As of the July, 2022, release via CMS

MIDWEST SURGICAL HOSPITAL

CMS id: 280131
7915 FARNAM DRIVE, OMAHA NE 68114. County: DOUGLAS
System: --
CBSA: Omaha-Council Bluffs, NE-IA

The 19-bed, acute-care hospital had $24,874,300 in net service to patients*, with a total profit margin of 40.61308% in fiscal year 2021, the latest year available.
It spent 0.57% of its operating expenses on uncompensated care and reported $30,801 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	forprofit	forprofit	forprofit	forprofit	forprofit
Acute beds Median	19 118	19 118	19 119.5	19 118	19 119
Total beds Median	19 162	19 162	19 162	19 162	19 163.5
FTEs Median	81.10 788.06	84.34 793.42	87.73 806.03	96.50 787.61	96.85 804.34

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	51,963,508 150,932,746	52,662,708 158,950,878	53,734,076 168,696,998	54,682,233 163,454,693	66,935,191 186,589,412
Operating expenses Median	29,686,267 149,311,209	30,714,734 156,110,414	32,237,905 164,890,568	34,001,960 166,516,854	42,060,891 180,120,888
Net income from service 2 patients (NS2P) ? Median	22,277,241 -964,173	21,947,974 -643,601.5	21,496,171 -116,254	20,680,273 -5,025,862	24,874,300 -1,284,564
NS2P margin ? Median	42.87% -0.62	41.68% -0.29	40.00% 0.18	37.82% -5.07	37.16% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for MIDWEST SURGICAL 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	528,736 5,089,215	436,412 4,572,541	332,182 5,268,134	1,298,051 13,092,619	5,085,596 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	109,117 299,524	143,102 188,688.5	188,630 370,813	72,134 309,361.5	139,493 375,329
⊳ 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	533	1,562	50	223	50
⊳ 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	419,086	291,748	143,502	1,225,694	4,946,053
Total income ? Median	22,805,977 6,586,430	22,384,386 6,767,106	21,828,353 8,419,950	21,978,324 8,094,175	29,959,896 15,162,888
Non-operating expenses Median	508,877 146,289.5	817,994 164,857	0 89,880.5	418,186 106,761	710,039 31,473.5
Net income Median	22,297,100 6,043,842	21,566,392 5,845,112	21,828,353 7,606,259	21,560,138 7,283,041	29,249,857 14,957,241
Net margin Median	42.47694% 4.62%	40.61535% 4.42%	40.37334% 5.16%	38.51381% 5.2%	40.61308% 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 MIDWEST SURGICAL 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	6,096,109 23,241,334	6,444,611 23,709,545	6,772,372 24,248,380	6,391,635 22,858,541	5,093,397 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	6,096,109 21,577,146	6,444,611 22,041,594	6,772,372 22,722,063	6,391,635 21,570,441	5,093,397 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	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	4,005,684 11,160,864	4,621,032 11,987,345	4,340,502 12,926,866	4,808,984 11,884,480	8,269,785 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	4,005,684 10,918,923	4,621,032 11,706,976	4,340,502 12,615,917	4,808,984 11,458,116	8,269,785 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	0 3,284,314	0 3,250,551	0 3,386,837	0 3,360,806	0 3,508,953
Disproportionate-share hospital (DSH) Median	0 594,888	0 595,761	0 577,894	0 542,168	0 549,667
Outlier Median	44,936 582,572	3,490 538,116	6,765 212,434	34,479 126,559	25,479 139,139

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	30,801 4,389,147
Charity care Median	65,657 2,654,636	55,304 2,940,659	71,412 3,380,215	54,567 3,488,738	95,943 3,233,405
Uncompensated care (UCC) Median	177,837 5,147,790	231,237 5,337,617	205,727 5,711,082	143,493 5,923,418	238,287 5,508,107
UCC as a % of operating expenses Median	0.60% 3.24	0.75% 3.12	0.64% 3.21	0.42% 3.3	0.57% 2.86
Total shortfall/UCC Median	177,837 9,489,989	231,237 9,424,297	205,727 10,120,158	143,493 11,171,337	269,088 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	6,261,357 52,142,039	6,586,026 54,485,252	6,683,258 57,395,589	7,362,668 58,830,919	8,781,403 61,722,907
Salaries as a % of operating expenses Median	21.09 36.68	21.44 36.56	21.15 36.37	21.65 35.93	20.88 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	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	588,815 1,449,244	624,343 1,475,986	651,802 1,563,078	705,217 1,721,954	752,267 2,991,828
Contract hours, direct-care Median	23,979.00 22,725	23,705.00 23,018.5	23,931.94 24,503.48	23,802.00 25,026.5	24,142.08 33,786
Contract wages, direct-care Median	24.56 64.67	26.34 64.53	27.24 65.06	29.63 68.97	31.16 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.