Forecast audit · Beds
Of 23 hospital projects that promised more beds, 10 showed the full gain in Medicare reports 3 years later
Filings in 9 states promised a bed total; cost reports, followed year by year, show which hospitals got there. 7 of the 23 had added no beds at all, and the two counts rarely agree.
· State filings, 2011 to 2021; Medicare cost reports to fiscal year 2024
A hospital that asks a state for permission to build usually says how many beds it will have when it is done. Medicare cost reports, filed every year, say how many beds it actually runs. Put the two side by side and a promise can be checked.
Delgam's database has 38 projects, at 36 hospitals in nine states, where that works: the filing gives a bed total for after the project, it can be matched to one hospital's cost reports with confidence, and it was filed between 2011 and 2021, so there are at least three years of reports after it. 23 of them promised more beds than the hospital had.
Beds promised to be added, and beds added in Medicare reports about three years later
23 projects that promised more beds, one per row. Hover or tap a row for the figures; click for the filing.
- Beds promised to be added
- Beds added in cost reports, about three years later
Source: State filings in the Delgam database (hollow); Medicare cost reports, Worksheet S-3 (filled): beds in the report about three years after the filing, less beds the year before.
10 of 23
About three years after filing, 10 of the 23 hospitals reported at least the beds they had promised to add. Six had added some, and seven none. The median project had added 75% of its promise. By the latest year, the count that had added all of it was 13; some had kept growing well past the plan, through other projects or mergers.
Projects promising more beds, by what the cost reports showed about three years later
One square per project.
- The full gain 10
- Part of it 6
- No gain 7
Source: State filings in the Delgam database; Medicare cost reports.
Two ways of counting a bed
Judging the bed totals instead gives a similar answer: 17 of all 38 projects reported at least 95% of the promised total about three years later, 20 by the latest year. But the totals mix two counts. Filings usually count licensed beds; cost reports count beds set up and staffed, on the units the hospital bills under its own number.
The year before each filing, the cost report showed a median 97% of the beds the filing said the hospital already had. For a quarter of the projects it was under 82%. The six projects that promised no change in beds ended up at a median 79% of their promised total, which is the counting gap alone.
The gap can also hide growth that never happened. FirstHealth Moore Regional Hospital told North Carolina in 2018 it would have 359 beds, and in 2020 384. Its cost reports showed 417 beds before the first filing and 412 in 2024: on totals it reached its promise without adding a bed.
Beds in the cost report, as a share of the beds the filing said the hospital had
The year before each filing. One circle per project; 100% means the two agree.
Source: State filings in the Delgam database; Medicare cost reports, Worksheet S-3.
The sample is small and uneven, from New York, Illinois, North Carolina, Washington, Tennessee, Maryland, California, Hawaii, Vermont. Of the 95 filings in Delgam's database that give a bed total for after the project and match a cost report hospital, most fall out for the reasons listed below. The same check for operating rooms in Illinois and North Carolina is the forecast audit.
All 38 projects
| Hospital | Filed | Existing | Promised | Reported before | About three years on | Latest |
|---|---|---|---|---|---|---|
| Scripps Memorial Hospital La Jolla, CA | 2011 | 389 | 531 | 332 (2011) | 325 (2014) | 372 (2024) |
| Highline Medical Center, WA | 2014 | 154 | 171 | 185 (2013) | 129 (2017) | 132 (2024) |
| Hilo Medical Center, HI | 2014 | 142 | 162 | 142 (2013) | 157 (2017) | 194 (2024) |
| Samaritan Hospital, NY | 2014 | 212 | 257 | 149 (2013) | 192 (2017) | 252 (2024) |
| Good Samaritan Hospital, WA | 2016 | – | 352 | 261 (2015) | 313 (2019) | 314 (2024) |
| Hendersonville Medical Center, TN | 2016 | – | 123 | 105 (2015) | 129 (2019) | 133 (2024) |
| Hospital for Special Surgery, NY | 2016 | 215 | 225 | 201 (2015) | 210 (2019) | 158 (2024) |
| Jamaica Hospital Medical Center, NY | 2016 | 408 | 408 | 325 (2015) | 285 (2019) | 275 (2024) |
| Samaritan Medical Center, NY | 2016 | 290 | 290 | 157 (2015) | 195 (2020) | 165 (2024) |
| Harrison Medical Center (St. Michael Medical Center), WA | 2017 | 347 | 336 | 254 (2016) | 238 (2020) | 238 (2024) |
| Rochester General Hospital, NY | 2017 | 528 | 528 | 470 (2016) | 470 (2020) | 470 (2024) |
| Saint Thomas Rutherford Hospital, TN | 2017 | 286 | 358 | 305 (2016) | 324 (2020) | 408 (2024) |
| SwedishAmerican Hospital, IL | 2017 | – | 333 | 302 (2016) | 284 (2020) | 338 (2024) |
| UPMC Chautauqua at WCA, NY | 2017 | 277 | 279 | 145 (2016) | 157 (2020) | 257 (2024) |
| University of Tennessee Medical Center, TN | 2017 | 581 | 625 | 597 (2016) | 671 (2020) | 698 (2024) |
| Advocate Christ Medical Center, IL | 2018 | – | 802 | 695 (2017) | 711 (2021) | 735 (2024) |
| Albany Medical Center Hospital, NY | 2018 | 716 | 748 | 738 (2017) | 743 (2021) | 719 (2024) |
| Duke University Hospital, NC | 2018 | 938 | 1,034 | 954 (2017) | 1,048 (2021) | 1,266 (2024) |
| FirstHealth Moore Regional Hospital, NC | 2018 | 337 | 359 | 417 (2017) | 412 (2021) | 412 (2024) |
| Kadlec Regional Medical Center, WA | 2018 | 270 | 337 | 258 (2017) | 288 (2021) | 283 (2024) |
| North Carolina Specialty Hospital, NC | 2018 | 18 | 24 | 18 (2017) | 18 (2021) | 18 (2024) |
| North Shore University Hospital, NY | 2018 | 738 | 756 | 764 (2017) | 782 (2021) | 815 (2024) |
| South Nassau Communities Hospital (Mount Sinai South Nassau), NY | 2018 | 455 | 455 | 350 (2017) | 312 (2021) | 312 (2024) |
| Taylorville Memorial Hospital, IL | 2018 | – | 25 | 25 (2017) | 25 (2021) | 25 (2024) |
| United Memorial Medical Center - Bank Street Campus, NY | 2018 | 131 | 133 | 131 (2017) | 126 (2021) | 126 (2024) |
| Duke University Hospital, NC | 2019 | 1,014 | 1,062 | 959 (2018) | 1,048 (2022) | 1,266 (2024) |
| Greater Baltimore Medical Center, MD | 2019 | 383 | 414 | 269 (2018) | 265 (2022) | 241 (2024) |
| Highland Hospital, NY | 2019 | 261 | 261 | 235 (2018) | 261 (2022) | 261 (2024) |
| Memorial Hospital of Carbondale, IL | 2019 | 154 | 162 | 167 (2018) | 175 (2022) | 175 (2024) |
| Providence St. Peter Hospital, WA | 2019 | 368 | 420 | 304 (2018) | 310 (2022) | 380 (2024) |
| FirstHealth Moore Regional Hospital, NC | 2020 | 337 | 384 | 412 (2019) | 412 (2023) | 412 (2024) |
| Good Samaritan Hospital Medical Center (Good Samaritan University Hospital), NY | 2020 | 437 | 437 | 437 (2019) | 437 (2023) | 426 (2024) |
| Mount Sinai Beth Israel (new hospital at NYEE campus, East 14th St), NY | 2020 | 543 | 70 | 466 (2019) | 432 (2023) | 377 (2024) |
| Northwestern Memorial Hospital, IL | 2020 | 894 | 943 | 874 (2019) | 944 (2023) | 930 (2024) |
| University of Vermont Medical Center, VT | 2020 | 509 | 516 | 401 (2019) | 448 (2023) | 448 (2023) |
| Luminis Health Doctors Community Hospital, MD | 2021 | 211 | 227 | 206 (2020) | 226 (2024) | 226 (2024) |
| Staten Island University Hospital - North, NY | 2021 | 454 | 450 | 543 (2020) | 544 (2024) | 544 (2024) |
| The University of Chicago Medical Center, IL | 2021 | – | 782 | 678 (2020) | 737 (2024) | 737 (2024) |
How these figures were made
- 38 hospital projects filed from 2011 to 2021 that promised a bed total, set against the beds the hospital reported to Medicare in the year before the filing, about 3 years after it and in the latest year.
- Filings with a resulting bed total, linked to a cost report hospital: 95.
- The total is for the whole hospital, not one department: 90.
- Linked with high confidence: 87.
- One filing per project: 87.
- Filed 2011 to 2021, with three or more years of cost reports after: 40.
- The cost report counts the same hospital the filing describes: 38.
- Cost report beds are Worksheet S-3 Part I line 14, beds available on the hospital's adult, pediatric and intensive care units; filings usually count licensed beds, including psychiatric and rehabilitation units. A cost report year counts when its beds agree with its bed-days available (within 80% to 125%).
- Projects whose cost report beds the year before were under half or over one and a half times the filing's existing beds are left out as probably not the same hospital (2). The filings give no opening dates, so "about three years later" is the report closest to the filing year plus three.
- For psychiatric and rehabilitation units that bill under their own Medicare numbers, fiscal year 2023 alone is available: adding them, 24 of 38 projects reach their total that year, against 20.