As of the July, 2022, release via CMS

DUKE UNIVERSITY HOSPITAL

CMS id: 340030
610 DOUGLAS STREET, DURHAM NC 27710. County: DURHAM
System: DUKE UNIVERSITY HEALTH SYSTEM
CBSA: Durham-Chapel Hill, NC

The 978-bed, acute-care hospital had $2,989,064 in net service to patients*, with a total profit margin of 4.40153% in fiscal year 2021, the latest year available.
It spent 5.23% of its operating expenses on uncompensated care and reported $0 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	629 118	629 118	629 119.5	629 118	636 119
Total beds Median	954 162	972 162	977 162	971 162	978 163.5
FTEs Median	8,275.35 788.06	8,535.95 793.42	8,835.11 806.03	9,205.51 787.61	9,792.45 804.34

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	2,201,077,373 150,932,746	2,339,265,283 158,950,878	2,472,235,232 168,696,998	2,521,490,635 163,454,693	2,675,540,231 186,589,412
Operating expenses Median	2,044,085,465 149,311,209	2,165,856,887 156,110,414	2,309,066,466 164,890,568	2,485,163,913 166,516,854	2,672,551,167 180,120,888
Net income from service 2 patients (NS2P) ? Median	156,991,908 -964,173	173,408,396 -643,601.5	163,168,766 -116,254	36,326,722 -5,025,862	2,989,064 -1,284,564
NS2P margin ? Median	7.13% -0.62	7.41% -0.29	6.60% 0.18	1.44% -5.07	0.11% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for DUKE UNIVERSITY 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	64,978,652 5,089,215	66,232,587 4,572,541	64,620,942 5,268,134	110,760,339 13,092,619	120,060,236 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	64,978,652	66,232,587	64,620,942	110,760,339	120,060,236
Total income ? Median	221,970,560 6,586,430	239,640,983 6,767,106	227,789,708 8,419,950	147,087,061 8,094,175	123,049,300 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	221,970,560 6,043,842	239,640,983 5,845,112	227,789,708 7,606,259	147,087,061 7,283,041	123,049,300 14,957,241
Net margin Median	9.79546% 4.62%	9.96222% 4.42%	8.97921% 5.16%	5.58788% 5.2%	4.40153% 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 DUKE UNIVERSITY 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	300,614,088 23,241,334	306,145,309 23,709,545	324,252,032 24,248,380	325,936,473 22,858,541	330,937,917 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	299,399,569 21,577,146	304,823,079 22,041,594	323,056,984 22,722,063	324,775,848 21,570,441	330,370,546 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	1,214,519 1,845,420	1,322,230 1,757,392	1,195,048 1,738,842	1,160,625 1,510,463	567,371 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	162,465,790 11,160,864	171,422,820 11,987,345	178,450,062 12,926,866	174,913,376 11,884,480	185,768,170 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	162,465,790 10,918,923	171,422,820 11,706,976	178,450,062 12,615,917	174,913,376 11,458,116	185,768,170 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	57,633,224 3,284,314	56,800,645 3,250,551	59,098,844 3,386,837	57,028,990 3,360,806	56,978,865 3,508,953
Disproportionate-share hospital (DSH) Median	7,305,602 594,888	7,195,763 595,761	7,247,885 577,894	6,704,113 542,168	6,505,312 549,667
Outlier Median	17,568,886 582,572	18,120,857 538,116	25,284,061 212,434	3,072,060 126,559	2,767,738 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,780,764 3,662,910	0 3,730,911	0 4,081,319	0 4,643,908	0 4,389,147
Charity care Median	66,462,954 2,654,636	64,007,058 2,940,659	76,773,229 3,380,215	81,224,978 3,488,738	124,398,566 3,233,405
Uncompensated care (UCC) Median	72,961,140 5,147,790	76,437,758 5,337,617	88,457,773 5,711,082	89,751,801 5,923,418	139,821,449 5,508,107
UCC as a % of operating expenses Median	3.57% 3.24	3.53% 3.12	3.83% 3.21	3.61% 3.3	5.23% 2.86
Total shortfall/UCC Median	75,741,904 9,489,989	76,437,758 9,424,297	88,457,773 10,120,158	89,751,801 11,171,337	139,821,449 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	577,550,250 52,142,039	609,880,420 54,485,252	643,753,038 57,395,589	683,433,514 58,830,919	752,013,606 61,722,907
Salaries as a % of operating expenses Median	27.11 36.68	27.01 36.56	26.80 36.37	26.51 35.93	27.30 35.24
Intern, resident salaries* Median	49,121,754 2,598,592	51,521,868 2,686,824	53,333,767 2,753,773	54,557,602 2,937,156	57,279,753 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	15,595,008 1,449,244	12,486,984 1,475,986	14,594,533 1,563,078	23,527,508 1,721,954	19,970,876 2,991,828
Contract hours, direct-care Median	259,891.24 22,725	195,246.06 23,018.5	216,250.79 24,503.48	350,372.50 25,026.5	275,449.20 33,786
Contract wages, direct-care Median	60.01 64.67	63.96 64.53	67.49 65.06	67.15 68.97	72.50 88.94

* in an approved program

Return to top

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.