CCN 130049KOOTENAI CountyGovernment - Hospital District or AuthorityUrban (USDA RUCC)256 bedsLatest FY 2025
Cost-report basis
HCRIS · as filed
Not audited by Astrelis
Operating margin: -18.8% in FY2025, the 11th percentile of 2,523 urban pps hospitals in the FY2025 pool. Days cash on hand: 152 days in FY2025, the 80th percentile of 2,413 urban pps hospitals in the FY2025 pool. Total operating revenue: $927.2M in FY2025, the 86th percentile of 2,553 urban pps hospitals in the FY2025 pool. Total margin (including nonoperating): +8.4% in FY2025, the 57th percentile of 2,523 urban pps hospitals in the FY2025 pool. Figures as filed; not audited by Astrelis.
The read
A hospital in Coeur D'alene, ID. It ran an operating loss of 18.8% in FY25 on $927.2M of operating revenue. It held 152 days of cash on hand (80th percentile of 2,413 Urban PPS hospitals on liquidity, FY25 pool). Operating margin declined from -8.7% in FY20 to -18.8% in FY25. Including nonoperating items, the all-in result was positive at 8.4%.
Operating margin · FY25
-18.8%
Astrelis calculation · as-filed inputs
▼ 1.4 pts vs FY24
vs Urban PPS hospitals11th pctl of 2,523 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Days cash on hand · FY25
152d
all sources
Astrelis calculation · as-filed inputs
▲ 10 days vs FY24
vs Urban PPS hospitals80th pctl of 2,413 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total operating revenue · FY25
$927.2M
Astrelis calculation · as-filed inputs
▲ $106.2M vs FY24
vs Urban PPS hospitals86th pctl of 2,553 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
Total margin · incl. nonoperating · FY25
+8.4%
Astrelis calculation · as-filed inputs
▲ 2.8 pts vs FY24
vs Urban PPS hospitals57th pctl of 2,523 (FY25 pool)
pool: this metric's own fiscal year · excludes historical, non-panel, and out-of-range values
One point of operating margin at KOOTENAI HEALTH is about $9.3M per year (1% of FY25 total operating revenue).
Where KOOTENAI HEALTH sits among Urban PPS hospitals
Operating margin · FY25 pool · n = 2,523 of 2,652 filed
Each point is one Urban PPS hospital in the national FY25 distribution for Urban PPS 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 Urban PPS hospital FY25 median is +2.4%. Descriptive context only, not a ranking.
One urban pps hospitalKOOTENAI HEALTHUrban 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 × 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
714,354
812,587
922,907
Other operating revenue
21,779
8,422
4,328
Total operating revenue
736,133
821,009
927,235
Total operating expenses
856,306
963,471
1,101,364
Operating income
(120,173)
(142,463)
(174,129)
Operating margin %
-16.3%
-17.4%
-18.8%
Grants & contributions
2,500
1,230
1,313
Investment income
12,255
9,825
21,682
Other non-operating, net
161,946
188,850
252,123
Net income
56,528
57,442
100,989
Net income %
+6.2%
+5.6%
+8.4%
— = Not reported in source for that year.
HCRIS Worksheet G-3 / S-3 · $ thousands · FY20–FY25 · FY20–21 may include COVID-era relief funding in nonoperating income
How it operates
quality & operational context · CMS public reporting
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
65.3%
Reported value2025
HCRIS WS S-3
Average daily census
167.28
Reported value2025
HCRIS WS S-3
Staffed beds (acute)
256
Reported value2025
HCRIS WS S-3
Annual discharges
19,644
Reported value2025
HCRIS WS S-3
Average length of stay
3 days
Reported value2025
HCRIS WS S-3
Cost per patient day
$18,039
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ total patient days (HCRIS WS G-3 / S-3)
Cost per discharge (unadjusted)
$56,066
Astrelis calculation2025
Astrelis calculation — total operating expense ÷ discharges, NOT case-mix adjusted (adjusted discharges are not on the public filing set)
Total FTEs
3,777
Reported value2025
HCRIS WS S-3 Pt II
Contract labor share of labor cost
20.3%
Reported value2025
HCRIS WS S-3 Pt V
Who it serves
Total unreimbursed & uncompensated care
$29.6M
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
14%
Better Than the National Rate
CMS-reported measure07/01/2023 to 06/30/2024
CMS Care Compare
Medicare spending per beneficiary
1
CMS-reported measure01/01/2024 to 12/31/2024
CMS Care Compare
Patient-safety composite (PSI-90)
1.21791
CMS-reported measure07/01/2022 to 06/30/2024
CMS Care Compare
Note 1: The results are based on the hospital or facility's data submissions. CMS approved the hospital or facility's Extraordinary Circumstances Exception request suggesting that results may be impacted.
Trajectory
Cost-report basis · 6 reporting years
Operating margin
Days cash on hand
The county this hospital serves
KOOTENAI County, ID
Median household income
$77.0K
vs $82.1K US · $59.7K rural median
Poverty rate
9.3%
vs 12.5% US · 14.3% rural median
Uninsured
9.6%
vs 8.6% US · 8.4% rural median
Age 65+
19.7%
vs 16.8% US · 20.6% rural median
Fair or poor health
16.1%
self-reported, adults · CDC PLACES
Primary-care shortage
Designated
HRSA HPSA
Economic context: 7.4% of county personal income is Medicare/Medicaid medical benefits; 19.8% arrives as government transfers (BEA, 2022).
Illustrative advocacy scenario: what this hospital means to Kootenai County
Illustrative estimate · FY24 cost report
Direct annual spending
$963.5M
total operating expense · Reported value, not a local-capture estimate
Labor income
$494.4M
$415.4M direct compensation × 1.19 · NCRHW 2016 CAH study · Illustrative estimate
Economic activity
$2.22B
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
4.9%
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 poolFY25Astrelis calculation
Operating margin vs its peer pool: FY25 pool · n = 2,523.
Performance Benchmark Report: FY25 peer pool · n = 2,523 · conservative low band; acuity limits stated in the report.
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.
$1,000delivered within 2 business days of invoice
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Astrelis Atlas, "Kootenai Health", https://astrelis.co/hospitals/130049, 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/130049.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.
