How the numbers are built.

Ratified definitions. AD-1353.AB · ratified 2026-07-31

1. Full year and period length. A full year is a reporting period of 355 to 380 days inclusive. The exact number of days in each filing is stored and shown. Periods longer than 380 days are labeled long-period and are excluded from comparisons; periods shorter than 355 days are labeled stub. Nothing is annualized — a short filing is never scaled up to look like a year.
2. Per-day measures. Per-day measures divide by the inclusive length of the reporting period (end date minus begin date plus one day), not by a fixed 365.
3. Multi-component measures. A blank line on a data-bearing schedule never withholds a figure. Where a measure adds several filed lines together, a line the provider left blank adds zero - which is what a sum already means - and the row records which lines were blank, so a reader can tell a reported zero from an empty line. A figure is unavailable in exactly four cases: a required sole source field is blank, the denominator is blank or zero, the source schedule is absent or carries no data, or the measure does not apply to that provider or form. Nothing else withholds: no plausibility rule, completeness test or reconciliation test may suppress a result that is mathematically computable, and negative, zero and extreme results publish as calculated. Amendment A (AD-1352, extended AD-1353): a ratio is computed only where its denominator is positive as stored, in thousands of dollars to one decimal. That is total revenue for the total margin and the EBIDA margin, operating revenue for the operating margin, total current liabilities for the current ratio, operating expenses less depreciation for days cash on hand, net patient revenue for days in accounts receivable, long-term liabilities plus fund balances for debt to capitalization, and the year's depreciation for average age of plant. Where a provider files that amount below zero, or so small that it rounds to zero in thousands, the figure is withheld and the row records why: a count of days cannot be negative, and a year of results cannot be measured against a few dollars.
4. Long-term debt. Debt ratios use TOTAL LONG-TERM LIABILITIES as filed: Worksheet G line 50, summed across all four fund columns. This is every long-term obligation the provider reported, not the interest-bearing subset — a large, non-random group of filers books long-term obligations on the 'other long-term liabilities' line, and measuring only lines 46 and 47 returns $0 of debt for hospitals plainly carrying it.
5. Occupancy basis. Occupancy is patient days divided by bed-days available on BEDS IN OPERATION as filed — not licensed beds, not certified beds. A facility that staffs surge capacity beyond its bed count can genuinely exceed 100%; that is reported, not corrected.
6. Case mix and wage index. Case mix index and wage index are pinned to a single published vintage — CMI to the FY2026 IPPS Final Rule impact file, geographic wage index to the FY2025 hospice wage index file (geographic) — and applied as a disclosed cross-sectional convention across every reporting year rather than re-derived per year. Critical access hospitals and other non-IPPS providers have no published CMI; their values are shown UNADJUSTED and carry the label "no published CMI for this provider type — value shown unadjusted". Nulling the value out for non-IPPS providers was considered and rejected: an unadjusted number that says it is unadjusted is more useful than an absence.
7. Peer pools. Every peer pool and benchmark is fiscal-year pure: a facility is only ever compared with other facilities' filings for the SAME fiscal year. Every peer key and benchmark key carries its fiscal year. A key without a fiscal year is a defect.
8. Derived zeros and the value-status contract. Where a hospital did not file Worksheet G line 50 (total long-term liabilities), a value of zero is derived only when the balance sheet proves it three ways: the statement foots within $1K (|L36 - (L51 + L59)|), line 51 total liabilities was actually filed, and line 51 equals line 45 current liabilities within $1K. Because L51 = L45 + L50 on this worksheet, that is the filer stating total liabilities are entirely current — which is what a genuine zero looks like. The source status stays UNREPORTED: the line was not filed and nothing pretends otherwise. A companion field, value_origin = DERIVED_FROM_FOOTING, marks every derived value, and derived zeros are published and eligible for ratios, medians, rankings and export. Rows that fail any of the three tests carry no value at all — a statement that foots is not enough on its own, because both sides can be understated in matching ways.
9. The commercial-rate bar. Commercial rates are expressed as a multiple of Medicare PPS rates, never of a facility's own cost. The benchmark is the same public rate for every facility, so the multiples compare. Where a facility has no published wage index, the bar is computed unadjusted and labeled as unadjusted; it is never replaced by a cost basis and never wage-imputed from an area.
10. The pricing basket. The pricing bar is a curated multi-department line-item basket. Each code is priced from the Medicare fee schedule that actually pays it - OPPS for facility outpatient services, the Physician Fee Schedule where OPPS does not pay separately, the Clinical Laboratory Fee Schedule for clinical lab - at national rates, unadjusted for wage index and labeled as unadjusted per ruling 9. A code priced from the wrong schedule is excluded, not approximated.
11. Net accounts receivable. Net accounts receivable is Worksheet G line 4 (accounts receivable) plus line 6 (allowances for uncollectible notes and accounts receivable) as filed, with the provider's own sign preserved. Line 5 is other receivables -- a separate asset -- and is excluded. The measure is accounts receivable net of its allowance, not total receivables. Amendment B (AD-1352): an allowance is normally filed as a negative number. Where a provider files line 6 positive it is added as filed and the figure is marked so; net days in accounts receivable computed from it carries the same mark. Two cases are treated differently. Where the positive line 6 carries net accounts receivable past the receivables the provider filed, line 4 plus line 5, and the provider's own total current assets reconciles with line 6 subtracted, the allowance was entered without its minus sign: net accounts receivable is line 4 less line 6, marked as sign corrected. Otherwise, where line 6 is a quarter of line 4 or more, or line 4 is at or below zero, the amount on line 6 is not an allowance against line 4: the figure is withheld and marked allowance filed positive, withheld. It is not derivable from the filing.
12. Headline measures: one definition, registered with its filed lines. Each headline measure has one definition per provider type, registered with the lines of the cost report it is computed from. Every book and every page prints the figure the dataset holds under that definition, and none computes its own. For hospitals (form CMS-2552-10): Total margin: Net income (Worksheet G-3 line 29) divided by total revenue: net patient revenue (line 3) plus total other income (line 25). The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Operating margin: Operating income divided by total operating revenue. Total operating revenue is net patient revenue (Worksheet G-3 line 3) plus other operating income (line 24); operating income is net income from service to patients (line 5) plus line 24. Where line 24 is blank the margin is line 5 over line 3 and is labeled so. It is computed from the filed dollars and stored to one decimal of a percent. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. EBIDA margin: Net income (Worksheet G-3 line 29) plus depreciation (Worksheet A-7 Part III line 3 column 9) plus interest (Worksheet A-7 Part III line 3 column 11), divided by total revenue: net patient revenue (G-3 line 3) plus total other income (G-3 line 25). It is the total margin with depreciation and interest added back; a blank depreciation or interest line adds zero and is flagged. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Current ratio: Total current assets (Worksheet G line 11) divided by total current liabilities (Worksheet G line 45), all funds. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Days cash on hand (cash and temporary investments): Cash on hand and in banks plus temporary investments (Worksheet G lines 1 and 2, all funds), times the days in the report's own period, divided by cash operating expenses: total operating expenses (Worksheet G-3 line 4) less depreciation (Worksheet A-7 Part III line 3 column 9). The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Days cash on hand (including investments): Cash on hand and in banks, temporary investments and investments (Worksheet G lines 1, 2 and 31, all funds), times the days in the report's own period, divided by cash operating expenses: total operating expenses (Worksheet G-3 line 4) less depreciation (Worksheet A-7 Part III line 3 column 9). Deposits on leases (line 32) are not a source of cash and are excluded. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Days in gross accounts receivable: Accounts receivable (Worksheet G line 4, all funds) times the days in the report's own period, divided by net patient revenue (Worksheet G-3 line 3). Net patient revenue must be positive as stored. Days in net accounts receivable: Net accounts receivable (Worksheet G line 4 plus line 6 as filed, all funds; line 5 excluded) times the days in the report's own period, divided by net patient revenue (Worksheet G-3 line 3). Where line 6 is filed positive the figure follows amendment B: added as filed and flagged, sign corrected, or withheld. Long-term debt to capitalization: Total long-term liabilities (Worksheet G line 50, all funds) divided by capitalization: line 50 plus total fund balances (line 59). Where line 50 was not filed, a zero is derived only when the balance sheet proves it; otherwise there is no figure. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Average age of plant: Accumulated depreciation (the eight accumulated depreciation lines of Worksheet G, lines 14 to 28 even, all funds, as a magnitude) divided by the year's depreciation (Worksheet A-7 Part III line 3 column 9). The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. For hospices (form CMS-1984-14): Operating margin: Net patient revenue (Worksheet F-2 line 8 column 4) less total operating expenses (line 41 column 2), divided by net patient revenue. Contributions, investment income and other non-patient income are not operating revenue and are not in it. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Total margin: Net income (Worksheet F-2 line 42 column 2) divided by total revenue (line 26 column 4). For home health agencies (form CMS-1728-20): Operating margin: Net income from service to patients (Worksheet F-1 line 18 column 2) divided by net patient revenues (line 3 column 4). Line 18 is net patient revenues less total operating expenses (line 17); other revenues and contributions are not in it. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why.

Registered headline measures. each with a stable anchor, the worksheet lines it is read from, and its unit

# Total margin · Hospital (CMS-2552-10) · G-3 L29 / (G-3 L3 + G-3 L25) · fraction

Net income (Worksheet G-3 line 29) divided by total revenue: net patient revenue (line 3) plus total other income (line 25). The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G-3 L29 C1 (net income); G-3 L3 C1 (net patient revenue); G-3 L25 C1 (total other income). Ratified 2026-10-04.

# Operating margin · Hospital (CMS-2552-10) · (G-3 L5 + G-3 L24) / (G-3 L3 + G-3 L24) · fraction

Operating income divided by total operating revenue. Total operating revenue is net patient revenue (Worksheet G-3 line 3) plus other operating income (line 24); operating income is net income from service to patients (line 5) plus line 24. Where line 24 is blank the margin is line 5 over line 3 and is labeled so. It is computed from the filed dollars and stored to one decimal of a percent. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G-3 L5 C1 (net income from service to patients); G-3 L24 C1 (other operating income); G-3 L3 C1 (net patient revenue). Ratified 2026-10-04.

# EBIDA margin · Hospital (CMS-2552-10) · (G-3 L29 + A-7 III L3 C9 + A-7 III L3 C11) / (G-3 L3 + G-3 L25) · fraction

Net income (Worksheet G-3 line 29) plus depreciation (Worksheet A-7 Part III line 3 column 9) plus interest (Worksheet A-7 Part III line 3 column 11), divided by total revenue: net patient revenue (G-3 line 3) plus total other income (G-3 line 25). It is the total margin with depreciation and interest added back; a blank depreciation or interest line adds zero and is flagged. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G-3 L29 C1 (net income); A-7 Part III L3 C9 (depreciation); A-7 Part III L3 C11 (interest); G-3 L3 C1 (net patient revenue); G-3 L25 C1 (total other income). Ratified 2026-10-04.

# Current ratio · Hospital (CMS-2552-10) · G L11 / G L45 · ratio

Total current assets (Worksheet G line 11) divided by total current liabilities (Worksheet G line 45), all funds. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G L11 C1-4 (all funds) (total current assets); G L45 C1-4 (all funds) (total current liabilities). Ratified 2026-10-04.

# Days cash on hand (cash and temporary investments) · Hospital (CMS-2552-10) · (G L1 + G L2) x period days / (G-3 L4 - A-7 III L3 C9) · days

Cash on hand and in banks plus temporary investments (Worksheet G lines 1 and 2, all funds), times the days in the report's own period, divided by cash operating expenses: total operating expenses (Worksheet G-3 line 4) less depreciation (Worksheet A-7 Part III line 3 column 9). The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G L1 C1-4 (all funds) (cash); G L2 C1-4 (all funds) (temporary investments); G-3 L4 C1 (total operating expenses); A-7 Part III L3 C9 (depreciation). Ratified 2026-10-04.

# Days cash on hand (including investments) · Hospital (CMS-2552-10) · (G L1 + G L2 + G L31) x period days / (G-3 L4 - A-7 III L3 C9) · days

Cash on hand and in banks, temporary investments and investments (Worksheet G lines 1, 2 and 31, all funds), times the days in the report's own period, divided by cash operating expenses: total operating expenses (Worksheet G-3 line 4) less depreciation (Worksheet A-7 Part III line 3 column 9). Deposits on leases (line 32) are not a source of cash and are excluded. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G L1 C1-4 (all funds) (cash); G L2 C1-4 (all funds) (temporary investments); G L31 C1-4 (all funds) (investments); G-3 L4 C1 (total operating expenses); A-7 Part III L3 C9 (depreciation). Ratified 2026-10-04.

# Days in gross accounts receivable · Hospital (CMS-2552-10) · G L4 x period days / G-3 L3 · days

Accounts receivable (Worksheet G line 4, all funds) times the days in the report's own period, divided by net patient revenue (Worksheet G-3 line 3). Net patient revenue must be positive as stored. Filed lines: G L4 C1-4 (all funds) (accounts receivable); G-3 L3 C1 (net patient revenue). Ratified 2026-10-04.

# Days in net accounts receivable · Hospital (CMS-2552-10) · (G L4 + G L6) x period days / G-3 L3 · days

Net accounts receivable (Worksheet G line 4 plus line 6 as filed, all funds; line 5 excluded) times the days in the report's own period, divided by net patient revenue (Worksheet G-3 line 3). Where line 6 is filed positive the figure follows amendment B: added as filed and flagged, sign corrected, or withheld. Filed lines: G L4 C1-4 (all funds) (accounts receivable); G L6 C1-4 (all funds) (allowances); G-3 L3 C1 (net patient revenue). Ratified 2026-10-04.

# Long-term debt to capitalization · Hospital (CMS-2552-10) · G L50 / (G L50 + G L59) · ratio

Total long-term liabilities (Worksheet G line 50, all funds) divided by capitalization: line 50 plus total fund balances (line 59). Where line 50 was not filed, a zero is derived only when the balance sheet proves it; otherwise there is no figure. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G L50 C1-4 (all funds) (total long-term liabilities); G L59 C1-4 (all funds) (total fund balances). Ratified 2026-10-04.

# Average age of plant · Hospital (CMS-2552-10) · |G L14 + L16 + L18 + L20 + L22 + L24 + L26 + L28| / A-7 III L3 C9 · years

Accumulated depreciation (the eight accumulated depreciation lines of Worksheet G, lines 14 to 28 even, all funds, as a magnitude) divided by the year's depreciation (Worksheet A-7 Part III line 3 column 9). The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: G L14, 16, 18, 20, 22, 24, 26, 28 C1-4 (all funds) (accumulated depreciation); A-7 Part III L3 C9 (depreciation). Ratified 2026-10-04.

# Operating margin · Hospice (CMS-1984-14) · (F-2 L8 C4 - F-2 L41 C2) / F-2 L8 C4 · percent

Net patient revenue (Worksheet F-2 line 8 column 4) less total operating expenses (line 41 column 2), divided by net patient revenue. Contributions, investment income and other non-patient income are not operating revenue and are not in it. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: F-2 L8 C4 (net patient revenue); F-2 L41 C2 (total operating expenses). Ratified 2026-10-04.

# Total margin · Hospice (CMS-1984-14) · F-2 L42 C2 / F-2 L26 C4 · percent

Net income (Worksheet F-2 line 42 column 2) divided by total revenue (line 26 column 4). Filed lines: F-2 L42 C2 (net income); F-2 L26 C4 (total revenue). Ratified 2026-10-04.

# Operating margin · Home health agency (CMS-1728-20) · F-1 L18 C2 / F-1 L3 C4 · percent

Net income from service to patients (Worksheet F-1 line 18 column 2) divided by net patient revenues (line 3 column 4). Line 18 is net patient revenues less total operating expenses (line 17); other revenues and contributions are not in it. The denominator must be positive as stored, in thousands of dollars to one decimal; where it is zero, negative, or too small to round above zero, the figure is withheld and the row says why. Filed lines: F-1 L18 C2 (net income from service to patients); F-1 L3 C4 (net patient revenues); F-1 L17 C2 (total operating expenses). Ratified 2026-10-04.