As of the July, 2022, release via CMS

CHI HEALTH ST. ELIZABETH

CMS id: 280020
555 SOUTH 70TH STREET, LINCOLN NE 68510. County: LANCASTER
System: COMMONSPIRIT HEALTH (FKA CHI)
CBSA: Lincoln, NE

The 258-bed, acute-care hospital had $-13,479,102 in net service to patients*, with a total profit margin of 17.29463% in fiscal year 2021, the latest year available.
It spent 5.73% of its operating expenses on uncompensated care and reported $8,748,133 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	181 118	174 118	176 119.5	167 118	199 119
Total beds Median	260 162	253 162	235 162	226 162	258 163.5
FTEs Median	835.92 788.06	739.77 793.42	664.85 806.03	641.87 787.61	636.88 804.34

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	190,203,236 150,932,746	186,398,004 158,950,878	161,912,592 168,696,998	148,383,213 163,454,693	162,690,664 186,589,412
Operating expenses Median	191,033,549 149,311,209	188,704,741 156,110,414	179,706,596 164,890,568	171,299,915 166,516,854	176,169,766 180,120,888
Net income from service 2 patients (NS2P) ? Median	-830,313 -964,173	-2,306,737 -643,601.5	-17,794,004 -116,254	-22,916,702 -5,025,862	-13,479,102 -1,284,564
NS2P margin ? Median	-0.44% -0.62	-1.24% -0.29	-10.99% 0.18	-15.44% -5.07	-8.29% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CHI HEALTH ST. ELIZABETH 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	43,184,825 5,089,215	30,645,446 4,572,541	14,417,509 5,268,134	14,593,563 13,092,619	50,318,185 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	131,726 224,999	252,246 199,009	13,007 206,870.5	131,746 194,343	164,070 249,496
⊳ Line 7: Investments ? ⊳ Median	21,948,400 299,524	23,654,434 188,688.5	11,987,327 370,813	3,958,549 309,361.5	37,498,917 375,329
⊳ 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	402,700	372,235	356,876	302,562	279,787
⊳ Line 15: Revenue from rental of living quarters	0	0	0	0	0
⊳ Line 16: Revenue from sale of medical and surgical supplies	1,852,695	1,168,897	0	0	0
⊳ Line 17: Revenue from sale of drugs to other than patients	68,340	54,774	33,830	43,127	51,385
⊳ 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	450,719	503,861	372,643	367,179	295,959
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	18,330,245	4,638,999	1,653,826	9,790,400	12,028,067
Total income ? Median	42,354,512 6,586,430	28,338,709 6,767,106	-3,376,495 8,419,950	-8,323,139 8,094,175	36,839,083 15,162,888
Non-operating expenses Median	459,648 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	41,894,864 6,043,842	28,338,709 5,845,112	-3,376,495 7,606,259	-8,323,139 7,283,041	36,839,083 14,957,241
Net margin Median	17.95073% 4.62%	13.05670% 4.42%	-1.91487% 5.16%	-5.10695% 5.2%	17.29463% 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 CHI HEALTH ST. ELIZABETH 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	43,643,697 23,241,334	40,360,860 23,709,545	31,601,543 24,248,380	31,327,247 22,858,541	28,748,743 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	43,643,697 21,577,146	40,360,860 22,041,594	31,601,543 22,722,063	31,327,247 21,570,441	28,748,743 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	0 1,845,420	0 1,757,392	0 1,738,842	0 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	17,064,907 11,160,864	17,506,286 11,987,345	16,102,812 12,926,866	13,867,610 11,884,480	11,888,918 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	17,064,907 10,918,923	17,506,286 11,706,976	16,102,812 12,615,917	13,867,610 11,458,116	11,888,918 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	588,095 3,284,314	587,333 3,250,551	441,122 3,386,837	412,645 3,360,806	292,890 3,508,953
Disproportionate-share hospital (DSH) Median	902,492 594,888	498,290 595,761	532,658 577,894	536,220 542,168	638,563 549,667
Outlier Median	2,798,362 582,572	3,026,554 538,116	1,306,832 212,434	316,733 126,559	309,680 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	5,177,678 3,662,910	4,829,486 3,730,911	7,370,463 4,081,319	8,261,300 4,643,908	8,748,133 4,389,147
Charity care Median	10,432,327 2,654,636	8,690,413 2,940,659	7,347,140 3,380,215	6,378,703 3,488,738	7,240,651 3,233,405
Uncompensated care (UCC) Median	11,496,780 5,147,790	10,634,086 5,337,617	9,893,911 5,711,082	9,444,934 5,923,418	10,088,958 5,508,107
UCC as a % of operating expenses Median	6.02% 3.24	5.64% 3.12	5.51% 3.21	5.51% 3.3	5.73% 2.86
Total shortfall/UCC Median	16,674,458 9,489,989	15,463,572 9,424,297	17,264,374 10,120,158	17,706,234 11,171,337	18,837,091 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	52,337,197 52,142,039	48,243,617 54,485,252	45,371,381 57,395,589	44,603,724 58,830,919	45,560,592 61,722,907
Salaries as a % of operating expenses Median	32.10 36.68	30.61 36.56	30.53 36.37	31.93 35.93	28.01 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	631,294 1,251,927	622,723 1,186,494	654,343 1,204,885	810,549 1,279,653	883,515 1,469,317
Contract adjusted salaries, direct-care Median	4,249,228 1,449,244	2,176,261 1,475,986	3,263,068 1,563,078	2,511,036 1,721,954	3,559,128 2,991,828
Contract hours, direct-care Median	72,267.63 22,725	30,248.00 23,018.5	48,607.00 24,503.48	31,170.91 25,026.5	38,093.89 33,786
Contract wages, direct-care Median	58.80 64.67	71.95 64.53	67.13 65.06	80.56 68.97	93.43 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.