Methodology
How the data is built, and how far to trust it.
Every figure on this site comes from a public federal file. This page says which files, how records are matched to a hospital, how a published number relates to the cost report behind it, and what to check before you rely on one.
Sources
Public federal files only.
Nothing here is HIPAA-covered. The portal screens on the cost report metrics (FY2010 – FY2025); the other sources sit in the warehouse behind it and are available through an engagement.
- HCRIS cost reportsKey: CCN
- Filed report headers, fiscal periods, settlement status
- HCRIS numeric valuesKey: CCN + WKST/LINE/COL
- Every reported figure, addressed by worksheet coordinate
- NPPES registryKey: NPI
- Provider identity, taxonomy, practice locations
- Medicare Part BKey: NPI
- Service-line utilization and allowed amounts
- Open PaymentsKey: Profile ID
- Industry transfers of value, research, ownership
- CMS CompareKey: CCN
- Quality and star ratings across five care settings
- PECOS affiliationsKey: NPI ↔ CCN
- The clinician-to-facility edge list
- IRS Form 990Key: EIN
- Nonprofit financials, Schedule H community benefit
From a cost report to a number
Every figure has an address.
A cost report stores each value by worksheet, line, and column. A published metric is read from that cell, or calculated from cells that are. These are the ones most often quoted.
- Net patient revenue
- Patient revenue after contractual allowances and discounts.Worksheet G-3, line 3, column 1
- Operating expenses
- Total operating expenses for the fiscal year.Worksheet G-3, line 4, column 1
- Total patient days
- Inpatient days across all payers.Worksheet S-3, Part I, line 14, column 8
- Net income
- Net patient revenue less operating expenses. It does not include other revenue the hospital reports.Calculated from the two figures above
- Margin
- Net income divided by net patient revenue, a margin on patient services. It is labelled Total margin on the public facility pages. It is left blank when net patient revenue is under $10,000, because a ratio against that is not meaningful.Calculated
- Occupancy rate
- Total patient days as a share of the bed-days available in the fiscal year.Calculated from patient days, beds, and the length of the fiscal year
How records are linked
Each public source identifies providers in its own way. Cost reports and CMS Compare use the CMS Certification Number (CCN). NPPES and Medicare Part B use the National Provider Identifier (NPI). Open Payments uses its own profile ID, and nonprofit tax filings on Form 990 use the organization's EIN.
A hospital's CCN is the key that ties its cost reports to its public page and to other CCN-keyed data. Crosswalks connect the other identifiers, such as the PECOS affiliation file, which lists the NPIs affiliated with each CCN.
Which report we use when there are several
A hospital's cost report for a fiscal year can exist in more than one version. CMS's published files carry the highest status for each one: a reopened report over a final settled one, and a final settled one over an as-submitted one. A hospital that changes its fiscal year or ownership can also file more than one report for a year.
We keep one row for each hospital and fiscal year end, and where two submissions share both we keep the latest. The report status is kept with the figures: 1 as submitted, 2 settled without audit, 3 settled with audit, 4 reopened, 5 amended. An as-submitted figure can change when the report is settled.
Fiscal years and reporting lag
Hospitals choose their own fiscal year, so year ends fall in every month. A fiscal year on this site is the calendar year in which the hospital's fiscal year ends. One year therefore mixes hospitals whose periods ended in June, September, and December, and a hospital that changed its year can have a short period.
There is a reporting lag. Hospitals file after their year ends, and CMS processes the reports afterwards, so the most recent fiscal years are less complete than earlier ones. We check CMS for new files on a weekly schedule. A new release reaches the site after it passes our validation checks, so the site can trail CMS.
Missing values, zeros, and outliers
When a cell is missing from a cost report, most metrics are stored as zero. A zero in the portal can therefore mean not reported, and it should not be read as a reported zero without checking the filing. Calculated figures such as margin and occupancy are left blank when their inputs are missing. On the public hospital pages, a stored zero for net patient revenue or beds is shown as Not reported and a blank as Not available.
We publish what was filed. A value can still be implausible, for example a bed count that jumps tenfold in one year, and the filing is the place to check it.
A screening signal is not a conclusion
A figure here is a derived screening signal: a reason to look at a hospital more closely, with the evidence behind it. It is not a finding about performance or causes. Before relying on one, check the fiscal year end, the report status, whether the value was reported at all, and the definition on this page, and read the source worksheet.
Check it yourself
Every claim should be checkable.
The CMS files are free. Our guide shows how to find a hospital’s cost report and read the same figures, and the worked example shows how a cohort is built and where its figures need care.
- How to look up a hospital’s cost report data by CCN
- Example: a hospital peer group for prospect research
- CMS: Cost Reports (HCRIS)
Found something that looks wrong? Tell us.