As of the July, 2022, release via CMS

ASCENSION NE WISCONSIN-ST. ELIZABETH

CMS id: 520009
1506 SOUTH ONEIDA STREET, APPLETON WI 54915. County: OUTAGAMIE
System: ASCENSION WISCONSIN
CBSA: Appleton, WI

The 279-bed, acute-care hospital had $45,795,111 in net service to patients*, with a total profit margin of 15.46533% in fiscal year 2021, the latest year available.
It spent 2.25% of its operating expenses on uncompensated care and reported $3,961,678 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	145 118	245 118	237 119.5	204 118	204 119
Total beds Median	190 162	308 162	308 162	279 162	279 163.5
FTEs Median	875.60 788.06	790.60 793.42	1,129.50 806.03	1,129.70 787.61	1,158.70 804.34

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	202,024,511 150,932,746	224,356,565 158,950,878	316,512,554 168,696,998	323,074,911 163,454,693	360,110,978 186,589,412
Operating expenses Median	171,093,840 149,311,209	225,633,860 156,110,414	290,658,011 164,890,568	300,610,052 166,516,854	314,315,867 180,120,888
Net income from service 2 patients (NS2P) ? Median	30,930,671 -964,173	-1,277,295 -643,601.5	25,854,543 -116,254	22,464,859 -5,025,862	45,795,111 -1,284,564
NS2P margin ? Median	15.31% -0.62	-0.57% -0.29	8.17% 0.18	6.95% -5.07	12.72% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASCENSION NE WISCONSIN-ST. ELIZABETH 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	4,475,568 5,089,215	3,774,121 4,572,541	6,507,693 5,268,134	9,621,704 13,092,619	11,707,898 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	163,593 224,999	443,566 199,009	217,722 206,870.5	154,171 194,343	161,799 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	-35,782 188,688.5	7,350 370,813	0 309,361.5	1,132,470 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	52,435	0	109,511	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	0	1,105,314	1,539,575	1,419,293	985,164
⊳ Line 15: Revenue from rental of living quarters	2,651,407	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	0	206,584	0	163,665	307,862
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	14,854	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	1,044,023	2,870,052	4,955,081	513,362	211,005
⊳ 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	549,256	-815,613	-321,546	7,371,213	8,909,598
Total income ? Median	35,406,239 6,586,430	2,496,826 6,767,106	32,362,236 8,419,950	32,086,563 8,094,175	57,503,009 15,162,888
Non-operating expenses Median	506,013 146,289.5	61,643 164,857	35,303 89,880.5	1,532,517 106,761	0 31,473.5
Net income Median	34,900,226 6,043,842	2,435,183 5,845,112	32,326,933 7,606,259	30,554,046 7,283,041	57,503,009 14,957,241
Net margin Median	16.90083% 4.62%	1.06745% 4.42%	10.00771% 5.16%	9.18376% 5.2%	15.46533% 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 ASCENSION NE WISCONSIN-ST. ELIZABETH 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	16,411,000 23,241,334	16,657,628 23,709,545	24,971,163 24,248,380	22,981,335 22,858,541	25,382,170 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	16,411,000 21,577,146	16,642,021 22,041,594	24,625,395 22,722,063	22,346,130 21,570,441	24,510,471 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	375,286 1,510,463	164,384 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	15,607 3,746,588	345,768 3,782,288	259,919 3,865,578	707,315 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	9,581,015 11,160,864	11,193,270 11,987,345	15,883,725 12,926,866	16,939,134 11,884,480	19,135,257 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	9,581,015 10,918,923	11,193,270 11,706,976	15,883,725 12,615,917	16,939,134 11,458,116	19,135,257 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	325,086 3,284,314	322,014 3,250,551	344,157 3,386,837	338,811 3,360,806	378,395 3,508,953
Disproportionate-share hospital (DSH) Median	478,931 594,888	554,364 595,761	745,385 577,894	675,283 542,168	679,020 549,667
Outlier Median	442,987 582,572	369,498 538,116	770,856 212,434	130,713 126,559	232,705 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	3,382,318 3,662,910	0 3,730,911	2,091,493 4,081,319	4,261,487 4,643,908	3,961,678 4,389,147
Charity care Median	1,728,566 2,654,636	2,455,575 2,940,659	3,380,215 3,380,215	4,575,913 3,488,738	3,743,779 3,233,405
Uncompensated care (UCC) Median	3,502,991 5,147,790	4,783,516 5,337,617	6,716,393 5,711,082	8,541,589 5,923,418	7,071,737 5,508,107
UCC as a % of operating expenses Median	2.05% 3.24	2.12% 3.12	2.31% 3.21	2.84% 3.3	2.25% 2.86
Total shortfall/UCC Median	6,885,309 9,489,989	4,783,516 9,424,297	8,807,886 10,120,158	12,803,076 11,171,337	11,033,415 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	52,064,422 52,142,039	53,931,528 54,485,252	78,154,969 57,395,589	80,567,641 58,830,919	83,094,841 61,722,907
Salaries as a % of operating expenses Median	36.68 36.68	30.80 36.56	33.08 36.37	34.46 35.93	32.67 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	334,110 1,186,494	384,641 1,204,885	372,631 1,279,653	354,259 1,469,317
Contract adjusted salaries, direct-care Median	896,683 1,449,244	658,864 1,475,986	856,746 1,563,078	1,328,379 1,721,954	3,823,343 2,991,828
Contract hours, direct-care Median	9,321.00 22,725	9,467.00 23,018.5	18,129.00 24,503.48	24,867.00 25,026.5	41,572.00 33,786
Contract wages, direct-care Median	96.20 64.67	69.60 64.53	47.26 65.06	53.42 68.97	91.97 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.