As of the July, 2022, release via CMS

THE NEBRASKA MEDICAL CENTER

CMS id: 280013
989200 NEBRASKA MEDICAL CENTER, OMAHA NE 68198. County: DOUGLAS
System: NEBRASKA MEDICINE
CBSA: Omaha-Council Bluffs, NE-IA

The 616-bed, acute-care hospital had $-535,748,076 in net service to patients*, with a total profit margin of 5.61427% in fiscal year 2021, the latest year available.
It spent 3.87% of its operating expenses on uncompensated care and reported $27,566,332 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	nfp	nfp	nfp	nfp
Acute beds Median	389 118	434 118	454 119.5	438 118	461 119
Total beds Median	520 162	559 162	578 162	569 162	616 163.5
FTEs Median	6,171.33 788.06	6,480.00 793.42	6,480.00 806.03	6,896.00 787.61	7,047.56 804.34

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	1,007,631,151 150,932,746	1,013,000,641 158,950,878	1,093,333,096 168,696,998	1,258,803,455 163,454,693	1,271,491,471 186,589,412
Operating expenses Median	1,270,754,371 149,311,209	1,385,498,416 156,110,414	1,552,421,590 164,890,568	1,658,366,512 166,516,854	1,807,239,547 180,120,888
Net income from service 2 patients (NS2P) ? Median	-263,123,220 -964,173	-372,497,775 -643,601.5	-459,088,494 -116,254	-399,563,057 -5,025,862	-535,748,076 -1,284,564
NS2P margin ? Median	-26.11% -0.62	-36.77% -0.29	-41.99% 0.18	-31.74% -5.07	-42.14% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for THE NEBRASKA MEDICAL CENTER 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	311,902,090 5,089,215	432,001,997 4,572,541	495,443,685 5,268,134	536,573,422 13,092,619	644,189,166 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	2,236,313 224,999	97,833 199,009	13,265 206,870.5	21,500 194,343	64,898 249,496
⊳ Line 7: Investments ? ⊳ Median	5,380,849 299,524	10,370,566 188,688.5	16,778,425 370,813	9,308,042 309,361.5	32,383,604 375,329
⊳ Line 8: Revenue from telephone service	NULL	NULL	NULL	NULL	NULL
⊳ Line 9: Revenue from tv and radio	--	--	--	--	--
⊳ Line 10: Purchase discounts	342,594	665,446	689,070	670,869	578,572
⊳ Line 11: Rebates and refunds of expenses	0	510,233	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	11,154	15,626	0	0	0
⊳ Line 15: Revenue from rental of living quarters	0	223,881	148,690	155,747	125,917
⊳ Line 16: Revenue from sale of medical and surgical supplies	41,000	41,000	41,000	41,000	41,000
⊳ Line 17: Revenue from sale of drugs to other than patients	283,684	135,393	141,071	162,514	38,414
⊳ Line 18: Revenue from sale of medical records and abstracts	0	118,820	108,958	102,348	104,761
⊳ Line 19: Tuition (fees, sale of textbooks, uniforms, etc.)	8,530	0	12,747	11,339	16,001
⊳ Line 20: Revenue from gifts, flowers, coffee shops, canteen	14,643	12,363	13,655	9,405	14,035
⊳ Line 21: Rental of vending machines	67,462	80,352	72,059	74,749	16,028
⊳ Line 22: Rental of hospital space	2,577,931	2,594,701	2,427,877	2,682,773	2,866,278
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	188,951 983,261.5	39,840 1,173,286	14,294 1,987,202	11,153 1,597,664
⊳ Sum Line 24	300,937,930	416,946,832	474,957,028	523,318,842	607,928,505
Total income ? Median	48,778,870 6,586,430	59,504,222 6,767,106	36,355,191 8,419,950	137,010,365 8,094,175	108,441,090 15,162,888
Non-operating expenses Median	566,984 146,289.5	692,543 164,857	729,254 89,880.5	822,469 106,761	889,602 31,473.5
Net income Median	48,211,886 6,043,842	58,811,679 5,845,112	35,625,937 7,606,259	136,187,896 7,283,041	107,551,488 14,957,241
Net margin Median	3.65371% 4.62%	4.07000% 4.42%	2.24235% 5.16%	7.58548% 5.2%	5.61427% 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 THE NEBRASKA MEDICAL CENTER 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	167,100,670 23,241,334	176,594,490 23,709,545	183,628,609 24,248,380	178,868,546 22,858,541	190,769,505 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	166,543,048 21,577,146	176,012,928 22,041,594	183,388,125 22,722,063	178,686,382 21,570,441	190,769,505 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	557,622 1,845,420	581,562 1,757,392	240,484 1,738,842	182,164 1,510,463	0 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	0 3,535,627	0 3,746,588	0 3,782,288	0 3,865,578	0 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	77,254,679 11,160,864	91,976,190 11,987,345	97,610,701 12,926,866	92,377,796 11,884,480	102,248,823 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	77,254,679 10,918,923	91,976,190 11,706,976	97,610,701 12,615,917	92,377,796 11,458,116	102,248,823 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	27,119,758 3,284,314	27,822,203 3,250,551	27,766,989 3,386,837	27,661,025 3,360,806	28,013,541 3,508,953
Disproportionate-share hospital (DSH) Median	3,301,573 594,888	3,166,855 595,761	3,105,405 577,894	3,115,193 542,168	3,518,240 549,667
Outlier Median	12,315,489 582,572	11,984,930 538,116	14,669,506 212,434	1,649,591 126,559	2,294,290 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	22,822,137 3,662,910	7,378,815 3,730,911	12,542,479 4,081,319	17,151,924 4,643,908	27,566,332 4,389,147
Charity care Median	11,931,632 2,654,636	19,783,424 2,940,659	37,683,203 3,380,215	29,301,639 3,488,738	42,857,767 3,233,405
Uncompensated care (UCC) Median	33,929,126 5,147,790	43,231,239 5,337,617	62,439,316 5,711,082	54,289,619 5,923,418	70,022,108 5,508,107
UCC as a % of operating expenses Median	2.67% 3.24	3.12% 3.12	4.02% 3.21	3.27% 3.3	3.87% 2.86
Total shortfall/UCC Median	56,751,263 9,489,989	50,610,054 9,424,297	74,981,795 10,120,158	71,441,543 11,171,337	97,588,440 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	577,864,353 52,142,039	617,651,504 54,485,252	674,714,304 57,395,589	712,540,182 58,830,919	772,704,634 61,722,907
Salaries as a % of operating expenses Median	45.47 36.68	44.58 36.56	43.46 36.37	42.97 35.93	42.76 35.24
Intern, resident salaries* Median	0 2,598,592	0 2,686,824	0 2,753,773	0 2,937,156	0 2,909,848
Contract intern, resident salaries* Median	16,755,689 1,251,927	16,546,276 1,186,494	18,260,399 1,204,885	20,033,815 1,279,653	21,676,731 1,469,317
Contract adjusted salaries, direct-care Median	24,352,703 1,449,244	22,815,906 1,475,986	21,236,539 1,563,078	23,375,307 1,721,954	32,698,395 2,991,828
Contract hours, direct-care Median	500,353.00 22,725	418,987.00 23,018.5	404,244.00 24,503.48	334,309.50 25,026.5	428,513.00 33,786
Contract wages, direct-care Median	48.67 64.67	54.45 64.53	52.53 65.06	69.92 68.97	76.31 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.