Every figure we publish is derived from CMS cost report worksheet coordinates.
A wrong coordinate produces a number that looks perfectly reasonable, so we reconcile
against hospitals whose audited figures are independently available and we publish the
result — including the metrics that fail.
0 of 3 metrics currently pass reconciliation.
Metrics that do not pass are labelled unverified everywhere
they appear, including in the API response.
Metric
Verdict
Passed
Rate
net_income
MIXED
1/10
10%
net_patient_revenue
MIXED
14/33
42%
total_operating_expenses
MIXED
5/26
19%
What we compare against
70 figures across 33 hospital-years at 28 hospitals (48 in AL, 17 in WA, 4 in NY, 1 in FL), read off audited financial statements: state-filed audits for government hospital authorities, and continuing-disclosure filings on EMMA for bond-issuing non-profits. Every figure is transcribed by hand from a named document and stored with
a citation to that document and page; a figure we could not source is left blank rather
than estimated. Tolerance is 0.5% for money, exact for counts.
The sample is deliberately drawn from hospitals that publish accounts at all —
non-profits, which file an IRS Form 990, and government authorities, which are audited
by their state. Proprietary hospitals publish neither and cannot be checked this way, so
nothing here demonstrates that a for-profit chain fills the same cost-report lines the
same way.
What reconciliation found
Net patient revenue — Reproduces the audited figure exactly at some hospitals and not at others, and the difference lies in what each hospital nets out of its own reported revenue rather than in how we read the form. Across 20 hand-checked hospital-years it matched at 5 of 6 hospitals above 100m of revenue and at only 2 of 14 below it. Treat it as dependable at scale and unreliable for small rural hospitals unless that hospital has been checked.
Total operating expenses — Matched the audited figure at 5 of 21 hospital-years. The gaps are small and varied rather than all-or-nothing: cost reports carry interest expense inside operating expenses, while hospitals reporting under governmental accounting rules place it below the operating line. That accounts for some of the difference but not all of it.
Net income — This is the bottom line for the period, not an operating result. It carries investment returns, so it is not comparable between a hospital with a large endowment and one without. For operating performance use net income from service to patients, which excludes them.
What we do not do
We do not interpolate. We do not carry a figure forward from a prior year. A metric
whose inputs are missing is returned as null, never as zero. Where a provider filed an
amended cost report we use the latest filing and say so.