Tennessee Smallest 30% of Hospitals Post Operating Losses of a Negative 5% of Revenues

In an earlier recent post Tennessee Non-Profit Hospital Earnings On Fire, from a review of audited financial statements and related footnotes contained in the Electronic Municipal Market Access (EMMA), I showed that the 8 large Tennessee Non-Profit Hospital Organizations with Net Assets above $400 mil each experienced Total Audited Bottom Line Earnings which were an exceptionally robust 8.8% of Total Operating Revenues in the most recent year.

So what about the smaller individual Tennessee Hospitals?  How did they do?

Fortunately, the State of Tennessee in its Dept of Health website discloses key operating statement information annually for each of its Tennessee individual Hospitals.  The most recent annual Hospital Operating Statement information contained there was for annual fiscal years ended in 2012.

There were 162 individual Tennessee Hospitals presented in the Tennessee Dept of Health website.  Of these 162, 130 of them were either General Hospitals, Specialty Hospitals or Medical Centers.  And of these 130, 39 of them, or a very significant 30% of them, generated Total Revenues of less than $20 mil in 2012.

These smallest 39 Tennessee individual Hospitals posted Total Bottom Line Losses (Excess of Total Expenses over Total Revenues) which were a negative 4.9% of Total Operating Revenues in 2012.  Whew!

Here is a summary of Total Bottom Line Profit Margins of these 130 individual Tennessee Hospitals by Revenue intervals:

41 Hospitals..2012 Revenues above $100 mil..Bottom Line Profit 6.2% of Revenues
50 Hospitals...2012 Revenues of $20-100 mil.Bottom Line Profit 6.9% of Revenues
39 Hospitals.2012 Revenues Below $20 mil..Bottom Line Loss (4.9)% of Revenues

I think Tennessee needs to Expand Medicaid fully.  These struggling Tennessee Hospitals will be substantially strengthened financially by the huge amount of hospital patient revenues which would flow from a full Medicaid Expansion. 

From a review and summarization of information contained in Tennessee's Dept of Health website, below here are the Bottom Line Profits (Losses) and Total Operating Revenues in 2012 for each of these 130 Tennessee individual Hospitals sorted by Revenues:

			2012		2012
		General Hospital	Total	2012	Profit
Tennessee	Tennessee	Specialty Hospital	Operating	Profit	(Loss)
Region	County	Or Medical Center	Revenues	(Loss)	Margin
			$000s	$000s	%
		Revenues > $100 Mil
Nashville	Davidson	Vanderbilt University Hospitals	1,906,077	125,898	6.6%
Memphis	Shelby	Saint Jude Children's Research Hospital	640,221	5,183	0.8%
Knoxville	Knox	University Tennessee Memorial Hospital	587,668	19,841	3.4%
Memphis	Shelby	Methodist Healthcare-Memphis Hospitals	542,196	(5,793)	-1.1%
Memphis	Shelby	Baptist Memorial Hospital	528,047	24,987	4.7%
Nashville	Davidson	Centennial Medical Center	522,676	50,737	9.7%
Jackson	Madison	Jackson-Madison County General Hospital	493,395	17,504	3.5%
Chattanooga	Hamilton	Erlanger Medical Center	491,009	(14,813)	-3.0%
Nashville	Davidson	Saint Thomas Hospital	461,453	39,701	8.6%
Northeast	Washington	Johnson City Medical Center	422,554	37,678	8.9%
Nashville	Davidson	Baptist Hospital	420,075	43,942	10.5%
Chattanooga	Hamilton	Memorial Healthcare System	410,656	18,662	4.5%
Memphis	Shelby	The Regional Medical Center at Memphis	363,073	51,183	14.1%
Memphis	Shelby	Lebonheur Children's Medical Center	358,046	28,534	8.0%
Sullivan	Sullivan	Wellmont-Holston Valley Medical Medical Center	308,014	17,800	5.8%
Knoxville	Knox	Fort Sanders Regional Medical Center	286,433	13,294	4.6%
Knoxville	Knox	Parkwest Medical Center	276,849	28,122	10.2%
Memphis	Shelby	Methodist Hospital-Germantown	276,255	39,780	14.4%
Memphis	Shelby	Saint Francis Hospital	273,525	33,318	12.2%
Mid-Cumberland	Rutherford	Middle Tennessee Medical Center	244,364	32,404	13.3%
Knoxville	Knox	Tennova Healthcare	239,019	(11,480)	-4.8%
South Central	Maury	Maury Regional Hospital	236,767	13,049	5.5%
Sullivan	Sullivan	Wellmont Bristol Regional Medical Center	230,989	17,241	7.5%
Upper Cumberland	Putnam	Cookeville Regional Medical Center	204,973	1,947	0.9%
Chattanooga	Hamilton	Parkridge Medical Center	195,653	28,139	14.4%
Knoxville	Knox	East Tennessee Children's Hospital	185,072	28,597	15.5%
Nashville	Davidson	Summit Medical Center	177,550	27,870	15.7%
Nashville	Davidson	Skyline Medical Center	174,294	23,499	13.5%
East	Blount	Blount Memorial Hospital	168,246	(6,445)	-3.8%
East	Anderson	Methodist Medical Center Oak Ridge	167,075	74	0.0%
Mid-Cumberland	Williamson	Williamson Medical Center	153,512	6,463	4.2%
Memphis	Shelby	Methodist Hospital-North	151,761	7,921	5.2%
Mid-Cumberland	Montgomery	Gateway Medical Center	146,445	9,440	6.4%
Southeast	Bradley	Skyridge Medical Center	119,996	2,445	2.0%
Memphis	Shelby	Saint Francis Hospital-Bartlett	109,245	24,974	22.9%
Mid-Cumberland	Sumner	Sumner Regional Medical Center	107,004	2,084	1.9%
Mid-Cumberland	Wilson	University Medical Center	105,992	8,630	8.1%
Nashville	Davidson	Metro Nashville General Hospital	102,513	(762)	-0.7%
Knoxville	Knox	Mercy Medical Center West	102,067	10,819	10.6%
Memphis	Shelby	Methodist Hospital-South	101,426	3,723	3.7%
Jackson	Madison	Regional Hospital of Jackson	101,035	11,449	11.3%
		Total 41 Revenues > $100 Mil	13,093,220	817,639	6.2%
		Revenues $20-100 Mil
Sullivan	Sullivan	Indian Path Medical Center	98,182	7,453	7.6%
Mid-Cumberland	Rutherford	StoneCrest Medical Center	97,336	12,673	13.0%
Upper Cumberland	Cumberland	Cumberland Medical Center	96,474	(107)	-0.1%
South Central	Coffee	Harton Regional Medical Center	96,187	23,749	24.7%
Mid-Cumberland	Sumner	Hendersonville Medical Center	93,366	18,914	20.3%
Nashville	Davidson	Southern Hills Medical Center	87,630	4,719	5.4%
East	Hamblen	Morristown-Hamblen Healthcare System	83,122	(1,245)	-1.5%
Mid-Cumberland	Robertson	NorthCrest Medical Center	80,228	11,985	14.9%
Knoxville	Knox	North Knoxville Medical Center	79,767	20,507	25.7%
Southwest	Tipton	Baptist Memorial Hospital-Tipton	78,667	7,786	9.9%
Memphis	Shelby	Baptist Memorial Hospital for Women	72,836	(4,222)	-5.8%
Mid-Cumberland	Dickson	Horizon Medical Center	68,351	(3,912)	-5.7%
Chattanooga	Hamilton	Parkridge East Hospital	65,825	9,575	14.5%
Southeast	Franklin	Southern Tennessee Medical Center	62,231	19,414	31.2%
Chattanooga	Hamilton	Memorial North Park	61,367	5,010	8.2%
East	Sevier	LeConte Medical Center	61,241	(449)	-0.7%
Northwest	Dyer	Dyersburg Regional Medical Center	61,138	694	1.1%
Northwest	Henry	Henry County Medical Center	58,859	745	1.3%
East	Campbell	TennovaHealthcare-Lafollette Medical Center	58,413	6,354	10.9%
Northeast	Greene	Laughlin Memorial Hospital	57,261	(5,427)	-9.5%
Northeast	Greene	Takoma Regional Hospital	54,333	2,033	3.7%
Memphis	Shelby	Baptist Memorial Hospital-Collierville	50,741	(5,542)	-10.9%
Upper Cumberland	Warren	River Park Hospital	49,959	5,000	10.0%
Northeast	Washington	Franklin Woods Community Hospital	49,226	(1,077)	-2.2%
Southeast	McMinn	Athens Regional Medical Center	47,451	3,916	8.3%
East	Jefferson	Tennova Healthcare-Jefferson Memorial Hospital	45,706	4,180	9.1%
Northwest	Obion	Baptist Memorial Hospital-Union City	44,429	2,207	5.0%
Memphis	Shelby	Delta Medical Center	43,723	(1,608)	-3.7%
Northeast	Carter	Sycamore Shoals Hospital	42,355	1,224	2.9%
East	Monroe	Sweetwater Hospital Association	42,218	8,864	21.0%
Nashville	Davidson	The Center for Spinal Surgery	40,603	16,661	41.0%
East	Cocke	Tennova-Newport Memorial Hospital	39,896	8,213	20.6%
Northeast	Hawkins	Wellmont Hawkins County Memorial Hospital	39,397	7,374	18.7%
East	Hamblen	Lakeway Regional Hospital	38,150	(4,278)	-11.2%
South Central	Bedford	Heritage Medical Center	33,576	(5,260)	-15.7%
Southwest	Hardin	Hardin Medical Center	32,731	1,594	4.9%
South Central	Lawrence	Crockett Hospital	32,548	1,940	6.0%
Upper Cumberland	Overton	Livingston Regional Hospital	31,812	1,658	5.2%
South Central	Giles	Hillside Hospital	31,659	417	1.3%
East	Roane	Roane Medical Center	30,151	(5,025)	-16.7%
Chattanooga	Hamilton	Erlanger East	28,338	752	2.7%
South Central	Lincoln	Lincoln Medical Center	28,183	2,016	7.2%
Upper Cumberland	White	White County Community Hospital	27,443	3,856	14.1%
East	Campbell	Jellico Community Hospital	26,697	2,551	9.6%
East	Claibome	Claiborne County Hospital	26,233	1,967	7.5%
Southeast	Marion	Grandview Medical Center	25,941	(5,137)	-19.8%
East	Loudon	Fort Loudon Medical Center	25,769	(1,315)	-5.1%
Northwest	Weakley	Volunteer Community Hospital	25,159	(1,877)	-7.5%
Upper Cumberland	Fentress	Jamestown Regional Medical Center	23,600	2,557	10.8%
Nashville	Davidson	Skyline Medical Center Campus	23,344	(2,757)	-11.8%
		Total 50 Revenues $20-100 Mil	2,599,852	179,320	6.9%
		Revenues < $20 Mil
Upper Cumberland	DeKalb	DeKalb Comminity Hospital	19,203	2,697	14.0%
Upper Cumberland	Smith	Riverview Regional Medical Center South	18,879	(4,227)	-22.4%
Southeast	Rhea	Rhea Medical Center	18,739	665	3.5%
Southeast	McMinn	Woods Memorial Hospital	18,282	(5,453)	-29.8%
Southwest	McNairy	McNairy Regional Hospital	16,998	(2,531)	-14.9%
Northeast	Unicoi	Unicoi County Memorial Hospital	16,255	(1,009)	-6.2%
South Central	Coffee	United Regional Medical Center	15,716	2,883	18.3%
Southeast	Bradley	Skyridge Medical Center Westside	14,831	302	2.0%
Upper Cumberland	Cannon	Stones River Hospital	14,138	924	6.5%
Southwest	Lauderdale	Lauderdale Community Hospital	13,759	346	2.5%
South Central	Marshall	Marshall Medical Center	13,725	718	5.2%
Northwest	Carroll	Baptist Memorial Hospital-Huntingdon	13,677	(2,008)	-14.7%
Southeast	Polk	Copper Basin Medical Center	12,267	39	0.3%
Southwest	Henderson	Henderson County Community Hospital	12,058	(3,243)	-26.9%
Northwest	Carroll	McKenzie Regional Hospital	11,959	(5,094)	-42.6%
Southwest	Decatur	Decatur County General Hospital	11,776	2,178	18.5%
South Central	Coffee	Medical Center of Manchester	11,344	(831)	-7.3%
South Central	Wayne	Wayne Medical Center	11,230	1,208	10.8%
Upper Cumberland	Macon	Macon County General Hospital	10,487	(310)	-3.0%
South Central	Hickman	Hickman Community Hospital	9,923	(3,056)	-30.8%
Mid-Cumberland	Trousdale	Trousdale Medical Center	9,672	1,297	13.4%
Mid-Cumberland	Cheaton	Centennial Medical Center Ashland City	9,482	(182)	-1.9%
Southwest	Fayette	Methodist Healthcare-Fayette	9,374	337	3.6%
Northeast	Johnson	Johnson County Community Hospital	8,728	636	7.3%
Northwest	Gibson	Milan General Hospital	8,336	442	5.3%
Southeast	Bledsoe	Erlanger-Bledsoe	7,952	(841)	-10.6%
Mid-Cumberland	Humphreys	Three Rivers Hospital	7,870	79	1.0%
Mid-Cumberland	Wilson	McFarland Hospital	7,796	2,030	26.0%
Southwest	Hardeman	Bolivar General Hospital	7,600	779	10.3%
Upper Cumberland	Clay	Cumberland River Hospital	7,459	(1,433)	-19.2%
Northwest	Gibson	Humboldt General Hospital	7,343	(409)	-5.6%
Northwest	Benton	Camden General Hospital	7,267	376	5.2%
Southwest	Haywood	Haywood Park Community Hospital	6,608	(5,268)	-79.7%
Mid-Cumberland	Houston	Patients' Choice Medical Center of Erin	6,415	(1,036)	-16.1%
Chattanooga	Hamilton	Erlanger North	6,317	(1,258)	-19.9%
Southeast	Franklin	Emerald-Hodgson Hospital	6,228	601	9.6%
Northwest	Gibson	Gibson General Hospital	6,031	(687)	-11.4%
Northeast	Hancock	Wellmont Hancock County Hospital	5,580	(281)	-5.0%
Mid-Cumberland	Sumner	Portland Medical Center	581	(234)	-40.3%
		Total 39 Revenues < $20 Mil	421,885	(20,854)	-4.9%
		Total all 130 General Hospital, Specialty Hospital or Medical Centers	16,114,957	976,105	6.1%

Let me put some additional numbers out here which shows just how Tennessee Hospitals and the rest of Tennessee will benefit greatly from full Medicaid Expansion in Tennessee.  Summarizing information supplied by the State of Tennessee's Dept of Health website, the 162 Tennessee Hospitals generated Total Bottom Line Profits of $1.046 bil in 2012.  Their Total Provisions For Bad Debts, which reduced their Total Bottom Line Profits, were $1.861 bil in 2012, which was 1.8 times their Total Bottom Line Profits of $1.046 bil.  And their Total Uncompensated Charity Care Charges Foregone were $1.835 bil in 2012, which was another 1.8 times their Total Bottom Line Profits of $1.046 bil.

When Tennessee's Hospitals get substantially enhanced financially like this from full Medicaid Expansion in Tennessee, it only makes sense that hospital patient prices decline, health insurance premiums decline, the State of Tennessee's financial coffers are substantially enhanced, and Tennessee's taxes assessed on individuals and businesses also decline.

When you think of the giant HCA, you first think of Tennessee, where it is headquartered.  But you know what?  Only 6% of HCA's combined licensed hospital beds are located in Tennessee.  There are many US States that haven't elected to Expand Medicaid where many of HCA acute hospital beds are located.  Just Florida and Texas combined house a total of 51% of HCA combined hospital beds.  Do you think HCA, as well as its common stockholders, want the States of Florida and Texas to Expand Medicaid?  You better believe it.  And in total, 77% of HCA's hospital beds are located in US States which presently do not expect to Expand Medicaid.

And it's the very same story with very large Tennessee headquartered Community Health System, which only has 7% of its total licensed hospital beds located in Tennessee.  In total, 51% of its total hospital beds are located in US States that presently do not plan to Expand Medicaid.  Just like HCA, Community Health System and its common stockholders also want to see Medicaid Expanded all throughout the US.