10,918,923	10,688,890 11,706,976	12,520,885 12,615,917	12,909,019 11,458,116	-- 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	-- 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	-- --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	-- 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	-- --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	19,859 3,284,314	2,757 3,250,551	5,909 3,386,837	5,066 3,360,806	-- 3,508,953
Disproportionate-share hospital (DSH) Median	427,544 594,888	548,704 595,761	557,706 577,894	484,949 542,168	-- 549,667
Outlier Median	101,456 582,572	173,268 538,116	10,296 212,434	16,469 126,559	-- 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	5,379,260 3,662,910	3,324,128 3,730,911	5,841,005 4,081,319	8,257,669 4,643,908	-- 4,389,147
Charity care Median	1,145,489 2,654,636	2,260,122 2,940,659	4,840,722 3,380,215	5,570,144 3,488,738	-- 3,233,405
Uncompensated care (UCC) Median	1,327,826 5,147,790	3,017,911 5,337,617	5,706,910 5,711,082	6,386,557 5,923,418	-- 5,508,107
UCC as a % of operating expenses Median	1.90% 3.24	2.47% 3.12	4.41% 3.21	4.74% 3.3	--% 2.86
Total shortfall/UCC Median	6,707,086 9,489,989	6,342,039 9,424,297	11,547,915 10,120,158	14,644,226 11,171,337	-- 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	33,316,250 52,142,039	47,460,132 54,485,252	48,250,857 57,395,589	53,437,992 58,830,919	-- 61,722,907
Salaries as a % of operating expenses Median	47.78 36.68	38.89 36.56	37.29 36.37	39.66 35.93	-- 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	-- 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	6,933 1,204,885	0 1,279,653	-- 1,469,317
Contract adjusted salaries, direct-care Median	404,083 1,449,244	881,476 1,475,986	279,645 1,563,078	596,798 1,721,954	-- 2,991,828
Contract hours, direct-care Median	6,335.00 22,725	11,771.00 23,018.5	3,782.00 24,503.48	6,904.00 25,026.5	-- 33,786
Contract wages, direct-care Median	63.79 64.67	74.89 64.53	73.94 65.06	86.44 68.97	-- 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.