As of the July, 2022, release via CMS

CHI HEALTH IMMANUEL

CMS id: 280081
6901 NORTH 72ND STREET, OMAHA NE 68122. County: DOUGLAS
System: COMMONSPIRIT
CBSA: Omaha-Council Bluffs, NE-IA

The 252-bed, acute-care hospital had $-2,365,790 in net service to patients*, with a total profit margin of 9.08391% in fiscal year 2021, the latest year available.
It spent 6.48% of its operating expenses on uncompensated care and reported $12,748,587 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	141 118	154 118	153 119.5	153 118	153 119
Total beds Median	239 162	253 162	252 162	252 162	252 163.5
FTEs Median	840.43 788.06	897.64 793.42	838.17 806.03	833.49 787.61	820.53 804.34

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	150,478,411 150,932,746	0 158,950,878	171,641,124 168,696,998	172,678,683 163,454,693	187,104,762 186,589,412
Operating expenses Median	163,207,526 149,311,209	136,582,469 156,110,414	170,132,345 164,890,568	171,904,102 166,516,854	189,470,552 180,120,888
Net income from service 2 patients (NS2P) ? Median	-12,729,115 -964,173	-136,582,469 -643,601.5	1,508,779 -116,254	774,581 -5,025,862	-2,365,790 -1,284,564
NS2P margin ? Median	-8.46% -0.62	--% -0.29	0.88% 0.18	0.45% -5.07	-1.26% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for CHI HEALTH IMMANUEL 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	11,144,782 5,089,215	0 4,572,541	0 5,268,134	21,626,291 13,092,619	21,296,789 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	0 194,343	0 249,496
⊳ Line 7: Investments ? ⊳ Median	0 299,524	0 188,688.5	0 370,813	0 309,361.5	0 375,329
⊳ 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	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	0 1,597,664
⊳ Sum Line 24	11,144,782	--	--	21,626,291	21,296,789
Total income ? Median	-1,584,333 6,586,430	-136,582,469 6,767,106	1,508,779 8,419,950	22,400,872 8,094,175	18,930,999 15,162,888
Non-operating expenses Median	0 146,289.5	0 164,857	0 89,880.5	0 106,761	0 31,473.5
Net income Median	-1,584,333 6,043,842	-136,582,469 5,845,112	1,508,779 7,606,259	22,400,872 7,283,041	18,930,999 14,957,241
Net margin Median	-0.98026% 4.62%	--% 4.42%	0.87903% 5.16%	11.52872% 5.2%	9.08391% 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 IMMANUEL 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	35,522,774 23,241,334	33,749,060 23,709,545	34,935,307 24,248,380	32,887,734 22,858,541	32,296,058 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	25,797,896 21,577,146	25,190,038 22,041,594	25,239,335 22,722,063	25,295,582 21,570,441	25,524,397 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	4,195,741 1,845,420	3,171,075 1,757,392	3,534,031 1,738,842	2,822,096 1,510,463	2,776,355 1,393,140
⊳ Inpatient rehabilitation facility (IRF) ⊳ Median	5,529,137 3,535,627	5,387,947 3,746,588	6,161,941 3,782,288	4,770,056 3,865,578	3,995,306 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	8,133,059 11,160,864	8,131,498 11,987,345	8,505,424 12,926,866	8,115,924 11,884,480	9,005,177 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	8,133,059 10,918,923	8,131,498 11,706,976	8,505,424 12,615,917	8,115,924 11,458,116	9,005,177 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	960,231 3,284,314	934,206 3,250,551	903,669 3,386,837	960,592 3,360,806	1,043,911 3,508,953
Disproportionate-share hospital (DSH) Median	961,298 594,888	1,014,062 595,761	1,000,348 577,894	946,567 542,168	1,090,011 549,667
Outlier Median	1,344,206 582,572	987,510 538,116	745,612 212,434	226,058 126,559	98,452 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	5,389,264 3,662,910	6,530,802 3,730,911	1,786,990 4,081,319	7,949,402 4,643,908	12,748,587 4,389,147
Charity care Median	12,675,428 2,654,636	11,677,666 2,940,659	11,916,960 3,380,215	12,491,154 3,488,738	8,668,628 3,233,405
Uncompensated care (UCC) Median	14,555,132 5,147,790	17,029,292 5,337,617	16,076,650 5,711,082	17,236,568 5,923,418	12,269,306 5,508,107
UCC as a % of operating expenses Median	8.92% 3.24	12.47% 3.12	9.45% 3.21	10.03% 3.3	6.48% 2.86
Total shortfall/UCC Median	19,944,396 9,489,989	23,560,094 9,424,297	17,863,640 10,120,158	25,185,970 11,171,337	25,017,893 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	52,962,172 52,142,039	53,355,184 54,485,252	57,088,926 57,395,589	57,320,196 58,830,919	56,438,086 61,722,907
Salaries as a % of operating expenses Median	38.73 36.68	39.06 36.56	41.14 36.37	40.96 35.93	32.51 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	1,191,971 1,251,927	916,578 1,186,494	0 1,204,885	1,402,183 1,279,653	1,491,971 1,469,317
Contract adjusted salaries, direct-care Median	3,979,492 1,449,244	2,170,357 1,475,986	0 1,563,078	2,785,358 1,721,954	6,800,085 2,991,828
Contract hours, direct-care Median	62,404.00 22,725	37,979.00 23,018.5	0.00 24,503.48	37,525.00 25,026.5	68,627.65 33,786
Contract wages, direct-care Median	63.77 64.67	57.15 64.53	0.00 65.06	74.23 68.97	99.09 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.