This document provides an overview and analysis of financial and operational metrics for different types of hospitals based on data from Medicare cost reports over six years. It examines metrics such as total profit margin, operating profit margin, labor costs, staffing levels, accounts receivable, and average age of facilities. Hospitals are grouped into peer groups and quartiles to benchmark performance and identify higher and lower performing facilities for each metric. The report finds variation in metrics between hospital types and based on number of beds.
In most hospitals, the perioperative department drives the lion’s share of revenues-typically around 50-60%-while contributing 30-40% of the costs.1 Those costs largely reflect supply consumption. According to one study, supply costs accounted for 56 % of the total expense budget for a perioperative department, exceeding salary costs by more than 20%. 2
Facing major capital and operational budget pressure, most healthcare organizations are seeking more effective ways to reduce OR supply costs while preserving or even improving patient safety, operational efficiency, and staff productivity.
In most hospitals, the perioperative department drives the lion’s share of revenues-typically around 50-60%-while contributing 30-40% of the costs.1 Those costs largely reflect supply consumption. According to one study, supply costs accounted for 56 % of the total expense budget for a perioperative department, exceeding salary costs by more than 20%. 2
Facing major capital and operational budget pressure, most healthcare organizations are seeking more effective ways to reduce OR supply costs while preserving or even improving patient safety, operational efficiency, and staff productivity.
Healthcare Total Cost of Care Analysis: A Vital ToolHealth Catalyst
How can healthcare organizations set themselves up for success as the industry shifts from fee-for-service to value-based reimbursement? They need to understand risk of their patients and population to identify ways to reduce healthcare costs and improve quality of care. This makes total cost of care (TCOC) analysis a necessary skillset in this time of transition.
TCOC analysis leverages key elements of the healthcare analytics infrastructure to understand how money is being spent at the organization and identify the drivers of high cost:
An integrated EDW.
Payer reporting tools.
Claims and membership data.
Predictive capabilities.
Risk scores.
Scorecards and dashboards.
Analyst support.
Running Head: FROM THE FRONT LINES1
From the Front Lines
Lisa M. Buentello
HCA 311: Health Care Financing & Information Systems
Professor Kathleen Martocci
May 29, 2015
- 1 -
[no notes on this page]
Future Direction of Health Care 2
From the Front Lines
The break even analysis figures can be used to establish the impacts of various
reimbursements such as Medicare, Medicaid, and Private and self-pay contributions. Notably,
from the break even analysis of the “From the Front lines” facility, increase in Medicare and
Medicaid benefits have an effect of increasing sales volume. Eventually, the value of the gross
margin increases leading to an upsurge of the value of the contribution per unit. This leads to a
reduction in the number of the break-even procedures. Private or self-pays have an effect of
increasing the volume of sales in addition to the increment made by Medicaid and Medicare
benefits. As a result, the break even procedures will become even smaller causing a
corresponding increase in profit margins.
Break even analysis is essentially important in developing my upcoming capital
investment proposal. It will be applicable in clarifying the extent of the viability of my planned
objectives. Specifically, this tool will be of great significance in evaluating expansion
opportunities, new providers, new services or new capital purchases (Cafferky, 2012). Break
even analysis is basically used in establishing whether the planned activity is viable enough to
cover the expected costs that are principally divided into variable and fixed expenses.
Also, I will utilize break analysis values to ascertain whether the capital proposal will be
financially viable. Specifically, it will be applicable in determining the activity level that will
- 2 -
[no notes on this page]
Future Direction of Health Care 3
cover the projected fixed and variable costs of the venture satisfactorily. It is at this point that a
break even analysis will be used to evaluate the critical components of my budget plan.
Typically, break even analysis and the budget plan are used interchangeably while
making financial analysis that concerns various capital investment plan proposals (Cafferky,
2012).
Break Even Analysis
Break Even
Analysis
Sales payment per procedure $885
numbe of procedures in year 1 500
numbe of procedures in year 2-5 850
Total Sales amount
1, 194,
750
Variable costs Cost of each Procedure $175
Total number of procedures 1350
Total Variable costs $236, 250
Contribution Per Unit 710
Gross Margin=sales-variable costs
$958,
500
Fixed Costs Purchasing costs
$ 11,
000
Rennovation Costs $9,000
$20,000
Employees Salaries
$ 336,
000
Total fixed costs
.
Lessening the Negative Impact of Human Factors Linking Staffing Variables & P...API Healthcare
In the United States, healthcare is a $2.9 trillion industry, costs $9,255 per capita and consumes 17.4% of the GDP.1 Healthcare is big business, and the way the entire industry conducts business is changing. While hospitals have always been in the business of providing patient care, the care delivery and payment models are undergoing an enormous paradigm shift. It’s no longer about the number of services provided, but instead about the quality of care delivered.
Running head John hopkins financial1John hopkins financial1.docxcowinhelen
Running head: John hopkins financial 1
John hopkins financial 12
John Hopkins Financial Analysis
jjjjjjjjjj
xxxxxxxx
xxxxxxx
xxxxxxxx
April 28, 2018
Contents
General Background……………………………………..……………………………………...3
Issues/Problems Identified………………...…………………………………………………….4
Analysis of ratios and other Financial Analysis tools….………………………………………5
Recommendations………….………………………………………………………………..…6-7
Implementation Plans.…………………………………………………………………………...8
Monitoring Methodology……………………….………………………………………………..9
References……………...……….……………………………………………………………….10Background
The start of this prestigious hospital dates to the late 1800’s when a wealthy Quaker philanthropist Johns Hopkins passed away. In his will, Johns Hopkins left seven million dollars to the start of a free hospital and medical colleges for the area of Baltimore, Maryland. Centuries later, Johns Hopkins Hospital is ranked in the top five hospitals in the nation. JHH serves as a leader in biomedical research, education, and treatment for the United States of America.
Johns Hopkins Hospital has evolved to become a complex system with six different hospitals, numerous healthcare sites, and four surgery centers in different locations of the USA.
Issues / Problems Identified
An analysis of John Hopkins Health System was done using several key ratios. This case study will identify the key problems. It will also suggest solutions to the problems, an implementation plan,and monitoring methodology.
According to the text,the total margin is the net income divided by the total revenues it is important because it provides a measure of a hospitals overall profitability. Analysts at the primary measure of a hospitals profitability. The industry average for total margin is 5%. According to the 2017 annual report, John Hopkins Health had a total profit margin of 2.9%. In comparison, UMass Memorial Health was 2.8. Both systems were lower than the industry average.(1)
The operating margin is the operating income divided by the total operating revenues. The industry average operating margin is 3.5%. John Hopkins Health 2017 operating margin was 2.5%. UMass Health had a slightly lower operating margin of 1.7%.
The Return of assets is the net income divided by the total assets. The ROA tells managers how productively, in a financial sense, a business is using its assets. The higher the ROA, the greater the net income on each dollar invested in assets and hence the more productive the assets. The industry average is 4.8%. John Hopkins Health 2017 ROA was 3.7, which was lower than the industry average. UMass Health was also lower at 2.7.
The return of equity is net income divided by the total equity. In a not-for-profit, the ROE is used to determine how well, in financial terms, its community supplied capital isused. The industry average for Return of Equity (ROE) is 8.4 percent. John Hopkins health had a 4.3 percent return of equity, which was lower than the industry average. Umass Health had ...
Introduction This chapter describes methods for assessing the.docxAASTHA76
Introduction
This chapter describes methods for assessing the financial health of hospitals and safety net institutions. The examples used are drawn principally from hospitals, but the principles and approaches apply to clinics and other safety net providers. The chapter discusses:
What is meant by financial health of institutions.
Alternative approaches and measures available to assess hospital financial health.
How these approaches and measures can be implemented using alternative data.
Issues and complications in interpreting this data.
The goal of this chapter is to enable the reader to identify potential measures, data sources for implementing these measures, and conceptual and accounting issues in implementing and interpreting these measures. It is not intended to be a primer on accounting or financial management, although accounting and financial management concepts are discussed (Lane, Longstreth, and Nixon, 2001).
Return to Contents
Measuring the Financial Health of Safety Net Hospitals
One definition of the financial health of an institution is its ability to continue to operate as a going concern. There are three dimensions to this ability:
1. Revenues and expenses must be in balance.
2. Adequate resources (that is, capital) must be available to deliver services and finance operations both in the short and long term.
3. The institution must be able to replenish or renew itself.
The first two dimensions are explicitly captured in a variety of measures; the third, ability to renew, is generally inferred from a range of data.
Revenues and Expenses
The first dimension of financial health is that revenues and expenses be in balance. More generally, we should expect that revenues at least match expenses ("break even"), and most financial analysts would expect an institution's revenues to exceed expenses, so as to finance increases in working capital and build funds as a cushion for a financial downturn and for renewal or expansion. The standard measure of profitability is margin:
(Revenues - Expenses) Revenues
Hospitals are multiproduct firms, with multiple sources of revenues. They provide inpatient and outpatient health care services, and they may provide other services to those using the hospital (parking, cafeteria, and so on) or to outside organizations (selling laboratory services, laundry, or catering services, for example, to other hospitals or health care providers). Some hospitals are involved in medical or related education, whereas others conduct research. Some receive philanthropy, government subsidies, or interest and investment income that may not be directly tied to any operational activities. Analyzing the margin requires specifying the level at which revenues are being aggregated and allocating expenses to match the revenues.
There are three common measures of margin. The broadest measure is total margin, which is computed as follows:
(Total revenues from all sources - Total expenses) Total .
Healthcare Total Cost of Care Analysis: A Vital ToolHealth Catalyst
How can healthcare organizations set themselves up for success as the industry shifts from fee-for-service to value-based reimbursement? They need to understand risk of their patients and population to identify ways to reduce healthcare costs and improve quality of care. This makes total cost of care (TCOC) analysis a necessary skillset in this time of transition.
TCOC analysis leverages key elements of the healthcare analytics infrastructure to understand how money is being spent at the organization and identify the drivers of high cost:
An integrated EDW.
Payer reporting tools.
Claims and membership data.
Predictive capabilities.
Risk scores.
Scorecards and dashboards.
Analyst support.
Running Head: FROM THE FRONT LINES1
From the Front Lines
Lisa M. Buentello
HCA 311: Health Care Financing & Information Systems
Professor Kathleen Martocci
May 29, 2015
- 1 -
[no notes on this page]
Future Direction of Health Care 2
From the Front Lines
The break even analysis figures can be used to establish the impacts of various
reimbursements such as Medicare, Medicaid, and Private and self-pay contributions. Notably,
from the break even analysis of the “From the Front lines” facility, increase in Medicare and
Medicaid benefits have an effect of increasing sales volume. Eventually, the value of the gross
margin increases leading to an upsurge of the value of the contribution per unit. This leads to a
reduction in the number of the break-even procedures. Private or self-pays have an effect of
increasing the volume of sales in addition to the increment made by Medicaid and Medicare
benefits. As a result, the break even procedures will become even smaller causing a
corresponding increase in profit margins.
Break even analysis is essentially important in developing my upcoming capital
investment proposal. It will be applicable in clarifying the extent of the viability of my planned
objectives. Specifically, this tool will be of great significance in evaluating expansion
opportunities, new providers, new services or new capital purchases (Cafferky, 2012). Break
even analysis is basically used in establishing whether the planned activity is viable enough to
cover the expected costs that are principally divided into variable and fixed expenses.
Also, I will utilize break analysis values to ascertain whether the capital proposal will be
financially viable. Specifically, it will be applicable in determining the activity level that will
- 2 -
[no notes on this page]
Future Direction of Health Care 3
cover the projected fixed and variable costs of the venture satisfactorily. It is at this point that a
break even analysis will be used to evaluate the critical components of my budget plan.
Typically, break even analysis and the budget plan are used interchangeably while
making financial analysis that concerns various capital investment plan proposals (Cafferky,
2012).
Break Even Analysis
Break Even
Analysis
Sales payment per procedure $885
numbe of procedures in year 1 500
numbe of procedures in year 2-5 850
Total Sales amount
1, 194,
750
Variable costs Cost of each Procedure $175
Total number of procedures 1350
Total Variable costs $236, 250
Contribution Per Unit 710
Gross Margin=sales-variable costs
$958,
500
Fixed Costs Purchasing costs
$ 11,
000
Rennovation Costs $9,000
$20,000
Employees Salaries
$ 336,
000
Total fixed costs
.
Lessening the Negative Impact of Human Factors Linking Staffing Variables & P...API Healthcare
In the United States, healthcare is a $2.9 trillion industry, costs $9,255 per capita and consumes 17.4% of the GDP.1 Healthcare is big business, and the way the entire industry conducts business is changing. While hospitals have always been in the business of providing patient care, the care delivery and payment models are undergoing an enormous paradigm shift. It’s no longer about the number of services provided, but instead about the quality of care delivered.
Running head John hopkins financial1John hopkins financial1.docxcowinhelen
Running head: John hopkins financial 1
John hopkins financial 12
John Hopkins Financial Analysis
jjjjjjjjjj
xxxxxxxx
xxxxxxx
xxxxxxxx
April 28, 2018
Contents
General Background……………………………………..……………………………………...3
Issues/Problems Identified………………...…………………………………………………….4
Analysis of ratios and other Financial Analysis tools….………………………………………5
Recommendations………….………………………………………………………………..…6-7
Implementation Plans.…………………………………………………………………………...8
Monitoring Methodology……………………….………………………………………………..9
References……………...……….……………………………………………………………….10Background
The start of this prestigious hospital dates to the late 1800’s when a wealthy Quaker philanthropist Johns Hopkins passed away. In his will, Johns Hopkins left seven million dollars to the start of a free hospital and medical colleges for the area of Baltimore, Maryland. Centuries later, Johns Hopkins Hospital is ranked in the top five hospitals in the nation. JHH serves as a leader in biomedical research, education, and treatment for the United States of America.
Johns Hopkins Hospital has evolved to become a complex system with six different hospitals, numerous healthcare sites, and four surgery centers in different locations of the USA.
Issues / Problems Identified
An analysis of John Hopkins Health System was done using several key ratios. This case study will identify the key problems. It will also suggest solutions to the problems, an implementation plan,and monitoring methodology.
According to the text,the total margin is the net income divided by the total revenues it is important because it provides a measure of a hospitals overall profitability. Analysts at the primary measure of a hospitals profitability. The industry average for total margin is 5%. According to the 2017 annual report, John Hopkins Health had a total profit margin of 2.9%. In comparison, UMass Memorial Health was 2.8. Both systems were lower than the industry average.(1)
The operating margin is the operating income divided by the total operating revenues. The industry average operating margin is 3.5%. John Hopkins Health 2017 operating margin was 2.5%. UMass Health had a slightly lower operating margin of 1.7%.
The Return of assets is the net income divided by the total assets. The ROA tells managers how productively, in a financial sense, a business is using its assets. The higher the ROA, the greater the net income on each dollar invested in assets and hence the more productive the assets. The industry average is 4.8%. John Hopkins Health 2017 ROA was 3.7, which was lower than the industry average. UMass Health was also lower at 2.7.
The return of equity is net income divided by the total equity. In a not-for-profit, the ROE is used to determine how well, in financial terms, its community supplied capital isused. The industry average for Return of Equity (ROE) is 8.4 percent. John Hopkins health had a 4.3 percent return of equity, which was lower than the industry average. Umass Health had ...
Introduction This chapter describes methods for assessing the.docxAASTHA76
Introduction
This chapter describes methods for assessing the financial health of hospitals and safety net institutions. The examples used are drawn principally from hospitals, but the principles and approaches apply to clinics and other safety net providers. The chapter discusses:
What is meant by financial health of institutions.
Alternative approaches and measures available to assess hospital financial health.
How these approaches and measures can be implemented using alternative data.
Issues and complications in interpreting this data.
The goal of this chapter is to enable the reader to identify potential measures, data sources for implementing these measures, and conceptual and accounting issues in implementing and interpreting these measures. It is not intended to be a primer on accounting or financial management, although accounting and financial management concepts are discussed (Lane, Longstreth, and Nixon, 2001).
Return to Contents
Measuring the Financial Health of Safety Net Hospitals
One definition of the financial health of an institution is its ability to continue to operate as a going concern. There are three dimensions to this ability:
1. Revenues and expenses must be in balance.
2. Adequate resources (that is, capital) must be available to deliver services and finance operations both in the short and long term.
3. The institution must be able to replenish or renew itself.
The first two dimensions are explicitly captured in a variety of measures; the third, ability to renew, is generally inferred from a range of data.
Revenues and Expenses
The first dimension of financial health is that revenues and expenses be in balance. More generally, we should expect that revenues at least match expenses ("break even"), and most financial analysts would expect an institution's revenues to exceed expenses, so as to finance increases in working capital and build funds as a cushion for a financial downturn and for renewal or expansion. The standard measure of profitability is margin:
(Revenues - Expenses) Revenues
Hospitals are multiproduct firms, with multiple sources of revenues. They provide inpatient and outpatient health care services, and they may provide other services to those using the hospital (parking, cafeteria, and so on) or to outside organizations (selling laboratory services, laundry, or catering services, for example, to other hospitals or health care providers). Some hospitals are involved in medical or related education, whereas others conduct research. Some receive philanthropy, government subsidies, or interest and investment income that may not be directly tied to any operational activities. Analyzing the margin requires specifying the level at which revenues are being aggregated and allocating expenses to match the revenues.
There are three common measures of margin. The broadest measure is total margin, which is computed as follows:
(Total revenues from all sources - Total expenses) Total .
Similar to HMP Metrics™: Investor Owned Hospitals October, 2010 (20)
Discover the innovative and creative projects that highlight my journey throu...dylandmeas
Discover the innovative and creative projects that highlight my journey through Full Sail University. Below, you’ll find a collection of my work showcasing my skills and expertise in digital marketing, event planning, and media production.
Implicitly or explicitly all competing businesses employ a strategy to select a mix
of marketing resources. Formulating such competitive strategies fundamentally
involves recognizing relationships between elements of the marketing mix (e.g.,
price and product quality), as well as assessing competitive and market conditions
(i.e., industry structure in the language of economics).
Putting the SPARK into Virtual Training.pptxCynthia Clay
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Event Report - SAP Sapphire 2024 Orlando - lots of innovation and old challengesHolger Mueller
Holger Mueller of Constellation Research shares his key takeaways from SAP's Sapphire confernece, held in Orlando, June 3rd till 5th 2024, in the Orange Convention Center.
2. Table of Contents
Executive Summary 3-5
Financial and Operational Study 6 - 59
• Total Profit Margin 6 - 14
• Total Operating Profit Margin 15 - 23
• Total Labor Cost as a Percentage of Total Operating Revenues 24 - 32
• Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 33 - 41
• Days Net Patient Revenue in Accounts Receivable (AR) 42 - 50
• Average Age of Plant and Equipment 51 - 59
Introduction to Healthcare Management Partners 60 - 64
Clients Our Professionals Have Served 65 - 66
Firm Leadership 67 - 70
Contact Information 71
October 2010 2
3. Executive Summary – Overview
Healthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its senior
executives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignments
across the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools are
necessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMP
MetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparable
facilities and against “1st Quartile” or “High Performing” competitors.
Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive study
comparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groups
selected include the following:
1. All General Acute Care Hospitals Regardless of Ownership or Sponsorship
2. All Investor Owned General Acute Care Hospitals
3. All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations
4. All State and Local Government Owned General Acute Care Hospitals
5. Free Standing Children’s Hospitals
6. All Non-Federal Major Teaching Hospitals
Using proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period or
statistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals,
specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensed
beds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer group
comparisons for dozens of standard industry metrics.
This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustrate
the benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess the
relative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or create
new peer groups and compare them to state, local or national benchmarks.
October 2010 3
4. Executive Summary – Key Terms
Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for all investor owned
general acute care hospitals within the peer groups.
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
2009
Quartile Rank
Mean Median Count
1st Quartile 19.14% 18.86% 148
2nd Quartile 10.53% 10.84% 150
3rd Quartile 4.37% 4.15% 153
4th Quartile (4.50%) (3.63%) 155
Total Population 7.23% 7.48% 606
Excluded Cost Reports 94
Total Cost Reports 700
As noted above, the first quartile contains the top 25% of the best performing hospitals in an applicable peer group,
the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains those
hospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%.
Mean Value: The mean value is the average of all amounts within a defined quartile or population.
Median Value: The report also contains the median value by quartile or total population.
Count: Actual number of qualified hospitals included in the mean or median calculation.
Excluded Cost Reports: Represents those metrics values not considered normative (i.e., outlier values). For
example, certain metric values that were greater than two standard deviations from the mean of a reported population
would be excluded from the analysis and included in this category.
October 2010 4
5. Executive Summary – Hospital Performance Metrics
A measure of overall hospital profitability presented as a percentage. A negative percentage
Total Profit Margin
indicates an overall loss, while a positive percentage indicates profitability.
A measure of operating profitability presented as a percentage. A negative percentage
Total Operating Profit Margin
indicates overall loss, while a positive percentage indicates profitability.
A measure of labor productivity. This metric divides labor costs by operating revenues. A
Total Labor Cost as a Percentage of
higher percentage compared to its peers indicates that a hospital uses more labor to produce its
Total Operating Revenues
revenue.
Measures the number of full-time equivalent (FTE) employees used for each occupied bed.
Full-Time Equivalent (FTE) Staff per
Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital
Adjusted Occupied Bed (AOB)
uses more labor to treat its patients.
Measures the number of days it typically takes to collect accounts receivable. A higher
Average Days Net Patient Revenue in
percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as
Accounts Receivable (AR)
its peers.
Measures the average age of the hospital including capital improvements and major equipment
Average Age of Plant purchases. A higher age compared to its peers indicates that the hospital has deferred the
replacement of its capital when compared to its peers, which can lead to further distress.
Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal
Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management
when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in
the Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations.
Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, and
hospitals where the computed metric is more than 2 standard deviations from the mean.
October 2010 5
6. Total Profit Margin - Summary
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
2009 2008 2007
Number of Licensed Beds
Mean Median Count Mean Median Count Mean Median Count
25 Beds or Less 6.17% 5.52% 75 5.93% 7.16% 89 5.79% 8.16% 89
26 to 100 Beds 5.39% 5.08% 166 5.38% 6.28% 187 6.08% 5.50% 196
101 to 200 Beds 7.54% 7.59% 197 6.00% 6.07% 221 6.27% 6.26% 226
201 to 300 Beds 9.90% 10.98% 86 7.65% 8.41% 89 8.39% 8.84% 92
301 to 400 Beds 8.29% 8.95% 43 6.97% 7.10% 47 7.16% 8.39% 49
401 to 500 Beds 7.61% 6.98% 21 6.48% 4.88% 24 7.85% 8.74% 23
Over 500 Beds 9.59% 9.36% 18 8.52% 8.05% 18 9.80% 8.99% 18
Total All Hospitals 7.23% 7.48% 606 6.19% 6.71% 675 6.64% 7.06% 693
Excluded Cost Reports 94 89 100
Total Cost Reports 700 764 793
2006 2005 2004
Number of Licensed Beds
Mean Median Count Mean Median Count Mean Median Count
25 Beds or Less 4.76% 3.80% 92 5.62% 4.56% 69 4.98% 5.75% 57
26 to 100 Beds 6.50% 6.10% 195 6.52% 6.70% 193 4.87% 5.23% 199
101 to 200 Beds 5.67% 5.61% 218 5.81% 6.27% 215 5.55% 6.21% 216
201 to 300 Beds 8.71% 9.20% 96 8.05% 8.35% 92 7.52% 7.30% 98
301 to 400 Beds 7.85% 6.52% 46 5.96% 6.47% 48 7.88% 8.17% 50
401 to 500 Beds 4.16% 6.48% 23 6.00% 5.59% 21 6.87% 7.58% 24
Over 500 Beds 8.56% 8.91% 20 10.03% 7.16% 20 9.64% 9.39% 19
Total All Hospitals 6.39% 6.48% 690 6.46% 6.63% 658 5.93% 6.16% 663
Excluded Cost Reports 107 106 87
Total Cost Reports 797 764 750
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 6
7. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.40% 20.53% 18 20.28% 19.39% 22 19.42% 19.31% 22
2nd Quartile 10.13% 9.73% 19 11.46% 11.66% 22 10.48% 9.93% 22
3rd Quartile 2.41% 2.31% 19 2.39% 2.48% 22 3.70% 4.22% 22
4th Quartile (7.53%) (6.49%) 19 (9.71%) (9.71%) 23 (9.73%) (9.63%) 23
Total Population 6.17% 5.52% 75 5.93% 7.16% 89 5.79% 8.16% 89
Excluded Cost Reports 21 29 33
Total Cost Reports 96 118 122
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.37% 20.09% 23 21.69% 21.72% 17 19.89% 19.48% 14
2nd Quartile 9.39% 9.05% 23 10.33% 11.41% 17 9.73% 9.03% 14
3rd Quartile 0.32% 0.26% 23 1.26% 1.99% 17 0.88% 0.10% 14
4th Quartile (11.05%) (9.87%) 23 (9.88%) (9.33%) 18 (9.55%) (9.28%) 15
Total Population 4.76% 3.80% 92 5.62% 4.56% 69 4.98% 5.75% 57
Excluded Cost Reports 35 25 23
Total Cost Reports 127 94 80
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 7
8. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.60% 18.98% 41 19.56% 19.39% 46 19.49% 19.09% 49
2nd Quartile 9.06% 8.32% 41 9.74% 9.79% 47 9.67% 10.11% 49
3rd Quartile 1.62% 1.26% 42 2.22% 2.27% 47 2.60% 2.49% 49
4th Quartile (8.27%) (7.64%) 42 (9.68%) (8.87%) 47 (7.46%) (6.22%) 49
Total Population 5.39% 5.08% 166 5.38% 6.28% 187 6.08% 5.50% 196
Excluded Cost Reports 34 33 34
Total Cost Reports 200 220 230
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.73% 20.82% 48 19.19% 18.75% 48 19.18% 18.55% 49
2nd Quartile 11.14% 11.40% 49 10.51% 10.46% 48 8.86% 9.19% 50
3rd Quartile 2.68% 2.68% 49 3.75% 4.15% 48 1.21% 0.95% 50
4th Quartile (8.25%) (7.17%) 49 (7.08%) (5.26%) 49 (9.49%) (9.55%) 50
Total Population 6.50% 6.10% 195 6.52% 6.70% 193 4.87% 5.23% 199
Excluded Cost Reports 34 36 28
Total Cost Reports 229 229 227
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 8
9. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 18.75% 18.90% 49 17.96% 17.41% 55 18.11% 17.48% 56
2nd Quartile 10.58% 10.50% 49 9.44% 9.74% 55 9.52% 9.42% 56
3rd Quartile 4.42% 4.24% 49 2.88% 3.09% 55 3.14% 3.07% 57
4th Quartile (3.38%) (2.43%) 50 (6.07%) (5.10%) 56 (5.45%) (3.76%) 57
Total Population 7.54% 7.59% 197 6.00% 6.07% 221 6.27% 6.26% 226
Excluded Cost Reports 25 16 23
Total Cost Reports 222 237 249
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 17.58% 17.32% 54 17.53% 17.42% 53 17.95% 16.71% 54
2nd Quartile 9.35% 9.45% 54 9.37% 9.17% 54 9.13% 9.19% 54
3rd Quartile 2.51% 2.33% 55 3.43% 3.59% 54 2.97% 3.17% 54
4th Quartile (6.47%) (5.79%) 55 (6.89%) (5.44%) 54 (7.84%) (6.94%) 54
Total Population 5.67% 5.61% 218 5.81% 6.27% 215 5.55% 6.21% 216
Excluded Cost Reports 30 34 27
Total Cost Reports 248 249 243
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 9
10. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 18.89% 17.62% 21 16.84% 16.09% 22 17.97% 17.33% 23
2nd Quartile 12.72% 12.34% 21 10.51% 10.49% 22 11.32% 11.34% 23
3rd Quartile 8.85% 8.77% 22 6.17% 6.40% 22 6.40% 6.25% 23
4th Quartile (0.34%) 3.19% 22 (2.47%) (0.63%) 23 (2.15%) (0.75%) 23
Total Population 9.90% 10.98% 86 7.65% 8.41% 89 8.39% 8.84% 92
Excluded Cost Reports 9 9 8
Total Cost Reports 95 98 100
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.05% 18.01% 24 18.78% 18.66% 23 19.07% 19.56% 24
2nd Quartile 11.86% 11.69% 24 10.86% 10.55% 23 10.33% 10.19% 24
3rd Quartile 6.52% 6.79% 24 5.52% 5.03% 23 4.56% 4.47% 25
4th Quartile (2.58%) (0.00%) 24 (2.98%) (0.42%) 23 (3.31%) (2.77%) 25
Total Population 8.71% 9.20% 96 8.05% 8.35% 92 7.52% 7.30% 98
Excluded Cost Reports 5 8 4
Total Cost Reports 101 100 102
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 10
11. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 18.00% 18.06% 10 18.17% 18.27% 11 18.16% 18.13% 12
2nd Quartile 11.39% 10.83% 11 9.76% 9.52% 12 10.97% 10.61% 12
3rd Quartile 7.14% 7.04% 11 4.07% 4.09% 12 4.91% 5.02% 12
4th Quartile (2.48%) (1.89%) 11 (3.21%) (3.22%) 12 (4.42%) (3.72%) 13
Total Population 8.29% 8.95% 43 6.97% 7.10% 47 7.16% 8.39% 49
Excluded Cost Reports 3 2 1
Total Cost Reports 46 49 50
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.21% 18.69% 11 18.52% 17.76% 12 19.91% 18.58% 12
2nd Quartile 10.38% 10.05% 11 10.21% 10.23% 12 11.00% 10.32% 12
3rd Quartile 5.05% 5.30% 12 3.19% 3.01% 12 5.37% 5.11% 13
4th Quartile (2.06%) (1.63%) 12 (8.06%) (5.65%) 12 (3.58%) (2.43%) 13
Total Population 7.85% 6.52% 46 5.96% 6.47% 48 7.88% 8.17% 50
Excluded Cost Reports 2 2 4
Total Cost Reports 48 50 54
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 11
12. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 16.77% 14.17% 5 16.44% 16.28% 6 18.55% 18.44% 5
2nd Quartile 9.53% 9.36% 5 7.33% 7.77% 6 10.16% 9.85% 6
3rd Quartile 5.33% 6.33% 5 2.79% 2.23% 6 6.47% 7.21% 6
4th Quartile 0.28% 1.17% 6 (0.63%) (0.35%) 6 (1.97%) (1.29%) 6
Total Population 7.61% 6.98% 21 6.48% 4.88% 24 7.85% 8.74% 23
Excluded Cost Reports 2 0 1
Total Cost Reports 23 24 24
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 16.34% 16.22% 5 15.29% 14.17% 5 18.97% 17.64% 6
2nd Quartile 9.48% 9.03% 6 10.58% 11.34% 5 10.53% 10.66% 6
3rd Quartile 2.57% 2.59% 6 2.73% 2.58% 5 3.55% 3.29% 6
4th Quartile (9.71%) (9.63%) 6 (2.84%) (1.33%) 6 (5.58%) (4.02%) 6
Total Population 4.16% 6.48% 23 6.00% 5.59% 21 6.87% 7.58% 24
Excluded Cost Reports 1 1 0
Total Cost Reports 24 22 24
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 12
13. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.75% 20.88% 4 20.60% 20.10% 4 19.43% 19.55% 4
2nd Quartile 14.12% 14.09% 4 12.43% 12.18% 4 12.30% 12.26% 4
3rd Quartile 7.58% 6.83% 5 6.47% 6.74% 5 8.12% 8.87% 5
4th Quartile (0.94%) (1.64%) 5 (2.21%) (2.07%) 5 1.80% 2.09% 5
Total Population 9.59% 9.36% 18 8.52% 8.05% 18 9.80% 8.99% 18
Excluded Cost Reports 0 0 0
Total Cost Reports 18 18 18
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 17.56% 16.91% 5 21.03% 22.05% 5 16.98% 16.00% 4
2nd Quartile 10.53% 10.49% 5 11.28% 11.46% 5 11.38% 10.77% 5
3rd Quartile 7.26% 7.79% 5 6.07% 5.72% 5 7.62% 8.24% 5
4th Quartile (1.11%) (0.58%) 5 1.76% 2.51% 5 4.06% 4.06% 5
Total Population 8.56% 8.91% 20 10.03% 7.16% 20 9.64% 9.39% 19
Excluded Cost Reports 0 0 1
Total Cost Reports 20 20 20
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 13
14. Peer Group Comparison – Total Profit Margin
Total Profit Margin
All Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.14% 18.86% 148 18.59% 18.38% 166 18.70% 18.21% 171
2nd Quartile 10.53% 10.84% 150 9.95% 10.11% 168 10.11% 10.29% 172
3rd Quartile 4.37% 4.15% 153 3.25% 3.14% 169 3.87% 3.85% 174
4th Quartile (4.50%) (3.63%) 155 (6.56%) (6.31%) 172 (5.74%) (4.72%) 176
Total Population 7.23% 7.48% 606 6.19% 6.71% 675 6.64% 7.06% 693
Excluded Cost Reports 94 89 100
Total Cost Reports 700 764 793
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.12% 18.57% 170 18.74% 18.56% 163 18.81% 17.89% 163
2nd Quartile 10.32% 10.57% 172 10.17% 10.28% 164 9.53% 9.66% 165
3rd Quartile 3.14% 3.16% 174 3.64% 3.99% 164 2.85% 3.08% 167
4th Quartile (6.70%) (6.20%) 174 (6.41%) (5.17%) 167 (7.04%) (6.36%) 168
Total Population 6.39% 6.48% 690 6.46% 6.63% 658 5.93% 6.16% 663
Excluded Cost Reports 107 106 87
Total Cost Reports 797 764 750
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 14
15. Total Operating Profit Margin - Summary
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
2009 2008 2007
Number of Licensed Beds
Mean Median Count Mean Median Count Mean Median Count
25 Beds or Less 3.21% 2.36% 76 3.64% 3.19% 85 2.27% 4.65% 94
26 to 100 Beds 5.46% 4.61% 166 5.10% 5.69% 187 5.03% 5.05% 199
101 to 200 Beds 6.59% 6.55% 196 6.01% 6.25% 210 4.98% 5.70% 217
201 to 300 Beds 8.51% 9.65% 85 7.33% 8.32% 87 7.54% 9.38% 86
301 to 400 Beds 7.77% 8.46% 42 6.38% 6.06% 46 6.88% 8.20% 48
401 to 500 Beds 6.38% 5.50% 21 6.37% 5.66% 24 6.29% 6.29% 24
Over 500 Beds 8.55% 8.84% 18 6.58% 6.61% 17 6.64% 7.89% 17
Total All Hospitals 6.26% 6.52% 604 5.67% 6.18% 656 5.16% 5.76% 685
Excluded Cost Reports 96 108 108
Total Cost Reports 700 764 793
2006 2005 2004
Number of Licensed Beds
Mean Median Count Mean Median Count Mean Median Count
25 Beds or Less 1.23% 0.89% 94 0.45% 0.46% 74 1.14% (1.71%) 58
26 to 100 Beds 5.14% 6.15% 201 5.35% 6.55% 200 3.62% 4.26% 197
101 to 200 Beds 4.42% 4.99% 216 4.59% 4.91% 208 4.66% 5.56% 216
201 to 300 Beds 7.90% 9.65% 90 7.15% 7.50% 90 6.51% 6.31% 94
301 to 400 Beds 6.48% 5.46% 45 5.69% 5.91% 49 5.73% 8.62% 53
401 to 500 Beds 4.88% 4.31% 23 4.10% 4.21% 19 4.42% 5.34% 22
Over 500 Beds 6.69% 7.59% 20 7.42% 4.97% 20 6.42% 7.96% 18
Total All Hospitals 4.87% 5.82% 689 4.86% 5.22% 660 4.43% 5.21% 658
Excluded Cost Reports 108 104 92
Total Cost Reports 797 764 750
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 15
16. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.04% 20.39% 19 20.25% 19.38% 21 19.57% 18.97% 23
2nd Quartile 8.57% 8.94% 19 9.69% 10.02% 21 9.53% 9.92% 23
3rd Quartile (1.36%) (0.53%) 19 0.21% 0.27% 21 (1.64%) (1.13%) 24
4th Quartile (14.41%) (13.46%) 19 (14.72%) (15.96%) 22 (17.35%) (17.54%) 24
Total Population 3.21% 2.36% 76 3.64% 3.19% 85 2.27% 4.65% 94
Excluded Cost Reports 20 33 28
Total Cost Reports 96 118 122
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.01% 19.02% 23 19.46% 19.29% 18 18.72% 17.35% 14
2nd Quartile 7.41% 7.03% 23 7.04% 7.40% 18 7.06% 5.69% 14
3rd Quartile (3.89%) (3.09%) 24 (4.49%) (3.38%) 19 (4.52%) (5.03%) 15
4th Quartile (16.62%) (16.99%) 24 (18.86%) (20.35%) 19 (15.11%) (12.75%) 15
Total Population 1.23% 0.89% 94 0.45% 0.46% 74 1.14% (1.71%) 58
Excluded Cost Reports 33 20 22
Total Cost Reports 127 94 80
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 16
17. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.44% 20.61% 41 20.28% 20.86% 46 19.18% 18.48% 49
2nd Quartile 10.05% 9.47% 41 9.91% 9.85% 47 9.89% 10.13% 50
3rd Quartile 0.86% 0.53% 42 2.01% 2.42% 47 1.69% 1.95% 50
4th Quartile (9.04%) (8.35%) 42 (11.49%) (10.15%) 47 (10.36%) (8.44%) 50
Total Population 5.46% 4.61% 166 5.10% 5.69% 187 5.03% 5.05% 199
Excluded Cost Reports 34 33 31
Total Cost Reports 200 220 230
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.78% 20.69% 50 18.88% 18.54% 50 18.21% 16.97% 49
2nd Quartile 10.95% 11.03% 50 10.58% 10.22% 50 8.40% 8.73% 49
3rd Quartile 1.68% 2.37% 50 2.46% 2.63% 50 (0.00%) (0.31%) 49
4th Quartile (12.49%) (12.04%) 51 (10.51%) (8.96%) 50 (11.83%) (11.68%) 50
Total Population 5.14% 6.15% 201 5.35% 6.55% 200 3.62% 4.26% 197
Excluded Cost Reports 28 29 30
Total Cost Reports 229 229 227
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 17
18. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.26% 20.33% 49 18.76% 18.29% 52 18.59% 17.98% 54
2nd Quartile 10.44% 11.01% 49 10.04% 10.07% 52 9.18% 9.40% 54
3rd Quartile 3.33% 3.28% 49 2.46% 2.20% 53 1.50% 1.27% 54
4th Quartile (7.67%) (5.95%) 49 (6.89%) (5.58%) 53 (9.10%) (7.33%) 55
Total Population 6.59% 6.55% 196 6.01% 6.25% 210 4.98% 5.70% 217
Excluded Cost Reports 26 27 32
Total Cost Reports 222 237 249
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 18.63% 18.50% 54 18.63% 18.36% 52 18.78% 18.60% 54
2nd Quartile 9.37% 9.28% 54 8.47% 8.52% 52 9.14% 8.90% 54
3rd Quartile 0.22% (0.29%) 54 1.21% 0.98% 52 1.52% 1.94% 54
4th Quartile (10.53%) (8.34%) 54 (9.96%) (9.12%) 52 (10.79%) (9.46%) 54
Total Population 4.42% 4.99% 216 4.59% 4.91% 208 4.66% 5.56% 216
Excluded Cost Reports 32 41 27
Total Cost Reports 248 249 243
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 18
19. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 201 and 300 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.33% 19.96% 21 18.88% 19.93% 21 19.05% 17.59% 21
2nd Quartile 12.14% 11.25% 21 10.97% 11.01% 22 11.82% 11.80% 21
3rd Quartile 7.05% 6.50% 21 5.34% 5.22% 22 5.27% 5.15% 22
4th Quartile (3.87%) (0.79%) 22 (5.33%) (4.48%) 22 (5.27%) (3.95%) 22
Total Population 8.51% 9.65% 85 7.33% 8.32% 87 7.54% 9.38% 86
Excluded Cost Reports 10 11 14
Total Cost Reports 95 98 100
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.33% 20.38% 22 20.11% 19.02% 22 19.40% 19.43% 23
2nd Quartile 12.72% 12.78% 22 10.80% 10.77% 22 10.93% 11.16% 23
3rd Quartile 5.71% 5.74% 23 4.02% 3.75% 23 2.97% 2.53% 24
4th Quartile (6.40%) (2.89%) 23 (5.62%) (3.14%) 23 (6.55%) (4.71%) 24
Total Population 7.90% 9.65% 90 7.15% 7.50% 90 6.51% 6.31% 94
Excluded Cost Reports 11 10 8
Total Cost Reports 101 100 102
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 19
20. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 301 and 400 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 18.63% 17.94% 10 19.17% 17.90% 11 18.40% 18.47% 12
2nd Quartile 12.07% 13.05% 10 9.60% 9.36% 11 10.45% 10.24% 12
3rd Quartile 6.16% 6.28% 11 3.83% 4.69% 12 4.44% 3.90% 12
4th Quartile (4.41%) (4.28%) 11 (5.74%) (4.58%) 12 (5.74%) (5.58%) 12
Total Population 7.77% 8.46% 42 6.38% 6.06% 46 6.88% 8.20% 48
Excluded Cost Reports 4 3 2
Total Cost Reports 46 49 50
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.23% 19.22% 11 19.84% 19.98% 12 19.04% 19.44% 13
2nd Quartile 10.11% 10.68% 11 11.04% 10.11% 12 10.64% 10.09% 13
3rd Quartile 3.57% 3.98% 11 1.98% 2.22% 12 3.87% 3.30% 13
4th Quartile (5.85%) (4.55%) 12 (8.88%) (5.80%) 13 (9.47%) (6.70%) 14
Total Population 6.48% 5.46% 45 5.69% 5.91% 49 5.73% 8.62% 53
Excluded Cost Reports 3 1 1
Total Cost Reports 48 50 54
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 20
21. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Between 401 and 500 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.01% 22.28% 5 18.29% 18.57% 6 20.63% 19.76% 6
2nd Quartile 8.98% 9.47% 5 8.24% 7.26% 6 9.41% 8.27% 6
3rd Quartile 2.81% 2.35% 5 3.06% 4.31% 6 1.25% 0.56% 6
4th Quartile (3.34%) (2.36%) 6 (4.11%) (3.58%) 6 (6.14%) (3.88%) 6
Total Population 6.38% 5.50% 21 6.37% 5.66% 24 6.29% 6.29% 24
Excluded Cost Reports 2 0 0
Total Cost Reports 23 24 24
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.26% 19.52% 5 17.66% 16.31% 4 17.67% 17.14% 5
2nd Quartile 9.92% 9.18% 6 8.65% 10.28% 5 9.14% 9.43% 5
3rd Quartile 1.21% 1.55% 6 0.13% (0.38%) 5 1.92% 2.07% 6
4th Quartile (9.31%) (8.28%) 6 (7.33%) (7.05%) 5 (8.06%) (6.69%) 6
Total Population 4.88% 4.31% 23 4.10% 4.21% 19 4.42% 5.34% 22
Excluded Cost Reports 1 3 2
Total Cost Reports 24 22 24
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 21
22. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States with Over 500 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 21.36% 20.61% 4 18.49% 18.70% 4 17.85% 17.27% 4
2nd Quartile 13.72% 13.70% 4 10.12% 10.51% 4 10.83% 10.78% 4
3rd Quartile 6.08% 6.32% 5 4.33% 5.40% 4 3.32% 2.41% 4
4th Quartile (3.35%) (2.96%) 5 (4.00%) (5.07%) 5 (3.01%) (3.53%) 5
Total Population 8.55% 8.84% 18 6.58% 6.61% 17 6.64% 7.89% 17
Excluded Cost Reports 0 1 1
Total Cost Reports 18 18 18
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 18.33% 16.43% 5 20.81% 21.23% 5 14.12% 14.10% 4
2nd Quartile 10.53% 9.26% 5 10.98% 10.90% 5 10.06% 10.13% 4
3rd Quartile 2.72% 0.36% 5 1.71% 1.13% 5 6.17% 7.50% 5
4th Quartile (4.82%) (3.07%) 5 (3.81%) (2.77%) 5 (2.42%) (0.92%) 5
Total Population 6.69% 7.59% 20 7.42% 4.97% 20 6.42% 7.96% 18
Excluded Cost Reports 0 0 2
Total Cost Reports 20 20 20
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 22
23. Peer Group Comparison – Total Operating Profit Margin
Total Operating Profit Margin
All Investor Owned General Acute Care Hospitals in the United States Regardless of Bed Size
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 20.03% 20.12% 149 19.41% 19.38% 161 18.99% 18.47% 169
2nd Quartile 10.48% 10.51% 149 9.99% 10.06% 163 9.90% 9.93% 170
3rd Quartile 2.85% 2.98% 152 2.60% 2.67% 165 1.84% 2.02% 172
4th Quartile (7.79%) (6.44%) 154 (8.74%) (7.47%) 167 (9.60%) (8.04%) 174
Total Population 6.26% 6.52% 604 5.67% 6.18% 656 5.16% 5.76% 685
Excluded Cost Reports 96 108 108
Total Cost Reports 700 764 793
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 19.61% 19.54% 170 19.13% 18.78% 163 18.56% 17.76% 162
2nd Quartile 10.10% 10.35% 171 9.54% 9.78% 164 9.13% 9.49% 162
3rd Quartile 1.12% 1.22% 173 1.36% 1.44% 166 1.07% 1.54% 166
4th Quartile (10.87%) (9.50%) 175 (10.19%) (8.83%) 167 (10.42%) (9.27%) 168
Total Population 4.87% 5.82% 689 4.86% 5.22% 660 4.43% 5.21% 658
Excluded Cost Reports 108 104 92
Total Cost Reports 797 764 750
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 23
24. Total Labor Cost as a Percentage of Total Operating Revenues - Summary
Total Labor Cost as a Percentage of Total Operating Revenues
All Investor Owned General Acute Care Hospitals in the United States Ranked by Number of Licensed Beds
2009 2008 2007
Number of Licensed Beds
Mean Median Count Mean Median Count Mean Median Count
25 Beds or Less 42.84% 40.62% 61 43.59% 40.46% 71 44.48% 43.43% 69
26 to 100 Beds 42.90% 40.77% 170 44.35% 42.50% 186 43.58% 43.19% 197
101 to 200 Beds 42.98% 41.94% 207 43.92% 42.54% 224 44.79% 44.16% 239
201 to 300 Beds 41.55% 40.13% 91 42.64% 41.13% 96 43.00% 41.72% 97
301 to 400 Beds 44.24% 43.69% 45 44.72% 45.15% 49 44.29% 44.25% 50
401 to 500 Beds 46.17% 44.86% 22 45.87% 45.51% 24 46.40% 45.08% 24
Over 500 Beds 42.66% 41.55% 18 44.51% 43.71% 18 44.24% 43.32% 18
Total All Hospitals 42.93% 41.49% 614 43.97% 42.45% 668 44.17% 43.56% 694
Excluded Cost Reports 86 96 99
Total Cost Reports 700 764 793
2006 2005 2004
Number of Licensed Beds
Mean Median Count Mean Median Count Mean Median Count
25 Beds or Less 44.99% 43.57% 79 44.79% 42.61% 62 48.59% 48.40% 51
26 to 100 Beds 43.55% 42.35% 191 44.58% 43.27% 200 44.89% 43.99% 201
101 to 200 Beds 45.39% 44.09% 234 45.44% 44.44% 239 45.45% 44.16% 233
201 to 300 Beds 42.90% 41.46% 98 43.81% 42.31% 98 44.12% 42.39% 100
301 to 400 Beds 44.53% 44.73% 48 45.32% 44.68% 50 44.52% 44.03% 52
401 to 500 Beds 46.14% 43.95% 24 45.71% 45.71% 22 46.29% 46.06% 24
Over 500 Beds 44.36% 42.57% 20 43.56% 42.36% 20 44.30% 43.43% 19
Total All Hospitals 44.42% 42.83% 694 44.85% 43.55% 691 45.25% 43.92% 680
Excluded Cost Reports 103 73 70
Total Cost Reports 797 764 750
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 24
25. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Total Labor Cost as a Percentage of Total Operating Revenues
All Investor Owned General Acute Care Hospitals in the United States with 25 Licensed Beds or Less
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 32.04% 32.42% 15 31.61% 31.62% 17 31.67% 31.84% 17
2nd Quartile 36.44% 36.21% 15 36.56% 36.19% 18 38.40% 38.15% 17
3rd Quartile 45.63% 46.09% 15 46.84% 48.48% 18 47.34% 48.25% 17
4th Quartile 56.35% 53.92% 16 58.69% 57.30% 18 59.62% 58.07% 18
Total Population 42.84% 40.62% 61 43.59% 40.46% 71 44.48% 43.43% 69
Excluded Cost Reports 35 47 53
Total Cost Reports 96 118 122
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 31.89% 32.07% 19 31.16% 31.17% 15 34.14% 34.32% 12
2nd Quartile 39.01% 39.35% 20 37.77% 37.65% 15 40.21% 39.23% 13
3rd Quartile 48.31% 48.33% 20 48.63% 49.79% 16 53.99% 56.28% 13
4th Quartile 60.12% 58.73% 20 60.31% 61.29% 16 64.89% 64.29% 13
Total Population 44.99% 43.57% 79 44.79% 42.61% 62 48.59% 48.40% 51
Excluded Cost Reports 48 32 29
Total Cost Reports 127 94 80
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 25
26. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Total Labor Cost as a Percentage of Total Operating Revenues
All Investor Owned General Acute Care Hospitals in the United States with Between 26 and 100 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 33.61% 33.93% 42 33.81% 34.29% 46 33.77% 34.27% 49
2nd Quartile 38.70% 39.05% 42 39.98% 39.76% 46 39.62% 39.72% 49
3rd Quartile 44.01% 43.60% 43 45.64% 45.52% 47 45.67% 45.35% 49
4th Quartile 54.98% 53.17% 43 57.65% 56.33% 47 55.01% 54.82% 50
Total Population 42.90% 40.77% 170 44.35% 42.50% 186 43.58% 43.19% 197
Excluded Cost Reports 30 34 33
Total Cost Reports 200 220 230
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 33.59% 33.67% 47 34.00% 34.28% 50 34.41% 35.02% 50
2nd Quartile 39.27% 39.20% 48 40.28% 40.24% 50 40.71% 40.99% 50
3rd Quartile 45.36% 45.40% 48 46.60% 46.78% 50 47.36% 47.18% 50
4th Quartile 55.78% 54.42% 48 57.44% 56.48% 50 56.84% 55.55% 51
Total Population 43.55% 42.35% 191 44.58% 43.27% 200 44.89% 43.99% 201
Excluded Cost Reports 38 29 26
Total Cost Reports 229 229 227
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 26
27. Peer Group Comparison – Total Labor Cost as a Percent of Total Op. Rev.
Total Labor Cost as a Percentage of Total Operating Revenues
All Investor Owned General Acute Care Hospitals in the United States with Between 101 and 200 Licensed Beds
2009 2008 2007
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 34.21% 34.38% 51 34.54% 34.67% 56 34.77% 35.11% 59
2nd Quartile 39.72% 39.80% 52 40.43% 40.54% 56 40.97% 40.96% 60
3rd Quartile 44.04% 43.89% 52 45.47% 45.76% 56 46.92% 46.42% 60
4th Quartile 53.78% 52.99% 52 55.25% 53.90% 56 56.34% 55.19% 60
Total Population 42.98% 41.94% 207 43.92% 42.54% 224 44.79% 44.16% 239
Excluded Cost Reports 15 13 10
Total Cost Reports 222 237 249
2006 2005 2004
Quartile Rank
Mean Median Count Mean Median Count Mean Median Count
1st Quartile 34.78% 35.29% 58 35.11% 35.48% 59 35.84% 36.52% 58
2nd Quartile 41.05% 40.80% 58 41.00% 41.22% 60 41.86% 42.27% 58
3rd Quartile 47.27% 47.21% 59 47.47% 47.42% 60 47.03% 47.00% 58
4th Quartile 58.21% 57.35% 59 58.03% 56.32% 60 56.86% 55.62% 59
Total Population 45.39% 44.09% 234 45.44% 44.44% 239 45.45% 44.16% 233
Excluded Cost Reports 14 10 10
Total Cost Reports 248 249 243
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.
October 2010 27