As of the July, 2022, release via CMS

UNIVERSITY OF ALABAMA HOSPITAL

CMS id: 010033
619 SOUTH 19TH STREET, BIRMINGHAM AL 35233. County: JEFFERSON
System: --
CBSA: Birmingham-Hoover, AL

The 1,286-bed, acute-care hospital had $-117,025,682 in net service to patients*, with a total profit margin of 13.62832% in fiscal year 2021, the latest year available.
It spent 6.30% of its operating expenses on uncompensated care and reported $64,238 in Medicaid shortfall.

* For more about Net Service to Patients and operating revenue, please the finance section below.

Note: Medians are from acute-care hospitals with "complete" fiscal years. For more about how we calculated medians and cost reports in general, please click here.

Details

	2017	2018	2019	2020	2021
# of days in fyear	365	365	365	366	365
Ownership	nfp	gov	gov	gov	gov
Acute beds Median	770 118	772 118	795 119.5	769 118	808 119
Total beds Median	1,201 162	1,205 162	1,242 162	1,227 162	1,286 163.5
FTEs Median	9,164.00 788.06	9,112.00 793.42	9,242.64 806.03	9,716.56 787.61	9,994.25 804.34

Finances As they appear in worksheet G3 of the cost reports.

Note: Net Patient Revenue is considered operating revenue, which means Net Service to Patients is considered operating profit. Click here for more about cost report financials

Hospital cost reports are an enormously complicated dataset. There are whole organizations and an offical CMS vendor dedicated to helping researchers work with the data.
It's important to understand that hospital financials in cost reports are not organized in the same as other sources such as annual financial reports to bond holders.

The biggest difference is the concept of operating revenue and profit. Net Service to patients (NS2P), which is the sum of net patient revenue minus operating expenses, is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

That would make Net Patient Revenue = operating revenue.

All this makes things challenging when comparing what's reported in cost reports to other sources. It becomes clearer when you consider that, beyond the purpose of reimbursement, cost reports are a tool for policymakers trying to understand the financial situation of a hospital doing the tasks specific to hospitals.

In other words, while a facility with a division that formulates drugs might include earnings from that as operating revenue in their corporate annual result, this is not central to the operations of a hospital caring for patients and so it is counted as "other income." (See below the financials section for more on "other income")

The healthcare consulting firm HMP, in a former partnership with Modern Healthcare, did develop a formula for estimating operating revenue closer to what one might find in other sources. We no longer use this for the following reasons:

The measure was not widely used beyond HMP and Modern Healthcare. Many hospitals had their own internal estimates of operating revenue and profit.
Because of this, there was confusion when reporting operating results for individual hospitals. There was often pushback when a facility's internal numbers did not match what Modern Healthcare was reporting.
The formula includes revenue from portions of the "other income" section, which may also include non-operating revenue. HMP themselves point out in a caveat on their site that they cannot exclude all non-operating revenue from their measure.

HMP's operating measure has proven problematic in the past for our reporting and the partnership with them ended years ago. It's best to not use a measure that we alone cannot defend.

	2017	2018	2019	2020	2021
Net patient revenue ? Median	1,530,834,591 150,932,746	1,548,385,737 158,950,878	1,785,283,427 168,696,998	1,866,934,345 163,454,693	2,198,201,563 186,589,412
Operating expenses Median	1,589,583,289 149,311,209	1,699,346,240 156,110,414	1,892,729,039 164,890,568	2,021,914,513 166,516,854	2,315,227,245 180,120,888
Net income from service 2 patients (NS2P) ? Median	-58,748,698 -964,173	-150,960,503 -643,601.5	-107,445,612 -116,254	-154,980,168 -5,025,862	-117,025,682 -1,284,564
NS2P margin ? Median	-3.84% -0.62	-9.75% -0.29	-6.02% 0.18	-8.30% -5.07	-5.32% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for UNIVERSITY OF ALABAMA HOSPITAL compared to all** acute-care hospitals, from CMS cost reports.
Note: NS2P is considered operating margin by MACPAC. The chart below is interactive: click or touch to see more.

* Data range does not show outliers, which fall beyond the minimum and maximum of the range.
** From cost reports with complete fiscal years. Number of acute-care hospitals available to calculate medians:

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

	2017	2018	2019	2020	2021
Other income* Median Click here to show/hide details	299,928,033 5,089,215	398,313,226 4,572,541	363,626,669 5,268,134	292,573,151 13,092,619	482,338,121 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	1,012,172 224,999	3,085 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	75,019,754 299,524	38,191,857 188,688.5	15,224,317 370,813	2,225,634 309,361.5	241,213,413 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	0	0	0	0	0
⊳ Line 11: Rebates and refunds of expenses	0	0	0	0	0
⊳ Line 12: Parking lot receipts	0	0	0	0	0
⊳ Line 13: Revenue from laundry and linen service	0	0	0	0	0
⊳ Line 14: Revenue from meals sold to emplyees and guests	0	0	0	0	0
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	0	0	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	0	0	0	0	0
⊳ Line 18: Revenue from sale of medical records and abstracts	0	0	0	0	0
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	0	0	0	0	0
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	0	0	0	0	0
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	0	0	0	0	0
⊳ Line 23: Gov appropriations ? ⊳ Median	33,406,248 1,017,693	33,406,248 983,261.5	34,588,828 1,173,286	36,887,362 1,987,202	37,955,804 1,597,664
⊳ Sum Line 24	190,489,859	326,712,036	313,813,524	253,460,155	203,168,904
Total income ? Median	241,179,335 6,586,430	247,352,723 6,767,106	256,181,057 8,419,950	137,592,983 8,094,175	365,312,439 15,162,888
Non-operating expenses Median	130,748,878 146,289.5	146,761,127 164,857	155,161,594 89,880.5	0 106,761	0 31,473.5
Net income Median	110,430,457 6,043,842	100,591,596 5,845,112	101,019,463 7,606,259	137,592,983 7,283,041	365,312,439 14,957,241
Net margin Median	6.03194% 4.62%	5.16729% 4.42%	4.70096% 5.16%	6.37150% 5.2%	13.62832% 9.25%

* About "Other income": Other income, or line 25 in worksheet G3, is the sum of lines 6 through 24. It includes three lines that are considered non-operating revenue - contributions, investments and government appropriations. Medians are included for these three lines. It also contains items that are not central to providing healthcare, such as revenue from parking or gift shops.
"Sum Line 24" is a special case. Called "Other (specify)" in the cost reports, CMS allows for this line to be "subscripted," or divided into sublines like 002400, 002401, 002402. And hospitals do that, up to 100 lines, to detail income (and sometimes negative returns) that are otherwise not covered in the previous "other" lines. Therefore, "Sum Line 24" is the sum of all the lines 24.

Range* of total profit (loss) margins

= Total margin for UNIVERSITY OF ALABAMA HOSPITAL compared to all** acute-care hospitals, from CMS cost reports.
The chart below is interactive: click or touch to see more.

2017	2018	2019	2020	2021
3,157	3,092	3,050	3,052	2,566

Medicare revenue

Inpatient and outpatient revenue

	2017	2018	2019	2020	2021
All inpatient revenue Median Click here to show/hide details	258,500,611 23,241,334	260,494,643 23,709,545	290,087,773 24,248,380	294,425,283 22,858,541	302,129,248 23,620,613
"All inpatient revenue" is made up of any Medicare payments for routine inpatient, swingbed SNFs, TEFRA, IPF, IRF, inpatient long-term care, CAH and inpatient SNF facilities. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine inpatient revenue ⊳ Median	248,609,516 21,577,146	251,473,658 22,041,594	280,483,682 22,722,063	286,090,949 21,570,441	293,654,922 22,140,684
⊳ Swingbeds ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Tax Equity and Fiscal Responsibility Act payments (TEFRA) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Inpatient psychiatric facility (IPF) ⊳ Median	4,164,218 1,845,420	4,218,406 1,757,392	4,006,104 1,738,842	2,978,681 1,510,463	3,623,237 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	5,726,877 3,535,627	4,802,579 3,746,588	5,597,987 3,782,288	5,355,653 3,865,578	4,851,089 3,983,889
⊳ Long-term care hospital (LTCH) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Critical-access hospitals ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Skilled-nursing facilities (SNF) ⊳ Median	0 1,203,033	0 1,215,295	0 1,313,657	0 1,365,298	0 1,179,746
All outpatient revenue Median Click here to show/hide details	104,788,371 11,160,864	106,294,293 11,987,345	111,577,918 12,926,866	105,594,591 11,884,480	114,253,369 13,145,163
"All outpatient revenue" is made up of any payments for routine outpatient, HHA, CMHC, rural health and other federally-qualified health clinics. Medians are only calculated when there are sufficient facilities reporting revenue.
⊳ Routine outpatient revenue ⊳ Median	104,788,371 10,918,923	106,294,293 11,706,976	111,577,918 12,615,917	105,594,591 11,458,116	114,253,369 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	0 1,282,808	0 1,407,728	0 1,341,512	0 1,407,046	0 1,476,867
⊳ Community mental health clinics (CMHC) ⊳ Median	0 --	0 --	0 --	0 --	0 --
⊳ Rural health clinics ⊳ Median	0 618,038	0 697,279	0 690,232	0 684,010	0 670,558
⊳ Other federally qualified health clinics ⊳ Median	0 --	0 --	0 --	0 --	0 --

Other payments

Item	2017	2018	2019	2020	2021
Graduate Medical Education (GME) Median	32,078,856 3,284,314	31,391,775 3,250,551	32,075,787 3,386,837	31,774,785 3,360,806	32,425,146 3,508,953
Disproportionate-share hospital (DSH) Median	6,368,949 594,888	6,135,188 595,761	7,311,078 577,894	6,612,236 542,168	5,970,868 549,667
Outlier Median	19,968,121 582,572	19,392,820 538,116	2,005,881 212,434	1,717,421 126,559	1,833,089 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	0 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	64,238 4,389,147
Charity care Median	79,132,003 2,654,636	96,799,315 2,940,659	92,725,954 3,380,215	99,276,854 3,488,738	102,705,777 3,233,405
Uncompensated care (UCC) Median	109,285,310 5,147,790	128,781,551 5,337,617	125,884,713 5,711,082	136,459,880 5,923,418	145,923,651 5,508,107
UCC as a % of operating expenses Median	6.88% 3.24	7.58% 3.12	6.65% 3.21	6.75% 3.3	6.30% 2.86
Total shortfall/UCC Median	109,285,310 9,489,989	128,781,551 9,424,297	125,884,713 10,120,158	136,459,880 11,171,337	145,987,889 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	572,060,552 52,142,039	595,834,014 54,485,252	626,044,323 57,395,589	677,798,066 58,830,919	746,023,565 61,722,907
Salaries as a % of operating expenses Median	35.99 36.68	35.06 36.56	33.08 36.37	33.52 35.93	32.22 35.24
Intern, resident salaries* Median	43,684,130 2,598,592	44,750,019 2,686,824	42,064,098 2,753,773	44,417,902 2,937,156	44,864,508 2,909,848
Contract intern, resident salaries* Median	0 1,251,927	0 1,186,494	0 1,204,885	0 1,279,653	0 1,469,317
Contract adjusted salaries, direct-care Median	5,442,857 1,449,244	6,269,478 1,475,986	8,118,954 1,563,078	10,594,742 1,721,954	34,467,526 2,991,828
Contract hours, direct-care Median	82,402.00 22,725	94,350.00 23,018.5	121,218.00 24,503.48	162,526.00 25,026.5	363,307.00 33,786
Contract wages, direct-care Median	66.05 64.67	66.45 64.53	66.98 65.06	65.19 68.97	94.87 88.94

* in an approved program

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Cost reports are self-reported by the facility, are subject to revision and should be considered preliminary.

* Net Service to patients (NS2P) equals net patient revenue minus operating expenses. NS2P is considered the equivalent of operating profit according to the Medicaid and CHIP Payment and Access Commission (MACPAC). See the last paragraph of "Primary Data Sources" on page 55 of Annual Analysis of Disproportionate Share Hospital Allotments to States (PDF).

About medians

Medians are calculated from reports with "complete" fiscal years, or reports with fiscal years of at least 300 days and no more than 420 days.

In cases where there are fewer than 50 values reported, medians are not calculated. For childrens' hospitals, it's when fewer than 20 are reported.

Web app by Tim Broderick | email.