As of the July, 2022, release via CMS

MARSHFIELD MEDICAL CENTER

CMS id: 520037
611 ST JOSEPH AVENUE, MARSHFIELD WI 54449. County: WOOD
System: MARSHFILED CLINIC HEALTH SYSTEM
CBSA: Wisconsin Rapids-Marshfield, WI

The 204-bed, acute-care hospital had $-56,529,406 in net service to patients*, with a total profit margin of 1.18161% in fiscal year 2021, the latest year available.
It spent 2.85% of its operating expenses on uncompensated care and reported $32,796,132 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	220 118	171 118	162 119.5	148 118	153 119
Total beds Median	307 162	222 162	210 162	192 162	204 163.5
FTEs Median	1,200.57 788.06	1,142.94 793.42	1,142.94 806.03	1,142.94 787.61	2,615.01 804.34

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	293,568,799 150,932,746	193,748,093 158,950,878	666,583,891 168,696,998	676,841,207 163,454,693	779,335,993 186,589,412
Operating expenses Median	267,501,339 149,311,209	430,554,028 156,110,414	677,063,198 164,890,568	722,794,460 166,516,854	835,865,399 180,120,888
Net income from service 2 patients (NS2P) ? Median	26,067,460 -964,173	-236,805,935 -643,601.5	-10,479,307 -116,254	-45,953,253 -5,025,862	-56,529,406 -1,284,564
NS2P margin ? Median	8.88% -0.62	-122.22% -0.29	-1.57% 0.18	-6.79% -5.07	-7.25% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MARSHFIELD 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	174,008,839 5,089,215	19,252,732 4,572,541	47,625,538 5,268,134	62,332,030 13,092,619	66,524,209 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	730,567 199,009	1,792,483 206,870.5	1,688,336 194,343	1,906,961 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	5,995 188,688.5	0 370,813	0 309,361.5	139 375,329
⊳ 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	0	0	0
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	0	12,960	9,155	9,624	12,239
⊳ Line 14: Revenue from meals sold to emplyees and guests	1,627,107	1,895,072	2,584,861	2,204,214	1,728,941
⊳ 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	4,256,154	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	9,941	0	0	0
⊳ Line 22: Rental of hospital space	0	119,396	236,586	127,178	165,969
⊳ 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	168,125,578	16,478,801	43,002,453	58,302,678	62,709,960
Total income ? Median	200,076,299 6,586,430	-217,553,203 6,767,106	37,146,231 8,419,950	16,378,777 8,094,175	9,994,803 15,162,888
Non-operating expenses Median	220,629 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	199,855,670 6,043,842	-217,553,203 5,845,112	37,146,231 7,606,259	16,378,777 7,283,041	9,994,803 14,957,241
Net margin Median	42.74278% 4.62%	-102.13726% 4.42%	5.20103% 5.16%	2.21582% 5.2%	1.18161% 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 MARSHFIELD 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	54,893,359 23,241,334	61,274,636 23,709,545	72,094,475 24,248,380	67,161,681 22,858,541	67,348,909 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	54,139,809 21,577,146	60,327,431 22,041,594	70,572,641 22,722,063	65,410,448 21,570,441	65,952,106 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	753,550 3,535,627	947,205 3,746,588	1,521,834 3,782,288	1,751,233 3,865,578	1,396,803 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	13,163,339 11,160,864	25,190,974 11,987,345	47,182,880 12,926,866	42,700,563 11,884,480	42,369,047 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	13,163,339 10,918,923	25,190,974 11,706,976	47,182,880 12,615,917	42,700,563 11,458,116	42,369,047 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	5,932,889 3,284,314	8,276,557 3,250,551	9,094,617 3,386,837	9,075,519 3,360,806	9,823,471 3,508,953
Disproportionate-share hospital (DSH) Median	1,025,302 594,888	869,109 595,761	937,352 577,894	1,127,668 542,168	1,226,829 549,667
Outlier Median	4,251,237 582,572	5,046,459 538,116	2,493,833 212,434	2,840,090 126,559	1,525,133 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	20,998,516 3,662,910	42,438,334 3,730,911	12,140,009 4,081,319	2,173,108 4,643,908	32,796,132 4,389,147
Charity care Median	1,422,620 2,654,636	2,406,730 2,940,659	2,936,888 3,380,215	3,013,332 3,488,738	15,341,516 3,233,405
Uncompensated care (UCC) Median	3,754,781 5,147,790	4,718,390 5,337,617	7,413,798 5,711,082	7,985,631 5,923,418	23,790,532 5,508,107
UCC as a % of operating expenses Median	1.40% 3.24	1.10% 3.12	1.09% 3.21	1.10% 3.3	2.85% 2.86
Total shortfall/UCC Median	24,753,297 9,489,989	47,156,724 9,424,297	19,553,807 10,120,158	10,158,739 11,171,337	56,586,664 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	57,874,435 52,142,039	133,835,498 54,485,252	256,505,975 57,395,589	254,484,352 58,830,919	281,137,255 61,722,907
Salaries as a % of operating expenses Median	26.57 36.68	31.79 36.56	38.24 36.37	35.75 35.93	34.23 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	6,681,477 1,251,927	7,068,222 1,186,494	7,041,344 1,204,885	5,194,823 1,279,653	7,161,862 1,469,317
Contract adjusted salaries, direct-care Median	17,692,402 1,449,244	15,812,252 1,475,986	9,372,056 1,563,078	5,722,838 1,721,954	24,418,263 2,991,828
Contract hours, direct-care Median	431,706.00 22,725	191,971.00 23,018.5	134,592.00 24,503.48	91,162.00 25,026.5	202,959.00 33,786
Contract wages, direct-care Median	40.98 64.67	82.37 64.53	69.63 65.06	62.78 68.97	120.31 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.