As of the July, 2022, release via CMS

GUNDERSEN LUTHERAN MEDICAL CENTER I

CMS id: 520087
1910 SOUTH AVENUE, LA CROSSE WI 54601. County: LA CROSSE
System: GUNDERSEN LUTHERAN ADMINISTRATIVE SE
CBSA: La Crosse-Onalaska, WI-MN

The 295-bed, acute-care hospital had $250,286,051 in net service to patients*, with a total profit margin of 14.58010% in fiscal year 2020, the latest year available.
It spent 1.61% of its operating expenses on uncompensated care and reported $54,050,912 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	--
Ownership	nfp	nfp	nfp	nfp	--
Acute beds Median	210 118	211 118	226 119.5	234 118	-- 119
Total beds Median	268 162	269 162	283 162	295 162	-- 163.5
FTEs Median	6,015.14 788.06	3,558.34 793.42	3,558.34 806.03	3,386.94 787.61	-- 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	1,071,193,024 150,932,746	1,073,771,721 158,950,878	1,129,737,538 168,696,998	1,113,613,891 163,454,693	-- 186,589,412
Operating expenses Median	1,064,702,411 149,311,209	758,967,291 156,110,414	806,623,298 164,890,568	863,327,840 166,516,854	-- 180,120,888
Net income from service 2 patients (NS2P) ? Median	6,490,613 -964,173	314,804,430 -643,601.5	323,114,240 -116,254	250,286,051 -5,025,862	-- -1,284,564
NS2P margin ? Median	0.61% -0.62	29.32% -0.29	28.60% 0.18	22.48% -5.07	--% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for GUNDERSEN LUTHERAN MEDICAL CENTER I 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	106,904,574 5,089,215	12,117,431 4,572,541	9,563,734 5,268,134	44,812,307 13,092,619	-- 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	5,732,491 224,999	1,705,316 199,009	1,881,715 206,870.5	625,250 194,343	-- 249,496
⊳ Line 7: Investments ? ⊳ Median	68,642,505 299,524	763,808 188,688.5	528,943 370,813	493,155 309,361.5	-- 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	5,301,877	1,919,597	1,777,938	1,371,007	--
⊳ 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	2,128,812	2,303,989	2,354,686	1,562,134	--
⊳ 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	0	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	0	0	0	0	--
⊳ Line 22: Rental of hospital space	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	-- 1,597,664
⊳ Sum Line 24	25,098,889	5,424,721	3,020,452	40,760,761	--
Total income ? Median	113,395,187 6,586,430	326,921,861 6,767,106	332,677,974 8,419,950	295,098,358 8,094,175	-- 15,162,888
Non-operating expenses Median	1,284,415 146,289.5	209,887,534 164,857	14,247,446 89,880.5	126,198,621 106,761	-- 31,473.5
Net income Median	112,110,772 6,043,842	117,034,327 5,845,112	318,430,528 7,606,259	168,899,737 7,283,041	-- 14,957,241
Net margin Median	9.51626% 4.62%	10.77774% 4.42%	27.94963% 5.16%	14.58010% 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 GUNDERSEN LUTHERAN MEDICAL CENTER I 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	65,978,455 23,241,334	67,580,357 23,709,545	64,490,899 24,248,380	67,859,022 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	63,502,204 21,577,146	63,978,350 22,041,594	60,932,723 22,722,063	64,226,271 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	2,476,251 3,535,627	3,602,007 3,746,588	3,558,176 3,782,288	3,632,751 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	67,944,834 11,160,864	75,156,200 11,987,345	77,179,175 12,926,866	72,820,417 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	67,944,834 10,918,923	75,156,200 11,706,976	77,179,175 12,615,917	72,820,417 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	6,767,572 3,284,314	6,842,265 3,250,551	6,892,795 3,386,837	7,142,304 3,360,806	-- 3,508,953
Disproportionate-share hospital (DSH) Median	1,563,074 594,888	1,451,879 595,761	1,341,525 577,894	1,477,617 542,168	-- 549,667
Outlier Median	8,877,122 582,572	10,757,649 538,116	6,225,656 212,434	5,143,484 126,559	-- 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	50,901,600 3,662,910	34,689,251 3,730,911	49,339,882 4,081,319	54,050,912 4,643,908	-- 4,389,147
Charity care Median	5,383,285 2,654,636	4,293,500 2,940,659	4,398,262 3,380,215	4,883,824 3,488,738	-- 3,233,405
Uncompensated care (UCC) Median	16,046,546 5,147,790	8,847,666 5,337,617	8,763,797 5,711,082	13,915,380 5,923,418	-- 5,508,107
UCC as a % of operating expenses Median	1.51% 3.24	1.17% 3.12	1.09% 3.21	1.61% 3.3	--% 2.86
Total shortfall/UCC Median	66,948,146 9,489,989	43,536,917 9,424,297	58,103,679 10,120,158	67,966,292 11,171,337	-- 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	497,427,100 52,142,039	327,543,607 54,485,252	338,001,793 57,395,589	349,925,347 58,830,919	-- 61,722,907
Salaries as a % of operating expenses Median	49.72 36.68	50.56 36.56	49.86 36.37	49.80 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	6,415,711 1,251,927	6,399,581 1,186,494	7,243,907 1,204,885	8,243,340 1,279,653	-- 1,469,317
Contract adjusted salaries, direct-care Median	7,684,054 1,449,244	6,974,083 1,475,986	7,570,684 1,563,078	8,536,515 1,721,954	-- 2,991,828
Contract hours, direct-care Median	161,396.00 22,725	170,807.00 23,018.5	203,191.00 24,503.48	208,666.00 25,026.5	-- 33,786
Contract wages, direct-care Median	47.61 64.67	40.83 64.53	37.26 65.06	40.91 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.