CCN 051328NEVADA CountyGovernment - Hospital District or AuthorityRural (USDA RUCC)19 bedsLatest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
Operating margin: +23.0% in FY2025, the 95th percentile of 1,322 critical access hospitals in the FY2025 pool. Days cash on hand: 71 days in FY2025, the 43rd percentile of 1,297 critical access hospitals in the FY2025 pool. Total operating revenue: $351.7M in FY2025, the 100th percentile of 1,331 critical access hospitals in the FY2025 pool. Total margin (including nonoperating): +11.9% in FY2025, the 72nd percentile of 1,322 critical access hospitals in the FY2025 pool. Figures as filed; not audited by Astrelis.
The read
A hospital in Truckee, CA. It ran an operating surplus of 23.0% in FY25 on $351.7M of operating revenue. It held 71 days of cash on hand (43rd percentile of 1,297 Critical Access Hospitals on liquidity, FY25 pool). Operating margin declined from 24.7% in FY21 to 23.0% in FY25, though it rose 4.9 points in the most recent year.
Operating margin · FY25
+23.0%
Astrelis calculation · as-filed inputs
▲ 4.9 pts vs FY24
vs Critical Access Hospitals95th pctl of 1,322 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
71d
all sources
Astrelis calculation · as-filed inputs
▼ 43 days vs FY24
vs Critical Access Hospitals43rd pctl of 1,297 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY25
$351.7M
Astrelis calculation · as-filed inputs
▲ $56.4M vs FY24
vs Critical Access Hospitals100th pctl of 1,331 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY25
+11.9%
Astrelis calculation · as-filed inputs
▲ 3.6 pts vs FY24
vs Critical Access Hospitals72nd pctl of 1,322 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at TAHOE FOREST HOSPITAL is about $3.5M per year (1% of FY25 total operating revenue).
Where TAHOE FOREST HOSPITAL sits among Critical Access Hospitals
Operating margin · FY25 pool · n = 1,322 of 1,404 filed
Each point is one Critical Access Hospital in the national FY25 distribution for Critical Access Hospitals, this hospital's comparison cohort, 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 Critical Access Hospital FY25 median is -0.6%. Descriptive context only, not a ranking.
One critical access hospitalTAHOE FORESTCritical Access 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 × days in the report's own period ÷ net patient revenue, same fiscal year
Astrelis calculation · HCRIS WS G / G-3
$ in thousands
Line item
FY23
FY24
FY25
Patient revenue
264,332
278,891
334,556
Other operating revenue
15,923
16,385
17,113
Total operating revenue
280,255
295,276
351,669
Total operating expenses
230,095
241,728
270,641
Operating income
50,160
53,549
81,028
Operating margin %
+17.9%
+18.1%
+23.0%
Grants & contributions
1,060
707
1,040
Investment income
1,628
7,481
4,649
Other non-operating, net
(33,667)
(34,579)
(41,057)
Net income
19,181
27,158
45,659
Net income %
+6.4%
+8.3%
+11.9%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY21–FY25 · FY20–21 may include COVID-era relief funding in nonoperating income
How it operates
quality & operational context · CMS public reporting
A 19-bed hospital running at 51% occupancy, where 85% 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
50.8%
Reported value2025
HCRIS WS S-3
Average daily census
9.66
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
19
Reported value2025
HCRIS WS S-3
Annual discharges
1,477
Reported value2025
HCRIS WS S-3
Average length of stay
2 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$76,756
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$183,237
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Swing-bed average daily census
0.41
Reported value2025
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
4.0%
Reported value2025
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
85.0%
Reported value2025
HCRIS WS G-2 L28
How the care measures up
C. difficile infection (SIR)
0.397
No Different than National Benchmark
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
14.9%
No Different Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Pricing
Pilot · FY25
Commercial rates vs Medicare
255%
Medicare baseline100%
Commercial negotiated rates255%
Commercial negotiated rates as a percent of Medicare rates, outpatient basket. Chart bound 300%; values beyond it are clipped at the bar edge and shown at their actual figure.
Hospital price files + Medicare rates
Directional indicator from public price files. Facility-specific rate positioning is the Commercial Pricing Study →
Trajectory
Cost-report basis · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
NEVADA County, CA
Median household income
$84.9K
vs $82.1K US · $59.7K rural median
Poverty rate
10.6%
vs 12.5% US · 14.3% rural median
Uninsured
5.2%
vs 8.6% US · 8.4% rural median
Age 65+
28.9%
vs 16.8% US · 20.6% rural median
Fair or poor health
19.0%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 8.1% of county personal income is Medicare/Medicaid medical benefits; 20.8% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Nevada County
Illustrative estimate · FY25 cost report
Direct annual spending
$270.6M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$622.5M
direct spending × 2.30 · AHA national hospital economic activity report — a national hospital ratio, not a CAH or county figure · Illustrative estimate
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 a critical access hospital, the NCRHW study population. 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 poolFY25Astrelis calculation
Operating margin vs its peer pool: FY25 pool · n = 1,322.
CAH Performance Benchmark: FY25 peer pool · n = 1,322 · conservative low band; acuity limits stated in the report.
Basis: 89 services in the basket · 14 classified commercial payers (69% of commercial volume classified) · pricing files · numerator: negotiated commercial allowed amounts (classified payers) · denominator: Medicare OPPS-equivalent for the same services · weighting: volume-weighted line-level outpatient service basket (CY2026 OPPS equivalent) (weight coverage 89%).
Report coverage: Limited Facility Benchmark. 14 of 17 facility measures available from public sources. The report covers the available measures against their peer benchmarks; measures the public record does not carry become findings. Coverage is disclosed here before you reserve, and thin data is never a decline reason. The refund guarantee stands: if we cannot deliver the published scope, you pay nothing.
The Board Briefing
Your facility and its world, board-ready. Measures the public record does not carry become findings, never a decline reason.
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Astrelis Atlas, "Tahoe Forest Hospital", https://astrelis.co/hospitals/051328, release 2321a4fc37a7 (2026-10-22). Figures as filed in the named public sources; not audited by Astrelis.
Machine-readable twin of this page: astrelis.co/hospitals/051328.md (Markdown, the same figures with their fiscal years, pools and definitions). Last modified: release 2321a4fc37a7, 2026-10-22. Figures are as filed in the named public sources. Astrelis is not a CPA firm and performs no audit, review or attestation of any facility.
