A hospital in Sonora, CA. It ran an operating loss of 0.9% in FY24 on $346.1M of operating revenue. It held 241 days of cash on hand (87th percentile of 386 Rural PPS hospitals on liquidity, FY24 pool). Operating margin improved from -4.4% in FY20 to -0.9% in FY24, though it fell 8.7 points in the most recent year. Including nonoperating items, the all-in result was positive at 8.3%.
Operating margin · FY24
-0.9%
Astrelis calculation · as-filed inputs
▼ 8.7 pts vs FY23
vs Rural PPS hospitals50th pctl of 387 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY24
241d
all sources
Astrelis calculation · as-filed inputs
▼ 3 days vs FY23
vs Rural PPS hospitals87th pctl of 386 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY24
$346.1M
Astrelis calculation · as-filed inputs
▲ $7.6M vs FY23
vs Rural PPS hospitals93rd pctl of 393 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY24
+8.3%
Astrelis calculation · as-filed inputs
▼ 7.0 pts vs FY23
vs Rural PPS hospitals66th pctl of 387 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at ADVENTIST HEALTH SONORA is about $3.5M per year (1% of FY24 total operating revenue).
Where ADVENTIST HEALTH SONORA sits among Rural PPS hospitals
Operating margin · FY24 pool · n = 387 of 410 filed
Each point is one Rural PPS hospital in the national FY24 distribution for this provider type, placed by operating margin. Facilities are not matched on size, case mix, or market; that is the matched-peer comparison in the paid benchmark. The Rural PPS hospital FY24 median is -0.9%. Descriptive context only, not a ranking.
One rural pps hospitalADVENTIST HEALTHRural PPS hospital median
The money
$ thousands · HCRIS cost-report basis · as filed, QA-gated
Ratios tell you how this hospital is doing. Statements tell you what kind of organization it is, and where the money comes from. Every figure below traces to a public cost-report filing, shown as filed. A ratio computes only when every input is reported in the filing (otherwise its cell states which input is Not reported in source); a year whose balance sheet does not reconcile is labeled, and its derived ratios read Astrelis calculation unavailable. Not audited by Astrelis.
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
274,296
325,215
327,880
Other operating revenue
328
13,302
18,242
Total operating revenue
274,624
338,516
346,122
Total operating expenses
294,730
312,314
349,373
Operating income
(20,106)
26,203
(3,251)
Operating margin %
-7.3%
+7.7%
-0.9%
Grants & contributions
1,135
550
802
Investment income
(3,425)
17,314
16,341
Other non-operating, net
16,029
12,355
17,715
Net income
(6,367)
56,422
31,607
Net income %
-2.2%
+15.3%
+8.3%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY20–FY24 · FY20–21 may include COVID-era relief funding in nonoperating income
How it operates
quality & operational context · CMS public reporting
A 78-bed hospital running at 46% occupancy, where 70% of patient revenue is outpatient.
The metrics this hospital type is judged on: care quality, patient experience, and scale. Each is labeled by provenance class and public source; descriptive context only, never a ranking or adequacy claim. Provenance labels: Reported value is copied from the named public source; Astrelis calculation is a formula applied to unchanged reported inputs, with the formula shown; Illustrative estimate is a benchmark gap, multiplier, or scenario — never a measurement.
Scale and flow
Occupancy
45.9%
Reported value2024
HCRIS WS S-3
Average daily census
35.93
Reported value2024
HCRIS WS S-3
Staffed beds (acute)
78
Reported value2024
HCRIS WS S-3
Annual discharges
5,450
Reported value2024
HCRIS WS S-3
Average length of stay
2 days
Reported value2024
HCRIS WS S-3
Cost per patient day
$26,637
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$64,105
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Swing-bed average daily census
0.16
Reported value2024
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
0.4%
Reported value2024
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
70.2%
Reported value2024
HCRIS WS G-2 L28
Total FTEs
1,079
Reported value2024
HCRIS WS S-3 Pt II
Contract labor share of labor cost
26.0%
Reported value2024
HCRIS WS S-3 Pt V
Who it serves
Total unreimbursed & uncompensated care
$4.1M
Reported value2023
HCRIS WS S-10 line 31
How the care measures up
C. difficile infection (SIR)
0.187
Better than the National Benchmark
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
15%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Medicare spending per beneficiary
0.91
CMS-reported measure01/01/2024 to 12/31/2024
CMS Care Compare
Patient-safety composite (PSI-90)
0.872198
CMS-reported measure07/01/2022 to 06/30/2024
CMS Care Compare
Trajectory
Cost-report basis · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
TUOLUMNE County, CA · nonmetro, urban 20K+, metro-adjacent
Median household income
$72.3K
vs $82.1K US · $59.7K rural median
Poverty rate
10.7%
vs 12.5% US · 14.3% rural median
Uninsured
5.8%
vs 8.6% US · 8.4% rural median
Age 65+
27.7%
vs 16.8% US · 20.6% rural median
Fair or poor health
20.8%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 14.1% of county personal income is Medicare/Medicaid medical benefits; 31.6% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Tuolumne County
Illustrative estimate · FY24 cost report
Direct annual spending
$349.4M
total operating expense · Reported value, not a local-capture estimate
Labor income
$133.7M
$112.4M direct compensation × 1.19 · NCRHW 2016 CAH study · Illustrative estimate
Economic activity
$803.6M
direct spending × 2.30 · AHA national hospital economic activity report — a national hospital ratio, not a CAH or county figure · Illustrative estimate
Share of county employment
5.9%
of all county jobs · Reported value
Employment and labor income multipliers are from the National Center for Rural Health Works 2016 study of Critical Access Hospital economic impact (IMPLAN Type II, U.S. rural county populations); the economic-activity ratio is from the AHA national hospital economic activity report and describes U.S. hospitals as a whole; it is not a CAH-specific or county-specific figure. Applying any of these to an individual facility is an illustrative advocacy scenario, not a measurement: local capture depends on payroll residency, purchasing patterns, and county economic structure the sources do not observe. This facility is not a critical access hospital, so the NCRHW-derived lines borrow from a different hospital type; the label says so here rather than in the number. Direct figures are reported values from the facility's HCRIS cost report. Want a defensible facility-specific figure? Request a Facility Economic Impact Study →
Operating margin vs its peer poolFY24Astrelis calculation
Operating margin vs its peer pool: FY24 pool · n = 387.
Performance Benchmark Report: FY24 peer pool · n = 387 · conservative low band; acuity limits stated in the report.
Report coverage: Standard Facility Benchmark. 17 of 17 facility measures available from public sources. Every declared facility measure is available for this record, benchmarked against its same-year peer pools. The refund guarantee stands: if we cannot deliver the published scope, you pay nothing.
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