As of the July, 2022, release via CMS

GUAM MEMORIAL HOSPITAL

CMS id: 650001
850 GOVERNOR CARLOS G CAMACHO RD, OKA TAMUNING GU 96911. County: GUAM
System: --
CBSA: Guam

The 296-bed, acute-care hospital had $-62,583,868 in net service to patients*, with a total profit margin of 1.53616% in fiscal year 2021, the latest year available.
It spent 11.08% of its operating expenses on uncompensated care and reported $17,674,843 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	147 118	147 118	147 119.5	189 118	234 119
Total beds Median	201 162	201 162	201 162	246 162	296 163.5
FTEs Median	1,276.00 788.06	1,266.55 793.42	1,387.41 806.03	2,161.42 787.61	1,184.68 804.34

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	74,186,685 150,932,746	102,485,355 158,950,878	110,947,244 168,696,998	100,315,871 163,454,693	109,516,624 186,589,412
Operating expenses Median	117,359,406 149,311,209	118,355,467 156,110,414	126,102,749 164,890,568	138,636,293 166,516,854	172,100,492 180,120,888
Net income from service 2 patients (NS2P) ? Median	-43,172,721 -964,173	-15,870,112 -643,601.5	-15,155,505 -116,254	-38,320,422 -5,025,862	-62,583,868 -1,284,564
NS2P margin ? Median	-58.19% -0.62	-15.49% -0.29	-13.66% 0.18	-38.20% -5.07	-57.15% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for GUAM MEMORIAL HOSPITAL 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	52,231,534 5,089,215	31,065,180 4,572,541	39,456,827 5,268,134	45,933,876 13,092,619	65,268,846 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	333,023 224,999	0 199,009	0 206,870.5	2,963,733 194,343	2,851,122 249,496
⊳ Line 7: Investments ? ⊳ Median	45 299,524	0 188,688.5	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	238	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	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	411,534	0	0	431,626	569,640
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	430,273	0	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	0	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	-4,128	0	0	0	0
⊳ Line 22: Rental of hospital space	0	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	0 1,597,664
⊳ Sum Line 24	51,060,549	31,065,180	39,456,827	42,538,517	61,848,084
Total income ? Median	9,058,813 6,586,430	15,195,068 6,767,106	24,301,322 8,419,950	7,613,454 8,094,175	2,684,978 15,162,888
Non-operating expenses Median	0 146,289.5	16,792,961 164,857	9,257 89,880.5	0 106,761	0 31,473.5
Net income Median	9,058,813 6,043,842	-1,597,893 5,845,112	24,292,065 7,606,259	7,613,454 7,283,041	2,684,978 14,957,241
Net margin Median	7.16575% 4.62%	-1.19647% 4.42%	16.15120% 5.16%	5.20579% 5.2%	1.53616% 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 GUAM MEMORIAL HOSPITAL 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	665,218 23,241,334	673,994 23,709,545	140,052 24,248,380	386,973 22,858,541	247,252 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	0 21,577,146	0 22,041,594	0 22,722,063	0 21,570,441	0 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	665,218 1,203,033	673,994 1,215,295	140,052 1,313,657	386,973 1,365,298	247,252 1,179,746
All outpatient revenue Median Click here to show/hide details	1,681,039 11,160,864	1,413,571 11,987,345	1,293,376 12,926,866	1,611,035 11,884,480	2,064,064 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	1,681,039 10,918,923	1,413,571 11,706,976	1,293,376 12,615,917	1,611,035 11,458,116	2,064,064 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	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	0 582,572	0 538,116	0 212,434	0 126,559	0 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	5,170,342 4,081,319	5,816,555 4,643,908	17,674,843 4,389,147
Charity care Median	0 2,654,636	0 2,940,659	0 3,380,215	0 3,488,738	0 3,233,405
Uncompensated care (UCC) Median	7,547,344 5,147,790	11,076,065 5,337,617	10,195,153 5,711,082	13,511,752 5,923,418	19,070,761 5,508,107
UCC as a % of operating expenses Median	6.43% 3.24	9.36% 3.12	8.08% 3.21	9.75% 3.3	11.08% 2.86
Total shortfall/UCC Median	7,547,344 9,489,989	11,076,065 9,424,297	15,365,495 10,120,158	19,328,307 11,171,337	36,745,604 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	59,732,486 52,142,039	59,673,624 54,485,252	60,893,360 57,395,589	65,925,846 58,830,919	76,143,314 61,722,907
Salaries as a % of operating expenses Median	50.90 36.68	50.42 36.56	48.29 36.37	47.55 35.93	44.24 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	0 1,449,244	0 1,475,986	0 1,563,078	0 1,721,954	0 2,991,828
Contract hours, direct-care Median	0.00 22,725	0.00 23,018.5	0.00 24,503.48	0.00 25,026.5	0.00 33,786
Contract wages, direct-care Median	0.00 64.67	0.00 64.53	0.00 65.06	0.00 68.97	0.00 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.