Worksheet G-3

also known as: W/S G-3 · Statement of Revenues and Expenses

Worksheet G-3 of CMS Form 2552-10 is the hospital's income statement, prepared on an accrual basis. It reports: - Line 1: Net patient services revenue (gross charges minus contractual adjustments and discounts) - Line 2: Other operating revenue (cafeteria, parking, rental income, etc.) - Line 3: Total operating revenues - Line 4: Total operating expenses - Line 5: Net income from service to patients (Line 3 minus Line 4) - Line 24: Total bad debt - Line 25–28: Various non-operating income components (investment income, gains on sale, etc.) - Line 29: Total net income (Line 5 plus non-operating) Most hospital financial analysis uses Line 5 (operating margin) as the key metric — it strips out one-time gains and investment performance, isolating core hospital operations.

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