A hospital in Kula, HI. It ran an operating loss of 33.3% in FY24 on $31.1M of operating revenue. It held 18 days of cash on hand (24th percentile of 1,325 Critical Access Hospitals on liquidity, FY24 pool). Operating margin declined from -11.9% in FY20 to -33.3% in FY24.
Operating margin · FY24
-33.3%
Astrelis calculation · as-filed inputs
▼ 2.3 pts vs FY23
vs Critical Access Hospitals5th pctl of 1,340 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY24
18d
all sources
Astrelis calculation · as-filed inputs
▼ 14 days vs FY23
vs Critical Access Hospitals24th pctl of 1,325 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY24
$31.1M
Astrelis calculation · as-filed inputs
▲ $1.0M vs FY23
vs Critical Access Hospitals52nd pctl of 1,356 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY24
-32.7%
Astrelis calculation · as-filed inputs
▼ 6.9 pts vs FY23
vs Critical Access Hospitals1st pctl of 1,341 (FY24 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at KULA HOSPITAL is about $311K per year (1% of FY24 total operating revenue).
Where KULA HOSPITAL sits among Critical Access Hospitals
Operating margin · FY24 pool · n = 1,340 of 1,399 filed
Each point is one Critical Access 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 Critical Access Hospital FY24 median is -1.8%. Descriptive context only, not a ranking.
One critical access hospitalKULA HOSPITALCritical 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.
1873d (FY24) — outside expected range; shown at the chart boundary and included in peer statistics
Net patient receivables ÷ (net patient revenue ÷ 365), same fiscal year
Astrelis calculation · HCRIS WS G / G-3
Medicare inpatient contribution margin
+41.3% (FY24)
79th percentile of 43 CAHs (FY24 pool). Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
Medicare outpatient contribution margin
+30.3% (FY24)
5th percentile of 43 CAHs (FY24 pool). Full comparison in the CAH Performance Benchmark.
HCRIS cost report · CAH economics engine
$ in thousands
Line item
FY22
FY23
FY24
Patient revenue
23,317
30,033
30,083
Other operating revenue
13
1
984
Total operating revenue
23,330
30,033
31,067
Total operating expenses
39,919
39,350
41,406
Operating income
(16,589)
(9,316)
(10,339)
Operating margin %
-71.1%
-31.0%
-33.3%
Grants & contributions
213
770
29
Investment income
164
392
0
Other non-operating, net
346
93
112
Net income
(15,866)
(8,061)
(10,198)
Net income %
-66.0%
-25.8%
-32.7%
— = 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 9-bed hospital running at 0% occupancy, where swing beds are 99% of the inpatient business, and 20% 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
0.4%
Reported value2024
HCRIS WS S-3
Average daily census
0.04
Reported value2024
HCRIS WS S-3
Staffed beds (acute)
9
Reported value2024
HCRIS WS S-3
Annual discharges
6
Reported value2024
HCRIS WS S-3
Average length of stay
2 days
Reported value2024
HCRIS WS S-3
Cost per patient day
$3,185,038
Astrelis calculation2024
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$6,900,917
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
3.93
Reported value2024
HCRIS WS S-3 L5–6
Swing-bed share of inpatient days
99.1%
Reported value2024
HCRIS WS S-3 (acute + swing days)
Outpatient share of patient revenue
19.9%
Reported value2024
HCRIS WS G-2 L28
Who it serves
Total unreimbursed & uncompensated care
$2.6M
Reported value2023
HCRIS WS S-10 line 31
How the care measures up
C. difficile infection (SIR)
Not reported in source (note 1)
CMS-reported measure07/01/2024 to 06/30/2025
CMS Care Compare
Hospital-wide unplanned readmission
Not reported in source (note 1)
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Note 1: Results are not available for this reporting period.
Trajectory
Cost-report basis · 5 reporting years
Operating margin
Days cash on hand
The county this hospital serves
MAUI County, HI · metro, under 250K
Median household income
$95.1K
vs $82.1K US · $59.7K rural median
Poverty rate
9.8%
vs 12.5% US · 14.3% rural median
Uninsured
4.5%
vs 8.6% US · 8.4% rural median
Age 65+
20.0%
vs 16.8% US · 20.6% rural median
Fair or poor health
17.9%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Illustrative advocacy scenario: what this hospital means to Maui County
Illustrative estimate · FY24 cost report
Direct annual spending
$41.4M
total operating expense · Reported value, not a local-capture estimate
Economic activity
$95.2M
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 →
Medicare inpatient contribution marginFY24Astrelis calculation from reported HCRIS inputs
+41.3% — 79th percentile of 43 matched CAH peers (FY24).
The Board Briefing
Operating margin declined 2.3 points vs FY23 — the briefing traces why, line by line.
CAH Performance Benchmark: FY24 peer pool · n = 1,340 · conservative low band; acuity limits stated in the report.
Report coverage: Limited Facility Benchmark. 15 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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