As of the July, 2022, release via CMS

ASCENSION SETON WILLIAMSON

CMS id: 670041
201 SETON PARKWAY, ROUND ROCK TX 78665. County: WILLIAMSON
System: ASCENSION TEXAS
CBSA: Austin-Round Rock-Georgetown, TX

The 143-bed, acute-care hospital had $18,717,618 in net service to patients*, with a total profit margin of 8.97951% in fiscal year 2021, the latest year available.
It spent 10.42% of its operating expenses on uncompensated care and reported $228,425 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	109 118	109 118	93 119.5	109 118	109 119
Total beds Median	143 162	137 162	119 162	143 162	143 163.5
FTEs Median	544.36 788.06	502.46 793.42	514.84 806.03	564.27 787.61	610.16 804.34

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	183,096,526 150,932,746	139,969,084 158,950,878	152,875,902 168,696,998	165,229,733 163,454,693	187,439,134 186,589,412
Operating expenses Median	182,241,851 149,311,209	136,800,440 156,110,414	142,933,117 164,890,568	162,355,912 166,516,854	168,721,516 180,120,888
Net income from service 2 patients (NS2P) ? Median	854,675 -964,173	3,168,644 -643,601.5	9,942,785 -116,254	2,873,821 -5,025,862	18,717,618 -1,284,564
NS2P margin ? Median	0.47% -0.62	2.26% -0.29	6.50% 0.18	1.74% -5.07	9.99% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for ASCENSION SETON WILLIAMSON 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	1,470,268 5,089,215	1,169,252 4,572,541	1,049,239 5,268,134	4,199,929 13,092,619	-2,072,612 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	448 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	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	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	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	0	0
⊳ 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	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	4,293	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	116,899	0	0	0	0
⊳ Line 21: Rental of vending machines	53,454	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	1,295,174	1,169,252	1,049,239	4,199,929	-2,072,612
Total income ? Median	2,324,943 6,586,430	4,337,896 6,767,106	10,992,024 8,419,950	7,073,750 8,094,175	16,645,006 15,162,888
Non-operating expenses Median	19,837 146,289.5	0 164,857	0 89,880.5	30,170 106,761	0 31,473.5
Net income Median	2,305,106 6,043,842	4,337,896 5,845,112	10,992,024 7,606,259	7,043,580 7,283,041	16,645,006 14,957,241
Net margin Median	1.24893% 4.62%	3.07351% 4.42%	7.14115% 5.16%	4.15723% 5.2%	8.97951% 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 SETON WILLIAMSON 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	24,103,645 23,241,334	25,445,975 23,709,545	27,989,769 24,248,380	28,614,755 22,858,541	31,086,813 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	24,103,645 21,577,146	25,445,975 22,041,594	27,989,769 22,722,063	28,614,755 21,570,441	31,086,813 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	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	5,153,900 11,160,864	5,931,968 11,987,345	6,874,389 12,926,866	6,165,017 11,884,480	6,547,136 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	5,153,900 10,918,923	5,931,968 11,706,976	6,874,389 12,615,917	6,165,017 11,458,116	6,547,136 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	243,656 577,894	261,278 542,168	322,742 549,667
Outlier Median	1,485,509 582,572	1,946,569 538,116	1,017,284 212,434	130,574 126,559	153,037 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	104,975 3,662,910	230,122 3,730,911	156,794 4,081,319	143,602 4,643,908	228,425 4,389,147
Charity care Median	6,740,990 2,654,636	10,797,294 2,940,659	13,967,639 3,380,215	17,662,016 3,488,738	11,853,144 3,233,405
Uncompensated care (UCC) Median	11,937,546 5,147,790	15,240,444 5,337,617	19,034,009 5,711,082	21,835,469 5,923,418	17,580,228 5,508,107
UCC as a % of operating expenses Median	6.55% 3.24	11.14% 3.12	13.32% 3.21	13.45% 3.3	10.42% 2.86
Total shortfall/UCC Median	12,042,521 9,489,989	15,470,566 9,424,297	19,190,803 10,120,158	21,979,071 11,171,337	17,808,653 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	40,342,450 52,142,039	38,794,435 54,485,252	39,837,176 57,395,589	44,601,574 58,830,919	47,734,862 61,722,907
Salaries as a % of operating expenses Median	28.14 36.68	28.36 36.56	27.87 36.37	27.47 35.93	28.29 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	1,644,611 1,449,244	2,001,160 1,475,986	411,401 1,563,078	488,427 1,721,954	1,824,441 2,991,828
Contract hours, direct-care Median	24,834.60 22,725	29,089.88 23,018.5	4,669.16 24,503.48	4,722.00 25,026.5	14,661.00 33,786
Contract wages, direct-care Median	66.22 64.67	68.79 64.53	88.11 65.06	103.44 68.97	124.44 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.