Nevada Hospital Reporting
(Pursuant to NRS 449.490, Sections 2 through 4)
Hospital Name: [Insert ]
Subsidized Health Services
Benefit $
Total Uncompensated Cost from Uncompensated Cost Report filed with DHCFP $35,334,539.00
Less: Medicaid Disproportionate Share Payments received for the Period $0.00
Less: Other Payments Received for these Accounts (County Supplemental Funds, etc.) $2,139,607.00
    Net Uncompensated Care $33,194,932.00
Uncompensated SCHIP (Nevada Checkup) Cost $0.00
Uncompensated Medicare Cost (see instructions) $9,679,155.00
Uncompensated Clinic or Other Cost $0.00
Other Subsidized Health Services $0.00
Less: Cost Reported in Another Category     $307,366.25
  Total Subsidized Health Services $42,566,720.75