As of the July, 2022, release via CMS

WYOMING MEDICAL CENTER

CMS id: 530012
1233 E. SECOND STREET, CASPER WY 82601. County: NATRONA
System: BANNER HEALTH
CBSA: Casper, WY

The 226-bed, acute-care hospital had $8,693,072 in net service to patients*, with a total profit margin of 7.07673% in fiscal year 2021, the latest year available.
It spent 8.22% of its operating expenses on uncompensated care and reported $5,633,381 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	180 118	177 118	198 119.5	212 118	212 119
Total beds Median	194 162	191 162	212 162	226 162	226 163.5
FTEs Median	960.91 788.06	1,002.16 793.42	1,198.40 806.03	1,140.22 787.61	1,136.00 804.34

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	194,493,994 150,932,746	220,717,830 158,950,878	253,615,901 168,696,998	268,703,128 163,454,693	267,152,148 186,589,412
Operating expenses Median	182,122,650 149,311,209	217,692,451 156,110,414	257,485,641 164,890,568	252,003,732 166,516,854	258,459,076 180,120,888
Net income from service 2 patients (NS2P) ? Median	12,371,344 -964,173	3,025,379 -643,601.5	-3,869,740 -116,254	16,699,396 -5,025,862	8,693,072 -1,284,564
NS2P margin ? Median	6.36% -0.62	1.37% -0.29	-1.53% 0.18	6.21% -5.07	3.25% -0.88

Range* of Net Service to Patient (NS2P) margins

= NS2P margin for WYOMING MEDICAL CENTER 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	19,649,125 5,089,215	15,891,816 4,572,541	14,594,791 5,268,134	28,085,112 13,092,619	4,960,585 12,369,236
⊳ Line 6: Contributions ? ⊳ Median	0 224,999	0 199,009	0 206,870.5	442,906 194,343	2,627 249,496
⊳ Line 7: Investments ? ⊳ Median	3,127,530 299,524	4,880,383 188,688.5	7,046,528 370,813	4,721,041 309,361.5	167,636 375,329
⊳ 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	625,604	463,536
⊳ 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	422,808	242,898
⊳ 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	289	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	507,835	440,523
⊳ Line 23: Gov appropriations ? ⊳ Median	0 1,017,693	0 983,261.5	0 1,173,286	0 1,987,202	206 1,597,664
⊳ Sum Line 24	16,521,595	11,011,433	7,548,263	21,364,629	3,643,159
Total income ? Median	32,020,469 6,586,430	18,917,195 6,767,106	10,725,051 8,419,950	44,784,508 8,094,175	13,653,657 15,162,888
Non-operating expenses Median	9,651,826 146,289.5	0 164,857	0 89,880.5	35,663,989 106,761	-5,603,013 31,473.5
Net income Median	22,368,643 6,043,842	18,917,195 5,845,112	10,725,051 7,606,259	9,120,519 7,283,041	19,256,670 14,957,241
Net margin Median	10.44565% 4.62%	7.99511% 4.42%	3.99874% 5.16%	3.07307% 5.2%	7.07673% 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 WYOMING MEDICAL CENTER 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	46,043,302 23,241,334	50,686,426 23,709,545	61,666,754 24,248,380	51,928,739 22,858,541	64,163,904 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	46,043,302 21,577,146	50,686,426 22,041,594	61,666,754 22,722,063	51,928,739 21,570,441	64,163,904 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	13,098,779 11,160,864	15,539,345 11,987,345	19,083,615 12,926,866	16,904,113 11,884,480	18,779,082 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	13,098,779 10,918,923	15,539,345 11,706,976	19,083,615 12,615,917	16,904,113 11,458,116	18,779,082 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	1,454,282 3,284,314	1,370,911 3,250,551	1,238,423 3,386,837	960,261 3,360,806	1,127,194 3,508,953
Disproportionate-share hospital (DSH) Median	301,211 594,888	277,537 595,761	0 577,894	271,763 542,168	0 549,667
Outlier Median	1,667,051 582,572	2,217,578 538,116	1,108,109 212,434	291,862 126,559	444,671 139,139

Uncompensated care

Item	2017	2018	2019	2020	2021
Medicaid shortfall Median	2,054,072 3,662,910	3,456,399 3,730,911	3,368,540 4,081,319	4,553,324 4,643,908	5,633,381 4,389,147
Charity care Median	15,438,101 2,654,636	8,707,189 2,940,659	7,150,041 3,380,215	5,470,448 3,488,738	15,670,431 3,233,405
Uncompensated care (UCC) Median	23,247,604 5,147,790	18,232,857 5,337,617	18,720,944 5,711,082	11,622,431 5,923,418	21,239,186 5,508,107
UCC as a % of operating expenses Median	12.76% 3.24	8.38% 3.12	7.27% 3.21	4.61% 3.3	8.22% 2.86
Total shortfall/UCC Median	25,301,676 9,489,989	21,689,256 9,424,297	22,089,484 10,120,158	16,175,755 11,171,337	26,872,567 10,133,851

Labor costs

	2017	2018	2019	2020	2021
Total salaries Median	74,145,436 52,142,039	79,567,992 54,485,252	92,383,134 57,395,589	92,636,570 58,830,919	89,315,106 61,722,907
Salaries as a % of operating expenses Median	35.83 36.68	36.55 36.56	35.88 36.37	36.76 35.93	34.56 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	1,779,299 1,449,244	2,118,684 1,475,986	1,559,781 1,563,078	2,306,469 1,721,954	14,731,549 2,991,828
Contract hours, direct-care Median	26,964.74 22,725	34,640.00 23,018.5	23,624.43 24,503.48	33,905.20 25,026.5	89,465.81 33,786
Contract wages, direct-care Median	65.99 64.67	61.16 64.53	66.02 65.06	68.03 68.97	164.66 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.