As of the July, 2022, release via CMS

REX HOSPITAL

CMS id: 340114
4420 LAKE BOONE TRAIL, RALEIGH NC 27607. County: WAKE
System: UNC HEALTHCARE SYSTEM
CBSA: Raleigh-Cary, NC

The 559-bed, acute-care hospital had $-26,626,000 in net service to patients*, with a total profit margin of 9.05903% in fiscal year 2021, the latest year available.
It spent 1.96% of its operating expenses on uncompensated care and reported $31,128 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	gov
Acute beds Median	371 118	377 118	346 119.5	346 118	346 119
Total beds Median	553 162	559 162	559 162	559 162	559 163.5
FTEs Median	3,574.96 788.06	3,704.81 793.42	3,773.38 806.03	3,630.87 787.61	3,581.24 804.34

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	986,623,987 150,932,746	1,060,817,400 158,950,878	1,105,696,841 168,696,998	1,116,673,136 163,454,693	1,216,062,000 186,589,412
Operating expenses Median	947,124,000 149,311,209	1,040,447,002 156,110,414	1,107,743,005 164,890,568	1,148,045,999 166,516,854	1,242,688,000 180,120,888
Net income from service 2 patients (NS2P) ? Median	39,499,987 -964,173	20,370,398 -643,601.5	-2,046,164 -116,254	-31,372,863 -5,025,862	-26,626,000 -1,284,564
NS2P margin ? Median	4.00% -0.62	1.92% -0.29	-0.19% 0.18	-2.81% -5.07	-2.19% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for REX 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	72,522,000 5,089,215	91,325,000 4,572,541	255,986,000 5,268,134	101,820,000 13,092,619	205,061,000 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	72,522,000	91,325,000	255,986,000	101,820,000	205,061,000
Total income ? Median	112,021,987 6,586,430	111,695,398 6,767,106	253,939,836 8,419,950	70,447,137 8,094,175	178,435,000 15,162,888
Non-operating expenses Median	29,805,000 146,289.5	44,117,000 164,857	11,174,000 89,880.5	73,337,000 106,761	49,695,000 31,473.5
Net income Median	82,216,987 6,043,842	67,578,398 5,845,112	242,765,836 7,606,259	-2,889,863 7,283,041	128,740,000 14,957,241
Net margin Median	7.76257% 4.62%	5.86546% 4.42%	17.82837% 5.16%	-0.23717% 5.2%	9.05903% 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 REX 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	121,753,716 23,241,334	121,337,544 23,709,545	129,303,960 24,248,380	124,392,402 22,858,541	125,271,190 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	117,645,431 21,577,146	116,803,588 22,041,594	124,930,771 22,722,063	119,130,977 21,570,441	122,390,406 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	4,108,285 1,203,033	4,533,956 1,215,295	4,373,189 1,313,657	5,261,425 1,365,298	2,880,784 1,179,746
All outpatient revenue Median Click here to show/hide details	80,867,434 11,160,864	89,501,660 11,987,345	96,938,126 12,926,866	96,720,047 11,884,480	100,776,040 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	76,849,041 10,918,923	85,529,629 11,706,976	93,230,226 12,615,917	93,225,947 11,458,116	99,989,118 12,776,716
⊳ Home Health agencies (HHA) ⊳ Median	4,018,393 1,282,808	3,972,031 1,407,728	3,707,900 1,341,512	3,494,100 1,407,046	786,922 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	911,497 577,894	954,089 542,168	981,655 549,667
Outlier Median	3,290,787 582,572	2,713,616 538,116	2,586,093 212,434	356,820 126,559	666,678 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	73,570 3,662,910	84,337 3,730,911	67,193 4,081,319	77,037 4,643,908	31,128 4,389,147
Charity care Median	6,265,558 2,654,636	10,282,840 2,940,659	15,067,764 3,380,215	13,762,049 3,488,738	14,967,771 3,233,405
Uncompensated care (UCC) Median	13,304,112 5,147,790	22,256,551 5,337,617	26,671,235 5,711,082	25,683,142 5,923,418	24,406,738 5,508,107
UCC as a % of operating expenses Median	1.40% 3.24	2.14% 3.12	2.41% 3.21	2.24% 3.3	1.96% 2.86
Total shortfall/UCC Median	13,377,682 9,489,989	22,340,888 9,424,297	26,738,428 10,120,158	25,760,179 11,171,337	24,437,866 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	387,992,219 52,142,039	411,922,867 54,485,252	441,972,024 57,395,589	450,311,151 58,830,919	473,452,520 61,722,907
Salaries as a % of operating expenses Median	45.41 36.68	43.93 36.56	43.86 36.37	43.14 35.93	42.52 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	680,742 1,449,244	1,603,539 1,475,986	1,139,870 1,563,078	1,623,700 1,721,954	4,739,861 2,991,828
Contract hours, direct-care Median	7,674.00 22,725	49,512.53 23,018.5	27,223.00 24,503.48	26,429.00 25,026.5	49,208.00 33,786
Contract wages, direct-care Median	88.71 64.67	32.39 64.53	41.87 65.06	61.44 68.97	96.32 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.