As of the July, 2022, release via CMS

CHI HEALTH ST. FRANCIS

CMS id: 280023
2620 W FAIDLEY AVENUE, GRAND ISLAND NE 68802. County: HALL
System: COMMONSPIRIT HEALTH (FKA CHI)
CBSA: Grand Island, NE

The 191-bed, acute-care hospital had $-8,274,721 in net service to patients*, with a total profit margin of 37.38180% in fiscal year 2021, the latest year available.
It spent 4.98% of its operating expenses on uncompensated care and reported $4,332,969 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	120 118	116 118	115 119.5	115 118	118 119
Total beds Median	190 162	186 162	186 162	186 162	191 163.5
FTEs Median	631.83 788.06	573.12 793.42	562.56 806.03	560.69 787.61	526.61 804.34

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	160,177,914 150,932,746	175,084,281 158,950,878	177,632,129 168,696,998	163,814,987 163,454,693	161,217,743 186,589,412
Operating expenses Median	142,432,260 149,311,209	144,173,145 156,110,414	147,742,871 164,890,568	161,707,253 166,516,854	169,492,464 180,120,888
Net income from service 2 patients (NS2P) ? Median	17,745,654 -964,173	30,911,136 -643,601.5	29,889,258 -116,254	2,107,734 -5,025,862	-8,274,721 -1,284,564
NS2P margin ? Median	11.08% -0.62	17.66% -0.29	16.83% 0.18	1.29% -5.07	-5.13% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CHI HEALTH ST. FRANCIS 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	40,741,880 5,089,215	36,963,814 4,572,541	23,017,540 5,268,134	23,120,084 13,092,619	109,458,285 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	104,053 224,999	10,996 199,009	20,210 206,870.5	28,143 194,343	174,872 249,496
⊳ Line 7: Investments ? ⊳ Median	19,121,911 299,524	22,120,078 188,688.5	9,338,733 370,813	7,174,501 309,361.5	72,405,760 375,329
⊳ 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	422,765	456,230	440,192	426,781	384,706
⊳ 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	232,520	179,629	13,400	29,072	12,402
⊳ 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	106,693	98,912	107,812	131,139	102,924
⊳ Line 21: Rental of vending machines	0	0	0	0	0
⊳ Line 22: Rental of hospital space	445,943	474,925	442,832	476,860	424,245
⊳ 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	20,307,995	13,623,044	12,654,361	14,853,588	35,953,376
Total income ? Median	58,487,534 6,586,430	67,874,950 6,767,106	52,906,798 8,419,950	25,227,818 8,094,175	101,183,564 15,162,888
Non-operating expenses Median	205,442 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	58,282,092 6,043,842	67,874,950 5,845,112	52,906,798 7,606,259	25,227,818 7,283,041	101,183,564 14,957,241
Net margin Median	29.00764% 4.62%	32.00922% 4.42%	26.36775% 5.16%	13.49550% 5.2%	37.38180% 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. FRANCIS 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	29,546,279 23,241,334	30,220,448 23,709,545	32,465,653 24,248,380	28,850,372 22,858,541	26,238,328 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	26,020,504 21,577,146	26,235,194 22,041,594	27,669,669 22,722,063	24,126,824 21,570,441	21,260,548 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	2,353,968 3,535,627	2,816,505 3,746,588	3,293,973 3,782,288	3,039,041 3,865,578	3,477,285 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	1,171,807 1,203,033	1,168,749 1,215,295	1,502,011 1,313,657	1,684,507 1,365,298	1,500,495 1,179,746
All outpatient revenue Median Click here to show/hide details	22,482,090 11,160,864	24,473,858 11,987,345	25,122,205 12,926,866	25,026,607 11,884,480	24,285,760 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	22,482,090 10,918,923	24,473,858 11,706,976	25,122,205 12,615,917	25,026,607 11,458,116	24,285,760 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	445,169 3,284,314	493,923 3,250,551	556,289 3,386,837	517,269 3,360,806	442,712 3,508,953
Disproportionate-share hospital (DSH) Median	322,755 594,888	303,865 595,761	337,601 577,894	288,018 542,168	220,832 549,667
Outlier Median	859,843 582,572	1,078,129 538,116	919,184 212,434	102,292 126,559	188,607 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	1,657,870 3,662,910	765,197 3,730,911	1,863,013 4,081,319	3,373,193 4,643,908	4,332,969 4,389,147
Charity care Median	5,911,385 2,654,636	4,329,550 2,940,659	5,620,278 3,380,215	5,251,517 3,488,738	5,502,336 3,233,405
Uncompensated care (UCC) Median	7,069,961 5,147,790	6,542,714 5,337,617	8,470,319 5,711,082	9,008,187 5,923,418	8,436,537 5,508,107
UCC as a % of operating expenses Median	4.96% 3.24	4.54% 3.12	5.73% 3.21	5.57% 3.3	4.98% 2.86
Total shortfall/UCC Median	8,727,831 9,489,989	7,307,911 9,424,297	10,333,332 10,120,158	12,381,380 11,171,337	12,769,506 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	35,243,298 52,142,039	34,376,655 54,485,252	35,917,663 57,395,589	37,775,812 58,830,919	36,940,602 61,722,907
Salaries as a % of operating expenses Median	29.01 36.68	28.39 36.56	29.16 36.37	28.09 35.93	23.50 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	561,148 1,251,927	571,179 1,186,494	411,305 1,204,885	566,023 1,279,653	385,593 1,469,317
Contract adjusted salaries, direct-care Median	4,300,605 1,449,244	1,186,197 1,475,986	1,183,224 1,563,078	2,337,904 1,721,954	5,430,482 2,991,828
Contract hours, direct-care Median	78,737.62 22,725	17,603.50 23,018.5	18,870.50 24,503.48	31,741.70 25,026.5	48,807.10 33,786
Contract wages, direct-care Median	54.62 64.67	67.38 64.53	62.70 65.06	73.65 68.97	111.26 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.